Modern medicine has lengthened our lives, but unfortunately, many older people physically deteriorate to a level that makes them vulnerable to minor health setbacks. Frailty is a syndrome marked by weakness, poor mobility, a slow gait, and excessive fatigue. Frail individuals are unable to adequately recover from physical activity or a challenge to their health. Minor illnesses send them to the hospital, nursing home, or assisted living center. Frail individuals are often unable to tolerate beneficial medical procedures and must live with pain and physical restrictions. Frailty is a problem that responds very well to treatment.
In the 65 year old plus population, frailty syndrome is common. Fifteen percent of the non-nursing home population is frail and forty five percent is pre-frail. Frail individuals are far more likely to fall. Forty percent of the frail and twenty two percent of the pre-frail individuals are hospitalized every year. Frailty is a marker for adverse health outcomes and a means of identifying opportunities for intervention in patient care.
Physical activity has been shown to be the best preventative and treatment for frailty. Patients bounce back from surgery much better if they under take a program of prehabilitation exercise prior to surgery. Research on rehabilitation has demonstrated the benefits of exercise to restore strength and mobility in the frail population. Take the time to read, One Last Question Before the Operation: Just How Frail Are You? by Paula Span in the October 27, 2017 issue of the New York Times. Read the article here: https://www.nytimes.com/2017/10/27/health/elderly-surgery-frailty.html
In the senior population, fitness activities must focus on training that maintains functional mobility and an independent lifestyle. You need to stand up and train to be a more graceful and competent walker. Practice drills that improve your capacity to transfer from the floor to standing. Always include balance and reaction exercises that keep you free from falls. Foremost are strengthening activities that maintain bone density and restore capacity to lift, carry, push, and pull.
Michael S. O’Hara, PT, OCS, CSCS
* New York Times, One Last Question Before the Operation: Just How Frail Are You? Paula Span, October 27, 2017
Advice From The Experts At Fenton Fitness/Fenton Physical Therapy
Tara Parker-Pope wrote a great article in the October 17, 2016 edition of The New York Times entitled “The 8 Health Habits Experts Say You Need in Your 20s.” While I agree with some of these recommendations, we at Fenton Fitness and Fenton Physical Therapy have some suggestions of our own.
#1—Don’t do dumb stuff
The cumulative injuries you suffer in your twenties echo through a lifetime. My long and busy career as a physical therapist has taught me that this is true. The 20 year old with a knee arthroscopy returns as a 32 year old with a ligament reconstruction and then again as a 50 year old knee replacement patient. Surgery and rehab can only do so much. Resist participation in the “hold my beer” events that inevitably present themselves in the social lives of 20 year olds. Think twice before you enter that Gladiator Challenge Race, swing from that rope suspended over a river, or text and drive. Your sixty-year old self will thank you.
-Mike O’Hara, Physical Therapist for the last 32 years. Fitness coach and board certified orthopedic specialist
To read the article, click on the link below:
Listen to Mike’s advice: https://youtu.be/8JCtFzj539M
Super Bowl Quarterback Peyton Manning
Peyton Manning, the Denver Broncos quarterback, will cap off a miraculous recovery from a serious neck injury with his appearance in the Super Bowl this weekend. Mr. Manning has undergone numerous surgeries and procedures on his cervical spine. The details of his medical treatment and rehabilitation are the topic of speculation on many sports talk shows. We do know that he underwent an anterior fusion of his sixth and seventh cervical vertebrae. An incision is made in the front of the neck and the two bones are fused together using screws and a titanium plate. The fusion removes compressive forces off the nerve root that exits between the vertebrae and eliminates any movement between these two spinal segments.
Compression on the seventh cervical nerve root creates all kinds of problems for someone who throws a football for a living. This nerve root carries the signals that fire the triceps muscle (back of the arm) and muscles that help grip the ball. Trauma to the seventh cervical nerve root can cause loss of sensation in the fourth and fifth fingers of the hand. Loss of neural control not only has an effect on muscle strength, but also on power production. You need to be able to create muscle contractions quickly to throw a pass with any velocity. If the signal that is sent down the seventh cervical nerve root is impeded by compression or inflammation, the pass will be slow.
There are risks associated with playing professional football with a fused cervical spine. When you fuse the sixth and seventh vertebrae together, you lose about 10% of the range of motion in your neck and you also lose some of the shock absorption capacity in your spine. The compressive forces and range of motion lost at the fused C6-7 segments are transferred to the vertebrae above and below the fusion. In the general population, thirty percent of the patients who undergo a cervical fusion require a second fusion in 10 years. I was unable to find a statistic on pro football players, but I am certain this percentage has to be much higher.
Cervical fusions are not uncommon in professional football, and 70% of the players who have a fusion are able to return to competition. Mr. Manning plays at the high skill position of quarterback and his passing numbers this year have been amazing. Win or lose this weekend, Peyton Manning, surgical medicine, and physical rehabilitation deserve applause.
Michael S. O’Hara, P.T., OCS, CSCS