bones & joints - osteoporosis · common ailments–tennis elbow, plantar fasciitis,...

AN iNdepeNdeNt SUppLeMeNt FrOM MediApLANet tO tHe NAtiONAL pOSt

no.2/september 2010

BonEs & Joints

The Terry Fox Foundation helps put an end to amputation treatment while lending an ear to those with cancer

STILL INSPIRING HOPE, DECADES LATER

Sports injuriesMake exercise work for you

Arthritis researchit’s on the move

beating the painA rheumatoid arthritis sufferer fi nally fi nds relief

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Don’t wait ’til it hurts: prevention is best policy

“i was the girl for whom nothing worked.”–Lene Anderson

Lene AndersonAn arthritis sufferer from the age of eight, she fi nally fi nds re

we reCoMMenD

pAGe 6

Canada leads the way p. 3Our country is the frontrunner on arthritis research.

Fighting back p. 7Osteoarthritis can be held at bay with preventative methods.

bONeS ANd JOiNtS2Nd editiON, SepteMber 2010

Country Manager: Gustav [email protected] Manager: Jackie [email protected]

responsible for this issue:Publishers: Danielle [email protected] [email protected]

Designer: penelope [email protected]

Contributors: angelique Berg, sheri Craig, Benjamin Deheshi, Margo Fraser, stuartFoxman, rajiv Gandhi , Jessica Hume, ross leighton, steven Mcnair

Distributed within:national post, september 2010this section was created by Mediaplanet and did not involve the national post or its editorial Departments.

Mediaplanet’s business is to create new customers for our advertisers by providing readers with high-quality editorial contentthat motivates them to act.

chances are you, a member of your family, a friend, or a neighbour lives with the intense pain and disability caused by arthritis.

Yet even though this chronic disease aff ects one in six adult Canadians, it goes largely unnoticed by the pub-lic. There are many misconceptions about arthritis. Until we set the record straight by debunking these common myths and raising awareness of the devastating impact of arthritis on our society, there won’t be a perceived need to address one of the major health challenges facing us.

Here are the hard facts about arthri-tis:

Arthritis is not just a disease of the elderly Arthritis does not discriminate against age, physical condition or eth-nic background. Sixty percent of Cana-dians living with arthritis are under the age of 65. That means most people with this disease face 20 to 40 years of struggling with it. Perhaps most sur-prisingly, one out of every 1,000 chil-dren under 16 has juvenile arthritis, a chronic disease that severely aff ects a child’s quality of life and may cause disability.

Arthritis is not a single disease.In fact, there are more than 100 types

of arthritis aff ecting more than four million Canadians. Arthritis can be divided into two main categories: infl ammatory and degenerative.

Because there are so many types of arthritis, the causes of each disease are often unknown. This poses a chal-lenge when it comes to treating the symptoms of, and fi nding cures for, these debilitating diseases.

Arthritis is not just aches and pains. Arthritis is one of the leading causes of disability in Canada. The symp-toms and severity of the disease vary from person to person and their dis-ease type. Some people with arthritis fi nd their pain so intense that they can barely get out of bed or turn a door knob. If not diagnosed early and aggressively treated, infl ammatory types of arthritis may cause perma-nent joint damage and lead to disabil-ity.

Arthritis is very costly. Arthritis costs more than $6.4 billion annually in health care expenses, with long-term disability accounting for about two-thirds of this total. Compared to those with other chronic diseases, people with arthritis experience both more pain and contact with health care professionals. They report twice as many disability days. Arthritis is the cause of over 80 percent of hip and 90 percent of knee replacement sur-geries in Canada.

While the prevalence of arthritis is already too high, it’s predicted to get much worse. By 2031, approximately

seven million or one in fi ve Canadian adults will be battling arthritis. With-out a corresponding increase in how much we invest in arthritis research, our understanding of the underlying causes of the disease, and therefore improved treatments and ultimate cures, will remain beyond reach.

The fi ght against arthritis is strictly a resource-based problem. It’s not beyond our capacity to unlock the mysteries of this terrible disease. When researchers are provided with the necessary funding, tremendous results are achieved.

Since its founding in 1948, The Arthritis Society has served as a pri-mary source of funding for major developments in arthritis care by investing more than $170 million in innovative research and the career development of rheumatologists. Some of the most notable discoveries in this fi eld have originated in Canada. For example, Canadian scientists have found a way to grow human cartilage in the lab. This development holds out the promise of repairing joints naturally rather than with the metal and plastic replacements used in joint replacement surgery.

With continued support, more breakthroughs are around the corner. Before that can happen, we have to sit up and take notice. Awareness of the toll arthritis takes on us all continues to be our single biggest challenge. Let the national conversation begin. To learn more, visit www.arthritis.ca.

arthritis: a costly disease that affects millions

like sprains, strains, fractures, and dislocations. Unintentional inju-ries clog our emergency rooms, and bone and joint injuries are a double-whammy, costing the health care system at the time they happen and again when they turn into arthritis later on.

Certainly, we all know enough about healthy eating, exercise and injury prevention to put those strategies into practice today. And with 206 bones, we should have enough reasons.

Need more motivation? Picture your happy retirement for a moment, and all you hope to be doing. Now add chronic pain and disability, and you have a very diff erent picture. Just as your retirement’s fi nancial health requires regular investments, so does your bone and joint health. Don’t wait until it hurts!

For more information on bone and joint health, visit www.canorth.org.

if you’ve thought about the health of your 206 bones lately, you’re in good company. Market research shows that next to cancer, Canadians are more concerned about back and joint pain than they are about any other health issue. Yet it also shows

that we are insecure in our knowl-edge of how to prevent bone and joint disorders.

Building knowledgeThere’s a lot we don’t know. Com-pared to cancer and cardiovascular health, fi elds where today’s preven-tion knowledge is backed by decades of funded research, our prevention knowledge is just building. Of all health research spending in this country, less than 2 percent is invested to bone and joint health. With soaring health care budgets and bone and joint disorders ringing in at more than $18 billion annually, one would think our “aches and pains” might

warrant a little more attention.Thankfully, there’s a lot we do

know. Bone and joint health results from lifelong healthy eating and exercise choices–similar answers to prevention questions for various dis-eases, so the benefi ts are many.

Our bodies need a balanced diet to absorb the calcium that keeps bones strong and healthy. Canada’s Food Guide is easy to follow to ensure we build bone density in our youth and maintain it as we age.

Strength buildingThe best exercises for strong bones are weight bearing activities like walking and jogging, customized to suit our age, weight and abilities. Even a few minutes of light to moderate exercise a few times a day will pay off in keep-ing joints limber.

But perhaps the single most important thing we can do for a life-time of movement is to prevent injury,

Angelique Bergpresident & CeO, Canadian Orthopaedic FoundationPHOTO: ANGELIQUE BERG

Steven McNair, president and CeO of the Arthritis Society

artHritis FaCts

■■ Approximately one in six (approximately four million) Cana-dian adults aged 15 years and over has arthritis.

■■ Two-thirds of those aff ected with arthritis are women.

■■ Nearly three of every fi ve people with the disease are of working age (under 65).

■■ Arthritis ranks second and third among the most commonly reported chronic conditions in women and men, respectively.

■■ At $16.4 billion, musculoskeletal conditions, including arthritis, are the second most costly category of diseases in Canada.

Source: The Arthritis Society

MAKE A PREVENTION

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If it seems unfair that some of the things we do for fitness have the potential to cause both acute and chronic in-juries, sports medicine spe-cialists say there are ways of maintaining an active lifestyle that won’t cause pain.

Joints are especially complicated parts of the body, and pursuant to that, are highly susceptible to injury. Jogging, tennis and other racquet sports can lead to some of the most common ailments–tennis elbow, plantar fasciitis, tendonitis–which, if left untreated, can potentially become chronic.

