You’ve probably heard that calcium is important for bone health and treating — or preventing — osteoporosis. Happily, calcium seems to be everywhere these days. Not only is it naturally in dairy and other foods, but it now appears in many fortified products — like oatmeal, cereal, protein bars, and orange juice. Calcium is also sold in countless supplements for bone health that line the aisles of your local drugstore.

Most people are not getting enough calcium in their diets.

Why? Part of the problem isn’t just that we’re not eating or taking enough calcium. For calcium to be absorbed and used, we need to have the right levels of other things, such as vitamin D. If we don’t, the calcium we take in just doesn’t do us much good. So some of us could be drinking milk by the bucket and yet still not get the calcium we need.

So here’s what you need to know about calcium supplements for bone health.

Why Is Calcium Important for Bone Health?

Calcium is key in the building of new bone. And bone development occurs every day of your life. Just as you shed skin cells and grow new ones to replace them, your body naturally removes old bone and replaces it with new. 

The pace of losing and growing bone differs depending on your age. When you were young, you made much more bone than you lost, which is why your bones got bigger and stronger. But the problems start when this balance tips too far in the other direction, and you start losing bone much faster than you can grow it.

Gradual bone loss begins in adulthood and becomes more serious after age 50. In women, the hormonal changes of menopause — and the drop in estrogen levels that occur with it — can greatly worsen the imbalance. The bones naturally lose mass, becoming more brittle.

While 1,200 milligrams of calcium per day is sometimes considered the maximum, many osteoporosis experts think that higher levels are preferable.

However, more calcium isn’t always better. Getting too much calcium — 2,500 milligrams or above — can increase your risk of some health problems, like kidney stones.

Do I Need Calcium Supplements for Bone Health?

Osteoporosis is often a silent disease — you don’t know your bones are weak until you break one. So what do you do?

Start by seeing your doctor at Greater Metropolitan Orthopaedics. Together, you can discuss your diet and work out a rough estimate of your calcium intake.

If you’re coming up short, then you either need to improve your diet or take a calcium supplement for bone health to bump you up to the recommended level.

Although some people with osteoporosis get enough calcium from their diets, most will wind up needing a calcium supplement.

Keep in mind that the numbers may not tell the whole story. Even if it looks like you’re getting enough calcium, you might not be absorbing enough of this mineral. That can be due to many factors, like smoking, using certain medications, and many health conditions. So make sure to have a frank discussion with your doctor about any other factors that might increase your risk of osteoporosis.

Vitamin D Supplements for Bone Health

While calcium is crucial, taking it alone might not be enough. To actually get calcium into your bones, the body relies on other vitamins, minerals, and hormones.

The most important may be vitamin D. Vitamin D helps your body absorb calcium from the kidneys and intestines — calcium that would otherwise pass out of the body as waste. And according to osteoporosis experts, vitamin D deficiency is disturbingly common.

Vitamin D is actually formed naturally in your body as a result of sun exposure. Usually just 10 to 15 minutes of sun a day will get you enough vitamin D. But your body becomes less efficient at making it as you age. Many of us should be using vitamin D supplements.

But which kind of supplements? You might see different types of vitamin D on your drugstore shelves, like “vitamin D2″ and “vitamin D3.” What’s the difference?

Vitamin D3 seems to be about three times as potent as vitamin D2.

Vitamin D3 may be preferable but not all pharmacies carry vitamin D3 supplements. If you can’t get it in your area, sticking with vitamin D2 is okay.

How Much Vitamin D Do We Need for Bone Health?

And how much vitamin D is necessary for good calcium absorption? Alas, the answer isn’t simple. The National Institutes of Health still uses the traditional recommendations, which are:

600 IU (international units) for ages 1-70

800 IU for ages 70 or over

But as the widespread deficiencies of vitamin D have become more apparent, some osteoporosis experts think that those levels are not nearly high enough.

As always, check with the doctors at Greater Metropolitan Orthopaedic Institute for all the facts.

Every mile you walk puts 60 tons of stress on each foot. Your feet can handle a heavy load, but too much stress pushes them over their limits. When you pound your feet on hard surfaces playing sports or wear shoes that irritate sensitive tissues, you may develop heel pain, the most common problem affecting the foot and ankle. A sore heel will usually get better on its own without surgery if you give it enough rest. However, many people try to ignore the early signs of heel pain and keep on doing the activities that caused it. When you continue to use a sore heel, it will only get worse and could become a chronic condition leading to more problems. Surgery is rarely necessary. Be sure to speak with a doctor at the Greater Metropolitan Orthopaedic Institute.

