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Why are my muscles sore after exercise? Hint: it’s nothing to do with lactic acid

<p><em><a href="https://theconversation.com/profiles/robert-andrew-robergs-435390">Robert Andrew Robergs</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a> and <a href="https://theconversation.com/profiles/samuel-l-torrens-1476404">Samuel L. Torrens</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a></em></p> <p>As many of us hit the gym or go for a run to recover from the silly season, you might notice a bit of extra muscle soreness.</p> <p>This is especially true if it has been a while between workouts.</p> <p>A common misunderstanding is that such soreness is due to lactic acid build-up in the muscles.</p> <p>Research, however, shows lactic acid has <a href="https://journals.physiology.org/doi/full/10.1152/physiol.00033.2017">nothing to do with it</a>. The truth is far more interesting, but also a bit more complex.</p> <h2>It’s not lactic acid</h2> <p>We’ve known for decades that lactic acid has <a href="https://pubmed.ncbi.nlm.nih.gov/27409551/">nothing to do with</a> muscle soreness after exercise.</p> <p>In fact, as one of us (Robert Andrew Robergs) has long <a href="https://journals.physiology.org/doi/full/10.1152/ajpregu.00114.2004">argued</a>, cells produce lactate, not lactic acid. This process actually <a href="https://journals.physiology.org/doi/full/10.1152/physiol.00033.2017">opposes</a> not causes the build-up of acid in the muscles and bloodstream.</p> <p>Unfortunately, historical inertia means people still use the term “lactic acid” in relation to exercise.</p> <p>Lactate <a href="https://www.science.org/doi/10.1126/science.1101141">doesn’t cause major problems</a> for the muscles you use when you exercise. You’d probably be <a href="https://journals.physiology.org/doi/full/10.1152/ajpregu.00114.2004?url_ver=Z39.88-2003&amp;rfr_id=ori%3Arid%3Acrossref.org&amp;rfr_dat=cr_pub++0pubmed&amp;">worse off</a> without it due to other benefits to your working muscles.</p> <p>Lactate isn’t the reason you’re sore a few days after upping your weights or exercising after a long break.</p> <p>So, if it’s not lactic acid and it’s not lactate, what is causing all that muscle soreness?</p> <h2>Muscle pain during and after exercise</h2> <p>When you exercise, a lot of chemical reactions occur in your muscle cells. All these chemical reactions accumulate products and by-products which cause water to enter into the cells.</p> <p>That causes the pressure inside and between muscle cells to increase.</p> <p>This pressure, combined with the movement of molecules from the muscle cells can stimulate nerve endings and cause <a href="https://www.sportsmed.theclinics.com/article/S0278-5919(11)00099-8/fulltext">discomfort</a> during exercise.</p> <p>The pain and discomfort you sometimes feel hours to days after an unfamiliar type or amount of exercise has a different list of causes.</p> <p>If you exercise beyond your usual level or routine, you can cause microscopic damage to your muscles and their connections to tendons.</p> <p>Such damage causes the release of ions and other molecules from the muscles, causing localised swelling and stimulation of nerve endings.</p> <p>This is sometimes known as “<a href="https://www.sportsmed.theclinics.com/article/S0278-5919(11)00099-8/fulltext">delayed onset muscle soreness</a>” or DOMS.</p> <p>While the damage occurs during the exercise, the resulting response to the injury builds over the next one to two days (longer if the damage is severe). This can sometimes cause pain and difficulty with normal movement.</p> <h2>The upshot</h2> <p>Research is clear; the discomfort from delayed onset muscle soreness has nothing to do with <a href="https://scholar.google.com/citations?user=UVjRNSUAAAAJ&amp;view_op=view_citation&amp;citation_for_view=UVjRNSUAAAAJ:J_g5lzvAfSwC">lactate</a> or <a href="https://journals.physiology.org/doi/full/10.1152/physiol.00033.2017">lactic acid</a>.</p> <p>The good news, though, is that your muscles adapt rapidly to the activity that would initially cause delayed onset muscle soreness.</p> <p>So, assuming you don’t wait too long (more than roughly two weeks) before being active again, the next time you do the same activity there will be much less damage and discomfort.</p> <p>If you have an exercise goal (such as doing a particular hike or completing a half-marathon), ensure it is realistic and that you can work up to it by training over several months.</p> <p>Such training will gradually build the muscle adaptations necessary to prevent delayed onset muscle soreness. And being less wrecked by exercise makes it more enjoyable and more easy to stick to a routine or habit.</p> <p>Finally, remove “lactic acid” from your exercise vocabulary. Its supposed role in muscle soreness is a myth that’s hung around far too long already.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/214638/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/robert-andrew-robergs-435390"><em>Robert Andrew Robergs</em></a><em>, Associate Professor - Exercise Physiology, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a> and <a href="https://theconversation.com/profiles/samuel-l-torrens-1476404">Samuel L. Torrens</a>, PhD Candidate, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-are-my-muscles-sore-after-exercise-hint-its-nothing-to-do-with-lactic-acid-214638">original article</a>.</em></p>

Body

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Ballet flats are back. Here’s what the research says about how they affect your feet

<p><a href="https://theconversation.com/profiles/kristin-graham-1427672">Kristin Graham</a>, <em><a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em>; <a href="https://theconversation.com/profiles/helen-banwell-305575">Helen Banwell</a>, <em><a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em>, and <a href="https://theconversation.com/profiles/saravana-kumar-181105">Saravana Kumar</a>, <em><a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p>Ballet flat shoes – those thin-heeled lightweight slip-on shoes – are making a fashion <a href="https://www.vogue.com/slideshow/ballet-flats">comeback</a>. And it’s not hard to see why: they’re versatile, easy to wear, soft, flexible and often worn by celebrities.</p> <p>We have often been warned of the dangers of high-heeled shoes, so you might think ballet flats are problem-free.</p> <p>When you look at the research, however, a complicated picture emerges. There’s no definitive evidence to show ballet flats are generally harmful to foot health in the long-term. But ill-fitting ballet flats can be a problem.</p> <h2>Make sure it fits, especially in the toe box</h2> <p>An estimated <a href="https://pubmed.ncbi.nlm.nih.gov/30065787/">70%</a> of the population are wearing ill-fitting shoes. This mismatch between foot and shoe shape can increase foot pain, <a href="https://pubmed.ncbi.nlm.nih.gov/17507530/">reduce stability</a>, and can mean more blisters, corns and calluses. And habitual wearing of tight shoes has been <a href="https://www.sciencedirect.com/science/article/pii/S0958259207000533">associated</a> with bone changes in the toes and feet over time.</p> <p>Many flats feature a shallow and narrow toe box (the part of the shoe where the toes go). A too-small toe box often doesn’t align with the shape of a foot and ends up squishing the toes. It can also <a href="https://www.sciencedirect.com/science/article/pii/S0958259206000770">increase</a> pressure on top of and under the foot, and <a href="https://jfootankleres.biomedcentral.com/articles/10.1186/1757-1146-6-28">restrict</a> the movement of the forefoot during walking.</p> <p>But a too-big toe box is also a problem. Too much foot movement within the shoe can cause pressure and friction on the skin, which can also lead to calluses, corns, blisters, and wounds.</p> <p>A poorly fitting toe box can also cause micro trauma to toenails which, ultimately, can change <a href="https://www.researchgate.net/profile/Anuva-Bansal/publication/347522694_Traumatic_Nail_Disorders/links/60d6135592851ca94487df7e/Traumatic-Nail-Disorders.pdf">their look and thickness</a>.</p> <p>So if you’re wearing flats, make sure you choose a shoe with the right sized toe box.</p> <h2>What about the heel?</h2> <p>Health professionals often recommend a small heel over a completely flat shoe. Very flat shoes can <a href="https://pubmed.ncbi.nlm.nih.gov/27498844/">place</a> <a href="https://www.sciencedirect.com/science/article/pii/S0268003307002082">more</a> strain on the soft tissues that support the foot arch – specifically, the plantar fascia.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/27498844/">Research</a> has shown moving from a completely flat shoe to a small, raised heel reduces the tension force on the plantar fascia during standing activities.</p> <p>On the other hand, other <a href="https://journals.lww.com/jpojournal/Fulltext/2009/01000/Effects_of_Shoe_Heel_Height_on_the_Roll_Over.7.aspx#:%7E:text=The%20roll%2Dover%20shapes%20seem,without%20a%20change%20in%20alignment.&amp;text=Photographs%20of%20the%20prosthetic%20feet,shapes%20of%20these%20feet%20superimposed">research</a> has shown most people will adapt their ankle and knee motion to accommodate shoes of different heel heights.</p> <h2>What about support?</h2> <p>Ballet flats tend to have very flexible, thin soles and heel counters (the part, coloured red in this picture, that hugs the heel and the back part of the foot).</p> <p>These thin and flexible structures mean flats are often accused of lacking support. But debate rages among foot and shoe experts about how important support is in the first place.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/27729290/">Research</a> on barefoot-style shoes has shown walking in these types of shoes significantly reduces some loads on the knee compared to more stable supportive shoes.</p> <p>Minimalist shoes have also been found to <a href="https://pubmed.ncbi.nlm.nih.gov/30102872/">increase strength</a> in certain foot muscles used when we push off during walking, running or jumping.</p> <p>However, other research found stable supportive shoes can <a href="https://pubmed.ncbi.nlm.nih.gov/33428439/">improve knee pain</a> when walking more than flat flexible shoes.</p> <p>The thin soles in flats mean there is little cushioning under the foot. While more cushioning can improve comfort, and reduce stress and strain on your foot sole <a href="https://www.sciencedirect.com/science/article/abs/pii/S0021929011001758?casa_token=gecXFCMi0LcAAAAA:TazyTd8TRaAl_bG0jprifYIUIlWRDwEH6bVeymBYTWups2iDGMuUjLs2gaNqsiNGHVJhHC3J9AdB">skin</a>, there is no evidence it reduces loads across the lower leg.</p> <p>In fact, walking in cushioned shoes has been shown to <a href="https://pubmed.ncbi.nlm.nih.gov/20191571/">increase</a> the load on the knee compared to flat, flexible shoes.</p> <h2>So, what’s the verdict?</h2> <p>The verdict is mixed. Yes, there’s evidence poorly fitting shoes and a flat heel can be detrimental, with consequences seen in the <a href="https://www.sciencedirect.com/science/article/pii/S0966636221000199">rearfoot</a> (around the ankle) and <a href="https://www.sciencedirect.com/science/article/pii/S0966636218300687">knee</a>.</p> <p>But there’s also no hard evidence ballet flats cause long-term foot health problems.</p> <p>What matters is choosing a well-fitted shoe to suit your foot shape and needs.</p> <p>If you’re shopping for ballet flats, try to:</p> <ul> <li> <p>choose a pair with a toe box that does not cramp your toes and has a sole at least as wide as your foot</p> </li> <li> <p>choose flats that offer at least some structure and support</p> </li> <li> <p>choose a pair with a small heel rather being than completely flat.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/207806/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> </li> </ul> <p><em><a href="https://theconversation.com/profiles/kristin-graham-1427672">Kristin Graham</a>, Lecturer in Podiatry, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a>; <a href="https://theconversation.com/profiles/helen-banwell-305575">Helen Banwell</a>, Lecturer in Podiatry, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a>, and <a href="https://theconversation.com/profiles/saravana-kumar-181105">Saravana Kumar</a>, Professor in Allied Health and Health Services Research, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/ballet-flats-are-back-heres-what-the-research-says-about-how-they-affect-your-feet-207806">original article</a>.</em></p>

