I came to Borneo to let the ground fight back.

This morning, outside Kota Kinabalu, Malaysia, my boots slipped on a tangle of wet roots.

The air smelled of earth and rain.

A quiet hum of life surrounded me.

In that awkward, humbling stumble, I felt something rare:

My body woke up.

The Comfort Trap That’s Making Us Weak

In Seattle, I walk sidewalks and treadmills — smooth, safe, and sterile.

For most of human history, humans moved across shifting ground.

Forests. Fields. Hills.

Every step required micro-adjustments.

Your feet, ankles, and hips worked together without your conscious effort.

But today?

Flat concrete. Cushioned shoes. Escalators and elevators.

The result?

• Weak stabilizer muscles in the feet and ankles
• Poor balance and slower reaction times
• A brain that tunes out during your most basic movement

Comfort stole our strength.

What Science Says About Uneven Ground

Clinical studies confirm what my jungle stumble reminded me:

Walking on uneven terrain:

✔️ Activates foot and ankle stabilizers
✔️ Improves proprioception (your body’s sense of position in space)
✔️ Sharpens reaction time
✔️ Reduces fall risk in older adults
✔️ Boosts mood and cognitive performance

A 2021 study found that older adults walking on rough paths improved their gait stability by 22%.

A separate trial revealed that rugged walking improved working memory and decision-making speed.

In other words: Your steps train your brain.

→ Your feet aren’t the only part of your body that’s asleep. Want to wake up your mind, too?

Join the 100,000 readers who have enjoyed → 10 Tiny Habits That Make You Healthier, Calmer, and Harder to Kill

Orangutans, Cobras — and the Gift of Paying Attention

I paused beneath the jungle canopy.

An orangutan swung overhead, effortless in its grace.

It stared at me as if to say, “You humans forgot how to move.”

A rustle in the underbrush.

Was it a cobra? A monkey?

Or just the wind reminding me to stay alert?

Either way, I wasn’t scrolling my phone.

You can’t walk distracted when the jungle might bite back.

Uneven ground forces presence.

And in a world addicted to autopilot, presence is a rare medicine.

Rough Terrain Rewires Your Brain for Survival

I used to think walking was the ultimate autopilot activity.

But neuroscience says otherwise.

Rough terrain lights up your prefrontal cortex — the part of your brain that handles attention and planning.

Your cerebellum and sensory nerves work overtime to keep you upright.

This sparks:

• Lower cortisol (stress hormone)
• Improved heart rate variability (a marker of resilience)
• Faster reflexes when life throws you off-balance

One landmark study found these brain benefits last long after the walk ends.

So the next time your foot meets uneven ground, know this:

Your brain is rebuilding itself, one step at a time.

Flat Surfaces Make Life Easy — and Make You Fragile

Modern life has flattened our world.

We walk in shoes that numb the sensation.

On surfaces designed to eliminate surprise.

And then we wonder why our balance fades with age.

Falls are the leading cause of injury-related death in people over 65.

However, the danger begins decades earlier, when our feet stop adapting and our brains stop noticing.

How I Brought This Home

Back in Seattle, I made some simple shifts:

✔️ I walked forest trails instead of smooth streets.
✔️ Hiked on pebble beaches where every step shifted.
✔️ Walked barefoot on grass during morning routines.
✔️ Kept a wobble board under my standing desk.
✔️ Balanced on sidewalk curbs instead of staying in the middle of the path.

Small, daily friction makes your body strong again.

And one more thing — stay safe.

Choose trails appropriate for your skill level, watch your footing, and skip barefoot walking where sharp rocks or hidden hazards could cause injury.

How to Start (No Jungle Required)

Here’s how I coach patients and friends to rebuild strength and balance:

✔️ Choose uneven surfaces: dirt trails, grassy parks, rocky beaches, or mulch paths.
✔️ Go barefoot (when safe): start on grass, packed earth, or soft sand.
✔️ Slow your pace: give your body time to adapt.
✔️ Add balance drills: balance on logs, low curbs, or balance cushions indoors.

You don’t need to overhaul your life.

But you do need to stop walking only on flat, predictable ground.

Adaptation is the Goal — Not Perfection

The real danger isn’t falling.

It’s losing your ability to adapt.

On uneven ground, your body learns to adjust.

Your brain stays alert.

Your nervous system sharpens.

It’s not about avoiding every stumble.

It’s about responding better when you do.

What Happens If You Ignore This?

If you wait until your balance is depleted, regaining it becomes harder.

The loss happens slowly:

• Your stabilizer muscles atrophy.
• Your reaction time slows.
• Your confidence erodes.

But rebuilding is simple.

Step off the pavement.

Find a trail.

Let the ground challenge you again.

Of course, be safe and don’t take unnecessary risks.

Final Thoughts: What the Jungle Taught My Feet

By the end of my hike, my legs were burning, and my boots were caked with mud.

But my mind felt clearer than it had in months.

Maybe this is what we’re wired for:

Not flat streets. Not endless comfort.

But uneven steps that challenge and strengthen us.

Modern life has made our paths smooth.

But with a little intention, we can rebuild what we lost — balance, strength, awareness.

And maybe, in the process, discover something deeper than comfort:

Vitality.

→ Ready to take the first step toward a stronger, sharper you?

Follow me on Medium for science-based habits to help you thrive in a chaotic world.

One more thing — My best-selling ebook: Extending Life and Healthspan

The post The Surprising Health Benefits of Walking on Uneven Ground — And Why You Should Start Today appeared first on Medika Life.

However, it was only recently that I began targeting something deeper.

Something upstream.

Something ancient.

Inflammation.

Not the helpful kind you get after a cut or cold. That kind heals.

I’m talking about chronic inflammation — the kind that lingers quietly, damaging your blood vessels, brain, joints, and organs like a slow, internal wildfire.

Over time, I’ve come to believe that chronic inflammation is the common thread behind most chronic diseases. The evidence keeps stacking up.

The Number That Predicts How Fast You’re Aging

Most doctors ignore it. I don’t.

medium.com

The Hidden Fire Behind Disease

Dementia? Check.

Type 2 diabetes? Check.

Heart attacks. Strokes. Obesity. Cancer?

Check, check, check.

We call these conditions separate diagnoses.

But I’ve come to see them as symptoms of a deeper cause: the body’s immune system stuck in the “on” position.

