According to my mom, there is a saying in the old country that most women lose one tooth per baby. Babies are nursed in the country side and formula is rarely used.  It is too expensive or there is limited access. Since I gave birth to now, I’ve developed 4 cavities. And yes, I believe breast feeding is the culprit. You lose some of your bone density with each child.

Amazing breast milk and bone density

Breast milk is amazing and indiscriminate of the mother’s health. The breast milk of a malnourished mother will provide just as much minerals and vitamins as a well nourished mother. The only difference may be the fat content might be higher for a well nourished mother.

If breast milk is providing all this good stuff, what happens to the mother if she is malnourished or undernourished? Since a woman’s body is made for reproduction, your treasonous body will compromise the mother’s body to feed the baby. Hence, the cavities for women not getting enough calcium in their diet.

If you are in your 20s, you can still increase your long-term bone density because the rate of bone density loss is slower than the rate you can increase your bone density. However, for someone in their 30s like me, my rate of bone density loss is equal to or greater than the rate I am building up my bone density.

Why women more prone to develop osteoporosis

My bones are much more vulnerable to developing osteoporosis than my husband’s even without the issue of carrying and nourishing our baby. Women stop building bone density between 30-35 years old. I am at a stage where my body is building and losing bone density at the same rate (without the baby factor).

Now add in yo-yo dieting without exercise and you have both fat loss and muscle loss each time you go on a diet. You naturally start to lose about 4% of your muscle mass per decade. Menopause accelerates the muscle mass loss to 10% per decade. Studies have shown that women who participate in a regular strength training exercise routine are less likely to develop osteoporosis. Men are less likely to develop osteoporosis because they do not experience the hormone changes we do over their lifetime and start out with more muscle mass to begin with.

You might think your bones are hard and a fixed lifeless structure. But bone density is constantly changing, growing, diminishing, or re-building, depending on your current circumstances. Taking calcium supplement is not the only preventative measure to curtail bone density loss.

Amazingly, you cannot tell whether someone has great bone density by their appearances. I used to belong to a bowling league where half the members have been collecting social security longer than I’ve been working since graduation. Two women fell while bowling one year. They are both the same age — 82 at the time. One is heavyset and the other is thin. You would think the thin senior would end up with the broken hip, but it is her heavyset friend who ended up sitting out two seasons.  Vi, the thin senior, ended up with a bruise and promptly brought a new pair of bowling shoes to prevent future falls.

Exercises to increase bone density

Regular weight bearing exercises increase your bone density. Swimming and biking has its place in your exercise routine, but not if you want to increase your bone density. These low impact exercises improves your endurance, but its low impact nature would not stress your bones enough to cause your bones to strengthen itself when it repairs or replace the cells damaged from the weight bearing exercise.

The most important factor in finding exercises you can do for the rest of your life is to find weight bearing exercises that is gentle on your joints, provides an aerobic element, and strengthens your bone density. I know this is a tall order.

Do you know what is Vi’s secret for strong bones? Vi never learned to drive. Vi walked everywhere in her youth, catching rides with her husband and friends for errands too far for her to walk. Every day she was adding an extra layer of spackle to her bone density when she walked in her youth. And now you have a sassy LOL (little old lady) that is an active member of our bowling league.

Why do people often ignore walking as an exercise option? Because people exercise for weight loss. However, you can lose weight from walking. Walking is gentle on your joints, provides an aerobic element, strengthens your bone density, and is an exercise you can do for the rest of your life no matter what age you are. Plus, you can walk anywhere, even in your own home with these free walking exercise videos.

Even with all the prenatal vitamins I am taking while nursing, you can clearly see from my cavities that I am not getting enough calcium in my diet. You cannot tell from looking at the exterior that my bone density is probably weaker after giving birth. I wish I’d paid more attention to building up my bone density in my 20s instead of believing that my body will always be strong and youthful. I need to get back into my regular walking routine. 

Until next time and thanks for stopping by Small Steps to Health. If you like what you are reading, please share it with your friends.

