By Dr. David Thomson
Childhood obesity is a weighty matter for a growing number of children in the United States. According to the Centers for Disease Control and Prevention, the percentage of American youth who are overweight has more than tripled since the early 1980’s. [1] Among children and teens aged 6–19 years, 16 percent (over 9 million young people) are considered overweight.[2]
While much of the attention on obesity in children has been focused on health related factors such as type 2 diabetes, asthma and hypertension, all of which are very serious problems, there are other risks that require the co-management of chiropractic physicians and pediatricians.
The need for chiropractics with obesity
Among growing youth, bone and cartilage in the process of development are not strong enough to bear excessive weight. Increase stress on the weight-bearing joints (i.e., the growth plate of the hip) can cause pain and limit range of motion. Extreme cases may develop into serious complications, such as idiopathic slipped capital femoral epiphysis (the posterior and inferior slippage of the proximal femoral epiphysis on the femoral neck), which is the most common hip disorder in adolescents.
The diagnosis of slipped capital femoral epiphysis should always be considered when a physician is assessing the causes of hip, thigh, and knee pain in obese children. Unfortunately, it is often overlooked due to the distribution of nerves throughout the hip. Often patients will target associated groin, thigh and knee pain, rather than the underlying hip pain.
Diagnosed promptly with chiropractic clinical examination, laboratory testing, diagnostic imaging and other diagnostic interventions, chiropractic care may be used to support medical treatment by relieving the musculoskeletal aspects associated with the condition. Delayed diagnosis increases risk of avascular necrosis (the temporary or permanent loss of blood supply to the bones), discrepancy in limb length, and thigh atrophy. Over time, internal rotation decreases, and abduction and flexion of the hip increases, along with automatic external rotation of the lower extremity with flexion of the hip.
Longstanding cases may necessitate surgery, such as the technique of percutaneous in situ fixation (the drilling of a cannulated screw into the patient’s hip), which carries the risks of unrecognized screw penetration of the hip, infection, nonunion, and once again, avascular necrosis (or osteonecrosis).
Wearing on our youth
Obesity in childhood increases the risk of premature degenerative (wearing) conditions such as osteoarthritis of the knee.[3] In the hip and the knee, joint forces are approximately 1.5 times body weight when walking on level ground. Other activities place even greater forces on the joints. Getting up out of a chair, or going up and down stairs increases the force to approximately 2 to 3 times body weight. With more vigorous activities, such as running or jumping, the forces on the joints can approach 4 to 5 times body weight.[4] For children who are overweight, this means dramatically increased wear on the joints and the possibility of chronic disease risk factors in adulthood.
Options for success
Doctors of chiropractic are qualified to detect the earliest degenerative changes in the joints. They have received the training and have the tools to see the impact of changes in the spine, the hips, the knees, and other weight-bearing joints. Doctors of chiropractic are trained to relieve pain and improve joint function through natural therapies, such as chiropractic manipulation, trigger-point therapy, or some massage techniques.[5]
Doctors of chiropractic can provide exercise counseling, helping patients and their parents choose exercises that are best for the child. If a painful or a swollen joint prevents exercise, there may be drug-free, pain-relief options (such as applying heat or cold to the affected area) available to the child.
Doctors of chiropractic may also assist patients by making available medical nutritional therapy. They can suggest supplements that play important roles in prevention and treatment, as well as products that may help maintain appropriate weight.
Contact us today if you or your child is suffering from any of the symptoms listed in this newsletter, or if you are experiencing other premature degenerative conditions caused by being overweight. Our patients experience faster recovery and more sustained wellness. We’ll start you on the road to recovery by giving you the education and the tools necessary to make permanent changes in your life!
[1] Overweight is classified as BMI >25.0, obesity as BMI >30.0, and extreme (class III) obesity as BMI >40.0 kg/m2. Data elements were excluded if a respondent's weight was >500 lbs or height was >7.0 ft.
