Tag Archives: exercise

Active Kids means Stronger Knees (Article)


 Summers spent sedentary can come back to haunt children once they are adults.  For some time now, physical activity has been recommended for children in order to improve joint health and function.  Now doctors are asking a more specific question: does an active childhood build stronger knees?  Are there physical changes, induced by physical activity during the early years of a child’s life, that carry benefit into adult life and even old age? The answer turns out to be a resounding, YES.

Data from a long-term follow-up study of approximately 300 children suggests that, indeed, active children may have stronger knees as adults.  Dr. Graeme Jones, head of the musculoskeletal unit at the Menzies Research Institute, reports that, “The response to physical activity in childhood is to increase the size of the bone to adjust for this and to spread the load out, and the cartilage will then expand to cover the bone area or the area of contact.” (1)  The idea is that if children are able to develop more cartilage, it will last longer in their adult lives, thus preventing or delaying the development of osteoarthritis. Dr. Jones’ research indicate that active running and jumping children grow more articular (cushioning bone on bone) cartilage than their sedentary friends!

Keeping kids active has always been important, and now, it may help them grow up with stronger knees.  “The take home message is we need to make our kids as active as we can,” says Dr. Jones.  “Send them outside.  Don’t leave them inside playing Nintendo, or Wii, or computer games.  Physical activity is good for them in many ways, and we can reassure parents that it is actually good for their joint development also.” “Like money in the bank collecting interest” as Doc Smo always says; physical activity, especially when a child is young, has tremendous benefits.  Don’t let your children miss out on every opportunity to be as physically active.  Add stronger knees to the list of reasons parents need to encourage their children be involved in active play.

Your comments are welcome at www.docsmo.com.  While you are there, take a few moments to check out the literally hundreds of pedcasts and articles on a wide range of pediatric topics. Until next time.

 Written collaboratively by Abbie Doelger and Paul Smolen MD

A doctor’s advice: harsh or life changing? (Pedcast)


-Welcome to another edition of DocSmo.com.  I am your host, Dr. Paul Smolen, the hardest working pediatrician east of the Mississippi, bringing you pedcasts… short, informative, entertaining mp3’s discussing everything kid:  subjects ranging from the crib to the country club , from the play pen to the prom….from diapers to the dorm.   Well, you get the idea. With his permission, I am going to tell you a story about one of my patients who we call Drew that I think you might find interesting.  I did.  So sit back and listen to how a visit to the pediatrician changed Drew’s life for the better.

-Drew’s story starts at a party at the University of North Carolina a few years back…when my daughter was an undergraduate there.  Sarah, my daughter and …the web master of this blog, was introduced to Drew at this party. When introduced, he asked Sarah was she related to a  Dr. Smolen, and of course Sarah answered yes. Smolen is an unusual name and I happened to have been Derek’s doctor growing up in Charlotte.  Derek then spontaneously goes into the story of how I changed his life…  you heard me right…changed his life.  As he tells it, he was in for his routine physical where, of course,  we discuss all the routine subjects… height, weight, BP, BMI, exercise, diet etc.  It turns out that Derek was overweight at the time of this physical and his diet was very poor… lots of sweet drinks and processed food.

–His recollection of our conversation was that I was rather blunt about his weight problem and his poor diet.  I told him he had to change his diet or he might well go into the adult world being overweight and in poor health I told him that men generally reach their peak physical capacity at age 17 years and if he wasn’t healthy then, when would he be?  I strongly encouraged him to stop drinking soda, sports drinks, sweet tea, and processed foods so that his weight would normalize.  He informed me that “he was a football player and that he burned plenty of calories.”  “Everyone drank these drinks”, he explained.   At that point we had a short discussion about calorie balance I explained to him that unless one runs marathons, keeping a normal healthy weight with excess calorie intake is almost impossible. “Our weight is much more about what we eat than how much we burn. “  I explained.

