Bench Pressing Won’t Replace Breast Reduction Surgery
Stop using fear of shrunken breasts to avoid bench pressing, ladies!
Some women worry that bench presses will reduce the size of their breasts. This is absolutely not true! Benching recruits primarily chest muscles.
The muscles of the chest are not located in the breasts. In fact, a woman’s prized feature has no muscle.
If you think breasts have muscle, try making one move independently of contracting a chest muscle.
Chest muscles (pectoralis major and minor) are situated deeper into the body, and have absolutely nothing to do with breast size.
Breasts are composed of fatty tissue. If you think bench pressing makes breasts smaller, then men who have “man boobs” would certainly have an easy fix-it solution in the bench press, wouldn’t they? But they don’t.
That’s because the motion of bench pressing will not make breasts smaller.
However, a woman who seriously takes up chest pressing will also seriously take up strength training other parts of her body.
And when a woman commits to a serious strength training regimen, she usually duplicates this commitment in the areas of cardio and diet.
The result? Loss of body fat over her entire body. This includes some of the fat in her breasts, creating the illusion that perhaps one of her weight-lifting routines shrunk them.
No. What made her breasts smaller is loss of body fat that resulted from the increased metabolic rate triggered by her exercise regimen, in combination with fat loss from a better diet.
So then, how come it seems that women who do a lot of bench pressing have small breasts? I myself have not made this observation. But some women have.
Well again, a woman who does a lot of chest pressing probably also does a lot of other strength training routines, perhaps routines that you haven’t seen her doing because maybe you keep running into her on her chest pressing days.
And she probably puts in some serious cardio workouts — and hence, has a low body fat percentage.
I’ve never heard of a woman doing only serious bench press work and nothing else.
Even women who compete in pressing competitions train other parts of their body, especially since heavy chest pressing requires strong shoulders and triceps.
Women who compete in benching also often compete in other routines, and hence, work their entire body for best competitive performance.
I’ve seen plenty of well-endowed women bench pressing, and have not observed any correlation between this exercise and breast size. So ladies, go ahead and start bench pressing.
This won’t shrink your breasts any more than dumbbell presses will, or the “butterfly” machine will.
Ironically, some women believe that bench pressing will make their breasts bigger!
This, too, is completely untrue. Remember, fat is fat, and muscle is muscle. Weight-lifting does not build fat.
Lorra Garrick is a former personal trainer certified through the American Council on Exercise. At Bally Total Fitness she trained women and men of all ages for fat loss, muscle building, fitness and improved health.
.
Top image: Shutterstock/4 PM production
How to Stop Arching Your Back when Bench Pressing
You can learn to stop arching your back while bench pressing.
The first thing you can do that will make it easier to stop arching your back while performing the bench press, is to watch someone else committing this mistake.
Yes, watch them, and you will see how erroneous this looks.
That’s how you look. This doesn’t fool your pecs one bit.
Sometimes, the back arch is done during the bench press because the person wants to be seen handling a heavy barbell, and the only way to move the barbell is to arch the back.
Even if the barbell is heavy for your body weight, you won’t impress anybody.
The next step is to abandon the idea of handling the weight load that you arch your back for.
If you can’t maintain proper form with a particular weight load, then stop using that weight load.
Bad form with heavy weights won’t progress you as quickly as good form with lighter weights.
There’s a woman I see at the gym who dramatically arches her back when bench pressing — the barbell is 135 pounds. She wants to be seen bench pressing 135 pounds.
However, what everyone sees is an exaggerated vertebral arch, and not only that, but she brings the bar down only halfway for every rep.
Do you do this?
And if so, is it to be seen handling a heavy barbell, or do you really believe that a big back arch (especially coupled with incomplete reps) will make you stronger and bigger?
Though an extreme back arch in a bench press is the norm for powerlifting competition (and training for such), many gym-goers arch their back for any reasons BUT training for a powerlifting competition.
Use lighter weights so that you are not tempted to arch your back when bench pressing.
People don’t care how much weight you have on the barbell as much as you think they do.
The next tip is to place both feet on the bench, legs bent, while lifting. You won’t be able to arch your spinal column this way.
Keep your feet on the bench for the entire set. The flat back will force your chest muscles to do much more work than if you arch your spine while your feet are on the floor.
