AOPA Pilot Magazine - January 2015 - 26

FLY WELL

Aching joints

BY DR. JONATHAN M. SACKIER

You know you're getting old when...
SUBTLE AGING INDICATORS-including feeling bad in the
morning without having fun the night before and what
doesn't work, hurts-lead me to believe I am aging. If I
were an aircraft, while I would not be museum-ready, I
certainly could use an AOPA Sweepstakes makeover-
specifically my feet, legs, back, elbows, and shoulders.
Always active, after a recent weight loss, I decided
my informal approach to fitness was insufficient and
I decided to get in shape. Now that I have the weight
and energy levels of a teenager, I am experiencing the
symptoms of what are charmingly called "overuse
syndromes."
Living near the Blue Ridge Mountains, beautiful
hiking beckons, and the National Park Service has created fabulous trails. My feet disagree. Sauntering back to
my car recently after a 13-mile hike, I experienced heel
discomfort. Within a day, severe pain rendered sauntering impossible-crawling, maybe. I instantly knew this
was plantar fasciitis, where ligamentous tissue binding
the Achilles tendon into the heel and sole of the foot is

Getting fit is important for both lifespan and health
span, but I should have been more cautious-
and so should you.

DR. JONATHAN SACKIER

is a British-born
and trained
surgeon who lives
in Virginia. He is an
active private pilot.

26 | AOPA PILOT January 2015

traumatized. A function of poor arch structure, inappropriate footwear, or tight muscles, fasciitis is common;
some implicate heel bone spurs, but I don't buy that.
A doctor will easily diagnose fasciitis; upward foot
stretching toward your leg is a tad painful (irony),
and your heel is tender if the doctor cruelly presses it.
Treatment is frustrating but includes anti-inflammatory
medications; carefully selecting footwear (comfort and
fashion appeal have an inverse relationship); wearing
shoe inserts, preferably custom-made to your foot; special strapping to provide support; exercises to stretch
tendons and ligaments; heating and then icing the troublesome area; wearing a splint at night (imagine a ski
boot, only less comfortable); and maybe steroid shots.
Expect a slow recovery over many months, or even
years, during which you cannot perform the precipitating exercise. Sometimes specialists recommend
using external shock waves to cause tissue damage
and encourage healing. I always thought that was daft,
somewhat like stomping on your toe to take your mind
off a bad headache, but it apparently works for some
folks. In really recalcitrant cases surgery is required.

Moving up the leg, shin splints are a grim, persistent pain often in the outer reaches of the leg brought
on by running or persistent walking. Leg muscles are
contained within tight compartments, and either
exercise-induced growth or temporary engorgement
with blood stretches the walls between these compartments, causing severe pain.
Treatment is very similar to plantar fasciitis,
although you must develop a different set of expletives to help deal with the discomfort. For this, and
plantar fasciitis, using hiking poles when walking helps to balance forces; some believe this might
reduce the risk of these two pains.
Tennis elbow refers to pain in that area and the
flashier medical name, lateral epicondylitis, hints at
the inflammatory process that is going on where arm
muscles attach to a bony area on the elbow's outer
edge. Rarely is this induced by playing tennis; in my
case it was weight lifting. Golfer's elbow affects the
medial or inner bony point. My feeble golfing efforts
cause pain in my instructor's brain and the greenkeeper's back. Physical therapy, the same meds as
above, rest in a brace; steroid injections usually help.
Frozen shoulder is a collection of problems with
musculature where the arm meets the shoulder girdle. Classically presenting as the inability to raise
your arm beyond a certain point without excruciating
pain-which, in my case, was from taking up tennis
again-together with medication and steroids, recovery involves exercises, slowly "walking" the affected
hand up a wall, or using stretchy bands. Surgery is
useful in some cases.
With any painful joint, one automatically adjusts
gait or posture to "protect" the wounded side, which
can cause secondary aches and pains such as ankle
tendonitis or backache; being conscious of this risk is
key. There are joints not currently on my squawk list,
and I'm monitoring closely for housemaids knee and
anything going awry with my left thumb.
Getting fit is important for both lifespan and
health span, but I should have been more cautious-
and so should you. The sad thing about experience is
that by the time you have it, nobody wants it-and you
know you're getting old when you look in the mirror
and say, "Dad?"
AOPA
EMAIL jonathan.sackier@aopa.org



AOPA Pilot Magazine - January 2015

Table of Contents for the Digital Edition of AOPA Pilot Magazine - January 2015

Contents
AOPA Pilot Magazine - January 2015 - Cover1
AOPA Pilot Magazine - January 2015 - Cover2
AOPA Pilot Magazine - January 2015 - Contents
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