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I am starting to experience some back pain from poor posture as a result of nursing a progressively growing baby. I don’t have the round, concave bad posture some of my peers exhibit from decades of working for hours in front of a computer. However, I occasionally catch myself letting my head hang forward and slumping.

With regular posture exercises, I can slowly strengthen my neck and back muscles to correct my poor posture and hopefully prevent further posture problems. This post discusses stretches you can to work home to correct your poor posture.

Why is Good Posture Important?

A forward hanging head is the most common posture problem. A human head weighs about 10 to 14 pounds. When it hangs forward, it is no longer in the center of gravity, therefore the neck and upper back muscles have to work extra hard just to hold your head up.

Every inch that your head hangs forward puts an additional 15 pounds of strain on your neck and upper back muscles. Over time, the trapezius muscle that runs from the base of the skull out to the shoulder and down the mid-back becomes thick and tight from the constant tension of holding your misaligned head. The nerves that run between the neck bones to the arms and upper body also get squeezed.

Good posture is important. A forward hanging head from bad posture can result in neck pain, tension headaches, and numbness or tingling in the arms and hands. In addition, the over-develop trapezius muscle causes pain in the upper and middle back from the muscle imbalance. The next time you have a tension headache, check the alignment of your head. Are you practicing good posture?

Stretches that improve your posture

• Trapezius stretch

The trapezius stretch is a simple posture exercise you can do anywhere. This posture exercise stretches the sides of your neck and upper trapezius muscle. You can do this while standing or sitting on a chair.

To stretch the left side of your neck, drop your right ear towards your right shoulder. Press your left shoulder down by extending your left arm. Hold for 10 seconds and then change side.

• Chin to chest stretch

This posture exercise stretches the back and sides of your neck. You can do this while standing or sitting on a chair.

To stretch the right side, turn your chin towards your left shoulder. Drop your chin to your chest. Place your right hand on top of your head and gently ease your chin towards your chest. Hold for 10 seconds and then change side.

You won’t actually touch your chin to your chest. Don’t force or yank on your head.

• Elbow press

This posture exercise strengthens the muscles of the middle, upper, and lower back and shoulders. You can do this posture exercise standing or sitting on a chair.

Claps your hands behind your head. Relax your shoulders and pressed them down. If you feel the muscles on the back of your neck tightening while doing this posture exercise, you are holding your shoulders to high. If you can’t get your shoulders to relax, then you should skip this posture exercise.

Gently press the back of your head into your hands. You should feel the muscles along your spine tightening. Hold for 5 seconds.

Next, press your elbows back 10 times. You won’t be able to move your elbows very far (maybe half an inch to an inch). You should feel the stretch in the muscles between your shoulder blades.

• Door frame stretch

This posture exercise stretches the front of the shoulders and chest. When I was pregnant, this stretch was a lifesaver for me. You have to do this posture exercise standing in front of a doorway.

Stretch out your arms at shoulder level. Bend your elbows at a 90° angle. Your fingers should point toward the ceiling. Place your palms on the door frame.

Lean your body forward until you feel a stretch in front of your shoulders and chest. Hold for 10 seconds.

Then slide your elbows several inches higher. Lean your body forward until you feel a stretch in front of the shoulders. Hold for 10 seconds.

Final thoughts on stretching posture exercises

These stretching exercises will reduce the muscle tension and discomfort you experience from poor posture. Do these posture exercises gently and adjust it to your level of flexibility. Stretch until you feel mild tension, but never discomfort.

Until next time and thanks for stopping by Small Steps to Health. If you like what you are reading, please share it with your friends.

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The last time I applied for a job, I had to get clearance from my employer’s doctor prior to employment. My employer wanted to make sure that I was healthy enough to work with my chronic health conditions—a torn hip labrum and occasional back pain from my car accident several years ago. I had to get a note from my doctor stating that I am healthy enough to work. It was the first time I was put through the wringer for my health by a future employer.

When you are diagnosed with a long term health problem

If you are diagnosed with a long term health problem such as arthritis or multiple sclerosis, do you feel obligated to tell your employer? Not only does a long term health problem impacts the cost of your health care, it can also impact your earning power.

