Preventing Falls

Maybe it's all those candles on the birthday cake but geriatric concerns are quickly becoming joeblack concerns.  Maybe it's the nature of my work too.

Anyway, I do know one of the greatest fears of those that are older is a fear of falling.  And it's a legitimate fear, with over 2 million people falling every year in this country alone.

One of the tragic consequences of a fall is a broken hip.   For those with already compromised health (the elderly are chief among those), that can be bad news.   Probably 25% of those that break a hip will die within a year of their injury.

 So what can be done about it?  Can we really do anything to prevent falls?

Oh yeah.  Lots. 

First up is staying physically active.   Not only does this give us stronger bones and muscles, it gives us better balance (but more on that in a minute).   Staying active means staying engaged in the community, staying active in your neighborhood, and exercising regularly.  Your exercise regime should include strength training.  I've said many times, it is more important to lift weights at 70 than it is at 30.

Osteoporosis is a really problem as we age, especially for women.  Weightbearing activities (running, walking, hiking) can have a huge impact on the development of osteoporosis.   One of the side effects of that is that if you do fall, your bones are stronger and can maybe withstand a fall without breaking.

Get rid of the vanity.   I strongly recommended to a patient not long ago that she begin using a cane.  After a series of falls and health issues that guaranteed more, it just seemed prudent.   Her refusal was quick and adamant.   A cane would not fit in with her "image."

Having something, anything to aid in balance might just prevent a fall.  It's not that much different from the hiking sticks that folks of all ages carry.   Maybe I should start recommending hiking poles instead of canes for some folks.

Bifocals (or progressive lens or whatever it is that you might have) contribute to falls.  The bottom of those lenses are made to allow you to see things up close.   The ground or the floor is blurry when you look down through them.   I don't wear mine when I go hiking.   I need to see the ground below me.  

The solution?  Maybe smaller frames so that you can see below your glasses.   Or just consciously looking below the lower rim.   In any case, the visual input of seeing where you are stepping is a huge assist in falls prevention.

Finally, balance can be trained.   If you are at significant risk, there are falls prevention programs available at many physical therapy clinics.   Those programs really work. 

But for most, a few simple exercises performed daily at home, can help your balance.   Start by standing on one foot.   Sounds simple but time yourself--how long can you stand on one foot?

Or stand with your eyes closed.   Be sure and have a family member available and some way of stabilizing yourself if you start to fall, such as a handrail (don't depend on furniture).

Next, stand on one foot and close your eyes.   Or maybe stand on one foot and swing your arms from side to side.  Get the picture?   Put demands on your balance system and it gets better.  

Stay sharp.  Stay active.  Stay balanced.

Happy Father's Day

Today is Father's Day.  For those of us blessed with children, I'm not sure that we have a more important role in our lives than to be good parents to our children.

I've said many times that I don't see many bad kids but I've seen way too many bad parents.  Anybody that's been around sports as much as I have has seen the worst of the worst.

Like the dad that didn't want to go to his daughter's games because she wasn't going to get to play anyway.  My sermon was that he needs to be there more if she's not playing than if she is.

Or the dad who was so overbearing that his child couldn't enjoy the basketball game because of the constant criticism that was being offered from the sideline.   That child ended up quitting the game they loved because of it.

I've listened to dads in the stands yell at their kid, coaches, referees, and opposing players.   One of the worst would criticize everyone on his son's team but his own son.  Loudly.  Bitterly.

I want to tell you about a couple of dads that I think got it right.

Logan Winders was a standout  on the 2012 MHS football team that made it to the state championship game and an important part of the 2011 team that won that same championship.  His brother Zane, who just completed his college career at Maryville College (where Logan will matriculate this fall), did much the same.

Their father, Joey Winders, has coached a variety of youth sports teams around here but is most widely known as the Head Coach of the Maryville Southerners, a Pee-Wee team in the Parks & Recreation football league.

Joey's efforts on behalf of youth sports in this community are almost beyond compare.  Long before his boys were playing, he was coaching.  Baseball, basketball, football.  I don't recall that he coached other sports along the way but I wouldn't be surprised to hear that he did.

He has been such a part of the fabric of youth sports around here that if he had tried to be heavy handed with the high school career of his sons, few would be surprised.   He coached them pretty much all the way up to high school, and it had to be hard to step aside and turn Zane and Logan over to other coaches.

But that's exactly what he did.   Sure, he worked behind the scenes, doing whatever parents could do to support the WHOLE team.  Like feed them, before and after games.  Come early and stay late to do those things that need to be done.

