About Oak Haralds

Oak graduated from Keele University in 2012 with a honors degree in Biomedical Science. She is currently studying at the University of Warwick, undertaking a MSc in Science, Media and Public Policy a sympathetic passion that has spurred her to pursue the perfection of science literary art. As a reader she enjoys the myriad of ethical dialog that surrounds medical law and public policy and has a clear understanding of the wearisome task that is providing a fair government funded health system.

Right Mind; Appropriate Perception

Artistic impression of the knee joint, inlcuding the often overlooked Popliteus Muscle crossing the back of the knee

Episodic or lifelong knee pain is increasingly familiar to a greater number of people. Amongst young adults, the most common pain is of the lower fraction, just below the patella (knee cap), and towards the inner side of the knee. Clinically this is referred to as Prepatellar Bursitis, common diagnoses are; patella tendonitis, Osgood-shlatter disease, chondromalacia patellae or even plica syndrome.

Yet it is comforting to recognize that what manifested the same in its clinical stage is often treated the same, and non-invasively; surgery is only sponsored in the more extreme cases, and only when propped up with an initial exploratory arthroscopy. The common non-invasive treatment is referred to as RICE; Rest, Ice, Compression and Elevation.

The proprioceptive idiom is a basic instrument of injury rehabilitation and sports specific training. Though the proprioceptive organ in humans still remains unsolved, many are in agreement that the phenomenon is endorsed at all levels and all body systems; from our skin, our respiratory system, to our eyes; when one fails, others pick up the slack.

With the London Olympics we saw the rise in the popularity of blue sports tape amongst the athletes. While there are many premade support equipments for knee pain like Prepatellar Bursitis, i.e. patella straps or jumpers knee strap, for my part at least, sports tapping has proved more beneficial.

Sports tape not only allows you to determine the degree and specificity of support given, a roll of tape allows you to cater for any other knee, ankle, hip or back problems suffered. All you need is a good quality sports tape, perhaps some under wrap and additional support tape, though this is not always necessary, coupled with an educational video provided by the familiar public video channel.

Taping provides greater skin contact than many premade supports, with the better quality tapes providing new natural movement; this increases our propreoceptive response and as such gives us a greater awareness of our knee and its weaknesses. It is important to note however that like with standard plasters some people may have a reaction to the tapes adhesive.

The Latin hybrid; propreoception, commonly dubbed as ‘own’s one’, owes an embellished footnote to its literate architect, as we see the fruits of decade’s worth of research coming to the fore, alongside the leaps in kinaesthetic understanding; specifically the sense model of body motion.

Bibliography

Bear, M.F. Connors, B.W. Paradiso, M.A. (2007) Neuroscience, Exploring the Brain, 3rd Edition. Lippincott Williams and Wilkins, USA. Chapter 13; p438

Links

http://www.drdavidgeier.com/injuries/

http://usaproductions.org/resources/team-clinic

http://www.floridaortho.com/foisports/patient_brochure/knee_pain.html

http://www.journalofprolotherapy.com/index.php/prolotherapy-of-the-arcuate-ligament-of-the-knee/

http://en.wikipedia.org/wiki/Proprioception

http://en.wikipedia.org/wiki/Osgood–Schlatter_disease

http://en.wikipedia.org/wiki/Plica_syndrome

http://www.drdavidgeier.com/injuries/plica-syndrome/

http://en.wikipedia.org/wiki/Chondromalacia_patellae

http://www.acti-tape.com/

http://youtu.be/e0Nxioeg314

http://www.springerlink.com/content/9jw3h9lpdjb0npye/

http://onlinelibrary.wiley.com/doi/10.1111/j.1475-097X.1990.tb00828.x/abstract

Foot Note

Photography by Fiona Banner

 

“Have you ever spent a day wearing mittens?

I do not suppose you have tried it too long with shoes.”

These were the thoughts I had as I sat on my kitchen table looking down at my feet wiggling my toes. Our autobiographical lives give ample coverage to back ache and neck pain, but our feet habitually go un-noted.