Beauty & Style

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10 things your feet can reveal about your health

<p><strong>You notice: Dry, flaky feet</strong></p> <p><span style="text-decoration: underline;"><em>It could be:</em></span> Thyroid problems, especially if moisturiser doesn’t help. When the thyroid gland (the butterfly-shaped gland at the base of your neck) isn’t working properly, it doesn’t produce thyroid hormones, which control metabolic rate, blood pressure, tissue growth and skeletal and nervous system development.</p> <p>“Thyroid problems cause severe dryness of the skin,” says foot specialist Marlene Reid. “When we see cracking on the feet, or if moisturiser doesn’t improve dryness over a few days, we usually refer patients to their primary doctor to make sure their thyroids are okay.” Brittle toenails can also signal thyroid complications.</p> <p><strong>You notice: Bald toes</strong></p> <p><span style="text-decoration: underline;"><em>It could be:</em></span> Arterial disease. If the fuzz on your toes suddenly disappears, it could signal poor blood circulation caused by peripheral arterial disease (PAD) which builds up plaque in the leg arteries. “Signs of PAD can include decreased hair growth on the feet and ankles, purplish toes and thin or shiny skin,” says podiatric surgeon Suzanne Fuchs.</p> <p>Symptoms are subtle, but doctors can check for a healthy pulse in the foot. In severe cases, they may spot PAD on an X-ray. “If I take an X-ray of a broken foot, and I see a hardening of the arteries, 99 per cent of the time the same thing is happening in the heart blood vessels,” says podiatric surgeon Gary A. Pichney.</p> <p><strong>You notice: Ulcers that don't heal </strong></p> <p><span style="text-decoration: underline;"><em>It could be:</em></span> Diabetes. Uncontrolled glucose levels can damage nerves and cause poor circulation, so blood doesn’t reach all areas of the body, including the feet. When blood doesn’t get to a wound caused by, say, irritating shoes, the skin doesn’t heal properly, and that’s how diabetic blisters and ulcers can develop.</p> <p>“Many, many people with diabetes are diagnosed first because of foot problems,” says Reid. Other signs of diabetes may include persistent tingling or numbness of the feet. If you suffer from these foot problems, ask your doctor about getting your blood sugar levels tested.</p> <p><strong>You notice: An enlarged, painful big toe</strong></p> <p><span style="text-decoration: underline;"><em>It could be:</em></span> Gout. Gorged on wine and steak? The painful aftermath could be gout, a type of arthritis that often affects the joint of the big toe. Foods high in purine, a chemical compound found in red meats, fish and certain alcohol, can trigger an attack by raising levels of uric acid in the body. Uric acid is normally excreted through urine, but is overproduced or under-excreted in some people.</p> <p>“You’ll see the deposition of the uric acid in the joint, most commonly the big toe or the ankle,” says podiatric foot and ankle specialist Bob Baravarian. “The patient will wake up with a hard, red, swollen joint. It’s extremely painful.” A doctor may prescribe anti-inflammatory drugs for short-term relief and medicines to reduce uric acid production. You may also need to follow a low-purine diet for long-term prevention.</p> <p><strong>You notice: Small, red lines under the toenail </strong></p> <p><span style="text-decoration: underline;"><em>It could be:</em></span> A heart infection. Red streaks underneath the toenails or fingernails could be broken blood vessels known as splinter haemorrhages. While problems like psoriasis, fungal infection, or even just experiencing trauma to the nail can cause splinter haemorrhages, it can also be a sign of endocarditis, or an infection of the heart’s inner lining, according to the American Academy of Family Physicians. (Keep in mind this is a rare condition.)</p> <p>People who have an existing heart condition are at higher risk of developing endocarditis. The infection can result in heart failure if left untreated. If you notice splinter haemorrhages on your toenails or fingernails, and haven’t experienced any recent trauma to the nail, see your doctor to check your heart and blood circulation.</p> <p><strong>You notice: Clubbing</strong></p> <p><span style="text-decoration: underline;"><em>It could be:</em></span> Lung cancer or heart disease. Another symptom that appears in both toes and fingers, clubbing is often associated with lung cancer, chronic lung infection, or heart conditions caused by birth defects or infection of the lining of heart valves and chambers. Clubbing often occurs in these conditions because of the lower amount of oxygen in the blood.</p> <p>The tissue swells and results in the ‘clubbed’ appearance – rounder, wider fingers and toes. Though patients are typically aware they have a disease that is causing the clubbing, it’s best to get checked if you see any abnormalities.</p> <p><strong>You notice: Pitted toenails </strong></p> <p><span style="text-decoration: underline;"><em>It could be:</em></span> Psoriasis. If you find tiny holes, grooves or ridges in your toenails, you may have nail psoriasis. Though most people who experience nail psoriasis also have skin psoriasis (an autoimmune disease that makes skin patchy and irritated), five per cent of people with nail psoriasis aren’t affected elsewhere.</p> <p>“If you’ve never been diagnosed with psoriasis, but your toenails have little pits in them, you should get them checked out,” says Pichney. Other symptoms include white patches and horizontal lines across the nails. To treat psoriasis, your doctor may prescribe topical creams or steroids injected under the nail.</p> <p><strong>You notice: Spooned nails </strong></p> <p><span style="text-decoration: underline;"><em>It could be:</em></span> Anaemia or lupus. Do you have a depression in the toenail deep enough to hold a water droplet? Also known as koilonychias, spoon-shaped toenails or fingernails are most commonly associated with an iron deficiency, research shows, but it can also come from malnutrition, thyroid disorders or injury.</p> <p>Spooned nails occasionally appear in infants, but normalise in the first few years of life. If you notice spooning, contact your physician, who will obtain a blood test to identify the exact cause.</p> <p><strong>You notice: A straight line under your toenails </strong></p> <p><span style="text-decoration: underline;"><em>It could be:</em></span> Skin cancer. A dark, vertical line underneath a toenail could be acral lentiginous melanoma, or hidden melanoma – a form of the skin cancer that appears on obscure body parts. (Other hidden melanomas include eye melanoma and mouth melanoma.)</p> <p>“It will be a black line from the base of your nail to the end of the nail,” says Pichney. “It should be seen by a podiatrist or dermatologist. You want to make sure it’s not cancer, but it may be a fungus, which is usually yellow-brown and sporadic throughout the whole nail.”</p> <p><strong>You notice: A suddenly high arch </strong></p> <p><span style="text-decoration: underline;"><em>It could be:</em></span> Nerve damage. “Most high-arched feet are associated with some form of underlying neuromuscular condition,” says Pichney. “If someone experiences thinning of the arch muscles in the foot, it could be an indication of a neurological condition called Charcot-Marie-Tooth (CMT).”</p> <p>An inherited disorder that damages the peripheral nerves (those outside the brain and spinal cord), CMT can also cause changes in gait, numbness in the feet, difficulty balancing, loss of muscles in the lower legs, and later on, similar symptoms in the arms and hands. See your doctor if you notice abnormalities. “For anything that’s different or changes when it comes to the foot, see your podiatrist right away,” says Reid.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://www.readersdigest.com.au/healthsmart/10-subtle-signs-of-disease-your-feet-can-reveal" target="_blank" rel="noopener">Reader's Digest</a>.</em> </p>

