Hello and welcome to Health on this Tuesday evening.

I'm Jennifer Blomquist.

Thanks so much for tuning in tonight.

I'm excited about our topic this evening.

I hope that you will join in in our conversation.

We're going to be talking about something different than we've ever done on the show before.

It's orthopedics related but it's taking it from the perspective of The Spectator.

How can you keep yourself comfortable and prevent yourself from getting what we call Bleacher Report at my house from sitting at all those games because we're getting into a new school year, lots of football games, all sorts of all sports and of course that's year round at school.

So we're going to talk to somebody who's got a wealth of information to share with us and you can join in ask a question any time starting out through the end of the show it's (969) 27 two zero.

If you're outside of Fort Wayne it's still a free call as long as you put an 866- in front of there, you will talk to a call screener first and then you can ask the question live which is great or if you prefer to just have me ask our guests the question that's also fine as well.

So again, we'll keep that phone number up at the bottom of the screen and feel free to interrupt any time we welcome your questions throughout the program we have a familiar face joining us tonight my all my one of my all time favorite guests, Jody Chambers.

We were just saying that you've been on the show four times probably five times in recent years.

>> So Jody is a physician assistant but she specializes orthopedics and I could just tell you from from past shows we get a lot of calls and she she has great advice to offer.

So please don't be shy if you have any issues orthopedic related, go ahead and ask.

It doesn't have to be specifically about the spectator thing that we're going to be talking about but it's going to be a good show.

I have to yeah we call it at our house.

We call it bleacher but because what else can you call it when you're sitting there most of the kids games well sports is at least a couple hours that you're sitting there and it is not always a good feeling after you've been sitting out on metal for two hours bleachers are not very ergonomically correct and you know they don't have backs and so a lot of times people can get back pain from sitting postures not very good.

And so when we talked about what to talk about, I felt like it was really important to talk about how much parents spend as much time sitting in the stands as the kids do on the field.

And I feel like there's always an uptick in the injuries that we see like people falling down the steps because there may not be handrails and so just being safe about going in and out of bleachers should you know, seat where and in exercise is that you can do maybe during the during the game you know, quarters you know, doing some squats or doing some stretches or instead of just walking to the concession stand there are something else you could do that counts the steps I guess.

>> Yeah.

So I felt like that that was a good topic to talk about this time of year because I mean any sport parent is going to be sitting in the stands with like bad parents are very active.

>> You know they they're lifting they're moving the instrumentation and the settings off and on the field and so I feel like there's a topic to discuss and just being able to have good health in general going into the fall, you know, we're going to start raking leaves and such.

Oh sure.

And you know, it's neat to see there are so many grandparents that come to me and I see you we were a baseball family and all six of our kids play we have a softball player, five baseball players.

I am just it's neat because these people they are diehards they come and most I notice most of the grandparents a few of them sit in the bleachers.

>> Almost all of them bring their own chairs is that I you can get inexpensive chairs or I've seen really nice ones with the umbrellas over them.

>> I mean from as far as maybe your pasture standpoint or just, you know, not hurting your back, what would you recommend them to do?

>> They think that there's you know, the ones that you can clip on to the scene.

>> Yeah.

Or they can cinch on and those are important because you can't sit back.

But I think that the biggest benefit to those is that it protects you and gives you some padding.

>> Sure.

And then also doesn't require as much posture muscles.

But you know, people tend to sit like this and then we're on our phones and I was recently at the Beach Fair and I was watching the show because my nephew show and we just watching you know, because I'm always looking at everybody from an orthopedist.

Oh and just everybody sitting so hunched over with covid and zoo meetings.

You know, we're spending all this time in a position where we're there so a lot of times people can't they're like oh it hurts too much to sit well it's because their posture muscles are tired and weak and they're just having you know, every time the whistle blows or whatever your little cue is, you know, just squeezing your shoulder blades together to open up that chest so that this isn't as tight and the back is doing more work because we get in the slump position.

I think that really feeds into people getting neck pain and shoulder pain and things like that.

