Each person has their own unique movement stereotype that distinguishes us just like a fingerprint. The body’s motor function is crucial for maintaining health, while a sedentary lifestyle and poor nutrition lead to slow degradation of the joints. Problems increase with age, and to find out how many of us have them, just go out into the street and watch. Orthopedist, dr hab. Bogusław Sadlik, MD, reminds that the simplest rescue for joints is movement. We should walk or run a distance of 4 to 7 km every day.
- A sedentary lifestyle and obesity are two factors that negatively affect the condition of our joints – the expert warns
- According to Dr. Bogusław Sadlik, walking is the most natural for us
- The expert explains how much we should walk, when to stretch and how to care for our posture
- You can find more such stories on the TvoiLokony home page
The following material was created as part of the #Prepare for movement campaign, encouraging Poles to increase their physical activity. We want to lift Poles off the couch and show that movement – simple exercises and dancing can change the quality of life. The action is carried out jointly with Zdrofit.
Monika Zieleniewska, MedTvoiLokony: What do we mean by correct posture?
Dr hab. n. med. Bogusław Sadlik: Even an orthopedist has difficulty defining where the boundary between correct and incorrect posture is, because each person is individually built, he also has the so-called individual movement stereotype. What does it mean? If we know someone and know how they move, we can recognize them without seeing their faces. It is similar with the attitude. Of course, it can be said that someone has a definitely crooked spine, slumps, knees and feet, so we can say that they have incorrect posture. However, it is difficult to draw boundaries when we move from right to wrong posture. Orthopedics does not fully define it, but rather describes it.
is the director of the Biological Joint Reconstruction Center at the ORTHOS Multispecialist Hospital in Komorowice near Wrocław and the medical coordinator at Go On Clinic in Wrocław.
So you have to approach each individual individually?
Yes, and look at the anatomy. If, for example, the spine is so distorted that it can be seen that the intervertebral joints will suffer mechanically, which predisposes to the development of spondylopathy (developmental disorders in the structure of the vertebrae) or disc prolapse, i.e. discopathy, then we will definitely talk about incorrect posture. On the other hand, our body has great adaptive abilities, which is very important in understanding the functions of the musculoskeletal system. If someone is born with a posture defect, their body will adapt to it as it develops. So if we wanted to heal him and straighten his spine or feet, for example, then …
Are we going to hurt him?
Yes, we usually worsen its functions, because the most important thing is the motor function of our body, not the structure itself. Before the operation, a wise orthopedic surgeon should anticipate how the patient’s motor stereotype will change, and therefore he should ask himself whether, by improving his posture, it will not worsen the motor function.
Probably the same applies to walking?
Yes, it is most important that the gait is symmetrical.
What do we mean by that?
The point is, one leg walks differently than the other – it shortens the step or puts the foot down or rotates. Pathologies, both in terms of posture and gait stereotype, are assessed primarily through the assessment of symmetry. Any asymmetrical gait features should arouse our vigilance. As for the classic definition, the spine with its lateral curves should be aligned in the frontal plane, the pelvis should be properly tilted when viewed from the side, but horizontal when viewed from the front. The limbs should be neither varus nor lopsided, but within a certain tolerance, since no human is perfectly built.
Meaning?
Crooked knees are X-shaped, and deformed ones are like sitting on a barrel. The same applies to the positioning of the feet. The child’s parents need to be vigilant, but they shouldn’t panic too much if they see any defects in the child’s legs. Often, parents report that the child has terribly crooked legs, it seems to them that he is suffering from rickets. Of course, if they are very crooked, you have to check it, but most of the time it develops that way. Crooked, asymmetrically loaded legs, the body will straighten itself during growth, you have to wait to see how the body reacts. Symmetry is key. If the feet are very crooked but symmetrical, we can wait. But if one is a curve and the other is straight, then something is wrong. Similarly with the spine – when we notice that one shoulder is higher and the other is lower, we should visit an orthopedist.
Can we estimate what percentage of our society is affected by postural defects?
Unfortunately, I do not have such data, but my practice shows that 10 to 15 percent we can show some irregularities. Looking at the youth who behave freely in the peer group, we could say that we are dealing with valgus of the knees, feet and abnormal curvature of the spine. However, nowadays, when we spend most of our time in a sitting position, contractures in the hip joints are quite a problem.
What is going on?
If we sit for a long time, the back part of the joint capsule stretches, and the front part shortens, so when we stand up, we cannot properly straighten the hip joints and, as a result, we tilt our buttocks back. As a result, the hyperextension of the lumbar spine, i.e. excessive lumbar lordosis, becomes permanent, which leads to overloads within the lumbar vertebrae.
Moreover, in flexion contracture of the hip joints, the leg stays in the crawl phase for too short a while while walking. This is called shortening of the crotch, which is the beginning of the abnormalities of the entire motor stereotype. Do we have contractures in the hip joints? We can check by lying on the stomach and lifting it on our hands – straighten the spine, trying to press the pelvis to the ground. If we can do it with outstretched arms, then everything is fine. On the other hand, if the pelvis keeps rising, it means that we may already have a contracture.
All the more, such a test should be performed by people who worked a lot or studied remotely during the pandemic.