Body

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Why does my back get so sore when I’m sick? The connection between immunity and pain

<p><em><a href="https://theconversation.com/profiles/joshua-pate-1399299">Joshua Pate</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/mark-hutchinson-105409">Mark Hutchinson</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a></em></p> <p>Have you ever wondered why your back aches when you’re down with the flu or a cold? Or COVID?</p> <p>This discomfort, common during many illnesses, is not just a random symptom. It’s a result of complex interactions between your immune system and your brain called the “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3314453/">neuroimmune synapse</a>”.</p> <p>A fascinating and yet-to-be-understood consequence of this conversation between the immune and brain systems during sickness is that it is particularly noticeable in the <a href="https://academic.oup.com/brain/article/145/3/1098/6370954">lower back</a>. This is thought to be one of the body’s most sensitive regions to neuroimmune threats.</p> <h2>Immunology basics</h2> <p>Our immune system is a double-edged sword. Yes, it fights off infections for us – but it also makes us acutely aware of the job it is doing.</p> <p>When our body detects an infection, our immune system releases molecules including signalling proteins called <a href="https://www.researchgate.net/publication/227831648_The_functions_of_cytokines_and_their_uses_in_toxicology">cytokines</a>. These proteins coordinate our immune system to fight off the infection and talk to our brain and spinal cord to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2740752/#:%7E:text=Production%20of%20proinflammatory%20cytokines%20induces,to%20depression%20in%20vulnerable%20individuals.">change our behaviour</a> and physiology.</p> <p>This can result in symptoms like fatigue, loss of appetite, fever and increased sensitivity to pain. Classically, we think of this as a beneficial behavioural change to help us conserve energy to fight off the infection. It’s why we often feel the need to rest and withdraw from our usual activities when we’re sick – and also why we are grumpier than usual.</p> <h2>Invisibly small changes</h2> <p>Part of this self-protective response is a change in how we perceive threats, including sensory stimuli.</p> <p>When we are sick, touch can become painful and muscles can ache. Many changes in behaviour and sensory systems are <a href="https://doi.org/10.1159/000521476">believed</a> to have origins at the nanoscale. When molecular changes occur in part of the brain linked to cognition or mood, we think and feel differently. If these neuroimmune synapse changes happen in the sensory processing regions of the brain and spinal cord, we feel more pain.</p> <p>Such sensory changes, known as <a href="https://www.iasp-pain.org/resources/fact-sheets/allodynia-and-hyperalgesia-in-neuropathic-pain/#:%7E:text=Allodynia%20is%20pain%20due%20to,stimulus%20that%20normally%20provokes%20pain.">allodynia and hyperalgesia</a>, can lead to heightened pain sensitivity, even in areas not directly affected by the infection – <a href="https://www.sciencedirect.com/science/article/abs/pii/S0889159114001731?via%3Dihub">such as the lower back</a>.</p> <h2>Immune memories</h2> <p>This immune response happens with a range of bacterial infections and viruses like COVID or the flu. In fact, the sick feeling we sometimes get after a vaccination is the good work our immune system is doing to contribute to <a href="https://theconversation.com/you-cant-get-influenza-from-a-flu-shot-heres-how-it-works-118916">a protective immune memory</a>.</p> <p>Some of that immune-cellular conversation also alerts our brains that we are sick, or makes us think we are.</p> <p>After some viral infections, the sick feeling persists longer than the virus. We are seeing a long-term response to COVID in some people, termed <a href="https://theconversation.com/when-does-covid-become-long-covid-and-whats-happening-in-the-body-when-symptoms-persist-heres-what-weve-learnt-so-far-188976">long COVID</a>.</p> <p>Women, who generally have a <a href="https://www.nature.com/articles/nri.2016.90">stronger immune response</a> than men, may be more likely to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7937378/">experience pain symptoms</a>. Their heightened immune response (while beneficial in resisting infections) also predisposes women to a higher risk of inflammatory conditions like <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7980266/">autoimmune diseases</a>.</p> <h2>When to worry and what to do</h2> <p>If the pain is severe, persistent, or accompanied by other concerning symptoms, seek medical attention. Mild to moderate pain is a common symptom during illness and we often notice this in the lower back. The good news is it usually subsides as the infection clears and the sickness resolves.</p> <p>While treating the underlying infection is crucial, there are also ways to dial down sickness-induced neuroimmune pain.</p> <p>Maintaining a diverse microbiome (the collection of microorganisms living in and on your body) by <a href="https://pubmed.ncbi.nlm.nih.gov/31704402/">eating well and getting outside</a> can help. Getting quality sleep, staying hydrated and minimising inflammation <a href="https://karger.com/bbe/article/97/3-4/197/821576/Sickness-and-the-Social-Brain-How-the-Immune">helps too</a>.</p> <p>Amazingly, there is <a href="https://pubmed.ncbi.nlm.nih.gov/34404209/">research</a> suggesting your grandmother’s traditional chicken broth recipe decreases the immune signals at the neuroimmune synapse.</p> <p>Scientists are also <a href="https://pubmed.ncbi.nlm.nih.gov/24799686/">showing</a> mindfulness meditation, cold water therapy and controlled breathing can drive profound cellular and molecular changes to help activate bodily systems like the autonomic nervous system and alter the immune response. These practices might not only help manage pain but also add an anti-inflammatory component to the immune response, reducing the severity and duration of sickness.</p> <p>Heat treatment (with a pack or hot water bottle) might <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8401625/">provide some relief</a> due to increased circulation. Over-the-counter pain relief maybe also be helpful but seek advice if you are taking other medications.</p> <h2>All in the mind?</h2> <p>Is this all mind over matter? A little of yes and a lot of no.</p> <p>The little of yes comes from <a href="https://pubmed.ncbi.nlm.nih.gov/26194270/">research</a> supporting the idea that if you expect your breathing, meditation and cold bath therapy to work, it may well make a difference at the cellular and molecular level.</p> <p>But by understanding the mechanisms of back pain during illness and by using some simple strategies, there is hope to manage this pain effectively. Always remember to seek medical help if your symptoms are severe or persist longer than expected. Your health and comfort are paramount.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/207222/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/joshua-pate-1399299">Joshua Pate</a>, Senior Lecturer in Physiotherapy, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/mark-hutchinson-105409">Mark Hutchinson</a>, Professor, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-does-my-back-get-so-sore-when-im-sick-the-connection-between-immunity-and-pain-207222">original article</a>.</em></p>

Caring

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Sore joints now it’s getting cold? It’s tempting to be less active – but doing more could help you feel better