Dr. Anna Georgiou, president of the College of Chiropodists of Ontario who also works at the Danforth Foot Clinic, says joint problems can be especially difficult because people are likely to work through them by find-ing ways of compensating to accom-modate the pain, increasing the likelihood of developing additional injuries.

“Changes at the level of the foot, for example, can have effects on the body all the way up to the lower back,” Georgious says.

Warm ups and stretches enhance benefits of exerciseAs students, Canadians are taught

about RICE– rest, ice, cold, elevation–an acronym to help kids learn how to deal with injuries. Though she admits there is much more to chiropody than that, Georgiou says common sense and heightened awareness of biome-chanics can go a long way in prevent-ing common sports injuries.

“It’s always good to get into exercis-ing slowly,” she explains. “We recom-mend warming up before and stretch-ing after.”

Less obviously, having more than one jogging route is important–unevenness in roads can subtly force joggers to adjust technique. Over time, too much adjusting can change the way we run and lead to potentially

serious problems such as shin splints. Finding the right shoe depends on knowing the mechanics of one’s feet–whether they pronate or supinate–as well as the nature of the activity; jog-ging, basketball and tennis will force the body to move differently and the nature of footwear support should reflect that, according to Georgiou.

Once a joint-related injury has been sustained, she recommends, in addition to rehabilitative measures, that patients work to strengthen the surrounding area in order to alleviate pressure from the problem area.

nEws

Jessica Hume

[email protected]

Exercising within the body’s limits can reduce injury to joints

Most falls result in little more than bruised pride, but about one fifth of falls are associated with injury; among the most serious are hip fractures.

In Canada there are over 20,000 hip fractures annually among seniors. What’s more, annually over one-third of Canadians aged 65 and over suffer falls.

Preventing falls is easier than you probably think. Being attuned to your body, spending a few minutes a few times a day to build strength and balance, and checking your environment for hazards is all it takes to significantly reduce the risk.

Build muscle strength and balance: Muscle strength

and balance training can be done at home, in just a few minutes a day, a few times a day. Talk to your physi-cian or a physiotherapist about spe-cific exercises that are right for you.

Book an eye exam: If you wear glasses, have your eyes

checked regularly and keep eye wear at the proper prescription for your corrective needs. If your glasses are for reading, remove them when moving about–impor-tant for judging depth around stairs.

Check your blood pressure and heart rate: Blood pres-

sure and heart rate changes can cause dizziness, so have it checked regularly.

Check your meds: Recognize signs that medication may

not be working well with another, or may be causing side effects that make you sleepy or dizzy, and tell your doctor about them. Check with your physician of pharma-cist before taking any self-selected remedies. Know, too, what foods or drinks–especially alcohol–you should avoid with your medica-tions.

Eat, and eat well: Eating well is important to avoid dizzi-

ness and fatigue. However, as we age, our appetite decreases and it’s a challenge to eat enough food to get the nutrients we need. Try smaller, more frequent meals, and talk to your doctor about liquid supple-ments if your appetite won’t coop-erate.

Fall proof your home: Ensure your home is well lit, with

nightlights installed near stairs and other hazards. Remove scatter rugs and ensure all carpeting is fully tacked down. Keep floor surfaces free of clutter and spills. Take a walk around your home–or challenge a child to do it for you–to spot any fall hazards, and correct them right away.

These small but important checks give way to strength and vitality–and staying strong on your feet!

Source: the Canadian Orthopaedic

Foundation

Fall prevention

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According to a recent study from McMaster University in Hamilton, most postmenopausal women aren’t aware of their actual risk of breaking a bone. Osteoporosis is a skeletal dis-ease whereby bones become thin and weak and more likely to break. One in four women over 50 suffers from osteoporosis. But it is not exclusively a woman’s disease; it also affects at least one in eight men over 50.

Fractures are the first signThe most significant consequence of osteoporosis is a fracture, typically of the hip, wrist or spine. The most com-

mon fracture for a woman under 75 is a wrist fracture, which is often the first indicator that she has osteoporo-sis. A vertebral fracture (a broken bone in the spine) can result from a fall, a twisting motion or carrying a load that is too heavy. Vertebral fractures often go undetected or are misdiag-nosed as a “pulled” muscle. Vertebral fractures can cause chronic pain and, because the individual fears fractur-ing again, can limit activity even after the fracture has healed. Marg MacDonell of Manitoba explains how she felt after a diagnosis of osteopo-rosis in the spine. “A part of me was really, really frightened. I have to say no when my friends go skiing, curling and golfing.”

Hip fractures have the most severe consequences. Walking can be impaired, possibly requiring the use of a wheelchair. In fact, 50 percent of people who suffer a hip fracture never walk without support again. A third lose independence, and 20 percet will die from complications following a hip fracture (complications such as pneumonia, blood clots or infection).

Breaking the bankAs well as the devastating personal consequences, fractures represent a major burden on the healthcare system. The cost of treating osteopo-rotic fractures is currently estimated at $1.9 billion, and as the population

ages, this number may well go up. By 2030, it is estimated that the health-care system will have to deal with four times as many hip fractures as in 1996.

But there are measures you can take to reduce the risk of fracture. Make sure you are getting sufficient calcium and vitamin D, and make weight-bearing activity a regular part of your life: walk, dance, take the stairs instead of the elevator, play rac-quet sports or do low-impact aerobics. And if you have been diagnosed with osteoporosis, talk to your doctor about the medications that significantly reduce the risk of fractures.

courtesy of

Osteoporosis Canada

are you aware that you may be at risk for fractures?news

However, some important advances in the last decade have offered hope to people living with arthritis.

A breakthrough treatment called biologic therapeutics has had, argu-ably, the biggest impact ever on the field of rheumatology. Biologic response modifiers, or biologics, are genetically engineered proteins derived from human genes found naturally in the body. They work by blocking the actions of the chemicals called cytokines, which are involved in attacking the lining of joints and tissues.

To people like Jean Légaré of Neu-ville, Quebec, biologics have made the difference between being con-fined to a wheelchair and regaining mobility. “I am strong today thanks to advances in arthritis research and new treatments. They give me hope

for the future,” says Légaré.

Canadian Arthritis NetworkUntil 1997, research on arthritis was usually conducted by isolated scien-tists “competing with each other for difficult to come by funding, defend-ing our turf to survive as researchers,” explains Dr. Robin Poole, Professor Emeritus, McGill University, Mon-treal and Scientific Director Emeritus, Canadian Arthritis Network. Then several researchers, including Drs. Tony Cruz and Poole, with the support of The Arthritis Society–a national health charity that funds arthritis research–came together to develop a plan for a collaborative, multi-institutional and trans-dis-ciplinary approach to research and the timely communication of new knowledge. This new direction would involve many partners, including aca-demia, industry, government and peo-ple living with arthritis as advisors.

In 1998, the Canadian Arthritis

Network (CAN) was established, funded by the federal government’s Networks of Centres of Excellence program, bringing together approxi-mately 75 scientists and resulting in new research groups. (Today CAN has over 200 researchers participating in the Network.)

“These groups addressed complex research questions that couldn’t be addressed by individual researchers and also identified research gaps… for example the pain of arthritis,” explains Dr. Jane Aubin, Scientific Director of the Canadian Institutes of Health Research’s Institute of Muscu-loskeletal Health and Arthritis.

“The Network can boast a long list of successes attributed to its initiatives and the work of its funded research-ers, but what is really exciting is that it facilitates all this communication, this knowledge transfer within the research community and outwards to patients and finally to policy-makers. This is essential,” argues Dr. Claire Bombardier, Co-Scientific Director of

the Canadian Arthritis Network.A recently launched resource to

assist the research community is the HQC Database (visit www.arthritis-network.ca). It contains the names of arthritis patients volunteering to work with researchers on projects. Having this perspective is invaluable and this database will expand the number of Canadians able to volun-teer.

