Standing is healthier to fight sedentary lifestyle?

Is your workplace killing you? It’s a possibility. At 8-hours per day, work covers one-third of your life. It contributes to a sedentary lifestyle that is further enhanced at home. Thoughts are rising about how a sedentary lifestyle may be hazardous to your health. Dong something about it is easier said than done. Yet, each day you wait may result in some toxicity that is avoidable. Is standing healthier to fight a sedentary lifestyle? Are you ready to explore this further? The answers may surprise you.

It doesn’t take a lot of sense to figure out that there are several health implications due to more sedentary lifestyles. New studies are demonstrating how lower activity levels impact physiological activity in your body.

Physiology aims to understand the mechanisms of living – how living things work. Human physiology studies how our cells, muscles and organs work together, and how they interact. Changes and greater access to different modes of transportation and mechanics over the past 500 years may have affected human physiological systems. Some say they constitute the basis of new motion diseases and pains over the past few decades.

20th and 21st century technology improvements have radically changed lifestyle choices. More people rely on vehicular transportation than walking. People sit while listening to radio, watch TV, and “work” at their computer. Thankfully, mobile technology is helping take radio, TV, and computing features here and there but more people continue to sit. On the positive side, hand muscles may develop as more people text than speak on those mobile devices.

One recent study of young people, age 2 to 18 and their sedentary ways. Observations that the tested people spend 2–4 hours per day in screen-based behaviors and 5–10 hours per day sedentary. Some say that parents use TV as a form of babysitting. According to an article published by the American Association of Pediatrics, use of tablets is increasing among 6-month to 4-year age groups, sacrificing some other motion-related activities.

A relationship between sedentary behaviour and deleterious health consequences was noted as early as the 17th century by occupational physician Bernadino Ramazzini. Ramazzini catalogued how activity can change the make-up of nerves and muscles and the onsets of certain diseases. He is regarded as the father of occupational medicine by many.

Occupational medicine has become a multidisciplinary approach in the prevention, diagnosis and treatment of workplace injuries and illnesses. Researchers in this field offered significant research in keyboard designs and the prevention of repetitive motion diseases affecting hands and forearms. Occupational medicine has explored and developed ergonomic approaches to prevent such diseases in offices and other work places. Some of those ergonomic approaches and recommendations are often not adopted by work areas or easily adapted by individuals.

The ramifications, however, are spreading wider beyond the scope of merely workplaces. Harvard researchers found in a recent February study involving more than 92,000 women that the more time participants spent sitting at work, driving, or watching TV, the greater their risk of dying from heart disease, cancer, or strokes. Basically, “too much sitting can lead to death” so excessive sedentary behaviors may be as threatening as smoking. It can also be addictive. Some believe that sedentarianism is an addictive disorder.

Many workplaces, where people spend approximately one-third of their lives, seemed interested in using work stands over traditional desks. One company, HubSpot, an inbound marketing and sales software company, purchased sit/stand desks that raise and lower with the push of a button for all 650 employees this year after staffers started asking for them. This simplistic and costly suggestion and implementation did not work as thought. Standing may burn more calories than sitting as hearts work harder to circulate blood upward. Standing also puts more strain on our veins, backs, and joints, especially if we’re overweight. This is why more chairs were introduced in workplaces over 100 years ago. Remember Bob Cratchett’s high desk in the Christmas Carol?

Prolonged standing causes health problems too. Plenty of studies show that it may significantly increase the risk of carotid atherosclerosis (a disease of the arteries in your neck) due to the extra load on your circulatory system to move blood to your brain. This may translate to the possibility of a stroke.

A study on economic costs of pain discussed that over 100 million people in the United States suffer from chronic pain from muscles and joints. The study found that the annual costs of pain were higher than the 2010 expenditures of heart disease, cancer, and diabetes.

Finding sources of pain and treatments might be beyond most Americans through lack of adequate insurance and knowledge. Highly technological diagnostic tests may be used to pinpoint possible sources. Where there is no specific cause, doctors may provide a diagnosis of fibromyalgia or rheumatism. Fibromyalgia syndrome is a common and chronic muscular disorder characterized by widespread pain, diffuse tenderness, and a number of other symptoms. Rheumatism is often associated with arthritis but a more debilitating form. Both might be associated with sedentary lifestyles but may also result from accidents and other things. The problem is that both fibromyalgia and rheumatism are blanket terms that may consist of hundreds (if not thousands) of possible causes.