Scientists have even coined a term: inflammaging — the chronic, low-grade inflammation that accelerates aging and shortens lifespan.

That realization changed the way I live.

6 Ways I’m Extinguishing the Fire

I don’t believe in silver bullets. But I do believe in stacking small daily wins. Here’s how I’m pushing back against chronic inflammation:

1. Sleep Like It’s Medicine

Sleep isn’t optional. It’s therapeutic.
Insufficient sleep increases inflammatory markers, such as C-reactive protein. But quality sleep can lower them, especially when it becomes a consistent, protected ritual.

I now aim for 7.5–8 hours per night, without apology. I treat it like an appointment; I don’t cancel.

2. Move Daily, Not Occasionally

Exercise cools inflammation, especially the aerobic kind.
Walking. Cycling. Swimming. Even light strength training. They all lower pro-inflammatory cytokines and boost your cellular resilience.
And yes, I consider walking to be medicine.

3. Eat Food That Fights for You

I’ve shifted toward a Mediterranean-style diet, which includes olive oil, vegetables, nuts, berries, and fatty fish.
I’ve also added turmeric, green tea, and fiber-rich legumes.
These foods don’t just fuel me. They protect me from the inside out.

4. Avoid the Fire-Starters

Two habits pour gasoline on inflammation:

• Smoking
• Excess alcohol

I’ve never smoked. But I do drink on occasion — and now I limit that to one glass a week, if that. Most of the time, sparkling water does the trick just fine.

5. Stay Lean for the Right Reason

Weight isn’t just cosmetic — it’s biochemical.

Visceral fat (the kind that wraps around your organs) fuels inflammation and increases risk for cancer, dementia, and heart disease.

I stay lean, not for a mirror, but for my mitochondria.

6. Take Oral Health Seriously

Inflamed gums = inflamed body.

I didn’t always take flossing seriously. But the link between periodontal disease and heart disease — even cognitive decline — is real.

Now I treat my toothbrush like a prescription.

We Can’t Stop Time — But We Can Stop the Fire

Aging is inevitable.

But how do we age?

That’s far more flexible than most people realize.

If you want more energy, sharper cognition, and a lower risk of disease, start by cooling the flame of inflammation.

It’s not glamorous. But it works.

Final Thoughts

I used to think aging was just a number. Now I think it’s a pattern.

A pattern of how we sleep. How do we move? How do we eat?

And how we treat the quiet signals our body sends us — before they become sirens.

You don’t need a prescription to start.

You just need to start.

If you’re interested in aging better, you might also enjoy This One Lab Result Predicts How Long You’ll Live.

Ready to fight inflammation? Download my free ebook here.
📘 Debunked: 7 Health Myths That Quietly Hurt You
You’ll learn the truth about common habits that silently fuel inflammation, disease, and aging — and how to reverse them.

Author bio:
Michael Hunter, MD, is a cancer doctor, writer, and wellness advocate who believes the best medicine often starts outside the hospital walls.

The post How Chronic Inflammation Accelerates Aging — And 6 Ways to Slow It Down appeared first on Medika Life.

What’s more, exercise is just not for your muscles and your strength. I’ve written on why muscles are involved in mood and you can go to this article to refresh your memory or read it if you haven’t already.

What recent research benefits those over 70? Undoubtedly, we have a great deal more in terms of input in our muscle maintenance than anyone thought when they considered people over 70. The newest research refutes that myth, providing new insights and amazing changes for this group.

But there are specific periods in our lives when certain changes will begin, and with each phase, there will be almost undiscernible changes. However, there are indications that those above 70, who are at greatest risk for instability, balance, problems, muscle weakness, and even bone fractures, require our attention. Previously, adequate work was not directed at the potential maintenance and retrieval of muscle strength in this group, and that is where new, exciting research is coming to the fore.

What Are the Groups?

Sarcopenia is the medical term for muscle loss, and it is a normal aging process that affects all humans, although the rate of onset and the severity of the condition is different among individuals. This slowdown in muscle mass, strength, and function has implications for the quality of life and dependence of the elderly. Muscle loss occurs at different ages and we need to pay attention to enable people to prevent or at least remediate this to some extent.

20s-30s Age Group

In the young adulthood (20s to 30s) age group, muscle mass is at its peak. This age group is likely to have the best muscle strength and function as most people. The body is well equipped to build up and preserve muscle tissue as long as the muscle is used and fed properly. However, even at this young stage, people with sedentary jobs may already experience some muscle atrophy that does not manifest itself clinically. It sets the stage for future deterioration, so appropriate physical activity and diet during these years are a sound investment into future muscle health.

40s Group

Beginning in the 40s, the person begins to show some changes as mentioned above. The literature reviews indicate that muscle mass starts to decline at about 0.5–1% every year after age 30 and the rate increases a little in the 40s. It is also the time when strength reduction is first noticed especially in muscle fibers which control power and speed.

The quadriceps, hamstrings, and calf muscles may start to weaken, especially in people with low levels of physical activity. Most people in this age bracket feel the fatigue and reduced physical endurance when engaging in physical activities.

50s Group

More specific features of muscle atrophy can be observed in the 50s. The rate of loss is higher, currently ranging between 1–2% every year. At this time, the hormonal changes worsen the muscle regeneration. To women menopause reduces the level of estrogen that accelerates muscle loss. Men also have low levels of testosterone that also worsen the muscle tissue.

The abdominal muscles and the lower back muscles, which are the stabilizers, also weaken a lot. Upper body strength, especially in the chest, shoulders, and arms, decreases at a higher rate than before.

60 Group

In the 60s, the loss of muscle is higher and the following rates are observed: 2–3% per year. The consequences of the changes are seen in the everyday life and the person needs help in performing certain actions. The muscles of the lower limb that include the quadriceps, hamstrings and gluteal muscles also weaken greatly.

Many people in this age group will report having problems with stairs, getting up from a chair, or walking for long distances. The hand grip strength is reduced which in turn affects the fine motor skills and the ability to handle objects. The sense of balance is also affected because muscle weakness and neurological changes in proprioception occur.