Arching your back while bench pressing is called a muscle substitution pattern, and that’s exactly what it sounds like it is:
Some chest muscle fiber gets substituted out by leg and lower back muscles when the bench press is performed with an arched back.
When you bench press, do you want to build your chest/arms, or lower back and legs?
Lorra Garrick is a former personal trainer certified through the American Council on Exercise. At Bally Total Fitness she trained women and men of all ages for fat loss, muscle building, fitness and improved health.
.
Top image: Depositphotos.com
Why Obese Children SHOULD Lift Weights
If your child is obese, it’s SO SAFE to get him/her into weightlifting for fantastic benefits!
Obese children in particular will greatly benefit from lifting weights, and this article explains the details.
Obese children as young as seven years can begin a supervised weightlifting program.
As a former personal trainer I strongly endorse strength training for overweight children.
So does Mayoclinic.com; the site says that kids can begin strength training “as early as age 7 or 8,” and that “strength training can become a valuable part of an overall fitness plan.”
Before I explain the tremendous benefits of weightlifting for obese children, I first want to briefly dispel a few myths.
“Lifting weights will stunt growth.”
Wrong. Smoking and poor nutrition may stunt growth. Strength training will not disrupt growth plate development.
This myth probably arose from the fact that often, a gym’s most muscled guys are on the short side.
This is better explained by short stature inspiring a man to build muscle since he can’t grow taller.
“Lifting weights is dangerous for children.”
With proper instruction and supervision, kids are far less likely to suffer injuries from strength training than from supposedly “safer” sports.
A report from the Centers for Disease Control and Prevention states that playground injuries are the No. 1 reason children under 10 visited the ER between 2001 and 2009.
Think lifting weights is more dangerous than riding a bike?
For boys 10-19, bike riding was a leading cause of head injuries.
For girls 10-19 it was bike riding, soccer and basketball.
Head injuries are extremely rare in weightlifting.
But what about musculoskeletal injuries?
The Consumer Products Safety Commission reports that basketball, cycling, football and soccer — in that order, head the list (e.g., 500,000 injuries a year in soccer).
Of course, millions of young kids play these sports, while millions of young kids do NOT lift weights.
Absolute numbers aside, strength training is slow, involves no wheels or possible collisions with other athletes, does not involve airborne objects, has very little slip-and-fall risk, and does not involve running.
This structure alone makes it obvious that lifting weights is not a dangerous undertaking for young children, including the obese.
Lifting weights for overweight children can be very basic. Here are the benefits of weightlifting for heavy children:
Lowers risk of muscle and joint injury from “safer” sports!
Improves performance in other sports
Strengthens bones
Inspires healthier eating habits
Promotes better cholesterol profile
Burns fat, improves strength
Dramatically improves self-esteem
If you’re still reluctant to get your young overweight child started on a weightlifting program, remind yourself that your child probably already IS lifting weights — every time they take out the garbage, carry luggage, carry a younger sibling or give piggy back rides to playmates, shovel snow, help you carry some heavy boxes around, pick up the dog, etc.
Strength training for obese kids need not be complicated nor consist of the giant moves you’ve seen in the Olympics.
Check your local recreation center to see if it offers beginner’s classes, or speak to a personal trainer.
Also, weightlifting implements designed just for children are on the market.
Lorra Garrick is a former personal trainer certified through the American Council on Exercise. At Bally Total Fitness she trained women and men of all ages for fat loss, muscle building, fitness and improved health.
Top image: Freepik.com/jcomp
Sources:
mayoclinic.com/health/strength-training/HQ01010
mayoclinic.com/health/strength-training/HQ01010/NSECTIONGROUP=2
healthland.time.com/2011/10/07/kids-er-visits-for-head-injury-on-the-rise-%E2%80%94-why-thats-a-good-thing/
safety.com/articles/most-dangerous-sports
Does Lifting More Weight than Someone Mean You’re Stronger?
WHY the big gorilla who can lift more weight than you isn’t necessarily STRONGER!
If you can lift more weight, say in the bench press, than someone else, this doesn’t necessarily mean your chest and arm muscles are stronger than your opponent! I’m a former certified personal trainer and have observed some interesting displays of strength.
If you can deadlift 400 pounds and your buddy can pull 280, this doesn’t necessarily mean that you’re stronger in the deadlift.
Of course, it means you can deadlift more weight, and this would count in a competition. And it also looks more impressive to other gym members. But it does not mean you’re stronger at pulling!
