Post by Lαrα on Sept 17, 2013 9:42:01 GMT -8
The musculoskeletal system and potential effects on it as we age.
Overuse of the upper limbs
Spinal cord injury increases your risk for shoulder dysfunction, early degenerative arthritis and osteoporosis.
At some point many individuals with SCI will start to suffer with pain in the shoulders, arm, wrists and hands. This is because the upper body limbs become relied upon so much more due to lack of function in the lower extremities.
Transfers,pressure releases, self wheeling and crutch walking as we age starts to take its toll over time and as we age pain often becomes more common and severe.
It is important to preserve the parts of your body that becomes more relied on and overused. The easiest way to do this is to find a balance so that you upper limbs do not become overused.
The ideal is not to wait until the onset of pain before you look at ways to preserve your function but instead look at ways you can balance the use. Independence can be soon lost if the parts of your body that you rely on to give you independence become too damaged to use.
Considerations should be given to modifying your activity if you do start with shoulder problems or any problems with the hands/wrist. I remember when i was in my unit i developed carpel tunnel syndrome in my wrists due to overuse from self wheeling. The pain caused me to have difficulty with wheeling and transfers and significantly reduced my independence.
If i were older then im sure i would not have recovered so quickly and the lack of independence would be a greater problem.
Obtaining an individualized exercise program from your rehab physician to balance the shoulder and maximize your ability to use that shoulder safely for the long-term. Take advice on this and be informed.
So what about bone loss and osteoporosis?
Bone loss starts immediately following the onset of SCI and continues for at least 12 to 16 months, then it plateaus, bone loss increases the risk for fractures, and this risk continues to increase over time.
Always be aware of the potential risk for fractures and what symptoms can be present and not seem like fractures. Even routine activities that are not associated with trauma, such as range of motion, can result in fractures in someone whose bone density is very low or who is many years past injury.
Fracture symptoms may include swelling, bruising and warmth of the fractured extremity, but not necessarily a visible bony deformity.
How can you preserve bone density to reduce the risks?
Reduce caffiene intake, alcohol and avoid smoking.
Keep up a regular exercise regime
Get adequate calcium in your diet:
Adults 19-50 years: 1000 mg/day
Adults 51 years and over: 1200 mg/day
Calcium rich foods and there value (mg)
Fortified oatmeal, 1 packet =350mg
Sardines, canned in oil, with edible bones, 3 oz = 324mg
Cheddar cheese, 1½ oz. shredded = 306mg
Milk, nonfat, 1 cup =302mg
Milkshake, 1 cup= 300mg
Yogurt, plain, low-fat, 1 cup= 300mg
Soybeans, cooked, 1 cup =261mg
Tofu, firm, with calcium, ½ cup =204mg
Orange juice, fortified with calcium, 6 oz. 200–260 mg=(varies)
Salmon, canned, with edible bones, 3 oz.= 181mg
Pudding, instant (chocolate, banana, etc.) made with 2% milk, ½ cup =153mg
Baked beans, 1 cup =142mg
Cottage cheese, 1% milk fat, 1 cup= 138mg
Spaghetti, lasagna, 1 cup= 125mg
Frozen yogurt, vanilla, soft-serve, ½ cup =103mg
Ready-to-eat cereal, fortified with calcium, 1 cup= 100–1,000mg (varies)
Cheese pizza, 1 slice =100mg
Fortified waffles, 2 100
Turnip greens, boiled, ½ cup= 99mg
Broccoli, raw, 1 cup= 90mg
Ice cream, vanilla, ½ cup =85mg
Soy or rice milk, fortified with calcium, 1 cup =80–500 mg(varies)
The ideal is to add the required calcium to your diet rather than take supplements.
Be careful not to affect the calcium intake as high levels of protein and sodium (salt) in the diet are thought to increase calcium excretion through the kidneys, it would be a shame for this to be wasted!
In addition to vitamin K2, you should also look for a few (or all) of the following nutrients in your bone support supplement: calcium, phosphorus, boron, magnesium and vitamin D3.
Vitamin K and D intake! (Green leafy vegetables, brussels sprouts, green beans, asparagus, dairy products,and broccoli are all great sources of vitamin K.)
Lower your homocysteine levels Homocysteine is an inflammatory protein that, if elevated in the blood, is a proven independent risk factor for osteoporosis as well as heart disease, Alzheimer’s and strokes. Homocysteine has been found to increase with insulin resistance so be sure to get your levels tested.
If your results are above 6.3, A complex of vitamin B6, vitamin B12 and folic acid in your daily vitamin regimen for at least three months is recommended
Medications such as Fosamax may be prescribed by your doctor .
Keep your weight (and insulin) in check
If you’re prone to osteoporosis, you may be shocked to discover that all the calcium in the world isn’t going to help you maintain your bones if your insulin levels are high. In fact, most of that calcium will be eliminated through your urine, or even worse, form calcifications in your arteries.
In addition to a diet that keeps your insulin levels low, such as the meal plan in 'The Carb Sensitivity Program'.
Add a conjugated linoleic acid (CLA) to your supplement arsenal twice daily with food. CLA has been shown to help preserve lean muscle as well as maintain bone density and muscle mass, improve insulin.
Wheelchair—make sure your wheelchair fits and is properly positioned
Standing...though the subject of standing and its benefits to bone density receives different opinions it is worth considering it to be beneficial as it offers so many other health benefits.
Functional Electrical Stimulation (FES).....again..the benefits are not confirmed but as it is beneficial in other ways then it is worth considering.
Low intensity vibration
Transmission of low magnitude mechanical signals are delivered by an oscillating platform. Tests have shown that bone mineral density in animals is maintained and also in some human studies too even though it isnt understood why.....SCI studies are ongoing at this moment, but no results as yet.
People with SCI need to use a standing frame with this in order to stand upright enough to put their full body weight on it.
The above has been derived from several sources....here, here and here