Physical exercise is any bodily movement that uses energy, and which improves and maintains health. Despite its persistent recommendation throughout the population, the percentage of women who exercise in the world is much lower compared to men. In Mexico around 48% of men do some physical activity while only 35% of women do.
Exercise is beneficial for everyone, it increases self-esteem, helps with stress, controls weight, and helps prevent chronic diseases. In the case of women there is also a greater mineralization of the bones, reducing the risk of osteoporosis; performing physical activity reduces the average risk of breast cancer by 25%, improves posture, and in pregnant women it helps prevent gestational diabetes.
The sports most performed by women are swimming, cycling, gymnastics, volleyball, and soccer. Compared to strength exercises, aerobic exercises are usually the most preferred and practiced in gym facilities. This is due to the myth that has been incorporated in into society about “muscle development” in women when weightlifting.
Strength training is necessary for toning muscles, reducing body fat, preventing injuries, osteoporosis, and for aesthetic results. It is important to mention that in the case of women, the hormonal difference compared to men prevents excessive muscle growth.
To obtain better results, it is essential to combine both aerobic and strength exercises, and not focus on one daily routine, since usually the same fear of masculinization prevents training from being suitable for the desired changes. For women, the optimal dose of physical activity varies from person to person. Mostly, it has been recommended to perform at least 150 minutes per week, with a minimum of two non-consecutive days per week of strengthening exercises. Remember that before starting any sport or physical activity it is essential to go to your sports medicine doctor for advice and a general check-up to prevent any injury or complication.
Sudden death occurs in an unexpected and unprecedented manner within the first hour from the onset of the first symptom. Athlete-related sudden death is considered when it happens during or after physical activity.
This phenomenon can occur to any athlete, mostly to men and apparently healthy young athletes. Which tends to be a devastating event for the sports community. Its frequency is low, reporting around one death per 200,000 inhabitants per year. However, it is a condition that is given a lot of emphasis and diffusion since it can prevented.
The causes of sudden death are diverse, including environmental factors (heat stroke), trauma (due to high-risk and contact sports), and chronic diseases, with cardiovascular diseases being the most prevalent.
It is important to know that there are normal physiological and morphological changes in the heart of high-performance athletes, this is called “athlete’s heart” and it is important to know these variations to differentiate normal from abnormal findings. Dichos cambios son: These changes are: symmetric thickening of the left ventricle, sinus bradycardia, prolongation of the p wave in the electrocardiogram, and no presence of atrial growth.
These changes must be distinguished from the most common cardiovascular causes of sudden death for a timely diagnosis, such as hypertrophic cardiomyopathy (main cause), ischemic heart disease, Marfan syndrome, and valvular diseases.
Even with a low rate of cases, sudden death is unfortunately unavoidable at the moment it occurs, but the frequency can be reduced through an appropriate approach. Its only treatment is prevention, which is why its diffusion and education to athletes, their teams and organizations is important.
The recommended measures are a medical check with a specialist in that area, which should include a complete physical examination, a clinical history with emphasis on family history, an electrocardiogram and a cardiological and sports stress test with ergospirometry to assess the heart function under physical stress.
Physical exercise refers to any series of movements performed by the muscles of our body that generate energy expenditure. The activities that can be performed are walking, dancing, running, or cycling; an specific sport isn’t necessary to be active.
There are multiple benefits of exercising. We must consider that a large portion of non-communicable diseases that affect us as a society are due to hypokinesia (low mobility). We have previously mentioned the importance of maintaining a daily physical routine to improve health, take care of body weight, increase muscle strength, and reduce the risk of chronic diseases and cancer. However, it has also been proven that one of the greatest benefits is its effect on mental health.
It can help reduce the symptoms of certain diseases such as anxiety and depression, as well as reducing stress, improving sleep, self-esteem and one’s mood.
The mechanisms involved are the activation of neurotransmitters during physical activity, such as serotonin, dopamine, and endorphins. Which are related to happiness, well-being, and sensation of pleasure. As well as the increase of the blood circulation in the brain after exercising and its influence on the hypothalamic-pituitary-adrenal axis, the limbic system (which controls motivation and mood), and the amygdala. Another explanation of the benefits is the feeling of self-efficacy that exercise emits in the person, the distraction and social interaction that comes from going out to perform a physical activity.
Aerobic exercises have been shown to have a greater impact on people suffering from depression, its benefits are evident and have been proven by studies. Doing 30 minutes of moderate-intensity physical activity at least 5 times a week is enough to present changes in mood.
Exercise is the best antidepressant that exists and at the same time it is the one least used. Exercise should be prescribed as medicine, to do it correctly sport medicine doctors consider different factors depending on the needs of each patient:
Type of exercise: Aerobic, anaerobic or mixed
Duration per session: Minutes, miles or laps
Number of sessions per day or per week.