“Canada has made major advances over the past 10 years, both in creating new knowledge and in training new researchers, but there is still a lot to do,” says Monique Gignac, who shares scientific director duties at CAN.

Collaboration and communication will be the keys to Canada’s continu-ing success in arthritis research over the next 10 years as well.

sHeri craig

[email protected]

For patients eagerly awaiting new treatments–or better yet, a cure–the pace of scientific progress can feel glacial.

canada leads the way on arthritis research


Often when individuals are suffering from an illness or injury that affects their bo-ne or joint health, they seek medical attention or rehabili-tation but neglect to address the aggravating activities in their work or home environ-ments. This can set up a cy-cle in which the positive be-nefits of treatment are nega-ted the next time the task(s) that aggravate the symptoms are performed.Ensuring that the physical, orga-nizational and cognitive aspects of the work and home activities are designed with good ergonomics in mind can reduce risk of aggravating existing symptoms so that treat-ment benefi ts are sustained, and help in maintaining overall well-being for those that are symptom free.

Optimizing capabilitiesErgonomics is about optimizing the fit between the capabilities of people and the demands of the activities that they perform. All of us need a certain level of activ-ity to stay healthy, but when we stay in one position for too long, perform the same motions repeat-edly, work in awkward postures or handle objects that are too heavy, the stresses on the tissues of the body can build up over time to the point that a musculoskeletal injury occurs. Pre-existing con-ditions may also be aggravated. Organizational factors that limit the physical and mental variation in activities over the work day and work stress contribute to increased injury and illness risk as well.

Professional interventionBy using ergonomics principles to examine the interaction between people and the tasks they are per-forming, qualified ergonomists (look for those with the CCPE desig-nation) can make appropriate rec-ommendations to improve safety, health, productivity and effi ciency. These may range from simple interventions such as reposition-ing items for a more eff ective work fl ow and optimal reaches, to more complex activities such as work-ing with facilities staff , designers or engineers to ensure human capa-bilities are considered in the up-front design or equipment selection process. In the case of those with existing joint disorders, ergono-mists can help fi nd ways, whether through positioning or the use of alternative technologies, to allow the individual to continue to per-form his/her work as eff ectively as possible. Be aware of symptoms early and remember to consider the ergonomics of your tasks in addi-tion to seeking medical advice.

inspiration

terry Fox continues to inspire millions

AGAINST THE ODDSTerry Fox ran the equivalent of a marathon a day.PHOTO: GAIL HARVEY

When Terry Fox decided to run across Canada despite having had one of his legs amputated, he did so in the hope that money he raised for can-cer research would save future gen-erations the pain and suff ering with which he was all too familiar.

For more than 140 days Fox ran the equivalent of a full marathon every day, putting more than 5,300 kilome-tres behind him before having to stop just outside of Thunder Bay, Ontario, when the cancer had spread to his lungs.

A common form of cancerFox suff ered from osteosarcoma, an aggressive and painful form of bone cancer that manifests in the growth

plates at the end of the long bones in arms and legs and is common in teens and children.

Fox’s older brother Fred has worked with the Terry Fox Foundation since his brother’s death in 1981.

“I remember always being active with my brother–playing in the river, playing football, rugby, soccer. We were competitive,” he says, adding that until his brother was offi cially diagnosed with cancer in 1977, the sore knee about which he had been complaining was assumed to be little more than a sports injury.

“He had a sore knee for a few months. But we knew nothing about cancer,” he remembers, explaining that only three days went by between the diagnosis and pursuant amputa-tion. “Terry was scared, of course. He

lost his right leg and as an athlete he was devastated. He wasn’t sure he’d be able to play sports again.”

An end to amputationIn the early 1980s amputation was the main form of treatment for people with osteosarcoma. Today, the Terry Fox Foundation alone has raised more than $500 million and medical advances have meant amputations are exceedingly rare. Surgical proce-dures have allowed limbs to be saved and the mortality rate associated with sarcoma has been reduced to about 20 to 30 percent.

“It’s amazing what’s happened since Terry’s diagnosis. That people today have a 70 to 80 percent survival rate is what Terry would have wanted;

he was told he had a 15 to 20 percent chance,” Fox says.

Through his work at the Terry Fox Foundation, Fox has the opportunity to hear from hundreds of people from around the globe who share with him their stories and experiences with cancer. In them, Fox says he derives the same inspiration they did from his brother.

“Terry wasn’t one to share what he was going through physically; he downplayed the pain. He inspires people because he decided not to feel sorry for himself. He was taught to fi nish what he started; that’s what he was trying to do.”

Jessica Hume

[email protected]

CHanGe

That professional athletes injure themselves may be assumed, but Dr. Tim Rindlisbacher, director of the sports health program at Cleveland Clinic Canada, says many of these common sports injuries - rotator cuff tendonitis, knee tendonitis, heel pain - can occur from every day activity. In serious cases these problems can become chronic. Dr Rindlisbacher sees it as his job to ensure this does not happen.

When he is successful, he attributes

this, at least in part, to taking a broad view in how to best treat his patients.

“Instead of ‘sport medicine’, I pre-fer to call it ‘sport and exercise medi-cine’,” he explains. Life is a sport. “My role is not to tell people not to do some activity, but to try and fi gure out how they can still do what they want, but in a healthier, better way.”

A joint issueRotator cuff tendonitis, for example, involves the small muscles surround-ing the shoulder joint. When these muscles are used properly, the area will be less painful. Joint problems are often genetic; people with a family history of arthritis and related issues have greater likelihood of sprains, joint-laxity and “wear and tear” eff ects including osteoarthritis. “What people in that category need to know is that problems can be pre-vented by strengthening the muscles

around the joint,” Dr Rindlisbacher says, explaining that more strength in the surrounding tissue alleviates strain on the joint. Additionally, those predisposed to joint problems but who enjoy maintaining an active life-style can make small adjustments to their activities that will go a long way in avoiding injuries.

Skating puts less pressure on the hip, knee and ankle joints than soccer; the elliptical machine (cross-country skiing) is also better for these joints than running.

Where people run a greater risk of developing chronic conditions is when the same action or injury occurs repeatedly.

Working with the Toronto Raptors, Dr Rindlisbacher saw many knee injuries, mostly patellar tendonitis or “Jumper’s knee”, a problem that results from overuse.

“Overuse injuries, degenerative

injuries tend to be chronic.”

Heel pain - plantar fasciitis - is another common complaint that can cause extreme discomfort, but one for which taking small measures can help.

“Often just stretching the calves before getting out of bed can greatly reduce the pain in those fi rst steps in the morning, which are usually the worst.”

An injury linked to the connective tissue along the sole of the foot, plan-tar fasciitis can lead to other prob-lems, including knee pain, as people change the way they walk to manage pain.

In addition to stretching, orthotics and deep tissue therapy can help alle-viate pain.

Make exercise work for you: preventing chronic problems

Jessica Hume

[email protected]

Some of the most common injuries arise from daily activi-ties that cannot be avoided, but that doesn’t mean they have to be eliminated from our routines entirely, says Dr. Rindlisbacher, a Toronto doctor of sports medicine.

Cleveland Clinic Canada believes that it takes multiple specialists to deliver care that is personalized to your lifestyle. Our team looks at your health from the inside out to better understand how to treat your injuries and maximize your performance. Regardless of the sport or the injury, you and your family will benefi t from our clinical expertise, on-site imaging and convenient downtown Toronto location.

To learn more about our Sports Health program or to book an appointment, contact us at 416.507.6673 Physician consultations and imaging are covered by OHIP.

181 Bay Street, 30th fl oor, Toronto, ON M5J 2T3 416.507.6600

SportsMedicinePhysician

ExercisePhysiologist

Diagnostic Imaging

SportsDietitian

Chiropractor

Physiotherapist

EXECUT IVE HEALTH • SPORTS HEALTH • L I FESTYLE MANAGEMENT clevelandclinic.ca

Maximizing your performance, from the inside out.

margo fraser

executive directorAssociation of Canadian ergonomists

news

news in BrieF

Economic cost of arthritis

■■ The economic cost of arthritis is estimated at $4.4 billion annually.

