LA Sports & Spine

01/10/2025

I’m grateful to the legions of people in our LASS community who’ve reached out to me asking about my safety. Thank you. I’m in Venice & thank goodness south of the Palisades tragedy. LASS is near Century City and safe as is Des in Redondo Beach as well.

The places in Pacific Palisades that are wiped from the face of the earth may be etched in my memory, but these places are now gone forever. Iconic landmarks I’ve passed on the PCH since 1982 on hundreds of Sunday drives are gone. I’m grieving more each day, but am grateful to be one of the lucky ones.

We need to help each other in these times. LASS is a community & Desiree Di Lorenzo & I are here to create & sustain an environment where we encourage each other during these difficult times.

Thank you all. 🩵🙏🩵

11/20/2024

Recreational running doesn't cause knee osteoarthritis and may have a protective effect. Only 3.5% of recreational (amateur) runners have osteoarthritis (knee or hip) compared with 10.2% of sedentary individuals.




https://bjsm.bmj.com/content/56/6/357

11/20/2024

“Saving up to $1 billion a year in healthcare costs sounds ambitious, but it’s possible with a shift in care. 💰”

“Prof. Ilana Ackerman from Monash University, addressed the stark gap between what we know is effective for managing osteoarthritis and what our healthcare systems prioritise.”

- lifestyle changes like exercise, diet, and patient education are proven first-line treatments, these interventions receive minimal funding.

- costly procedures like knee replacements - often unnecessary for people with mild symptoms – are still widely used, burdening the healthcare system and leading some patients to outcomes that show little improvement.

- data suggests that up to 1 in 3 could be avoided through early intervention.

This link will take you to a page that’s not on LinkedIn

11/20/2024

“More than 200,000 Medicare patients with back pain underwent $2 billion worth of unnecessary surgeries, including spinal fusion”

"The times in which spinal fusion and laminectomy work for spinal stenosis is when the stenosis is causing neurogenic claudication, or radicular symptoms, meaning you're getting pain shooting down the leg”

"The answer about why Medicare pays is because Medicare doesn't really use appropriateness criteria to decide whether to pay,"

“It's really not terribly accepted in academic circles to operate on just back pain or discogenic disease”

“there's been a number of studies that showed that losing weight, stopping smoking, and engaging in healthier activities is a better treatment for back pain when you don't have a specific diagnosis, like nerve compression or deformity.”

Rosen also pointed to the heavy influence that the spine surgery equipment industry has on hospitals and surgeons. "I mean, spinal hardware is $1,000 a screw and you put in three or four levels, you can get $20,000, $30,000 of equipment put in."

“There was also wide variation in unnecessary procedures from state to state”

Lown Institute names hospitals, states with high rates of overuse

09/16/2024

09/15/2024

Caitlin Clark scored a career-high 35 PTS & knocked down 6 3PTS to give her the 3rd most 3PTS in a WNBA season.

She also broke the WNBA rookie scoring record & added 8 AST to the WNBA single-season assist record.

Most 3PTS In A Season
Sabrina Ionescu: 128
Diana Taurasi: 121
Caitlin Clark: 120

Most PTS In A Rookie Season
Caitlin Clark: 761
Seimone Augustus: 744
A'ja Wilson: 682

Most AST In A Season
Caitlin Clark: 329
Alyssa Thomas: 316
Courtney Vandersloot: 314

09/15/2024

Hakeem Olajuwon on the NBA legend who taught him how to use finesse instead of strength

The Houston Rockets icon didn't become one of the greatest players overnight. The Nigerian-American center maximized his God-given abilities through sheer hard work and dedication.

He was also encountered one of the sport's legends, which helped propel him to superstar status. The legendary Moses Malone played with Hakeem before the Dream's early years in the NBA, an experience that sharpened his skill and hardened his mettle.

"I would never have accomplished what I did if I did not play against Moses at Fonde," Olajuwon said, referring to the legendary basketball gym in Houston graced by various NBA legends.