Intensity: Mild, moderate, or intense.
Example: Denisse does Karate training, which is a mixed sport with predominantly anaerobic activity, each session is 60 mins. and she goes to the dojo for 2 sessions per week where she practices with moderate intensity. But she complements her exercise by going for a continuous (aerobic) run for 30 minutes, 3 times a week at a moderate intensity.
The sum of these activities is known as volume and it will be important to calculate the weekly energy expenditure per exercise as well as the recovery and rest times in order to prevent injuries.
To find out more about how you practice your sport or how to improve your sports performance, visit your sports medicine doctor.
Asthma is a chronic disease of the respiratory system characterized by inflammation and reversible spasm of the bronchi. According to the WHO, it is estimated that there are approximately 230 million patients with asthma around the world, being more frequent in children. In Mexico up to 12% of the population suffers from this disease.
The are several risk factors for developing asthma, among them are: family history, respiratory infections and frequent allergies during childhood, being born prematurely, smoking, living in highly industrialized areas, and obesity.
The most common triggers of an asthma attack are dust mites or molds, the presence of pets in the house such as dogs or cats, pollution, exercise, and cold weather.
The main mechanisms present in airflow limitation are due to a bronchial hyper-response to different stimuli of the triggering agents already mentioned, which activate an inflammatory chain, these mechanisms are the contraction of bronchial smooth muscle, thickening of the bronchial wall (due to edema) and hypersecretion of mucus in the bronchial lumen; This causes dyspnea (shortness of breath), chest tightness, cough, and wheezing.
Although exercise can cause an asthma attack, also called exercise-induced bronchoconstriction, it is not contraindicated to do some physical activity. Exercising improves tolerance of ventilatory demand and increases aerobic capacity. It improves physical condition and decreases crises caused by physical exertion, as well as helping with body weight and the immune system (which is important to avoid triggers).
It is important to mention that the treatment of each person is individual and personalized depending on the stage of the disease. Therefore, their established pharmacological treatment must be adequate to control symptoms that may occur during physical activity.
Aerobic exercises are mainly recommended and when choosing sports, it is best to choose one of short duration or intensity, such as yoga, gymnastics or swimming. Swimming is one of the most recommended sports since breathing the water’s vapor in the case of heated pools helps a lot to prevent exercise-induced asthma. Likewise, it is important to mention that the weather at the time of practice is important, dry environments are contraindicated.
Sports that involve greater effort such as long runs, soccer, etc. are not ruled out for the patient, however, before starting any activity, not only should you go to the specialist for a guided treatment, you should also go to the sports medicine doctor for an exercise plan adapted to your specific needs. Among the tests that can be carried out, in addition to a complete cardiopulmonary and metabolic evaluation, are a spirometry to measure pulmonary capacities and spasm tests where the stress situation that induces bronchial spasm is simulated and counteracted in the moment.
Lumbago (low back pain) is one of the pain syndromes that most frequently affect the working population. Low back pain is a very common pathological entity throughout the world, and our environment is no exception, since in Mexico musculoskeletal conditions rank as the fourth cause of consultation at an institutional level, and within this category, low back pain occupies the first place.
The main risk factors for low back pain have been the following: history of low back pain, insufficient overall physical fitness, smoking, poor development of dorsal muscles, lifting heavy objects, spondyloarthrosis, spondylolisthesis, scoliosis, joint hyper-elasticity, abdominal muscle weakness, height and overweight.
90% of low back pain cases are attributed to mechanical alterations of the vertebral structures, most of which are nonspecific (mechanical or nonspecific low back pain).
Within the types of low back pain there are those that are caused by compression of the interverbal discs. The intervertebral discs are the discs that separate the vertebrae from the spinal column. Each forms a cartilaginous cushioning that allows slight movements of the vertebrae and acts as a ligament that holds them together.
Herniated Discs is the pathology in which the intervertebral discs move from their normal position, pressing the nerves that pass along the spinal cord, causing pain that is generally moderate to intense.
Ozone is a strong oxidizing agent, if injected into the paravertebral muscles, it stimulates the production of antioxidant enzymes, and neutralizes the toxic products released by the rupture of the nucleus pulposus that produce inflammation of the nerve.
During ozone discolysis, its injection into the intervertebral disc accelerates the degradation of polyglucosides in the degenerated nucleus pulposus, which leads to its reabsorption and dehydration, with the consequent reduction in the volume of the herniated material, which has been responsible for nerve compression.
The results are like those of surgery, good in 80% of patients, with the advantage that it is ambulatory, with local anesthesia and practically painless. This system can also be used in the treatment of Cervical Disc Herniation and has the advantage over Laser Discectomy that it can be used with excellent results on extruded discs in the spinal canal.
With the ozone therapy technique, satisfactory results have been achieved in 98% of the patients who have received this treatment.