■■ Musculoskeletal diseases accounted for 10.3 per cent of the total economic burden of all illnesses in Canada in 1998, arthritis alone accounts for more than 40 per cent of drug expenditures for musculoskel-etal diseases in that same year.

■■ Long-term disability accounts for almost 80 per cent of arthri-tis-related costs, with 70 per cent of these costs incurred by individuals aged 35-64.

■■ Research projects a need for a 64 per cent increase in the number of rheumatologists in Canada to deal with the growing prevalence of the disease by 2026.

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terry Fox continues to inspire millions

Jessica Hume

[email protected]

Cleveland Clinic Canada believes that it takes multiple specialists to deliver care that is personalized to your lifestyle. Our team looks at your health from the inside out to better understand how to treat your injuries and maximize your performance. Regardless of the sport or the injury, you and your family will benefi t from our clinical expertise, on-site imaging and convenient downtown Toronto location.

To learn more about our Sports Health program or to book an appointment, contact us at 416.507.6673 Physician consultations and imaging are covered by OHIP.

181 Bay Street, 30th fl oor, Toronto, ON M5J 2T3 416.507.6600

SportsMedicinePhysician

ExercisePhysiologist

Diagnostic Imaging

SportsDietitian

Chiropractor

Physiotherapist

EXECUT IVE HEALTH • SPORTS HEALTH • L I FESTYLE MANAGEMENT clevelandclinic.ca

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Question: How did Lene Anderson go from being the “girl for whom nothing worked” to regaining control of her life?Answer: With the release of a new form of drug called biologics, she is feeling relief for the fi rst time in decades.

how biologics helped beat the pain Lene Andersen remembers a Christmas not long ago she thought would be her last. Her rheumatoid arthritis meant that since the age of four, pain had been a part of her life, but in 2003 she experienced the worst flare-up yet.

“I woke up every day crying,” Andersen recalls, describing painful swelling in her joints and a general stiff ness she could not sleep off . “It took over my life.”

Among her earliest memories is one of her father carrying her home from a fam-ily party because it was too painful to walk. When she hit puberty, the RA spread from

only two joints to all of them. At 16 Ander-sen had both hips replaced.

“I haven’t really walked since I was 14,” she says, seated in the wheelchair she uses to get around.

Andersen has what Dr. Joanne Homik, professor of rheumatology at the Univer-sity of Alberta and chair of The Arthritis Society’s medical advisory board, says is a severe case of a disease that aff ects roughly one percent of Canadians.

“In worst case scenarios people lose their ability to groom themselves; they can’t cook, there are mobility problems,” Homik explains. “They lose the ability to be functional.”

Historically, rheumatoid arthritis patients have had few pharmaceutical options from which to choose.

“Twenty years ago there were only six medications to choose from,” she says. “If you went through them all and none of them worked, you ended up on the one that worked best.”

Andersen understands this all too well. She has been prescribed gold injections, steroids, malaria pills, aspirin and meth-otrexate–a common RA drug during the 1950s.

“I was the girl for whom nothing worked,” she says.

That was until 2004. After the fl are-up she was prescribed a new form of drug, biologics, to which she attributes her “sec-ond lease on life”. The fi rst new RA drug to appear on markets in more than a decade, biologics are protein-based substances that targets the specifi c chemicals that

trigger RA infl ammations. The trouble was Andersen had already

spent tens of thousands of dollars on medi-cations and biologics can cost more than $25,000 annually. Add to that to the fact that biologics work by suppressing the immune system, which can weaken the body’s ability to fi ght infection.

Andersen is able to aff ord the medica-tion through funding received through a provincial program.

“For months, every day I could do some-thing new, I could put more weight on my joints without them hurting,” she beams. “I can buy groceries again.”

proFile

Lene Anderson

■■ Age:48■■ Age when

diagnosed: 9■■ Type of

arthritis: rheu-matoid arthritis

■■ Previously prescribed: Gold injections, steroids, malar-ia pills, aspirin, methotrexate

How i MaDe it

inspiration

Jessica Hume

[email protected]

Leanne Grechulk has always main-tained an active lifestyle. So when she decided she wanted to begin running marathons, she knew from experi-ence that choosing the right footwear would be key in her getting the most out of training and avoiding injury.

“I used to play soccer and I have a few injuries, particularly one in my knee, that I knew I would have to be careful not to aggravate with train-ing,” she explains. “I wanted to learn good technique and train properly.”

Learning good jogging technique is

something that will change according to the individual’s physique. The right footwear, on the other hand, has more to do with the nature of the activity.

The foot bone is connected to the kneeboneDr. James Hill, President of the Ontario Podiatric Medical Associa-tion, says the trouble with foot inju-ries is that people tend to compensate for them in ways that can negatively aff ect other parts of the body.

“It’s not uncommon for someone

with a problem in their ankle to com-pensate in ways that put stress on the knee, the hips, even the back,” he says.

For the 34-year-old Burlington resi-dent, Grechulk says her knee injury meant she wanted to take extra pre-caution in her training and avoid col-lateral injuries. She had a specialist examine her feet prior to her purchas-ing shoes.

“If you know how you walk, how you run, what requirements your feet have, then you know what kind of shoes you need to buy,” she says.

The right shoe can help more than your feetDr. Anna Georgiou, president of the College of Chiropodists of Ontario, who also works at the Danforth Foot Clinic, says when it comes to jogging, shock absorption is the most impor-tant quality in shoes.

“Shoes are very important. If you’re jogging you want a shock absorbing sole, you want a fl exible toe box and what is called a bunny tab at the back–so that the shoe doesn’t inter-fere with the achilles tendon.”

Grechulk says after finding the shoes that best fulfi lled her needs, she had noticed signifi cant improvement.

“Comfort-wise you can defi nitely tell. But more importantly, my knee actually got better when I bought diff erent shoes.”

Jessica Hume

[email protected]

athlete or not, the shoe should fi t

A BIG RELIEFLene Anderson suffered for decades before trying biologics

PHOTO: DAVID GOVONI


inspiration

Volunteer to advise arthritis researchers.

Visit www.arthritisnetwork.ca and click on Consumers for more details. Or call 416-586-4770.

Be a part of the Canadian HQC Database.

We’re ready to GoNow all we need is You!

athlete or not, the shoe should fit

Imagine driving your car wit-hout shock absorbers. That’s what happens to your body when osteoarthritis develops.

Cartilage, the tough elastic material that cushions the ends of your bones, is also slippery. This lets the bones move smoothly, and acts like a shock absorber when you put weight on the joint.

With osteoarthritis the cartilage gets rough and thin, while the bone thickens. You can get stiffness or swelling, and have trouble moving the joint. More problems can emerge; bits of cartilage can break away and float inside the joint, bones may form bumps on their ends (spurs), or bones may rub together if the cartilage

wears away entirely.Osteoarthritis usually strikes

weight-bearing joints–hips, knees, feet and spine (hands too)–and affects 1 in 10 Canadians, usually after 45 (over half of people by age 70).

Managing the condition

While osteoarthritis has no cure, there are several common treatments and ways to cope. Here are five from The Arthritis Society, from lifestyle changes to surgery:

■■ Exercise: Moderate stretching and low-impact exercises (e.g. swimming, walking, stationary cycling) can reduce pain, keep the muscles and

tendons around joints more flexible and strong, and slow joint damage.

■■ Protect your joints: One, pace yourself (take breaks, or alternate heavy tasks with easier ones). Two, use larger, stronger joints to carry loads (e.g. shoulder bag instead of a hand-held one). Three, use devices like canes, grocery carts and reach-ing aids. The result–less pain and greater ease in doing daily tasks.

