Inside Sports Center

This is Inside Sports Center

Welcome to Inside Sports Center - the online information and connection source for Sports Center clients helping them lead an active, athletic lifestyle.

Here, we'll talk about how we help you live life fully; how to get past injuries or surgeries and pour yourself into a lifestyle that embraces the life-enhancing effects of vigourous exercise; how we use what our friend and former client, Nick Grant, PhD, refers to as our "wisdom system": The Sports Center Training System.

We invite you to become a part of the discussion. By posting your comments, ideas, experiences and insights for others to read, you help build a health oriented, live life to the fullest community!

A Game of Grid Iron

Hi Doug,

in a game of gridiron i was hit in the knee by a defender. The report from the MRI had a couple of things in it that the doctors didn't explain very well.

"The pattern of injury is very suggestive of lateral patellar dislocation/relocation. The configuration of the patellar and the corresponding shallow femoral sulcus are likely to be predisposing factors."

"A 6mm loose body is noted in the medial suprapatellar pouch. The donor site is likely to be from the patellar cartilage. Small effusion noted"

Two questions: is it likely that my other knee has the same "structure" (ie. shallow femoral sulcus) as the one that was examined by the MRI? and is the 6mm loose body a concern/how do I get rid of it?

Also, I've been told that I'm going to need a patello-femoral joint reconstruction. Is 5.5 months long enough for recovery before I get back to training camp?

Cheers,

Tim
**************************************************************************************************** Tim,

Yes, there's a good chance that your other knee will have the same or similar structure - shallow femoral sulcus. A loose body, in your case, is the chunk of cartilage broken off the under side of the patella. The only way to get rid of it is through surgery. The fragment may irritate your joint causing intermittent swelling and pain. In terms of recovery time, it's hard to say without seeing you and testing your leg. I know five and a half months seems like a long time but often, it is 9 months or more when there is a cartilage injury.

Preachin' to the Choir

Dr. Kelsey,

Maybe it wasn't my meniscus, but this is my story and I have told it many time to all who will listen.  I'm so thankful that Dr. Davis sent me to you, instead of following the advice of the Doc who read the film.  Thankfully, in my case, you're preachin' to the choir.  Loved last weeks View, also.  Very interesting stuff.

Thanks again,
Melanie

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Hi Melanie -
Thanks very much for the note and the kind words. All of us at Sports Center are very pleased with how well you're doing. Just keep it up!

Exercise Training Question

Hello,
Your advice on your website and in your "Fat Burning 101" dvd, and in your strength training cd have made me very aware of strength training myths from bodybuilders and personal trainers, and you've led me to books by McGill, which have made a big change in my "don't do" list. The talk/sing test has been very helpful and simple. You should self-publish a book!
Do you have any other references for strength training, or other exercises that are essential besides the planks, bird-dogs, pushups, one-legged squats (these have saved my knees and increased my glute strength--I never would have guessed!)?

Thank you,
Mike
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Mike -

Thank you for your note and kind words. I'm pleased you find our resources helpful and that you have improved your physical function.

There are a number of great resources for exercise information. One of my favorite texts is by Tudor Bompa. This text does a great job of explaining how to design training regimens. The Chek Institute has some interesting ideas as well.

There are thousands of exercises, drills, etc. to choose from but the issue is what are you trying to accomplish? Then, the exercise prescription becomes paramount. Strength, endurance, balance, coordination, cardiovascular, power, speed, etc. require slightly different mixtures of repetitions, sets, resistance, and fatigue levels as I discussed in the strength training CD.

Keep up the good work.

Foot Pain After Tennis

Hi

I am 41 yrs. old and in relatively good physical shape (5'10", 155lb).  I play a little tennis and softball, walk, etc.  I was playing tennis at the National Kidney Foundation's Transplant Olympics (I had a kidney transplant 16 yrs. ago) when my foot "popped" and I believe I tore a tendon under my foot.  Prior to this I'd been having trouble for about a year with Plantar Faciitis.  After about 2 months of Physical Therapy and no sports, it improved.  Unfortunately, I now experience pain throughout my entire foot, not just in the arch and heel.  It feels like the bones in my foot just can't support my weight.  Touching my foot causes me no pain.  I feel a great deal of pain throughout the sides and top of my foot when I bear weight on it.  Needless to say, simple walking is a chore.  I am soo disappointed about this.  I want to be able to play tennis and softball and hike and walk my dog for years to come.  Any suggestions what might be going on and what I could do to improve the situation.  I had xrays this summer, after the tennis injury, which confirmed no broken bones.

