Months into a new year awakens great opportunities to invest in HEALTHY CHANGE in your lifestyle. For the many Americans who live a sedentary lifestyle, most of us use time markers (like a new year) as a sensible time to re-dedicate to new challenges. Losing weight is the number one goal each year for most people - and the undisputed culprit to a non-active lifestyle drives unhealthy choice-making into a situational life trap. Meanwhile, other members of the community are situated with the inability to perform physical activities due to chronic pain or a debilitating disease (ie. spinal cord injury, traumatic brain injury or stoke sufferers).
In an interview with Dr. Jonathan S. Kirschner, physiatrist at HSS (Hospital for Special Surgery), we found his expertise, his thought process and his insight on certain health solutions to deliver remarkable value to us all- especially those affected in some way by the debilitating effects of the pandemic lifestyle.
Every little bit that you can do helps and the first part is assessing where the patient is in their readiness to change. Some people are really just absorbing information, but are not ready to make that step -- others want actionable items or things that they can do. I can encourage them to get up and take breaks from the computer to slowly increase the amount of physical activity. A lot of doctors encourage walking- but then again, that's good and bad because patients think that’s all you’re supposed to do. But to walk for exercise, you have to walk briskly at a certain pace—and you have to walk a lot. When I tell patients that they need to start exercising more, there are really four pillars; One is AEROBIC EXERCISE. One is STRENGTH TRAINING. One is working on FLEXIBILITY and then the other is BALANCE. This is especially important in our older population because that can help prevent falls. But even in the younger population, the high level athletes, they have good balance, they have good muscle control of their flexibility and strength. Walking (in and of itself) doesn't really make you stronger or more flexible. So they have to do a little bit of all four.
There are certain cellular growth factors within the PRP, but you are also stimulating some of the local tissue responses as well. PRP is used for treatment of tendon tears or tendinosis which is chronic tendonitis- a degenerative condition within the tendon. It is used for osteoarthritis, it's used for cartilage and other soft tissue injuries like meniscal tears. The research shows that PRP probably is most effective for tendinopathy and specifically lateral epicondylitis- which is tennis elbow. I've done research on tendinopathy and PRP and also shoulder arthritis. Part of the issue with PRP is there's a lot of variability in how it's made, who manufactures it, how it's being used clinically and the proportion of the different cells and growth factors within it. There's Leukocyte rich PRP that has a lot of white blood cells in it. Leukocyte poor PRP has white blood cells taken out. By taking out the white blood cells, you are reducing the inflammation that's caused by the PRP so it's less painful. Some people think that might be better for osteoarthritis because you don’t want to create more inflammation- versus the Leukocyte rich PRP which is better for treating tendon issues because you want some of that inflammation to help remodel and heal the area.
The Krebs’s Cycle is a multi-step chemical reaction that is the main source of energy for cells during Aerobic respiration. Also called the TCA (TriCarboxylic Acid) Cycle or Citric Acid Cycle, the Krebs cycle occurs in eukaryotes (cells with a nucleus) in the matrix of the mitochondria and the cytosol of prokaryotes (no distinct nucleus). In a living organism, the TCA cycle is a series of reactions in which oxidation of Acetic Acid/glucose provides energy for storage in phosphate bonds (ATP). Fuel for this comes from lipids and carbohydrates, which produce Acetyl-CoA. These reactions are the major source of energy in all living organisms. (see full article)