<p><a href="https://theconversation.com/profiles/charlotte-ganderton-1170940">Charlotte Ganderton</a>, <em><a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a></em>; <a href="https://theconversation.com/profiles/inge-gnatt-1425767">Inge Gnatt</a>, <em><a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a></em>, and <a href="https://theconversation.com/profiles/matthew-king-1177304">Matthew King</a>, <em><a href="https://theconversation.com/institutions/la-trobe-university-842">La Trobe University</a></em></p> <p><a href="https://www.health.gov.au/topics/chronic-conditions/what-were-doing-about-chronic-conditions/what-were-doing-about-musculoskeletal-conditions#:%7E:text=In%20Australia%3A,stiff%2C%20painful%2C%20swollen%20or%20deformed">One in three</a> Australians has a musculoskeletal condition involving joint pain, and the most common cause is arthritis. Around <a href="https://arthritisaustralia.com.au/1in7witharthritis/">3.6 million</a> Australians have arthritis and this is projected to rise to <a href="https://www.arthritiswa.org.au/arthritis/australians-in-the-dark-with-arthritis-one-of-our-most-prevalent-and-costly-diseases/#:%7E:text=Arthritis%20is%20a%20leading%20cause,to%205.4%20million%20by%202030">5.4 million by 2030</a>.</p> <p>For some people with joint pain, cold weather <a href="https://doi.org/10.1186/1471-2474-15-66">seems to make it worse</a>. But temperature <a href="https://doi.org/10.1016/S0304-3959(99)00010-X">is just one factor</a> impacting perceptions of <a href="https://doi.org/10.1097/j.pain.0000000000001776">greater pain</a> during winter. Other factors include those we have some level of influence over, including <a href="https://link.springer.com/article/10.1007/s00702-019-02067-z">sleep</a>, <a href="https://link.springer.com/article/10.1007/s00702-019-02067-z">behavioural patterns, mood</a> and <a href="https://link.springer.com/content/pdf/10.1038/s41598-019-44664-8.pdf">physical activity</a>. Emerging research suggests greater pain levels in winter may also be related to a person’s <a href="https://doi.org/10.1371/journal.pone.0216902">perception of the weather</a>, lack of <a href="https://doi.org/10.1016/j.sjpain.2010.05.030">vitamin D</a> and <a href="https://doi.org/10.1093/rheumatology/kel414">fluctuations in their disease</a>.</p> <p><a href="https://doi.org/10.1002/msc.1191">Physical activity</a> is one of the best treatments to increase function, strength and mobility – and improve quality of life. It also <a href="https://doi.org/10.1002/msc.1191">promotes</a> mental and physical health and <a href="https://www.sciencedirect.com/science/article/pii/S1466853X21000304?via%3Dihub">reduces the risk</a> of other chronic diseases.</p> <p>But pain can be a barrier to exercise and activities you’d usually do. So what can you do about it?</p> <h2>Our brain tries to protect us</h2> <p>When it comes to pain, our brain is very protective: it’s like an inbuilt alarm system and can warn us about impending danger or harm that has occurred so we can respond.</p> <p>But it’s not always a reliable indicator of actual damage or trauma to the skin, muscle or bone, even when it feels like it is. In some instances, this warning system can become unhelpful by setting off “false alarms”.</p> <p>Joint pain and stiffness can also appear to worsen during colder weather, prompting <a href="https://doi.org/10.1177/26335565221100172">fears</a> we could <a href="https://doi.org/10.1002/jor.25151">make it worse</a> if we undertake or overdo movement. This <a href="https://doi.org/10.1016/j.jbspin.2017.07.007">can result in</a> people avoiding physical activity – even when it would be beneficial – which can worsen the pain.</p> <h2>We tend to exercise less when it’s cold</h2> <p>Seasons <a href="https://doi.org/10.1016/j.jshs.2016.07.007">affect</a> how much physical activity we get. Summer months bring warmer weather, longer daylight hours and people get outdoors more. Warmer weather also tends to elicit a positive outlook, a lift in mood and burst of physical activity to fulfil New Year’s resolutions.</p> <p>Cooler months can mean a decline in physical activity and more time being cosy indoors. A reduction in movement and less exposure to light may evoke higher levels of joint pain and can be associated with a reduction in our overall sense of well-being and mood.</p> <p>This can create a cycle where symptoms worsen over time.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/526947/original/file-20230518-19-gzmuv8.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/526947/original/file-20230518-19-gzmuv8.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/526947/original/file-20230518-19-gzmuv8.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/526947/original/file-20230518-19-gzmuv8.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/526947/original/file-20230518-19-gzmuv8.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/526947/original/file-20230518-19-gzmuv8.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/526947/original/file-20230518-19-gzmuv8.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=3 2262w" alt="Older woman exercises with weights" /><figcaption></figcaption>But with the right knowledge and support, people <a href="https://doi.org/10.1080/08870446.2022.2126473">can remain engaged in an active lifestyle</a> especially when it’s aligned to personal values and goals. Health professionals such as physiotherapists and GPs can assess any concerns and provide strategies that are right for you.</figure> <h2>How to motivate yourself to stay active in winter</h2> <p>When looking for an approach to help you stay active during the cooler months and beyond, it can be helpful to become aware of the many <a href="https://doi.org/10.1002/msc.1191">interconnected factors</a> that impact you. They include:</p> <ul> <li>biological (your genes, other illnesses you have)</li> <li>psychological (how you think, feel and behave)</li> <li>social (your relationships and social support).</li> </ul> <p>Starting with the end goal in mind can be beneficial, but this can feel overwhelming. Try creating smaller, achievable steps to help get you there, like climbing a ladder. For example, park a short distance from the shops and increase this incrementally to increase your exercise tolerance.</p> <p>A little bit each day can often be less tolling on your body than a big effort once a week.</p> <p>Create goals that are personally meaningful and encourage you to celebrate success along the way (for example, catching up with friends or a healthy snack). Then, as you climb your “ladder”, one rung at a time, you will likely feel more motivated to continue.</p> <p>If you’re not sure where to start, talk to a friend or health provider to help you determine what is realistic and right for your situation. That way you can <a href="https://doi.org/10.1002/msc.1191">work towards your goals in a safe, non-threatening environment</a> and avoid developing fear and avoidance. They can also help you establish goals that align with your aspirations and pain experience.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/200911/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em>Image credit: Shutterstock</em></p> <p><a href="https://theconversation.com/profiles/charlotte-ganderton-1170940">Charlotte Ganderton</a>, Senior Lecturer (Physiotherapy), <em><a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a></em>; <a href="https://theconversation.com/profiles/inge-gnatt-1425767">Inge Gnatt</a>, Lecturer (Psychology), Provisional Psychologist, <em><a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a></em>, and <a href="https://theconversation.com/profiles/matthew-king-1177304">Matthew King</a>, Lecturer, Research Fellow, and Physiotherapist, <em><a href="https://theconversation.com/institutions/la-trobe-university-842">La Trobe University</a></em></p> <p>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/sore-joints-now-its-getting-cold-its-tempting-to-be-less-active-but-doing-more-could-help-you-feel-better-200911">original article</a>.</p>

Body

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Simple yoga moves that help with hand and wrist pain

<p><em><strong>Tracy Adshead is a yoga teacher specialising in yoga for seniors. She is passionate about bringing healing and healthy ageing to the community.</strong></em></p> <p>As we age, tendonitis is one of the most common problems associated with the hands and wrists. If you are experiencing pain or having difficulty bending one or more of your fingers normally then you may have a tendon inflammation or irritation. The condition is usually short-lived but because many of our daily activities involve repetitive movements such as knitting, texting or typing, joints can easily become aggravated.</p> <p>Yoga helps us to engage in our daily activities in a less stressful way. We can address the cause of the injury by slowing down and observing our habitual movements, then think about how we can do things differently.</p> <ol> <li>Stop whatever activity triggered the inflammation.</li> <li>After swelling has subsided, rest the hand(s) for 4 – 6 days.</li> </ol> <p>Yoga is best used for helping with the healing process at this point when a very slow range of motion can be performed. Be careful not to stretch the muscles so much that you trigger any pain. This practice should be used to supplement conventional therapy, not replace it:</p> <p><strong>1. Lift up the injured hand in front of you</strong>, if possible straighten out all the fingers, finger-tips pointing towards the ceiling. If the fingers are not able to straighten then just move them to a comfortable position.</p> <p>With a slow count of five, little by little, draw the thumb in towards the palm – it may not touch the palm and that’s fine. Next the index finger for the same count. Repeat for each of the fingers.</p> <p>Open up the hand slowly.</p> <p>Now reverse it, small finger moves first towards the palm for the count of four, then all the rest of the fingers follow, thumb comes last. Open up the hand and repeat once more.</p> <p><strong>2. Spread all of your fingers out like a starfish.</strong> With a slow count of 10, begin to fold all your fingers down, closing the hand down into a fist or as close to. Then slowly, all the way open again spreading the fingers out like a starfish. Repeat five to seven times.</p> <p>When this practice becomes comfortable move into a really active hand movement by speeding up.</p> <p><strong>3. Bring the palms together into “namaste” or “prayer” position in front of the chest.</strong> Press the fingers and palms together as you gently lift up your elbows and stretch your wrists.</p> <p>Inhale, lift the elbows up for the count of three. Exhale, lower the elbows for the count of six. Repeat five times.</p> <p>Consult your doctor before starting any new forms of exercise.</p> <p><em>Images: Getty</em></p>

