Ankle bone spurs; the importance of dietary protein for seniors
Q: My ankle has been chronically sore, so I had it X-rayed. It showed a bone spur. My doctor wants me to do physical therapy before deciding on surgery. Is PT really going to help, or should I just go ahead and have the operation? - Jerry H., Roanoke, Virginia
A: As a general rule, always try physical therapy first. Bone spurs in the ankle (or anywhere) occur when the cartilage between bones breaks down and the bones generate lumpy outgrowths to try to make up for the lost cartilage. The cause of the cartilage loss is usually osteoarthritis, but bone spurs also can be caused by an accident or injury. In those cases, spurs may form because you injured a tendon or ligament and that caused local inflammation of the bone.
When you do PT, the goal will be to strengthen the muscles around the spur, which will then relieve some of the bone on bone/tissue pressure and lessen your discomfort. If that solves your problem, you might avoid surgery - at least for a while. But if you do end up having the surgery, your joint will heal faster, because it will be stronger after PT.
Your PT probably will include heat, stretching and strengthening exercises, ultrasound, massage and ice. You also might ask your doc about taking an anti-inflammatory over-the-counter medication to reduce pain and possibly even a cortisone injection. Ultimately, you and your doc will decide on next steps based on how large the spur is and how much pain you're experiencing. But the good news is that if your bone spur isn't too severe, your chance of being able to manage the discomfort without surgery is pretty good.
Q: My great aunt is 76 and swims or walks almost every day, but she's starting to get bent over and has the beginnings of a hump between her shoulders. What can she do to reverse this or at least keep it from getting worse? - Patricia O., New York
A: What you're describing calls for a physical exam and perhaps a bone scan. Chances are your great aunt may be developing osteoporosis (loss of bone density leading to easy fractures). There are several self-care steps she can take that will improve her overall strength and her bone health. If she has to be treated for bone loss, they will make her treatment more effective.
First, she should have a blood test to check her calcium level. For anyone over 60, it should be in the 9 milligrams per deciliter range. And whatever the results, she should make an effort to eat calcium-rich foods such as dark leafy greens, sunflower seeds, carrots, green beans, almonds, broccoli, and low-fat dairy. A supplement of 600 milligrams of calcium with 300 milligrams of magnesium daily is safe to take and may provide benefits - don't take more without a doctor's OK.
Also, vitamin D is important for bone health. She should talk to her doc about taking a supplement of vitamin D-3 - at least 800 to 1,000 international units (IU) daily to get her blood level to 35 to 80 milligrams per deciliter.
But there's another dietary component doctors are beginning to realize is particularly important for seniors: protein. The International Osteoporosis Foundation just released a meta-analysis that found: "dietary protein levels even above the current RDA may be beneficial in reducing bone loss and hip fracture risk, provided calcium intakes are adequate. [And] insufficient dietary protein intakes may be a more severe problem than protein excess in the elderly."
The current recommendation for protein intake for folks 50 plus is 55 grams to 70 grams of protein a day, but after age 65, 75 grams to 80 grams might be smart (unless you have kidney problems). So suggest your aunt start the day with protein from skinless chicken, fish or an egg white omelet, and that she eat protein in each meal. Non-meat sources of protein include rice and beans, nuts and whole grains.
Distributed by King Features Syndicate, Inc.
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