What to do with that foam roller at the gym?

Originally Posted Here: https://www.health.harvard.edu/blog/what-to-do-with-that-foam-roller-at-the-gym-2019041616427

The foam roller is possibly the least intimidating piece of equipment in the gym. It’s light. It’s no-tech. And like most things in the gym, you’ve heard something about its benefits, seen a few people using it, and wonder if you should be doing the same.

What is myofascial release?

Foam rolling is a myofascial release technique. The fascia is a sheet of fibrous connective tissue made of collagen that surrounds muscles. It holds muscles in place and helps them glide through their range of motion, says Carina O’Neill, DO, medical director of Spaulding Outpatient Center–Braintree. Think of the relationship like an orange cut in half, she suggests: the edible sections are the muscle, the surrounding white part is the fascia.

Whether you use massage, chiropractic care, or foam rolling, when you press on one tissue, you unavoidably press on the other. There are spots where only fascia is being worked, such as the bottom of the foot and the iliotibial band that runs along the outside of your upper leg, but mostly it’s a combination.

Why is myofascial release performed?

Muscles and fascia can become tight from overuse, repetition, body mechanics, and weakness. In response, the body may protect itself by limiting your range of motion. That protection can be a benefit, except when it doesn’t allow the body to heal itself or move freely.

“Muscles tighten up for a reason, but sometimes they don’t get the memo that they can loosen up because there’s no tissue damage,” Dr. O’Neill says. “Muscles can be stupid.”

How can a foam roller help?

Myofascial release techniques manipulate tissue in order to return it to the proper position and looseness. For example, with massage a therapist would feel the muscle, sensing changes in texture and tenderness, and use pressure to stretch and soften up the tissue, Dr. O’Neill says. The challenge is that sometimes myofascial pain and the source of it are not in the same place. Pain running down the legs could be from tightness in the glutes. Headaches can be from tightness in the trapezius muscles.

The limited research about foam rolling comes from short-term studies of specific sports or even specific muscles. Most studies are small and some involve performing intense activities, such as box jumps, or foam rolling for an extended period of time. Within this context, there is evidence that foam rolling helps with delayed onset muscle soreness (DOMS), recovery, muscle fatigue, and range of motion. Another possible use for a foam roller, Dr. O’Neill says, is during a warm-up for exercise to enhance flexibility.

How should I use a foam roller?

Consider foam rolling a tool to try — an option if you find it helps with your warm-up or eases muscle stiffness, rather than a mandatory segment of your exercise routine. Target big muscle groups — the glutes, legs, back — and slowly roll over an area. Once you hit the “hurt so good spot,” as O’Neill calls it, use your body weight to roll back and forth, moving only about two to six inches. The area could be tender at first, so start with five to 10 seconds to make it more pliant. As you become more accustomed to foam rolling, you can work up to 15 to 30 seconds.

Any exercise-related activity comes with caveats. If pain causes you to clench or grimace, stop rolling. Post-exercise soreness (DOMS) is normal and should resolve within two to four days. Lingering pain reflects a bigger problem and you should call your health care provider for advice. Finally, even if rolling initially feels good, start slowly and don’t overdo it. If you roll too vigorously or for too long, you can cause tissue damage. “Too much of anything is a bad thing,” Dr. O’Neil says.

The post What to do with that foam roller at the gym? appeared first on Harvard Health Blog.

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5 reasons we need to help kids live “heads up” instead of “heads down”

Originally Posted Here: https://www.health.harvard.edu/blog/5-reasons-we-need-to-help-kids-live-heads-up-instead-of-heads-down-2019041516422

I was recently at an accepted-students day at a local university with my daughter, and the president of the university spoke of how youth these days live a “heads down” life. We need them to be more “heads up,” he said.

He is right.

He is quite literally right that our youth are “heads down.” Our children and teens, like the rest of us, have their faces in their phones more often than not. We’ve grown used to it. Everywhere we go, kids are looking down at their phones and other devices. This could have real implications not just now, but for their future — because looking down all the time has some real downsides.

There are five important ways living “heads down” is bad for our youth.

1.  Safety. This is the obvious one. Anyone who does any driving anywhere has seen someone lost in their phone walk out into traffic — or worse, drive with their attention on their phone. We look down as we walk along a hallway or sidewalk and collide into others doing the same, or into doors, or poles, or other hazards. The university my daughter and I were visiting is an urban one, adding a whole other layer of danger: being aware of one’s surroundings is hard when you are looking at your device.