Diagnosis

Heel pain can have many causes. If your heel hurts, see your doctor right away to determine why and get treatment. Tell him or her exactly where you have pain and how long you’ve had it. The doctors at Greater Metro Ortho will examine your heel, looking and feeling for signs of tenderness and swelling. You may be asked to walk, stand on one foot or do other physical tests that help your doctor pinpoint the cause of your sore heel.

Treatment

Conditions that cause heel pain generally fall into two main categories: pain beneath the heel and pain behind the heel.

Pain Beneath the Heel

If it hurts under your heel, you may have one or more conditions that inflame the tissues on the bottom of your foot:

•Stone bruise. When you step on a hard object such as a rock or stone, you can bruise the fat pad on the underside of your heel. It may or may not look discolored. The pain goes away gradually with rest.

•Plantar fasciitis (subcalcaneal pain). Doing too much running or jumping can inflame the tissue band (fascia) connecting the heel bone to the base of the toes. The pain is centered under your heel and may be mild at first but flares up when you take your first steps after resting overnight. You may need to do special exercises, take medication to reduce swelling and wear a heel pad in your shoe.

•Heel spur. When plantar fasciitis continues for a long time, a heel spur (calcium deposit) may form where the fascia tissue band connects to your heel bone. Your doctor may take an X-ray to see the bony protrusion, which can vary in size. Treatment is usually the same as for plantar fasciitis: rest until the pain subsides, do special stretching exercises and wear heel pad shoe inserts.

Pain Behind the Heel

If you have pain behind your heel, you may have inflamed the area where the Achilles tendon inserts into the heel bone (retrocalcaneal bursitis). People often get this by running too much or wearing shoes that rub or cut into the back of the heel. Pain behind the heel may build slowly over time, causing the skin to thicken, get red and swell. You might develop a bump on the back of your heel that feels tender and warm to the touch. The pain flares up when you first start an activity after resting. It often hurts too much to wear normal shoes. You may need an X-ray to see if you also have a bone spur.

Treatment includes resting from the activities that caused the problem, doing certain stretching exercises, using pain medication and wearing open back shoes.

•Your doctor may want you to use a 3/8″ or 1/2″ heel insert.

•Stretch your Achilles tendon by leaning forward against a wall with your foot flat on the floor and heel elevated with the insert.

•Use nonsteroidal anti-inflammatory medications for pain and swelling.

•Consider placing ice on the back of the heel to reduce inflammation.

As with all unfamiliar and comfortable pains you may be experiencing, be sure to speak with a physician at Greater Metropolitan Orthopaedic Institute to further assess your symptoms. Don’t wait to get proper treatmen

Tennis elbow is a condition in which tendon fibers that attach on epicondyle on the elbow’s exterior degenerates. The tendons talked about here anchor the muscles that help the wrist and hand to lift. Although tennis elbow occurs mostly in patients of 35 to 50 years of age, it can happen to people of any age. Tennis elbow affects almost 50 percent of teenagers who are involved in racquet sports hence the name “tennis elbow.” Still most of the patients who suffer from tennis elbow are people who don’t play racquet sports. The majority of times there isn’t any specific injury before the symptoms start showing up. Tennis elbow can also happen to people who use their forearm muscles frequently and vigorously for day- to-day work and recreational activities. Ironically some patients develop the condition without any of the activity related reasons that leads to the symptoms. It’s best to check with Greater Metropolitan Orthopaedic Institute to be certain.

The symptoms of tennis elbow include severe burning pain on the elbow’s exterior region. In majority of the cases this starts as a slow and mild pain gradually worsening with the passage of few weeks or sometimes months. The pain worsens when they try to lift objects. In some cases it may hurt even while lifting light objects like a book or full coffee cup. In the severest cases it can hurt even at the movement of the elbow.

The diagnosis of the tennis elbow involves your doctor inquiring about the medical history of the teenager and a physical examination of the elbow by pressing directly on the part where the bone is prominent on the elbow’s exterior to check if that causes any pain. Your physician may also ask the teenager to lift the fingers or wrist and apply pressure to check if it causes any pain again. X-rays are never opted for diagnosis. However a MRI scan may be done to see changes in tendons at the attachment to the bone.

