Category Archives for Uncategorized

Just Say No to Rotator Cuff Tears; Keeping Active Shoulders Healthy

 Fall is here, and with it comes great weather, which has many Triangle-area residents are out enjoying all sorts of physical activity, from golf and tennis to gardening and fishing. While these activities promote health, relaxation and all around fun, many people find themselves plagued with recurrent pain and soreness around their shoulder.  What could be causing this pain, you may ask? Rotator cuff tendons. 

Often thought of as an issue that only affects baseball pitchers, rotator cuff problems are actually far more common in active adults.  Certain physical activities, such as the ones mentioned above, can place excessive stress on the rotator cuff tendons. These activities often involve repetitive overhead motions, sudden deceleration of the arm, or loading the shoulder with resistance in extreme positions, such as behind the back.  This can lead to tendonitis, or painful inflammation and swelling of the tendons, as well as more serious problems like an actual tendon tear.  Understanding what can cause rotator cuff disorders and what can be done to prevent them may help you avoid prolonged periods of discomfort and the need to take a break from your regular activities or exercise routines.

Following are some suggestions to help keep your rotator cuff tendons in check and avoid problems throughout the dog days of summer:

• Listen to your body.  High-level baseball pitchers are taught to never ignore pain in their shoulders.  You should do the same.  If you experience pain while engaging in an activity or into the next day, take a break for several days and do something less stressful on the shoulder.  This may involve modifying your activities on a long-term basis.
• Avoid activities that force you to place the shoulder in extreme positions, particularly if any weight or resistance is involved.  This includes doing things like overhead presses behind the neck, pushups where you touch the floor with your chest, and certain extreme yoga positions.  The twisting force on the tendon fibers can cause small tears, which may ultimately progress to larger tears with repetitive activity.

Incorporate regular low resistance / high repetition rotator cuff exercises into your regular exercise routine.  Gentle and focused strengthening of the rotator cuff can go a long way to preventing injury.  Programs that you can do at home can be found on the Internet, or consider investing in a few visits with a physical therapist who can teach you safe and proper.

Don’t Let Knee Pain Bring You Down

Knee pain is a common, yet frustrating part of getting older, which often keeps baby boomers from maintaining the active lifestyle they’ve come to know and desire. More than 60 percent of people age 45 and older experience periods of moderate knee pain at least once per year.  Whether your knees ache when getting out of bed, going up the stairs, tending to the yard or during a morning mountain biking session, how can you make sure that these aches and pains don’t get the best of you?

When people go to their orthopedist for knee pain, the physician will usually look to see if the person has muscle imbalance around the knee. In my practice I find this tightness and imbalance to be the main underlying contributor of knee pain in approximately 85 percent of patients.

How can you best avoid knee pain?

• A simple program of focused stretching for the quadriceps and hamstring muscles done 3-4 times per week is very effective and can often completely alleviate certain types of knee pain in just a few weeks.  Studies show that large muscle groups like the quadriceps are best stretched when held for 30-45 seconds rather than in short bursts.  A physical therapist can be helpful in providing you with a solid home stretching program.
• Simple lifestyle modifications, including maintaining a healthy weight, engaging in exercises that are easy on the knees, such as swimming or cycling; and incorporating a stretching into your weekly routine can help keep your knees in check, and “tuned up” over time.

Let’s Go Retro: The Benefits of “Free Play”

“Free play.”  I haven’t heard that term since my days at summer camp.  However, it is a term we should to add back into our vernacular, and this especially rings true for young athletes.

Several studies have recently shown that young athletes who engage in “free play” are less likely to suffer a sports-related injury. In today’s day and age, many teens now focus their efforts on one single sport and play it year-round.  However, research demonstrates that these single-sport athletes are less likely to engage in “free play” or recreational sports. Research continues to demonstrate that participating in a variety of sports – competitive and/or recreational – can help prevent sports-related injuries.  This may be due to building up resistance in muscles that aren’t regularly engaged by playing just one particular sport.

How can you or your child incorporate “free play” into the daily routine?

• Warm up for your sport de jour by working other muscle groups or engaging in other “sports.” For instance, take to the tennis court and hit a few balls before swim practice.
• Partake in a recreational game or activity to spice things up. Shoot hoops with friends or take a cardio-kickboxing class.
• Team up with a friend and share your athletic interests.  If you have a friend that’s an avid runner and you are an expert softball player, teach each other a thing or two. Head for the running trails one morning and the next day visit the batting cage.
• If you have athlete friends who play a different sport than you, reach out and give what they do a shot.