Over 70 Group

Muscle loss is at its highest in adults over 70, with annual losses of 3–5% if no schedule for slowing or reversing this loss is introduced. This accelerated decline has a major effect on the quality of life and independence. This age group has distinct muscle weakness with well-defined patterns of muscle involvement that have important functional implications

The quadriceps, hamstrings and gluteal muscles are the extremity muscles that are affected in a greater degree. This weakness is manifested as:

1. Difficulty in rising from sitting position
2. Slow walking
3. High chances of falling,
4. Difficulty in climbing stairs. The ankles are also liable to weaken, and this causes the client to have difficulty with walking and increased chances of falling.

Strengthen these muscle groups by including functional exercises that may involve using body weight, resistance bands, or light weights. Of course, any exercise routine in any age group should always be planned with a certified trainer or someone in a rehabilitation facility specifically to address these needs.

Some of the exercises that can be of great help include; standing from a chair, slow walks, sitting leg raises, and ankle exercises to build strength. Exercises in water are an excellent way to work on these muscles with minimum impact on the joints.

Balance is trained very effectively by standing exercises that reduce the base of support step by step. The tandem stance is particularly effective — this is when one stands with one foot in front of the other, heel to toe, to begin with, leaning on a sturdy chair or counter. In the event that stability improves, the support can be reduced to fingertip touch, then to no support at all.

The single leg stance is another basic exercise; start by holding a chair and lift one foot slightly off the floor for 10–15 seconds and then switch to the other side. This exercise directly strengthens the stabilizing muscles around the hips and ankles that are crucial for the prevention of falls.

Weight shifting exercises are used to develop the dynamic balance. The weight shift is to stand with feet hip width apart and then slowly shift weight from one foot to the other without moving the feet. Clock reaches expand on this by visualizing standing at the centre of a clock face and reaching one foot towards different ‘hours’ whilst remaining balanced. These movements enhance proprioception, which is the sense of where the different parts of the body are in space, and this sense is often reduced as one gets older.

The good news is that even though you have lost muscle strength, there is still the ability to help your muscles, pull back some of that strength and renew your ability to move and continue an active lifestyle. As has been noted by several of the articles, water exercises seems to be one of the best, especially for anyone with arthritic conditions. And, don’t forget that exercise is intimately associated with mood.

The post Strength Beyond Years: How Exercise Redefines Aging appeared first on Medika Life.

This article dives into the core of mental strength in athletics, exploring the challenges that test an athlete’s resilience and the strategies to build a robust mindset. We’ll look at how athletes can develop confidence, maintain control under pressure, and prioritize their mental health. From goal-setting to stress management, we’ll cover practical techniques that help athletes not only survive but thrive in the competitive sports environment. Whether you’re a seasoned pro or just starting out, understanding and honing your mental game is key to reaching your full potential on and off the field.

Understanding Mental Strength in Athletics

Mental strength in athletics goes beyond physical prowess, playing a crucial role in an athlete’s success. It’s the secret weapon that sets apart good athletes from great ones, influencing everything from training consistency to game-day performance.

Defining mental toughness

Mental toughness is a personality trait that enhances performance and well-being, making individuals more likely to succeed in both personal and professional life. It’s defined as the ability to bounce back from setbacks (resilience) and the capacity to spot and seize opportunities (confidence). Mentally tough individuals are more focused on outcomes and better at making things happen without being distracted by their own or others’ emotions.

The four C’s model: Control, Commitment, Challenge, and Confidence

The 4 C’s framework, developed by Professor Peter Clough, measures key components of mental toughness:

1. Control: This relates to self-esteem and the sense of control over one’s life and emotions. High control individuals are comfortable in their own skin and can manage their anxieties effectively.
2. Commitment: This refers to focus and reliability. Those high in commitment can set and achieve goals consistently without being easily distracted.
3. Challenge: This represents drive and adaptability. Athletes high in challenge view obstacles as opportunities rather than threats and are likely to be adaptable and agile.
4. Confidence: This encompasses self-belief and influence. Confident individuals believe in their ability to perform productively and can influence others effectively.

Benefits of mental resilience for athletes

Mental resilience offers numerous advantages for athletes:

1. Enhanced performance and goal achievement
2. Better stress management and coping skills
3. Improved self-reflection and positive thinking
4. Reduced likelihood of experiencing mental health issues like burnout and depression
5. Increased ability to overcome challenges and stay motivated in the face of failure

By developing mental toughness, athletes can significantly improve their overall performance and well-being in their chosen sport.

Challenges to Mental Resilience in Sports

Pressure and expectations

Athletes often face immense pressure during major competitions, making it challenging to perform at their best when it matters most. This pressure, which can be both internal and external, has a significant impact on an athlete’s mental state. It manifests physically through increased adrenaline and heart rate, mentally through positive or negative thoughts about the event, and emotionally through feelings of anticipation, excitement, or fear.

The way athletes perceive a particular athletic event determines their internal response and, ultimately, their performance. When they focus on the outcome or fear what might happen, they worry about meeting expectations, leading to a tentative and controlled performance. This makes it difficult for athletes to take risks and perform at their peak.

Media scrutiny and social media impact

The media plays a significant role in challenging athletes’ mental resilience. With the rise of social media, athletes are now more exposed to public scrutiny than ever before. This constant attention can be a double-edged sword, providing a platform to connect with fans but also exposing them to criticism, harassment, and abuse.

Many high-profile athletes have experienced the negative effects of media scrutiny. For example, gymnast Simone Biles withdrew from five finals during the Tokyo Olympic Games, citing concerns for her mental well-being. Similarly, tennis star Naomi Osaka withdrew from the Roland Garros tournament due to anxiety related to media interactions.

Balancing physical and mental health

While physical activity and sports can enhance mental health, elite athletes face unique challenges in maintaining this balance. The intense training schedules, strict diets, and unrealistic body expectations can lead to burnout and disordered eating. Additionally, injuries can force athletes to take time off, often resulting in depression.

Athletes may spend up to 40 hours a week on their sport, sometimes on top of a full-time job or school. This demanding schedule can lead to missed personal events, financial troubles for student-athletes, and difficulties in maintaining a work-life balance. The pressure to perform consistently at a high level can also take a toll on an athlete’s mental health, with up to 34% of elite athletes experiencing symptoms of anxiety and depression.

