Thursday, March 16, 2006
“Walking for exercise” advocate has some caveats
LOOKING FORWARD by Wally Dobelis
We have used our Southern winter getaways from the cold s and sniffles of New York to tone up the bodies, lose some weight and gather up some stamina for the coming year of strains and stresses of city life. Our main method for tune-ups has been walking, at a somewhat aerobic rate for my age group, three miles per hour. In fact, an hour a day, early enough not to be melted down by the hot sun has been our daily routine. We have a small group, up to half a dozen souls, enough to keep one or two conversations going while walking a circular half-mile route in a town park, with time out for stops when catching sight of any unusual birds, such as the green-bodied black headed screeching parakeets that flock to feed on the unripe green berries in a cherrylike tree.
Feeling strong and ready for a straight plunge into health, I jumped into the daily walk routine practically right off the airplane. A few stretches, a slow startup to get into gear were needed, but it worked, and I was briskly switching from one to two to three miles a day without interruption, under the pretext that in my day of life time is precious and must not be wasted.
This was fine with my younger walking companions, but over the next two weeks I became disturbed by a little nagging pain in my left hip that was growing, to the point that I would excuse myself after two miles and get in the car to fetch a copy of the New York Times, while my co-walkers finished the route.
Not good, and a visit to the local orthopedist was indicated. A physical therapist who had helped my family over the years for rotator cuff and knee problems brought me up to date – our old good doctor had retired, but there were two new ones. The office of the first, when called had no date available for two weeks; the second gave me an appointment the next day, albeit with a physician’s assistant.
This was fortunate – the physician’s assistant, also a high school football coach, had dealt with what he called “Fourth of July exercisers,” and their injuries for years, his office had knee and hip models and explicit color posters of all joints and bones. My x-ray showed minimal hipbone deterioration, not guilty, but his questioning and palpation pinpointed sacro-ileitis, an inflammation of the area where the hip joins the spine, as the problem area. My explanation that the pain grew with lengthening and speeding up of my stride clinched the diagnosis. I was right there with the men and particularly ladies who come for vacations and join the gyms such as the popular Curves for rapid tone-up of the bodies and loss of weight. Seeing the established local clientele joyfully go through a series of exercises using weight and walk/step machines, they tend go too fast too early, sometimes coming back more than once a day, despite the advice of the watchful coaches. Some of the zealous ones can end up with bursitis and tendon problems. In the workaday T&V Country, where we do not try to squeeze maximum exercise in a short vacation, these injuries are less prone to happen.
What to do? My coach prescribed Celebrex, an arthritis medication, and ordered the walking reduced, substituting swimming and bicycling as no-impact exercises. I should also put an icy compress on the back area after the exertions. That was fine, and the pains disappeared, except on days when sustained walking was needed. No icing, though. On a return follow-up visit my coach reinforced the advice about icing, reminding me that baseball pitchers, even after pitching practice, put ice compresses on their arms, and ordered me to get some support walking shoes such as New Balance.
Not too happy, I checked with a family friend, retired physician and another walking enthusiast, who reminded me of RICE, the acronym of cures for injuries: rest, ice, compression and elevation. He prompted me to look into COX-2 or cyclooxygenase, the pain enzyme that makes contact with cell-building arachadonic acid in the body, forming pro-inflammatory prostaglandins, and can be medicated with non-steroidal anti-inflammatory drugs (NSAID) such as Celebrex. Those are the tech terms. The NSAIDs have side effects, and one, Vioxx, has been recently taken out of use and the maker, Merck, has been sued.
One way or another, the results have been happy. I’m off the NSAID, my new shoes fit tightly, and after a while the sacro-iliac pains stopped. I am walking again a couple of miles a day, somewhat more slowly, keeping my back straight and no longer wobbling from side to side.
Please note that this is a cautionary tale of personal experience and not medical advice, and I am offering it to my neighbors whom I previously tried to hector into walking as a cure-all exercise. Moderation in all efforts, and consider alternatives, but do not stop moving.
Wally Dobelis thanks Dr. Miro Petani and offers congratulations to Sylvia Friedman, our new Assemblyperson.