2.  Health. Our devices tend to make us more sedentary. Too often, our kids are happy to curl up with their phones, their tablets, their computers, or their video games instead of being active. Kids should be active for an hour a day to be healthy, and devices get in the way of that. Since using devices is generally an indoor thing, kids also lose out on being outdoors, in the sunshine, which impacts health. Devices also get in the way of sleep. More and more, especially with teens, cell phones keep kids awake — and wake them up during the night. All of these factors could have both short- and long-term effects on health.

3.  Anxiety. There is growing concern that social media fuels anxiety in our youth. Too often, youth feel measured by how many people click on or “like” their posts. They can feel like their lives pale in comparison to the lives of peers that look so successful and happy on social media. In so many ways, social media can make youth worry and feel inadequate.

4.  Social connections. Not only do kids not notice people around them when they are on their devices, it’s becoming more common for kids to be on their phones even in social situations — rather than talking or otherwise interacting. Kids are at risk of losing the important social skills of making conversation and building relationships, and losing these skills could have lifelong implications.

5.  Losing connection with the physical world. It’s not just about avoiding bumping into people or not learning how to make small talk. There is a bigger problem when people experience the world through devices. They miss out on experiencing the natural world and on all the hands-on experiences and skills the physical world provides.

There is much that devices can offer in terms of connection and information, so many ways they can make our lives streamlined and more efficient. But we owe it to our children to be sure that they live their lives in a “heads-up” way: fully engaged with everyone and everything around them.

Follow me on Twitter @drClaire

The post 5 reasons we need to help kids live “heads up” instead of “heads down” appeared first on Harvard Health Blog.

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Is obesity a reason to avoid joint replacement surgery?

Originally Posted Here: https://www.health.harvard.edu/blog/is-obesity-a-reason-to-avoid-joint-replacement-surgery-2019041216404

“Come back when you’ve lost 40 pounds.” That’s something obese patients have heard often when being evaluated for a hip or knee replacement for severe arthritis. And sometimes the recommendation is to lose even more — 50, 75, or even 100 pounds… as if that’s an easy or realistic prospect.

As you might expect, patients hearing this often feel disappointed and disheartened. After all, most have already tried hard to lose weight with limited success. Their arthritis pain impairs their ability to exercise, and decreasing activity has contributed to their weight gain. So being told to lose significant weight before they can be considered for joint surgery sounds a lot like being told it’s just not going to happen.

Why should obesity preclude joint surgery?

While the surgeon’s recommendations may be disappointing, the rationale seems sound: people carrying a lot of excess weight have long been considered at higher risk for complications, and less likely to experience the profound pain relief expected from this major operation. Indeed, several studies describe higher rates of infections and dislocations and lower rates of good results after hip or knee replacement among the obese, especially the severely obese.

Importantly, many of these studies are more than a decade old, and newer studies are beginning to paint a different picture. A recent study on the risks and benefits of joint replacement among the obese sheds new — and positive — light on an issue that affects many thousands of people.

A new study suggests that being obese should not preclude joint replacement

Researchers analyzed the results of more than 5,000 people having hip or knee replacement surgery, comparing pain and function before and six months after surgery. Here’s what they found:

Those who were the most obese (about 25% of those in the study) had more pain and poorer function prior to surgery than those who were leaner. The amount of functional gain in obese individuals six months after joint replacement was significant, and similar to that experienced by those who were not obese. Pain relief was greater among the most obese than other weight groups. After surgery, pain levels were similar in all weight groups.

The authors conclude that “obesity in itself should not be a deterrent to undergoing total joint replacement to relieve symptoms.” However, the potential for more complications must be considered as well, something this study did not formally examine.

Given the high and rising rates of obesity and arthritis in this country, the results of this study will likely apply to many people. And they suggest that surgeons should change expectations about what surgery has to offer obese individuals with severe arthritis.

The bottom line

While avoiding obesity in the first place is still preferable, there is increasing evidence that the benefits of joint replacement surgery are not limited to those who are lean. If this new research is confirmed by others, we may see fewer obese people turned down for joint replacement surgery in the future.

Follow me on Twitter @RobShmerling

The post Is obesity a reason to avoid joint replacement surgery? appeared first on Harvard Health Blog.

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