Strategies for Developing Mental Toughness

Goal-setting and visualization techniques

Athletes can enhance their mental toughness by setting specific, observable, and measurable goals. Instead of vague objectives like “improve shooting percentage,” coaches should provide clear directives. For instance, basketball players might be instructed to “draw a ‘C’ with their wrist” and use a cue word like “push” to improve mechanics. Writing down goals and regularly monitoring progress is crucial. Keeping a journal or a publicly posted goal chart can help athletes and coaches track their advancement.

Visualization, or sports imagery, is a powerful tool for athletes. By creating mental scenes and imagining successful performances, athletes can improve their skills and confidence. This technique has a significant impact on the brain, as neural circuits respond to visualized scenarios similarly to real-life events. Athletes can use visualization to handle pressure, gain mastery in a skill, relax, and even continue training while injured.

Mindfulness and meditation practices

Mindfulness-based interventions (MBIs) have shown promising results in improving athletic performance and mental health. These practices help athletes stay focused and centered, regardless of distractions. Mindfulness involves embracing the present moment and treating thoughts and emotions with kindness.

Practical mindfulness exercises for athletes include:

1. Mindful breathing
2. Body scans
3. Meditation
4. Movement practices like yoga
5. Gratitude practice
6. Visualization

Incorporating these exercises into daily routines can enhance mental clarity, composure under pressure, and overall performance. Athletes can start with just a few minutes each day, gradually increasing the duration as they become more comfortable with the practice.

Building a support system

Seeking support for goals is essential for athletes. This support system typically includes coaches, family, friends, teachers, and teammates. Educating these individuals about the athlete’s goals and the importance of their encouragement can significantly contribute to success.

Coaches play a crucial role in helping athletes manage their emotions and develop mental toughness. They should assist athletes in understanding and controlling their emotions, rather than avoiding or ignoring them. This approach allows athletes to reach their full potential and cope effectively with challenges.

By implementing these strategies, athletes can develop the mental resilience necessary to overcome adversity, bounce back from setbacks, and consistently perform at their best in competitive environments.

The post Mental Strength: Building Resilience in Athletes appeared first on Medika Life.

This article dives into the world of sports injury rehabilitation, exploring common injuries and their causes, immediate management strategies, and long-term recovery approaches. We’ll look at how NSAIDs play a role in pain management, the importance of proper warm-up and cool-down routines, and techniques to address issues like tendinopathies and delayed onset muscle soreness. You’ll also learn about the significance of balance exercises and improving range of motion in the rehabilitation process. Throughout, we’ll highlight pharmacists’ crucial role in supporting athletes on their path to recovery, offering insights on medication management and injury prevention strategies.

Common Sports Injuries and Their Mechanisms

Sports injuries can occur in various forms, ranging from minor discomfort to severe trauma. Understanding these injuries and their mechanisms is crucial for effective prevention and treatment. Let’s explore some of the most common sports injuries athletes encounter.

Sprains and Strains

Sprains and strains are among the most frequent sports-related injuries. They involve the stretching or tearing of tissue, with sprains affecting ligaments and strains impacting muscles or tendons. These injuries are classified into three categories based on severity:

1. Grade I (Mild): Tissue is stretched with slight swelling and mild loss of range of motion and strength (0–25%).
2. Grade II (Moderate): Involves stretching and some tissue tearing, moderate swelling, and loss of range of motion and strength (25–75%).
3. Grade III (Severe): Complete tissue tearing with significant swelling, bruising, and near-complete loss of range of motion and strength (75–100%).

Common sites for sprains include ankles, knees, and wrists, while strains often affect the lower back and hamstring muscles.

Overuse Injuries

Overuse injuries develop when a muscle, tendon, ligament, or bone is repeatedly stressed without adequate rest. These injuries are particularly common in endurance sports and activities involving repetitive motions. Some examples include:

• Tendinitis: Inflammation of tendons, often affecting the shoulder, elbow, wrist, hip, knee, or ankle.
• Shin splints: Pain along the shinbone, typically seen in runners.
• Stress fractures: Tiny cracks in bones due to repetitive force.

Acute Traumatic Injuries

Unlike overuse injuries, acute traumatic injuries result from sudden accidents or impacts. These injuries often cause immediate pain and restrict activity. Common acute traumatic injuries include:

• Ligament tears
• Tendon tears
• Joint dislocations
• Bone fractures
• Contusions (bruises)

Athletes in contact sports like football, hockey, and wrestling are at a higher risk for these types of injuries.

To address sports injuries effectively, the P.R.I.C.E. therapy is often recommended:

• P: Protect the injured area
• R: Rest and restrict activity
• I: Apply ice for 10–15 minutes every 3–4 hours
• C: Compress the injured area with an elastic bandage
• E: Elevate the injured area above the heart

Understanding these common sports injuries and their mechanisms helps athletes, coaches, and healthcare professionals take appropriate measures to prevent and manage them effectively.

Pharmacist’s Guide to Immediate Injury Management

First Aid Principles

When it comes to sports injuries, immediate and appropriate first aid can make a significant difference in recovery time and prevention of further damage. The PRICE method is a widely recognized approach for managing acute injuries:

1. Protection: Safeguard the injured area from additional harm.
2. Rest: Limit activities involving the injured part for 48–72 hours.
3. Ice: Apply ice for 20 minutes at a time, 4–8 times a day.
4. Compression: Use an elastic bandage to reduce swelling.
5. Elevation: Keep the injured limb above heart level to decrease swelling.

For bleeding wounds, it’s crucial to stop the bleeding first. Apply direct pressure using a clean dressing, and if bleeding persists, seek immediate medical attention. For nosebleeds, have the athlete sit down and pinch their nostrils shut for several minutes.

Over-the-Counter Treatment Options

Pharmacists are key in recommending appropriate over-the-counter (OTC) medications for sports injuries. NSAIDs like ibuprofen and naproxen are commonly used to reduce pain, inflammation, and swelling. Naproxen is often preferred due to its longer half-life. Topical NSAIDs, such as diclofenac, can be applied directly to the affected area, minimizing systemic side effects.

Acetaminophen is another option for pain relief, though it may be slightly less effective than NSAIDs for musculoskeletal pain. However, it has fewer side effects with prolonged use and can be used to treat lingering pain after initial NSAID courses.