Body

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4 signs your body is trying to tell you something

<p>Have you noticed any odd changes in your body? Perhaps your nails have become more brittle lately, or you’ve started to get cracks on the corners of your mouth. These small signs might seem insignificant, but they are your body’s way of signalling that a change has occurred.</p> <p>Here are some of the key signs that your body is trying to tell you something:</p> <p><strong>Burping and indigestion</strong></p> <p>Find yourself burping or struggling with indigestion more than usual? It could be a sign that you’re low on stomach acid.</p> <p>If your body is low on stomach acid, you won’t digest foods efficiently, especially those heavy in fat and protein. As digestion slows, food sits in the stomach along with the air you naturally swallow when you eat. The longer food stays in the stomach, the more likely you’ll burp.</p> <p><strong>Yellow spots around your eyes</strong></p> <p>Discoloured spots around your eyes and elbows can be a sign that your cholesterol levels are raised. It’s a condition known as xanthelasma, which can be your body’s way of telling you that your diet or exercise routine is amiss.</p> <p>Be sure to consult a doctor if you need to check your cholesterol. A routine blood test will be able to give you the answer, and you can talk to your doctor about what lifestyle changes will help.</p> <p><strong>Itchy feet</strong></p> <p>Summertime often means more visits to the pool or time exercising outdoors. But sweaty trainers and damp feet can also lead to an increase in fungal infections.</p> <p>If you notice your feet are itchy, take a closer look at the skin. If it’s white and flaking off, or simply damp between the toes you may have a fungal infection. Head to the pharmacist for an anti-fungal cream to clear it up, stat.</p> <p><strong>Cracks in the corners of your mouth</strong></p> <p>Small cracks in the skin at the corner of your mouth is often a sign that your body isn’t getting enough B vitamins. If your diet is high in refined and processed foods- think soft drink, pastries and pasta- B vitamins are often the first to take a hit.</p> <p>The answer? Opt for a diet high in whole foods. Try eating more grains, legumes, salmon and red meat, all foods high in B vitamins. If in doubt, always contact a healthcare professional.</p> <p><strong>Related links:</strong></p> <p><span style="text-decoration: underline;"><em><strong><a href="../health/wellbeing/2015/10/how-to-lose-weight-after-60/">How to lose weight after 60</a></strong></em></span></p> <p><a href="http://www.oversixty.co.nz/health/body/2015/11/how-to-stay-asleep/"><span style="text-decoration: underline;"><em><strong>5 tips to stay asleep all night</strong></em></span></a></p> <p><span style="text-decoration: underline;"><em><strong><a href="http://www.oversixty.co.nz/health/body/2015/11/best-outdoor-exercise-options/">The best ways to exercise outdoors</a></strong></em></span></p> <p><em>Image credit: Shutterstock</em></p>

Body

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Artist can draw with both hands and both feet at the same time

<p dir="ltr">Dutch artist Rajacenna van Dam has taken being ambidextrous to the next level, as she taught herself to not only use both her hands to create her art, but her feet as well. </p> <p dir="ltr">Rajacenna is a former child prodigy who, at the age of 16, was discovered as one of the world’s best and youngest hyper-realistic pencil drawing artists.</p> <p dir="ltr">Now 28 years old, Rajacenna is known worldwide for being quadridextrous, as she uses both her hands and both her feet at the same time to create up to six photo-realistic portraits at the same time.</p> <p dir="ltr">While Rajacenna knew she was talented with her hands, she was surprised to discover the talent transferred to her feet. </p> <p dir="ltr">“I love to challenge myself so I thought why not try for the first time painting with my feet while drawing in a realistic way, while being upside down and also one drawing in 3D,” she said.</p> <p dir="ltr">“It surprised me how much control I was able to have over my feet, something I never realised before. All that time I was drawing while I thought my feet were useless with art and now, I discovered they can do way more than I thought!”</p> <p dir="ltr">Rajacenna’s talent was proven during an EEG scan for a popular scientific TV program when it became clear that during drawing, there is superhuman brain activity to be registered in Rajacenna’s brain, according to neuro therapist and world’s number one EEG Biofeedback expert Bill Scott.</p> <p dir="ltr">Mr Scott said Rajacenna is an “extraordinary human being; she has a very exceptional brain”, claiming, “I have never seen this before in anyone’s brain.”</p> <p><iframe title="YouTube video player" src="https://www.youtube.com/embed/enZbw1j8-ZE" width="560" height="315" frameborder="0" allowfullscreen="allowfullscreen"></iframe></p> <p dir="ltr" style="line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;"><em>Image credits: Youtube</em><span id="docs-internal-guid-59ad9a48-7fff-f220-3f61-c21971eb0597"></span></p>

Art

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10 subtle signs of disease your feet can reveal

<h2>You notice: Dry, flaky feet</h2> <p>It could be: Thyroid problems, especially if moisturiser doesn’t help. When the thyroid gland (the butterfly-shaped gland at the base of your neck) isn’t working properly, it doesn’t produce thyroid hormones, which control metabolic rate, blood pressure, tissue growth and skeletal and nervous system development. “Thyroid problems cause severe dryness of the skin,” says foot specialist Marlene Reid. “When we see cracking on the feet, or if moisturiser doesn’t improve dryness over a few days, we usually refer patients to their primary doctor to make sure their thyroids are okay.” Brittle toenails can also signal thyroid complications.</p> <h2>You notice: Bald toes</h2> <p>It could be: Arterial disease. If the fuzz on your toes suddenly disappears, it could signal poor blood circulation caused by peripheral arterial disease (PAD) which builds up plaque in the leg arteries. “Signs of PAD can include decreased hair growth on the feet and ankles, purplish toes and thin or shiny skin,” says podiatric surgeon Suzanne Fuchs. Symptoms are subtle, but doctors can check for a healthy pulse in the foot. In severe cases, they may spot PAD on an X-ray. “If I take an X-ray of a broken foot, and I see a hardening of the arteries, 99 per cent of the time the same thing is happening in the heart blood vessels,” says podiatric surgeon Gary A. Pichney.</p> <h2>You notice: Ulcers that don’t heal</h2> <p>It could be: Diabetes. Uncontrolled glucose levels can damage nerves and cause poor circulation, so blood doesn’t reach all areas of the body, including the feet. When blood doesn’t get to a wound caused by, say, irritating shoes, the skin doesn’t heal properly, and that’s how diabetic blisters and ulcers can develop. “Many, many people with diabetes are diagnosed first because of foot problems,” says Reid. Other signs of diabetes may include persistent tingling or numbness of the feet. If you suffer from these foot problems, ask your doctor about getting your blood sugar levels tested.</p> <h2>You notice: An enlarged, painful big toe</h2> <p>It could be: Gout. Gorged on wine and steak? The painful aftermath could be gout, a type of arthritis that often affects the joint of the big toe. Foods high in purine, a chemical compound found in red meats, fish and certain alcohol, can trigger an attack by raising levels of uric acid in the body. Uric acid is normally excreted through urine, but is overproduced or under-excreted in some people. “You’ll see the deposition of the uric acid in the joint, most commonly the big toe or the ankle,” says podiatric foot and ankle specialist Bob Baravarian. “The patient will wake up with a hard, red, swollen joint. It’s extremely painful.” A doctor may prescribe anti-inflammatory drugs for short-term relief and medicines to reduce uric acid production. You may also need to follow a low-purine diet for long-term prevention.</p> <h2>You notice: Small, red lines under the toenail</h2> <p>It could be: A heart infection. Red streaks underneath the toenails or fingernails could be broken blood vessels known as splinter haemorrhages. While problems like psoriasis, fungal infection, or even just experiencing trauma to the nail can cause splinter haemorrhages, it can also be a sign of endocarditis, or an infection of the heart’s inner lining, according to the American Academy of Family Physicians. (Keep in mind this is a rare condition.) People who have an existing heart condition are at higher risk of developing endocarditis. The infection can result in heart failure if left untreated. If you notice splinter haemorrhages on your toenails or fingernails, and haven’t experienced any recent trauma to the nail, see your doctor to check your heart and blood circulation.</p> <h2>You notice: Clubbing</h2> <p>It could be: Lung cancer or heart disease.</p> <p>Another symptom that appears in both toes and fingers, clubbing is often associated with lung cancer, chronic lung infection, or heart conditions caused by birth defects or infection of the lining of heart valves and chambers. Clubbing often occurs in these conditions because of the lower amount of oxygen in the blood. The tissue swells and results in the ‘clubbed’ appearance – rounder, wider fingers and toes. Though patients are typically aware they have a disease that is causing the clubbing, it’s best to get checked if you see any abnormalities.</p> <h2>You notice: Pitted toenails</h2> <p>It could be: Psoriasis.</p> <p>If you find tiny holes, grooves or ridges in your toenails, you may have nail psoriasis. Though most people who experience nail psoriasis also have skin psoriasis (an autoimmune disease that makes skin patchy and irritated), five per cent of people with nail psoriasis aren’t affected elsewhere. “If you’ve never been diagnosed with psoriasis, but your toenails have little pits in them, you should get them checked out,” says Pichney. Other symptoms include white patches and horizontal lines across the nails. To treat psoriasis, your doctor may prescribe topical creams or steroids injected under the nail.</p> <h2>You notice: Spooned nails</h2> <p>It could be: Anaemia or lupus.</p> <p>Do you have a depression in the toenail deep enough to hold a water droplet? Also known as koilonychias, spoon-shaped toenails or fingernails are most commonly associated with an iron deficiency, research shows, but it can also come from malnutrition, thyroid disorders or injury. Spooned nails occasionally appear in infants, but normalise in the first few years of life. If you notice spooning, contact your physician, who will obtain a blood test to identify the exact cause.</p> <h2>You notice: A straight line under your toenails</h2> <p>It could be: Skin cancer.</p> <p>A dark, vertical line underneath a toenail could be acral lentiginous melanoma, or hidden melanoma – a form of the skin cancer that appears on obscure body parts. (Other hidden melanomas include eye melanoma and mouth melanoma.) “It will be a black line from the base of your nail to the end of the nail,” says Pichney. “It should be seen by a podiatrist or dermatologist. You want to make sure it’s not cancer, but it may be a fungus, which is usually yellow-brown and sporadic throughout the whole nail.”</p> <h2>You notice: A suddenly high arch</h2> <p>It could be: Nerve damage.</p> <p>“Most high-arched feet are associated with some form of underlying neuromuscular condition,” says Pichney. “If someone experiences thinning of the arch muscles in the foot, it could be an indication of a neurological condition called Charcot-Marie-Tooth (CMT).” An inherited disorder that damages the peripheral nerves (those outside the brain and spinal cord), CMT can also cause changes in gait, numbness in the feet, difficulty balancing, loss of muscles in the lower legs, and later on, similar symptoms in the arms and hands. See your doctor if you notice abnormalities. “For anything that’s different or changes when it comes to the foot, see your podiatrist right away,” says Reid.</p> <p><strong>This article originally appeared on <a href="https://www.readersdigest.com.au/healthsmart/10-subtle-signs-of-disease-your-feet-can-reveal" target="_blank" rel="noopener">Reader's Digest</a>.</strong></p> <p><em>Image: Shutterstock</em></p>

