Grandma's hip osteoarthritis

GRANDMA'S HIP OSTEOARTHRITS

COULD IT HAVE BEEN PREVENTED?

"Acetabular Rim Syndrome in Young Adults: A Major Cause of Osteoarthritis of
the Hip..."
--Warren Hammer, MS, DC, DABCO
http://www.chiroweb.com/columnist/hammer/index.html

OPEN LETTER (archived for global access at http://groups.google.com)

Warren Hammer, MS, DC, DABCO
Norwalk, Connecticut


Warren,

In 1953, Harrison et al. called hip osteoarthritis "the
commonest clinical site of severe osteoarthritis." [Harrison et al. J Bone
Joint Surg 1953;35B(4):598-626]...

You say of hip osteoarthritis that it "may be crucial" to recognize
"acetabular rim syndrome" before development of hip osteoarthritis.

You write:

"Acetabular dysplasia causes secondary osteoarthritis in 25 percent to 50
percent of patients by the age of 50 years...recognizing what is sometimes
called 'acetabular rim syndrome' before the development of this disease may
be crucial..."
http://www.chiroweb.com/columnist/hammer/index.html

You indicate that the hip motions of "flexion, adduction and internal
rotation" will cause early acetabular rim symptoms "due to overload of the
acetabular rim."

Aren't flexion, adduction and internal rotation the hip motions of the
fundamental human rest posture called squatting? See the photos of two
different flat-footed squats in Fahrni WH. Orth Clin N Am 1975;6(1):93-103.
In one photo (p. 94), the feet and knees are adjacent. In another (p. 95),
the feet are shoulder-width apart and the knees are spread wide.

Can it be that people in squatting cultures are somehow paradoxically
AVOIDING "overload of the acetabular rim" by squatting daily - i.e. - by
daily PERFORMING hip "flexion, adduction and internal rotation"?

I ask because in 1974, orthopedic surgeon DR Gunn exclaimed "Don't sit:
Squat!" in an article in which he noted "the virtually complete absence of
primary degenerative arthritis of the hip" in Southeast Asians...
[Gunn DR Don't sit: Squat! Clin Orth Rel Res 1974(103):104-5. Taken
from a larger article by Gunn in the Indian Journal of Orthopaedic Surgery]

In 2002, Nevitt et al. studied Chinese elderly in Beijing, China and wrote:

"[H]ip OA was 80-90% less frequent than in white persons in the US."

See Nevitt MC, Xu L, Zhang Y, Lui LY, Yu W, Lane NE, Qin M, Hochberg MC,
Cummings SR, Felson DT. Very low prevalence of hip osteoarthritis among
Chinese elderly in Beijing, China, compared with whites in the United
States: the Beijing osteoarthritis study. Arthritis Rheum. 2002
Jul;46(7):1773-9. PubMed abstract]

Nevitt et al. concluded:

"Identification of the genetic and environmental factors that underlie these
differences may help elucidate the etiology and prevention of hip OA."

What if (as suggested by Gunn and others) the etiology of much hip
osteoarthritis is the fact that we chair-dwellers - as a consequence of our
chair-dwelling - fail to take our hips through the full range of motion - as
we lose a fundamental human rest posture?

See Biomechanics experts to help babies?
http://health.groups.yahoo.com /group/chiro-list/message/1693

Canadian orthopedic surgeon W. Harry Fahrni (citied above) recommended
allowing and encouraging children to maintain their innate flat-footed
squatting ability into adulthood.

Fahrni's recommendation accords with your "conservative treatment" for
acetabular rim syndrome. ("Conservative treatment, consisting of flexibility
stretching and strengthening of the pelvic and lower extremity muscles,
should be attempted.")

Warren, thank you for your article, "Acetabular Rim Syndrome in Young
Adults: A Major Cause of Osteoarthritis of the Hip..."

Sincerely,

Todd

Dr. Gastaldo
Hillsboro, Oregon


PS As an aside, Grandma's stroke risk is the same as baby granddaughter's
stroke risk...

See Baby stroke risk = elderly stroke risk (Lee et al. UCSF)
http://health.groups.yahoo.com/group...t/message/3728

I believe obstetricians are causing strokes in babies via gruesome spinal
manipulation - closing birth canals up to 30% (semisitting and dorsal
delivery) and KEEPING birth canals closed the "extra" up to 30% (keeping
women semisitting or dorsal) when babies get stuck - as they pull with
hands, forceps and vacuums - sometimes pulling so hard they rip spinal
nerves out of tiny spinal cords.

It's a chiropractic emergency, Warren.

I mention the chiropractic emergency for obvious reasons - but also because
it's relevant to this post: Obstetricians have blamed their bizarre
practice of closing birth canals up to 30% on our culture-wide loss of the
easy squatting ability.

See British obstetrician Jason Gardosi et al.'s 1989 Lancet "randomised
controlled trial of squatting" where nobody squatted because - ostensibly -
sedentary Western women cannot squat well enough to deliver squatting.

NOTE #1: It took some time, but Gardosi now RECOMMENDS squatting at delivery
- this after assuring me in a personal letter in 1990 that two British
trials had demonstrated that squatting delivery is "definitely NOT an
option." (Emphasis Gardosi's - LOL!)

NOTE #2: Women do NOT have to squat to allow their birth canals to open the
"extra" up to 30%.

See ACOG's 2005 edition: How NOT to birth
http://health.groups.yahoo.com/group...t/message/3606

I may as well mention UNNECESSARY C-SECTIONS and UNNECESSARY EPISIOTOMIES...

As noted at the just cited URL, obstetricians are slicing vaginas and
abdomens en masse (episiotomy/c-section) - surgically/fraudulently inferring
they are doing/have done everything to open birth canals - even as they
close birth canals up to 30%.

Of course, compelling obstetricians to allow birth canals to open maximally
will not prevent all c-sections or episiotomies or forceps use - but
obstetricians have no business keeping birth canals closed the "extra" up to
30% when babies get stuck.

Similarly, Western culture has no business robbing children of their innate,
comfortable prolonged flat-footed squatting ability - regardless whether
squatting prevents hip osteoarthritis.

Warren, feel free to reproduce this email, in its entirety, anywhere you
like.

This Open Letter to Warren Hammer, MS, DC, DABCO will be archived for global
access in the Google usenet archive.

Search http://groups.google.com for "Grandma's hip osteoarthritis"