Other OTC options include:

• Lidocaine 4% patches for localized pain relief (approved for athletes 12 years and older)
• Topical preparations containing capsaicin, menthol, or camphor for counterirritant effects
• Arnica cream or gel for its anti-inflammatory and analgesic properties

When to Seek Emergency Care

While many sports injuries can be managed with first aid and OTC treatments, some situations require immediate medical attention. Athletes should seek emergency care if they experience:

• Uncontrolled or persistent bleeding
• Difficulty breathing
• Chest pain
• Loss of consciousness
• Severe headache, dizziness, or double vision (potential signs of concussion)
• Extreme pain or obvious deformity
• Inability to use the injured area

Pharmacists should advise athletes to stop activity immediately if they suspect a serious injury and to avoid “working through” the pain, as this may cause further harm. By providing guidance on immediate injury management and knowing when to refer for emergency care, pharmacists play a crucial role in supporting athletes through the rehabilitation process.

Rehabilitation Strategies: From Acute to Chronic Phase

Early stage recovery techniques

The R.I.C.E method (Rest, Ice, Compression, and Elevation) is a widely recommended approach for early-stage recovery. This doctor-suggested technique helps treat injuries and promote healing. Rest prevents further injury, ice reduces pain, compression controls swelling, and elevation minimizes discomfort. These steps are crucial in the acute or immediate care stage of rehabilitation.

Progressive rehabilitation exercises

As the athlete moves into the subacute or recovery stage, progressive exercises become essential. These exercises aim to restore strength, flexibility, and balance. The rehabilitation process typically includes:

1. Range of motion exercises
2. Strengthening exercises
3. Stability training
4. Sport-specific skill development

Quadriceps extensions, hamstring flexions, and hip exercises are common components of knee rehabilitation programs. These exercises should be performed daily, with 3 sets of 10 repetitions, gradually increasing resistance as strength improves.

Return-to-sport considerations

The decision to return to sport is not made in isolation but involves input from the medical team, physical therapist, coach, and the athlete’s support network. The StaRRt framework, a 3-step model, helps guide this decision:

1. Assessment of tissue health
2. Evaluation of tissue stresses
3. Consideration of risk tolerance modifiers

Athletes should only return to play when the risk assessment falls below the acceptable threshold. This process is viewed as a continuum, comprising:

• Return to participation
• Return to sport
• Return to performance

Pharmacists play a crucial role in this process by providing guidance on medication management, supporting adherence to rehabilitation protocols, and offering strategies for injury prevention. Their expertise ensures athletes receive comprehensive care throughout their recovery journey.

Pharmacist’s Role in Long-Term Injury Management

Pharmacists play a crucial role in supporting athletes through their long-term rehabilitation journey. Their expertise extends beyond simply dispensing medications, encompassing a wide range of services that significantly enhance the recovery process.

Medication management for chronic conditions

Pharmacists are instrumental in managing medications for chronic sports injuries. They guide athletes on the safe use of nonsteroidal anti-inflammatory drugs (NSAIDs), analgesics, and corticosteroids to reduce inflammation and alleviate pain. However, they also monitor long-term use to avoid potential side effects. For rapid pain relief, pharmacists may recommend paracetamol or, in some cases, opioids, always ensuring the athlete’s safety and adherence to anti-doping regulations.

In addition to traditional medications, pharmacists advise on regenerative medicine options. These include:

1. Hyaluronic acid (HA) for joint lubrication and tissue health
2. Platelet-rich plasma (PRP) therapy for accelerating healing
3. Prolotherapy for stimulating the body’s natural healing processes
4. Prolozone therapy for tissue repair and regeneration
5. Perineural Injection Therapy (PIT) for reducing neurogenic inflammation

Advising on alternative therapies

Pharmacists also guide athletes on complementary therapies that can support their recovery:

• Acupuncture for pain relief and healing promotion
• Chiropractic care for spinal adjustments and pain reduction
• Mind-body techniques like yoga and meditation for pain management and stress reduction

They provide valuable advice on the safe use of dietary supplements, ensuring athletes avoid substances banned by sports-governing bodies.

Collaborating with healthcare team

Pharmacists work closely with other healthcare professionals to optimize therapeutic outcomes. They participate in anti-doping activities, provide crucial drug information, and educate athletes on basic anti-doping rules. Their role in interpreting lab results and recommending appropriate over-the-counter medications is invaluable.

In collaboration with sports physicians and rehabilitation teams, pharmacists contribute to personalized treatment plans. They help close the gap between prescribed medications and their effects on athletes, ensuring treatment efficacy and safety across different sports.

The post Sports Injury Rehabilitation: Pharmacist-Approved Strategies appeared first on Medika Life.

The Marfan Foundation is the world’s most extensive patient and professional community addressing the needs of people living with genetic aortic and vascular conditions, serving one million people with educational materials and reaching 3.2 million people in the digital space annually.

The Marfan Foundation will play a crucial role in informing individuals living with Marfan, Loeys-Dietz, Vascular Ehlers-Danlos syndromes, and related conditions about the resources and community dialogue offered by StuffThatWorks. This collaboration will enable StuffThatWorks to develop a comprehensive strategy for engaging non-profits with the goal of ultimately benefiting the global patient community.

“We’re honored to have been selected as the first non-profit to align with StuffThatWorks to elevate community members’ voices, foster additional personal empowerment, and advance access to potential learnings that may be derived through global self-reporting,” said Michael L. Weamer, CEO of The Marfan Foundation.

StuffThatWorks’ operational value is that patients’ crowdsourcing information can highlight issues that need to be addressed from the patient perspective as well as spotlight various treatment options, side effects, and obstacles to care: “Understanding how patients experience various treatments is one of them,” according to their website. “The Marfan Foundation has a steadfast commitment to scientific rigor and fostering a strong global community. Operationally, the Foundation leverages world-class experts to focus on research and best practices in patient engagement and empowerment,” says Yael Elish, CEO of StuffThatWorks. “The Foundation’s investment in basic and applied research and translating these understandings into patient support and education reinforces that real-world data is valued in applications with the potential to advance treatments and quality of life.”

“We’re enthused to share what we know about specific non-profit needs and goals while we learn more about the possibilities StuffThatWorks’ patient-centric knowledge-base will offer,” said Weamer.

