Weight control can be quite a challenge and I applaud your effort. Proper, permanent weight loss takes time so be patient. Your best program combines healthy eating with proper exercise. Neither diet nor exercise alone is as effective as when the two are combined in to a one-two punch.

Learn about your foods and beverages by learning to read labels. Keep your fat intake low (not easy because it is hidden everywhere), keep your portions small (not easy in the USA where portions are huge), eat plenty of fruits and vegetables, and drink 8 – 8oz. glasses of water a day. Learn to count calories. For every 3500 calories you go into debt, thru proper eating and exercise, you lose 1 pound. If you can drop 500 calories a day, you lose 1 pound a week. Relatively slow but safe. It’s about both the quantity and quality of the food and beverages you consume.

For exercise build up to 30-45 minutes of aerobic exercise (walking, cycling etc.) 4 or 5 days out of the week. Strength training is essential to fat loss and weight control. Muscle tissue is highly active from a metabolic standpoint and having more muscle or “lean” tissue on your frame helps you burn more calories both during activity and even at rest. 2 or 3 weight training sessions a week, working all major muscle groups, is all you need. Never work the same muscle group two days in a row to allow for recovery and growth.

As you can see, I’m not a big believer of any “fad” diets or extreme diets. Most individuals don’t need them. They are hard to sustain for the long run and this is why so many individuals see great results initially only to fall off the wagon and re-gain all lost pounds, and then some. I prefer sustainable lifestyle changes that you can commit to, for life. It’s like the difference between a lasting marriage and a Hollywood one.

Always check with your doctor before starting any new exercise or diet program especially if you have any medical or orthopaedic issues.

Each knee has two menisci. These C-shaped rubbery type shock absorbers are on the medial (medial meniscus) and lateral (lateral meniscus) side of the knee. If you develop a “cartilage tear” the treatment depends on the size, type, and location of your tear and whether there are other factors in your knee such as ligament tears or arthritis. Sometimes it is correct to remove a piece of the cartilage and other times it can be repaired, and that is best determined by your surgeon at the time of surgery when they directly visualize your cartilage or meniscal tear through the arthroscope.

If the meniscus is repaired and saved the recovery is usually longer but in the long run it is better for your knee. Age is also a factor. The younger you are, the more likely your meniscal tear can heal, and efforts should be made to try to save it. Also, if you are young and have had your entire meniscus removed and you are having symptoms, there are some new alternatives. A donor meniscus from a cadaver (meniscal allograft) can be transplanted into your knee. This is a promising technique and the long term effects are not known for certain, but it seems to be an excellent alternative in select situations, especially younger patients who have lost significant meniscus.

If all or even part of your meniscus has been removed then you have lost some shock absorption in your knee so it becomes even more important to build up the external shock absorbers around your knee which means strength training and muscle building, especially your quadriceps muscle on the front of your thigh. Also, you can also reduce the stresses placed on your knee joint by keeping your weight down and avoiding higher impact activities such as running.

Here’s a video of one athlete’s meniscus surgery experience.

I believe that chiropractic work can help with certain more acute low back and spinal problems such as yours. Chiropractic manipulation seems to help individuals get over the acute episode of back pain quicker than if they let their body heal on its own. If you continue to have these episodes I certainly would get them checked by an orthopaedic surgeon or spine specialist.

I also think it would be great for you to start certain preventive measures. A short course of physical therapy can teach you a variety of preventive exercises specifically for your back and they can also give you “back school” type information that teaches you how to lift properly, bend properly and avoid recurrent strains. Sitting, especially in a car, results in very high forces and strain to the lower back area, especially the spinal discs, so you need to be sure that your car seat is properly adjusted and consider the use of a lumbar support.

Also, avoid long rides without getting out and walking around a little bit. At the gym you should add exercises to strengthen your “core” muscles, something easily done on the large “beach balls” (known as Swiss Balls or Thera-Balls) that you might see lying around. Focus on building your torso area such as your abdominals, obliques and your spinal extensor muscles.

While I do believe that occasional chiropractic work can help, I would not recommend it long term with continuous repeat visits. I work with many chiropractors and feel that they have a tremendous amount to offer as part of the healthcare team. I am the orthopaedic consultant for the Philadelphia 76ers Basketball Team and our chiropractor, Dr. Neil Liebman, helps our players tremendously and helps keep them in the game.

You, like many active individuals in your age group are in that middle ground in terms of treatment options for your arthritic knee. You have been through several surgeries already and unless there is something very specific such as a new torn cartilage or loose body more arthroscopic surgery is not the answer. There comes a point where repeat, relatively minor arthroscopic surgery procedures really don’t offer much. You are young for knee replacement surgery and hopefully your arthritis is not yet at that point.

There are some treatment options for you and usually it is a combination of things that can help keep you active and comfortable in terms of your knee. Hopefully you can also avoid or prevent the knee from knee replacement down the line. Keeping your weight down is essential. Every extra pound you carry puts significant weight on your knee, in fact, with certain activities your knee senses 4 or 5 pounds for every 1 extra pound that you carry. Keeping your legs strong is also very important especially your quadriceps muscle on the front of your thigh. Weight training and stationery cycling are excellent in that regard.

Occasional cortisone or steroid injections could be helpful especially around times of significant flare-ups. Certain supplements are very effective in helping to control osteoarthritis symptoms and I would recommend Glucosamine and Chondroitin Sulfate. My preference is Cosamin DS because in the supplement world brand does matter and you want to be sure you are getting the best of ingredients. Tumeric is another supplement that has also been shown to help osteoarthritis.

