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Hello to all our friends,

“Use it or lose it”, was a phrase I heard often during my life. Whether I was practicing a sport, singing in a choir, or learning in a classroom, the concept was quite clear. Whether it meant to strengthen my body, voice, or brain, I needed to use and practice whatever I was trying to improve or develop. Whatever coach or teacher I worked with, it was just a matter of time before I would hear “Use it or lose it”!

In my public high school of 3,600 kids, I played three sports, sang in advanced choir, and was president of classes and choir. In college at the University of Notre Dame, I walked onto the football team, sang in the Glee Club, (when I wasn’t sitting the bench in the fall), and studied science and theology. During those years as well, I would often hear the same phrase.
Currently, as a 69-year-old, I rarely hear young people use this phrase. It makes me wonder whether the concept may have been a fad of my time. Might this be one of those cliché conversation points that have slowly become irrelevant? The answer is no!

We all need to continue to be aware of our bodies and trying to create a balance. We need to find a way to balance our eating, exercising, relaxing and finding a way to serve the needs of others if we want to live a long active life, spending quality time with our family and friends.

I know I have been blessed with few physical challenges throughout my life. My past surgeries consist of a tonsillectomy, (which was common when I was a child), and an Achilles repair from a basketball injury. I have been sick but, as of yet, never seriously ill. I do want to point out that since I am a physical therapist, I have been personally committed to health for quite a while. I have tried to slowly create a balance between consistent exercise, weighing myself daily, watching my diet and how different foods affect my stomach and health. (My wife thinks I’m a little obsessive.) I have also been journalling my thoughts, feelings and activities since I graduated college, meditating since 2000, praying daily, and keeping in close contact with friends. I believe these are other forms that have helped me along the way and are part of the reason for my overall health. Obviously, family is paramount. Being a part of our family of 4 children and presently 8 grandchildren, along with my own 9 siblings and their children sometimes challenges my stress levels, but helps remind me that I am here on earth to strive to be loving, compassionate and forgiving to all I meet.

Where am I going with my original thought, “Use it or lose it”? I have noticed in my 40 years of working with injured people that we slowly lose this idea as we get into our 40’s and 50’s. I have worked with high school kids, who were active and healthy in their teens and college years. They were able to get away with eating whatever they wished and exercising whenever they chose. Their busy lifestyles and young healthy bodies kept them healthy. Unfortunately, as they hit their 40’s and 50’s, I began to hear their medical histories change. All of a sudden, they were up 10 or 20 pounds. They had high blood pressure medication and/or cholesterol medication, and some were pre-diabetic! In a matter of 10-20 years of a less active life and a possibly slower metabolism, the weight gain began and medications came to the rescue ( or the demise?) of their health.

I believe the key is to find a way to develop some kind of simple eating, exercising, and spiritual program that might help you begin to maintain and/or improve your physical, psychological and emotional state. As many of you might know from your own experience, allowing your health to be left up to your genetics alone creates major challenges as you age. Most of us would benefit greatly by educating ourselves about our health. As a result, we would than know not eating as well as we could, not exercising as well and not relaxing and addressing our need to read, journal and/or develop our spiritual lives can slowly cripple us and leave us in a great deal of pain as we age.

I realize there are outliers, like George Burns (for those who remember him), who could drink and smoke cigars and live to 100! However, he and those outliers are the exception. Some of us, if we do not choose to develop and follow through on a plan, end up on a walker or in a wheelchair, even in our 50’s and 60’s, which greatly affects our quality of life.

These words may seem insensitive if you are in a wheelchair or on a walker or in a bed, and you are only 60. Please know that I am not saying that we have total control of our health, but I am saying that there are steps we can take as we age that greatly increase our chances to have better health and quality of life. Also, I know you may be an exception and have done everything right and still have had major health issues.

For the majority of us, however, it will help us if we remember the timeless concept of “Use it or lose it”.

I hope you are having a joyful spring and counting your blessings along the way.