We have used our Southern winter getaways from the cold s and sniffles of New York to tone up the bodies, lose some weight and gather up some stamina for the coming year of strains and stresses of city life. Our main method for tune-ups has been walking, at a somewhat aerobic rate for my age group, three miles per hour. In fact, an hour a day, early enough not to be melted down by the hot sun has been our daily routine. We have a small group, up to half a dozen souls, enough to keep one or two conversations going while walking a circular half-mile route in a town park, with time out for stops when catching sight of any unusual birds, such as the green-bodied black headed screeching parakeets that flock to feed on the unripe green berries in a cherrylike tree.
Feeling strong and ready for a straight plunge into health, I jumped into the daily walk routine practically right off the airplane. A few stretches, a slow startup to get into gear were needed, but it worked, and I was briskly switching from one to two to three miles a day without interruption, under the pretext that in my day of life time is precious and must not be wasted.
This was fine with my younger walking companions, but over the next two weeks I became disturbed by a little nagging pain in my left hip that was growing, to the point that I would excuse myself after two miles and get in the car to fetch a copy of the New York Times, while my co-walkers finished the route.
Not good, and a visit to the local orthopedist was indicated. A physical therapist who had helped my family over the years for rotator cuff and knee problems brought me up to date – our old good doctor had retired, but there were two new ones. The office of the first, when called had no date available for two weeks; the second gave me an appointment the next day, albeit with a physician’s assistant.
This was fortunate – the physician’s assistant, also a high school football coach, had dealt with what he called “Fourth of July exercisers,” and their injuries for years, his office had knee and hip models and explicit color posters of all joints and bones. My x-ray showed minimal hipbone deterioration, not guilty, but his questioning and palpation pinpointed sacro-ileitis, an inflammation of the area where the hip joins the spine, as the problem area. My explanation that the pain grew with lengthening and speeding up of my stride clinched the diagnosis. I was right there with the men and particularly ladies who come for vacations and join the gyms such as the popular Curves for rapid tone-up of the bodies and loss of weight. Seeing the established local clientele joyfully go through a series of exercises using weight and walk/step machines, they tend go too fast too early, sometimes coming back more than once a day, despite the advice of the watchful coaches. Some of the zealous ones can end up with bursitis and tendon problems. In the workaday T&V Country, where we do not try to squeeze maximum exercise in a short vacation, these injuries are less prone to happen.
What to do? My coach prescribed Celebrex, an arthritis medication, and ordered the walking reduced, substituting swimming and bicycling as no-impact exercises. I should also put an icy compress on the back area after the exertions. That was fine, and the pains disappeared, except on days when sustained walking was needed. No icing, though. On a return follow-up visit my coach reinforced the advice about icing, reminding me that baseball pitchers, even after pitching practice, put ice compresses on their arms, and ordered me to get some support walking shoes such as New Balance.
Not too happy, I checked with a family friend, retired physician and another walking enthusiast, who reminded me of RICE, the acronym of cures for injuries: rest, ice, compression and elevation. He prompted me to look into COX-2 or cyclooxygenase, the pain enzyme that makes contact with cell-building arachadonic acid in the body, forming pro-inflammatory prostaglandins, and can be medicated with non-steroidal anti-inflammatory drugs (NSAID) such as Celebrex. Those are the tech terms. The NSAIDs have side effects, and one, Vioxx, has been recently taken out of use and the maker, Merck, has been sued.
One way or another, the results have been happy. I’m off the NSAID, my new shoes fit tightly, and after a while the sacro-iliac pains stopped. I am walking again a couple of miles a day, somewhat more slowly, keeping my back straight and no longer wobbling from side to side.
Please note that this is a cautionary tale of personal experience and not medical advice, and I am offering it to my neighbors whom I previously tried to hector into walking as a cure-all exercise. Moderation in all efforts, and consider alternatives, but do not stop moving.
Wally Dobelis thanks Dr. Miro Petani and offers congratulations to Sylvia Friedman, our new Assemblyperson.
# posted by Wally Dobelis @ 5:48 PM 
