Saturday, October 20, 2012

Exercise Helps Decrease Arthritis Pain!

Did you know that arthritis is the leading cause of disability in the United States? 22% of adults have arthritis. For many of my patients a diagnosis conjures up fears of needles, medication side effects, and ultimately--surgery. Most look at me with disbelief when I tell them that exercise--even weightbearing exercise--may actually help alleviate their pain.

Numerous medical studies have shown that physical activity is an important but underused intervention for adults with arthritis that decreases pain, delays the onset of disability, improves physical functioning, mood and independence, and enhances quality of life, aerobic capacity, and muscle strength.
Here are some recommendations for all adults:

  • 2 hours and 30 minutes of moderate intensity, or 1 hour and 15 minutes a week of vigorous intensity aerobic physical activity.
  •  Additional health benefits are provided by increasing to 5 hours a week of moderate intensity aerobic physical activity, or 2 hours and 30 minutes a week of vigorous intensity physical activity, or a combination of both.
  • Muscle-strengthening activities that involve all major muscle groups performed on 2 or more days per week.

Brisk walking is a good example of moderate intensity exercise and more intense jogging is considered vigorous. Biking and swimming are also good options.

It is often difficult for folks to find time in their busy schedules to exercise, but the great thing is that these periods of exercise can be broken up into small chunks. Even a ten minute bout of exercise is worth it. Strive to do enough of these a week to add up to the recommendations above. Those knees won't ache as much if you do!

For more ideas on exercise activities:

-Written by:
Brandon D. Larkin, MD
St. Peters Bone & Joint

Monday, October 15, 2012

Meet Dr. Glueck

Dr. Glueck was able to sit down with Barnes-Jewish Hospital and give a insight
into him and the way he practices.

We’re All Athletes

Dane Glueck, MD
October 2012

One of the definitions I found for athlete:  a person who has a natural aptitude for physical activities. 

Here’s the thing -- we all have a natural aptitude for physical activities.  We all utilize our bodies to accomplish tasks.  Here’s the problem – we’ve abdicated permission to train our bodies and to perform at a higher level to a select few – to “athletes”.  I believe that we all should reclaim the title of athlete.  This should include the fourteen-year-old basketball player, the forty-year-old mother of three working second shift, the fifty-year-old electrician, and the seventy-year old grandmother. 

Ultimately, all of our bodies respond to training.  Our muscles grow and our bones strengthen as we apply force across them.  This is true whether someone increases our bench press from 250 to 300 pounds or increases their walking program from one mile to two miles every other day.   Of course, any significant increase in activity should be in moderation with a gradual program to prevent undue stress and steadily improve function.  Importantly, training improvements aren’t limited to just the young.  Studies have shown an increase in muscle mass and strength in patients as old as 90 years.1

I think it’s likely that Rick Hoyt, unable to walk due to cerebral palsy, considers himself an athlete.  Rick, and his father, Dick, have completed over 1,000 races together – including marathons and triathlons.  Dick provides the muscle power that moves them forward together. A quote from their website ( quotes Rick after their first race where Dick pushed Rick’s wheelchair, “Dad, when I’m running, it feels like I’m not handicapped.”

Rick’s spirit propels himself forward when his legs can’t.  His father’s heart and legs propels them both forward.  While neither fits the standard criteria of an athlete that plays on Sunday afternoons or makes history in October, they certainly have the hearts, minds, and bodies of athletes in the greatest sense of the word.  Surely, the rest of us can emulate their behavior to become our best athlete.  In doing so we’ll find better health, and, our natural aptitude for physical activities.

1.  Fiatarone MA, Marks EC, Ryan ND, Meredith CN, Lipsitz LA, Evans WJ:  High-intensity strength training in nonagenarians:  Effects on skeletal muscle.  JAMA 1990;263(22):3029-3034.

Wednesday, October 3, 2012


The knee is a joint that we call a hinged joint.  This is a very restrained joint; therefore, it is subject to stresses from overuse, as well as trauma, that result in tearing of cartilages and ligaments that one may not see in a shoulder that is more unrestrained, such as the shoulder.  Common knee injuries that are treated by your orthopedist are anterior cruciate ligament (ACL) injuries.  The ACL is a major restraining ligament from the lower leg subluxing.  These are commonly non-contact injuries seen in patients that participate in sports, such as skiing and basketball, as well as weekend athletes playing softball.

Medial collateral ligament injuries, or MCL injuries, are also a result of a direct blow to the outside of the knee.  It can be seen in football, but also can be seen in industrial accidents where the patient will fall and sustain an injury, where the leg will point out from the body at a so-called valgus injury. 

PCL Injuries:  The posterior cruciate ligament injury is commonly seen in a blow from the front of the knee.  This can be seen in accidents such as a dashboard injury or from a direct blow anteriorly, such as a football injury where a helmet would hit the leg and the tibia anteriorly. 

Torn Cartilages:  The cartilages that we commonly talk about are the menisci.  There is a medial and a lateral meniscus.  This is commonly seen torn with a twisting flexion injury.  It can be intermittently painful, having the patient have a sensation of sticking and catching in the knee or popping or locking associated with swelling.  This can then go away, as a meniscus fragment can actually reduce itself and become essentially asymptomatic until the knee is stressed again.

I have enclosed a schematic of what a knee looks like so that you can view these different components that we discussed that are part of what we treat routinely in orthopedics.

If you have any problems with your knee, I would be happy to see you and treat you and educate you for now, in your future endeavor.