June 2, 2014 at 11:18 am

Despite exercises, 66-year-old woman has trouble getting up

Dear Dr. Roach: I am a 66-year-old white female, 5 feet, 5 inches tall (was 5 feet, 6 inches), weighing 170 pounds. Even though I use gym weight machines for upper and lower body three times a week, walk daily for two miles and spend 15 minutes on a motion trainer at the gym, I cannot stand up easily after gardening on my knees or getting on my knees on the floor. Is there anything I can do to regain the ability to get up off the floor/ground without a struggle?

S.C.

Dear S.C.: It sounds to me that despite your good exercise regimen, you may have weakness specifically in your thighs — what we call “proximal muscle weakness.” There is a very long list of medical illnesses that affect these muscles specifically (my textbook lists 28 different diagnoses), including common conditions such as low thyroid levels and vitamin D deficiency. I would recommend a visit to your doctor for a careful exam of your nerves and muscles to see if my suspicion is correct. Your doctor may suggest a trial of vitamin D.

If no medical cause is found, I would work specifically on strengthening the hip muscles, which extend the thighs. A trainer at the gym can show you those exercises.

Dear Dr. Roach: If I walk briskly for a certain time and distance, is that not just as good for you as jogging, if you are going for the same time?

A.

Dear A.: It depends on what you mean by “good.” If you mean what I think you do, in terms of overall health and maybe living longer and feeling better, then yes, a brisk walk is nearly as good for you as jogging.

Jogging probably is better for preventing osteoporosis, since it gives more impact to the bones, but on the other hand it is harder on the joints. If your goal is to get faster and win races, then you need to practice going faster. But walking is nearly as good for most aspects and is easier on the body than jogging for most people.

Dr. Roach writes: Several people asked about vitamin K for osteoporosis. One person asked if it is safe, since it is used to reverse warfarin (Coumadin). Yes, vitamin K is very safe unless you are taking warfarin, in which case it negates the effect. Another asked about vitamin K-2 supplements. Vitamin K-2 is synthesized by the bacteria normally present in our intestines. As I noted, vitamin K trials in the U.S. and U.K. have shown no benefit in fractures or in bone density. I don’t recommend K-1 or K-2 supplements for bone health, but continue to recommend plenty of leafy green vegetables. People on Coumadin should not take vitamin K or change their dietary intake without discussing it with their doctor.

Email questions to ToYourGoodHealth@med.cornell.edu.