Proper way of walking

Aside from looking less than graceful, a sloppy gait is a waste of energy and a sure way to injure yourself. By delegating some of the load to your abdominal and hip muscles, you can walk faster and more efficiently, reduce your risk of injury, and eliminate much of walking's joint-jarring impact. With fewer pains and strains, you might even walk farther. And that means you'll burn more calories.

If you think about how you walk and you know the correct way, you'll simply do it better. This walking-awareness checklist will get you started.



Pull your navel toward your spine. Your abdominal muscles will form a girdle of stability, and your movements will be more controlled (you'll have great abs, besides). As you walk, let your arms swing, but try not to swivel your torso—its job is to support movement.

Consciously engage your butt and thigh muscles. As you prepare to take a step, focus on your trailing leg, creating a crease where your butt and thigh meet by lifting your cheek and tightening your hamstring. Continue to use those muscles as you bring that leg forward. Notice how your inner thigh muscles keep your knee pointed forward and stabilize your leg.

Walk with your toes pointing forward. "Turning your toes out can stress the knees," Tripp says. When you walk, allow your heel to strike first, then push off from the big toe, flexing at the ankle.

Relax your shoulders. Hold them back and down, and resist the tendency to hunch or shrug.

Hold your head high. Loping forward headfirst stresses your neck and throws your gait off balance. To distribute the force of gravity over your body along the natural curves of your spine, walk as if you're suspended by a string attached to the top of your head. Or just recall that old charm-school drill of walking while balancing a book on your head.

Sure, it takes work to imagine, and place, your body into a perfect walking posture. But in the two months since I attended the workshop, I've been surprised at how aware I am of the way I move and stand. I haven't revolutionized my walk, but for now, it's nice to know I'm moving in a healthier way. 

Dorothy Foltz-Gray

Tip of day

Symptoms of food allergy include: itching of the mouth, swollen lips, vomiting, diarrhoea, abdominal cramp and pain, difficulty in breathing, drop in BP.

Opioid (Pain) Medication May Decrease Testosterone

Opioid (pain) medication, including morphine sulfate and oxycodone, commonly used for patients with chronic pain or abused by those with addiction, carries many risks and side effects.  In addition to the most devastating complication of overdose, pain medication side effects include nausea, itching, constipation, depression, and endocrine abnormalities such as low testosterone in both males and females.  The focus here is on males, but females are also affected and remain understudied in terms of endocrine problems stemming from pain medication overuse.    

The issue of pain medications affecting the hormones produced by the brain are often not recognized, and are not well studied in pediatric, adolescent, or adult popluations.  A patient with narcotic medication addiction or those taking pain medication for chronic pain may have many symptoms which overlap with symptoms of low testosterone.  Opioids are among the most frequently prescribed analgesic drugs but may lead to low testosterone in 20 to 80% of men with decreased attention span, decreased sex drive (libido), fatigue, depressive state, erratic mood.  In addition,muscle loss, bone loss (osteoporosis), low blood count (anemia), erectile dysfunction, delayed ejaculation (semen emission) may occur.  In addition, the risk of cardiovascular disease and diabetes mellitus (increased blood sugar which has many negative effects on the body) are increased.  Chronic opioid use may also adversely affect sperm function (very few studies have addressed this).

The treatment of patients with low testosterone (due to pain medication) is the same as for those with low testosterone of other causes and is managed by a urologist.  Testosterone replacement therapy (TRT) in multiple preparations may have beneficial effects on serum testosterone and qualtity of life.  An alternative to topical or injected testosterone would be the use of human chorionic gonadotropin (hCG injection) or clomiphene citrate (oral pill) which act through a different mechanism to “turn on” the body’s natural testosterone production.

Matthew Wosnitzer, M.D.

Tip of the day

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Breaking Bad Habits: Why It’s So Hard to Change

If you know something’s bad for you, why can’t you just stop? About 70% of smokers say they would like to quit. Drug and alcohol abusers struggle to give up addictions that hurt their bodies and tear apart families and friendships. And many of us have unhealthy excess weight that we could lose if only we would eat right and exercise more. So why don’t we do it?

NIH-funded scientists have been searching for answers. They’ve studied what happens in our brains as habits form. They’ve found clues to why bad habits, once established, are so difficult to kick. And they’re developing strategies to help us make the changes we’d like to make.

“Habits play an important role in our health,” says Dr. Nora Volkow, director of NIH’s National Institute on Drug Abuse. “Understanding the biology of how we develop routines that may be harmful to us, and how to break those routines and embrace new ones, could help us change our lifestyles and adopt healthier behaviors.”

Habits can arise through repetition. They are a normal part of life, and are often helpful. “We wake up every morning, shower, comb our hair or brush our teeth without being aware of it,” Volkow says. We can drive along familiar routes on mental auto-pilot without really thinking about the directions. “When behaviors become automatic, it gives us an advantage, because the brain does not have to use conscious thought to perform the activity,” Volkow says. This frees up our brains to focus on different things.

Habits can also develop when good or enjoyable events trigger the brain’s “reward” centers. This can set up potentially harmful routines, such as overeating, smoking, drug or alcohol abuse, gambling and even compulsive use of computers and social media.

“The general machinery by which we build both kinds of habits are the same, whether it’s a habit for overeating or a habit for getting to work without really thinking about the details,” says Dr. Russell Poldrack, a neurobiologist at the University of Texas at Austin. Both types of habits are based on the same types of brain mechanisms.

“But there’s one important difference,” Poldrack says. And this difference makes the pleasure-based habits so much harder to break. Enjoyable behaviors can prompt your brain to release a chemical called dopamine. “If you do something over and over, and dopamine is there when you’re doing it, that strengthens the habit even more. When you’re not doing those things, dopamine creates the craving to do it again,” Poldrack says. “This explains why some people crave drugs, even if the drug no longer makes them feel particularly good once they take it.”