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Keeping to the beat controlled by 69 genes – not just our feet

<p class="spai-bg-prepared">Are you a dancing queen or do you have two left feet? Turns out that keeping to the beat is partly to do with our <a class="spai-bg-prepared" href="https://www.nature.com/articles/news.2007.359" target="_blank" rel="noreferrer noopener">genetics</a>.</p> <p class="spai-bg-prepared">An international team of researchers conducted a study on the genetic variation of 606,825 individuals, all of whom completed a musical ability questionnaire (including “Can you clap in time with a musical beat?”), with some also participating in beat synchronisation experiments including telling rhythms apart (Phenotype Experiment 1) and tapping in time with music (Phenotype Experiment 2).</p> <p class="spai-bg-prepared">Of the participants, 91.57% said yes to the question, “Can you clap in time with a musical beat?” Those who said yes also scored higher in the rhythm perception and tapping synchrony experiments.  </p> <p class="spai-bg-prepared">Looking at the genetic variation, 69 genes showed significant difference between the rhythmic and arhythmic participants, with <em class="spai-bg-prepared">VRK2 </em>being the most strongly associated. This gene has been linked previously to behavioural and psychiatric traits (including depression, schizophrenia and developmental delay), suggesting a biological link between beat synchronisation and neurodevelopment.</p> <div class="newsletter-box spai-bg-prepared"> <div id="wpcf7-f6-p195164-o1" class="wpcf7 spai-bg-prepared" dir="ltr" lang="en-US" role="form"> <form class="wpcf7-form mailchimp-ext-0.5.62 spai-bg-prepared init" action="/science/biology/keeping-the-beat-genetics/#wpcf7-f6-p195164-o1" method="post" novalidate="novalidate" data-status="init"> <p class="spai-bg-prepared" style="display: none !important;"><span class="wpcf7-form-control-wrap referer-page spai-bg-prepared"><input class="wpcf7-form-control wpcf7-text referer-page spai-bg-prepared" name="referer-page" type="hidden" value="https://cosmosmagazine.com/people/" data-value="https://cosmosmagazine.com/people/" aria-invalid="false" /></span></p> <p><!-- Chimpmail extension by Renzo Johnson --></form> </div> </div> <p class="spai-bg-prepared">Several physiology traits also seemed to be linked to beat synchronisation, including processing speed, grid strength, usual walking pace, and peak respiratory flow. These may be linked to the evolution of language and sociality through music in early humans.</p> <p class="spai-bg-prepared">For modern humans, our ability to keep the beat may help to predict developmental speech-language disorders, and serve as a mechanism for <a class="spai-bg-prepared" href="https://www.frontiersin.org/articles/10.3389/fnhum.2021.789467/full" target="_blank" rel="noreferrer noopener">rhythm-based rehabilitation</a>, including for <a class="spai-bg-prepared" href="https://cosmosmagazine.com/science/biology/bilingual-patients-recover-better-from-stroke/" target="_blank" rel="noreferrer noopener">stroke</a> and <a class="spai-bg-prepared" href="https://www.nature.com/articles/s41598-017-16232-5" target="_blank" rel="noreferrer noopener">Parkinson’s disease</a>.</p> <p class="spai-bg-prepared">This study has been <a class="spai-bg-prepared" href="https://doi.org/10.1038/s41562-022-01359-x" target="_blank" rel="noreferrer noopener">published</a> in <em class="spai-bg-prepared">Nature Human Behaviour</em>.</p> <figure class="wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio spai-bg-prepared"> <div class="wp-block-embed__wrapper spai-bg-prepared"> <div class="entry-content-asset spai-bg-prepared"> <div class="embed-wrapper spai-bg-prepared"> <div class="inner spai-bg-prepared"><iframe class="spai-bg-prepared" title="The Go-Go's - We Got The Beat (Official Music Video)" src="https://www.youtube.com/embed/f55KlPe81Yw?feature=oembed" width="500" height="281" frameborder="0" allowfullscreen="allowfullscreen"></iframe></div> </div> </div> </div> </figure> <p class="spai-bg-prepared">We got the beat… well maybe some of us!</p> <p><!-- Start of tracking content syndication. Please do not remove this section as it allows us to keep track of republished articles --></p> <p><img id="cosmos-post-tracker" class="spai-bg-prepared" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=195164&amp;title=Keeping+to+the+beat+controlled+by+69+genes+%E2%80%93+not+just+our+feet" width="1" height="1" /></p> <p><!-- End of tracking content syndication --></p> <div id="contributors"> <p><em><a href="https://cosmosmagazine.com/science/biology/keeping-the-beat-genetics/" target="_blank" rel="noopener">This article</a> was originally published on <a href="https://cosmosmagazine.com" target="_blank" rel="noopener">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/qamariya-nasrullah" target="_blank" rel="noopener">Qamariya Nasrullah</a>. Qamariya Nasrullah holds a PhD in evolutionary development from Monash University and an Honours degree in palaeontology from Flinders University.</em></p> <p><em>Image: Getty Images</em></p> </div>

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How to roll away all your sore back blues