The two-time NBA Champion claimed that while he knew the rules and fundamentals of the sport, Malone was the one who taught him how to excel at it.

"With Moses, there were no rests, no breaks," he continued. "He was working every time down the court — scoring, rebounding, or just making you feel his body. He would laugh when he slammed into you. If you tried to take a breath, he went by you or over you. There was no stop."

During their duels, Olajuwon would try to bully Malone but to no avail. The Chairman of the Boards was just too strong. It was then that The Dream realized he had to use finesse to beat Moses.

"I usually couldn't go through Moses because he was just so strong," Olajuwon said. "So I had to learn to use speed and agility to go around him. That's how I built my game."

09/12/2024

“it’s almost always safe to move with low back pain. Motion is lotion”

“Ninety per cent of low back pain is not linked to one specific structural cause (eg a joint, muscle, ligament or disc) and instead is the result of a number of physical and psychosocial factors, according to Prof O’Sullivan.”

“Scans rarely show the cause of low back pain and so-called ‘abnormal findings’ on scans like disc bulges, disc degeneration and arthritis are common and normal for most people without pain, especially as they get older.”

“90 per cent of low back pain is caused by a combination of physical and non-physical factors including poor sleep, relationship or family stress, job dissatisfaction or financial pressures.”

“the dirty dozen of myths about low back pain. These include “my back hurts a lot so I must have damaged it”, to which Prof O’Sullivan said: “There is lots of pain without injury and low back pain has much more in common with headaches, which we don’t usually associate with injury.”

He also suggested that rather than resting or avoiding carrying or lifting heavy objects to prevent back strain, the best approach is to strengthen the back by finding an exercise that you enjoy and that you will keep doing. “It’s hard to exercise without any pain, but it’s almost always safe to move with low back pain. Motion is lotion and it’s about spending time doing the activity – swimming, pilates, walking, yoga, aqua-aerobics – that you are most comfortable doing and that you will continue to do for a long time.”

https://www.irishtimes.com/health/your-wellness/2024/09/12/low-back-pain-treatment-scans-rarely-show-the-cause-expert-says/

Factors including poor sleep, relationship stress and job dissatisfaction cause 90% of low back pain

09/03/2024

09/02/2024

Disabling arthritis is on the rise, but it doesn’t have to be this way:

What is it:
Osteoarthritis is a clinical diagnosis that can be made without imaging in people who are 45 or over, have activity related joint pain, and have either no morning joint related stiffness or morning stiffness that lasts no longer than 30 minutes

What works best?:
Therapeutic exercise is important for people with osteoarthritis to reduce pain and improve physical function and quality of life

What’s changed?:
Analgesia should only be used for the shortest possible time, primarily to support therapeutic exercise

“compared with patients with osteoarthritis who did not exercise, those that did exercise had clinically important and statistically significant benefits in reduction of pain and improvement in physical function.”

❇️ Consider supervised therapeutic exercise sessions for people with osteoarthritis.
❇️ Advise people with osteoarthritis that joint pain may increase when they start therapeutic exercise. Explain that:
- doing regular and consistent exercise, even though this may initially cause pain or discomfort, will be beneficial for their joints
- long term adherence to an exercise plan increases its benefits by reducing pain and increasing functioning and quality of life.
❇️ Consider combining therapeutic exercise with an education programme or behaviour change approaches in a structured treatment package.

❇️❇️ “pharmacological management, including non-steroidal anti-inflammatory drugs (NSAIDs) and intra-articular corticosteroids, should not be seen as preventing disease progression but as a therapy to facilitate maximum function and engagement with non-pharmacological treatment approaches, such as therapeutic exercise. When used, pharmacological treatments should be provided at the lowest effective dose for the shortest possible time”

When should I consider joint replacement surgery?

