We are back with our “2 for Tuesday” series on Back Talking! I am hosting weekly Facebook Live sessions every Tuesday at 2 pm, so check us out over on Facebook at The Joint Morrisville page. This was our second show on Facebook Live, and the first question that I answered was submitted by Margarita, a listener here in North Carolina who had a question about wearing waist trainers. The second question that I tackled is a frequently asked question in my office, “what is the popping sound when I crack a joint?”

Waist Trainers

Well this was a new one for me, I had absolutely no idea what she was talking about with a “waist trainer”. So off to google I go and the first thing that popped up was an image of Kim Kardashian wearing a “waist trainer”. Right away I recognized what they were talking about. It is essentially a corset. Now celebrities are claiming to have gotten back “in shape” quickly after giving birth, wearing a waist trainer. One new celebrity mom touted that it helped reduce water retention and swelling of the uterus, “all the while supporting that unwanted baggy baby skin.”

Well what is waist training? It is the practice of wearing a constricting garment – such as a corset or shapewear – to reduce the size of your waistline. This practice goes back hundreds of years, and were popular around a hundred years ago as a fashion statement.

Now waist trainers wrap around the lower rib cage and waist area to provide an instantly slimming look, they can reduce your midsection instantly by one to 3 inches. But the result is only temporary – giving a smaller waistline and a overall thinner appearance.

If you want to go out and look really thin, I don’t have a problem with you wearing one of these. But, you’ll probably have to put up with some discomfort as well. As far as claims that these can reshape the body or trigger fat loss, there is no evidence. That discomfort I was talking about includes difficulty breathing as it interferes with diaphragm motion, heartburn as it pushes the stomach and its contents back up into the diaphragm and esophagus, it also compresses all of your organs such as the liver, kidneys, intestines and lungs as mentioned before. There is an interesting video out there on Dr Oz’s website, and I’ll put a link to the video in the show notes. He takes a woman volunteer and they perform an MRI on her, with and without the corset on. The results are rather dramatic as we get to peer inside of her and see what is happening to her organs. You see the liver being indented and deformed by the ribs, you see the stomach grossly misshapen and pushed back up to the diaphragm. You see the kidneys squished and actually elongated. Now all this squishing of your organs can decrease their blood flow and their ability to function properly!

Also, wearing a waist trainer can actually decrease your core strength, your abdominal muscle tone, and cause atrophy of the muscles that make up you abdominal wall. This is exactly the opposite of what you want if you are looking for that smaller-flatter stomach!

These are not a substitute for a consistent exercise program and proper diet and nutrition. If you want tighter abs, core training including curl-ups and planks form the basis for increasingly abdominal muscle strength and endurance. To lose weight, there isn’t a cheat or a quick fix to fitness. You have to do it the old-fashioned way of proper nutrition and hard work in the form of moderate to intense exercise. And to those new moms, that uterus is going to shrink when it feels like shrinking, and you can’t get rid of water weight with a corset – it’s simply not true!

What makes that popping sound when you crack a joint?

So on to the second question of the day, and this is asked in the office almost consistently on a daily basis, and the question is “What causes the popping sound when you crack a joint?”

So this is an interesting question, and I was a little bit surprised that there was some active research being conducted out there on this topic. I guess man’s quest for knowledge never ceases.

So let me give you a quick anatomy lesson first. The most common type of joint in the body is called a synovial joint. We’ll use my finger joint here as an example. Where the 2 bones come together, from the outside in we have the ligaments that attach from bone to bone that keep them connected and give the joint stability, then there is a fibrous capsule that wraps around the joint, and inside of that capsule is fluid or synovial fluid. That fluid helps to lubricate the inside of the joint to make it more slippery, and it also helps to carry nutrients to the cells on the inside of the joint.

So in April of last year, a study was published that used MRI machines to image knuckles being cracked. And what they saw on the images were the collapse of bubbles that form in the fluid surrounding our joints. So they theorized that the bubbles “popping” were what causes the audible crack that we hear.

Not to be outdone, another group of radiologists decided to take a look at this issue, but this time they decided to use ultrasound imaging instead of MRI imaging. The reason that they chose US machines is that they are 100x faster than MRI, and can capture events that are 10x smaller than MRI is capable of.

Participants were asked to crack the knuckle at the base of their finger. What startled researchers while watching the images was and I quote “What we saw was a bright flash, like a firework exploding inside of the joint.” They continued on to say “We are confident that the cracking sound and the bright flash on ultrasound are related to the dynamic changes in pressure associated with a gas bubble.”

So is the crack the result of a bubble bursting, or of a bubble forming?? Based on the US studies I’ll go with a bubble forming, which is what we were taught back in school. I always use the analogy of opening a soda bottle for the first time. Prior to opening, you couldn’t see the gas in the soda. But after opening the bottle and lowering the pressure inside the bottle, you get the formation of all those gas bubbles.

Listen to the podcast below:

We are back with our “2 for Tuesday” series on Back Talking! I am hosting weekly Facebook Live sessions every Tuesday at 2 pm, so check us out over on Facebook at The Joint Morrisville page. This week was our first show on Facebook live, so the first question that I answered was an easy one – Who am I, and why you should listen to me. The second question was asked of me in the office last week, someone was surprised to find out that x-rays weren’t necessary. So question 2 is “Are x-rays necessary?”

Are X-rays Necessary?

There are many tools that doctors have in their toolbox, and imaging studies such as x-ray, CT scans, and MRI allow us to peer into the body like never before. But in my opinion, the most important part of a patient encounter is the history. If the doctor asks the right questions, they have in their mind a working diagnoses before they have even touched the patient. In the answers that the patient is giving the doctor, they are listening to what are termed red flags. These are items that get the doctors attention and require further investigation.

In regards to x-rays for back pain, they are only indicated if one or more of the following red flags are present:

• severe or progressive neurologic deficits such as loss of motor control ( i.e. foot drop or loss of reflex upon exam)
• loss of bowel or bladder control
• fever
• unexplained weight loss
• previous history of cancer
• long term use of steroids or immunosuppressants
• trauma

So the answer to the question “are x-rays necessary?” is occasionally. Thank goodness that these red flags are not very common. In my practice maybe less than 5% of first time patients are referred out for some type of imaging.

To listen to the podcast, click on the link below.

We continue with the series titled “what is causing your low back pain?” on Blab. We’ve been hosting weekly blab episodes every Friday at 1p, so come check us out over at blab.im. This week we discuss John, he is an elder gentleman who has arthritis, most likely caused by the 30 plus years of working on a police force.

Arthritis

One of the most common causes of low back pain worldwide. There are actually over 100 different types of arthritis, which is essentially a condition where one or more of your joints is inflamed. The most common form is osteoarthritis. Its typical presentation is that of pain, stiffness, and in some cases swelling. It affects around 1 in 5 Americans, and it is estimated that more than 20 million Americans have severe limitations on a daily basis due to arthritis. It places a tremendous burden onto the US healthcare system and on the economy. It causes more than 1 million hospitalizations and 45 million doctor visits in a given year. We spend more than $100 billion in its treatment. Recent discoveries have found a genetic link to osteoarthritis. But yet we are no closer to having a solution to the problem.

In this episode we follow John. He is a retired cop who spent over 30+ years either walking a beat, or behind the wheel of a patrol car. I’ve seen him off and on for over 10 years now, so I know what he diagnosis is when he walks through the door. Typically he will have done something crazy to cause the arthritis in his back to flare up. This time around it was painting a room while sitting in a chair.

Take a listen to this episode below!