It is natural to want to put off telling your employer. However, if your long term health problem is preventing you from doing certain parts of your job, putting off the discussion is not an option. Though there are laws protecting workers with long term health problems, you are not protected if you are fired or demoted before you tell your boss.

Preparing to tell your boss about your long term health problem

Before talking to your boss, find out what “reasonable” accommodations you might need from your doctor. For example, if your maintenance medication makes you drowsy in the morning, a “reasonable” accommodation might be starting your workday at 10am instead of 8am. You can find out more about reasonable accommodations from this website.

When you request accommodations, be as specific as possible and offer more than one option. Keep written records of all your discussions and try to keep the focus on coming up with solutions rather than your long term health problem.

What are your rights if you have a long term health condition?

Under federal law, if you work for a company with 15 or more employees, your employer cannot fire you for a long term health condition if you can perform the “essential” functions of your job with accommodations. However, if you need to take a large amount of leave for your long term health problem, you are only protected under FMLA if your company has 50 or more employees.

Your employer has the right to offer to move you to another position with the same pay as long as there is a position open. However, when there is no open position and they cannot accommodate your long term health condition, they can offer you another position with less pay.

If you feel that your employer is hostile about your health condition, you might want to consult with an employment lawyer. An employment lawyer can set you back several hundred dollars, but it would be worth it if an employment lawyer can protect your job. You can find a lawyer here.

However, don’t count on suing an employer for discrimination on your long term health problem. While federal laws might offer some protection, you only have a 25% chance of winning a case against your employer for discrimination.

Am I glad that I disclosed my health problem? Yes, I am. Sure, there was a breathless moment waiting for the employer’s doctor to approve the manager’s decision to hire me, but I do not have to worry about this health problem with this employer again. After all, we are both going into this with our eyes open.

Until next time and thanks for reading Small Steps to Health. If you like what you are reading, please share it with your friends.

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This post is a response to a reader question about my pregnancy and torn hip labrum. But first I want to announce that I created a hip pain resource page listing all my postings regarding this injury in chronological order and grouped around pain management and pregnancy.  You will find it much easier to follow my progress and reader questions than dig through the archives.

Reader Question about torn hip labrum

Hailey asked:

So I guess I have a few questions for you…woman to woman (I realize you’re not a doctor, but you have been through this)

1.  did you do physical therapy during your pregnancy?  any cortizone shots to help with pain?

2.  did you have to go on bed rest at all? i’m concerned/wondering if my chances to be on bedrest will increase b/c my body will be less stable

3.  childbirth – vaginal or c-section?

4.  are you choosing to have surgery now?  I saw your post about things to prepare before having surgery. Its funny, I have read so many different things about the actual recovery/time and the doctor that wanted to do surgery said its an outpatient procedure and crutches for only 2 weeks. which just baffles me!

Physical therapy during pregnancy

I went to physical therapy once during my third trimester… for my back pain. I gained so much weight (42 pounds!) that I started experiencing back pain just from walking (around the 7^th month). The weight gain was my fault.

My friends said they ate the healthiest when they were pregnant, but it was the exact opposite for me. For some crazy reason I just started this “see food” diet. I see the food; I want to put in my mouth. I had more donuts during those 9 months than the last 9 years combined.  But I was able to exercise well into the 7^th month and was able to climb up the side of a sloping levee at 6 months (which made my male co-workers really nervous, but as an engineer I had to do field visits).

Since I was so far along in my pregnancy, the physical therapist said she could not help me and recommended I start using a pregnancy support belt.  Once I started using the pregnancy support belt and support hose, I was still very uncomfortable, but managed to work up until I gave birth.

The last time I had a cortisone shot was in 2009.  I injured my hip in 2006. However, I did take Tylenol a total of 4-5 times during my entire pregnancy.

