Q&A With Dr. Michelle Henderson

DR. MICHELLE HENDERSON, MD is a board certified orthopedic surgeon at Cape Canaveral Hospital in Cocoa Beach, Florida. She specializes in hip and knee surgery. A native of Michigan, she attended Michigan State University College of Human Medicine. She practiced in Michigan for 10 freezing years before she came to her senses and moved to Florida four years ago. An avid sports enthusiast (running, biking, surfing, scuba, hunting, fishing, yoga. kiteboarding), she takes personal as well as professional interest in the aging athlete.Chester, PA and has been with Health First for 14 years.

‘BOOMERITIS’

BABY BOOMERS are not like their parents or grandparents.  Being tired or suffering from a little bit of pain is not accepted as a natural part of aging.  “Boomers” are driven by higher expectations for healthy living and the means to be able to attain a healthier life style.

The good news is that more of us will be active and enjoying our later years.  But to meet the health challenges that come with that, we will need a greater focus on wellness and prevention, and new approaches to care delivery.

The demographics of the United States patient base are rapidly changing along with the population as a whole. The average age of the population continues to increase as baby boomers enter their 50s and 60s.  Members of the post World War II era, born between 1945 and 1965, baby boomers represent the largest group of health care consumers in the country.

Physical activity is a critical, yet often neglected, part of staying healthy as we age. At least 30 minutes of moderate physical activity five times per week is recommended.  Joint pain from arthritis is the most common condition that prevents participation in physical activity.  Almost half of the “Boomers” will live with arthritis with that number peaking at over 26 million by 2020.

Space Coast Medicine and Healthy Living is delighted to welcome Dr. Michelle Henderson, Board Certified Orthopedic Surgeon, to address non-surgical management of the inevitable “Boomeritis” that is or will be inflicting a significant and very influential segment of our society.

SCM&HL: What is arthritis?

Dr. Henderson: Arthritis is a degenerative condition of bones and joints characterized by joint pain, stiffness and swelling.  There are several kinds of arthritis, the most common being osteoarthritis.  Osteoarthritis is deterioration of, or wearing out of the cartilage and bone.  Causes are aging, genetics, obesity, and trauma.  In the early stages of arthritis, pain starts with activity, and can be relieved by rest.  As arthritis progresses, pain may also occur at rest or when trying to sleep.

SCM&HL: The older I get, I feel stiffer and less limber.  Is that arthritis?  Can anything be done?

Dr. Henderson: As we age, our tendons, ligaments, and muscles become less flexible, causing decreased range of motion in our joints.  Arthritis can cause loss of range of motion and stiffness.  Regular exercise, especially stretching and balance can help maintain flexibility and decrease the symptoms of stiffness.  Yoga can increase flexibility, maintain or improve balance, improve strength, and is weight bearing, thus providing an excellent all around exercise.

Buy a DVD and do yoga or exercises at home.  Water aerobics and swimming help maintain flexibility, and are well tolerated by most patients with arthritis, as the water helps unload the weight from joints, thus causing less stress.  Go to a local gym.  Keep moving.  A stiff arthritic joint is more painful than a mobile joint.  Try different kinds of exercise until you find one that doesn’t hurt, and stick with it.

SCM&HL: I love to run, but my knees hurt.  How can I keep running?

Dr. Henderson: Running shoes are very important.  The rule of thumb is to replace running shoes every 500 miles.  Buy good quality shoes with arch supports and well padded soles.  Try running on soft surfaces, trails or a tread mill instead of concrete.  Softer surfaces are more forgiving and less traumatic.  Alternate running with other exercise such as biking, elliptical trainer, or swimming.

Anti-inflammatories such as aspirin, Aleve, Ibuprophen, or tylenol arthritis, can help with pain and swelling associated with arthritis.  Side effects such as ulcers, kidney or liver problems can occur, so take them sparingly, with food and a large glass of water.

Consider glucosamine and chondroitin supplements.  They are cartilage building blocks that can help prevent the progression of arthritis.  As we age, our bodies stop making glucosamine and chondroitin.  Supplements are available over the counter.  It’s like taking a vitamin for your cartilage.  Some patients get improvement of pain, too

SCM&HL: What can I do for hip pain?