It has to do with LEVERS.
Yes, there’s that taboo word again in the strength training community. If you have the same levers as your buddy, then yes, you truly are stronger with the deadlift or bench press.
However, levers often play a significant role in how much a person can lift. This isn’t about how “strong” a person is.
It’s about how much they can lift. These are not the same thing. Here is a very simple illustration that will make this crystal clear to you:
Imagine a very heavy rock on the ground. It is so very heavy that you must strain and grunt to place it on top of a 12-inch stool.
Now suppose your buddy has to pick up the same rock off the ground. However, your buddy’s assignment is to place the rock on an 18-inch stool. He can’t do it. He gets it off the ground, but just can’t get it up high enough.
In fact, he gets it 12 inches off the ground, but just can’t budge it higher and must drop it.
Does this mean you’re stronger than he is? Or does it mean that you had a smaller range of motion to work with? Hmmm.
Suppose your buddy’s range of motion was reduced to the 12 inches. With grunting and straining, he, like you, gets the rock up on the lower stool.
Unfortunately, change in range of motion (ROM) can’t occur this easily in powerlifting moves like the bench press and deadlift.
A person with long arms relative to their height won’t have to bend over as much to pick a heavy barbell off the floor.
An individual of equal height, but with a shorter wingspan, but everything else being equal (e.g., hip height from the floor, femur length), will need to bend over more and/or squat deeper to reach the barbell!
This means he has more ROM to cover!
The lift is harder for him. At the final stage of the deadlift, the man with the “T-rex arms” is holding the barbell higher off the floor than is the man with the “gorilla arms”!
The T-rex guy had to do more work and move the weight through more space:
1) Bend over more to reach the bar, stressing his low back with a greater range of motion once he grabs the bar and begins straightening, and/or
2) Squat deeper to reach the bar, and though his back may still be fairly upright if he compensates only with a deeper squat, the deeper squat means more work for his legs and glutes on the way up with the bar due to more distance for his legs to “unsquat.”
His pal gets to bend over just a little bit to reach the bar, with only a partial squat. This means less ROM once he begins straightening with the bar in his hands.
This does not mean he’s stronger than the T-rex guy. It means he can lift more weight. Do you see how this doesn’t necessarily mean that he’s stronger in the absolute sense?
If the leverages were matched, it’s very possible that the T-rex guy would be stronger, or maybe not, or maybe equal in strength.
It’s not over. When these two men bench press, the T-rex guy has the advantage with his shorter arm span.
This means his elbows don’t have to go down as far when he lowers the barbell to his chest (assume both men use the same distance between their hands on the bar).
His arms are so short, relative to his height, that by the time the bar is to his chest, the angle formed by his elbow flexion is only 90 degrees.
The gorilla guy, on the other hand, must flex his elbows to much less than 90 degrees, meaning, his elbows are closer to the floor; his arms are much more bent at the bottom of the lift.
He must press upward for a greater distance than the T-rex person.
That’s more distance to move the weight! As a result, he can only press the weight twice, since the greater distance covered completely fatigues him in only two repetitions.
The man with the shorter arms has less distance to move the weight; he takes longer to fatigue and can press the barbell 12 times. Does this mean he’s stronger?
Short arms mean he can lift more weight, but short arms don’t always mean greater strength.
He can press 400 pounds because the 90 degree angle of his arms minimizes the distance he must lower and raise the weight.
The deadlift champ can only press 275 because he must lower, then raise, the weight a greater distance. Is he necessarily weaker? No.
Recall the stool example with the rock to make sure you understand that levers (anthropometrics) often determine how “strong” a person is and how much weight they can pull or push.
Lorra Garrick is a former personal trainer certified by the American Council on Exercise. At Bally Total Fitness she trained clients of all ages for fat loss, muscle building, fitness and improved health.
.
Top image: Shutterstock/Ajan Alen
Can Cardio Exercise Make You Too Thin?
Never mind elite marathon runners, cardio exercise will NOT make you too thin.
The question has come up by fitness enthusiasts if a lot of cardio exercise can make a person too thin.
I’m a former personal trainer, and what makes a person too thin is that of taking in fewer calories per day than what one can burn.
Doing a ton of cardio, such as running 10 miles every day, will burn a lot of calories.