Yeah, I was going to say that's there is I feel like there's a lot of camaraderie among fans but it's also pretty quiet sometimes because yeah, people are constantly on their phones and now there's all this you know most of the sports I think the you can sign up for an app where you can follow the game because they don't always use at least in baseball they don't always use the scoreboards or you may not recognize who's at the plate or whatever and so you get it from your phone.

>> Well, you can even watch the game you right and listen to you know, the play by play.

Yeah.

On the on the TV, the radio or if they're putting live on TV.

So in the other concern that I see is that it's really the steps are really deep and so if your quads are weak or your hip abductor's which are the muscles on the side of your leg, if those are weak you really have a hard time getting it up and down the stairs so don't be afraid to ask somebody to hold your hand.

I always yeah.

Make a point of offering my hand to somebody because I don't want them to fall and I see what happens at that that that side of it.

>> So you're right there really are not many railings.

>> I mean I guess it's one thing if you go to like a big hall, you know, like it's essentially any high school university you know they usually do the railings but I've noticed bleachers do not know so yeah.

>> So I don't know you know and being able to sit on seats on the ground and your sight is limited but I think getting the the seats are just helpful from a posture standpoint and a comfort standpoint.

I don't know that it's orthopedic going to correct anything by sitting there really it's as with any type of activity where you're going into a season being ready ahead of time and you know, making sure that your your strength is good to get, you know, up and down out of a chair and sometimes, you know, people have to kind of rocked and that's all strength.

That's not like a knee problem or a hip problem typically it's just a strength problem and so just taking time to just like stand up and do five squats and you know, sit down, stand sit down, stand up and then you know, your quads will probably burn but that's a good thing.

>> Well and you talked about there are some exercises you can do beforehand.

I want to ask you about that.

But I also want to remind everybody at home we have not had any calls yet.

It is a beautiful night outside so maybe that's where everybody is.

But if you're watching us, please give us a call if you have any questions about anything orthopedic related, that's what Jody specializes in.

She's a physician assistant specializing in orthopedics.

We are tonight talking about things you can do as a spectator to help from an orthopedic standpoint but feel free to interrupt any time again that number is (969) 27 two zero.

Yeah, I guess I don't think about that.

You know my kids warm up before they play a game but I never thought about doing exercises myself before.

>> I think that there's just a couple when I talk to patients they're like you know I think we're so bombarded and overwhelmed with so much information and you know you know, people are like Oh I want to lose weight.

Well, what day?

There's eight thousand diets that are available.

And so you know my I always say keep it simple.

I have a somebody I work out with and he's a really good mentor to me and you know, he's very good about keeping things simple and sustainable.

>> So if I could say give you three things to do probably one is getting in your steps every day so important because we are we do not understand how sedentary we are.

Yeah.

And so you have to try and make those steps and it's not anybody's fault.

It's just the way we are with computers and everything.

So you know, if you're only getting on an average of let's say four thousand steps a day increased by ten percent one week and then increase the next time by ten percent because that's something that's easy to do and it's sustainable that vary by age or even hour when and how many steps because if you're a postmenopausal woman that's weight bearing activity which is going to help with your bone density.

It's burning calories so people are like well you should run because that's better than walking a step is a step is a step.

Yeah.

So it takes you longer to do ten thousand steps if you're walking but it's not burning calories any less or any more and you're not getting the cardiovascular fitness from it but any more.

We've kind of gotten away from that from just a general health now we could go into cardiology and that would be a different conversation but just weight training because that increases your bone density, increases your basal metabolic rate which is how many calories you burn on it.

You and strength you know, I always tell people you don't want to do you want to be an arm piece and look really nice or do you want to be able to go up on a couch or what if you needed to lift something off of a child or something like that.

So strength training whether it's your own body weight but I feel like the steps are very important.

I feel like in also being outside because vitamin D is very important.

We spend so much time to that side and vitamin D is very important for mental health .

That's why people get seasonal affective disorder in the winter because you know in Indiana we don't get enough sunlight throughout the day or throughout the year so everybody should be on a supplement and I would say two thousand international units a day is completely appropriate.

You know, that's easy way to just no matter what age you are there would be what about kids as well?

>> Do you recommend it for them?

Yeah.

