Exercising prior to joint replacement quickens recovery time. Indoor rowing is great.

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Exercise Prior to Hip and Knee Replacement Reduces Need for Inpatient Rehabilitation

HOBOKEN, NJ -- September 29, 2006 -- Osteoarthritis is increasingly common among aging Americans and is the leading cause of disability in the U.S. Exercise is often used in treating osteoarthritis and is an important part in rehabilitation following joint replacement.

The level of function prior to knee and hip replacement has been shown to be strongly related to function after surgery, yet little is known about the effects of exercise on patients with end-stage osteoarthritis. A study published in the October 2006 issue of Arthritis Care & Research examined whether an exercise program prior to hip or knee replacement would benefit patients in terms of function, pain, and muscle strength before or after surgery.

Led by Daniel S. Rooks, ScD of New England Baptist Hospital, Beth Israel Deaconess Medical Center and Harvard Medical School in Boston, MA, the study included 108 patients scheduled to undergo hip or knee replacement between November 2001 and November 2003.

The patients were divided into two groups: 54 patients participated in water and land-based exercise three times a week for the six-week period immediately before surgery and 54 controls received educational materials. Prior to surgery all patients were questioned about their level of function and were evaluated in terms of lower-extremity strength, balance, and mobility. The exercisers participated in strength training, aerobic and flexibility exercises that were individually tailored to each person's fitness level, performed in a group and supervised by a physical therapist.

The results showed that patients who exercised reduced their odds of discharge to an inpatient rehabilitation facility by 73%. "The potential economic implication of this finding is noteworthy and should be examined in future studies, particularly with the rise in inpatient rehabilitation use," the authors note. The exercisers were also more likely to walk more than 50 feet at the time of hospital discharge. Those who exercised responded differently before surgery and immediately following surgery depending upon the joint replaced: although patients who exercised increased lower-extremity muscle strength, only those undergoing hip replacements showed improved function before surgery.

"Our findings show that an appropriately designed program of water and land-based exercise involving cardiovascular, strength training, and flexibility activities can be a safe, well tolerated, and effective approach to improving function and muscle strength in middle-aged and older adults with severe osteoarthritis of the hip and knee," the authors state.

They point out that patients participated in strength training for only 3 weeks (9 sessions), which is well below the recommended duration required to bring about significant strength gains. They suggest that the increase in strength was due to a combination of increased neuromuscular coordination and a reduction of fear about anticipated pain associated with increased muscular effort. They note that knee replacement patients would probably need to participate in strength training for a longer period of time in order to experience increased function prior to surgery.

The fact that the patients responded differently depending upon what joint was being replaced suggests the need for different approaches for people with osteoarthritis of the hip and knee. Also, because several participants who dropped out of the study did so because of the travel required to get to the group exercise location, the authors suggest that future studies should consider the location and convenience of the exercise sessions.

They conclude: "Additional attention should be placed on testing postoperative interventions for building on preoperative gains in function and fitness, adapting the intervention more successfully for the TKA [knee replacement] population, and examining the cost effectiveness of exercise for patients undergoing total joint replacement."

REFERENCE:
"Effect of Preoperative Exercise on Measures of Functional Status in Men and Women Undergoing Total Hip and Knee Arthroplasty," Daniel S. Rooks, Jie Huang, Benjamin E. Bierbaum, Sarah A. Bolus, James Rubano, Christine E. Connolly, Sandra Alpert, Maura D. Iverson, Jeffrey N. Katz, Arthritis Care & Research, October 2006; (DOI: 10.1002/art.22223).


SOURCE: John Wiley & Sons, Inc.

Xeno Muller, Olympic gold and silver medalist, indoor rowing, rowing technique.

Fighting Cancer through aerobic exercise such as rowing is the way to go!

This is a nice short article which underlines the benefits of aerobic training to stay healthy and help prevent cancer. The benefits of rowing as arguably the greatest form of exercise is still pretty unknown to the general public and many doctors and writers... In this article dragon boat paddlers are wrongfully called rowers. This is a good mistake because even though they did not mean the true form of rowing, the article came up on the rowing website www.row2k.com. In the end rowing is so superior to any other form of aerobic exercise because of of its full body motion and ZERO impact movement. Ok, I am getting off my rowing high horse, enjoy the article. XENO over and out.


Cancer prevention through exercise



By Margaret Evans
Sep 26 2006

Fourteen years ago, I was diagnosed with breast cancer. It was caught in its early stages and treated with surgery, chemo, and radiation. I spun through the fear-driven loop of ‘what if…’, ‘why me…’, ‘how come…’ But I got on with practical living and adopted a holistic recovery approach by staying fit. I’ve always ridden horses but that’s not aerobic from a cardiovascular point of view, except for the horse. So, to be fit to ride and to use fitness to distance myself from cancer, I took up jogging and resumed with more focus a regimen of yoga exercises.