The pandemic has caused this problem, and another one is obesity, unfortunately. It’s hard to keep weight by sitting at home and pretending to move. Man needs natural movement, he needs to walk a few kilometers a day to function properly, to maintain a proper weight. Movement is important not only for joint function, but for health in general. The most natural movement for us is, of course, walking. We are made to walk, and if we deprive ourselves of it, we hurt ourselves. We do a lot of harm to ourselves by making it easier. The fact that we build them in such a way that we do not get tired of walking anywhere.
What should we do every day to be physically fit?
Most of all, walk. You have to assume that, depending on your age and fitness, you have to walk several kilometers a day. You can also run if you like. This simple form of exercise should accompany us every day.
How many steps should you walk per day?
It is believed that 10 thousand. steps is the minimum daily norm. I encourage you to make it 4 – 7 km a day, so 6 to 10 thousand. steps depending on age and physical capacity. This is already the right effort to keep the joints working. But why bother so much? Articular cartilage must be loaded and lubricated. If this does not happen, the cartilage begins to degenerate, fades away, softens and, as a result, becomes sick. Contrary to popular belief, most joint diseases are caused by a lack of exercise, not an excess of it. Most of my patients are people who are not physically active.
And the active ones do not get sick?
These people do not have problems with joints in the sense of degeneration or cartilage diseases, but they usually report with injuries resulting from sports activities. Osteoarthritis mainly affects people who move little. Of course, it is also said that being overweight is a factor that damages our joints. From my observations, it is not so. Overweight people who are physically active do quite well even compared to those who are of a healthy weight and hardly move.
Should we take care of anything else besides walking?
You have to stretch properly. We sit for a long time, we do not change positions, so a daily 15-minute dose of “PE” is essential. I don’t have time to go to the gym regularly, but every day I do 25 push-ups, 50 sit-ups, I work a bit with dumbbells, stretch my legs, hips, all joints including the entire spine. Daily exercise should be a habit, as is brushing your teeth. However, the important thing is not to force yourself into a movement that we don’t like. Everyone should choose the physical activity they enjoy. It is not true that we must make terrible austerities and torture ourselves two hours a day.
We are flooded with advertisements for dietary supplements, wonderful preparations for joints, spine, cartilage … Is it worth investing in them?
Unfortunately, there is no objective research on a large group of patients that would prove that the use of supplementation improves something. In the absence of evidence, we must apply logical deduction. In my opinion, dietary supplements are needed when we do not provide all the necessary ingredients with normal food. For example, an egg contains most of the substances that humans need to build bone, muscle and cartilage, including vitamins. So if someone is not allergic to eggs and likes to eat one or two for breakfast, they probably don’t need any additional supplementation. Another thing is where these eggs come from… The value of an egg from a wild hen will be greater than that of a factory hen. Generally speaking, a varied diet is advisable. The knowledge about the food pyramid, propagated in the 60s, is still up-to-date.
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Return to a balanced diet?
Elimination diets should only be used by people suffering from food allergies, while people follow the trend in this regard. The fashion for vegetarianism, which brings with it positives, e.g. the fact that we consume less calories and have no problems with being overweight, but at the same time creates problems with deficiencies. Young girls have cartilage degenerating spontaneously in their knees. In lean girls who have not had any injuries, the cartilage begins to crumble, and when they go to the doctor they find themselves vegan, avoiding any animal products. It has not yet been described and studied, but we can already talk about the vegan syndrome in young girls, manifested by tissue diseases. Cartilage is the tissue most sensitive to deficiencies. The problem starts with the joints. Therefore, I repeat, the most important thing is health, nutrition, hygiene of life, adequate sleep duration. These are vital things for your health. If someone lives unhygienically, works a lot, stresses, does not get enough sleep and eats poorly and wants to be treated with supplements, nothing will help.
What is the age limit from which the joints function worse?
It is believed that after the age of 60, we start to age faster, but of course we work all our lives on the quality of our pension. After XNUMX, we will not improve our efficiency, but rather we will fight to maintain fitness, or possibly delay the aging processes, and we have to come to terms with that. Change your lifestyle, save yourself more, avoid stress and enjoy something else, such as having a little more time, reading a good book, wandering deep into your soul. Some even claim that only when they do not have so many external stimuli, they feel happy.
What types of joint problems are the most common?
With cartilage that gets thinner after the age of 60, some people start to crack. We also have problems with bones, with osteoporosis, in most cases it is about degenerative changes or the so-called arthritis. Discs “sit” in the spine, the spine starts to ache, muscle pains begin.
And what are the most common surgical interventions in the field of orthopedics?
I deal with the treatment of joints, mainly of the lower limbs – knee, ankle joint, sometimes the hip. I am also working on a project for the regeneration of cartilage in the elderly in degenerative changes using stem cells.
Is it part of an experimental therapy?
These methods are allowed at different levels. The idea is to force the stem cells, which are deposited on special “interlinings”, called matrices, which are glued to the damaged joint surface, to restore the cartilage. Tissue orthopedic engineering is all about removing dead cartilage or bone fragments and transplanting new bone and a new matrix with stem cells to recreate the cartilage. In this way, we try to extend the life of the joints. Of course, surgery is always a last resort, because first we try to mobilize the body to regenerate itself. Preventive action is the most important, so we make patients aware of what to do to force themselves to physical activity. Like her, go to a trainer or physiotherapist who will take care of their problems in a comprehensive manner.
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