<p>We all know that working a 9-5 and sitting all day leads to various health problems. For me personally, it manifests itself through chronic back pain and tight hip flexors. </p> <p>Fortunately, there's a way for me to soothe these aches and pains from home. I've been using <a href="https://www.therabody.com/anz/en-au/wave-roller-anz.html" target="_blank" rel="noopener">Therabody's Wave Roller</a> for the past week, and my back pain has significantly reduced. </p> <p>The Wave Roller is a Bluetooth-enabled vibrating foam roller that proposes benefits like increasing blood flow, enhancing mobility, and releasing tension. You can connect the roller to a free Therabody App, where you can find personalised recovery routines targeting all parts of your body, along with instructions and how-tos. </p> <p>Here are some of my initial thoughts. </p> <p><img src="https://oversixtydev.blob.core.windows.net/media/2022/03/03_RizWaveroller01.jpg" alt="Therabody Wave Roller in use" width="1280" height="720" /></p> <p>My personal favourites are the mid back and upper back routines, which take up to 5 minutes to complete. Since most of the tension is in my upper body, which causes my lower back to overcompensate, I've decided to focus on these areas. </p> <p>The foam roller comes with a bag and charger and is reasonably lightweight, so you could easily carry it around. The foam itself is a high-density foam, and I like that you can customise the intensity and frequency of the vibrations. </p> <p>There are five customised vibration settings, with 5 being the highest and most intense. I could only handle up to the third setting or the medium-intensity.</p> <p>But, the higher the intensity, the more noise it produces, although I didn't mind it so much for the other benefits it provided. </p> <p>The routines are easy to follow, with pictures demonstrating each move and seamless transitions from one exercise to the next. I also liked that the intensity of the vibrations automatically changes according to what's best for that particular movement. </p> <p>I would have loved seeing a video demonstration before each routine, as I wasn't sure if I was doing some of the exercises quite correctly. </p> <p>I also found that the Wave Roller can be slippery to use in some movements, like when I tried it on my rotator cuffs. </p> <p>Despite this, the Wave Roller is a pleasure to use after a long day, when my muscles are the most tense. I find it a helpful tool in managing pain, soreness, and releasing tension. </p> <p>Although it is on the higher end of the price range compared to other foam rollers, I think it's worth the investment. The technology is advanced, and you can personalise the areas you want to work on using the step-by-step programs in their app. </p> <p>It also feels like you're getting a massage, but it's more personalised and customisable. </p> <p>If using the app seems intimidating or too complicated, you can use the Wave Roller by itself and adjust the intensity using the + and - buttons. </p> <p><img src="https://oversixtydev.blob.core.windows.net/media/2022/03/02_RizWaveroller.jpg" alt="Therabody Wave Roller" width="1280" height="720" /></p> <p>In summary, here are the pros and cons to consider if you're thinking of purchasing one for yourself. </p> <p><strong>Pros: </strong></p> <ul> <li>Relieves soreness and muscle tension</li> <li>Variety of settings for the vibrations</li> <li>App integration </li> <li>Personalised programs that are quick and easy to follow</li> <li>3-hour battery life and it doesn’t take too long to charge</li> </ul> <p><strong>Cons: </strong></p> <ul> <li>The cost (RRP $249), but worth every penny! </li> <li>Medium to High setting intense and pretty noisy </li> <li>Depending on the exercise you do it can be quite slippery</li> <li>Video demonstrations before each exercise would be even better </li> </ul> <p>The Wave Roller series is available via the <a href="https://www.therabody.com/on/demandware.store/Sites-Theragun-ANZ-Site/en_AU/Default-Start" target="_blank" rel="noopener">Therabody website</a>. </p> <p>Images: Rizna Mutmainah &amp; Therabody</p>

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Sore jaw or damaged teeth? You might be suffering from bruxism

<p><span style="font-weight: 400;">If you’re feeling stressed, you might notice you’re snappier with people or having trouble getting enough sleep. </span></p> <p><span style="font-weight: 400;">But, one area of the body that is greatly affected but seldom talked about when it comes to stress can be found in your mouth.</span></p> <p><span style="font-weight: 400;">Teeth grinding - also known as bruxism - can occur in almost anyone and result in broken fillings and cracked teeth.</span></p> <p><span style="font-weight: 400;">Before you get too worried about your oral health, you should know that everyone grinds their teeth at least a little bit.</span></p> <p><span style="font-weight: 400;">“Everybody grinds their teeth a little bit at night, it’s normal and we do it subconsciously - usually during dream sleep,” Dr Tami Yap, a lecturer in oral medicine at Melbourne University, told </span><span style="font-weight: 400;">The Age</span><span style="font-weight: 400;">. </span></p> <p><span style="font-weight: 400;">“If sleep is fragmented, you’re not getting solid sleep cycles, or you have a period of stress where you mood is impacted into the night-time, you will probably grind more.”</span></p> <p><span style="font-weight: 400;">The problems arise when grinding causes the teeth to become worn down or break, or if it causes the muscles in your face to ache.</span></p> <p><span style="font-weight: 400;">Additional symptoms can vary, from temperature sensitivity or a sore jaw to tension headaches or pieces of your teeth breaking off in your mouth.</span></p> <p><span style="font-weight: 400;">Though there isn’t a simple way to “switch off” tooth grinding, Yap explained, there are some things you can do to manage it.</span></p> <p><strong>What makes us grind our teeth?</strong></p> <p><span style="font-weight: 400;">According to Dr Elizabeth Milford, a dentist and scientific relations consultant for Oral-B, tooth grinding can be triggered by increased anxiety, not getting enough exercise, and poor sleep habits.</span></p> <p><span style="font-weight: 400;">Other habits can also exacerbate night-time tooth grinding, such as smoking, drinking large amounts of alcohol, and taking recreational drugs. But these habits are more influential on how much we grind our teeth during the day.</span></p> <p><span style="font-weight: 400;">Daytime tooth grinding is often triggered by our mood, habits, and stress levels.</span></p> <p><span style="font-weight: 400;">“When we are worried or highly stressed, we are physiologically perceiving a low-grade threat,” Yap explained. “And when this happens, stress hormones run around the body and the sympathetic system is engaged because the body is prioritising you to fight or flight.”</span></p> <p><span style="font-weight: 400;">With this comes extra tension in your muscles, with people often holding their teeth together like you would clench your fist.</span></p> <p><span style="font-weight: 400;">“And if you were clenching your fist, it would be very clear you shouldn’t be doing that. Similarly, if you’re touching your teeth together at times other than eating, you’re going to be loading your teeth more, and you’re going to get cracks, and possibly muscle pain.” </span></p> <p><strong>What can you do about it?</strong></p> <p><span style="font-weight: 400;">Minimising tooth grinding requires a holistic approach. Consciously choosing the position of your mouth and jaw and thinking about what our facial muscles are doing can help reduce it.</span></p> <p><span style="font-weight: 400;">“Teeth should only be touching when you’re eating, maybe when you phonate certain words and sometimes when you swallow,” Dr Yap said. “That amounts to a few minutes a day, the rest of the time the teeth should actually be apart.”</span></p> <p><span style="font-weight: 400;">Dr Yap recommends focusing on breathing, since this helps you become “more aware of how your mood and your stress is impacting changes on your body”.</span></p> <p><span style="font-weight: 400;">Treatment can also include jaw exercises, relaxation techniques, and custom-made dental appliances that reduce pressure on teeth.</span></p> <p><span style="font-weight: 400;">Dentists often recommend night guards, but becoming more aware of how we’re feeling and how our body is reacting will pay off in the long run.</span></p>

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How missing feet washed up on Canadian beaches is helping solve the Melissa Caddick mystery

<p><span>The strange phenomenon of dismembered feet sweeping up on Canadian beaches may just help investigators into understanding what happened to missing Sydney businesswoman Melissa Caddick.</span><br /><br /><span>The 49-year-old’s severed foot drifted ashore Bournda Beach on the NSW south coast – hundreds of kilometres from her home in the eastern suburbs.</span><br /><br /><span>Other remains have now washed up on other south coast beaches – a holiday spot in Mollymook, at Cunjurong Point near Lake Conjola, and Warrain Beach at Culburra.</span><br /><br /><span>Forensic testing is currently being done on the remains to figure out whether they are animal or human, and if so, whether they match to Ms Caddick’s DNA.</span><br /><br /><span>A senior investigator who spoke to The Daily Telegraph revealed that the condition of the body parts that have been discovered means that she was most likely on the run for weeks before her death.</span></p> <p><img style="width: 500px; height: 281.25px;" src="https://oversixtydev.blob.core.windows.net/media/7840095/daily.jpg" alt="" data-udi="umb://media/113aa55b8cd945fdb990a299d92e0cbf" /><br /><br /><span>However, a forensic pathologist has pointed to a bizarre phenomenon in Canada which could possibly point to an alternative theory which is that she met her death in Sydney.</span><br /><br /><span>21 disembodied feet so far have washed up along the British Columbian coast since 2007.</span><br /><br /><span>A coronial investigation that has been ongoing for over a decade, has ruled out that the feet came from people who were killed either in accidents or by suicide, and the feet detached during the normal decomposition process.</span><br /><br /><span>The feet were usually found inside of sneakers, just like Melissa Caddick’s, which the coroner believed was responsible for both keeping the feet buoyant enough to eventually wash ashore.</span><br /><br /><span>The shoes also allegedly gave the feet enough protection from decomposition.</span><br /><br /><span>Dr Matthew Orde, a forensic pathologist with the University of British Columbia, told the Sydney Morning Herald that a modern running shoe provides protection and buoyancy.</span><br /><br /><span>He revealed the decomposing feet were often found “many, many miles” from where they first entered the water.</span><br /><br /><span>“One of the theories is that those running shoes, by virtues of the air pockets in them, are quite buoyant,” Dr Orde said.</span><br /><br /><span>Police are set on searching waters near Caddick’s home in Dover Heights, follow a senior investigator’s doubts over whether her foot could have floated 400km to where it was discovered.</span><br /><br /><span>Superintendent Joe McNulty, Commander of the NSW Marine Command said he has never heard of a case where a body in water could float hundreds of kilometres down the south coast.</span><br /><br /><span>“Something in the water for that long, say a bit of flotsam or jetsam that washes on to the shore, has got green growth on it,” he told The Daily Telegraph.</span><br /><br /><span>“At first examination the shoe doesn’t appear to have been in the water for three months. The shoe needs extensive analysis to see how long it was in the water. It’s a vital clue where hopefully marine biology can provide some answers.”</span><br /><br /><span>Investigators are also exploring the possibility that Ms Caddick is still alive somewhere, without her foot.</span><br /><br /><span>Speaking to Weekend Today on Saturday, University of Newcastle Associate Professor of Criminology Dr Xanthe Mallett said that losing a foot doesn’t automatically spell out death.</span><br /><br /><span>“When it was just a foot I would caution against the possibility that somebody is deceased. You can survive without your foot,” she said.</span><br /><br /><span>Ms Caddick disappeared on November 12 od 2020 after she left her home for what her husband believed was a morning run at 5.30am.</span><br /><br /><span>She has been accused of swindling her friends and family out of millions of dollars through her finance business Maliver Pty Ltd.</span></p>

