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Skeleton Crew 

Keeping Bones Strong Takes a Unified Effort

The components of good health that a generation ago were naturally incorporated into a less complicated lifestyle now are things we must learn about and concentrate on more diligently. As three home-cooked meals a day have been replaced by more convenient but less healthy fast foods and child's play has changed from active outdoor games to television and computer use, families must be mindful of how to counter the ill effects these lifestyle changes have on overall health.

With increases in illnesses such as heart disease, diabetes and cancers exacerbated by unhealthy lifestyles, physicians are placing renewed emphasis on getting back to basics and preventing debilitating maladies by building and maintaining strong bodies. One of the most basic -- and overlooked -- aspects is bone health, which when neglected can lead to osteoporosis, pain and immobility in later years.

"Your bones are your internal support for your body," says Dr. Ralph P. Katz, a surgeon and back/spine specialist at Westside Orthopaedic Clinic in Marrero. "[The skeletal system] is living; it's constantly being remodeled. The most important thing is that all this stuff you need to do -- drink milk, take vitamins, exercise -- it all needs to start in teenage and pre-teen years. That will determine your overall bone structure. After that ... you start losing part of your bone structure (as a natural process of aging). It's vitally important to gain as much bone mass as possible in the early ages, because you store it and use it the rest of your life."

Given the right tools, the body is naturally equipped to continually rejuvenate and replace bone that is broken down by the stresses of living. However, a diet that lacks enough calcium and vitamin D, too little rest or inadequate exercise can weaken the bones and leave people vulnerable to osteoporosis, aching joints and other maladies in later years and stress fractures, shin splints and injuries in the young.

"The key to it all is the development of healthy lifestyle patterns: proper nutrition, rest and exercise," says Dr. Treg Brown, an orthopedic sports medicine physician at Tulane University. "An amazing statistic I read recently was that by the time a child finishes high school, more than half will spend more time in front of the TV than in school. What we're seeing is the development of poor lifestyle patterns, where a child is on the computer for hours, gets up and eats some chips, then watches TV."

Just as concrete can't harden correctly without the right mix of sand, cement and water, bones can't properly form and replenish themselves in the absence of a balanced diet, exercise or sleep. Because children have replaced outside activities that offer varying degrees of muscle use and weight-bearing movements with more sedentary activities, proper exercise and daily selections from the four basic food groups must become a focus and priority for parents.

"The parents are the role models," Brown says. "It goes back to the whole concept of developing healthy lifestyles. If [children are] not into swimming, riding a bike, playing basketball or something, if all they want to do is watch TV or play on a computer, then make it an incentive -- a reward -- to get on a walking program or other athletic activity with their parent. Developing a health lifestyle helps them develop self-motivation, a goal-oriented mentality and self-respect."

Balance among nutrition, sleep and exercise also can counter physical and chemical stresses that cause bones, muscles and nerves to become out of whack and cause discomforts and bring on conditions such as sinuses and allergies. Bringing the body's systems back into alignment often allows the body to repair itself without medication or invasive therapies.

"The body has an innate ability to heal itself," says Dr. Nicholas DiGerolamo of Crescent City Chiropractic Medical Center in Metairie, which takes patients through a four-day education about how the body works. "We're taking the pressure off the nerves and allowing the body to heal itself. You can relate pressure on nerves (from stress and misalignments) to a kink in a garden hose that won't allow the water to get out. We take out the kink so things can flow the way they should."

Unaligned bones, which can result from the physical stresses of repetitive work at a computer, inactivity, chemical stresses from inadequate diets, etc, place pressure on nerves, which run through every part in the body and can drain a person's energy and affect overall health. Some of the major signs of such stress include frequent headaches, fatigue even upon waking and a lack of energy to make it through the day, sleeping problems, irritability and mood swings, pain, digestive complications, and sinus and allergy problems. The latter can result from pressure on nerves originating in the neck which triggers sensitivity in those nerves and hypersensitivity in mucus membranes, DiGerolamo says. Chemical stresses that can cause the body to go haywire often are caused by food allergies, which also is addressed at Crescent City, which is a medical and chiropractic clinic.