Enjoy the journey,
Fran McDonald President/CEO
Physical Therapy Guide to Hyperkyphosis (Humpback)

What Is Hyperkyphosis?
Hyperkyphosis is a spinal deformity. It occurs when the natural forward-curving shape of the upper back becomes extreme. It leads to rounded shoulders with a head-forward posture (where the head and neck are forward of the trunk). People with this condition often have difficulty standing up straight. A worsening curvature increases the risk of health problems. These can include back and neck pain, spinal fractures, breathing difficulties, and falls.

Hyperkyphosis can result from conditions such as:
  • Osteoporosis (bones with low density).
  • Fractures of the vertebrae due to low bone density.
  • Scheuermann's disease (juvenile kyphosis): excessive curvature of the upper back that appears in childhood.

If no fractures are present, other suspected causes for the deformity include:

Signs and Symptoms
The most prominent symptom of hyperkyphosis is a rounded upper back.
  • You may not notice the changes in your back posture because in most cases, the curve develops gradually. Friends and family may notice it before you do.
  • Other subtle signs can include:
  • Changes in how your clothes fit.
  • Feeling like it takes a lot of effort to stand or sit up straight.
  • Fatigue during walking and other activities.

Caution: If you notice a sudden increase in the curvature of your back, call your doctor. A sudden change in the curve of the spine could be a sign of other health problems.

If left untreated, hyperkyphosis can cause:
  • Difficulty doing everyday tasks such as bathing, getting out of a chair, reaching overhead, bending, or walking. It also may take more energy to complete common tasks.
  • Decreased flexibility and strength of the trunk muscles.
  • Changes in the body’s center of gravity.
  • Balance problems (due to the change in center of gravity) that can increase the risk of falls and injury.
  • Upper back pain or pain between the shoulder blades.
  • Spinal fractures as the condition advances.

If you have advanced hyperkyphosis, you may experience:
  • Difficulty breathing, even without a history of lung or heart disease.
  • A lessening of the distance between your lowest ribs and your pelvic bones. In this case, pulmonary function tests may be prescribed to measure whether your curvature is restricting your breathing.

A physical therapist can help you with your pain and address changes in your posture to help prevent worsening. They also will work with you to address any functional limitations, loss of strength, or balance problems.
Your physical therapist will first review your medical history, including any medications you take.

Note: Any sudden rounding of your back may point to a more serious health problem. Your physical therapist will refer you to your primary care provider if you report:
  • A sudden change in your posture.
  • Severe pain.
  • A major change in function.

Your physical therapist will perform special tests to assess your condition. They will begin by measuring your:
  • Postural alignment.
  • Functional strength.
  • Range of motion.
  • Balance.
  • Flexibility

If you have problems walking or keeping your balance, your physical therapist will perform additional tests. They also will assess whether you have an increased risk of falling. Your physical therapist will design a treatment program to address your specific needs and goals. Your treatment may include:
  • Postural alignment training, stretching, and strengthening exercises. These exercises can help reduce the spinal curvature, decrease your pain, and prevent your condition from getting worse. Doing the prescribed exercises in the clinic and at home is essential for success. You can lessen or slow the progression of your curve by improving how you sit, stand, and do daily activities.
  • Balance exercises and walking (gait) training. These treatments will help increase your tolerance for activity. They also can improve your safety by reducing your risk of falls.
  • Education. Your physical therapist will teach you ways to improve how you do your daily activities. For example, they can teach you how to safely get in and out of a bed, a chair, or a bathtub. They also can help you learn how to bend and walk with more ease.
  • Breathing exercises. These can help you improve your tolerance for physical activity by increasing your lung capacity.
  • Manual (hands-on) therapy. Your physical therapist may use gentle techniques to massage or reduce stiffness in your muscles and soft tissues. They also may mobilize your joints using gentle movements to help improve spinal flexibility.
  • Specialized braces or therapeutic taping. These methods may help reduce the angle of your upper-back curve.
  • Pain management. Your physical therapist may use heat, ice, and/or electrical stimulation to help reduce your pain. They will choose the right treatment that will help you most — and help reduce your need for pain medication, such as opioids.

All cases of hyperkyphosis are different. Your physical therapist will choose the best treatment options for you based on your specific condition.

** from choosept.com


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