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Tag Archives: Research

Find Balance during the Holidays

Start your day with the stork pose to help you find balance during the holidays.

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What better way to center yourself during this busy time than with a yoga pose that promotes strength and balance? Yoga’s stork pose helps you focus the mind and calm the body. It’s just what you need when your days are filled with shopping, cleaning, cooking, travel and social events. Ready to be flooded with zen? Simply stand tall and focus your gaze at a point in front of you. Gently lift one foot and try to stand on the opposite leg for as long as you can. If you falter, just put both feet back on the ground and steady yourself; then try again. Keep your gaze on that focal point, breathing gently and evenly. If you’d like more of a challenge, rotate your raised ankle and draw circles in the air with your foot. Return your foot to the ground and repeat on the other side. You can even practice stork pose while standing on line at the bank or grocery store. It will help you float through your errands gracefully.

 

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Top 5 Things You Need to Know About a Superior Labral Tear

Understanding how a SLAP lesion occurs and what exactly is happening pathologically is extremely important to diagnose and treat these shoulder injuries appropriately.

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Classification of SLAP Lesions
There are several variations of injuries that can occur to the superior labrum where the biceps anchor attaches (see the above figure to view the biceps attaching into the labrum). Following a retrospective review of 700 shoulder arthroscopies, Snyder et al: Arthroscopy ’90 identified 4 types of superior labrum lesions involving the biceps anchor. Collectively they termed these SLAP lesions, in reference to their anatomic location: Superior Labrum extending from Anterior to Posterior. This was the original definition but as we continue to learn more about SLAP tears, they certainly do not always extend from anterior to posterior. But, the most important concept to know is that a SLAP lesion is an injury to the superior labrum near the attachment of the biceps anchor.

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Type I-IV SLAP lesions from left to right

•Type I SLAP lesions were described as being indicative of isolated fraying of the superior labrum with a firm attachment of the labrum to the glenoid. These lesions are typically degenerative in nature. At this time, it is currently believed that the majority of the active population may have a Type I SLAP lesion and this is often not even considered pathological by many surgeons.

•Type II SLAP lesions are characterized by a detachment of the superior labrum and the origin of the tendon of the long head of the biceps brachii from the glenoid resulting in instability of the biceps-labral anchor. These is the most common type of SLAP tear. When we receive a script from a surgeon to treat a “SLAP repair” he or she is more than likely talking about a Type II SLAP and surgery to re-attach the labrum and biceps anchor. Three distinct sub-categories of type II SLAP lesions have been further identified by Morgan et al: Arthroscopy ’90. They reported that in a series of 102 patients undergoing arthroscopic evaluation 37% presented with an anterosuperior lesion, 31% with a posterosuperior lesion, and 31% exhibited a combined anterior and superior lesion. (33) These findings are consistent with my clinical observations of patients. Different types of patients and mechanisms of injuries will result in slightly different Type II lesions. For example, the majority of overhead athletes present with posterosuperior lesions while individuals who have traumatic SLAP lesions typically present with anterosuperior lesions. These variations are important when selecting which special tests to perform based on the patient’s history and mechanism of injury. We’ll get to this in a future post on all the different clinical tests for SLAP tears.

•Type III SLAP lesions are characterized by a bucket-handle tear of the labrum with an intact biceps insertion. The labrum tears and flips into the joint similar to a meniscus. The important concept here is that the biceps anchor is attached, unlike a Type II.

•Type IV SLAP lesions have a bucket-handle tear of the labrum that extends into the biceps tendon. In this lesion, instability of the biceps-labrum anchor is also present, similar to that seen in the type II SLAP lesion. This is basically a combination of a Type II and III lesion.

What is complicated about this classification system is the fact that the Type I-IV scale is not progressively more severe. For example a Type III SLAP lesion is not bigger, or more severe, or indicative to more pathology than a Type II SLAP lesion.

To further complicate things, Maffet et al: AJSM ’95 noted that 38% of the SLAP lesions identified in their retrospective review of 712 arthroscopies were not classifiable using the I-IV terminology previously defined by Snyder et al (49). They suggested expanding the classification scale for SLAP lesions to a total of 7 categories, adding descriptions for types V-VII. (29)

•Type V SLAP lesions are characterized by the presence of a Bankart lesion of the anterior capsule that extends into the anterior superior labrum.
•Type VI SLAP lesion involve a disruption of the biceps tendon anchor with an anterior or posterior superior labral flap tear.
•Type VII SLAP lesions are described as the extension of a SLAP lesion anteriorly to involve the area inferior to the middle glenohumeral ligament.

These 3 types typically involve a concomitant pathology in conjunction with a SLAP lesion. Although they provided further classification, this terminology has not caught on and is not frequqntly used. For example, most people will refer to a Type V SLAP as a Type II SLAP with a concomitant Bankart lesion. Since then there have been even more classification types described in the literatue, up to at least 10 that I know of, but don’t worry, nobody really uses them.

Top 5 things you need to know about classifying SLAP lesions

1.Just worry about Type I-IV SLAP lesions and realize that any classification system above Type IV just means that there was a concomitant injury in addition to the SLAP tear.
2.You can break down and group Type I and Type III lesions together. Both involved degeneration of the labrum but the biceps anchor is attached. Thus, these are not unstable SLAP lesions are not surgically repaired. This makes surgery (just a simple debridement) and physical therapy easier.
3.You can also break down and group Type II and Type IV lesions togther. Both involve a detached biceps anchor and require surgery to stabilize the biceps anchor. Type IV SLAP tears are much more uncommon and will involve the repair and a debridement of the bucket handle tear.
4.Type II lesions are by far the most common that you will see in the clinic and are almost always what a surgeon is referring to when speaking of a “SLAP repair.”
5.We all may have a Type I lesion, it is basically just fraying and degeneration of the labrum.

source: MikeReinhold.com
Image via Wikipedia

 

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Nutritional Bang for your Buck

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Get big nutritional bang for your buck with potatoes, greens and beans. They deliver the most nutrients per penny.