OK, And even kids now you know when we were kids we were outside all the time so it's not so vitamin D exposure to the sun and or supplements which you need to get because you could not physically eat enough vegetables to get it you have to eat bushels and bushels and bushels and so the supplements are pretty much standard across the board and then hit mobility I think as we get older I feel like I it's very important for balance because that's one of the things that really gets you in trouble going up and down the bleachers.

So working on balance and standing on one leg when you're washing the dishes or you know, just things to just work on that proprioception which is your body's ability to say hey, I'm getting ready to tip and I need to correct that and by by increasing your base being appropriate and you're lifting mechanics, all those things will help you establish a better base so that you won't be as Tippee.

And there are physical therapy sessions specifically for balance training and it doesn't have to be post stroke.

>> It can just be balanced training.

Yeah, my sister is a yoga instructor and she has a whole class is really geared toward older folks, you know and she had a point that I thought was well taken.

She was telling me she's like once somebody falls, you know, she's like a lot of them are never the same right.

And so she's the their whole thing is let's get out in front of it and not try and fix it afterward, which you can try to.

>> But you know, her whole big thing is trying to prevent it in the beginning.

So I just wanted to go ahead and take a quick question if you wanted to answer this one.

This is from Judy.

She wanted me to ask it for her .

>> So Judy's wondering are there any exercises you would recommend for the hips?

So from a strength standpoint I think it's important to work on the balance and in some people can't get on the floor to do those exercises.

So if you're standing against standing at the counter with your hands on your hips just doing that leg lateral move helps work on your head abductor's side and those are very important for both hip balance and knee health .

And so not only is the one that's lifting your leg working but the one that has to stabilize you is working harder.

So doing those things and you could do it to the side into the back now if you can get on the floor and do it laying on your side, then you're increasing the resistance because now you have more gravity fighting against you.

>> The old Jane Fonda exercise you say I think a Jane Fonda Victoria principal Suzanne sorry I can't tell half my all of my patients that because they don't know that we know who they are but hip abductor strength that is a super, super important for both health and we talk about that in athletes if they have knee pain you know, if you have weak hip abductor's um let me use this to some models.

>> Whispering Oh yeah.

Yeah.

So this is your hip up here if you're hip is weak so you'll collapse and then it makes your knee do this and then your kneecap has to work harder.

So one of the things that we work work on for people who have kneecap pain is working on their hip abductor so it keeps them steady.

So this is a lot better.

>> So that's one being able to just cross your legs.

You know, some people when they start to get hip arthritis they can't cross their legs.

>> They can't put their shoes and socks on because they lose that congruency of the ball in the socket.

So just, you know, lifting your legs up and reaching them out the side, mimicking the activities like getting in and out of a car, you know, things like, you know, mimicking what you do on a daily basis honestly and just repeating it a couple times ten to twenty times some of this stuff you're talking about you could do while you're watching TV or listening to podcast or something.

>> That's a big thing for for people.

I think most people don't it's hard with their busy schedules for them to make time to go to a gym.

Absolutely.

Or an exercise class.

And so sometimes it's like well if you're at home and there's some show or maybe like this show you could you could do your exercise.

>> And I think the other thing that we forget is that everything is accumulative.

>> Your steps are cumulative.

So parking your farther away from the door just just little silly things like that that you don't think about all add up so there's a book that I read that talks about just 10 percent improvement every day.

So if a plane is flying and its trajectory is ten percent off of this one, where is it going to be in a year?

>> OK, yeah completely different in different directions.

And so those little those little things are going to add up.

So adding up your steps, adding up the number of times you do something if you do it three times every hour ten times that's still thirty times you don't have to do thirty times at one sitting and I think we as Americans we're into this all or nothing thing.

>> And so you know, if we if we fall off the track on one thing then we fall off the track on everything and in just being one percent better every day adds up.

>> Yeah.

And you know, in a year's time I like that analysis.

You know that analogy of the you know, going ten miles off the trajectory.

I know that's one of the you know I've written some articles and stuff with local nonprofits that are all about health and fitness and just helping people to change their habits.

And I know that was like the first thing that all of them have said is when you go to the grocery store especially for their diet, their diabetic patients, they'll say, you know, if you're if you're struggling with your weight and everything just park you know, park ten spaces farther away than you normally would and then keeping keep parking further and further away which you know, it's hilarious how many people to sit there and wait with their turn signal and to get that close as it is.