About 1 in 5000 people have Marfan syndrome, including men and women of all races and ethnic groups. Roughly 3 out of 4 people with Marfan syndrome inherit it. There is a 50 percent chance that a person with Marfan syndrome will pass along the condition each time they have a child. Because connective tissue is impacted and found throughout the body, Marfan syndrome can affect many body parts. Features of the condition are most often found in the heart, blood vessels, bones, joints, and eyes. Some Marfan features – for example, aortic enlargement (expansion of the main blood vessel that carries blood away from the heart to the rest of the body) – can be life-threatening. People living with Marfan syndrome and related conditions have a 250 times greater risk of aortic dissection than the general public. The lungs, skin, and nervous system may also be affected.

About StuffThatWorks

Created by Waze founding team members, StuffThatWorks uses crowdsourcing and AI to empower patients to transform their experiences into organized, large-scale structured Real-World Data needed for research. StuffThatWorks is the home to three million members across 1250 condition communities that have shared 1.3B data points. Now the largest organized Patient Level Real World Data platform, StuffThatWorks is differentiated by its expansive data collection, structuring, and organization of accessible information. The unique proprietary data set and unique AI and powerful Chat GPT-like capabilities enable the generation of insights for research, market access, and drug development.

Crowdsourcing Treatments that Work | Community Research | StuffThatWorks

About the Marfan Foundation

The Marfan Foundation is a global nonprofit organization that empowers people with genetic aortic and vascular conditions to foster optimal quality of life and longevity while building community. We save lives through research and education, enabling healthcare providers to offer the best-quality treatment and helping to foster mental and physical wellbeing. We serve communities impacted by Marfan syndrome, Loeys-Dietz syndrome, Vascular Ehlers-Danlos Syndrome, and related conditions. To learn more, visit marfan.org or meet us on social media:

Facebook | Instagram | LinkedIn | X (Twitter) | Threads | YouTube | TikTok

The post StuffThatWorks and The Marfan Foundation to Engage in Pilot Program appeared first on Medika Life.

I recently wrote about sarcopenia, or muscle loss surpassing what is typical with age.

Sarcopenia: What You Need to Know

SARCOPENIA IS AGE-RELATED PROGRESSIVE LOSS of muscle mass and strength. Researchers posit that a sedentary lifestyle here: medium.com

Fighting Muscle Loss

In my article, I discussed ways to fight back against muscle loss.

1. Exercise. I am always physically active life. My physical activity includes resistance training.
2. Eat well. I eat a relatively balanced, healthy diet incorporating 25 to 35 grams of high-quality protein in each main meal.
3. Routine physicals. I regularly see a healthcare provider.

Supplements for Optimizing Your Muscle Mass

With my recent turn to over-60 bodybuilding, I use these evidence-based supplements:

• Creatine. This substance can help me increase or maintain muscle mass.

• Whey protein is a central supplement to my diet, helping me preserve muscle mass. I currently consume about one gram per pound.
• Vitamin D. This supplement helps me maintain my bones and muscles.

New Study Examines Sarcopenia and Early Mortality

Researchers recently reported the results of a population-based cohort study published in JAMA Network Open.

They wanted to better understand the prevalence of more than usual muscle loss with age.

Here is how they defined sarcopenia: Subjects had it if they had a low handgrip strength and low skeletal muscle mass.

They measured muscle mass in the legs (including the pelvis) and arms (including the shoulders).

Study Results: Sarcopenia and Early Mortality

Here are the results after ten years of follow-up:

Subjects with sarcopenia had a nearly 1.3 times higher risk of early mortality (than those without the condition). Those with sarcopenia and obesity had a three times higher risk for all-cause mortality.

Age and sex did not affect the findings.

Takeaway Messages

The investigators concluded that we might use low muscle strength as a first step to diagnose sarcopenia.

The study suggested that non-drug interventions — including diet and exercise training — can help delay sarcopenia onset.

I could not find a consideration of specific causes of death in the study.

Finally, because most subjects had European ancestry, we do not know if we can broadly generalize the research findings.

My Take

A greater amount (than usual) of muscle loss is not uncommon.

In this study, 13 percent had low muscle function.

The early mortality risk for obese individuals with sarcopenia is quite disturbing.

The good news?

As we develop better screening tools (such as testing hand grip), we can intervene with helpful lifestyle recommendations.

The post Is Age-Related Muscle Loss Linked to Early Mortality? appeared first on Medika Life.

Master influencer Kim Kardashian donning hospital garb before a powerful magnetic resonance imaging machine? Check.

Actress and television host Maria Menounos had unexplained pain for months. Maria decided to get a Prenuvo scan to investigate the issue further.

The bottom line? Menounos had an early pancreas neuroendocrine tumor, a rare form of pancreas cancer. Fortunately, she has a good prognosis after she had a resection of the tumor (and parts of her pancreas), spleen, and 17 nearby lymph nodes.

But should you and I consider a full-body MRI? Today, we’ll examine the debate over full-body MRIs (and their risks).

MRI

How does a whole-body MRI work?

The device uses radio waves and extraordinarily strong magnetic fields to scan the body. The technologist obtains detailed images from the subject’s head to toe.

The image acquisition can take 40 to 60 minutes and can identify inflammation, cancer, or other concerning growths in the body.

MRI — Details

I cannot resist releasing a bit of my inner nerd. Let’s look at how MRIs work in more detail.

First, the strong magnetic field created by the MRI scanner leads to your body’s atoms aligning in the same direction.

Second, the machine sends radio waves to move these atoms out of their original position. As the radio waves are turned off, the atoms return to their original position and release radio waves.

Finally, a computer converts these radio waves into an image of the examined body part. The radiologist can view the images on a viewing monitor.

Because the scan does not use ionizing radiation, there is no radiation exposure risk with an MRI.

Should you have an MRI?

You will not be surprised that Maria Menounos’ experience has made her a strong advocate for full-body MRI.

“I’m working diligently to get this covered by insurance for people and it’s my mission,” Menounos said in an interview with TODAY. “I’m going to get it covered for everyone to have an annual scan because it just makes sense.”

However, radiologists are more skeptical of whole-body MRI for screening. Listen to Zhen Jane Wang, MD, chief of abdominal imaging at the University of California San Francisco (USA) Department of Radiology and Biomedical Imaging:

“There’s really no evidence-based findings to show that full-body MRI in a larger population will save lives.”