■■ Medication: Choices include analgesics (for mild-to-moderate osteoarthritis); codeine prepa-rations (if acetaminophen isn’t enough for pain); topical creams and gels (may provide temporary pain relief); and corticosteroid injections

(when osteoarthritis progresses to the point where it’s hard to get around). Always talk to your doctor to discuss side effects and suitability.

■■ Viscosupplementation: For osteoarthritis of the knee, a gel-like substance is injected into the knee to help the joint fluid regain its “vis-coelasticity”– in essence, it lubricates joint cartilage and for many restores the “shock absorber” properties.

■■ Surgery: If osteoarthritis gets bad enough, doctors can perform minor arthroscopic surgery to clean out cartilage debris from the joints (espe-cially the knee). With severely dam-aged joints, options are reconstruc-tions or joint replacement (usually

hip or knee). Artificial joints can relieve pain, and allow you to move and function normally again.

The possibility of preventionCan you prevent osteoarthritis? While you can’t change your age, Health Canada notes that follow-ing a healthy lifestyle–exercise to strengthen your muscles and stay supple, a healthy weight to reduce the stress on your moving parts–is always good for bones and joints.

For more advice on handling osteo-arthritis, visit The Arthritis Society at www.arthritis.ca.

stuart foxman

[email protected]

Fighting back against osteoarthritis


make no bones about it

Calcium is essential in maintaining strong bones

many Canadian women may not have adequate dietary calcium

intakes.1 Calcium is the most abundant essential mineral in our body. most of

this calcium (99%) is stored in our bones. in fact, calcium is what helps to build and maintain strong bones. Getting enough calcium is essen-tial at every age, but is especially important for menopausal and post-menopausal women2.

before you consider taking calcium supplements, remember that certain foods, like dairy products, are great options because the high levels of calcium they contain are easily absorbed by the body.

Yoplait asana™ was especially formulated for women who want to meet their daily calcium requirements so they can stay strong. Did you know that a 175 g serving of Yoplait asana provides 30% of the recommended daily value of calcium?

available only in Canada, Yoplait asana is an innovative product that has taken two years of research and significant investments to develop. indeed, Yoplait asana’s exclusive recipe contains three complementary ingredients: calcium and vitamin D, which promote strong bones, and mbP™, selected dairy proteins exclusive to Yoplait in Canada. studies on target populations have shown that mbP helps to reduce the activity of osteoclasts, the cells responsible for bone degeneration3.

Yoplait asana is a delicious way to take care of your bones every day. is it any wonder that it was crowned “best all Canadian Product” at the 17th annual new Canadian Products Grand Prix awards?

make sure you’re getting enough calcium by calculating your daily intake on yoplaitasana.ca.

1 Vatanparast et al. 2009 2 Rolfes et al. 8th edition, 2009. 3 Aoe et al., 2005

Mom was right–that glass of milk is good for you, not to mention cheese, yogurt, broccoli, brussels sprouts, fi sh, beans, soy and tofu. All are excellent sources of calcium, which, along with vitamin D, are essential for your bone and joint health.

You need enough calcium to build strong bones when you’re younger, and to fi ght bone loss when you’re older. If your diet doesn’t give you enough calcium, you’re at greater risk of developing osteoporosis, which in turn boosts the risk of fractures due to weaker bones.

Calcium is also important for regu-lating the heartbeat, conducting nerve impulses, stimulating hormone secretions, and clotting blood. With-out enough calcium in your diet, your body will take it from your bones to perform other functions, again weak-ening your bones.

Calcium and vitamin D work together. Dr. Michael Roizen, Chief Wellness Officer at the Cleveland Clinic, uses this analogy: if calcium absolutely, positively has to get to your bones on time, then vitamin D is FedEx.

Vitamin D increases the absorption

of calcium, making it more effi cient to deliver calcium to your bones. In addition, vitamin D may be good for your joints, slowing the progression of arthritis in some studies.

Where to fi nd sources of vitamin D? Go outside and look up. Our skin manufactures vitamin D when we’re exposed to the sun–something that’s in short supply during Canadian win-ters. The Arthritis Society reports a study at Toronto’s Mount Sinai Hospi-tal, where nearly one-third of women were vitamin D-defi cient over the winter months.

Dietary sources aren’t abundant; fortifi ed milk and, in small amounts, margarine, egg yolks, and fi sh oil, which is why many people take vita-min D supplements.

Just as vitamin D can assist in delivering calcium, other nutritional choices can be an impediment. The Canadian Orthopaedic Foundation points out that caff einated beverages or alcohol can interfere with the way the body absorbs and uses calcium.

Maintaining a healthy weight is also critical. Even small weight gains can make a big diff erence on your hips and knees, as the joint forces multiply

that weight when you walk. As the Alberta Bone & Joint Institute notes, carrying just 4.5 kg of extra weight increases the force on your knees by 13.5 kg to a whopping 27 kg with each step.

So watch those sweets, fats and por-tions. Keeping your weight down is

one of the best things you can do for your overall health – and certainly for the sake of your joints.

stuart foxman

[email protected]

Bone up on nutrition: fortify with calcium and vitamin D

Osteoporosis and osteoarthritis affect millions of Canadians each year; howe-ver personalized therapies can help us manage them better.

Osteoporosis, the most common metabolic bone disease in the elderly, aff ects 1.4 million Canadians each year and is most common amongst post-menopausal women. It is a con-dition where the microarchitecture of the bone deteriorates over time, resulting in decreased bone mass and an increased risk of fragility fractures. Risk factors include meno-pause or andropause, advanced age, family history, previous fragility fractures and malnutrition. Accord-ing to the Surgeon General’s report (2004), a regular diet with adequate calcium and vitamin D, together with regular weight-bearing physi-cal activity, can prevent bone loss later in life.

Strong muscles for strong bonesAn exercise program that focuses on strengthening the right combina-tion of muscles can help maintain and improve bone density in the spine and upper and lower extremi-ties, ultimately resulting in bet-ter balance and coordination and decreased fracture risk. The main challenge for individuals interested in treatment or prevention of osteo-porosis is lack of knowledge of exer-cises type, duration, frequency, and risk of fracture or injury during exer-cise. A medically-supervised and cus-tomized exercise program focused on individual activity level, medical co-morbidities, and physical limi-

tations helps maintain or improve bone density, muscle strength, pos-ture, and balance.

Keep your cushionOsteoarthritis is a chronic degen-erative disorder where the carti-lage, which acts as a cushion for our joints, begins to wear away causing pain and stiff ness in our joints. Osteoarthritis aff ects 3 mil-lion Canadians each year and is most common in people over 65. Risk fac-tors include advanced age, family history, obesity, previous trauma and heavy labor jobs. In advanced osteo-arthritis, joint replacements are per-formed in order to improve mobility and function. However, in the major-ity of cases, patients diagnosed with early arthritis that are limited by joint pain, stiff ness, and decreased mobility, are too young or active to undergo joint replacement surgery.

Minimizing symptoms

Although there is no medical cure for osteoarthritis, patients can delay surgical treatment, decrease pain and stiffness, and improve daily function by appropriate physical activity. Best results are obtained by an individually tailored approach that focuses on improving muscle strength, correcting muscle imbal-ances, improving range of motion, and maintaining an active lifestyle. The biggest cause for osteoarthritis pain is increased burden and load on the joints due to weak, imbalanced, or inactive muscles. Strengthening the correct muscles in combina-tion with weight loss can offl oad the strain on the aff ected joints, decrease pain and improve function. A medically-supervised program can address these issues by indi-vidualizing the treatment approach to prevent further bone loss and delay surgery when possible in the osteoporosis and osteoarthritis populations .

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Medically supervised exercise helps manage bone diseases

chronic pain, meet your match

nEws


nEws

For many of Canada’s graduating orthopaedic surgeons, 2010 has been a year of cruel disappointment. Only a handful of these much-needed surgeons can fi nd full-time employ-ment.The prospects for the next few years do not look any brighter: Canadians are losing some of their very best and brightest.