Trying to figure out how to squeeze more nutritious food from your budget? Add potatoes, greens and beans. A cost analysis found that these foods provide the most nutrients per penny and that tubers offer the best nutritional value in the produce aisle. Potatoes are a valuable source of potassium, vitamin C, magnesium and fiber, especially when eaten, after cooling, with the skin. They cost just 11 cents per one-cup serving and are filling to boot. Greens are simply a nutrition powerhouse. Canned or dried beans are an inexpensive and healthful alternative to meat, which is often among the priciest items at the supermarket. “Protein sources like beef, turkey, fish and chicken can be really expensive,” says Amy Jamieson-Petonic, MEd, RD, director of wellness coaching at the Cleveland Clinic, “but if you buy beans and lentils, you’re getting a lot more for your money.” One cup of beans supplies a third of a woman’s daily protein needs.

 
 

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Pink Noise & Sleep…it’s a Good Thing

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Sleep more soundly with pink noise — a low-frequency version of white noise. Playing it while you sleep improves the quality of your zzz’s.

Here’s good news for light sleepers: Adding pink noise to your bedtime routine could help you sleep better. Similar to white noise, the pink variety has a lower frequency and sounds like gentler, more muted static. Researchers found that 75 percent of sleepers reported a more restful sleep when exposed to pink noise while they slept. Brainwave activity showed that stable sleep time of people listening to pink noise increased by 23 percent.

source: The Cleveland Clinic Wellness site

 

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Gentlemen…

protect your prostate by eating olive oil and nuts. Choosing healthy fats over the saturated kind can help you live longer.

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Men, improve your chances of a long and healthy life by choosing olive oil and avocado over butter and mayo. Research shows that men who swapped 10 percent of their daily calories from animal fats with healthy fats like olive oil, seeds, avocados or nuts were 30 percent less likely to die from prostate cancer and 25 percent less likely to die from any other disease compared to those who did not make the switch. Even a single daily tablespoon of oil-based salad dressing, such as balsamic vinaigrette, resulted in a noticeable drop in mortality risk. To protect your health and enjoy delicious flavor, use oil and vinegar instead of cream-based dressings and cook your food with extra virgin olive oil instead of mystery “vegetable” oil.

 
 

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Mean People….Just Stay Positive

CC_Wellness TipTo deal with mean people, “Stay positive and courteous,” says mind-body coach Jane Ehrman. “Fighting back only fuels the problem.”

From rude coworkers to short-tempered bosses to impatient drivers, mean people do make an appearance now and then. As we all know from experience, being the recipient of someone else’s antagonistic behavior can really bring us down, even on an otherwise great day. Research shows that a negative interaction has a five times greater impact on us than a positive one. In other words, it takes five good things to offset just one bad thing. So how do you keep a mean person from ruining your day? Instead of attacking back, kill that meanie with kindness. And treat yourself with kindness too. Sometimes we don’t want to admit that someone has gotten under our skin. Instead of denying your hurt feelings, acknowledge them.

As for the other person, try to see past their actions. “Mean-spirited people are unhappy, to say the least. Inside they are hurting, living out of fear, insecurity and anger. They don’t feel good about themselves or their lives, so they lash out at others,” says Jane Pernotto Ehrman, MEd, mind-body coach and behavioral health specialist at the Cleveland Clinic Wellness Institute’s Center for Lifestyle Medicine. “Mostly, it isn’t about you, it’s about them. Recognizing that there are underlying issues can make it easier for you to respond with compassion and understanding. Take the high road and respond with kindness.” After all, while you can’t change another person’s behavior, you can change your reaction to him or her. Being kind to someone who has hurt you may inspire that person to see the good in themselves as well.

 

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Stay Away from the Market when you’re Hungry…

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If you need to stop by the market on your way home from work, eat a healthful snack first to avoid splurging on high-calorie items.
Dropping by the grocery store on your way home from work? Here’s why that could make it harder for you to maintain a healthy diet: Research shows that even short-term food deprivation (like the hours between lunch and quitting time) is enough to make you buy nutritionally bankrupt food. A better time to shop: after you’ve already eaten. If you know you’re stopping by the market on your way home, be sure to have a healthful snack first. Keep a small fruit bowl on your desk, or stock some nuts, sunflower seeds and dried fruit in your drawer. Other good choices to keep in the office fridge: baby carrots, hummus, no-fat string cheese and no sugar added Greek yogurt.

 

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Don’t Lose Sleep!

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Don’t let work eat into your sleep. Lack of rest is the biggest predictor of on-the-job burnout.
Are you letting your job impact your sleep? According to a study published in the journal SLEEP, the more hours a person works, the less sleep he or she gets. According to the Centers for Disease Control and Prevention, 30 percent of employed Americans get less than the recommended seven to nine hours of sleep a day. Though you may not feel especially tired, lack of sleep could be affecting your performance at work. One study found that sleeping less than six hours a night was one of the best predictors of job burnout. Another study calculated that our collective lack of sleep costs U.S. businesses and medical centers $63.2 billion a year in lost productivity. In other words, you’re actually doing yourself — and your career — a disservice by letting work take away from your sleep time.

 

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