Apart from steroid and non-steroid analgesics, acupuncture, or Reiki, physical therapy is most often prescribed as a possible bridge to pain relief. Physical therapy is often called medical exercise and is used for a wide scope of pain and mobility disorders. The efficacy of physical therapy has been questioned and proven as beneficial to some, long-term patient compliance tends to drop dramatically after a few sessions.

Chiropractors often discuss that gravity is a constant stressor to possible back pain and certain postural conditions that are pain associated.

More research is being focused on the effects of sedentary behaviors. If chronic pains and sedentariness prove more positive, exercise therapy may prove positive. Of course, 30 minutes of exercise daily may not reverse the possible negatives of chronically sedentary conditions, it is better than zero. Overall, physical activity lifestyle changes have been examined and recommended as probable mediators that may reduce the effects of many hours and years of being mostly sedentary.

Age, gravity, furniture, and other variables may, through your lifetime, result in agony. You could sit through it or start moving – even walking habitually at a brisk pace for a longer time span each day. It’s easier to say and listen than doing.

It is likely that most healthcare providers will recommend activity and physical therapy. Do your homework. It is strongly advisable to undergo a thorough medical examination prior to beginning a physical activity regimen. Sedentary behaviors may be life threatening but activity may be shocking to your body’s age-old balancing systems called homeostasis or survival through stability. Finding a balance between sedentary and active has been established to help support longer living and less pain.

Pain management specialists are licensed medical doctors that deal with people who have difficulties or pain associated with moving. Clinical research is continually being conducted to help determine which pain management therapies are the most effective in treating back pain and neck pain. There are various diagnostic paths to find the sources that might be ailing you. Pain management specialists are most commonly found in the following disciplines:

•Physiatry (also called Physical medicine and rehabilitation) – MD
•Anesthesiology – MD
•Interventional radiology – MD
•Physical therapy (usually Ph.D.)

The most important consideration in looking for a pain management specialist is to find someone who has the training and experience to help you with your particular pain problem. You must also find one who is willing to interact with you in positive, productive ways. Generally, other pain specialists and therapists may be involved in the course of your treatment. Guess what? Most will be anti-sedentary. That is why you need to create a cooperative relationship with the pain-management specialist who is monitoring your course of treatment. If sedentary lifestyle behaviors are at the root of your problem, they can help (if you feel positive).

One form of activity you can do at your desk is Progressive Exercise and one of the promoters is a company that produces products many professional physical therapists use. Progressive resistance exercise (PRE) is a method of increasing the ability of muscles to generate force. TheraBand is a selection of large rubber bands (generally 3 to 5 feet long each), with varying resistance gradients classed by color. There are groups of exercises that you can do at your desk or on your couch. These devices are available by many online and fitness stores. If you are in a physical therapy treatment, it may be advisable to speak with your therapist about this about whether this might apply to your condition.

Altering your current everyday tasks to increase your physical activity, may be painful if irresponsible. Sitting and moving require attention and perseverance. The acts of movement integration to your living lifestyle require patience and positive attitudes. Are you ready?

Physiatrist not psychiatrist

Orthopedic trauma is an unforeseen life-changing event. Sometimes it goes beyond fractures to nerves and muscles. Sometimes it’s genetic or a symptom of a disease. It may not be orthopedic at all. The results and the traumatic quality of life deviations may have psychological consequences but you don’t need a psychiatrist. You may need another medical specialist. Ever hear of a physiatrist?

Sometimes personal outcomes depend on the choices you make. Often, the menus are limited. In a reality of physical aches and pains that dishearten even the heartiest. There are often overlooked options. When it comes to bones, nerves, and muscle interactions, physiatry or PM&R are often overlooked as a therapeutic means for body aches, pains, and mobility issues.

In medicine, there are many specialists. Knowing the right specialist may mean a great deal as to how a problem is diagnosed and treated. For broken bones, you might seek out an orthopedist. For nerve pain, a neurologist may be fine. For foot aches, a podiatrist might have answers. Bones ache? Try a chiropractor. These are all disciplines for ache and pain therapy. The one specialty that is ignored is that of a physiatrist.

Physiatrist? You must mean psychiatrist! A Physiatrist is a physician who has trained in an accredited program in the specialty of Physical Medicine and Rehabilitation (PM&R), which established board certification in 1947. This specialty seeks to restore a person’s functional capacity to the fullest extent possible. The major divisions of the field are musculoskeletal medicine, inpatient rehabilitation, and electrodiagnosis (EMG).