>> And I know that it's frustrating for a lot of people because they have hip arthritis or new arthritis or you know, back pain or something like that.

That's my job is to help get those things better so that you can be functional.

>> But some people hear the word I have arthritis so I don't want to do those things but joints are made to move and I always use the analogy of you don't buy new tires on a car and park it in the garage for six months.

>> Tires are designed to be rotated, rotated and moving and joints are like that.

So when people have arthritis and they stop moving, their arthritis is going to become much more symptomatic not necessarily structurally worse but it will become more symptomatic to where it's going to feel worse.

So you need to be moving to to maintain what you have and hopefully gain some more motion strength, flexibility, whatever it is.

>> Yeah, no great advice things a little thing all those little things like you said they add up so they just flashed me the car that we're now below ten minutes time left.

>> I know it goes so fast and so we would appreciate anyone any more.

Call us if you want to call in and ask about anything orthopedic related.

We had a good one from Judy earlier about things you can do to help your out with your hips as far as exercises and so we're getting another one coming in as well.

But there's the number (969) 27 two zero and like you said like I said, you have two choices.

You can ask the question live during the show or you can ask me ask the question for you.

So we just got another one now from a woman named Jen.

She is wanted to know about scoliosis prevalence and how to prevent it.

I don't hear much about I feel like in the eighties at school we had scoliosis checks.

>> I don't know if you ever did.

They don't do them anymore.

>> Yeah, they they they used to all the time.

That was a big thing and I don't know much about their sixth grade.

You had to walk the and then bend over and they made sure that your shoulder blades were even right that your back didn't have a curve into scoliosis.

>> Is it something that you can prevent?

It's more of your it's usually genetic.

Yeah.

And it's congenital.

So identifying it before you get into puberty is ideal because as if you if you are in puberty and for girls that would be below the age of menses.

So once they've started their periods, their growth plates are starting to close a lot faster and so we kind of have to treat them as orthopedic adults.

And so you want to see that in it before that time frame and then we can brace them to help because once you're done growing you can't modify that because it's kind of like after a tree's grown you can't really change it.

>> But when you plant a tree and you put little sticks and try and try and straighten him out, that's basically what the oh the bracing does.

>> And then they we typically monitor every six months or a year and we take what we call scoliosis films which is a big, big plate and every place probably not orthopedic place would have those plates and we measure the degrees and as long as they're not increasing and they're decreasing then we keep an eye on it.

>> If they get to the point if they're eighteen and they didn't they've met the best they can do then there is surgery but it's really not preventable but it is treatable.

>> OK, good to know.

Yeah and I think they they normally do during a wild child as kids get older too so I guess I have something to ask your doctor as well.

We have one more now from Marc.

So Mark is saying that he's had two hip surgeries and has since had physical therapy but he's struggling to lift his legs and he exercises he would recommend Mark some of that would depend on what surgery you had.

So the typical surgeries you would see for hips would be in hip arthroscopy which is where they scope your hip for maybe early arthritis or if you've had hip replacement surgery then you can get off into did you have an A. hip or did you have a post your hip.

So a lot of times they don't make you do exercises after hip surgery because walking is your best thing.

>> Walk, walk, walk.

Doing those exercises we talked about standing at the counter when you're brushing your teeth, standing on one leg, lifting it up, doing it on both sides.

I'm a big proponent of do it while you're doing something else sitting on an exercise ball when you're watching TV or you know adding it because you're more likely to do it.

>> So walking would be very important.

Any post up back patient or patient you can't walk too much .

You're not going to like some of it because you're those muscles in your are going to be very weak from your hip margaritis and or if they had to do an incision.

>> So I would suggest those things you can ask for physical therapy.

>> There is direct access now for like so many sessions and then you would get a formal prescription from a provider to get that.

>> So you have YouTube for everything.

>> Yeah.

Yeah.

So I would suggest those things the the one I had already mentioned which was the standing in lifting your legs and then walking and biking is not really going to help you a lot because you're sitting right.