A person who does this needs to eat enough to subsidize this kind of training.
If they appear gaunt and too thin, the cardio isn’t to blame; it’s that of not eating enough.
However, if a person who does a lot of cardio appears to be too thin, this doesn’t always mean he or she isn’t eating “enough.”
Winners of the Boston and New York Marathon always look “too thin,” especially the men.
In order to be this skilled at such a strenuous event, these athletes need to be well-fed.
Pounding out 26 miles is extremely grueling on the body; an underfed body won’t last long in a marathon.
In fact, people have been known to drop out early in marathons simply due to dehydration.
A serious long-distance runner consumes quite a bit of food in order to sustain many hours of training week after week. Long-distance events require well-trained slow-twitch muscle fiber.
People who excel in long-distance running are born with a high amount of slow twitch fiber relative to fast twitch fiber.
Slow twitch fiber is designed for endurance, while fast twitch is designed for short bursts of power, strength or speed.
Because slow twitch fiber does not grow in size, the most prolific marathoner will still appear too thin; their muscle mass is small; the slow twitch fiber is highly efficient at duration, not speed or power.
Speed and power athletes do not appear “thin” because their sports require well-trained fast twitch fiber, which does grow in size.
So here’s something that will shock you: The body percentage of an elite sprinter is actually lower than that of an elite marathon runner!
The sprinter, however, is not “thin” because he or she has significantly more muscle development (fast twitch fiber).
As long as one eats appropriately, a lot of cardio will not make him or her too thin.
Lorra Garrick is a former personal trainer certified through the American Council on Exercise. At Bally Total Fitness she trained women and men of all ages for fat loss, muscle building, fitness and improved health.
.
Top image: Shutterstock/ShotPrime Studio
How to Get Rid of Fat Thighs: Strength Training or Cardio?
Hate your fat thighs?
You’re going to love the solution! Hint: It’s not endless grinding hours on cardio equipment or tricky dance moves in group classes.
If you had to choose between strength training or the same amount of time doing cardio, to lose fat in your thighs, do you know which it should be?
I do. I’m a former certified personal trainer who has witnessed with delight, over and over, the shrinking thighs of my overweight clients.
When it comes to losing fat in the thighs, strength training wins hands down.
This assumes that the strength training program is solid and utilizes proven fat-burning principles, as opposed to a lame approach that consists of little more than going through mere motions.
You will burn tons more thigh fat by performing the deadlift, squat and leg press than you will by using cardio equipment or attending cardio classes.
Shutterstock/kozirsky
Traditional cardio works slow-twitch muscle fibers because these are designed for duration and stamina.
Intense strength training works fast-twitch (and slow-twitch) fibers, but it’s the fast-twitch that burn more calories.
And that’s just the beginning as to why strength training beats cardio out at burning thigh fat.
Intense strength training, unlike standard cardio sessions, causes a significant after-burn: post-exercise elevated resting metabolism.
Freepik..com
So even hours after your strength training session has ended, you are still burning calories at an accelerated rate.
This translates to fat loss in your thighs (and everywhere else: overall fat loss).
To train intensely with weights, use a resistance that’s impossible to complete for more than 12 repetitions, but that allows you to do at least eight reps.
Next, stay away from the inner/outer thigh machines and instead, do the deadlift, squat and leg press.
These work major muscles, while the inner/outer machines tap into only smaller muscles.
Large muscle groups burn more fuel, and require more fuel to recuperate in the hours following an intense workout.
Shutterstock/B-Media
These three exercises work several major muscle groups at the same time, thus creating a huge fat-burning effect during, and after, the session is over.
Intensely working large muscle groups incites hormonal changes in the body that will crush excess fat.
This means a prolonged accelerated resting metabolism for up to 24 hours after the workout.
This hormonal response does not happen with long duration cardio, no matter how many days a week you do it.
Nor will it happen no matter how “hard” you work on the inner or outer thigh machines.
The Magic Is in the Deadlift, Squat and Leg Press
The deadlift is best done with a barbell. Squats are usually done with a barbell but can also be done with dumbbells or a single kettlebell.
Freepik
The leg press is done either with floor equipment or a horizontal apparatus.
When strength training is pitted against cardio for losing thigh fat, head for the heavy metal in the free weights area of the gym.