No bed rest during pregnancy for hip pain

I was concern about bed rest as well prior to getting pregnant.  My energy level declined and my hip pain level went up as my pregnancy progressed. But I kept up with my hip exercises, foam rolling, and icing throughout the pregnancy.  I eventually got to the point where I could only walk half a mile and do stretches (3^rd trimester), but there was no concern about bed rest.

The support belt and hose are little miracle workers! They basically help with the instability created by my weak hip and bulging belly.  The physical therapist noted that my back swayed too much each time I walk.  So I make a conscious effort to take small steps (to minimize the swaying) and tightening my butt muscles (to take the pressure off my back). This makes walking during the last two months a hassle, but at least I was able to get through the most physically uncomfortable part of my pregnancy.

Childbirth and beyond

First off, I want to say that if I did not have a previous injury on my hip and back, I would be one of those women with a prefect pregnancy and birth. Little to no morning sickness and labor and delivery in less than 9 hours (7 hours if you only count the time at the hospital). Vagina birth with minimal tearing. I started exercising again 4 weeks postpartum and was walking 3 miles a day with the stroller by 7 weeks post partum. It could be genetics or that I take care of my body with exercise and healthy eating (personally I think it is mostly from the latter and a handful of supplements I take on a daily basis PRIOR to getting pregnant).

Due to my previous injury, I believe I experienced slightly more hip pain during pregnancy than average. However, most women tend to experience back pain by the 3^rd trimester anyway due to the size of the belly so I don’t think the back pain I experienced was unique.

The hip pain during pregnancy is definitely from my torn hip labrum since I did not experience pain on my “good hip.”  But the hip pain peaked around mid-2^nd trimester (coinciding with the peak of the relaxin hormone and leveled off after the 5^th month).

Hip surgery not in the near future (pain level about the same)

With a 6 month old infant, hip surgery is not in my near future.  It is not even on the radar for the next 5 years since I would like another baby when Hazelnut becomes a pre-schooler (darn this biological clock!). If I started my family in my late 20s, then I would consider hip surgery between the two kids, but I am heading towards my mid-30s really fast.  I want to get through the early years first (you can’t have down time with babies and toddlers). I don’t even have time to get sick with a full time job and a baby.

From everything I read, your recovery time from hip surgery depends on how athletic you are and the surgeon you selected (and it is never as quickly as initially estimated).  My orthopedic surgeon recommends I get pregnant first before considering hip surgery. And I am happy that I did. If I have to make the same choice again, I would still choose to have a baby.

My hip pain level post pregnancy is about the same as before. Sometimes I actually think it might be slighter better since I don’t seem to need to do hip exercises as often as before. However, I cannot say for sure because I do not have a record.

A Chiropractor might help!

Hailey mentioned alignment issues in her email. Though I only mentioned going to a chiropractor on this site once or twice, I am a regular chiropractor patient. I go once per month for an adjustment (more for my back and neck). A torn hip labrum is too deep for a chiropractor to be of much help (though you should let them know you have such an injury).

Would I have to go to a chiropractor if I do not have a torn hip labrum?  I do not know. I got this injury from a car accident several years ago and at the time I also injured my back and neck. I just know that after a session with my chiropractor I feel better and feel like she corrects my alignment issues (albeit temporarily). But I do think my torn hip labrum might contribute slightly to my alignment issues as well.

Please keep me posted on how you are doing Hailey and let me know what decision you make about your hip injury.

Until next time and thanks for stopping by Small Steps to Health.

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• Torn Hip Labrum after Pregnancy
• Can a Torn Hip Labrum Heal Itself?
• My Hip Pain is from a Torn Labrum
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Since I rarely discuss my torn hip labrum with co-workers and friends, it is amazing to find many people with hip and back problems once I open up. Though surgery is the only way to “heal a torn hip labrum,” here is a checklist of several things to do before you schedule hip surgery to rid yourself of hip pain.

Hip surgery might not improve your hip pain

Sadly, some people experience only a small improvement to their hip pain from surgery. Maybe it has to do with not being informed by the orthopedic surgeon on how much improvement they can expect, but some people I talked to are frustrated that they are not noticing an immediate improvement to their pain level. And then there are some people who are just happy to be mobile again even with a smaller amount of residual pain from their hip surgery (but these are generally older people with hip replacement surgeries).

