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Healthy Advice for Navigating
the Hazards of an Active Lifestyle
Kevin Cronin, PT, ATC, JSCC
Many experts agree that regular physical activity is the best medicine for improving and maintaining one's health. The challenge for most of us who are either currently engaged in an active lifestyle, or considering one, is to find activities that are at least somewhat enjoyable while at the same time safe and effective. Regardless of our exercise preferences, it is important to learn how to avoid injury during our noble attempts to stay fit and healthy. When injuries do occur, however, we need to be able to recognize potentially serious problems, and know where to turn for valuable assistance.
First, to avoid injury, let's consider some general guidelines for exercise. Whether you walk, run, swim, lift weights, do aerobics classes, martial arts, or yoga, listen to your body...DON'T STRAIN!!! Injury can usually be avoided if you start slowly, build gradually, and use proper form always. If you aren't sure what proper form is, seek the advice of a licensed physical therapist or a personal trainer with a degree in exercise physiology. They can design a safe program for you and show you how to do it.
When an injury does occur, how do you know if it is serious, and what should you do about it? Most of us, when we feel joint or muscle pain, prefer to "wait it out", to see if it will "go away". If the pain you feel is just muscle soreness, it will go away, usually within a week or less. Pain that persists for more than a week, pain that "shoots" down an arm or leg, or across the low back and hip, weakness or numbness in an arm or leg, severe pain with motion, or consistent limping ARE SERIOUS PROBLEMS that require IMMEDIATE ATTENTION! Don't wait until it is too late. Failure to seek help when a serious problem exists can result in permanent disability. Don't risk it!
So what do the typical injuries that active people encounter feel like, and what can you do about them? Most painful conditions are the result of overuse, doing the same motion over and over without proper rest or stretching. Tendinitis is an example of an overuse syndrome that you have probably heard about before. Tendons are the cord-like structures that connect muscle to bone. When a joint is stressed with heavy, repetitive motion, the tendon itself can become inflamed, swollen and irritated. Some examples are:
- Rotator cuff tendinitis is usually the result of repeated throwing or swinging the arm overhead such as in volleyball or tennis. Pain is felt in and around the shoulder joint.
- Patellar tendinitis occurs with repetitive jumping, as in basketball or volleyball, and is felt on the front of the knee, just below the kneecap(or patella).
- Plantar fascitis is an irritation of the muscles on the bottom of the foot, near the heel. This condition is often blamed on a heel spur, which can be seen on an xray, but heel spurs are also present in many people who have no heel pain and never did. Surgery to remove the heel spur is usually not the answer, as the results are poor, at best.
- Tennis elbow or golfer's elbow are tendinitis conditions of the muscles that attach to the bones on the inside and outside of the elbow. Often referred to by medical practitioners as epicondylitis, you don't have to play tennis or golf to get these. Gripping a racquet tightly, using a screwdriver, typing, computer mousework, and carrying heavy bags can all contribute to epicondylitis.
- Shin splints is a painful, tendinitis-like condition felt along the front of one or both shins. It is usually the result of running on hard surfaces, especially when running longer distances than your body is used to, or running for the first time in a long time, and overdoing it.
All of these tendinitis conditions usually respond favorably to rest, ice, and stretching of the affected area. A doctor may inject the area with cortisone, prescribe anti-inflammatory medication, or suggest taking ibuprofen to decrease the inflammation. Injections and medication do not replace rest, ice, and stretching. Strain and Counterstrain is also very effective with many of these conditions, and was discussed at length in segment one and two of this health series. For more information about Strain and Counterstrain call The Jones Institue at 760-942-0647.
Lesser known, but very effective alternative interventions are magnetic technology and augmented soft tissue mobilization. Magnetic technology helps to decrease the discomfort and speed the recovery process, often working as well or better than medication or injections, but without side effects. The Japanese have perfected magnetic technology, developing many safe products that seem to work quite well. To learn more about magnetics, two good internet resources are www.5pillars.com and www.nikken.com. Augmented soft tissue mobilization or A.S.T.M. is a deep, soft tissue technique to break up scar tissue (fibrosis) and encourage the regrowth of healthy tissue. To learn more about A.S.T.M., call Performance Dynamics at 1-800-333-0244.
Back pain/Neck pain
Nearly 80% of the population will suffer with low back pain at some point during their lifetime. Neck pain is affecting a growing number of people with the advent of computer use. Most of the time low back and neck pain diminishes in a week or two, and is forgotten. When low back pain or neck pain is recurrent, with episodes two or more times a year, seek professional help before it gets worse. A simple xray can rule out conditions like degenerative arthritis or degenerative disc disease. In the absence of these conditions, the low back or neck pain is usually soft tissue related, and is best treated by the soft tissue experts, the physical therapist, naprapath, or chiropractor. A thorough Strain and Counterstrain evaluation can save you time and aggravation, and if treatment is indicated, get you back to functional activity more quickly. Be sure to review with your medical professional the activities you participate in and the postures you work in to eliminate sources of irritation.
Low back or neck pain that refers pain or numbness/tingling to the leg or arm might be related to a bulging disc, and should be evaluated by an orthopedic surgeon or neurosurgeon specializing in low back or neck disorders. If disc surgery is recommended, a second opinion will confirm the need for surgery. If surgery is not indicated, the disc can be treated conservatively in physical therapy, preferably by a McKenzie trained therapist. The McKenzie evaluation and treatment method is specifically designed to treat non-surgical disc problems. Combining Strain and Counterstrain with Mckenzie therapy is ideal for treating disc disorders. Ask for a physical therapist who can provide both.
Contact the McKenzie Institute at www.mckenziemdt.org for more information.
Rotator cuff tears
The rotator cuff is a combination of muscles and ligaments around the shoulder that support and move the upper arm. A torn rotator cuff can make it painful to lift your arm up, push, pull, or reach behind you. If you have difficulty lying on the affected shoulder, or if you have pain even at rest, seek help! An orthopedic surgeon specializing in sportsmedicine can confirm the diagnosis.
Knee injuries
Pain with squatting or climbing up and down stairs, accompanied by a loud "crunching" noise in the knee is likely chondromalacia, a roughening of the underside of the kneecap. Physical therapy for strengthening and stretching usually alleviates the pain. When it doesn't, arthroscopic surgery by an orthopedic physician will smooth out the rough spots.
Twisting injuries to the knee can sometimes damage the meniscus or cartilage inside the joint. If your knee locks up painfully, or will not bend or straighten completely without pain, consult with an orthopedic surgeon to rule out a torn meniscus.
Damage to the ligaments deep inside the knee joint are the most serious types of knee injuries. A torn anterior cruciate ligament, or ACL, usually results in knee instability, or "giving way" when trying to turn or change direction with weight on the leg. Reconstructive surgery can be done to replace the ligament, followed by a physical therapy rehabilitation period of 4-6 months.
If you are experiencing any of the symptoms listed above, seek professional advice. Many private practice physical therapists offer free injury assessments, where they will evaluate your condition and advise you of your options. For active individuals, a physical therapist with orthopedic experience and a working knowledge of Strain and Counterstrain is best equipped to assess your situation and point you in the right direction, because they will know who the best specialists in orthopedic and neurosurgery are for your particular condition, and can refer you to them. For a listing of private practice physical therapists in your area, contact your state chapter of the American Physical Therapy Association (e.g., Illinois Physical Therapy Association).
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