Lorra Garrick is a former personal trainer certified through the American Council on Exercise. At Bally Total Fitness she trained women and men of all ages for fat loss, muscle building, fitness and improved health.
Can Elderly Heart Failure Patients Benefit from Cardio Exercise?
An elderly person who’s been diagnosed with chronic heart failure absolutely must do aerobic exercise.
Doctors warn that the absence of cardio exercise is bad for the patient’s body.
If you’re over age 60 and have been diagnosed with heart failure, there is no better time to do aerobic exercise.
There’s NO such thing as a heart failure patient being too old to benefit from cardio exercise.
A study beats down any doctor’s recommendation that aerobic exercise is useless once a heart failure patient reaches a certain age.
The study (Gielen et al) concludes that cardiovascular-type exercise counteracts breakdown of cardiac muscle, reduces inflammation and increases strength—when these problems are caused by heart failure and old age.
Why should heart failure patients be exempt from the amazing benefits of exercise?
The paper points out that many doctors and insurance companies still believe that aerobic-type exercise is of no help in old age.
Though the paper was published in 2012 (Circulation), many cardiologists and primary care physicians continue to feel this way — or at least, barely mention exercise during patient routine visits.
Exercise Benefits
“Formal exercise testing in patients with heart failure is a powerful predictor of outcomes, with higher exercise capacity associated with lower long-term mortality rates,” says Roger Mills, MD, cardiologist and former professor of medicine, University of Florida, and author of “240 Beats per Minute. Life with an Unruly Heart.”
Dr. Mills explains, “Patients with both types of heart failure seem to respond to exercise training, although the data for HFrEF patients are much more extensive.”
How the Study Determined that Elderly Heart Failure Patients Should Do Cardio Exercise
- The study involved taking leg muscle biopsies before and after the four-week study course.
- The exercise involved 20 minute aerobic sessions five days a week, plus an hour-long group session.
- The subjects were both healthy and had heart failure, and some did the aerobics and some did not.
- The heart failure patients who did the aerobic exercise had a 25 to 27 percent improvement in peak oxygen uptake.
Heart failure but never exercised? How to get started.
Freepik.com
“If you have or someone you know has heart failure, how should you start exercising?” says Dr. Mills.
“By far the safest approach is to ask your doctor for a referral to a cardiac rehabilitation program, where patients start to exercise with careful supervision and learn to progress to greater independence over a couple of months.”
If the patient’s doctor has not spent much time talking about exercise, it may be because the medical organization the doctor works for has a separate department and specialists in cardiac rehab. Ask for that referral.
“Learning to warm up and cool down properly is critical to exercising safely,” continues Dr. Mills.
An elderly person who can barely walk for five minutes at a slow pace before tiring out still needs a warm-up.
Such a warm-up could be nonstop walking for just one minute, or marching in place for 30 seconds for a few sets.
“But the days of ‘Oh, you mustn’t do that!’ are over,” says Dr. Mills.
Dr. Mills is the former medical director of the heart failure and heart transplant service at the University of Florida, was a staff cardiologist at The Cleveland Clinic and has authored over 100 peer-reviewed publications.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
.
Top image: ©Lorra Garrick–
Source: sciencedaily.com/releases/2012/05/120507165341.htm
HOW Parents Can Find out if Their Child Is Being Bullied
Here’s HOW you can find out if your child is being bullied, whether it’s physical, verbal or online, regardless of age.
Don’t assume you can figure this out all on your own; many parents miss the boat with this one.
Sadly, it’s very uncommon for a victim of bullying to report this to their parents.
This is why parents need to be hyper-alert to signs of bullying, says Rona Novick, PhD, who developed the BRAVE bully prevention program.
She is a clinical psychologist, has worked with schools nationally on the issue of bullying, and is director of the Fanya Gottesfeld Heller Doctoral Program at Yeshiva University, NY.
One way a parent can discover clues that their child might be getting bullied is to (without pressure) make the child’s social world a regular area of discussion, says Dr. Novick.
This may seem like a no-brainer to any responsible parent, but the digital age has made this more difficult to accomplish.
Pre-Facebook and iPads, “When friends called the house phone to ask for your child, you knew who his or her friends were,” says Dr. Novick. “Now, a child can live their social life on their cell phones and computers!”
Parents Should Be Approachable
- Ask yourself if your child feels at ease initiating any topic to you.
- Ask yourself WHY you believe that your child would not be reluctant to share a problem with you: a bullying problem.