There are many treatment options available and in majority of the cases non-surgical treatment is given a try. The ultimate goal of the 1st phase of the treatment is pain relief. Be ready to hear from the physician to stop any activity leading to the symptoms. The doctor may also tell the teenager to apply ice to elbow’s exterior and he/she may also tell them to take anti-inflammatory medicines for relief from pain.

Symptoms also diminish with the help of orthotics. Your doctor from Greater Metropolitan Orthopaedics may also want to go for counterforce braces and wrist splints which can greatly cut down symptoms by providing rest for tendons and muscles. The symptoms should show signs of recovery within 4 to 6 weeks otherwise your next option would be to go for an injection called corticosteroid in the vicinity of the elbow. This greatly reduces pain and is also very safe to use. There are many side effects involved if it is overused.

Once there is a relief from pain the treatment’s next phase starts which involve modification of activities in order to prevent the symptoms from returning. The doctor may also prescribe the teenager to go for physical therapy which may include stretching exercises to gradually increase the strength of the affected tendons and muscles. Physical therapies have high success rates and return your elbow back to normal working again. Again non-surgical procedures are highly successful in 85 to 90 percent of patients.

Surgical procedures are considered only when patients undergo relentless pain that doesn’t improve even after six months of non-surgical treatment. The procedure involves removal of affected tendon tissue and attaching it back to bone. The surgery is done on outpatient basis. The surgery is done by making a small incision on elbow’s exterior’s bony prominence. In recent years a surgery known as arthroscopic surgery has also been developed but no major benefits have been seen using it over the traditional method of open incision.

As always, should any pains or aches give you reason for concern, please call Greater Metropolitan Orthopaedics Institute for an appointment.

Osteoporosis (or porous bone) is a disease in which bones become weak and are more likely to break. Without prevention or treatment, osteoporosis can progress without pain or symptoms until a bone breaks (fractures). Fractures commonly occur in the hip, spine, and wrist. Osteoporosis is the underlying cause of more than 1.5 million fractures annually (300,000 hip fractures, approximately 700,000 vertebral fractures, 250,000 wrist fractures, and more than 300,000 fractures in other areas). The estimated national cost (hospitals and nursing homes) for osteoporosis and related injuries is $14 billion each year in the United States.

Although women are more likely to get osteoporosis, it is not just a disease of elderly women. Osteoporosis is more common in white or Asian women older than 50 years, but osteoporosis can occur in almost any person at any age. In fact, more than 2 million American men have osteoporosis and 3 million are at risk. Many people who have osteoporosis and risk factors for osteoporosis often do not know they have thin or weak bones. This is because osteoporosis has no symptoms, so many people do not know they have weak bones until they have an unexpected fracture. For example, a simple everyday movement such as picking up a grocery bag causes a broken bone or a slip and fall in a parking lot causes a broken hip, and that is the first “symptom.”

Osteoporosis is often not recognized in men. There are many reasons for under-diagnosis in men. Identifying risk factors is important because osteoporosis is more or less preventable for most people. Identifying men with osteoporosis is also important because, while there is no cure for osteoporosis, there are treatments.

Why Osteoporosis is Under-diagnosed in Men

Greater bone mass

Osteoporosis is more commonly diagnosed in women, and women are at greater risk than men. However, men really have only temporary protection against osteoporosis. The temporary protection is related to the size of men’s skeletons, which are generally larger than women’s bones. This means that men have larger reserves of bone mass to draw from as they age, so their bone loss progresses more slowly. Also, men do not experience the same rapid bone loss that occurs in women during and after menopause.

Because bone loss is delayed and osteoporosis does not have any symptoms, men do not usually know they have osteoporosis until a fracture occurs. Increasing awareness about the true frequency of osteoporosis in men is essential for prevention and long-term health.

Screening standards for osteoporosis

Osteoporosis is diagnosed using bone mineral density (BMD) tests to measure the solidness and mass (bone density) usually in the spine, hip, and/or wrist (the most common sites of fractures due to osteoporosis). These tests are performed like x-rays, and they are the only reliable way to determine loss of bone mass. They are painless, noninvasive, and safe.

