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Trauma Care in the Himalayas

David Lhowe Trauma Surgeon at Mass General Hospital David Lhowe, MD is an Orthopedic Trauma and Hip & Knee Replacement surgeon in the Department of Orthopaedic Surgery, Massachusetts General Hospital, and Assistant Clinical Professor of Orthopedic Surgery at Harvard Medical School.


Sandwiched between its gigantic neighbors, China and India, the tiny nation of Bhutan is making a rapid transition from an isolated kingdom to a modern Asian democracy. Its 600,000 residents are almost exclusively Buddhist, and are dispersed over a landscape that remains largely forested with relatively little arable terrain. The population clusters in valleys, separated by Himalayan mountain barriers which have only recently become connected by two-lane roads. Through most of its history the country has been isolated from even its closest neighbors, and has only opened to Western tourists in the last 20 years. While visiting Bhutan from the United States is now possible it doesn’t come cheaply. The Bhutanese government charges US citizens a substantial daily tax for the duration of their visits. Continue reading

Daniel Lieberman, PhD: What we can Learn about Running from Barefoot Running

Daniel Lieberman at the Mass General Orthopaedic Surgery Grand Rounds Barefoot RunningWhat we can Learn about Running from Barefoot Running
Daniel E Lieberman, PhD
Department of Human Evolutionary Biology
Harvard University, Cambridge, MA
Grand Rounds presented on March 15, 2012 at the O’Keefe Auditorium, Massachusetts General Hospital, Boston, MA
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The Plank: Strengthening the Core

The core is commonly thought of as only your abs, but consists of multiple muscle groups in your abdomen, back and pelvis. Core muscles are engaged during all activities requiring a coordinated movement of the upper and lower body. They generate the force and power required for many activities, while simultaneously playing a foundational role in stabilizing the torso.

Our modern sedentary lifestyle does nothing to working these important core muscles and over time result in their weakening, and the consequent injuries from seemingly simple tasks.

There are various ways to strengthen these core muscles. The PLANK, for instance, is easy to perform, effective and appropriate for any age and fitness level. With no special equipment, the plank can be performed on a carpeted floor or mat in your living room, in the gym between sets of other exercises, or at the end of a workout. Also, the plank literally only takes a minute!

In performing the plank, you hold a steady position by isometrically contracting the deep stabilizing abdominal muscles (transverse abdominus), while keeping the lower back (erector spinae and multifidi) stable, fighting fatigue and simultaneously building endurance. This exercise is not appropriate if you have any shoulder weakness or injury.


Step by Step: How to perform and hold the Plank
Plank Strengthening the Core Aches & Joints

  • Have a wrist watch or clock nearby to track time
  • Place forearms on floor, shoulder distance apart (see above) and elbows directly below the shoulders as demonstrated below
  • Extend legs back, one at a time, straightening the knees and balancing on your toes
  • Keep your body straight as a plank (see below)
  • Relax your neck and look down at the floor
  • As you fatigue, there will be a tendency for your hips to sag. Squeeze your deep abdominal muscles and glutes, and hold your hips in line with the rest of the body
  • For starters, hold the position for 30 seconds and work up to 60 seconds or longer
  • Rest on your knees; when ready, repeat plank for two additional sets

Plank Strengthening the Core Aches & Joints


For a more challenging workout: In the plank position, alternately lift and move each leg outwards (see demonstration below)
Plank Strengthening the Core Aches & Joints


Julie Schlenkerman, Personal Trainer, Clubs at Charles River ParkThe Plank was demonstrated by Julie Schlenkerman, certified personal trainer at the Clubs at Charles River Park, Boston, MA. Julie is an avid runner and ran the 2009 Boston Marathon in 3:16:14!


From our Archives: Simple exercises & Related articles

Yoga for Arthritis

This piece accompanies the article Men are from Mars and Women get Arthritis.


Yoga can provide immense physical benefits for women with arthritis.

For arthritis patients, aerobic exercises, muscle conditioning and increased physical activity can keep you strong and agile, improve heart fitness and reduce your weight. Yoga provides an effective alternative to the traditional strengthening and aerobic exercises, and offers other benefits as well.

While yoga may bring visions of complex body contortions, most yoga classes provide simple, gentle movements that gradually build muscular strength, promote balance and improve flexibility. Its meditative nature soothes and relaxes the mind, and is associated with increased mental alertness and enthusiasm. Scientific studies have shown that practicing yoga is a safe and effective way to increase physical activity, which is strongly recommended for arthritis patients. Yoga does not increase pain or worsen arthritis.

Picture of Padmasana Yoga Pose
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Heel and Achilles Tendon Stretch

A warm-up exercise to perform before running or participating in sports. This stretches the Achilles tendon as well as calf muscles. If you have heel pain (plantar fasciitis), this stretch may help alleviate the pain. You don’t need to go to a health club or gym to do this exercise, it can be performed while sitting in your office or waiting in the coffee line, or even during a walk in the park.

Heel and Achilles Tendon Stretch

heel achilles tendon stretch, Meg Vitter

  • When out for a walk, find a wall to lean against. Even a tree will do.
  • Stand an arms length from the wall.
  • Place the leg to be stretched about 12-18 inches behind you.
  • Keep your toes pointed forward and slightly inward.
  • Bend your arms and gradually lean towards the wall.
  • Make sure your leg is straight and the heel of your back leg is pressed to the floor.
  • Feel the stretch in the calf and heel of the back leg.
  • Hold this position for 30 seconds and return to starting position.
  • Repeat three times for each leg.

Stretches demonstrated by Meg Vitter of Boston, MA.


From our Archives: Try these simple exercises at home