"We try to get patients out of the vicious cycle where they get into pain and don't feel like exercising so they're sitting on the sofa and compounding the problem," he says. "We try to get them to feel as well as possible so they can get out and do the things they love, whether it's exercising or a hobby, bowling or golf.

"We do a number of different things. With some people, when they get to a certain age their body is depleted of the natural ability to repair itself. They want to have the energy they had before 45 or 55. We're talking to people not only about the physical ways they can help their body, but we're talking about diet and getting the proper amount of sleep and exercising, which reduces overall stress, too."

Maintaining a balance in all the areas and developing habits that incorporate the areas as a natural part of life are key to feeling well and keeping the body's inside structure -- its bones -- viable over time. So-called "weekend warriors," who work at demanding and sedentary jobs during the week and go overboard on physical activities on weekends, are regulars at chiropractor's and other doctor's offices as they seek relief from injuries and strains. Even children are making more frequent appearances in doctors' offices for relief of overuse injuries, muscle strains and stress fractures.

"A few of the things we see fairly commonly are young children participating in sports-specific training year-round," says Tulane's Brown. "It can be harmful when done in excess. It doesn't allow the muscles and tendons and bones to rest and heal. As a sports medicine doctor, our goal is to get you back into the sport you enjoy ... but to treat the injury while also guiding you regarding proper technique."

Overemphasizing one sport year-round also can lead children into eating problems as they try to maintain the ultimate weight for activities such as ballet, gymnastics and long-distance running. Overtraining in one discipline also can be detrimental if it entails overdevelopment of certain muscle groups or repeated impact stresses on bones. Brown says a good solution is cross-training, where children spend some time doing the favored sport, but also do walking, biking, aerobics or swimming to exercise muscles and bones with a lower impact workout.

"Children need to be in a regular exercise program, and parents need to take an active role," he says. "It needs to be year-round and it needs to be throughout the week, not just during the weekend. As far as nutrition goes, it needs to be three square meals a day representing all of the food groups.

"If you realize that women reach their maximum bone density during the late second and early third decade of life, if they were not eating properly and exercising regularly up to that point, then their bone density mass is going to start off low and by the time they're 60, they're at high risk for osteoporosis and fractures."

Other ways to protect adults and children from discomforts and injuries to muscles and especially bones are to make sure they have proper footwear that provide arch support and fit properly to take stress off the bones of the leg. Children also should be aware of the strains caused by improperly carrying backpacks filled with heavy books. These should be carried on the back by both straps, not the popular way in which the entire weight is borne by a strap flung over one shoulder. In addition, the straps should be adjusted to a snug position where the bag is centered and balanced on the back instead of hanging low.

Parents also should beware of an overly intense devotion to a sport that leads children (and adults alike), even those who are in good shape, to push themselves too hard, which sets them up for injuries.

"What you want is variety in your activity and athletic endeavors," Brown recommends. "You want to cross-train, which implies running one day, swimming another day, biking another day. You maintain your cardiovascular status, improve your aerobic activity, and you're still working the muscles and building the bone mass and providing variety. It also minimizes the risk for injury."

Westside Orthopaedic Clinic's Dr. Katz agrees that balance is key to long-term conditioning and bond health and emphasizes the necessity of properly stretching and warming up before strenuous endeavors.

"Overall, you try to keep in shape and maintain your body weight with what's recommended for your body height," he says. "Try to do some aerobics three to four times a week, warm up before doing activities -- that includes a stretching warm up -- and allow your body time to recuperate and heal."

Many of the spine and back problems Katz sees can be helped with time, heat, ice, anti-inflammatories and aerobic conditioning. "Most of these problems are self-limiting ... and 85 to 90 percent of the time they can make it OK if they just give it time to heal.

"I'm a surgeon, but my job is trying to prevent people from having surgery at all costs. It's a last resort. If you can wait them out for six to eight weeks, most people get better and over time it does improve."

For those who opt for surgery, technology has made giant strides in minimally invasive surgeries to relieve herniated disks in the back, correct spine problems, stabilize fractures and treat other conditions.

"We're always going to see the same problems," Katz says. "It's going to be how we approach the problem and how we treat it that will change. We're making strides; we're doing good medicine."

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