How to avoid expensive orthopedic visits...YOGA

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					How to avoid expensive orthopedic visits…YOGA
Saturday, June 16th, 2012

Jane Brody of the New York Times has some good advice.
Rotator cuff injuries are extremely common, especially among athletes,
gym and sports enthusiasts, older people, accident victims and people
whose jobs involve repeated overhead motions.
For patients facing surgery to repair a tear in the rotator cuff and
many months of rehabilitation, the yoga maneuver can seem almost a
miracle. It is especially useful for the elderly, who are often poor
candidates for surgery.
Dr. Fishman said he successfully treated a former basketball player, who
responded immediately, and a 40-year-old magazine photographer who had
torn his rotator cuff while on assignment. The photographer, he said,
had been unable to lift his arm high enough to shake someone’s hand.
Instead of an operation that can cost as much as $12,000, followed by
four months of physical therapy, with no guarantee of success, Dr.
Fishman’s treatment, is an adaptation of a yoga headstand called the
triangular forearm support. His version can be done against a wall or
using a chair as well as on one’s head. The maneuver, in effect, trains a
muscle below the shoulder blade, the subscapularis, to take over the
job of the injured muscle, the supraspinatus, that normally raises the
arm from below chest height to above the shoulder.
The doctor discovered the benefit of this technique quite accidentally.
He had suffered a bad tear in his left shoulder when he swerved to avoid
a taxi that had pulled in front of his car. Frustrated by an inability
to practice yoga during the month he waited to see a surgeon, one day he
attempted a yoga headstand. After righting himself, he discovered he
could raise his left arm over his head without pain, even though an M.R.I. showed that
the supraspinatus muscle was still torn.
Dr. Fishman, who has since treated more than 700 patients with this
technique, said it has helped about 90 percent of them. “It doesn’t work
on everyone — not on string musicians, for example, whose shoulder
muscles are overtrained,” he said in an interview.
In a report published this spring in Topics in Geriatric Rehabilitation
(an issue of the journal devoted to therapeutic yoga), he described
results in 50 patients with partial or complete tears of the
supraspinatus muscle. The initial yoga maneuver was repeated in physical
therapy for an average of five sessions and the patients were followed
for an average of two and a half years.
The doctor and his co-authors reported that the benefits matched, and in
some cases exceeded, those following physical therapy alone or surgery
and rehabilitation. All the yoga-treated patients maintained their
initial relief for as long as they were studied, up to eight years, and
none experienced new tears.
Yoga for Bone Disease
Perhaps more important from a public health standpoint is the research
Dr. Fishman is doing on yoga’s benefits to bones. Bone loss is epidemic
in our society, and the methods to prevent and treat it are far from
ideal. Weight-bearing exercise helps, but not everyone can jog, dance or
walk briskly, and repeated pounding on knees and hips can eventually
cause joint deterioration.
Strength training, in which muscles pull on bones, is perhaps even more
beneficial, and Dr. Fishman has observed that osteoporosis and resulting
fractures are rare among regular yoga practitioners.
In a pilot study
that began with 187 people with osteoporosis and 30 with its precursor,
osteopenia, he found that compliance with the yoga exercises was poor.
But the 11 patients who did 10 minutes of yoga daily for two years
increased bone density in their hips and spines while seven patients who
served as controls continued to lose bone. He noted that yoga’s
benefits also decrease the risk of falls, which can result in
osteoporotic fractures.
Medical guidance here is important, especially for older people who may
have orthopedic issues that require adaptations of the yoga moves.