Rules of the Road: Tips For Staying Fit And Keeping Joints Healthy Through Running

Running is one of the most common forms of exercise, among elite athletes and regular, fitness conscious people alike. Whether you jog three-to-five times a week to keep active – like myself – or you regularly train for ultra-marathons, there is always that underlying risk of injury. Runner’s knee, Achilles tendonitis, shin splints, plantar fasciitis, stress fractures, hamstring issues – all common injuries we don’t like to say out loud, but unfortunately are often associated with running.

However, no need to hang up your running shoes yet. Following are key tips for safe and healthy running:

• Support means everything. This comes from both the shoes you wear and the terrain on which you run. Having the right support in your running shoes is key. Be sure to take note if you are arched or flat footed, then do some research on the best running shoe for you. A lot of specialty running stores, like Fleet Feet Sports here in Raleigh (where I go), can help determine the right shoe for you. You should also consider where you will do the majority of your running. If you run on hard ground such as concrete, you will probably need more cushion than you would should you choose to mostly run in grassy and soft-grounded trail-like areas. The “give” of the terrain plays a major role on how your joints react to the impact of your strides.

• Listen to your body. Even the most experienced runners can still experience sharp pains brought on by joint fluctuation and agitation. This is especially common in knees. Although hips have a smooth ‘ball and socket’ joint and ankles are designed to accommodate impact and rotation, knees tend to fall short in the functionality department. Cartilage and tissues can rapidly wear down from over-exertion and lack of support and stability. Make sure you rest between runs and stretch liberally during your warm-up and cool-down.

• Cross-train. From preventing and rehabilitating injuries, to improving overall fitness, cross-training is key. Supplement your running with strength training, swimming, biking, yoga – whatever tickles your fancy.

• Jump on the yoga bandwagon. Yoga helps strengthen your core and makes you more flexible – two elements that can keep you running injury-free.

Keep these tips in mind the next time you lace up and hit the streets or trails. Happy running!

Battle of the Medicine Cabinet Treatments: Ice Vs. Heat

A common question I get in my practice is whether it is better to use ice or heat when treating an injury. The simple answer is that both ice and heat can be beneficial in treating an injury at different times. But determining which one to use can prove quite confusing. Following are my top-line guidelines:

• Ice is generally used after an initial injury to help prevent inflammation, swelling and pain. It can also be used to treat a “flare up” of an older injury following physical activity. Ice cools the injured muscle and tissue by limiting blood flow and provides a direct numbing effect to sensitive nerves.
• Heat – in the form of a heating pad, warm towel, or hot shower or bath – is best used to treat older injuries that have begun to heal. Since heat improves blood flow to an area, it is used to “soften up” sore, stiff muscles or joints and “warm up” the injured area prior to exercise or activity.

As a general rule-of-thumb, consider applying heat before exercise to encourage blood flow, thereby allowing the injured area to move more freely. Following exercise, use ice to treat any swelling or irritation the activity may have caused.

New Research Reveals 1.35 Million Youths A Year Obtain Serious Sports Injuries

With fall sports back in full swing, hundreds of thousands of Triangle-area youth and their parents are thinking about how they can avoid injury and stay in the game all season – whether it be football, soccer, volleyball, cheerleading, lacrosse or cross-country.

Last month, USA Today highlighted results from a study conducted by nonprofit advocacy group, SafeKids Worldwide, which found that more than 1 million youths a year obtain a sports injury serious enough to send them to the ER. The most common types of injuries include strains or sprains, fractures, contusions and concussions. And football (394,350 injuries), soccer (172,470 injuries), volleyball (43,190 injuries) and cheerleading (37,770 injuries) rank in the top 10 sports associated with the most injuries. These sobering statistics leave many wondering how common sports-related injuries can be prevented.

What’s interesting is that teenage athletes are injured at about the same rate as professional athletes, but injuries that affect high school athletes are often different from those that affect adult athletes, primarily because teens are often still growing. High school sports injuries can also cause lasting problems that require surgery as an adult and could lead to arthritis later in life. I see this in my practice everyday – people who have sustained injuries in high school or college that required surgery often end up feeling the effects of these injuries as they get into their 40s and 50s – at a time when they are trying to re-enter exercise for health and vitality reasons and are now limited in what they can do.

However, “athletes” of all kinds – from kids to aging weekend warriors – can significantly reduce their risk for injury and ensure they stay in the game all season. Warming up and cooling down before and after engaging in a sport, staying hydrated, incorporating strength training and stretching into the mix and cross-training to avoid overuse injuries are just a few simple steps people can take to decrease their risk of falling prey to injury.