[2] http://www.cdc.gov/nccdphp/dnpa/obesity/
[3] http://pediatrics.about.com/cs/conditions/a/knee_problems.htm
[4] http://www.hughston.com/hha/a_16_2_1.htm
[5] http://www.amerchiro.org/content_css.cfm?CID=1465
Childhood obesity is a weighty matter for a growing number of children in the United States. According to the Centers for Disease Control and Prevention, the percentage of American youth who are overweight has more than tripled since the early 1980’s. [1] Among children and teens aged 6–19 years, 16 percent (over 9 million young people) are considered overweight.[2]
While much of the attention on obesity in children has been focused on health related factors such as type 2 diabetes, asthma and hypertension, all of which are very serious problems, there are other risks that require the co-management of chiropractic physicians and pediatricians.
The need for chiropractics with obesity
Among growing youth, bone and cartilage in the process of development are not strong enough to bear excessive weight. Increase stress on the weight-bearing joints (i.e., the growth plate of the hip) can cause pain and limit range of motion. Extreme cases may develop into serious complications, such as idiopathic slipped capital femoral epiphysis (the posterior and inferior slippage of the proximal femoral epiphysis on the femoral neck), which is the most common hip disorder in adolescents.
The diagnosis of slipped capital femoral epiphysis should always be considered when a physician is assessing the causes of hip, thigh, and knee pain in obese children. Unfortunately, it is often overlooked due to the distribution of nerves throughout the hip. Often patients will target associated groin, thigh and knee pain, rather than the underlying hip pain.
Diagnosed promptly with chiropractic clinical examination, laboratory testing, diagnostic imaging and other diagnostic interventions, chiropractic care may be used to support medical treatment by relieving the musculoskeletal aspects associated with the condition. Delayed diagnosis increases risk of avascular necrosis (the temporary or permanent loss of blood supply to the bones), discrepancy in limb length, and thigh atrophy. Over time, internal rotation decreases, and abduction and flexion of the hip increases, along with automatic external rotation of the lower extremity with flexion of the hip.
Longstanding cases may necessitate surgery, such as the technique of percutaneous in situ fixation (the drilling of a cannulated screw into the patient’s hip), which carries the risks of unrecognized screw penetration of the hip, infection, nonunion, and once again, avascular necrosis (or osteonecrosis).
Wearing on our youth
Obesity in childhood increases the risk of premature degenerative (wearing) conditions such as osteoarthritis of the knee.[3] In the hip and the knee, joint forces are approximately 1.5 times body weight when walking on level ground. Other activities place even greater forces on the joints. Getting up out of a chair, or going up and down stairs increases the force to approximately 2 to 3 times body weight. With more vigorous activities, such as running or jumping, the forces on the joints can approach 4 to 5 times body weight.[4] For children who are overweight, this means dramatically increased wear on the joints and the possibility of chronic disease risk factors in adulthood.
Options for success
Doctors of chiropractic are qualified to detect the earliest degenerative changes in the joints. They have received the training and have the tools to see the impact of changes in the spine, the hips, the knees, and other weight-bearing joints. Doctors of chiropractic are trained to relieve pain and improve joint function through natural therapies, such as chiropractic manipulation, trigger-point therapy, or some massage techniques.[5]
Doctors of chiropractic can provide exercise counseling, helping patients and their parents choose exercises that are best for the child. If a painful or a swollen joint prevents exercise, there may be drug-free, pain-relief options (such as applying heat or cold to the affected area) available to the child.
Doctors of chiropractic may also assist patients by making available medical nutritional therapy. They can suggest supplements that play important roles in prevention and treatment, as well as products that may help maintain appropriate weight.
Contact us today if you or your child is suffering from any of the symptoms listed in this newsletter, or if you are experiencing other premature degenerative conditions caused by being overweight. Our patients experience faster recovery and more sustained wellness. We’ll start you on the road to recovery by giving you the education and the tools necessary to make permanent changes in your life!
[1] Overweight is classified as BMI >25.0, obesity as BMI >30.0, and extreme (class III) obesity as BMI >40.0 kg/m2. Data elements were excluded if a respondent's weight was >500 lbs or height was >7.0 ft.
[2] http://www.cdc.gov/nccdphp/dnpa/obesity/
[3] http://pediatrics.about.com/cs/conditions/a/knee_problems.htm
[4] http://www.hughston.com/hha/a_16_2_1.htm
[5] http://www.amerchiro.org/content_css.cfm?CID=1465
No comments:
Post a Comment