One day I chanced upon meeting a veteran while waiting at a bus stop. Ironically, he returned home fine but was in a car accident that damaged his bones, muscles, and nerves in his ankle-foot joint, making it painful to stand and walk. He saw that I wore foot braces and I told him that they support my ankle and foot muscles to help me walk. He had been seeing a podiatrist routinely with no real help. I suggested he might be helped by a physiatrist and he thought I was talking about a psychiatrist. I advised that a physiatrist pays attention to the after-effects that deal with motion disorders.

Many people don’t realize that a physiatrist is very different from a psychiatrist. Most people do not know what a physiatrist is. A physiatrist is a medical doctor that specializes in movement disorders, often associated with diseases.

A physiatrist focuses and offers different perspectives on bones, nerves, and muscles than orthopedists, podiatrists, and chiropractors. Virtually unknown or not regarded by the other three, a physiatrist’s target of dealing with motion and interaction may deliver movement and freedom from pain to many of those people for whom movement can be insurmountable challenges.

Physiatrists focus on a personalized method of treatment to improve their patients’ quality of life — one that involves a comprehensive approach. The treatment is often a guided process. Using a physiatrist often points to multidisciplinary approaches in seeking to rehabilitate movement. Physiatrists are often associated with comprehensive rehabilitation team of professionals that may include physical therapists, occupational therapists, recreational therapists, rehabilitation nurses, orthotists and prosthetists, as well as psychologists and social workers.

Why are physiatrists generally confused with psychiatrists? Some people can’t read and more people don’t know. Many medical specialists do not recommend them. They are generally affiliated with hospitals that perform complex surgeries, such as the Hospital for Special Surgery, generally performing joint replacements. Keeping physiatrists a secret route of treatment by those medical specialists may disrupt proper healing and promote greater challenges for needy patients.

Fortunately, people do discover physiatrists through other means.

Physiatrists are generally found in hospitals but many have private practices. Simonetta Sambataro, MD, operates from a small office in Chelsea on West 23rd Street in New York. She is a physiatrist that specializes in recovery, and provides rehabilitation, physical therapy and other types of therapy that help patients learn to regain normal/near-normal function. Trained in Italy, she provides physiatry care to pediatric and adult patients.

Dr. Sambataro offers very practical guidance of a European style and has a stack of business cards for reference to supportive professionals. One of those, that fitted me with my leg and foot brace is David Zwicker, a rather experienced and understanding orthotist. He helps provide supportive devices for people from head-to-toe.

Many patients may benefit by seeing a physiatrist to alleviate many frustrating physical and motion challenges that other specialty doctors simply might ignore. When you have chronic pain and movement disorders, finding a physiatrist might be challenging. but there are about 8,000 practitioners in the United States. That’s half the number of podiatrists and about an eighth of the number of practicing orthopedists. A physiatrist is part of a very small group.

Going to a physiatrist usually means a non-operative, no-drug and no quick-fix solution. The methods used are process based. The patient must be self-motivated to get better. Sadly, such motivation is often brushed aside in this society and patients may be less inclined to pursue seeking a physiatrist. The results may be poor healing or lingering pains.

Those suffering with otherwise untreatable degenerative neuromuscular diseases, such as muscular dystrophy, multiple sclerosis, and some stroke cases, may gain a little improvement by seeking out a physiatric approach. It may not be a miracle cure but may improve your general lifestyle.

It seems that physiatry is a much maligned, ignored medical discipline in the USA. When it comes to helping support your physical and emotional struggles with mobility challenges, a physiatrist may deliver more help than the more common medical disciplines dealing with nerves, muscles, and bones. Yet, physiatry often is perceived among the lowest levels in the treatment process and is often overlooked. Physiatry is a demanding medical specialty and a good physiatrist can be extremely helpful in the recovery process.

Mobility disorders are more than breaks, pulls, and sprains. From small to large, any shift from what you normally do can be traumatic. In those cases, your physiatrist may offer resources for a trauma services network that aids the process of healing and habilitating. Sometimes sharing helps boost your outlook.

Physiatry is physical medicine and rehabilitation (PM&R). The patient’s physical, functional, emotional, and psychosocial well-being are all considered in treatment. It may require more effort than swallowing pills but the positive outcomes may elevate your general mood when coping with movement challenges that affect your life and lifestyle choices. Physiatrists as medical rehabilitation specialists may help optimize patient outcomes and qualities of life by participating in strategies to help you cope throughout the process of reaching a better degree of wellness.

So when your muscles chronically ache, you may want to choose the aid of a physiatrist.