It occurred to me that we restrict our feet quite often and I wondered to what advantage or disadvantage this was? To this end I decided that I would free my feet as often as possible, avoiding socks and opting for sandals over shoes. My first hurdle was work, concluding that the NHS would most likely frown on me turning up in sandals, to many a readers delight, I wore shoes.  It did not take long until I noticed the return of my knee pain and the relief that came with sneaking my shoes off on the odd tea brake.  My knee pain was often followed by back ache and neck pain. This contrasted with the Nursery shifts where I was often barefoot for the majority of the day; there I was generally pain free.

Observing the complexities of the situation I sought a compromise in my footwear.  Such a compromise I found in a pair of super sleek Vibram fivefingers ®. I debut my innovative footwear in the nursery, the curious and open minded children jumped on any opportunity to touch and wiggle my toes.

As children often our first lesson of anatomy is the nursery rhyme where we are taught the names of each part of the body and how each part is connected to the other.  As adults we need to remember that once we saw the body as a whole and this is no less true just because we know more about all its subtle parts and habits.

So let us reflect; back ache or neck pain, in some cases, may be a consequence of a disregarded ankle and/or knee injury.  As adults, we need to stop looking for quick fixes in abstract solutions and observe our bodies, take note of our weakness and strengthen ourselves where we are weakest.

Since my move to more lucid footwear, my toes are straighter, sleeker and arranged more closely together, my foot is less flat with my arch higher and stronger, my knees are stronger, and my bum looks great.  Also,   I have virtually no back pain.

Quite the bargain for the price of a new pair of shoes.

http://www.vibramfivefingers.it/default.aspx

 

 

The Essential Artifacts?

“Pure science and practical applications push each other” [1].

With the demise of NASA, our attention is drawn to the everyday commodities and understanding gained in receipt of space entrepreneurship; invisible braces, scratch-resistant lenses, temper foam, portable cordless vacuums, freeze drying, water purification, solar energy, and remotely controlled ovens[2]. As we approach the end of 2012 and the beginning of a New Year, once again, we will begin to see movement in support of global nuclear disarmament. As such, I feel it is necessary to review what nuclear science has brought us, discuss what it has done for society, and begin to chart a future without nuclear arms.

Nuclear science is responsible for the creation and the continuing perfection of a number of technologies. Progress in nuclear power efficiency and safety, reduction in cost and aptness of nuclear medicine in diagnostics and treatment, and the humble smoke detector, is a bounty one can be appreciative of [3].  Nuclear science for the purpose of power synergy or arms is often part of political discourse. Though nuclear power and nuclear weapons are both products of nuclear science and both present a definitive risk for human life, the call for nuclear disarmament does not call for; the disassembly of nuclear power (though many anti-nuke campaigns have called for such an action).

On the 12th of November this year public officials will be convene in Brussels to continue discussions on plans and strategies for a future without nuclear arms.  This event is hosted by Global Zero, endorsed by David Cameron and Barac Obama, and is responsible for the gathering and training student leaders for this event [4]. These student leaders will be responsible for spreading the movement and gaining momentum towards creating a world without nuclear weapons.

The threat of nuclear weapons is an instrument that historically has been worn in the monopolies of power.  Nuclear weapons over other armaments have the superior inborn capacity to instil fear in man, a fear that can be invoked with or without their long term materialisations. The press of nuclear weapons has proved an elementary device to help promote awareness and provide some perspective, though more often it is a source to feed mans fears.

Instilling fear in man coupled with authoritarian rule is historically responsible for the world’s most horrendous violations of Human Rights and mass murder. Milgram’s famous experiment on obedience to authority figures demonstrates the capacity of such tools. The Global movement towards disarmament would help remove this fear and provide people with the confidence of voice.

The future is in balance, It is time to watch this space.