Retaining our surgeonsIf a country like Canada can-not afford to hire the ortho-paedic surgeons it trains, what does that say about our health care system and our abil-ity to provide care for an aging population? Right now, because orthopaedic surgeons who special-ize in foot and ankle procedures are so few and in such demand, it can take years just to get an appoint-

ment, let alone actually undergo an operation.

Currently, the provinces and territo-ries enjoy a 10-year, six percent annual increase in health care transfers from the federal government, thanks to the 2004 First Ministers Health Accord. In just four years’ time, that funding arrangement will end. What follows is anybody’s guess. The whole issue of health care funding has gone dormant since the Accord was signed.

Controlling the budgetHowever, at a ministerial conference in PEI this June, Federal Finance Minister Jim Flaherty urged his pro-vincial and territorial counterparts to get their health care budgets under control. These sentiments were echoed recently in a report by two top economists at the Conference Board

of Canada. They have a point: The annual pub-

lic health tab in 1998 was $59.2 billion. Now it’s $128.6 billion. In virtually every province, spending on health care is growing faster than six per-cent. Budgets for education, social services and infrastructure projects can’t compete with the demand for health care services and, as a result, are being squeezed. Health care spending eats up more than 40 per-cent of government budgets in Nova Scotia, Ontario, Manitoba and B.C.

Finding the fundingMr. Flaherty seems to be signaling that annual six percent increases to federal health transfers are very unlikely after 2014. Provincial and territorial fi rst ministers are begin-ning to talk among themselves

about where to fi nd the necessary funds to not only meet today’s needs but also tomorrow’s.

Realistically, can Canadian tax-payers continue to foot the bill for health care at the expense of other key government services? What happens when our health care spending eats up 60 percent of provincial and territorial budgets, and there are still long wait times for care? No one wants to go there, but that’s where we’re headed with-out health-care reform and decisive action.

Keeping canada’s orthopaedic surgeons

stuart foxman

[email protected]

SUPPLEMENTS CAN GIVE YOU A

BOOST

SUPPLEMENTS

3TIP

Jessica Hume

[email protected]

When provincial health minister Deborah Matthews announced in April new le-gislation that would change how pharmacists in Ontario are paid, it ignited a deba-te about what the role of the pharmacist is, should be, and how they would be best com-pensated for their expertise. While consensus has yet to emerge with regard to the latter, that the role of pharmacy is evolving inspires more agreement among industry professionals.

Pharmacists say the scope of their profession has broadened and they are spending more of their time providing information and advising patients in addition to simply dispensing medication.

Dr. Zubin Austin, pharmacy pro-fessor at the University of Toronto, says it is pharmacists’ interest to undergo drug system reform. The problem with the new legislation, he says, is that it throws away an old system without replacing it with a new one, a reality that could hurt many smaller pharmacies in the meantime.

“For years, how pharmacists were compensated was linked to dis-pensing. So there was no compensa-tion for consultations and no incen-tive for pharmacists to use their knowledge,” Austin explains. “The new legislation acknowledges that pharmacists need to be compen-sated for the services they provide beyond dispensing, but it doesn’t say what that new model is going to be.”

Though Ontario is one of the larg-est purchasers and distributors of medical drugs, it pays among the highest prices for generics in the world. In order to cut provincial spending on generics, under the new legislation the government said it would reduce the amount it spends from 50 percent of the price of brand names to 25 percent, and require that new measures be intro-duced by 2014 to regulate the price of generics on the private market so that individuals will pay the same price as the province.

That the industry is changing is undeniable, and with its evolution will come growing pains, says Den-nis Darby, CEO of the Ontario Phar-macists’ Association. But in broad-ening the scope of the pharmacist’s role, Darby says it is the patients who stand to benefi t most.

“Until three years ago there was no compensation for anything other than dispensing,” he says. “Right now there are concerns about how smaller pharmacies are coping, and changes are having to be made: fees are having to be charged for services that weren’t paid for in the past, people are hav-ing to pay for delivery advice. But what this legislation does too is help patients get more out of their pharmacist. They provide much more care than just dispensing drugs.”

the evolving role of pharmacies

Jessica Hume

[email protected]

Medically supervised exercise helps manage bone diseases

CHanGe!

Every Monday, sports chiropractor Dr. Mohsen Kazemi sees what he calls the “weekend warriors”. These are the super-active exercise enthusiasts for whom enough exercize and pain is no reason to rest. Unfortunately, an over-zealous work-out regimen or sudden increases in duration or intensity can lead to painful conditions that come much quicker than they go away.

Overexertion and repetitive motions can lead to no shortage of problems. The bad news is that if left untreated some of the most com-mon ailments can become chronic, but the good news is that a relatively new therapy has shown high success

rates in patients suff ering with tennis elbow or plantar fasciitis.

“We’re fi nding that 70 to 80 percent of patients who undergo shockwave therapy have a 90 to 100 percent reso-lution rate,” says Kazemi, who is a Fellow at the College of Chiropractic Sports and Rehabilitation Sciences and works at the Sports Specialist Rehab Centre in Toronto, a clinic that uses shockwave therapy on some of its patients.

Remind the body is has to healDr Kazemi explains that often in chronic pain cases, the healing pro-cess in the body has stopped and the patient is likely making physiological

adjustments to accommodate dis-comfort. Shockwave therapy works by infl icting microtrauma to a localized area of the body, an action which can cause an infl ammatory response and kick start the recovery.

First studied in Europe in the early 1980s, shockwave therapy was the gold standard for treating kidney stones because of its ability to shatter them and alleviate the tremendous pain that accompanies them.

Treatment can take as little as three weeks to see pain gone

“Then we saw the eff ect it was hav-ing on the surrounding muscles and

it started being used to treat chronic pain,” Kazemi says. “By 2000 we had a good body of research on using shock-wave therapy to treat tennis elbow and plantar fasciitis, but because it was so expensive, it was still only a last resort.”

As the treatment has become more popular, its cost has decreased signifi -cantly. Still, Kazemi says, the price is higher than other therapies.

Shockwave therapy works best when treating chronic pain, not acute problems. Most treatments occur once a week for three weeks.

sHoCKwave tHerapY

chronic pain, meet your match

Statistics Canada reports that about 3 million Canadians get inadequate concentrations of vitamin D, a nutrient that helps the body use calcium to build strong bones. In adults, low le-vels of vitamin D can contribu-te to osteoporosis.

It’s no surprise that Osteoporosis

Canada recommends vitamin D sup-plements for adults. That’s just one of many dietary supplements that may off er benefi ts for bones and joints–as The Arthritis Society notes, it depends on who you ask, your condition, your nutrition, and even your age. The best advice: check with your doctor or pharmacist fi rst.

For consumers looking to wade

through the natural supplement options, Sarah Holvik of SierraSil Health Inc. suggests talking to a naturopath or checking the Natural Medicines Comprehensive Database online (http://naturaldatabase.thera-peuticresearch.com).

Holvik’s company markets a mineral complex “joint formula” that’s touted to signifi cantly reduce

infl ammation and the breakdown of cartilage.

“I think there’s an increasing awareness of the role of supplements in health in general,” says Holvik, “and bone and joint products are gain-ing in popularity.”

Know YoUr sUppleMentsThe Arthritis Society’s web-site, www.arthritis.ca, outlines the possible advantages of common supplements. Some considerations:

■■ Calcium: Supplemental calcium may help to maintain bone strength, especially if you don’t drink much milk. Our best dietary source of calcium could help to ward off the bone-thinning disease osteoporosis.

■■ Vitamin D: Works in tandem

with calcium to create healthy bones. One study found that low vitamin D intake may be linked to the progression of osteoarthritis of the knee.