Consider referring people with hip, knee, or shoulder osteoarthritis for joint replacement if:
❇️ their joint symptoms (such as pain, stiffness, reduced function, or progressive joint deformity) are substantially affecting their quality of life
and
❇️❇️ non-surgical management (for example, therapeutic exercise, weight loss, pain relief) is ineffective or unsuitable.

See Desiree Di Lorenzo & me at LASS for guidance on your options to make your health span last your lifespan. Together let’s keep you active!

https://www.bmj.com/content/380/bmj.p24

08/28/2024

Like the Sackler’s & opiates. I’ve been fighting this drugs excessive off-label use for over a decade.

“Big Pharma paid $430M in penalties for fraudulently promoting Gabapentin's effectiveness. Yet it's still wantonly prescribed for everything from pain to insomnia. *It has ONLY been approved by the FDA for seizures + neuralgia.* END THE MADNESS☠️” Rachel Zoffness PhD Stanford University

https://www.nytimes.com/2024/08/17/health/gabapentin-seniors-pain.html

In huge numbers, older people are taking gabapentin for a variety of conditions, including itching, alcohol dependence and sciatica. “It’s crazy,” one expert said.

08/25/2024

Arthritis needs motion not rest.

https://www.abc.net.au/news/2024-08-25/knee-pain-osteoarthritis-need-surgery-what-to-try-instead/104251444

Non-surgical treatments work well for most people with osteoarthritis, regardless of their age or the severity of their symptoms.

08/21/2024

“contrary to popular belief, knee osteoarthritis is not caused by “wear and tear”.” If you want to know how to stay active in spite of OA come see Desiree Di Lorenzo & I. Let us guide you to a fuller future.

“Many people believe that exercise and physical activity will cause further damage to their joint. But it’s safe and can reduce pain and disability. Exercise has fewer side effects than commonly used pain medicines such as paracetamol and anti-inflammatories and can prevent or delay the need for joint replacement surgery in the future.

Many types of exercise are effective for knee osteoarthritis, such as strength training, aerobic exercises like walking or cycling, Yoga and Tai chi.”

Most people with knee osteoarthritis can control their pain and improve their mobility without surgery, according to updated treatment guidelines. Here’s how.

08/21/2024

Injuries do happen. Desiree Di Lorenzo & I can help you.

Pickleball is the country's fastest growing sport. How to avoid one of its most devastating injuries, an Achilles tendon rupture.

08/21/2024

Revolutionary study on the negative metabolic effects of a sedentary lifestyle.

07/24/2024

“Weightlifting Is Not Just for Jocks: Strength training prevents diabetes and lowers overall death risk more than aerobic exercise alone"

“We do not just need to get our steps in; we need to get in reps—as in curls, push-ups and squats. That’s why the federal Physical Activity Guidelines for Americans, the World Health Organization, and others specify two or more sessions a week of muscle-strengthening activities. They mean weight-bearing exercises of moderate or greater intensity involving all major muscle groups.”

“In 2022 an analysis of several studies found that muscle-strengthening exercises were associated with a 10 to 17 percent lower risk of all-cause mortality than in people who didn’t do such exercises.”

https://www.scientificamerican.com/article/simple-resistance-exercises-improve-overall-health-and-reduce-death-risks/

Weight training turns out to be as important as aerobic activity for warding off disease

07/22/2024

Did you know that running is safe for your knee?

Sedentary individuals (nonrunners) have 3 times more knee and hip OA than recreational runners.

“A free online evidence-based educational resource about running and knee health was useful for the public and health care professionals. After reading the material, most people had more positive perceptions about running and knee health.”

https://www.jospt.org/doi/full/10.2519/josptopen.2024.0149

07/19/2024

Ozempic and similar drugs have rapidly become weight loss drugs of choice. Invaluable for tackling obesity.

However, similar to weight loss achieved via caloric restriction when you lose weight you lose lean muscle mass as well as fat mass if you:
❇️ don't maintain protein intake
or
❇️ resistance train

Be sure you resistance train while losing weight, so most of the lost weight is fat mass.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5946208/