He lifted his kids up when they were down and stood to the side and let them live in the glory when they thrived.  For my money, he was a really great dad--an example of how that role should be played out.

Nick Myers was the quarterback of this same football team.  Few would argue that his performance from game 1 through the championship game wasn't a big reason, maybe the biggest, for this year's success. 

His dad Don Don was also a youth sports coach but what I will always remember about him is that he was at football practice pretty much every single day of Nick's high school career, quietly observing from the periphery of the practice field. 

As far as I can tell, he never tried to coach or criticize, and I honestly never heard a negative word come out of his mouth, even when his son was battling for a starting position or having a bad day.

Joey & Don Don:  Good dads that understand that these days passed too quickly yet made the best of them.

Well done guys.  Happy Father's Day.

Choose To Be Happy

"The Lady Who Cuts My Hair" has accused me on a couple of occasions of seeing the world through rose-colored glasses (if that's a metaphor that you don't understand, Google it up) but I'm capable of getting down too.

Like just the other day.  I was really, really tired.  As in, dinner-is-over-are-you-ready-for-bed-yet tired.  There had been some tough issues to deal with at work and I hadn't slept real good the night before and I'm getting older but you already knew that.

I was beginning to think that maybe those birthday candles had finally caught up with me and I was definitely feeling sorry for myself.  Anyway, I was walking around looking like the weight of the world was on my shoulders.  My wife noticed and asked about it. 

And then I saw this video clip of the little girl throwing a baseball to start a game because her daddy was in the middle east fighting a war that seems to be more than half a world away from us when the catcher popped his mask off and it was that same daddy come home.

And I stopped to think about my new friend and former patient whose dog just died and that dog and the one this guy lost last year were just about the best things going on in his troubled life.

I look at a lady that I know that is a retired "lunch lady" (cafeteria worker) that has remained one of the most enthusiastic high school sports fans know despite steadily declining health.  And one of the nicest people too. 

She was concerned with paying a $10 bill because she had just spent her last $10.  No mention of eating or other expenses.  She wanted to make sure she could meet her obligations.

Then just yesterday, I was behind a vehicle traveling down 321 traveling so slowly that other cars were backing up behind it.  The driver then pulled off and began driving down the shoulder to let cars go by, but he kept moving.

I'm gonna bet that this vehicle was probably going as fast as it could go.  The driver and his young family were maybe headed home, maybe having gone to the grocery store or to the doctor or something.  I know I'm jumping to some conclusions here but I believe I may be guessing correctly.

If all that is true, then it would be easy to then assume that he couldn't afford to get his vehicle fixed.  But it was probably their only means of transportation and so off they go.

Can you imagine how embarrassing this would be for this young man?   Trying to make ends meet and put food on the table and yet driving a vehicle that would barely get them around?  How powerless that situation would make him feel?

I'm in good health, the only time I'm hungry is by choice or neglect, and my truck starts when I turn the ignition every morning.  

So what possible reason could I have for feeling down?  What burdens do I carry...really?

 

Simplifying Weight Loss

Weight loss is a topic that I've tackled in this space many, many times.  Some might offer  too many.

It's just  that a lot of the health issues that we face today are because of obesity.  Diabetes, heart disease, blood pressure, even certain types of cancer.  And we know that obesity makes it hard on your joints. 

Obesity is the #1 preventable problem facing Americans today.   And notice the "preventable" part of that.  We can do something about it.  

Throughout time, there have been more diets than...well, you can imagine or I can describe.  I've looked at many of them.  The Adkins diet.  The Watermelon diet.  Paleo.  South Beach.  The detox diet.  The grapefruit diet. 

But the main conclusion that I've reached is that the simpler the weight loss program, the more likely it will be that you will stick with it.  That the easier it is to live with, the less self-control that you will have to use   That the better you stick with it, the more effective it will be.

So I've adopted a very simple plan that most people can follow.  A path, if you will, to better health.   I believe that you need to look at doing two things:  Exercising every day and eliminating that one "worst" thing from your diet.

That every day exercise thing is important and is probably the most daunting aspect about this whole concept.  Studies distributed by the American College of Sports Medicine have indicated that to achieve fitness, you should exercise at least 4 times a week.

Notice the "at least" part of that.  I don't believe that is enough.  If your exercise is going to affect your metabolism (and it can in very important and profound ways), you've got to do it every day.

The exercise doesn't have to be vigorous but you do need to do it every day.  Walking is a great start but you'll find that if you do it daily, pretty soon it won't be enough.  Swimming is great if you've got access to a pool.  Most people know of my love for everything bicycling and CrossFit. 