■■ Vitamin C: Beyond its reported benefits as everything from an anti-inflammatory to an antioxidant, vitamin C could be good for your joints. A study from Boston University linked a high intake to a three-fold reduction in the risk of osteo-arthritis of the knee. It also

appeared to cut the risk of knee pain, while low intake corre-lated with the risk of cartilage loss.

■■ Omega-3 fatty acids: Avail-able in supplements like fish oil. There’s some evidence that supplements can reduce tenderness in joints and morn-ing stiffness. Other research has shown that they decrease inflammation and the activity of enzymes that destroy cartilage.

■■ Glucosamine: Supposed to slow deterioration of cartilage, relieve osteoarthritis pain, and improve joint mobility.

■■ Chondroitin sulfate: Said to reduce pain and inflammation, improve joint function and slow progression of oseteoporosis. It’s believed to enhance the “shock-absorbing” properties of collagen and block enzymes that break down cartilage.

can supplements help your bones and joints?

stuart foxman

[email protected]

ross LeigHton

Md, FrCpSC

[email protected]


proFEssional insight

anthroscopy lowers pain, speeds recovery

As the world’s #1 health and wellness franchise focusing on foot care and proper fit, we not only know what our customers need, but also what they want. We know you want shoes that look great. We know you want choice. And we

know you need the expertise that will help alleviate foot, leg and back pain through properly fitted shoes and custom orthotics that support and align your body, literally from head to toe.

At Foot Solutions, our products actually enhance performance, helping you achieve a more efficient workout that burns more calories and delivers better results.

To find the retail location closest to you, visit footsolutions.ca

For years, it was believed that the relationship between obe-sity and osteoarthritis (OA) was related to excess weight on the hip or knee joint. However mo-re recent research, including work by researchers at Toron-to Western Hospital’s Arthritis program, has shown a strong biochemical relationship bet-ween excess fat and joint car-tilage death.

This metabolic link between obesity and OA has been identifi ed as Leptin. This hormone exists naturally in your

body as a regulator of appetite; how-ever, with excess production from fat deposits, it can contribute not only to OA but also diabetes, high cholesterol, and coronary artery disease.

These findings have been strengthened by a correlation between an elevated body mass index (BMI) and the development of OA in non-weight bearing joints of the body, such as the shoulder and hand. The research team also found a link between genes controlling diabetes and OA. With funding for this research from donors and from the Arthritis & Autoimmunity Research Foundation

(AARCF), these breakthrough fi ndings have given us a new understanding in how diseases such as diabetes and OA are related and are leading to us to new treatments for arthritis pain.

A large culpritObesity is well recognized as a risk factor for developing OA and progression of disease once it has started. In 2005, 74 percent of those who underwent hip replacement and 87 percent of those who under-went knee replacement in Canada were overweight or obese.

Many researchers have warned

Canadians of the increasing preva-lence of diabetes and obesity in not only adults, but also in children. The projected burden of arthritis in Canada is rising at a rate greater than would be expected simply based on an aging population alone. There is an urgent need for a greater understanding in how to treat and possibly prevent osteoarthri-tis. Long unrecognized relation-ships between diseases such as high cholesterol, diabetes and osteoarthritis will hopefully pro-vide new insights into curing this crippling disease.

Dr. Rajiv GandhiOrthopedic Surgeon and Clinician Scientist,toronto Western Hospital,University Health Network

“the metabolic link be-tween obesity and OA has been identifi ed as Leptin.”

When defenceman Chris Pronger of the Philadelphia Flyers was playing Boston in the NHL playoff s in the spring, he heard a “crunch” in his right knee on one shift. This summer, with the knee still swollen and sore, physiotherapy wasn’t enough. On July 27, Pronger had arthroscopic sur-gery to remove some loose particles, and just two weeks later, he was start-ing rehab. He’s expected to be ready for training camp in September.

A non-traditional wonderThat’s the wonders of arthroscopy, which helps athletes like Pronger and tens of thousands of other patients to undergo knee repairs–with less

cutting, reduced pain, a lower risk of infection, and quicker recovery com-pared to traditional “open” surgery.

With arthroscopy (also known as “keyhole” or minimally invasive sur-gery), a miniature fi ber-optic camera and a light source are inserted into the joint through a tiny incision. On a monitor, surgeons can see a clear picture of the inside of the joint. One or more additional incisions are made to insert the instruments needed to perform the procedure.

Arthroscopic surgery is probably the most common orthopaedic proce-dure, notes the Canadian Orthopaedic Foundation. It can be performed on other major joints, like the shoulders

and elbows, but knee procedures have become routine.

Effective for torn cartilage and OAThe two main reasons for knee arthroscopy, according to the Cana-dian Orthopaedic Foundation, are torn cartilage and osteoarthritis (OA).

Because cartilage tears don’t heal on their own, arthroscopic surgery is the only eff ective option. During arthroscopy, the precise fi x depends on the type of meniscal tear. Most often, any ragged edges or fl aps are removed, with the remaining menis-cal cartilage contoured for optimal function.

For knee OA, early non-surgical treatment can include medication, braces, massage, acupuncture, hot/cold compresses, and strengthening and stretching exercises. As the con-dition worsens, arthroscopy can clean up fl aking cartilage, and surgeons can also pump saline fl uid into the joint and then fl ush away debris from the eroding cartilage.

The Canadian Orthopaedic Foun-dation, however, points out the arthroscopic procedure might only “buy time” for knee OA, as eventu-ally, a total knee replacement may be needed.

Not all knee damage can be eff ec-tively treated arthroscopically, but

some other uses of arthroscopy include reconstruction of the anterior cruciate ligament (ACL) and cartilage transfers.

Usually, arthroscopic knee proce-dures are done as day surgery, and can be completed in as little as 30 min-utes. Recovery depends on the treat-ment and the individual, but today’s patients can be back on their feet–or their skates, like Pronger–quicker than ever before.

stuart foxman

[email protected]

obesity, Diabetes & osteoarthritis: Biochemically linked?


nEws

Getting older has its perks. Retirement, grandchildren, community, travel; for seni-ors, these can be the spoils of a life well lived and also things they’ve been looking forward to for years. Even though their bodies may be slowing down, many seniors have built lives, and homes, that they maintain and love, and they want no-thing more than to remain in-dependent and in their homes as they age.

Aging is a difficult thing to face, let alone plan for, and a recent poll showed that less than half of seniors aged 65-85 have researched ways to live independently at home. Ninety-seven per cent, however, said they are trying to be pro-active about their health. Seniors don’t want to give away control of their health or focus on how their health may decline, but

by not planning the specifi cs, they may be missing out on vital resources that could keep them living healthily at home.

Planning ahead involves under-standing possible obstacles. Many problems that could cause seniors to lose independence can be avoided. One of the leading causes of death and disability in the elderly is falling. Bone and joint disorders such as arthritis can contribute to falling, and muscle weakness or loss of balance can also add to the problem. “Musculoskeletal disorders and bone and joint disorders are a major part of seniors’ natural aging process,” says Holly Quinn, chief nursing officer at Bayshore Home Health, Canada’s largest pro-vider of home and community health care services. “If we can keep them pain-free and keep them from falling, they can have a high quality of life in their home.”

Home care services off er a wide

array of in-home help, depending on the needs of individual seniors. Life-style support can help lessen strain; in-home visits can lower the risk of depression; assessment of hazards in the home can make recommenda-tions on lighting, how to make stairs safer, or on special equipment that can make daily living easier.

As the population ages, prevention becomes increasingly important. It’s one thing to treat illness or accidental injury after the fact, but most agree it’s far better to prevent these things from occurring in the fi rst place. But seniors may not always know about the full range of home care and com-munity services available to them that could help them get ahead of potential problems. Each province has diff erent services available, but often they include things like help with homemaking, home security, trans-portation, home maintenance and repair, caregiver training/education

or social networking. These services can be accessed through government care programs or insurance plans, or sometimes purchased directly.