The recovery period from hip surgery varies greatly from person to person, depending on the age and health of the patient prior to getting hip surgery.  However, the more physically active the patient is prior to experiencing hip pain, the faster the recovery period. Yet, most people I talked to believe they are not sufficiently recovered until well after the doctor’s initial estimate of recovery time.

Expertise of orthopedic surgeon is important

According to The Journal of Bone and Joint Surgery 6% of hip replacement surgeries have to be re-done within 5 years. Even within the orthopedic specialty, there are doctors who specialize in specific types of surgeries.  For example, I would look for an orthopedic surgeon who repaired several hundred torn hip labrums rather than a surgeon who replaced several hundred hips. You are better off postponing hip surgery to save up for the difference in co-pay for an out of network doctor specializing in your hip problem than to go with a so-so doctor in network. In the meantime

Not sure about how to find an orthopedic surgeon who specialize in your specific hip problem?  More likely than not, your primary care physician would send you to a round of physical therapy before referring you to a specialist.  Talk to your physical therapist about your hip pain.  Then, ask which orthopedic surgeon sends them patients with similar hip problems who have quick recoveries from their hip surgeries.

There are other costs to consider other than just the hip surgery itself

Even when you go to an in-network HMO orthopedic surgeon, there are other costs to consider in addition to the surgical cost. During your recovery from hip surgery, you would need some medical devices to help make post-surgery life easier.  Here is a short list of some things you might need:

Crutches (usually covered by health insurance)

Walker (usually covered by health insurance)

Bathroom grab bars

Elevated toilet seat

In addition, you might want to hire help (if family or friends are not available) to drive you to follow-up appointments or physical therapy, bathe, and other household chores. When I was recovering from my car accident, I barely have the stamina for 15 minutes of grocery shopping. If not for my husband, I probably would starve or use an online grocery shopping option.

Your hip surgery might impact your paycheck

Even with short term disability, you are only covered up to a certain percentage of your pay check while recovering from hip surgery.  For example, the state’s short term disability insurance for California only covers up to 55% of my pay and only after a 7 day waiting period.  If you have private short term disability, you typically have a 30 day waiting period.  So during that waiting period before short term disability kicks in, you need to have sick days or savings to cover your lost in pay while recovering from hip surgery.

With my job, they make up the difference in my pay with my sick leave.  For example, the state disability insurance covers 55% of my pay.  My sick leave will cover 45% of my pay.  So I would get 100% of my pay for the duration I am out.

According to doctors, you are typically recovered sufficiently enough to work by 12 weeks (maybe on a modified duty or schedule capacity depending on what you do at work).  In most cases, you want to be back at work within 12 weeks since your job protection under the Family Medical Leave Act (FMLA) ends in 12 weeks. However, most people do not feel fully recovered 12 weeks post hip surgery. Even after going back to work, you would still need to take time off for physical therapy. So plan for this accordingly.

What happens if you still want to stay home after 12 weeks post hip surgery? At this point, you are no longer covered by FMLA, so your employer has every right to deny your request for additional time off to recover from your hip surgery. And you might have to dip into savings if your short term disability insurance ran out or stop paying once your doctor deemed you sufficiently recovered to return to work.

Hip surgery final thoughts

Make sure you really need hip surgery for your hip pain. Find the best doctor possible for your specific hip problem.  Line up family and friends to help you out (at least for the first few weeks post hip surgery).  And make sure you have a large leave balance or savings to make up for any lost in pay while you are recovering from your hip surgery.

Until next time and thanks for stopping by Small Steps to Health.

Similar Posts:

• Torn Hip Labrum after Pregnancy
• My Hip Pain is from a Torn Labrum
• Can a Torn Hip Labrum Heal Itself?
• Specific Reader Questions about Torn Hip Labrum and Pregnancy
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• Hip Exercises for a Hip Injury (Torn Labrum)