I had a stubborn belief that exercise and some kind of fitness regimen would be helpful for recovery and staying healthy. Turns out, I wasn’t too far off track in linking exercise and cancer recovery. Current science is pointing toward fitness as a means to keeping breast cancer at bay.

Donald McKenzie, a professor and cancer researcher at the University of British Columbia’s Faculty of Medicine, specializes in sports medicine and exercise. His pioneering research into lymphedema, the accumulation of upper body fluids in people who have had their lymph nodes removed or radiated as part of cancer treatment, led him to theorize in 1996 that strenuous, upper body exercise like rowing might alleviate the build up of fluids and other complications from lung diseases. His theory led to the launch of the celebrated Dragon Boat races, the rowers all breast cancer survivors.

His theory begged answers to two tantalizing questions: Could exercise help prevent the onset of breast cancer and could exercise help prevent a recurrence of the disease? According to many recent studies across Canada, the results are leaning toward a very encouraging yes.

“There have been some good studies done,” said Dr. McKenzie. “The vast majority show that aerobic exercise has benefits to help prevent the onset of cancer with as much as a 30-40 per cent reduction in risk. In terms of primary prevention (to prevent breast cancer) the results are clear. For secondary prevention (to prevent recurrence of breast cancer) exercise makes sense.”

Why?

Across the country there have been over 200 studies in recent years focused on the link between cancer and exercise. A few facts are emerging. Regular aerobic exercise changes hormones, reduces obesity, and lowers fat levels. The current focus is gauging what exercise-induced changes occur to the metabolic system, insulin levels, and key hormones like estrogen and androgen.

Breast cancer is a hormone-influenced disease. Estrogen and androgen levels rise in post-menopausal women. Hormones are produced in body fat and if women have significantly increased their weight by over 12 kg since age 18, they could increase their exposure to risk by perhaps 40 per cent. But as exercise burns body fat it lowers hormone levels, therefore lowering the risk.

“It is generic exercise,” said Dr. McKenzie. “Women need to do something aerobic like walking or jogging.”

How long should each session be? How many times a week? To what intensity? Gym work? Distance running? Power walking? Cross-over sports? Interval training? An ongoing study at the University of Alberta involves 330 cancer-free women between 50 and 74 years of age who have been put on an intensive five-day-week exercise program for the first time in their lives. Their blood and body fat levels will be scanned and scrutinized to find links between exercise-induced changes and body chemistry. Results are expected this fall.

Exercise not only combats breast cancer but it also appears to be valuable for other forms of cancer including colon, lung, endometrial and possibly prostate cancer.

Grabbing those running shoes has taken on a whole new fitness meaning.

Xeno Muller, Olympic gold and silver medalist, indoor rowing, rowing technique.

Tim Mclaren coming to the US (and he also loves the Rowperfect)

US Rowing + Great Coach = Olympic Medals

Well, the first two parts to this equation has happened here in the United States. My former coach from Brown University, Steve Gladstone, who now coaches the University of California Berkley has hired Tim McLaren to head the California Rowing Club. Steve has long wanted to see a more successful U.S. rowing team at the World Championship and Olympic Games, will his wish come true?

In October the 300 millions American will be born. That is a lot of people. Yet the United States have had in comparison to smaller rowing countries a deplorable result of international rowing medals per capita since the beginning of the modern Olympics. US sculling boats have a catastrophical record in comparison to its sweep rowing program. The explanation for this is that all Universities with a crew specialize in fours and eights.

I often hear that the US is too large for its own good to crank out medals. Too many coaches are teaching different techniques and when the time comes to form the national team there is hardly any time left to practice before the major international competition. Mike Teti the US head coach, figured out how to shrink the vast US territory into Princeton New Jersey. He has created an environment for sweep rowing talent to train together and to find local jobs. His system is working. The result is that the US is producing medals in the men’s and women’s eight.

Princeton, New Jersey… sounds nice, but between November and April it is C O L D and definitely not the environment that I would choose to train in. So I wonder where the rest of the people are who are interested in sculling at the international level. If they are not the runts of the Mike Teti sweep program, they are scattered throughout the US. There seems to be a Boston and Seattle enclave for sculling programs, but I am not going to vaste out time talking about those obscure programs. The bottom line is, there is no successful small boat US flotilla that can make a dent in the medal count at the Olympics and world championships.

Now the US has Tim Mclaren! Right from the get go I can tell you that I am a believer in Australian coaches. My own Aussie coach Marty Aitken helped me figure myself out to win Gold and Silver in Atlanta and Sydney. If you are an Australian you ought to feel good about what I am going to say. You people are roughly 20 million or less and your per capita medal count is ridiculously high at the Olympics. Jeez, I wonder how that is possible… Simple, Aussie’s have good athletes and great coaches. Marty was so methodical with my training that I NEVER had a doubt that I couldn’t do the job at the major yearly rowing championship. He introduced me to methodical lactate testing and cross training that kept my thirst high for on the water rowing.