-You need to understand, I have these conversations all the time with teens.  I see about 5-8 teens everyday and diet is a big part of a checkup.  I don’t remember him getting upset or angry during the visit but apparently I struck a cord.  As he tells it, “ he was very angry when I left that day.  He felt that I had been overly critical of him and he resented it.”…buuuut , the message got through.  He said the other doctors just danced around his weight but I was direct and he heard it.  Maybe he was just ready to hear it or maybe he understood that I cared about him and really wanted him to change… but for whatever reason, he decided to take action.

– After that visit, he stopped drinking soda and processed foods and his weight quickly normalized.  Activity was not his problem since he was quite athletic… it was his diet.  The short conversation we had at his checkup had truly changed his life.

-So here is what I learned from Derek’s experience:

People hear messages when they are ready to hear them…Derek was ready the day I saw him

Showing concern for someone’s well being, even if what you tell them is painful, is worth the effort.

Direct communication is the most effective way to connect with young people. My rule is, listen first, then speak.

And finally, people in positions of authority need not be afraid to use their influence in a positive way.  Children respond to honesty and direct communication.  We owe it to our kids to help them with direction and guidance when we can.  Remember, someone did it for us.

-Thanks for joining me today for this edition of DocSmo.com.  If you enjoyed this podcast, fell free to check out the myriad of other topics discussed in this blog.  And if you really get excited, write a comment about this story or any others you find interesting.  Don’t forget to “like” DocSmo on Facebook, or to subscribe on either my website www.docsmo.com, or on iTunes. This is Dr. Paul Smolen, hoping you won’t find it too strange, to adjust to inevitable life change.

Until next time


From the Desk of DocSmo-Exercise and “Your Little People”

I find very little useful, practical knowledge in most of my pediatric journal reading, but an article in the February 2012 journal, Pediatrics, caught my eye as different.  The authors of this article decided to study how much physical activity children are getting in daycare centers.  Seventy five percent of children are in group care settings in the United States; fifty six percent of these are in daycare centers.  The study observed thirty-six daycare centers in Cincinnati, Ohio.  The results of this study shocked me.  In these daycare centers, only two and one half percent of a child’s day is spent being active–by my calculations, this translates to, on average, about 37 minutes in the average ten hour day.

The authors did in-depth interviews with the care givers in these centers and found three main barriers to physical activity for these children:

1. Safety Concerns–Licensing laws limit the types of play equipment permitted; moreover, weather concerns—particularly fear of lightening and severe weather—limit outdoor time.

2. Academic Knowledge–Pressure from parents to prepare their children for kindergarten results in reduced unstructured and play time.

3. Budgetary Constraints–Tight budgets mean that expensive play equipment is just not affordable.


         The authors draw some interesting conclusions from their data.  Children in daycare centers are probably not getting enough exercise on a daily basis, certainly not what experts recommend  (Experts at the National Association for Sport and Physical Education recommend one and one half hours a day for toddlers and two hours for preschoolers).  The study authors suggest that the lack of exercise in daycares is contributing to the obesity epidemic in the United States.  Finally, they think that lawmakers, daycare operators, and parents need to find a new balance between exercise, safety concerns and academics offered to our children in daycare.  My guess is that parents, armed with the knowledge that these researchers uncovered, could solve this problem very quickly.  Parents, let’s get started.

Smo Notes:

1. http://kidshealth.org/parent/nutrition_center/staying_fit/exercise.html#

2. Copeland et. al., Pediatrics Volume 129, Number 2,February 2012

Let’s not forget to care for the Mamas and the Papas! (Pedcast)

As parents, it’s easy to become absorbed in your children’s well-being and forget to take care of yourself.  Don’t forget,  one of your most important assets is YOU. Taking care of yourself now can make a world of difference economically, physically, and mentally down the road.  In this “Pedcast”, Doc Smo reminds parents to be mindful of their well-being and illustrates some simple ways that you can improve your health for the betterment of you and your family.

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