References (Harvard)

[1].  Lawrence Berkeley National Laboratory (2010) Applied nuclear physics for biomedicine, nuclear security and basic science. URL: http://phys.org/news194720066.html accessed: 20/20/12

[2].  NASA, et al (2012) NASA spin-off technologies. URL: http://en.wikipedia.org/wiki/NASA_spin-off_technologies accessed: 20/10/2012

[3].  Anon, a. (2012) Nuclear Engineering. URL: http://en.wikipedia.org/wiki/Nuclear_engineering accessed: 25/10/2012

[4].  Global Zero (undated) Brussels (European) Institute 2012. URL: http://www.globalzero.org/institutes/brussels accessed: 20/10/2012

[5].  Anon, b. (2012) Milgram Experiment. URL: http://en.wikipedia.org/wiki/Milgram_experiment accessed: 25/10/2012

Bibliography (Havard)

[1].  Public Awareness of Nuclear Science. URL: http://www.nupecc.org/pans/index.html Accessed: 20/10/2012

[2].  World News Inc (2012) European Organisation for Nuclear Research. URL:http://wn.com/european_organization_for_nuclear_research?orderby=relevance&upload_time=today accessed: 20/10/2012

[3].  Adams, R. (2010) Guest Blog at Scientific American – The Influence of Information on an Open, Inquiring Mind. URL: http://atomicinsights.com/2010/05/guest-blog-at-scientific-american-the-influence-of-information-on-an-open-inquiring-mind.html accessed: 20/10/2012

ACL Reconstructive Surgery – Knee Destructive?

Damage of the anterior cruciate ligament in the knee is one of the most common serious injuries in young athletes and, reflecting individual activity, is habitually treated surgically.  ACL reconstruction, the gold standard, requires the harvesting of a hamstring or patella tendon graft, which is used as scaffold for new ACL growth. Cadaveric ligament harvesting and transplant is promising, though autologos (own) tissue graft placement is still proffered owing to the reduced risk of graft failure and tissue rejection.

Soft tissue graft harvesting for ACL reconstruction is the current choice amongst surgeons due to the relatively straight forward procedure and recovery seen. However more recent studies have concluded that the patella tendon graft is superior. The shift in muscle dominance required of an ACL vulnerable knee, means hamstring harvesting may be counterproductive. Increase in hamstring strength is crucial to reduce impact within the joint.

Recent studies of ACL injuries comparing patients that opt to delay surgery for early rehabilitation with those that have early surgical intervention and subsequent physiotherapy, show that from the time of operative intervention a similar recovery and success rate is achieved. However those patients that delay treatment demonstrate a higher rate of meniscus damage, suggesting some in this group may have benefitted from immediate intervention. Nonetheless, close to half of those who delay surgery never opt for surgical intervention, with many showing partial to full recovery. Although these assertion may seem to favour no surgical intervention, accept in the extreme of cases, this may not be the case; prognosis is fundamentally an art of intuition.

Physiotherapy therefore remains the key figure in successful rehabilitation with patient education of the utmost importance. Dynamic intervention is paramount; dips in physical fitness promote stiffness and loss in range of motion as well as increased load bearing in the joint, whilst over activity promote relapse. Maintained physical activity inclusive of the knee joint promotes maintenance of tissue integrity and supports repair of damaged tissue conceivably as a result of increased vascularisation. A physiotherapy program built on eccentric exercises focusing on increasing lower body strength to a degree greater than before damage is vital to successful recovery and maintenance of strength is symptomatic of long term stability.

Novel methods for ACL repair are focusing on promoting the body’s own regenerative ability. One such method, aptly named the Healing Response Technique has been used by athletes for the best part of the last decade yielding a superior response, yet formal evaluation seems to be primarily in the clinical testing stage. Kohl and colleagues from the University of Bern and the University of Zurich utilising sheep models (2012) boast:

“The dynamic intraligamentary stabilization technique successfully induced self-healing of ruptured ACL in a sheep model. Knee joints remained stable during the healing period allowing free range of motion and full weight bearing, and no signs of osteoarthritis or other intraarticular damage in the follow up were observed.”

As an individual having come through ACL reconstruction, a partial (50%) menisectomy and with an ACL revision on the cards, I can only emphasise the importance of educating patients, reinforcing the function of physiotherapy and the benefits of maintaining physical activity. There is indeed a call for public funding and investment for non invasive therapy.

Images reproduced from orthopedics.about.com, muscleprodigy.com and buzzle.com