Some programs, like Bayshore’s groundbreaking myNurse program, off er individualized plans incorpo-rating many diff erent services. The myNurse program was launched last year and assigns seniors a per-sonal nurse who helps them plan and access services with the goal of helping them stay healthy and avoid having to move into assisted living or retirement homes. “We’re getting a lot of early enthusiasm around the program,” says Ms. Quinn. “I think it’s because it’s something that [seniors] can proactively do to remain healthy and remain in their homes.” Depend-ing on the individual senior, the pro-gram provides things like risk, pain and falls assessments, referrals, sug-gestions on rearranging furniture for safety or a muscle-strengthening

program. All are based on in-home visits on a schedule tailored to the individual.

Home care should be thought of as a tool to help seniors live the way they want to, despite the limitations they have to face. And even if life is not yet posing challenges, it likely will in the future. Seniors should feel free to use the available resources without feel-ing overwhelmed or over-managed.

Ms. Quinn explains how home care is a nice balance of independence and assistance: “There’s nothing more reassuring than the familiar face of a health professional who understands your personal needs and will visit you in your home [to] take care of you.”

courtesy of

tHe canaDian ortHoPaeDic

founDation

home is where the hope is

HEALTHY AT HOMEBy planning on specif-ics, seniors can be sure they’re not missing out on vital resources.

Falls are a leading cause of se-rious injuries, and are arguably the most preventable, espe-cially in our own homes. Here are some tips to help you make your home fall-proof this Fall.

All about the house:■■ Ensure your home is well lit■■ Install nightlights in halls, near

stairs, and in bathrooms used at night■■ Avoid the use of scatter rugs■■ Ensure all carpeting is firmly

tacked down■■ Keep fl oor surfaces free of clutter

and spills■■ Arrange furniture to avoid catching

clothing on corners

Bathroom:■■ Floor surfaces are clutter-free and

dry■■ Shower curtains or doors can be

fully closed to keep water in■■ A non-skid mat placed outside the

shower or tub absorbs water and pro-vides a place to plant your feet as you step out

■■ A rubber bath-mat inside the shower provides traction for standing

■■ Especially for seniors, consider: handles for tubs, showers and toilets; mat seat for the tub or shower; raised

toilet seat.

Stairways:■■ There is a handrail and it is in good

repair■■ Stairs are free of toys and other

clutter, and are in good repair■■ Any carpeting on the stairs

is fi rmly tacked down■■ Bare stairs have a non-skid

surface■■ The pathways at the top

and bottom of the stairs are free of plants or other items

Kitchen:■■ Floor surfaces are clutter-

free and dry, and only non-slip fl oor wax is used

■■ Appliance and cupboard doors are kept closed

■■ Often-used kitchen appli-ances are stored in easy-to-reach locations

■■ Heavier items are stored in lower cupboards

■■ A step-stool with non-skid feet and a safety rail is avail-able to reach items in high places

Outside:

■■ All entrances are well-lit■■ Stairs and decks have handrails and

are in good repair■■ Bare stairs have a non-skid surface■■ Stairs and walkways are free of

snow, ice, leaves or other clutter■■ Gardening and other tools are put

away when not in use

Want some help? Why not challenge a child? Ask your kids, grandkids, or visiting children to be your Safety Agent. Give them this check list and ask them to perform a safety inspec-tion. Not only are they helping you, but you’re helping them to recognize common household hazards and

teaching them how to avoid them.

tips for fall-proofi ng your home

Laura mann

[email protected]

1 800 430-7898webbernaturals.com/ease

SAVE $5 on any Osteo Joint Ease TM product from webber naturals ®

with the NEWEST Innovation for Joint Care from webber naturals® – Canada’s #1 Joint Care Brand!

ULTRA STRENGTH, FAST RELIEF for CHRONIC PAIN Osteoarthritis sufferers commonly use over-the-counter pain relievers, and nonsteroidal anti-infl ammatory drugs (NSAIDs) to reduce pain and swelling and to cope with joint stiff-ness. While these drugs may be helpful they can cause side effects, and they do nothing to support long term joint health.

Osteo Joint Ease represents the next generation of natural joint care. This innovative formula contains patented Infl amEase, a synergistic combination of anti-oxidant, anti-inflammatory and pain-relieving botanicals that relieve pain and infl ammation fast and with-out side effects.

PROTECTS AGAINST CARTILAGE DETERIORATIONOsteo Joint Ease addresses pain associated with osteo arthritis, and protects against deterioriation of cartilage.

Osteo Joint Ease contains the joint care superstars Glucosamine, Chondroitin, and MSM. They not

only help with pain and infl amma-tion, but support long term joint health, helping to rebuild cartilage and lubricate joints.

Only two caplets a day provide the key nutrients to ease joint pain and support healthy cartilage, without drugs or unwanted side effects.

Infl amEase™– What is it?Osteo Joint Ease contains In-fl amEase™ BioStandard™ process super extract formula. Simply said, we’ve put our best scientifi c minds together to make Osteo Joint Ease

—the best product for chronic joint pain available in Canada!

Infl amEase™ contains these natu-ral anti-infl ammatory ingredients:

76% Polyphenols. These prom-ising plant compounds may help control oxidative stress and con-sequently infl ammatory response, related to chronic and acute infl ammation.

Boswellia works by blocking en-zymes, 5-LOX and HLE. 5-LOX leads to the formation of harmful inflammatory substances called leukotrienes—thought to directly infl uence disease processes in a

number of different disorders, in-cluding rheumatoid arthritis, cancer, and asthma.2,3 HLE is a pro-infl am-matory enzyme that along with leukotrienes is increased in a num-ber of infl ammatory conditions.

Turmeric has powerful anti-infl am-matory properties due to its high curcumin content. “Curcumin is as effective as cortisone or phenylbu-tazone against acute infl ammation.” 4

This unique botanical formula combines the power of Boswell-ia, Turmeric and Polyphenols (extracts from 7 of nature’s most powerful antioxidants) into a POWERHOUSE antioxidant, an-ti-inflammatory, and analgesic complex.1,2

1. Kimmatkar N, Thawani V, Hingorani L, Khiyani R. Ef-fi cacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee--a randomized double blind placebo controlled trial. Phytomedicine. 2003 Jan;10(1):3-7.

2. Ammon, HP., Safayhi, H., Maeck, T., Sabieraj, J. Mecha-nism of anti-infl ammatory actions or curcumine and boswellic acids. J Ethnopharmacol. 1993 Mar;38(2-3).

3. Ammon, HP Boswellic acids (components of frank-incense) as the active principle in treatment of chronic infl ammatory diseases. Wien Med Wochenschr. 2002;152(15-16).

4. Murray, Michael T. The Healing Power of Herbs: The Enlightened Person’s Guide to the Wonders of Medicinal Plants, revised and expanded 2nd ed. Prima Publishing, 1995.

* Use for a minimum of 4 weeks to get the most benefi cial effects.

100% natural anti-infl ammatory ingredients

Results within one week*

Only 2 per day

The most natural and effective way

to build joint cartilage and reduce

infl ammation

EASEEASEEASEYOUR PAINYOUR PAINYOUR PAINYOUR PAIN

Infl amEase TMwithPatent Pending

TM

TO THE DEALER: WN Pharmaceuticals® Ltd. will reimburse the face value of coupon plus regular handling fee provided you accept it from your customer on purchase of item specifi ed. Other applications may constitute fraud. Failure to send in, on request, evidence that suffi cient stock was purchased in previous 90 days to cover coupons presented, will void coupons. Coupons submitted become our property. Reimbursement will be made only to retail distributor who redeemed coupon. For redemption mail to: WN Pharmaceuticals® Ltd., PO Box 3000, Saint John, N.B. E2L 4L3

MANUFACTURER’S COUPONExpires September 30, 2011

4 3 4 0 2 9 0 2

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