Lactate testing is arguably a foreign concept for rowing training here in the US. Yet, today it is a simple process to monitor lactate levels in athletes and benefit from its information. It boggles my mind that the high performance committee of the US Rowing Federation has not gotten a clue yet and informed the thousands of rowers and hundreds of coaches about its benefit to avoid overtraining. When it comes to sculling styles there seem to be as many as there are coaches here in the US…

BUT! Other countries better beware and not get too comfortable things are going to change. Tim Mclaren has a proven Olympic record and is about to build a system that will crank out highly trained athletes who understand the subtleties of training and rowing small boats, which in turn will create superb large boats. My prediction is that we will see a rapid convergence of rowing talent to the California Rowing Club. Heck, if I were still in competition mode, I would migrate to see Tim… I guess I am not too old for that yet… Hmmm this makes me think… In any case I am wishing Tim and his family a great time.

Xeno Muller, Olympic gold and silver medalist, indoor rowing, rowing technique.

From a U.K. Paper

Note from me. 99.9% of the rowing machines available to the unsuspecting public are static machines. Rowing machines which do not move back and forth. Much healthier rowing machines are the ones that are DYNAMIC such as the ROWPERFECT and the Concept2 on Slides (cumbersome equipment needed when you using a C2)


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No pain, more gain: Why exercise can transform your life
By Anastasia Stephens
Published: 26 September 2006
1. CYCLING

Cycling, even for short periods, gives you an all-round aerobic workout. But cycling regularly and for long distances can strain your knees and, if you're a man, may put fertility at risk.

"The main problems I see with cycling involve the hips and kneecaps," says Gavin Burt, the London-based osteopath and spokesman for the General Osteopathic Council. "If your thigh muscles are out of balance, your kneecaps won't be stable - they'll move slightly sideways with the bending motion of your knee. That can cause grinding and inflammation."

Cycling can also harm male fertility. Recent studies show that 3 per cent of male cyclists who ride regularly become impotent, and virtually all of them felt pain or numbness before the problem occurred. The studies found that the more a person rides, the greater the risk of impotence or loss of libido.

Risk reduction Burt recommends the following exercise to strengthen your quadriceps and surrounding muscles. Lie down on your back with a rolled towel under your knee. Keeping your heels on the ground, press each knee down into the towel as if trying to straighten your legs.

Men who cycle for short or moderate periods shouldn't worry about fertility. Serious cyclists should take regular breaks along you cycling route - say every 30-40 minutes. Some bicycle seats such as Easy Seat (from £30; www.derri-air.com; 001 406 889 5288) are now specifically designed without the usual "nose" that compresses blood and nerve supply.

2. RUNNING

Running isn't as bad for your knees as most people think, says Siobhán O'Donovan, the chartered physiotherapist and sports rehabilitation specialist. "A study at Stanford University looked at the cartilage in the knees of runners," she says. "They found that in people who took up running while young, and continued to run, the sport had a cartilage-strengthening effect." For this benefit, you need to start running in your 20s, while your body is still growing. A sudden decision to take up running and cover long distances, without preparatory training, can cause knee strains.

The main risk for regular runners is Achilles tendonitis. "If the arch of your foot is slightly collapsed, your Achilles tendon will be slightly twisted. Run on it repeatedly, and the tendon will eventually become strained and inflamed."

Risk reduction Build up any running regime slowly and seek appropriate advice in choosing a good pair of shoes. O'Donovan, the clinical director at Meridian Sports in Bolton, recommends seeing a podiatrist or sports professional to get your feet screened. "This will identify if you have low or collapsed arches," she says. "You can then rectify the problem."

3. SWIMMING

Swimming is a great low-impact sport which strengthens and tones muscles of the whole body - and gives cardiovascular fitness a boost. But take into careful account which stroke you use. While front crawl is great for improving all-round muscle tone and fitness, O'Donovan believes breast stroke is so harmful, it should be banned.

"It's bad for your neck, back and knees," says O'Donovan. "Keeping your head above water compresses your neck, contributing to neck pain and tight shoulders. It also strains your lower back. Knees also suffer. "Your knees joints are made to kick up and down, not to kick out sideways as in breast stroke. This movement can strain ligaments and irritate membranes within the joint."

Risk reduction If you insist on doing breast stroke, you can minimise the strain by keeping your head in the water while swimming and coming up for breaths of air. Burt recommends reducing knee strain by propelling yourself forward using the momentum of your upper-body and kicking gently with your legs. Never extend them completely so that they are straight.

