Saturday, December 20, 2014

Thoracic back injury – Scheuermann’s disease / Kyphosis (by Anca Wessels, Biokineticist)

Scheuermann’s disease is classified as the wedging together of several bones of the spine (vertebrae) in a row which then causes a rounded upper back.

It can otherwise be described as a hunched back or severe kyphosis.




Normal curvature of the upper (thoracic) spine is 20 – 50 degrees. A curvature of more than 50 degrees, where the spine has three contiguous vertebral bodies that have wedging of 5 degrees or more, constitutes Scheuermann’s disease.

This disease is mainly found in teenage boys. It is commonly found throughout their growth spurt years.

The cause of Scheuermann’s disease is unknown, but it is thought to be due to osteochondrosis. This is where the vertebral growth plate stops growing on one side, but continues on the other.

The causes of kyphosis are:

· Degenerative diseases of the spine (such as arthritis or disk degeneration)
· Fractures caused by osteoporosis (osteoporotic compression fractures)
· Injury (trauma)
· Slipping of one vertebra forward on another (spondylolisthesis)
· Certain endocrine diseases
· Connective tissue disorders
· Infection (such as tuberculosis)
· Muscular dystrophy
· Neurofibromatosis
· Polio
· Spina bifida
· Tumors

Treatment:

· Scheuermann's disease is treated with a brace (in severe cases) and by doing specific exercises.
· Occasionally surgery is needed for large (greater than 60 degrees), painful curves.
· Kyphosis is best treated by doing regular specific exercises and stretching.

Adolescents with Scheuermann's disease that need surgery tend to do very well and full recovery is at a high percentage.

The best way to identify this problem is to have thoracic spine x-rays done.

Postural kyphosis can be distinguished from Scheuermann’s by the fact that the deformity goes away when the patient lies down. Typically, patients with true Scheuermann’s need to sleep on more pillows at night to stay comfortable because their deformity remains when they lie down.

Prevention:

·       Early diagnosis and bracing (if necessary) of Scheuermann's disease can reduce the need for surgery, but there is no way to prevent the disease.
·       Treating and preventing osteoporosis can prevent many cases of kyphosis in the elderly.
·       Living a healthy lifestyle and doing regular exercise can prevent kyphosis from occurring.

Scheuermann’s disease (condition of adolescent kyphosis) should not be confused with Juvenile disc disorder (condition of adolescent disc disorder).

Wednesday, December 17, 2014

10 tips for being Summer ready (Tony Paladin – Biokineticist)


As a health professional; I have to engage this topic with all that painful common sense that has been drilled into me over the years and grapple with the underlying tone of whether my advice is going to be like giving a loaded gun to a 3 year old.

In a nutshell, the following tips I am going to offer need to have sufficient sustainable appeal to elicit behavioural change and not end up in the back of the fad-closet like the ab-blaster, thigh-master, crazink and Tae-Bo.

1.     Input vs output: Food is like petrol. Sure we have different octanes that burn at different rates in different engines; but the bottom line is that if you ain’t revving your engine, you ain’t burning the fuel and if the fuel ain’t burning, its getting stored on your butt and gut.
2.     Zero to Hero will result in injury. If you are sedentary; don’t try train like an Olympic Athlete in 1 week. You will get hurt.
3.     Unbalanced training will result in tears. Too much cardio, not enough strength & flexibility equals risk of injury.
4.     Gaining muscle and losing fat are about as different as Helen Zille and Julius Malema. Resistance exercise gains muscle (add functional for strength) and cardio exercise burns fat (and muscle depending on intensity, protein intake and rest). Choose your weapons carefully: Treadmill vs Dumb Bell
5.     Long slow steady state is not the long road to slimming freedom. You need to get the heart rate up regularly through moderated interval training to burn the bingo wings (ignore this if you are a cardiac patient or are on a beta blocker…).
6.     Yoyo’s are for children, not diet & exercise. Being an unhinged, cigarette sucking, binge drinking desk sitter in Winter and an Ironman in Summer is bad for your health. Keep moderate activity and lifestyle management going in the “off months” so you don’t have to double up to catch in the “on months”.
7.     Join a group or get a trainer. You tend to stick to appointments with other people. Training by yourself takes LOTS of motivation.
8.     Measure your improvements. Skinfolds and circumferences are great indices of whether what you are doing is working!
9.     Zombie apocolpyse needs to remain a movie. 8 hours of sleep per night is necessary to tackle any goal. Being tired is going to increase binge tendencies, non compliance and injury risk.

10.  Most animals in nature aren’t fat because they are either chasing their food or running away from being eaten. Try find activities that you enjoy but at the same time result in physical fitness. In human society, such activities are called “sport”.