There are also other newer non-surgical alternatives such as Viscosupplementation (VS). VS agents are a gel that can be injected into your joint and act as a “lubricant” for your creaky knee. It may help control inflammation and even possible protect the joint, although more research is needed in that regard. If patients respond, pain is often reduced and function improved for up to six months. I have had some patients actually get one year or more remarkable improvement of their symptoms. More recently, injections like PRP (Platelet-Rich Plasma, where your blood is drawn and spun down in a centrifuge, and the growth factors from the blood are injected in your knee) have shown even better clinical results than viscosupplementation. Here’s the latest research regarding PRP for arthritis. In the relatively new field of regenerative medicine, even newer options like stem cell injections are being used to manage arthritis. All of these novel options may help younger athletes and other patients postpone, or maybe even someday completely avoid, a knee replacement!

Depending on the pattern of wear in your knee, you may be a candidate for other non-arthroscopic surgical procedures (i.e. osteotomy or partial joint replacement). There are also many newer regenerative surgical technologies that might prevent you from ever having to actually have a knee replacement. The future is very bright in this area!

It sounds like you are on the right track to better bone health. In addition to calcium supplements you need to look closely at your diet and be sure that you are taking calcium rich foods in your meals since that calcium is absorbed much better than any supplement. Avoid soft drinks like sodas that contain phosphorus and blocks calcium absorption.

Talk to your family doctor about any possible medical conditions such as thyroid dysfunction that may be contributing to accelerated bone loss. Continue your exercise but remember that it needs to be weight bearing, and that only those bones that are experiencing direct “stress” will get stronger. For example, walking will strengthen the bones in your legs and hip but not your wrist area. A good weightlifting and strength training program is best for targeting all of your bones and should be included in your exercise program.

Also, since you have already gotten a fracture at a relatively young age, and have a family history of osteoporosis, you should absolutely have a Dexa Scan. These are very simple, non-invasive test that requires very little time and no pain. It gives great information about your bone density and bone health and can serve as an important baseline for you to monitor bone gain or bone loss over the years. It can also help determine if you need any newer medical treatment options to build bones and/or prevent further bone loss. I would have the Dexa Scan repeated in approximately 2 years to check your progress.

Although it is happening in droves to the baby boom generation, it can happen to anyone whose body or frame has picked up some dings along the way.

In addition to the physical ailments such as tendinitis, arthritis and bursitis, Boomeritis has another component. “Fix-Me-Itis” is the mindset typical of the baby boomers who don’t want to deal with the changes their body is experiencing and want things fixed, now. It’s part of their never ending quest to try to turn back the clock.

Boomeritis is a new ailment that we will be seeing much more of as time goes on. For more on the history of Boomeritis, as well as some Boomeritis links, click here.

Hamstring injuries are very common in runners, especially sprinters. Runners never stretch enough and tight hamstrings are almost a guarantee. Tight hamstrings are more likely to be injured.

It sounds that you need to spend some time away from running, doing more cross-training activities such as swimming or cycling and also getting into a good rehabilitation program geared towards preventing recurrent muscle strain. Once a muscle is strained it sometimes heals with some scar tissue which is even tighter then the tight muscle you started with.

Therapy involves the use of certain modalities such as ultrasound or heat to help the healing process. Also proper preventive stretching and strengthening is essential. When strengthening the muscle it should be strengthened in both the positive (concentric) and negative (eccentric), phase. Eccentric muscle strengthening, also known as a lengthening contraction (the movement when lowering the weight), is often neglected but very useful in prevention of muscle strains. Eccentric strength training should be done slow and controlled and is great to prevent recurrent muscle pulls. Also, be sure to warm-up properly and stretch before running- and stay well hydrated.

The kneecap or patella is a common area for instability or looseness- especially in teenagers. This results in episodes of subluxation (kneecap partially slips out of place) or a full dislocation (kneecap completely pops out of place). Some individuals are more “loose-jointed” than others and are more prone to these episodes. This happens especially in teenage girls who tend to be more “loose jointed”. It is also related to genetics and knee alignment.

Every patellar dislocation should be evaluated by an orthopaedic surgeon who can best determine your treatment. Proper rehabilitation is essential since strengthening certain muscles, and stretching other ones, can help prevent recurrence. There are also certain patellar stabilizing knee sleeves that can help prevent episodes of patellar instability during sports.

If your daughter is lucky enough to avoid surgery with rehabilitation, then preventive exercises need to become a lifetime habit. I see many young athletes who do well with preventive rehabilitation and once they stop the home exercises, problems arise again. Don’t let that happen to your daughter.

“Burners” are fairly common in football and other collision sports. They usually happen when making a tackle. If your shoulder is used in the tackle and your head is tilted away from that shoulder, a sudden stretch of the brachial plexus network of nerves, under the collarbone, can result in the “lightening bolt” that you felt. It is basically a stretched nerve.

Most of these resolve within a few minutes but sometimes some weakness can occur and you should be checked for this when one of these episodes occurs. I am concerned about the recurrent burners that you are experiencing and I would ask you to remain out of football until this is properly checked. You should be checked for any residual weakness or nerve damage, and also the possibility of symptoms coming from your cervical spine or neck area which can also easily be injured in football.

Be sure you are using proper tackling technique and that your equipment, especially shoulder pads, are properly fitting.

Dance is a very demanding sport and craft, placing tremendous stresses especially on the foot and ankle area.

It takes many years of training to develop the strength, balance, and endurance needed for pointe work. It is important not to rush this. Usually dancers need to be in training intensely for at least 4 years, and their foot needs to be more mature, approaching adult size but not necessarily fully grown.

Usually dancers who have been training 4 years or so and are at the age of 11 or 12 are ready to go on pointe, especially if their instructors feel that they have developed adequate protective strength and endurance in the lower leg, foot, and ankle muscles.

All young dancers want to reach this milestone but it is important to let them know that their training can still be advanced and improved on demi-pointe and that once pointe work is introduced, it should be gradual and monitored.