Toe-off braces against foot drop

While most evident with aging, foot drop is a condition when ankle muscles or nerve signals cause your foot to drop when walking. Foot drop makes it difficult to lift the front part of your foot, so it might drag on the floor when you walk. It can affect people of different ages as well. While some mild foot drop conditions respond to physical therapy, moderate to severe cases often require a brace that helps reposition your foot to a normal gait. The Allard Toe-off is one such brace and the best of its kind. There are others as foot drop is more common than most people think. Statistics are difficult to ascertain because so many people function with foot drop and don’t recognize the mobility challenge. Certain diseases, however, make it a clearly disabling symptom. Toe-Off makes that disability somewhat less disabling for young and old challenged walkers.

Foot drop can be associated with a variety of conditions such as flexor injuries, peripheral nerve injuries, stroke, neuropathies, drug toxicities, or diabetes. Basically, Foot drop can be defined as a significant weakness of ankle and toe dorsiflexion during movement as you walk and stand. You drag your foot while walking. Some compensate when approached by hills and steps by elevating the hip. The result is a Frankenstein-monster like foot drop that results in imbalance and consequences like frequent falls. On level ground, the feet drag on the surface. Carpets and walkway cracks can often be threatening as a foot fails to lift.

Allard ToeOFF is a leader among several manufacturers making devices known as Ankle Foot Orthoses for children and adults to help cope with chronic foot drop. These are braces that fit into shoes and create a rocking motion at the base of the foot. It helps the foot simulate a smooth walking gait by lifting the toes off the ground, as evident in foot drop cases.

Foot drop may also be evident in young babies who have difficulties toddling at toddling ages. They have difficulty standing and walking. Pediatricians may recommend a Supra Malleolar Orthosis (SMO) if the child is 18 months or older.

Up to age 3, the diagnosis is usually hypotonia. Hypotonia is the medical term for decreased muscle tone. Healthy muscles are never fully relaxed. They retain a certain amount of tension and stiffness (muscle tone) that can be felt as resistance to movement. When it comes to orthotic management of pediatric patients with hypotonia, the medical literature is only beginning to document the effectiveness that clinicians have been reporting anecdotally for years. There may be several reasons for hypotonia in babies, including nerve, muscle, and metabolic syndromes.

An SMO is shorter than an AFO and usually has a baby-friendly decoration. It will help babies stand. Walking may require physical therapies. Sometimes a pediatric physiatrist (medical specialist in rehabilitation medicine) may organize a team of multifaceted supporters. Small studies indicate that the SMO with phased rehabilitation may help children overcome foot drop and walking issues within a couple years. After that, genetic testing may be required to determine whether hypotonia is more of a symptom of another disease than a condition itself.

Hypotonia is not the same as muscle weakness, although it can still be difficult to use the affected muscles. Depending on the cause, weakness may sometimes develop in association with hypotonia. As people age, muscle weaknesses may develop along with normall loss of lean tissues. Hypotonia influences the movement, condition, and action of muscles.

Foot drop is very evident in diseases like Muscular Dystrophy, Cerebral Palsy, CMT, Stroke, and Multiple Sclerosis patients. An Ankle Foot Orthosis (AFO) helps relieve foot drop. It resembles a brace but it fits in most of your shoes. Worn beneath long pants or skirts, an AFO is practically invisible.

While an AFO may not directly repair dorsiflexor problems or neuro-muscular conditions, it helps deliver a near-normal gait when walking. The key is near-normal but that is a vast improvement. You may experience difficulty ascending and descending stairs. Your speed may be slow, but significantly faster than dragging. Your maneuverability may be somewhat compromised. Compared to foot drop, an AFO is a very significant mobilizer for the somewhat immobilized.

The Dorsi-strap is the least invasive AFO and also relatively inexpensive in the $150 range. While users should first consult a sports medicine doctor about using it, purchase does not require a prescription. The manufacturer seems to promote its use as a cure-all, even supportive for obese and big people, but the Dorsi-strap is really only effective for very mild foot-drop conditions.

For moderate and severe foot drop, dynamic braces are often prescribed. These are light, generally made of carbon fiber, a foot-length foundation is placed in your shoe and covered with shoe’s (or your) orthotic. A vertical support goes up and the brace attaches to your leg by one or two Velcro straps. A dynamic response Orthosis helps support a stable, balanced gait for walking and enable better posture while doing so. These are expensive but when you’re immobilized, they help you become (somewhat) mobile. They are covered by Medicare and most insurance providers.

Some people might say that, if you’re immobile, why not get a wheelchair or scooter? It’s a good question from an outsider’s view. There are classes of stubborn immobilized adults who want the illusion of mobility as a biped (not including cane support) in a world designed for most healthy people that can walk normally. There are fewer doctors and people aware of dynamic AFO devices so few are seen. They are used, though a minority compared to wheelchair devices.