- Have you let your kids know they can come to you about anything without fear of judgment? This is exceedingly important, says Novick.
Other Signs of Bullying
“A child who wants to stay home from school on the day of a big test is of less concern (for bullying) than a child who wants to stay home from the field trip, or miss a friend’s party,” says Dr. Novick.
Additional signs that can mean bullying include regressive behavior (such as bedwetting), old habits returning (such as thumb sucking or hair pulling), clinginess and social withdrawal, says Dr. Novick.
Also be on the lookout for skin picking and skin cutting.
Though these can trigger harassment in the school setting, they can also be the result of bullying by peers.
Dr. Novick is recognized for her expertise in behavior management and child behavior therapy. She has published scholarly articles on school applications of behavior management, children and trauma, and bully prevention in schools.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
.
Top image: Shutterstock/SpeedKingz
Can You Get Aortic Valve Replacement with NO Surgery?
If you’re worried about “pump head” from the heart lung machine, there is now hope for people who need aortic valve replacement but cannot have open heart surgery.
“TAVR is the replacement of the aortic valve without cutting the chest open for replacing the valve under direct vision of a surgeon,” says Asim Cheema, MD, who’s board certified in internal medicine, cardiovascular diseases and interventional cardiology by the American Board of Internal Medicine. Dr. Cheema is with Your Doctors Online, an online doctor chat site.
TAVR is FDA-approved and makes it possible for patients who need an aortic valve replacement to have this done without the major invasion of traditional surgery, which includes the heart lung machine (cardiopulmonary bypass).
In this minimally invasive procedure, the heart remains beating while the damaged aortic valve is replaced.
TAVR stands for transcatheter aortic valve replacement.
No Heart Lung Machine
A team of highly skilled surgeons gain access to the patient’s heart via a small catheter that’s inserted into the skin.
The surgical team may consist of two interventional cardiolotists, a heart surgeon, a cardiothoractic surgeon and a cardiac anesthesiologist.
Replacement of the diseased valve is crucial for long-term survival.
The damaged aortic valve is replaced with a device that is made up of both a steel frame and animal tissue.
It’s fed into the catheter and then threaded to the heart, where it replaces the original, damaged aortic valve. The TAVR procedure takes two hours.
The replacement device is called the Edwards SAPIEN transcatheter and is quite strong.
It actually uses a portion of the patient’s diseased aortic valve to securely anchor in place.
Aortic Stenosis: Reduces Blood Supply
The situation that eventually necessitates surgical intervention is aortic stenosis (stenosis means narrowing), and primarily affects the older population.
This is a serious condition and is linked to a 50 percent increase in the risk of mortality from a heart attack.
Risk Factors for Aortic Valve Disease
- Age 65+
- Calcium deposits on the valve
- Lack of regular exercise
- Congenitally deformed aortic valve
- History of rheumatic fever
An echocardiogram and chest X-ray are among the tests that can detect this condition.
Your Doctors Online offers a free 7 day trial where you can ask a doctor questions online and get answers in minutes from anywhere 24/7. Learn more here. Dr. Cheema teaches and provides supervision to graduate students at the Institute of Medical Sciences, University of Toronto.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
Brain Bleed from Head Trauma: CT Scan vs. MRI
Why are CT scans used so much more than MRI’s for suspected brain bleeds from head trauma when CT scans emit lots of radiation?
MRI vs. CT Scan for Suspected Bleeding in the Brain
The MRI may very well win over the CT scan for people who hit their head or otherwise experience mild brain injury from blunt force, says a study from the University of California, San Francisco and the San Francisco General Hospital and Trauma Center.
Both my parents have fallen and hit their heads: my mother twice and my father once.
All three times, they got CT scans in the emergency room. The CT scans (in the ER and next day) for my mother’s first fall were normal.
For the second fall, the ER and next-day scans were also normal.
However, six weeks after the second fall when my mother developed neurological symptoms, the CT scan showed a brain bleed. My father’s ER and next-day CT scans were normal.
At the time of me writing this article, he is still within the “incubation period” for a brain bleed to develop, and I’m on the lookout for neurological symptoms.
MRI?
The UCSF study followed 135 people over two years who had mild traumatic brain injuries.
They had CT scans. The CT scans for 99 were normal. A week later all the patients had an MRI.