Prolotherapy is a superior treatment than the others to cure chronic pain and more importantly it helps bring people back to an active and happy lifestyle.
If your pain comes between you and your desire to do the activities you like such as: walking, swimming, golf, running. It will also eventually come between your ability to work and spend quality time with your family.
It will take from a few months to several years for a patient here in Mexico to finally go consult a professional. I’ve personally seen cases of pain with an evolution of more than ten years. Once the person decides to be treated, the scenario is more or less the following:
They go to a masseur without obtaining any improvement.
Attend consults with general allopathic doctors and specialists.
Start treatment with anti-inflammatories and analgesics.
Visit Physiotherapy centers.
Get an infiltration with cortisone (dexamethasone, betamethasone, methylprednisolone, etc.).
Increase dosage of medications and use of controlled pain medications.
Sometimes a therapeutic block is performed.
On many occasions the patient continues with pain…
Why is this happening to many millions of people around the world?
Because none of the treatments that we mentioned above cure the cause of the pain, the root of the pain.
Prolotherapy is a treatment to cure the main cause of pain. Prolotherapy’s basic mechanism is very simple. The proliferating solution is injected into the injured tissue which leads to a local inflammatory process, this inflammation triggers the proliferation-healing cascade which results in the formation of new collagen. The new collagen shrinks as it matures, this stabilizes the ligaments making them stronger and more stable.
Why don’t most doctors know about prolotherapy?
Most doctors don’t know prolotherapy, firstly because prolotherapy is not taught in medical schools. In addition, each specialist treats the same condition from the perspective of their specialty. Example: Many people get scared when they go to a neurosurgeon and they want to operate their spinal column… for a neurosurgeon their focus, training and business is to operate on the spine. For a rheumatologist, for example, they will look for a rheumatological approach and will use cortisones and other medications to treat pain.
In regenerative sports medicine, prolotherapy is a first-line treatment. It is economical up to a certain point, but above all, it does NOT have the side effects of anti-inflammatories and does not have the consequences of a failed surgery.
In a few words, the worst thing that can happen with prolotherapy is that the patient does not experience the benefit they expected, and this can be due to different situations that we will mention later.
There are different solutions to carry out a prolotherapy treatment. Let’s remember that prolotherapy is a treatment to proliferate tissue and lead to healing. Some of these solutions are:
Platelet Rich Plasma (PRP)
is theDextroseis the most widely used proliferative solution in the world, it has been used in the United States since the 70’s, not only is it cheap, but it is accessible in all countries and has practically no side effects. Dextrose is a sugar that comes from corn which makes it a natural solution without allergy issues. The inflammation that it causes to start the proliferative process is mild to moderate, which is why the patient experiences pain days after its application for approximately 3 to 5 days.
thisPlatelet Rich Plasma(PRP) has gained a lot of popularity in recent years, this is because the platelets that we have in our blood cause the regeneration of new and healthy tissue. A clear example of this is when we cut ourselves. In this case, what happens is that after a few minutes, with the help of compression, the person stops bleeding. This occurs because the platelets have already adhered to the site of injury, subsequently they begin the proliferative process causing the formation of a crust that over time will become healthy skin. Broadly speaking, this is what happens in any injury.
Compared to Dextrose, PRP is a moderate solution since the patient has the direct action of the platelets and with the Dextrose solution the patient has to slowly stimulate their own platelets, in a few words the solution of PRP saves us a step in the proliferative-regenerative process. After a correct application of PRP, the patient experiences moderate pain for approximately 1 week at the injection site.
thisStem Cellsare a very popular treatment nowadays. This is due to the extensive study they have had in different areas of medicine and not only in the area of regenerative orthopedic medicine.
There are different types of stem cells.
Those obtained from the same person (autologous) and stem cells from stem cell banks (heterologous).
There are 2 widely used places to obtain stem cells from the same person. One is the hip where, under local anesthesia, a bone marrow aspirate can be performed, obtaining a large concentration of stem cells. Another important site is the abdominal fat where this type of autologous cells can be obtained through a mini liposuction type technique.
The second option is cells that come from licensed stem cell banks where they are obtained from young, healthy donors.
What are Stem cells? These are cells in our body that have the ability to become any type of tissue because in their current state they have not differentiated or specialized into any type of cell. This means that if I require muscle cells and I put autologous or heterologous stem cells under a good technique in the place where they are required and they are surrounded by more muscle cells giving them the appropriate stimulus, these stem cells will become new muscle.
Compared to Dextrose and PRP, stem cells treatment requires a more elaborate process and can currently be performed as an outpatient procedure in a doctor’s office. The concentrate of this solution tends to be the most aggressive of all, which is why the patient will have some moderate to intense pain days after application. However, it is the treatment of choice in cases of injury or severe osteoarthritis.