Thanks for any advice!
Adrienne
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Hi Adrienne -

It sounds to me like you have an unresolved tendon or ligament injury to your foot. Sometimes plantarfasciitis, once the pain subsides, will leave your foot in a weakened state unless you specifically rehabilitated it. These types of injuries need prescriptive exercise to promote tissue healing and strength. The ligaments and tendons of your foot must be stressed in the manner in which they will be used so exercises like curling your toes or stretching your foot typically yield unsatisfactory results once you begin using your foot in daily activities or try to jog, play tennis, etc. We solve this problem by using special equipment that reduces the force on your foot while you perform such exercises as squatting or running (click here to see our invention that makes you weigh less while you run on a treadmill). If you would like us to examine your foot and give you an opinion, please call our office at 512-206-0433. We would be happy to help you.

Knee Pain From Running

Dr. Kelsey,

I came across an article you wrote on January 9, 2005 while looking for information on Patellofemoral syndrome and had a question. I am training for a marathon (this is my first and only), and have recently been having really bad knee pain. It used to be limited to just when I run, but now is continuing on for days afterwards, especially after my long training runs. It now hurts to walk, lift my daughter sometimes, the most is when I have to walk down stairs. Sitting for a long time or crossing my legs hurts, and I don't know what to do. I went to the doctor today and she told me it sounded like patellofemoral syndrome. I thought I came across some great info when I stumbled across the about.com article you referenced, and felt ridiculous when I read yours. I asked a friend at work who has run several marathons and he suggested taking some time off and alternate using ice and heat. I am a Marine and am on my feet almost all day, have been running for a couple of years, and I don't want to take too much time off b/c I do want to finish the marathon at the end of the month. Could you recommend something to help? My husband suggested going to the gym and doing strength training, but I don't have time for the gym. Are there exercises or stretches I could do at home to help? I would appreciate your help.

Thank you,

Emilie

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Emilie,

I'm sorry to hear about your knee pain and can understand your worry and concern. From your description it sounds like you injured the articular cartilage - the cartilage that lines the end of your bones. I suggest contacting a physical therapy practice in your area and ask about how they handle an articular cartilage injury. Until then, read this article or consider purchasing our CD on Runner's Knee for more information about cartilage injuries.

Request from Men's Health Magazine

Anna M. Maltby of Men's Health Magazine emailed Dr. Kelsey with a question that some of her readers had regarding back pain from sitting too long. Here's her question:

"How can I keep my back from hurting when I sit for a long time"

Dr. Kelsey's reply is below:

The answer to "How can I keep my back from hurting when I sit for a long time" has a few components. I'll break it down for you and if after reading it, you have additional questions, please feel free to call me.

The most common reason you hurt from sitting is increased pressure on the annular wall of the intervertebral disc. The disc is like a cushion between two bones of the back and is made up of an inner gelatinous substance (nucleus) and an outer ligamentous tissue (annulus).  Sitting places high levels of pressure on the disc and causes a stretching of the annulus and since the annulus has a nerve in it, you can hurt if the stretch is too much.

Butt amnesia is a term I use to describe weakness and atrophy of the gluteus maximus muscle. This muscle, when working properly, helps "share the load" with the spine. With a sedentary lifetsyle (now classified as taking fewer than 5000 steps per day), this muscle can whither away from lack of use. And, sitting causes the hip flexors to become tighter which tends to aggravate the gluteal weakness. Some people, who for example work at a desk job, think that by going to the gym three or four days per week, that they are not sedentary but unless you are getting at least 5000 steps per day, weight lifting at they gym may still place you in the sedentary category.

To reduce the pain in sitting:

1. Get up from the sitting position for 3-5 minutes each hour. I often suggest using a digital timer. Set it for one hour. When it goes off, re-set it, get up and take a brief walk. This will greatly reduce the accumulated pressure in the spine.
2. Use a small pillow or other support in the lower part of the back (between the back and the chair). This will shift some of the force to other parts of the spine instead of most of it going directly to the disc.
3. Use a chair that has a reclining feature. Once an hour, tilt the chair back and rest for 3-5 minutes (if you are getting up and moving around, you do not have to do this also).
4. Buy a pedometer to find out exactly how many steps you take in a day and shoot for 10000 .(http://www.amazon.com/Omron-HJ-112-Digital-Premium-Pedometer/dp/B0000U1OCI/sr=8-1/qid=1160059617/ref=pd_bbs_1/102-2981924-6995346?ie=UTF8&s=hpc).

The key is to reduce the pressure of sitting and move intermittently. Your spine was built for movement; not to be stationary for long periods of time.