4. TENNIS

Beware of the classic tennis injury, tennis elbow. Caused by the backhand movement, the muscle and ligament leading from the forearm to the outer elbow becomes torn and inflamed.

Risk reduction As tennis elbow is painful and difficult to treat, your best strategy should be prevention. Using a double-handed backhand, where you use both arms to take the impact of the ball, will help.

Burt recommends this exercise for people with tennis elbow: place a moderately tight elastic band around the fingertips of your injured arm. Pull open your fingers against the resistance of the band and repeat several times every day. The exercise builds "support muscles" which help you use your arm while the strained ligament recovers.

5. ROWING

Rowing is one of the best sports for a strong back, but rowing machines in the gym can put your lower back at risk unless you get tuition in technique, says O'Donovan. Rowing outdoors may also put your lower back at risk if it is stiff. If you have scoliosis - a sideways curve along the spine - one side of your back may end up stronger than the other, causing muscular imbalances and strain.

Risk reduction O'Donovan suggests that you first ask yourself whether rowing is the best sport for you. "If your lower back isstiff, rowing could easily strain the joints, causing irritation and muscle strain," she says. "In extreme cases, it could lead to a prolapsed or slipped disc." If you do row, it's best to get professional advice. Burt says: "Your legs, low back, upper back and arms should all be involved in one effortless movement to propel yourself with each stroke."

6. YOGA/PILATES

While yoga and Pilates help prevent injuries by improving flexibility and strengthening abdominal muscles, both can cause the very injuries they're designed to protect against. "Overstretching can tear muscle fibres and irritate tendons or ligaments," says Burt.

Risk reduction Warm up properly before any stretching to prevent muscle tears in stiffness the following day, says O'Donovan. In winter, when the outdoor temperature is cold, give your body a good 20 minutes to warm up.

7. SNOWBOARDING

You don't get a rush without risk. And when it comes to winter sports, snowboarding tops the list for both. It offers speed and adventure along with a risk of knee strain, whiplash and wrist injury. "Your feet are fixed on to the snowboard in a way that stresses the knees," says Burt. "And if you fall, your upper body twists but your low body is fixed - that can snap and strain the cruciate ligaments of the knee." Falling forwards or backwards at speed on to compacted snow can cause wrist sprains and whiplash injuries respectively.

Risk reduction Get instructions and don't take on difficult slopes before you're ready. Protect your wrists from fractures or sprains by wearing wrist guards. Knee-braces worn under your salopettes can reduce any twisting when you fall.

Tips for safe and successful sport

Siobhán O'Donovan suggests picking a sport that will complement and help your physiology - then building up your fitness routine at a gradual rate. "I wouldn't recommend that someone prone to shoulder dislocation takes up rugby, for obvious reasons," she says. "Likewise, I'd be careful about suggesting rowing to somebody with a stiff lower back." Often, she adds, people may be predisposed to particular injuries without their realising.

Most people wouldn't know if they had a low foot arch, or if their pelvis was slightly twisted leaving one leg slightly longer than the other. These conditions are very common and can lead to muscular imbalances, tightness and injury in a wide range of sports.

She recommends a pre-exercise screen: an examination that looks at foot posture, leg length and your muscle balance. Orthotics and specific exercises can then ensure your bio-mechanical alignment is good to begin with.

A thorough warm-up routine is recommended before any sport - consisting of around 20 minutes of gentle aerobic activity and some stretches. It's vital not to overstretch early on, or you risk causing tightness and strain. Remember to finish any brisk activity with a 10-minute warm-down to help your physiology gradually adjust from an active to an inactive state.

Pre-exercise screening (£50 for one hour) is available at Meridian Sports in Bolton (www.getmebetter.co.uk; 08007 312 738). Consultations with podiatrists and physiotherapists are available at Health and Fitness Solutions, London (020-7702 1112).

For further details on sports injuries and rehabilitation, go to www.sportsinjuryclinic.net.

Xeno Muller, Olympic gold and silver medalist, indoor rowing, rowing technique.

Tori Amos ROWS!

I picked up this piece of information from Row2k.com today. They had a link to some newspaper. Now we just need to know all the celebrities who row indoors. Forget about the celebrities who row on the water.

Question for Tori Amos:


HOW DO YOU STAY IN SHAPE?

I am convinced that Frenchwomen don't get fat because they eat two or three proper meals a day - real food. I don't do sugar substitutes.

I play the piano for a few hours a day - it's a real workout. Then I get on the rowing machine for about 20 minutes four times a week. And a sauna about five times a week. You can steam toxins out. Just sit in there for about 20 minutes and drink two big bottles of water. It changes your health.

XENO

Xeno Muller, Olympic gold and silver medalist, indoor rowing, rowing technique.