Medical questions answered

 

I often get pain and discomfort in my right knee and hip, I’ve been told that orthotics fitted into my shoes could help to realign the way I walk. Can you explain how they could help?

Our feet are the foundation of our body and carry our total body weight when standing and walking. The foot arches perform as shock absorbers. Because of this concentrated stress, the feet are often involved in deformities which will affect other joints of the body.

Your muscles keep you balanced when standing still and they perform with every step you take. They do so in a sequence of chains. The position of the foot will set off a chain reaction in your muscles starting in the foot, through the knees to your hips, pelvis and lower back.

For example, walking over the outside of the foot places the knee in the O-position and turns the hip inwards. On the other hand a collapsed foot arch brings the knee in the X-position and tilts the hip upwards. These changes in the natural position could eventually lead to joint problems.

More often than not this only happens in one foot and leg. 

When you stand in front of the mirror it is easy to see if your knees are in an X- or an O-position. The finer unbalance in foot- and body posture can only be seen by a professional podiatrist who uses a footscope and a footscan to check this. Following an analysis of your walking pattern the treatment of your right knee and hip might very well begin with the correction of your foot posture by using custom made footbeds.  Correcting and re-aligning your right foot will relax some muscles and activate others, relieving the stress in your right knee and hip.

It is very important that the footbeds are tailor-made for you and not standard as in your case the right footbed will be completely different from the left one.

I would recommend you to visit a podiatrist and find out your general posture. Good luck!

 

 

 

I was involved in a car accident recently and whilst I was checked out at the time and assured that everything was OK, the headaches I previously suffered from have magnified into migraines.  Can you help – please?

 

Ouch!  Most of us are aware of headaches which at best are annoying and at worst, with migraines, totally debilitating. The good news is yes, we can help.

 

There are various things that trigger migraines such as hormonal changes (3 times more women than men suffer from migraines) to different types of food and drink. The key word here is “trigger”, as the root cause of the problem is usually elsewhere. 

 

Research coming out of Australia points to the neck as being one of the major root causes of migraines, even if the sufferer does not think they have a neck issue. In layman’s terms, what this new research is saying is that if the nerve leading from the neck into the brain is irritated, it sends signals to the brain. If it fills a “box” full of irritant signals and if you top up that “box” with your particular trigger i.e. chocolate or cheese, and this “box” overflows, you get a migraine. What we therefore need to do is stop the neck from producing these irritant signals and therefore stop this “box” from filling up and overflowing”.

 

Migraine sufferers need to be very careful where they go for help, as neck treatments in the wrong hands can make matters much worse, rather than better. There are very specific and very gentle neck mobilisations that I have been taught and sufferers often can’t believe the outcome, their migraines simply dissolving away and often over a period of a few weeks, not recurring. 

 

Another treatment is this new and exciting Magnetic Resonance Therapy (MRT), the derivative of MRI scanner technology. MRT calms down bone inflammation, forces the body to re-grow and harden cartilage and allows the neck joints to move smoothly and freely.  This all leads to no nerve irritation signals so again, the “trigger” does not fill that “box” to overflowing!

 

I do hope this helps and hope you can get treatment for your migraines.

 

 

 

My chiropodist says that I have a bunion starting. I don’t want to end up like my mother, who had surgery and still had problems. Is there anything I can do?

 

 

 

First of all, do not worry, bunions are not heredity. The American College of Foot and Ankle Surgeons state “Bunions are most often caused by an inherited faulty mechanical structure of the foot. It is not the bunion itself that is inherited, but certain foot types that make a person prone to developing a bunion.”  In layman’s terms, it is all down to how you walk – your foot biomechanics – that causes the problem and it is how you walk that is inherited, not the bunion!

  This is good news because a biomechanical specialist, like myself, can assess how you walk and can easily correct any imbalances. So if you have the start of a bunion, you need to stop it now before it needs surgery and remember, medicines will not reverse the condition, a bunion will only get worse. 

  In the short term, ice the area to reduce any inflammation, but as the problem is usually a biomechanical one, a biomechanical solution needs to be found. In this regard, the use of prescriptive orthotics is widely accepted in the medical community, clinical studies verifying the value of orthotics in relieving foot related issues, including bunions.

With bunions being preventable, they should rarely require surgery but if this is necessary, the operation is not only uncomfortable, but the bunion will inevitably return because it is the way you walk (your foot biomechanics) that caused it in the first place and this does not change with surgery. Any good surgeon will advise wearing orthotics after bunion surgery, so personally, I think it makes sense to wear orthotics as a preventative measure and avoid the need for surgery.

 

I hope this helps.

 

 

 

 

 

I work in front of my computer most of the day and though I do try to get up every now and again and have a walk around, I seem to always have a stiff neck and shoulders in the evenings. A friend said this could be due to my seating position during the day. Is there anything, like certain exercises, that I can do to try and stop this stiffness?