MRI price

Let’s start with the costs. As of 13 January 2024, a whole-body MRI with Prenuvo costs US $2499.

Do you only want the head and torso? That will set you back US $1799.

Finally, a torso-only (without additional dedicated prostate-focused imaging) MRI scan is US $999.

In the United States, the odds that your health insurance will cover the cost are greater for those with a genetic predisposition.

MRI risks

One of the biggest problems with MRIs is that they are sensitive enough to pick up subtle abnormalities that can only be clarified with additional tests. We may discover that a growth is benign (not cancer).

These added tests can lead to

• radiation exposure (for example, if a CT scan is needed to direct a biopsy needle)
• infections
• pain
• psychological distress
• financial issues.

In addition, the test may find a cancer that was so indolent that the patient would not have ever known it was there. With a cancer diagnosis, many often offer treatment (even if it is not mandatory for a very low-grade process). I call these “incidentalomas.”

Final thoughts — Navigating the Controversy: The Debate Over Full-Body MRIs and Their Risks

On the other hand, the test may save your life.

However, we should discuss wonderful stories such as that of Maria Menounos in the context of the risks I described.

Plus, given her symptoms, an MRI scan directed at the abdomen would have discovered the problem.

I am particularly intrigued with the idea of using full-body MRI scans for those who are at high risk for cancer. For example, those with particular genetic disorders might be good candidates.

The average person would benefit from a full-body MRI less than 0.1 percent of the time, under one in 1,000. Still, it might save your life.

For me, I’ll wait for higher-level evidence of efficacy.

The post Navigating the Controversy: The Debate Over Full-Body MRIs and Their Risks appeared first on Medika Life.

Have you ever thought you were physically more robust, flexible, and agile than in reality? I had convinced myself of this falsehood in 2020. During the height of the pandemic, on a cold winter night, out of boredom, I decided to showcase and brag about my dazzling gymnastic abilities to my parents in the form of a bridge pose that rocked back and forth. The result? Over the next 24 hours, I was unable to walk and hunched over in severe pain.

Fast forward a year; I neglected to shovel snow properly and, again, doubled over in agony, unable to stand straight. In both of these instances, I seemingly recovered after a few weeks. Finally, in January 2023, when lifting my dog into the car, I heard a crunch in my lower back, which culminated in an inability to walk for a couple of weeks and experienced piercing pain with most movements. This time, recovery wasn’t in the cards. Coupled with a lower back issue, I began to feel a strong electric current coursing down my right leg, a constant source of aggravation and sleep loss. Despite all this, I still finished the downhill ski season, not wanting to suffer from FOMO. Talk about obsessive-compulsive!

Over the spring and summer of 2023, the sciatic nerve pain escalated; I was constantly sleep-deprived and felt agitated at the most minor things in life, never mentally operating at total capacity. In August 2023, at the urge of family and friends, tired of hearing me complain, I booked an MRI to discover the root cause of the issue.

The Diagnosis

The MRI results were immediate; I was diagnosed with degenerative disk disease, a deterioration of the lower three rungs of my spine. The issue was most likely caused by a curvature of the spine pre-existing from birth, along with the above-mentioned physical activities, which exacerbated the condition.

Proposed Solutions

Armed with a diagnosis, for the first time in my life, I decided to embark upon a short-term leave of absence from my corporate career and take care of my mental and physical health.

In consulting with medical practitioners at Medcan, a Canadian privatized healthcare provider, I was provided with two options:

1. Cortisone shots in the lower spine.
   Pro — potential immediate relief?
   Con — A band-aid solution that will not fix the root cause or extract positive benefits after some time.
2. Titanium plates can be inserted into the lower spine via an operation.
   Pro — not aware of any.
   Con — 50% chance of success with high risk of issues later in life.

Neither of these options intrigued me, and I felt annoyed at the limitations of modern Western medicine. Have we yet to evolve beyond archaic practices?

I used my frustration as motivation to research other potential procedures to cure the issue, and after a mad Google search, I discovered stem cell therapy. But wait, aren’t stem cells made up of baby placentas and ethically questionable? No. Quite the contrary. We’ll return to the process in a moment.

Next, I contacted and met with Dr. Shammaa from the Canadian Centres for Regenerative Therapy in Toronto, Ontario, Canada, for a clinical assessment to determine if I am an ideal candidate for a stem cell procedure.

Dr. Shammaa reviewed the MRI and affirmed the Medcan diagnosis:

Multilevel degenerative disc disease, most pronounced at L4-L5 with the central disc protrusion impinging upon thetraversing L5 nerve roots.

Given my age and active lifestyle, he confirmed I made an ideal candidate for the procedure, a spine issue he treats roughly once a month for other patients suffering the same circumstance. The most prevalent challenge is stem cell injections in the knee as a replacement for knee replacement surgery. The doctor also confirmed my suspicion that the sciatic nerve was pinched by one of the degraded rungs of the spine and would have to be decoupled during the procedure.

After giving Dr. Shammaa’s details more thought, I decided to embark upon the process, and we agreed upon Wednesday, November 8, 2023, for the date of the procedure. Since stem cell therapy is considered ‘experimental’ and not covered by the Canadian health care system, I incurred an out-of-pocket cost of 18K. Ouch.

What Is Stem Cell Therapy?

According to the Canadian Center for Regenerative Therapy, stem cells are a part of a field of research called Regenerative Therapy:

Regenerative Therapy is a branch of translational research in tissue engineering and molecular biology that deals with the “process of replacing, engineering or regenerating human cells, tissues or organs to restore or establish normal function

The Mayo Clinic describes stem cells as:

Stem cells are the body’s raw materials — cells from which all other cells with specialized functions are generated. Under the right conditions in the body or a laboratory, stem cells divide to form more cells called daughter cells.

In my example, I was an excellent candidate for stem cell replacement therapy, as the Mayo Clinic continues to articulate:

Stem cells can be guided into becoming specific cells that can be used in people to regenerate and repair tissues that have been damaged or affected by disease

The Stem Cell Procedure

On November 8, 2023, the stem cell operation proceeded as planned at the Toronto clinic. Initial blood work was drawn to ensure vitals were functioning as expected, as you can see by my “joyous” expression in the picture below.

The next step included inserting approximately 25+ needles from my lower hips to the top of my back to freeze the entire area to ensure I remained awake for the procedure. While the process was agonizing, my body started to reject the needles halfway through and ejected some from piercing through the skin.

