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A Day With Orthopaedic Surgeons: An Osteopath’s Perspective

As an osteopath, I approach the human body with a deep respect for its intricate balance and ability to heal. Recently, I had the unique opportunity to shadow an orthopaedic surgical department for a day, and it was an eye-opening experience that challenged my perceptions of surgical medicine.

Going in, I expected the environment to be extremely clinical and high-tech, but what I witnessed was a blend of learned human skill, knowledge, and hand precision. The surgeons used screws, drills, and saws—tools you might find in a carpentry workshop, and in many respects, the job of the orthopeadic surgeon is a lot like carpentry.  One of the surgeons even mentioned that the body is more forgiving than wood because it has the remarkable ability to grow back. This comment struck a chord with me and underscored the body’s resilience, something I see daily in my osteopathic practice.

The surgical team was incredibly professional, with a noticeable difference in how they approached routine surgeries versus trauma cases. In routine procedures, like a knee arthroscopy and a total knee replacement, the team worked seamlessly, almost like a well-rehearsed orchestra. The lead surgeon, his registrar, a team of nurses, and the anesthetist all moved in unison, efficiently operating at a specific time.

However, when it came to trauma repairs, such as fixing a fractured clavicle or a shoulder with multiple fractures of the humerus, the dynamic shifted. These surgeries required more time, careful consideration, and problem-solving. One of the highlights for me was seeing the use of real-time X-rays to guide the placement of screws over a fracture site. The precision was impressive, as the team worked meticulously to ensure that the shoulder would retain its full range of motion after the surgery.

Before each surgery, the lead surgeon held a team meeting. Introductions were made, especially since the anesthetic teams rotate between surgeries and don’t always know each other. Each case was discussed in detail, ensuring everyone was on the same page before the patient went under. This level of preparation was fascinating and highlighted the importance of teamwork in such high-stakes situations.

One of the most striking differences between osteopathy and surgery became evident during the total knee replacement. The patient had multiple comorbidities, including obesity, diabetes, and significant bunions, all of which likely contributed to the rapid deterioration of the knee joint. When I pointed this out to the surgeon, he acknowledged it but remarked that his job was simply to replace the parts that had worn out. This interaction illuminated the contrasting approaches of our fields. As an osteopath, I would aim to address the underlying factors that led to the surgery or could impact recovery. Surgeons, on the other hand, focus on the immediate mechanical fix.  Seeing it in action and hearing the surgeon’s perspective helped me understand that as much as they might want to help in that regard, it simply isn’t part of their job. 

My day in the orthopaedic theatre was a powerful reminder of the body’s strength and resilience. Watching the surgeons use mallets, saws, and screws, I couldn’t help but marvel at how well the body recovers from such interventions. It’s a lot stronger than we often give it credit for, and its power to heal is immense. 

This experience deepened my appreciation for the complementary role that osteopathy can play both before and after surgery. While a surgeon’s tools and training allow them to do amazing things to and with our bodies, the ultimate goal is the same: to restore function and improve the quality of life for our patients.

Many thanks to consultant surgeon Mr Oliver Donaldson and his team at Yeovil Hospital, UK.

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Blog

Understanding Sarcopenia: The Battle Against Age-Related Muscle Loss

As we age, maintaining our physical strength and functional abilities becomes increasingly important. One of the crucial aspects of this is understanding sarcopenia, which is the age-related loss of muscle mass and function. In this article, we will explore what sarcopenia is, its implications for longevity, and practical strategies to combat its effects. I had the pleasure of sitting down with Justin Keogh who is the Associate Dean of Research for the Faculty of Health Science and Medicine at Bond University, with a special interest in geriatric exercise prescription who helped me understand this area better and write this guide to help you maintain muscle health as you age.

What is Sarcopenia?

Sarcopenia is defined as the progressive loss of muscle mass, strength, and function associated with aging. It is not merely a consequence of getting older; rather, it significantly impacts independence and quality of life. As muscle mass decreases, older adults often find everyday activities more challenging. Tasks like standing up from a chair, walking, or climbing stairs become increasingly difficult.

Contemporary definitions of sarcopenia encompass not only muscle mass but also muscle strength and physical performance. Physical performance can be gauged through assessments such as gait speed and the ability to perform sit-to-stand activities. These metrics are used because the movements offer a proxy for fundamental movements for maintaining independence and functionality in daily life.

The Importance of Muscle Health in Aging

Taking steps to maintain and enhance muscle strength as we age is important for several reasons. Loss of muscle mass can lead to:

  • Increased risk of falls
  • Reduced mobility
  • Decreased overall strength
  • Lower metabolic health

How Does Muscle Loss Affect Longevity?

One of the key questions surrounding sarcopenia is its relationship with longevity. Studies have shown that individuals who lose muscle as they age may not only experience functional decline but may also have a higher risk of premature death. For instance, walking speed has been identified as a significant biomarker of longevity. A gait speed of less than 0.8 meters per second is associated with increased negative health outcomes aka not living as long as you might. 