You've just got to find something that you can stick with.  I would suggest that it should be several "somethings."   Strength training should definitely be in there part of the time.   Interval training and cardio are important too.   But if you don't do something that you find fun, you won't be able to sustain it.

And I can tell you from years of experience in working with people pursuing fitness, you've got to sustain it.   You've got to be in for the long haul.  A commitment to the lifestyle change that this requires is not something you can do for 6 months, see great gains, then move on to something else.

You have to build it into your daily schedule.  If it's Tuesday, it must be cardio day, or something like that.  Have a plan and then stick with it until it doesn't work anymore and then change it.  It helps to have exercise partners.  Being accountable to anyone makes it harder to miss a workout.

And the best time to exercise is in the morning.   Even light exercise will change your metabolism (for the good), with the net result being that you burn more calories the rest of the day (another good thing).

The other part:  remove that one worst part of your diet.  Not everything, just the worst thing.

I used to have a secretary that brought a 65 ounce jug of soda to work every day.   And she refilled it at least once every day.  She didn't really have a weight problem but she had a lot of health problems that were likely the result of all that sugar. 

What is that one bad thing for you?  Identify it and cut it out.  It really is that simple.   No wholesale changes to your diet and definitely no "diet" to follow nor calories to count.  

You Look Good for 60!

One of my workout buddies, Kenny Wiggins mentioned recently that he really doesn't watch the clock during our workouts  but instead just looks for the "milestones."

Such as "half way through" or "5 minutes to go."   If he watches the clock, it's not as much fun. 

I had a pretty big milestone yesterday:  My 60th birthday.  I haven't been watching that clock:  60 has sort of sneaked up on me.  It really sneaked up on my wife--early this year she suggested maybe we should take a big vacation when I turned 60.  "Uh...honey...that's this year!"

Most people at 60 are starting to look at retirement.  Not me.  Not really.  I have no real plans for retirement.  I've always thought it sad that someone knew the days and minutes until they could finally retire.  I would not have wanted to work at a job that would make me feel that way. 

I'm not sure what I would do in retirement anyway--I enjoy what I'm doing now too much.  My life is complex but not complicated.  I do a lot of things.

I paint, I sing in a quartet, and I ride my bicycle. I dance, but only once in public.  I chase grandbabies.  I paddle a canoe, travel a lot, and raise blueberries, cherries, and blackberries.  I try to grow apples, pears, and peaches but I'm not real good at those.  Still, it doesn't stop me.  Actually, not being real good at something doesn't seem to deter me from trying new things.

I really enjoy sharing in this space with you and plan on writing until the good folks at The Daily Times discover I've truly lost my mind.  It used to be that I was "Joe Black, the physical therapist."  Anymore, I'm "Joe Black, the guy that writes in the newspaper."  That's OK.

I've said many times that I'll quit my job when it stops being fun.  Well, it's still pretty darn fun.  For me, there is nothing like the dynamic of a clinic, particularly one that is truly focused on helping folks and being proactive about health issues.   It is still a thrill to walk into the room of a patient that is there to seek my expertise and guidance.  

It's been a really great 60 years and I would do it again the same way in a heartbeat.  Sure, I've made mistakes (even some really big ones) but the path has led me to a point in life where I'm truly happy, to where I feel I'm the luckiest man in the world, so why would I even change the bad stuff?  I'm pretty sure I've learned from the mistakes I've made and the trials I've been through.

60 really is only a milestone in my life that has now passed.  The clock is ticking and if I don't want to lose sight of what is really important, if I don't want to miss out on living life, I won't be watching the clock.  I'll simply get on with life.

I've got a lot to do.

Bullying By Any Other Name

Maybe you followed the story of Bearden High School senior Alex Notte and his prom date with professional golfer Belen Mozo.   This beautiful, successful 24-year-old stepped away from her busy schedule to join Alex on this special night. 

That Alex had physical and communication challenges didn't stop him from asking for a date with Belen.  That she said yes I believe is a testimony to her heart and her character.

I'm going to call the rest of this my Jane Doe story.  Maybe you were never this person.  Maybe you were. 

I can remember how badly we treated Jane.   She wasn't one of the "cool kids" and, truth be known, was pretty obnoxious.   The kind of person that might get on your nerves quickly.

I can remember never wanting to be seen talking to her because my buddies might think that I "liked" her.  So I shunned her.  Ignored her if she tried to talk to me. 

Was she that bad?  Oh heavens no.

We had a "fat girl" in our class too.  Shunned as though she had a contagious disease, I can't imagine what life must have been like for her.   I do know that we became re-acquainted as adults and I found her to be engaging, smart, funny, and an all-around decent person.   I think she was still big but I'm not real sure because I didn't see her that way anymore.