>> So that wouldn't be a good hip exercise for you.

All right, great.

And there we're just getting inundated with questions now so we're going to take one more from Martha.

She had she also had hip surgery now she says one leg slightly longer than the other and she wants to know if she has any options to change that things she could do to help her with balance.

>> That's a very common question when we surgically fix those the patients lying on their side and we like line them up and we stuck her legs on top of each other and we're matching their knees and we're matching her ankle bones, it's going to feel like it's a huge leg length discrepancy because we've replaced the space that they lost.

Usually it's it's millimeters, maybe centimeters and I think sometimes there's an illusion that there really is a leg length discrepancy when it's a weakness.

So there's a certain gait that people have when they walk that they kind of dip and we call that trendelenburg gait and that can make you feel like you're off.

>> But it's really a strength thing that you've got to get at things kind of balanced up.

You can't get shoe inserts but you would have to go see somebody to get those because depending on how high it is would depend on if it would be an inside the shoe insert or an outside of the shoe insert and that depends on the length of or the height that they would need to correct.

>> But most of the time it's millimeters or centimeters are very minimal.

>> It probably like you said it probably feels bigger, it feels different and I think different means uneven.

But a lot of times we tell people no matter what procedure you've had waiting up to a year your scar maturity is it a year, your muscle strength, everything.

So when people get really upset about I'm not making progress I always tell them give it a year because it what you have it a year is probably what you're going to have then we can reassess chasing a moving target is basically what you're doing between surgery and a one year time frame.

>> OK, so there's a lot of things that just survive on our own that you don't need to constantly be messing with.

>> Yeah I think a lot of people it's just a year seems like a long time you know and they think they're used to especially when you're older you think about when you were younger, maybe had some surgery or an injury or something.

>> You tend to bounce back and you have to.

>> How long have you had arthritis?

Thirty years.

Forty years.

So you've been you've been walking with an anti gait meaning a painful gate or you're an alternating gait for years and so some of that's just a reeducation of your muscles.

It's reeducating your brain to muscle memory to to to reestablish that normal gait because you don't know your body doesn't know what normal was.

>> Right.

And so I think that's patience is just something Americans don't have and unfortunately sometimes I just have told people it's just a time thing.

Yeah, I think we hear that a lot from callers that you know and I and I know in your field they always take a conservative approach first they don't just jump in and do surgery but I think a lot of people just yeah they they want it to be fixed, you know, tomorrow.

>> I think that's a good time to mention I get this conversation a lot.

We're patients bounce around and they're like well so and so would you do surgery on me?

>> And and this is my response to them.

I said if a surgeon tells you they don't want to do surgery, there's a reason.

Sure.

That's what they do for a living.

>> That's what they love to do.

That's what they're wired to do.

That's how they pay their house payment.

So if a patient is told no surgery is not a good idea for reasons X, Y and Z, there's a reason for that.

It's not a personal insult to that that that patient there's a there's either too much risk involved.

>> They don't feel like the reward is going to be there.

There's a complication or something is going on but they're not telling you that just because they don't feel like doing it that day.

Sure.

And so I think I have that conversation at least a couple of times a month and so that was a perfect segue way for me to get that up.

>> Yeah, no I you said that because people do they try and they call it you know like doctor shopping or shopping and yeah.

>> No take take their advice to heart.

I mean most of these and some of these doctors are so busy anyway they'll say hey I you know I mean it's not like I need the business.

>> I'm just telling you, you know that this is either what we're going to do or not so well in the shopping thing people ask for .

You know, there's several times I've had to say you're asking too many people you you know, everybody has an opinion and there's you know, if you go to a mechanic there's going to there's going to be different ways you do it.

So don't get too you're just muddying the water.

You're not clearing it.

>> So sometimes I just have to say you have to stop at this table.

We're out of time.

This stinks but Jody, this is awesome to have you on.

Jodi Chambers, thank you so much for being a guest tonight.

We appreciate it.

And thanks so much to all of you who called in great questions.

>> Yeah, they did.

They were really I appreciate those super thank you so much.

Take care.

And there is another HealthLine one week from tonight Mark Evans will be hosting it.

Take care.

Have a super weekend.

We'll see you later