You must also rehabilitate the weakened gluteal muscles. I gave some tips for this in the article I wrote. Your readers may also want to contact a physical therapist for more detailed information.

Can You Help My Shoulder Pain?

I was in the lab this morning working with a few clients and checked one woman who was walking on a treadmill using one of our Newton Speed Trainers. She had come to see us for a knee problem. I asked her how things were going - inquiring about her knee - but, she replied that she was having some trouble with her workout routine at the gym. I asked her what she meant and she said, "Well, I have had to cut back on my shoulder exercises. I am down to about 3lbs. now."

I replied, "That's because your shoulder hurts?" She immediately said yes. After visiting with her a few minutes, I explained what I thought might be the problem and she asked, "Is there anything that can be done about it?"  I explained to her that we could very likely help her. She seemed genuinely surprised and pleased.

I realized then how many other people are probably wandering around with some ache or pain laboring under the misdirected illusion that they just have to live with it. Time to get the word out to my friends. Hall of famers, spread the word.

Pain Relief from a Flower?

Arnica is a topical cream used to reduce pain, aching, and bruising. It's made from the flower, arnica montana. In the topical form, there are no known side effects although some people may experience skin irritation with prolonged use.

Apply a thin layer of the cream to the painful region two to three times per day for temporary pain relief.

In Austin, you can find Arnica at Whole Foods Market or Central Market.

Theraband for an Ankle Sprain?

I ran into someone a little while ago and when he learned I was a physical therapist, he asked me about ankle sprains. The conversation centered on his inability to run since he had sprained his ankle. He asked about how we help people run again after an ankle sprain and when I explained it, he said, "So, you don't use those rubber band exercises? I thought everybody used those." He was referring to Theraband, the wide rubber exercise bands.  Here's why we don't use it for an ankle sprain.

Ankle sprains account for 20% of the injuries in an active, athletic population with a re-injury as high as 80%. The conventional rehab approach is a mixture of stretching and exercises with Theraband. The band is attached to your foot and you move your foot up and down, side to side and maybe spell the alphabet too.

While these exercises are not necessarily a waste of time, they should serve as a vehicle to more functional drills (on your feet). One of the reasons clinicians use these types of exercises is that any other type of exercise, where you're on your feet, hurts. So, out comes the rubber band.

Following an ankle sprain, you have to get on your feet as soon as you can while controlling the forces in and around your ankle. Your body has to learn how to control the motion and react in milliseconds to sudden changes in position. The only way this happens is training on your feet.

This is why we use special equipment we invented to reduce the force through your foot while you exercise on your feet. This machine, one of several different tools we use, makes you weigh less. Less weight, less pain. Find the right amount of weight that the injured tissues can withstand and you can run pain free.

So, can you see why we don't use the Theraband exercises? Who wants to spell the alphabet when you can run?

Neckonomics

We just completed our free lecture, "Neckonomics: Solve Your Neck Pain Without Breaking the Bank." With a full house, there were several good questions from the audience:

1. Of all the natural anti-inflammatories, which one should I start with?
2. Which position is best for the neck?
3. Is it ok to take an anti-inflammatory before I go to the gym?

Natural inflammatories include bromelain, an enzyme found in pineapple. Bromelain has been found to be an effective anti-inflammatory (similar to Advil or Aleve) with no known side effects. Suggested dosage is 500 mg, three times per day for two weeks. Some people who are sensitive/allergic to honeybee venom, latex, birch pollen, carrot, celery, fennel, cypress pollen, grass pollen, papain, rye flour, or wheat flour may also have an allergic reaction to Bromelain. If you have any signs of an allergic reaction, stop taking Bromelain.

The best position for the neck is one that creates balance between the head and the body.

1. Sit on the edge of chair and sit up tall and as straight as you can.
2. Take a pencil and hold the eraser end on your cheek bone just below your eye.
3. The other end of the pencil should point directly at your upper chest or sternum (sometimes referred to as the breastbone). If you extend an imaginary line from the end of the pencil, that line should run directly into the breastbone (notice in the image how far forward the red line is from the woman's upper chest - this is too far).
4. If the pencil's imaginary line extends farther down your body, you are not sitting up straight enough.

I answered the final question with a question. "Would you be able to go to the gym and do your workout without taking an anti-inflammatory?" If you must take an anti-inflammatory in order to exercise, you should change your exercise routine such that you can perform it without symptoms. In some cases, you'll need professional help to create such a routine.

Our next lecture is September 19, 2006 covering the topic of shoulder pain. See you there!