The results of a bone mineral density test are compared to standards, or norms, determined from a large average population. One of the problems with measuring the bone mineral density of men is that many of the standards used for comparison are from young women rather than men. The average bone mass in healthy young women is always lower than that observed in healthy young men. This means that a man may have low bone mass (osteopenia) compared to healthy men, but the comparison with the norm (from young women) will not show that they are at risk for osteoporosis. Consequently, few men are classified as osteoporotic based on the normal data from young women.

Everyone should have their bone density tested. Make an appointment today with the Greater Metropolitan Orthopaedic Institute to determine your bone density level. Don’t get caught by surprise!

Are you one of the thousands of Americans suffering everyday because of hip or knee pain? If so, we have some great news for you. You are invited to join Edward Rabbitt, MD, board certified orthopedic surgeon at Southern Maryland Hospital’s Center for Joint Replacement and of Greater Metropolitan Orthopaedic Institute, for a lively and informative discussion about the causes and treatment options for hip and knee pain on February 26 beginning at 10 a.m.

Free seminar by Dr. Rabbitt on knee and hip pain.

The surgeons at the Center for Joint Replacement have helped thousands of people who struggle with hi, shoulder or knee pain. They offer innovative surgical and rehabilitative programs known for their excellent clinical outcomes.

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To reserve your seat for this highly informative program, please call 866-724-2099.

Snow is pretty but ice is just plain scary, especially if you slip and twist your ankle.

Home Care for an injured ankle

RICE treatment is the hallmark of home care for an injured ankle. RICE stands for rest, ice, compression and elevation. Anti-inflammatories are also an important part of the healing process.

Rest, in terms of ankle rehabilitation and management, means avoiding activities that cause pain or discomfort. With a severe sprain, ankle immobilization may even be necessary. This is done either with a cast or a brace.

Ice helps reduce pain and swelling and promotes healing. Ice should be used in place of heat as long as swelling persists. Ice should be applied for 20 minutes on then 40 minutes off either every hour or several times a day, depending on the extent of the swelling. Ice should not be applied directly to the skin.

A pillowcase or a T-shirt or over two wraps of the ACE bandage are a good thickness between the ice and the skin. Compression is used to support and immobilize the ankle. An ACE bandage or an ankle brace works well. When using either, make sure that at least two fingers can easily be slipped between the compression device and the ankle.

Elevation: the ankle should be elevated at or above the level of the heart whenever possible as long as swelling persists to minimize swelling and encourage circulation return to the heart.

Anti-inflammatory and/or analgesic medication can assist in decreasing swelling and pain. Ibuprofen is good for both pain and swelling, but is hard on the stomach and can cause kidney damage if used in large doses or for long periods. Make sure you don’t exceed 2400 mg/day unless advised to do so by a medical professional, and it should not be used regularly or for longer than 4-6 weeks. Aspirin, acetaminophen (Tylenol) and naproxen sodium (Aleve) can also be used for short periods for pain and/or swelling.

The amount of time it takes for an ankle injury to heal depends on the severity of the sprain.

When to Seek Professional Care

Although few ankle injuries will require surgical repair, many may need stabilization. Severe sprains require professional medical advice and intervention, as home care may result in improper healing and a resulting weak or stiff ankle.

You should seek immediate medical care if:

·         Severe swelling occurs immediately, especially if accompanied by a loud pop.  

·         The ankle appears pale, blue, cold and numb.

·         The ankle is obviously deformed or bent the wrong way.

Medical care should be sought within 24 hours if:

·         You cannot tolerate even the slightest weight on the ankle immediately and several hours after the injury.

·         The skin over the injury is hot, red and swollen and/or you have a fever.

Consult with a provider within 3-5 days if:

·         The sprain is not improving after 3 days of home care.  

·         Pain or swelling increases after 3 days of home care.  

·         You have questions or concerns about how to care for your injured ankle.

When snow, ice and frigid weather blast into town, watch out, says the doctors at Greater Metropolitan Orthopaedic Institute.  Winter recreational activities and chores can pose problems for the outdoor enthusiast whose body is not in condition. Winter sports like skating, skiing and sledding can cause painful muscle spasms, strains or tears if you’re not in shape. Even shoveling snow the wrong way, clambering awkwardly over snow banks, slipping on sidewalks and wearing the wrong kinds of clothing can all pose the potential for spasms, strains and sprains.