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Mum's sweet name for baby born at 18,000 feet

<p>Chrystal Hicks has a unique story to tell her son who was born at 18,000 feet in the air.</p> <p>She was 35 weeks pregnant and unexpectedly started contractions in her small town of Glennallen, Alaska.</p> <p>“At about 7 or 8 p.m., [the contractions] really started getting stronger, and then finally my neighbour came over and called 911,” she told <a rel="noopener" href="https://www.businessinsider.com.au/alaska-woman-son-name-sky-birth-on-plane-2020-8" target="_blank" class="_e75a791d-denali-editor-page-rtflink">Insider</a>.</p> <p>On August 5th, she boarded a Lifemed Alaska plane and her water broke 20 minutes into the flight at an elevation of 18,000 feet.</p> <p>“I had to push right away,” Hicks said. “I rolled over on my back, and then all of a sudden, he was out.”</p> <p>At first, she wasn't sure what to name her fourth child, but her cousin gave her a great idea.</p> <p>Hicks came up with the name Sky Airon which describes succinctly where he was born and the unique story he came with.</p> <p><img style="width: 500px; height: 281.25px;" src="https://oversixtydev.blob.core.windows.net/media/7837533/baby-body.jpg" alt="" data-udi="umb://media/c871a24112354244ac850c0190b16517" /></p> <div class="body_text "> <p>Her delivery was shocking for the Lifemed Alaska team, who said that onboard deliveries are rare.</p> <p>“In my 20-plus-year career, I can think of maybe four [births],” Lifemed Alaska’s Chief Operations Officer, Steve Heyano, told Insider.</p> <p>However, the plane flies with an Isolette, which is an incubator that has life-support capabilities just in case a birth does happen on board.</p> <p>Patients on flights are also in good hands with onboard care providers, including neonatal nurse practitioners, flight paramedics and nurses.</p> <p>Despite Sky's exciting start to life, he initially had respiratory problems and was placed on a breathing machine in a neonatal intensive care unit in Anchorage, Alaska.</p> <p>He has since been discharged after two weeks and is safely at home with mum and his new siblings.</p> <p><em>Photo credits: </em><em><a rel="noopener" href="https://www.businessinsider.com.au/alaska-woman-son-name-sky-birth-on-plane-2020-8" target="_blank" class="_e75a791d-denali-editor-page-rtflink">Insider</a></em></p> </div> <div class="body_text "></div>

Family & Pets

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Check your feet! 'COVID toes' are a new and more rampant sign of coronavirus

<p>Skin doctors are currently looking at a lot of toes, as concern grows that for some people, a symptom COVID-19 might be in an unusual spot.</p> <p>Boston dermatologist Esther Freeman expected to see skin complaints as COVID-19 hit the US but wasn’t expecting them to be toes.</p> <p>"But I was not anticipating those would be toes," Massachusetts General Hospital employee Dr Freeman said to <em><a rel="noopener" href="https://www.9news.com.au/world/covid-toe-rash-possible-coronavirus-infection-sign/5bf041bd-a472-44e9-9e95-f8eb10695447" target="_blank">9news</a>.</em></p> <p>Cases were initially recorded in children but has appeared to have spread to adults as well.</p> <p>Dr Freeman has viewed via telemedicine more toes in the last several weeks than in her entire week.</p> <p>They’re being called ‘COVID toes’, which are red, sore and sometimes itchy swellings on toes.</p> <p>"I think it's much more rampant than we even realize. The good news is it resolves spontaneously," Dr Amy Paller of Northwestern University said.</p> <p>There are many theories as to why ‘COVID toes’ are appearing, including that it could be inflammation triggered by the infection instead of the cold as well as the virus potentially irritating the lining of blood vessels in the skin.</p> <p>"The public health message is not to panic," Dr Freeman said, noting that most toe patients she's seen haven't become severely ill. Are they contagious?</p> <p>"We can't tell if you've got COVID-19 just by looking at your toes," she said.</p>

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Talk about creepy! Erin Molan shares bizarre social media request

<p>Sports presenter Erin Molan has definitely received her fair share of odd message requests on social media, however this bizarre series of requests have undoubtedly taken the cake for “most creepy”.</p> <p>The Channel 9 star took to Twitter to share a series of obsessive, relentless and cringe-worthy messages spanning over a number of years.</p> <p>The admirer appeared to have an intense foot fetish and was persistent in messaging Molan about her feet.</p> <p>Dating back to September 2018, Molan shared the messages which read: “You have such beautiful toes!”</p> <p>“Can I buy feet pics?”</p> <p>“How much $$ for feet pics?”</p> <blockquote class="twitter-tweet"> <p dir="ltr">I get some weird stuff but this is up there... anyone know current going rate for feet pics? Asking for a friend... <a href="https://t.co/4ueGIXyWS5">pic.twitter.com/4ueGIXyWS5</a></p> — Erin Molan (@Erin_Molan) <a href="https://twitter.com/Erin_Molan/status/1234968753424625664?ref_src=twsrc%5Etfw">March 3, 2020</a></blockquote> <p>Molan was able to see the humour in the messages, captioning the post, “Anyone know current going rate for feet pics? Asking for a friend …”</p> <p>Sydney FC Footballer and Greater Western Sydney player Ellie Brush admitted she too had received “these messages as well,” along with Journalist Melinda Farrell who confirms she too has gotten requests from men online for feet pics.</p> <p>“I was telling friends about this! I’ve had loads of foot fetish guys in my mentions over the past few years. I never knew it was such a big thing,” she tweeted.</p> <p>Foot fetishism is also known as podophilia and is an oddly common obsession.</p> <p>Molan is a central member of Nine’s Wide World of Sports, who has covered the Australian Open, NRL Premiership and Fast5 Netball World Series.</p>

Beauty & Style

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Sorry, not sorry: Djokovic speaks out on patting chair umpire's feet

<p>Novak Djokovic has apologised for touching the umpire during his Australian Open final match on Sunday night.</p> <p>The Serb initially defended his decision to tap official Damien Dumusois twice on the foot, describing it as “a nice, really friendly touch”, but expressed his regret on Monday.</p> <p>“In a professional sport, things happen that obviously you’re not proud of,” Djokovic said.</p> <p>“Sometimes you do things that you’re not happy with and you go through different emotions, you go through ups and downs.</p> <p>“Of course, I’m not happy that I touched the chair umpire. And I’m sorry if I offended him or anybody else.</p> <p>“But in the heat of the battle, some decisions that he makes or some decision that happens just distracts you and sets you off the balance a little bit.”</p> <p>According to the official grand slam rule book, Djokovic could be charged with a fine of up to AU$30,000 for the action.</p> <p>“Players shall not at any time physically abuse any official, opponent, spectator or other person within the precincts of the tournament site,” the rules state. “Violation of this section shall subject a player to a fine up to US$20,000 [AU$30,000] for each violation.”</p> <p>In the post-match press conference, Djokovic said he did not believe he overstepped the mark. “For touching his shoe? I mean, I didn’t know that’s completely forbidden,” he said after securing his 6-4, 4-6, 2-6, 6-3, 6-4 against Dominic Thiem.</p> <p>“I thought it was a nice, really friendly touch. I wasn’t aggressive with him in terms of physical abuse.”</p>

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