Dr. Henderson: The three main causes of hip pain are arthritis, trochanteric bursitis, and sciatica or pinched nerves.  Arthritis pain usually hurts in the groin, in the middle of where your hip bends.  Sometimes the pain radiates toward the inside of your knee.  Glucosamine and chondroitin supplements, anti-inflammatories such as Aleve and Ibuprophen, and tylenol can help.  If your pain is severe using a cane in the opposite hand may help.

Trochanteric bursitis hurts near the bony prominence on the side of your hip, the spot you lay on when you are laying on your side.  The pain is aggravated by hip flexion and getting out of a car or chair.   Ice or heat can help.  Stretching exercises with your hip and knee bent 90 degrees and pushing you knee toward the opposite hip can help.  Physical therapy with ultrasound treatment may help.  Cortisone injections can be helpful if stretching and anti-inflammatories don’t help.

The third cause of hip pain can be due to a pinched nerve in your back or pelvis.  Symptoms are pain in the buttocks that radiates down the back of the leg to the knee (sciatica) or to the calf or foot (Pinched nerve in you back).  Back pain may or may not be associated with the pain in the buttocks or leg.  Exercise to stretch and strengthen the back and abdomen, as well as improving the posture, can help.  Aleve, Ibuprophen, or tylenol are good medications to start with.

SCM&HL: I am losing motion in my shoulder and it hurts.  I can’t get my hand behind my back.  Do I have arthritis?

Dr. Henderson: Arthritis can cause loss of motion in shoulders.  A grinding sensation can often be felt and heard as the cartilage wears out.  Mechanical blocks to movement are due to bone spurs and the flattening of the humeral head, the ball portion of the shoulder.  Treatment includes anti-inflammatories, glucosamine and chondroitin, cortisone injections, and, as a last resort, surgery to clean out or to replace the joint.

Adhesive capsulitis, or “frozen shoulder”, is another cause of a stiff painful shoulder.  Middle-aged, fair skinned females and diabetics are most commonly affected.  The layers of skin, fascia, muscles, tendons, ligaments and joint capsules get stuck together with adhesions, similar to a rusty hinge.

IRIS DAVIS says exercise “helps you with aches and pains, and it makes you stronger.” Davis is pictured here training at Parrish Health & Fitness in Titusville, Florida.

The adhesions can be broken with stretching, stretching, stretching.  Physical therapy can help guide the exercises and provide stretching passively by the therapist manipulating the joint. Anti-inflammatory medications can help, too.

SCM&HL: What are the “rooster comb” injections for arthritis?

Dr. Henderson: Cartilage is made of collagen fibers woven together like a sponge.   The holes in the sponge are filled in with a thick fluid called hyaluronic acid, or HA.  HA gives the cartilage more resilience and makes it more resistant to compressive forces.  As we age, the collagen fibers wear out and flake off, the start of arthritis.

The HA then leaks out of the cartilage, making it less spongy and less of a shock absorber.  HA production by your body decreases with age.  HA injections help replace what is lost.  Through unknown processes, HA helps relieve arthritis pain.  It does not stop the progression of arthritis, but can ease up the symptoms.  HA used in these injections are produced from rooster combs, which are made up of a lot of cartilage.

SCM&HL: It is encouraging to know that there are a variety of effective non-surgical treatments for arthritis.  Any concluding suggestions for us “Boomers?”

Dr Henderson: Those affected with arthritis pain need to work with their doctors in order to find the best arthritis pain treatment regimen.  Most cases of arthritis can be managed with medications, physical therapy and other non-surgical approaches as described.

Although the hierarchy of treatment plans for arthritis requires that more simple and conservative steps be tried and exhausted before surgical consideration, there are a variety of surgical procedures that are very effective and can render tremendous pain relief for patients suffering from more severe arthritis refractory to non-surgical treatment.

CLICK HERE FOR RELATED STORY

YOU CAN HEAR the pride in her voice when Ruthie Porter says, “I’m keeping up with the younger generation.

Related posts:

1. Osteoarthritis Most Common Form of Knee Arthritis
2. Osteoarthritis Also Known as “Wear and Tear” Form of Arthritis.
3. Birmingham Hip Resurfacing Offers Better Stability
4. Minor Knee Pain Responds Well to Self-care