Dr. Nicholas Cappello

Walking is the ultimate easy-to-do, good-for-you exercise. You don’t need special gear, you can go with friends or solo, stay indoors or venture outdoors, and, best of all for those with tender knees, you can do it at your own pace. Start slowly – try for three 10-minute outings a day at first – and add speed, hills and longer distances as your endurance and strength builds.

1. Walking improves circulation. It wards off heart disease, brings up heart rate, lowers blood pressure and strengthens the heart. One study showed that postmenopausal women who walked just 1 to 2 miles a day lowered blood pressure by nearly 11 points in 24 weeks. Women who walked 30 minutes a day reduced their risk of stroke by 20 percent – and 40 percent when they stepped up the pace.
2. Walking lowers the risk of fractures. Any exercise that places your body’s weight on your legs helps build stronger bones. In one study, women who walked 30 minutes a day reduced their risk of hip fractures by 40 percent.
3. Walking supports joints. It tones muscles that, in turn, support the joints. Strong leg, abdominal and lower back muscles take the burden off knees and lower-body joints.
4. Walking improves sleep. In a study of women age 50 to 75, those who took one-hour morning walks were more likely to relieve insomnia than women who didn’t walk.
5. Walking slows mental decline. One study of 6,000 women, age 65 and older, found that age-related memory decline was lower in those who walked more.
6. Walking lowers Alzheimer’s risk. One study showed that men between the ages of 71 and 93 who walked more than a quarter of a mile a day had half the incidence of dementia and Alzheimer’s disease compared with those who walked less.
7. Walking lightens mood. Research shows that walking 30 minutes a day may boost mood faster than antidepressants do. Why? Walking releases natural pain-killing endorphins into the body.
8. Walking burns calories. When you burn more calories than you consume, you’ll lose weight, which has benefits of its own, including less stress on painful joints.
9. Walking brings you closer. Walking is a good way to spend time with friends or family members and enjoy nature.
10. Walking is economical. A good pair of shoes is all you really need – no expensive lessons, gear or gym memberships. Just get moving!

Duke Sports Medicine experts Randall Lazicki, and Shefali Christopher talk about how essential it is to build your “core muscles”, or “muscle core” for a strong and healthy body along with living a healthly lifestyle.  In this video they teach a particular exercise called “Table Top” that helps to strengthen the body core muscles

Please follow these easy steps to properly execute the this exercise:

1.  Position body on hands and knees, shoulders overhand and hips over your knees.

2.  Pull your belly button toward your spine a few times to active your core muscles

3.  While doing step 2, you can slowly life your arms and legs in rythm to further exercise your core muscles

4.  Alternate arms and legs while exercising your core muscles.

5.  Keep core muscles contracted so there is minimal movement in the lower back area

Shefali  also provides and anatomy lesson on the core muscles and core region of the body.  This exercise is does not treat any current condition, but it is meant to help you build a strong an healthy core to help you improve your lifestyle.

Thousands of adults between the ages of 20 and 50 suffer from a debilitating hip disorder called avascular necrosis (AVN), in which the femoral head of the hip bone (the “ball” part of the joint’s ball-and-socket design) dies due to inadequate blood supply.

The three most common causes of AVN are hip fractures, alcohol abuse, and long-term use of corticosteroid medications. (A severe sports injury known as a hip subluxation can also lead to the condition.) Nearly three out of four people with AVN have it in both hips.

Despite remarkable advances in joint replacement technology, even state-of-the-art hip replacements last only a few decades, due to the continual stresses placed on the joint. So, while a hip replacement is a good option for older patients whose hips have succumbed to degenerative conditions such as osteoarthritis, it’s less suitable for younger people with AVN, who later must undergo the ordeal of repeated surgeries.

Thirty years ago, James Urbaniak, MD, Virginia Flowers Baker Professor of orthopaedic surgery, developed another approach to AVN: a remarkable procedure known as a free vascularized fibular graft.

To perform the graft, Urbaniak first removes the blood-starved dead bone from the hip, then inserts into the hip bone a section of the fibula — the small bone in the lower leg whose removal does not affect walking. Once Urbaniak links this healthy implanted bone to nearby blood vessels, it rejuvenates the femoral head, or ball, of the joint, literally bringing the hip back to life.

“Until we developed this technique, virtually the only other option was to fuse the hip, making it stiff,” Urbaniak says. “However, later in life, these patients developed often severe back and knee pain, because the hip was rigid.”

Urbaniak has performed more than 3,500 free vascularized fibular grafts,  and the results have been remarkable. “If we catch AVN early enough, the procedure can restore normal function in 90 percent of young people’s hips,” Urbaniak adds. “Our success rate drops to 70 percent if we catch them later, which is why we emphasize that patients should come to us as early as possible.”

The wealth of data gleaned from the experiences of past patients has steadily improved Urbaniak’s ability to determine whether the operation will help a patient. In fact, he considers such data so important that he has even been known to hire a private detective to track down patients to determine their outcomes.

Even with his impressive success rate, however, Urbaniak remains unsatisfied. Dr. Urbaniak recently retired from active surgery and his surgical procedure continues to be performed by a well-trained and experienced team of his colleagues, including David Ruch, MD, Marc Richard, MD, and Samuel Wellman, MD.

Urbaniak and his colleagues are currently seeking to improve the operation by treating patients with natural substances called growth factors that encourage the spread of new blood vessels to better nourish the regenerating bone. He emphasizes that prevention of AVN in the first place is the Holy Grail that guides his ongoing research efforts.

“We don’t really know why alcohol, steroids, or blood coagulation disorders focus on bone death in the hip,” Urbaniak says. “We have identified some factors that prevent blood from getting to the bone. If further research allows us to pinpoint the causes, we envision the development of medications or gene therapy that would one day allow us to increase blood flow to a hip to treat bone disease — or prevent it altogether