 

 

Yes – your friend is right in that your computer position is of paramount importance, possibly even more so than the exercises which ideally should be done every 20 minutes.  You need to sit straight in front of the computer, not to the side or twisted, with the screen at a comfortable reading distance and with the top slightly below eye level.  If you are using a lap top, you may need to use an angled stand and/or adjust your chair height.  When sitting upright and correctly, bend your elbows 90 degrees and where your hands are, your keyboard and mouse should be!  Any deviations will give you problems, especially in the long term.

 

As for some easy exercises (every 20 minutes);

1. Gently stretch your neck to the side away from your dominant hand.  Hold each stretch for a deep breath and repeat to the other side.  Do this 2 – 3 times.
2. Lower your arms and simply give them a good shake circling your wrists and wriggling your fingers.
3. Push your elbows together behind your back and stretch the front of your chest. Hold for 5 seconds and repeat 2 – 3 times.
4. Roll both shoulders backwards a couple of times helping release any tension.
5. Also, a couple of good, deep breaths will help relax the body and importantly, will aid your concentration.

 

If you are starting to have problems, the sooner they are treated the better the outcomes.  Use pain or discomfort as a prompt to re-organise yourself and remember, “an ounce of correction is worth a pound of cure”!

 

 

I am 56 years old and in very good shape, performing a substantial amount of exercise each week. I run 3 times a week, play tennis at least once a week and play golf twice a week. For the last couple of weeks I have been noticing a slight decrease in my exercise capacity. I get short of breath quicker than before. I can still get through my tennis match, but I do feel worn out. My wife says I am just getting older, which of course I don’t want to believe. Any advice?

 

Mark. 56.

 

Shortness of breath when exercising is a common problem and the underlying reason can vary from bad physical shape, to age and even severe lung and heart disease. The spectrum is wide and clearly requires thorough investigation to find the cause. What seems a little worrying in your case is the fact that you have been able to exercise without any problems until a few weeks ago, which makes your wife’s diagnosis rather unlikely. The first things that come to mind are heart problems that occur with exertion, like coronary heart disease, valvular heart disease that has been progressing and of course lung conditions like asthma – especially allergic asthma and other types of obstructive or restrictive lung diseases. Another often forgotten reason for shortness of breath is anemia.

What I do recommend is a detailed physical exam and a complete check-up of your heart and lungs. A simple ECG shows arrhythmias, an echocardiography will show any structural heart problems, including the pumping capacity of the heart muscle and the integrity of the valves. A stress test, an ECG run during defined exercise, will show any problems with your coronary arteries, the oxygen supply to the working heart muscle. Should this be positive, you would need a heart catheter investigation to treat blockages in your arteries and to prevent a possible heart attack. Further tests should include lung function testing and blood analysis looking for anemia and thyroid problems.

In general it takes about 2-3 hours to get everything done. Should all the tests be ok, then you know, it’s nothing serious and you should start thinking about other things you might have done differently in the last couple of weeks. Have you gained weight? Is your professional or private life more stressful than it used to be? Is there more alcohol involved? Life style changes can also disturb our inner balance.

In any case, your first step should be a consultation with your physician and cardiologist.

 

 

 

 

I am a 21 year old tennis player. I have always been healthy and cannot complain about any problems. Still, recently there have been so many reports in the media concerning sudden heart problems in young, healthy athletes and it actually makes me feel insecure about my health. What can I do to feel safer with my training?

 

Lucy.

 

 

Sudden cardiac death is not such a new problem as the media makes us believe. And of course it is not worth panicking about it.

But, as we usually like to say, it is better to be safe than sorry, so yes, you might want to go for a heart check up and evaluate your individual risk factors for heart disease. The cases of sudden heart death that we do hear about are due to so called arrhythmias which lead to a short cut in the electrical system of the heart, which then stops pumping and the person drops dead. The underlying causes for such problems could be rare heart conditions which are genetic, like the Arrhythmogenic, Right Ventricular Cardiomyopathy or diseases of the electrical System like the WPW-Syndrom, just to name a few. The thickening of the heart muscle, which happens automatically when the person is training hard, can also cause some problems. Another important aspect is your family history. If there are heart problems in your family or even someone who has died unexpectedly, you might be at risk and should get an evaluation.

What we recommend is a thorough heart check, which should be done by a cardiologist, since only specialists have encountered enough such sophisticated cases to feel comfortable with making a diagnosis. With the help of a heart ultrasound we can look for structural and functional problems of the heart muscle and the heart valves. The holter-ECG examination does help us evaluate for electrical problems over a longer period of time and the stress ECG shows us the electrical performance during exercise. In some rare cases it is indicated to look for genetic causes of possible diseases, which can be done by a simple blood test.

So, if you are worried and looking for a peace of mind, find a cardiologist near you and discuss it with them in detail.