MEN WHO EXERCISE LESS MORE LIKELY TO WAKE UP TO URINATE

Men who are physically active are at lower risk of nocturia (waking up at night to urinate), according to a study led by a Loyola University Chicago Stritch School of Medicine researcher

The study by Kate Wolin, ScD, and colleagues is published online ahead of print in Medicine & Science in Sports & Exercise, the official journal of the American College of Sports Medicine.

Nocturia is the most common and bothersome lower urinary tract symptom in men. It can be due to an enlarged prostate known as benign prostatic hyperplasia (BPH) -- as the prostate enlarges, it can squeeze down on the urethra. Other causes include overproduction of urine, low bladder capacity and sleep disturbances. Nocturia increases with age, and is estimated to occur in more than 50 percent of men 45 and older.

Wolin and colleagues analyzed data from a large, ongoing clinical trial called the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO). Men ages 55 to 74 were eligible for the trial. The study included questions on BPH-related outcomes, including enlarged prostate, elevated PSA levels and nocturia. PLCO also asked men about physical activity and other lifestyle factors.

Wolin's analysis included 28,404 men in the PLCO trial who had BPH outcomes before enrolling in the study (prevalent group) and 4,710 men who had newly developed BPH (incident group).

Among men in the incident group, those who were physically active one or more hours per week were 13 percent less likely to report nocturia and 34 percent less likely to report severe nocturia then men who reported no physical activity. (Nocturia was defined as waking two or more times during the night to urinate; severe nocturia was defined as waking three or more times to urinate.)

"Combined with other management strategies, physical activity may provide a strategy for the management of BPH-related outcomes, particularly nocturia," Wolin and colleagues wrote.

There are several possible mechanisms by which physical activity can protect against nocturia, including reducing body size, improving sleep, decreasing sympathetic nervous system activity and lowering levels of systemic inflammation.

Future studies should explore physical activity as a potential symptom-management strategy, "with particular attention to the dose of physical activity necessary and the mechanisms that might underlie the association," Wolin and colleagues wrote.

Strength In Knees And Ankles Less With Neuropathy

Today's short post from medicalxpress.com (see link below) may seem a no-brainer to many people living with neuropathy but it's always useful to have a symptom recognised and verified. Many neuropathy patients notice that their ankle and knee strength diminishes the longer they have the disease. Many people also put that down to age, or rheumatism or other causes but the fact is that extensor muscles in those areas are affected by nerve damage and the lack of, or incorrect nerve signals which normally control physical response. The link between nerves, muscles and instability then becomes another symptom of neuropathic problems.

Ankle, knee strength generation slower with diabetic neuropathy 

Oct. 14 in Diabetes Care (HealthDay)—

When walking up and down stairs, patients with diabetic peripheral neuropathy (DPN) are slower at generating strength at the ankle and knee compared to control participants, which may increase the risk of falls, according to a study published online Oct. 14 in Diabetes Care.

Joseph C. Handsaker, from the Manchester Metropolitan University in the United Kingdom, and colleagues examined 63 participants (21 patients with DPN, 21 controls with diabetes, and 21 healthy controls) walking up and down a custom-built staircase. Analysis included assessment of speed of strength generation at the ankle and knee and muscle activation patterns of the ankle and knee extensor muscles.

The researchers found that patients with neuropathy displayed significantly slower ankle and knee strength generation than healthy controls during stair ascent and descent (P; 0.05). Ankle and knee extensor muscles were activated significantly later by patients with neuropathy during ascent and they also took longer to reach peak activation (P; 0.05). Patients with neuropathy activated the ankle extensors significantly earlier during descent, while ankle and knee extensors took significantly longer to reach peak activation (P < 0.05).

"These changes, which are likely caused by altered activations of the extensor muscles, increase the likelihood of instability and may be important contributory factors for the increased risk of falling," the authors write. "Resistance exercise training may be a potential clinical intervention for improving these aspects and thereby potentially reducing fall risk."

http://medicalxpress.com/news/2014-10-ankle-knee-strength-slower-diabetic.html

The Right To Do Less If You Have Chronic Pain

Today's post from health.com (see link below) is a short article intended to make people feel less guilty about being able to do less than others with chronic pain. It quite rightly says that the psychological effects of living with chronic pain can have a severe effect on a person's mental health. They feel constantly guilty that they're not contributing as much as they should and are becoming a burden. The fact is, you can do more than you think you can but you should never do more than your body tells you is healthy. Being at peace with your limitations will help you bear them so much better.

When You're in Pain, You Have a Right to Do Less
Lead writer: Suzanne Levy Last Updated: May 08, 2008

Ironically, letting go can sometimes help you keep control of the pain.
(SUNNY S. UNAL/CORBIS) The American Chronic Pain Association has issued a list of the basic rights of a chronic pain sufferer. Perhaps one of the most important of them is the right to "do less than you are humanly capable of doing."

In a culture that celebrates efficiency, maximum productivity, and pushing limits, doing less is a radical concept. But Penney Cowan, executive director of the association, believes it is crucial.

Real Life Strategies for Coping with Chronic Pain

Patients and experts share surprising ways you can bring the joy back and lessen the pain Read more

More about coping with chronic pain
Keeping Your Marriage Healthy When You're in Pain
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 "People with pain tend to be overachievers who don't listen to what their body is telling them when the pain starts," says Cowan. "They push themselves until the pain is screaming, instead of stopping when the pain is whimpering."

For many, stopping an activity before it's done may result in a complete reappraisal of how they see themselves.

Andrea Kramer, a back-pain and fibromyalgia sufferer from Montgomery Village, Md., describes herself as "a doer, a pusher, a runner." But as the reality of her condition set in, she had to adjust to the fact that she "couldn't do laundry, dishes, lifting, washing a car—it depended upon the level of pain," says Kramer.

The lurking tendency to overdo it
 
One problem is that even if pain temporarily sidelines the superachiever, that person's underlying mindset doesn't disappear. It just lays low until pain takes a brief vacation.

Then on a good day the go-getter wants to do as much as possible. "You push, you don't pace, you overexert," says Cowan.

Dan Clauw, MD, director of the Chronic Pain and Fatigue Research Center at the University of Michigan, sees this ebb-and-flow pattern all the time and says it's not good for pain management.

"I would suggest that people do the same amount of activity every day so they can even out their peaks and valleys," says Dr. Clauw.
Too many bad days in a row can leave a lot undone, making a pain sufferer feel overwhelmed and melancholy. Cowan says chronic pain demands a clear eye for priorities, which is why she suggests that the pain patient make lists. "Set realistic goals for yourself," she says, "and narrow them down to a point where you're not going to set yourself up for failure."

Accepting your limits is critical
 
Judy, 49, who runs a headache support group in Nashua, N.H., has taken the "right to do less" mantra to heart. But it's not easy if the price is a less tidy home.

"I've lessened expectations on myself over the years," she explains. "If things don't get done, they don't get done. I just can't get down on myself about them, because it's a choice between trying to feel well and saying my house has to look absolutely perfect."

Amanda, 39, a migraine sufferer who attends Judy's support group, has also learned to pace herself. For example, she cleans early and often, little bits at a time. "My parents are coming in a few weeks, and I've already started cleaning because I have no idea how I'm going to feel. So I do things slowly or piecemeal here and there. I've learned to work around it."

http://www.health.com/health/condition-article/0,,20189766,00.html