Stuff like this still happens every day.   What were we thinking?   We weren't bad kids but obviously we could be cruel.

Bullying is not just  physical beatings or even pushing someone down on the playground.  Bullying takes many faces.  Cruelty like this is a form of bullying. 

When you make fun of what someone is wearing, that's a form of bullying.   Did you ever stop to think that maybe that's all they had?  Or that maybe their parents were unable to make the kind of choices that you think are fashionable?

Or the way someone looks?  That's bullying too.  The kid with size 14 shoes in the 5th grade and you just think that's the funniest thing you've seen in a long time?  That is the same kid that will be 6'6" and a basketball star in just a few short years.

Or the girl that had to have glasses too young and gets called "Four Eyes" everywhere she goes.   Whose nose doesn't seem to fit her face.   She's the one who grows into those things and is knock-dead gorgeous and believe me, you will wish you had been nicer to her when you were younger.

I honestly believe that is all about our own insecurity.   We don't know who we are and are despite desperately searching for that person but in the meantime we elevate our status (in our own minds) by treating others badly.

There's this one guy that I knew well in college that may have helped me understand how this is just basically wrong.  When a bunch of us guys were hanging out together, he would pick the one person in the room that he saw as the weakest or least and make fun of  him.  What we called "teasing," although it was something much darker than that.

I was sometimes that person being picked on.  It took me many years to forgive him.   What he did do was teach me a little about how to treat people.     And what I've discovered is that if you treat others with respect, if you make yourself blind to whatever faults they might have, you're going to find some really great people out there.  

People that you have a lot more in common with than you could ever have dreamed.   And that's a good place to be.

Tie your shoes!

This may be one of those columns that confirms my old fogey-ism but have you ever wondered why (mostly) teenagers never want to tie and untie their shoes?  Maybe you haven't  noticed but I sure have.  

I guess it starts with injuries because that's mostly when I see them.  

Without a shadow of a doubt, the most frequent sports injury is the ankle sprain.   The classic sprain is where the foot turns to the inside, injuring the outside of the ankle.  More commonly the result of jumping and then landing on someone else's foot, it can happen while alone while simply stepping off of a curb.

If you have injured your ankle, there are a couple of keys to deciding maybe what you've done.  First, let me teach you a couple of terms.  "Inversion" is when your foot turns to the inside.  Since the ankle sort of goes out, some people mistakenly describe what happened to them by saying that their ankle turned "out."   What's important here isn't what happens at the ankle but what happens to the foot.

"Eversion" is where the foot goes to the outside.

Now here's the important part of that.  If you have an eversion injury and it hurts on the inside of your ankle, you can probably ice it and watch it for a few hours to see what happens.

If you have an eversion injury and it hurts on the outside of your ankle, you very well may have broken your ankle and need to avoid weightbearing and get it evaluated, particularly if the pain is severe.

If you have an inversion injury and it hurts on the inside of your ankle, you can probably ice that one too and watch it for a few hours.  However, if an hour later you can describe the pain as severe, then you should have it seen about.

And if you have an inversion injury and it hurts on the outside of your ankle, you probably have a garden-variety ankle sprain and need to put ice on it, rest it, and elevate it.  If severe pain lasts for more than a few hours, get medical attention.

None of this is meant to be a substitute for medical attention to any injury.  But the fact of the matter is that most people will do one of three things when they hurt their ankle:  Do nothing, do the right thing (Rest Ice Compression Elevation), or do the wrong thing.  Maybe the first and last are the same.

In other words, most people self-treat ankle injuries anyway so I'm just trying to help you make smarter decisions and understand what is going on.

Now back to the shoelace thing.

Let me tell you first that laces on athletic shoes are there for a reason.  Do this:  Look at your running shoes.  See those stripes and bands on the side?   Those are there for a purpose.

When your shoelaces are snugged up, those stripes pull up on the shoe so that it cradles and protects the foot.   Bands that go from front to back are there primarily to assist in cupping and supporting the heel.  

You can prevent a lot of injuries by having well-fitted shoes with the laces up tight.  And that means also that you untie your shoes when you take them off and re-tie them when you put them back on.   Tucking your laces into your shoes, making them so you can simply slip them off and on without bothering with the laces defeats the purpose of the shoe.

You might as well wear houseshoes (or those flimsy, rubbery things that too many people wear that I will not name because I don't really like to be sued) around for all the good your shoes are to you.

So now parents, feel vindicated because what you've been preaching forever is now gospel.