Walking outside in the freezing weather without layers of warm clothing can intensify older joint problems and cause a great deal of pain. As muscles and blood vessels contract to conserve the body’s heat, the blood supply to extremities is reduced. This lowers the functional capacity of many muscles, particularly among the physically unfit. Preparation for an outdoor winter activity, including conditioning the areas of the body that are most vulnerable, can help avoid injury and costly health care bills.

Warming up, like you do prior to any exercise program, is essential and the key to a safer experience outdoors.

Start with some light aerobic activity (jogging, biking, fast walking) for about 7-10 minutes. Then follow these tips to help you fight back the winter weather:

* Skiing – do 10 to 15 squats. Stand with your legs shoulder width apart, knees aligned over your feet. Slowly lower your buttocks as you bend your knees over your feet. Stand up straight again.

* Skating – do several lunges. Take a moderately advanced step with one foot. Let your back knee come down to the floor while keeping your shoulders in position over your hips. Repeat the process with your other foot.

* Sledding/tobogganing – do knee-to-chest stretches to fight compression injuries caused by repetitive bouncing over the snow. Either sitting or lying on your back, pull your knees to your chest and hold for up to 30 seconds.

* Don’t forget cool-down stretching for all of these sports – At the bottom of the sledding hill, for instance, before trudging back up, do some more knees-to-chest stretches, or repetitive squatting movements to restore flexibility.

Be wary when shoveling snow!

Shoveling snow can also wreak havoc on the musculoskeletal system. Greater Metro Ortho suggests the following tips for exercise of the snow shoveling variety:

* If you must shovel snow, be careful. Listen to weather forecasts so you can rise early and have time to shovel before work.

* Layer clothing to keep your muscles warm and flexible.

* Shoveling can strain de-conditioned muscles between your shoulders, in your upper back, lower back, buttocks and legs.

* When you do shovel, push the snow straight ahead. Don’t try to throw it. Walk it to the snow bank. Avoid sudden twisting and turning motions.

* Bend your knees to lift when shoveling. Let the muscles of your legs and arms do the work, not your back.

* Take frequent rest breaks to take the strain off your muscles. A fatigued body asks for injury.

* Stop if you feel chest pain, or get really tired or have shortness of breath. You may need immediate professional help.

After any of these activities, if you are sore, apply an ice bag to the affected area for 20 minutes, then take it off for a couple of hours. Repeat a couple of times each day over the next day or two.

If you continue to feel soreness, pain or strain after following these tips, it may be time to visit the great doctors at Greater Metropolitan Orthopaedic Institute. They are truly there to help get you back to your favorite, and not so favorite, activities this winter.

For some people, the weekend is the only time they have to (or want to) exercise and, once warm weather hits, spending all day at an amusement park, hiking up mountains or going on long bike rides can cause unexpected overload injuries. Sprained ankles, shin splints, tennis elbow and foot pain are just a few injuries that can happen when you go from the couch to the golf course or mountain without any preparation.

Even in colder weather, some of us just can’t find the time to devote to weekday workouts, so we save up and hit the gym or the pavement on the weekends and this can lead to muscle strain and stress.

It’s best, although this takes a little more planning and discipline, to keep your physical activities consistent throughout the week. But if you just can’t, here are a couple tips to keep in mind.

To avoid weekend warrior injuries:

•Start Slowly: Instead of going straight for that 14,000 foot mountain or 18-hole golf course, start with short, easy hikes or a few days at the driving range to get a sense of where you are and what your body can handle.

•Prepare Ahead of Time: A little light training and preparation can give your body a strong foundation and help you avoid hurting yourself:

•Add Intensity Gradually: If you’re not much of an exerciser but want to work towards a coming event, say hiking up a mountain or a 5K race, start with what you can handle and only increase the intensity (whether it’s mileage or time) by about 10 percent each week to avoid injury.

•Take Lots of Breaks: If you do decide to head out for that 3-hour tennis match, take plenty of breaks to recover and stay hydrated. Fatigue and dehydration can sneak up on you, putting you at risk for hurting yourself.

Attend a FREE seminar January 15, 2011 at 10 a.m. at the Sleep Inn & Suites in La Plata when

Dr. Sabloff's seminar focuses on hip and knee pain.