Out of those 99, 27 had MRI’s positive for a brain bleed.
I’ve always wondered why MRI was not used for my parents.
I figured this was because MRI’s take longer, but why should this matter if my parents had not exhibited alarming neurological symptoms in the ER? Why isn’t MRI the standard?
Perhaps an emergency room MRI could have shown the brain bleed in my mother that began generating symptoms six weeks later!
“Having a normal CT scan doesn’t, in fact, say you’re normal,” states the research paper.
In-Depth Comparison of MRI vs. CT Scan for Head Trauma
MRI scanner. Mj-bird, CC BY-SA 3.0/creativecommons.org
“When a doctor makes decisions on how to treat a patient, they are always weighing a risk/reward profile to determine what is the best option for the patient,” says Scott Schultz, MD, a board-certified emergency medicine physician.
The answer to, “Why aren’t MRI’s used instead of CT scanners for head imaging in the emergency room?” is multi-factorial.
Dr. Schultz points out the following logistical reasons.
• Some ER’s actually don’t have an MRI machine.
• “Even when a hospital does have a machine, they are quite often not available quickly,” says Dr. Schultz.
• If the patient comes in overnight, there may not be an MRI technician available.
• “The CT scanner is usually placed directly adjacent to the ER for emergency use.
“If there is another routine scan scheduled for the CT scanner, the ER patient will take their spot if it’s an emergency.
• “MRI’s are usually located in locations like the basement,” due to their heaviness, plus “their large magnet can disrupt other machines if not shielded appropriately.
• “If a physician is concerned enough about a patient to get imaging for intracranial hemorrhage, she would most likely consider them unstable, and they will need to be close to us in case something bad happens.
“In the basement, where you cannot have a lot of necessary equipment in the room because of the big magnet, is not a good idea.”
Dr. Schultz also says there are patient and doctor centered reasons for why the CT scanner is the mode of choice, despite its radiation.
A small number of people can’t tolerate the MRI’s enclosure.
“Patients with intracranial hemorrhage are likely not to be completely coherent, and this makes it difficult for them to lay still for the MRI.
“You typically wouldn’t want to medicate a patient before knowing the status of the brain.”
What about radiation risk?
“Radiation risk is real, but very very small,” says Dr. Schultz.
“It’s estimated that it causes cancer in about 0.01% of pediatric patients who get a CT scan.
“This is definitely a horrible risk, and is not taken lightly, but relatively speaking, very rare.
What about a CT scan missing a diagnosis that an MRI might pick up?
“CT scans are very accurate,” says Dr. Schultz.
“If there is a lesion of any significant size, it is almost always going to pick it up.
“But if the physician still is concerned, they will admit the patient to the hospital and monitor their status.
“If the patient continues to have concerning symptoms in the future, the hospitalist will typically order more testing, usually an MRI.
“Remember, in the ER, the No. 1 priority is to determine if there is an issue that needs immediate action to be taken.
“Do I need to call in a neurosurgeon tonight because the patient has a leaking aneurysm?”
No MRI Phobia, No Acute Rapid Symptoms
What if the patient got hit in the head two months ago, rather than two days ago, and thus, the new symptoms would suggest a slow bleed rather than a rapid one?
And what if they don’t have an MRI phobia?
Dr. Schultz explains, “If all other things were equal (speed, resources and financial), an MRI would most likely be preferred, but just marginally.
“But that isn’t how the sausage is made, if you will. The patient who presents like this is going to be elderly.”
A younger person who experiences the same head impact will not acquire an insidious brain bleed because their brain is bigger {less room for veins to get torn).
“The chances of cancer in their [elderly] lifetime from radiation are incredibly small.
“So even with no logistical issues, the choice could be a coin flip in my mind.
“In reality, all the previous limitations of MRI’s are real and a huge pressure on ER physicians.”
UPDATE: My father was discharged in a timely fashion as his neurological symptoms faded, and he never developed any delayed new neurological symptoms.
The MRI vs. CT scan report is in Annals of Neurology (Dec. 2012), led by Esther Yuh, MD.
Dr. Schultz worked for 5+ years at a level 1 trauma center at the University of Missouri. After witnessing deaths from overheating in the ER, he’s been devoting his life to the prevention of heat related illness. His app, Zelus WBGT, alerts users when it gets too hot outside to continue their physical activity.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
.