Once my back and thigh area were frozen, the doctor took a larger needled and extracted bone marrow from my right hipbone, which would be used to remove fresh stem cells.

Next, six strategically placed larger needles were injected into the lower three rungs of my spine, three on each side. Here, the new stem cells were injected into the six needles. I was able to feel fluid and movement in my lower back as the injections occurred, an odd and unpleasant sensation.

The grand finale saved the worst experience for last. I was required to stay awake for the process to verbally verify whether the sciatic nerve decoupled from being caught in the lower spine. Dr. Shammaa forewarned me of the pain to follow and provided a stress ball to hold onto. While he microscopically moved the sciatic nerve, I experienced highly sharp jolts of pain coursing through my lower back and right leg. SweatHot and cold sweat poured out of my body, and I screamed in agony, yelling obscenities that would make a nun’s face turn yellow. I felt like I was holding onto a high-powered electric fence, the source coursing through my body.

Overall, the process took approximately 3 hours, with a hopeful outcome. Not long after, I drank a glass of water, slowly sat up, and, with assistance, was placed into a wheelchair, hauled out, and moved into my car for a long journey home in rush hour traffic and pouring rain.

Aftercare & Recovery

As of writing the blog post, I’ve been in recovery for one month. Some days are better than others, and more recently, I have begun to feel more significant discomfort in my lower back, which may be a positive indication of an active healing response. Unfortunately, the healing process takes eight months to a year for stem cells to grow fully. I will know if the procedure works once I conduct a second MRI in late winter 2024 to visualize growth progress.

My body is currently experiencing extreme fatigue, which is normal, given the additional stress on the system. I have frequent brain fog and sometimes forget words, an often frustrating dilemma when speaking with friends and loved ones. Another annoyance is my inability to accomplish as many tasks as I used to due to exhaustion; I’m currently learning to go easy on myself with the knowledge this, too, shall pass.

A few weeks ago, I felt intense anger rising from within and became curious about where the emotion came from. After consulting my naturopathic doctor, she confirmed how, in Chinese medicine, there is a belief humans hold their frustration and fury within the lower back area (along with the liver). And given the invasive nature of the poking and prodding from the needles, there is little wonder I am expressing anger.

While in recovery, my sole objective is to create and maintain an anti-inflammatory environment within the body to ensure maximum success toward stem cell growth. The current protocol includes:

• Follow an anti-inflammatory diet
• Consume specific vitamins and minerals
• Cupping the back and the stomach
• Acupuncture
• Physiotherapy
• Red light therapy
• Oxygenate cells in a hyperbaric chamber for 1–3 hours a day

In a future post, I will discuss the benefits of hyperbaric chambers in stem cell development, a fascinating topic.

My goal is to inform the public of the miracle of stem cell technological advancement; there are promising medical options beyond what traditional medical practitioners offer. I’m happy to answer any questions you have and will inform readers of progress once more information is known.

The post My Life-Changing Journey With Stem Cell Therapy appeared first on Medika Life.

ARC Innovation and Sheba Medical Center, Israel’s largest medical center and a Newsweek ranked world’s best hospital for the last five years, announced today the integration of technology developed by two startups, Cognishine and Kemtai, to augment healthcare in the hospital’s newly expanded rehabilitation ward.

Sheba Medical Center is home to Israel’s largest rehabilitation hospital. Amid the Israel-Hamas war, Sheba expanded the hospital with the addition of a new state-of-the-art 36-bed ward to treat wounded soldiers. The new ward leverages a range of innovative digital medical technologies to augment medical staff capabilities and improve overall quality of care. 

“Now is the time to innovate. During the COVID pandemic, Sheba created innovative solutions to save lives and helped set the health protocols for the rest of the world,” said Prof. Eyal Zimlichman, Chief Transformation Officer and Chief Innovation Officer at Sheba Medical Center and Director and Founder of ARC Innovation. “Times of crisis present an opportunity to accelerate innovation and transformation in care. And this is exactly what we are setting out to do, given the immense need for rehabilitation in Israel at this time.”

To maximize the effectiveness of the new ward, Sheba called upon Israel’s startup ecosystem, inviting health tech companies to submit solutions for potential use in the rehab hospital. Out of 82 companies that applied to the project, eight were selected to pitch their solutions to a panel of Sheba clinicians and industry leaders. Out of these eight companies, Cognishine and Kemtai were selected to begin a pilot program at Sheba, with the aim of incorporating the solutions into day-to-day rehab treatment.

Cognishine’s digital platform supports therapists in providing effective care for cognitive, emotional, speech and language disorders. Digitizing traditional therapeutic processes, the company offers a wide range of activities based on real-world scenarios to help patients to regain cognitive, speech and social-emotional capabilities.

“Cognishine extends the reach of medical professionals, enabling them to continue providing care through digitized therapeutic activities aiding cognitive abilities,” said Nimrod Zilkha, Co-Founder & CEO of Cognishine. “We are honored to play a role alongside Sheba helping soldiers recover from the war and get back to their daily lives.”

Kemtai is an AI-powered exercise platform for physical therapy and rehab, compatible with most phones and computers. The app provides real-time feedback and corrective guidance during exercise, enabling patients to improve their performance and accelerate recovery.

“Kemtai is enabling patients to fully adhere to their rehabilitation exercises with AI-guided, real-time guidance, helping achieve the best possible outcomes,” said Dr. Mor Amitai, CEO of Kemtai. “Our pilot at Sheba will see even more patients with physical limitations recover through augmented exercise.”

# # #

About Sheba Medical Center

The largest and most comprehensive medical center in the Middle East, Sheba Medical Center, Tel Hashomer is generating global impact through its medical care, research and healthcare transformation. Sheba’s City of Health boasts acute-care, rehabilitation, children’s, cancer and geriatric hospitals, research and innovation hubs, medical simulation center and center for disaster response on one comprehensive campus in the center of Israel. Sheba serves as a true hospital without borders, welcoming patients and healthcare professionals from all over the world and consistently providing the highest-level medical care to all in need. Sheba has been ranked a World’s Best Hospital by Newsweek five years in a row (2019, 2020, 2021, 2022, 2023). For more information, visit: https://sheba-global.com/

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