As walking speed decreases, the risk of severe health consequences and mortality increases. Therefore, maintaining muscle strength along with function is paramount for promoting longevity.

Factors Contributing to Sarcopenia

Sarcopenia can result from various factors, including:

  • Reduced physical activity
  • Hormonal changes
  • Chronic diseases
  • Malnutrition

These factors can compound over time, leading to significant muscle loss. It is crucial to address these elements proactively to mitigate the effects of sarcopenia.  You might do this with your doctor, nutritionist, chiropractor or osteopath, but whomever you work with make sure they have skills in working with an elderly population. 

Strategies to Combat Sarcopenia

To effectively combat sarcopenia, a multifaceted approach is required. Here are some practical strategies:

1. Engage in Resistance Training

Resistance training is one of the most effective ways to maintain and build muscle mass. Engaging in strength training exercises at least twice a week can help counteract muscle loss. Focus on exercises that target major muscle groups, which can start with things like getting up and down from a chair and progress to:

  • Squats
  • Lunges
  • Push-ups
  • Rowing

2. Incorporate Balance and Flexibility Exercises

Improving balance and flexibility is crucial for functional mobility. Incorporate exercises such as:

  • Tai Chi
  • Yoga
  • Dynamic stretching

These activities can enhance stability and coordination which increase the brain’s control of your muscles.  This can reduce the risk of falls.

3. Optimize Nutrition

A well-balanced diet rich in protein is essential for muscle repair and growth.  For most people as they age their protein requirement actually goes up.  This is due to difficulty absorbing some proteins as the intestines age. So, aim to include for following foods in your diet. 

  • Lean meats
  • Dairy products
  • Legumes
  • Nuts and seeds

Consuming adequate amounts of protein can help maintain muscle mass as you age.

4. Maintain an Active Lifestyle

Incorporating physical activity into your daily routine is vital. Consider activities such as:

  • Walking
  • Gardening
  • Dancing
  • Swimming

These activities can help sustain muscle health and improve overall fitness levels.  In some communities they have exercise classes specifically for an elderly population.  For example my mother, who is currently 86 regularly attended a group exercise class for the elderly in the UK.  She does this with friends and finds it a really good way to socialize as well as exercise. 

5. Use Movement Snacks

For those struggling to find time for formal exercise, “movement snacks” can be an effective solution. This concept involves integrating short bursts of physical activity into your day. Examples of movement snacks include:

  • Doing calf raises while cooking
  • Performing squats while watching TV
  • Taking the stairs instead of the elevator
  • Standing on tiptoe while brushing your teeth.

These small actions can accumulate significant benefits for muscle health.

Addressing Common Concerns

Many individuals may question whether they can still gain muscle mass as they age. Dr. Keogh says that while it is more challenging, it is certainly possible, especially for those who are new to resistance training. Older adults can experience significant strength gains and improvements in functional capacity.

It is essential to start with a manageable routine and gradually increase the intensity. Consulting with a fitness professional can help tailor a program that meets individual needs and goals.

Understanding and addressing sarcopenia is critical for promoting longevity and maintaining a high quality of life as we age. By engaging in resistance training, optimizing nutrition, and incorporating physical activity into our daily routines, we can combat the effects of muscle loss. Remember, it is never too late to start prioritizing your muscle health—every effort counts towards enhancing your health span and lifespan.

For more information on muscle health and effective strategies to combat sarcopenia, reach out to me via the Contact Page and we’ll see if we can start making Your Lifestyle Your Medicine.

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Podcasts

Episode 42: Aging Strong – Insights on Sarcopenia and Longevity with Justin Keogh

Can losing muscle mass determine how long we live independently? Join me, Ed Padgett, as I explore this critical question with Justin Keogh, the Associate Dean of Research at Bond University and a seasoned expert in sports science and geriatric exercise. We’ll dissect the phenomenon of sarcopenia, the age-related loss of muscle mass, and its profound effects on our daily lives and longevity. Justin shares his extensive knowledge on maintaining muscle strength and physical performance as we grow older, providing invaluable insights into overcoming the challenges of aging.

One muscle often overlooked but vital for preventing falls and maintaining balance is the tibialis anterior. We’ll discuss the significance of strengthening this muscle and how tailored exercises can boost muscle strength and endurance in older adults. Justin also highlights the potential risks of overly accommodating environments that can hasten physical decline and underscores the benefits of an active lifestyle. Drawing lessons from communities known for their longevity, we touch on the importance of incorporating resistance training and cognitive challenges into daily routines to sustain muscle mass and overall function.

Ever heard of “movement snacks”? We’ll introduce this practical concept, perfect for those struggling to find time or motivation for traditional gym sessions. Justin offers creative ideas to seamlessly integrate resistance training into everyday activities, making fitness an achievable goal for everyone. Additionally, we emphasize the importance of varying exercise routines to keep engagement high and prevent monotony. From changing sets and repetitions to using different equipment, these minor adjustments can significantly enhance physical fitness. Join us for a holistic discussion on health and wellness, blending physical activity with mental well-being, and learn strategies to live a longer, healthier, and more independent life.