ASK THE GP: Dr Marin Scurr answers your health questions
ASK THE GP: Why doing the splits in old age isn’t bananas! Dr Marin Scurr answers your health questions
Much has been made of former Strictly Come Dancing star Debbie McGee’s ability to do the splits at the age of 59. There’s now a book called Even The Stiffest People Can Do The Splits. But, apart from the satisfaction which might follow this achievement, is it actually a good thing to do? I’m a fit 74-year-old, though, like most men, am pretty stiff in the hip area and want to increase my mobility.
Grayden Purches, Bristol.
There are some people who can do the splits with relative ease. For example, up to 10 per cent of the population have joint hypermobility syndrome (JHS), a condition that means their ligaments are more stretchy than normal.
But otherwise, most people are able to do the manoeuvre with practice, which develops the degree of flexibility in the muscles and ligaments that attach to the bones.
Providing the attempt is made after practice (the book mentions a four-week period), doing the splits will not result in damage to the body.
Yet I question whether it’s true, as its title suggests, that even the stiffest people can do the splits.
There are some — those with arthritis in their hips, for example — for whom no amount of practice or yoga lessons will get them into that position. And, importantly, anyone who’s had a hip replacement should not try the splits, as the risk of dislocating the joint is too great.
But if you are otherwise fit and healthy, learning to do the splits will bring a new challenge into your life, which is always a good thing.
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However, I fear that taking on this challenge with the hope that it will end the stiffness in your hips will result in disappointment. For unless you are a dancer or acrobat, for instance, there’s no real benefit in terms of overall health and fitness to being able to achieve the splits.
As you describe a lack of flexibility in your hips, the question I would ask you is whether you’re able to flex your hips to the extent needed to cut your toenails?
If you can, then the degree of stiffness you mention is probably normal for your age. If you can’t, you may have a degree of osteoarthritis in the hip joint. But, if there are no other symptoms — such as pain — then there’s nothing to be done, except to walk, keep fit and maintain a healthy weight.
That’s strictly impressive! Reality TV star Debbie McGee, 59, is still able to do the splits
In fact, rather than trying to do the splits, a better challenge for anyone from middle age and beyond is to get into the habit of taking exercise on a daily basis, incorporating activities that you enjoy.
There is no perfect activity — it could be table tennis, golf, weightlifting, yoga, swimming or ballroom dancing. But whatever you choose, the evidence from research is clear: exercise benefits your blood pressure, heart, bone strength and even brain function.
The need to engage with determination and enthusiasm cannot be overestimated for anyone who hopes for a long and enjoyable life.
My daughter suffers from very bad attacks where she feels as though she is dying: the right-hand side of her chest goes very tight, she has to breathe deeply and feels very strange. She’s 53, and has very low blood pressure (80/40) and all heart checks and tests have come back clear. She does have high cholesterol, which is being treated by a statin. She is otherwise healthy, 8st, doesn’t drink or smoke and is very active.
R. Taylor, Burton upon Trent, E. Staffs.
Your daughter presents a picture of a healthy person, yet she has been experiencing these alarming episodes.
Rather than pin down what is wrong with her, as is so often the case in medicine, she’s been told what is not wrong with her, in the hope of giving reassurance. But without a convincing explanation of the cause of her symptoms, she — like so many in this position — is left mystified and increasingly anxious.
Based upon your longer letter, I suggest your daughter has panic disorder. Her symptoms are characteristic: the attacks occur abruptly, and feelings of intense anxiety and discomfort quickly build into a peak before dissipating.
With this condition, there are both physical and psychological symptoms, often including chest pain, palpitations, breathlessness or a sense of being unable to breathe, along with light-headedness, tingling and occasionally abdominal symptoms or nausea.
Write to Dr Scurr
To contact Dr Scurr with a health query, write to him at Good Health Daily Mail, 2 Derry Street, London W8 5TT or email [email protected] — including contact details.
Dr Scurr cannot enter into personal correspondence.
His replies cannot apply to individual cases and should be taken in a general context.
Always consult your own GP with any health worries.
Some patients describe feeling a sense of doom during an episode. The episodes can also lead to chronic worry about recurrences. With failure to reach a diagnosis, agoraphobia (a fear of going into open spaces or of not being able to escape from somewhere) and hypochondria may then develop.
In my practice, I see several such cases every year. The cause remains unknown, but in recent years sophisticated imaging has made it possible to see that in people with panic disorder, there is a change in the way fear is processed in the brain.
This underlines the need to understand panic disorder as a problem with physiological roots, not to be dismissed as ‘a psychological problem’ and that the patient should just ‘pull themselves together’.
All psychiatrists and psychologists are familiar with confirming the diagnosis and may well suggest cognitive behavioural therapy and antidepressants. Neither is a quick fix, but should begin to make a difference within six weeks.
Your daughter should discuss the possibility of referral with her GP. This can be resolved.
IN MY VIEW…BRING BACK WHITE COATS
It wasn’t so long ago that hospital doctors (and some GPs) would wear a white coat. Then, in 2008, the Labour government decided to ban it — ostensibly because white coats were a vehicle for the spread of infection.
There is no doubt white coats (and nurses’ uniforms) carry bacteria. But that will be true whatever clothing is worn, and at least a white coat can be changed daily.
Anyway, the presence of bacteria is not the same as actually transferring infection. I can’t find any research confirming that white coats — or ties (now also banned) — transmit infection from one patient to another.
But the ban wasn’t just about bacteria (or emphasising the democratic nature of healthcare teams). It was also a political move orchestrated by management so it could take over the running of healthcare. De-professionalising doctors by banning the ‘uniform’ that set them apart, reducing them to the level of technicians and, in turn, diminishing their authority, sent a signal: management was now in charge.
Several different studies show that what doctors wear is important to patients, with up to 65 per cent in support of white coats. In another study, ‘formal attire under a white coat’ was ranked as patients’ preferred attire.
What doctors wear has an effect on whether their patients see them as trustworthy, caring, knowledgeable, and approachable — all of which play a role in patient satisfaction and, therefore, treatment outcomes. I respectfully suggest that jeans, tattoos, piercings and a casual or ungroomed appearance have the opposite effect.
It’s time to bring back the white coat.
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