Among dynamic AFO manufacturers, Allard’s Toe-Off family recognizes this for adults with varying degrees of disability. They also remember children who can suffer at many levels when confined to wheelchairs when they have foot drop as a main concern. Allard’s KiddieGAIT offers innovative options that have never been available for AFO management of these challenges. Functional environments can be created that supplement gait function instead of immobilizing and inhibiting that function.

Designed to provide dynamic toe-off assist with maximum control for the unstable ankle, Toe-Off is available in five sizes from X-Small to X-Large to fit children through adults. The unique, patented design features a lateral strut which “wraps” over the instep to provide maximum medial-lateral and rotational control of the foot and ankle complex, when none or little normally exist. Approximate weight variations are Size 01 (XS) weighs 3.6 oz., Size 02 (S) weighs 4 oz., Size 03 (M) weighs 4.9 oz., Size 04 (L) weighs 6.4 oz. & Size 05 (XL) weighs 6.7 oz. This permits an almost invisible sense of added weight. There is, however, a training period to get accustomed to the rocking support of these braces. Significantly advantageous, the Toe-off AFO fits into the shoe like an insole and accommodates most shoes without having to increase shoe size. New Balance sneakers are recommended for daily use.

Beyond the KiddieGAIT and the regular Toe-Off AFO, Allard has introduced the Toe-Off BlueRocker to their AFO family. BlueRocker is identical in shape and design as Toe-Off but offers more orthotic control. It is developed primarily for bilateral patients and those with more involved pathology. The extra stability will improve both balance and posture and give the wearer greater security, especially individuals with weak quadricep muscles.

It is also the most preferred orthosis to be used in conjunction with a socket and toe filler for management of partial foot amputations. Every BlueRocker should be padded on the inside towards the tibia crest. The SoftKIT padding system is designed specifically for use with BlueRocker for optimum patient comfort and product performance.

There are several other dynamic response AFO brands available for all degrees of foot drop. Helios (Helical Energy Loading Integrated Orthotic System) focuses on the category that the Toe-off BlueRocker targets. Helios is quite different as it does not use Velcro straps but requires a custom wrap-around shell for additional support. The double-helical construction is designed to correct skeletal structural deformities and provide an increase in walking function. This unique energy loading design offers the potential of normal walking. Because of its energy return in walking, the manufacturer claims there is less fatigue. Like the Toe-Off, it targets muscular dystrophy, peripheral neuropathy, CMT, Stroke, Cerebral Palsy, Polio, and many other neurological and muscular diseases that compromise function of the dorsiflexor.

If you find walking painful and your feet are consistently dragging, find a physiatrist or sports medicine doctor. These doctors study and serve patients with movement disorders. Orthopedists primarily deal with bones. A thorough exam will help form a diagnosis. Physical therapy may help most people. If it doesn’t, an AFO may be prescribed. Use a recommended practitioner.

I was advised to go to Prothotic Laboratory for my AFO orthosis. While there are hospitals and other providers, this place was highly recommended by my physiatrist. David Zwicker is their certified orthotist and was a pleasure to work with. He suggested the Toe-Off and considered the basic model as satisfactory. I must admit that, once I put the Toe-Off on, it seemed a radical improvement. As with a cane, I’d advise moving up to the Toe-Off BlueRocker for maximum strength and support, though it does require a suitable get-comfortable period. Zwicker offers seasoned experience and provides an intuitive, independent approach to help maximize comfort. When using an AFO device, your relationship with the orthotist is very important. Do not get an AFO unless you are certain that your orthotist is right for you. If you are in the New York City area, David Zwicker of Prothotics offers excellent service, although many pediatricians and physiatrists offer AFO and SMO devices.

There are varying degrees of foot drop and many reasons behind it. There’s no assurance that a dynamic AFO will get you running or even fast-walking. In cases of muscular dystrophy (and my Myotonic dystrophy), happiness comes from the ability to walk without foot drop, or the use of a wheeled scooter. The myotonia is still there and instability and weakness may dominate. Using the Toe-off offers significant help in walking from point-A to Point-B. Without the Toe-off AFO, trying to walk is a monstrous challenge. Be thankful that world technology is designing products to help the significant few sample the illusion of normalcy again.

Ultimately, an AFO or SMO is an aid to enhance mobility against foot drop due to weak muscles and nerves. Seeking medical or rehabilitation help may be advised to avoid accidents or falls is advisable.