In a sense, then, parts of our brains are working against us when we try to overcome bad habits. “These routines can become hardwired in our brains,” Volkow says. And the brain’s reward centers keep us craving the things we’re trying so hard to resist.

The good news is, humans are not simply creatures of habit. We have many more brain regions to help us do what’s best for our health.

“Humans are much better than any other animal at changing and orienting our behavior toward long-term goals, or long-term benefits,” says Dr. Roy Baumeister, a psychologist at Florida State University. His studies on decision-making and willpower have led him to conclude that “self-control is like a muscle. Once you’ve exerted some self-control, like a muscle it gets tired.”

After successfully resisting a temptation, Baumeister’s research shows, willpower can be temporarily drained, which can make it harder to stand firm the next time around. In recent years, though, he’s found evidence that regularly practicing different types of self-control—such as sitting up straight or keeping a food diary—can strengthen your resolve.

“We’ve found that you can improve your self-control by doing exercises over time,” Baumeister says. “Any regular act of self-control will gradually exercise your ‘muscle’ and make you stronger.”

Volkow notes that there’s no single effective way to break bad habits. “It’s not one size fits all,” she says.

One approach is to focus on becoming more aware of your unhealthy habits. Then develop strategies to counteract them. For example, habits can be linked in our minds to certain places and activities. You could develop a plan, say, to avoid walking down the hall where there’s a candy machine. Resolve to avoid going places where you’ve usually smoked. Stay away from friends and situations linked to problem drinking or drug use.

Another helpful technique is to visualize yourself in a tempting situation. “Mentally practice the good behavior over the bad,” Poldrack says. “If you’ll be at a party and want to eat vegetables instead of fattening foods, then mentally visualize yourself doing that. It’s not guaranteed to work, but it certainly can help.”

One way to kick bad habits is to actively replace unhealthy routines with new, healthy ones. Some people find they can replace a bad habit, even drug addiction, with another behavior, like exercising. “It doesn’t work for everyone,” Volkow says. “But certain groups of patients who have a history of serious addictions can engage in certain behaviors that are ritualistic and in a way compulsive—such as marathon running—and it helps them stay away from drugs. These alternative behaviors can counteract the urges to repeat a behavior to take a drug.”

Another thing that makes habits especially hard to break is that replacing a first-learned habit with a new one doesn’t erase the original behavior. Rather, both remain in your brain. But you can take steps to strengthen the new one and suppress the original one. In ongoing research, Poldrack and his colleagues are using brain imaging to study the differences between first-learned and later-learned behaviors. “We’d like to find a way to train people to improve their ability to maintain these behavioral changes,” Poldrack says.

Some NIH-funded research is exploring whether certain medications can help to disrupt hard-wired automatic behaviors in the brain and make it easier to form new memories and behaviors. Other scientific teams are searching for genes that might allow some people to easily form and others to readily suppress habits.

Bad habits may be hard to change, but it can be done. Enlist the help of friends, co-workers and family for some extra support.

NIH

Tip of the day

Don't puncture a blister unless it's painful. Unbroken skin over a blister provides a natural barrier to bacteria and decreases the risk of infection.

The Health Implications of Botox

Botulinum Toxin, or Botox as it's more commonly known has been around since the early 20th century, but it wasn't until the early 1990s that doctors started using it as an anti-wrinkle treatment.

Nowadays, getting an injection of Botox can be part of a maintenance routine for many women and men just like going to the hairdressers or the spa every few months. It can be an ideal solution to keep skin looking youthful and line-free, but is it entirely risk-free?

The risks

One of the main risks with getting Botox is that as with any other cosmetic procedure, if your doctor is not highly skilled or experienced, you could end up with the dreaded "botch job." As the Botox needs to be injected precisely in the face to paralyse the small muscles in the face that cause wrinkles, putting it in the wrong place can cause the wrong muscles to paralyse, meaning that you may end up with a droopy expression or frozen look.

While this may go away over time once the Botox has worn off, it can also last weeks or even months. So making sure that the person administering your cosmetic procedure is fully accredited and experienced is of upmost importance.

In addition to this, there are some side-effects of getting injected with Botox that will subside after a while including bruising, swelling, bleeding and headaches, which many people will experience but can be uncomfortable.

The right procedure

It's important to know before you book an appointment that not all wrinkles can be smoothed out with Botox too. While it's ideal for using on fine lines, those deep wrinkles that have been caused by the weight of sagging skin can't simply be made to disappear with an injection of Botox.

If you want your skin to be completely smooth, then a combination of Botox and wrinkle and line fillers may be the best solution for you. Botox works well on wrinkles which are caused by moving muscles, such as laughter or frown lines, whereas fillers can be used on immobile wrinkles where there are no muscles to paralyse.

The benefits

Of course, the benefits of having a Botox treatment is that it's one of the few anti-wrinkle treatments on the market that actually work. While it might be a hefty price to pay up-front, it beats having to buy endless supplies of anti-wrinkle cream, which probably don't work anyway!

With Botox the results are instant, the treatment usually takes minutes and doesn't require any surgery, and it's also long-lasting, usually needing topping up every three to six months.

It's also not just used for smoothing wrinkles: Botox can be used as an anti-sweating treatment by injecting it into the armpits, and it can also be used to relieve migraines and headaches.

So if you're thinking of getting this procedure done, make sure you talk to a cosmetic specialist before you jump in. They'll be able to explain whether the procedure is right for you and will talk you through the process so you can decide whether you want to use Botox or opt for another cosmetic procedure.

Andrew Weber