Dr. Jeffrey Sabloff, a board certified orthopedic surgeon and medical director of the Center for Joint Replacement at Southern Maryland Hospital, answer all your concerns about hip and knee pain.

This lively and informative discussion will cover the causes of these pains and treatment options. Dr. Sabloff will talk about some of the latest medical and surgical techniques for managing hip and knee pain; minimally invasive surgery, hip resurfacing, technological advances in the design of the artificial joints and what you should look for in a joint replacement program.

The surgeons at the Center for Joint Replacement have helped thousands of people who struggle with hip, shoulder or knee pain. They offer innovative surgical and rehabilitative programs known for their excellent clinical outcomes.

If you or someone you know is suffering with joint pain, please attend this free seminar.

The Sleep Inn & Suites is located at 6860 Crain Highway/US 301 in La Plata, Maryland. Please call to reserve your seat today at 1-866-724-2099.

Start your workout program with a visit to your doctor’s office for a medical check-up. Why go to the doctor now, when you haven’t gotten in shape yet? The doctor will be much more impressed with your physique after you have been working out for about six months.

The point of the physical is not to impress your doctor. You need to find out if there are any fitness activities you should avoid NOW because of your current physical condition. Just consider this check-up the first of many snapshots of your physical fitness. In fact, it will give you a great basis for measuring your progress later on.

Get Instruction on the Proper Technique

OK, so your doctor gave you a clean bill of health. Now, you can start working out, right? Wrong! First, be sure to get instruction on the proper technique. If you joined a gym, you should be entitled to at least one introductory session with a licensed personal trainer. Your personal trainer will show you how to use the exercise equipment properly.

Warm Up and Cool Down

Professional athletes don’t take the field for a big game without warming up first. Neither should you start a workout without including a warm-up period. Also, remember to cool down by slowing down and stretching again at the end of your routine.

Use Proper Breathing

While you are exercising, be sure to incorporate proper breathing techniques. This is especially important for weight training. People have a tendency to hold their breath when they are lifting weights. This actually weakens the body and can lead to more serious problems, including dizziness and blackouts.

Concerning the proper breathing techniques for weight training while you are exerting positive movement, you should exhale. For instance, if you are performing a bench press - you would inhale when you bring the barbell down to your chest and exhale when you lift it back up.

Don’t Overdo It!

Remember to begin your workout program with low to moderate activity. You can gradually increase the duration and intensity of your exercise sessions as you become more physically fit.

Apply the concept of natural progression to your exercise program. In other words, if you complete a mile run this week, don’t start running five miles next week. Increase your exercise goals in smaller increments.

As for weight training, you should work out to the point of momentary muscle failure. Let’s say it takes you 12 repetitions to get to this point.  When you are strong enough to complete 13 repetitions, it is time to increase the weight by 5 percent. You may be able to increase the weight slightly more, but no more than 5 percent as a general safety precaution.

Get a Heart Rate Monitor

Another way to ensure you are exercising safely is to invest in a heart rate monitor. Using a monitor will help you stay within your target heart range and keep you in a safe zone for exercising and fat burning.

The formula for determining your target heart rate is to subtract your age from the number 220. In other words: 220 – age = maximum heart range (you should stay within a 60-80 percent range of this number). For instance, if you are 30 years of age, your maximum heart range would be 220 – 30 = 190.

Add Variety to Your Routine

Include a variety of sports and exercises in your fitness routine. The human body is designed to adapt to any routine in four to six weeks. If you add the right balance of exercise to your workout routine, you can reduce the potential for overtraining.

Stop Exercising If You Experience Severe Pain or Discomfort!

If you experience severe pain, discomfort or swelling during your exercise session, you should immediately stop working out. If any of these conditions persist, you should see a doctor.

Drink Plenty of Water

When you engage in regular exercise, it is important to increase your intake of water. Drink water before, during and after your exercise sessions in order to keep yourself hydrated.

For normal activity, drink .55 x your body weight in ounces of water every day. For instance, if you weigh 175 pounds, you should drink 96 ounces of water every day.

Increase your intake of water on an as needed basis. If you are very active, drink a minimum of a half gallon of water a day.

Give Yourself Recovery Days

Schedule recovery days in order to make sure your body has ample time to rest. Most people need at least two full days of rest every week. Your muscles, your cardiovascular system, your nervous system and even your bones and joints all need the rest.