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Seeking Help for an Injury at Any Price

I just read an interesting, but distressing article with the same title as this blog entry in the July 23^rd New York Times - Thursday Styles section    by Gina Kolata

Gina is a long-distance runner who tore her hamstring - the muscle on the back of the thigh.

Being a long-distance runner myself, I can only have the most sympathy for her.

Been there, did it done it. It’s the pits. Few things are worse

Well almost.

One thing that is worse is not knowing what to do about the injury.

Gina is getting advice from all quarters and from the article she wrote in the Times, most of it sounds absolutely ridiculous.

If this was your cat, your kid, your car or the space shuttle - would anybody put up with this:

Her hometown MD / Orthopedist Dr. concluded she injured her hamstring ....Brilliant!

He sends her to Dr. Feinberg at Hospital for Special Surgery in NYC.

He says the "magic letters" PRP which stands for Platelet Rich Plasma - Ooh! they take your (at least you know where it came from...), own blood out of a vein in your arm and inject it into the site of the injury. You’re supposed to stop All activity ( running in Gina's case), that caused the original injury for several weeks to months. It theoretically causes a "switch" to be turned on and a miraculous healing to take place. Right!

They charge up to a $1000 for the injection to be done - That’s not for the substance that is injected (that’s yours to begin with). - a $1000 to give you a shot!

The people at Hospital for Special Surgery readily admit there have been no valid studies and there’s none in the works to substantiate that this treatment is anything but experimental and results to date are admittedly anecdotal.

Funny - that’s what the MD’s have always say about chiropractic. When chiropractor gets a gal back to work after a back injury they say "Ah, she would have gotten better anyway..."

Now anecdotal is no longer junk science and is acceptable...

In this case the docs say tendon injuries are not well understood nor is the reason they heel.

But they will charge $1000 to inject you with your own blood because somebody had it done and didn’t do anything for 4- 6 months and her tendon heeled and... So they claim it was the injection of the patient’s own blood that did it ????

Are you kidding me?

I’m not sure about the MD’s, but

we chiropractors study, among other body parts, tendons, what injures them, how they heel and - how long it takes to heel.

Referring to your embryology textbook you’ll find that tendons are made of a type of tissue that takes 6-8 weeks to grow New cells and thus heel... Just like bones and ligaments.

Remember we heel by growing new cells and that doesn’t happen by squirting more of your own blood all over the torn / damaged cells.

     What would really help our friend Gina is to analyze her lower spine, hips and pelvis for misalignments and correct that.

This problem will never go away until you fix what caused it.

I would put my money on finding that the side of her pelvis (that she has the torn hamstring) is tipped forward or anteriorly compared to the opposite. When looking in the mirror, that same side will present as raised up & superior compared to the lower and opposite side. When laying down straight, the leg on the torn hamstring side will present, functionally, longer than the other.

This type of misalignment will cause the hamstring to be tighter and prone to tearing. Her stride when walking and running will be altered and she will not reach / kick as far as the other leg. The brain will over-compensate and the muscle will be torn as result.

It will also, in time, cause failure of the hip on the same side (as the torn tendon). Are they going to do another experimental "PRP" injection for that too?

Following a series of adjustments to correct this imbalance and a series of cold laser treatments to promote natural tissue healing and a several weeks of incremental increases in rehabilitative running, work-hardening, and re-conditioning she will be able to return to a full schedule of running as she had prior to her injury with minimal risk of re-injury.

I bet nobody said this to her. Not when they can get her or her insurance to pay $1000.

The chiropractic treatment program referred to above which has a long track record of successes   would probably cost about $500 but the insurance would probably not pay for it.

No wonder she’s frustrated.

Chasing Fading Youth

When I want to re-charge my batteries I like to go out to Montauk and work on trying to regain my fading youth by working out all day.

Actually, I am in the midst of a short mini-vacation as I write this.

Unlike others who, when they go on vacation, stay up all night drinking and then sleep until noon, I like to get up at first light and go for a 4-5 mile run on the beach and then go for a swim in the ocean before all the people show up and set up their umbrellas and chairs.

Then I make a nice, healthy egg-white omelette for breakfast and sit and watch the surfers for a while. Then I’ll take a twenty mile bike ride.

                                    I basically play and exercise all day.

If you want to feel young and youthful again - go take a long run down a deserted beach at 6 AM

Don’t look for reasons Not to -

I’m too tired...

It’s too chilly at 6 AM...

I don’t like to run...

My knees hurt...

The bed is soooooo cozy at 6 AM...

I can’t find my favorite running socks...

What if I get tired?...

                     All = excuses that don’t make you feel young and youthful again

Yea - I won’t deny it - I love my margaritas too, but I obviously can’t run and exercise if I drink too much of them and that’s my priority.

It’s just three months since I had prostate surgery and at sixty...well, "bouncing" back is a little bit slower than it would have been if it had taken place 10 years ago.

Still, I get up every day and work at it

Maybe a little denial, maybe a little head strong but definitely determined.

Because I see numerous seniors in the practice I have the opportunity to talk about getting older with many of them - they frequently say... "don’t get old"...

Are you kidding me?

Hey - Consider the alternative!

Youth slips away almost imperceptibly slowly...until one day you get up and realize it’s gone

You have to work at all of the time - not just on your get away weekends

What are you doing on a regular basis to maintain your youth?

It can’t be wishing and hoping or even "planning..." - It’s got to be a "doing"

It really ought to be something enjoyable so you keep doing it but it doesn’t have to be -

you just need to keep working at it and never stop

You won’t likely catch the carrot but what's important is that you try to.

The Little Things In Life That Lead to Neck and Back Pain

Margaret was in the office this morning. She hasn’t been in in a while but when she comes in - it’s always for the same reason:

         Her neck hurts on the left side and her low back hurts on the right side.

No - there’s been no injury - not even an old one. Margaret has never had an accident. She doesn’t ski, skydive or play any other sports. She basically gets up every day, goes to work and comes home and feeds the cat. She goes to church every Sunday and the most exertion she gets is going to the mailbox.

So - why does her neck and back hurt?

                           It’s her pocketbook.

It probably weighs 10 - 15 lbs. And she carries it on her left shoulder.

Do you think if I asked her to carry a 15 lb. dumbbell in her left hand all day it might have the same effect?

               Of course it would.

It’s one thing to carry something in one hand for a few minutes and then put it down.

And it’s quite another to habitually carry a heavy weight in the same hand all the time.

We tend to forget, while we’re in the midst of our daily routine, how important it is to maintain our body symmetry and balance.

The same thing happens when you’re raking the lawn and you hold the rake the same way throughout the job...

Next day your neck and shoulder is killing you on one side and the other side... is fine

Another example is the way you hold your cell phone against your ear while driving...(As if the trooper can’t see you doing it), by holding your shoulder up against it - Fine for one call once in a while but what happens when that’s the way you drive / work all day?

You end up like Margaret who comes in and says: "but I didn’t do anything..."

One thing I have noticed is that necks and backs do not get out of alignment and start hurting for no reason at all.

Pets On the Bed Leads To Back Problems

You’ve probably heard the expression - "The shape you’re in determines the shape you’re in..."

What is the likelihood that with your golden retriever or a couple of nice furry little cats lying on the bed with you...you’re going to be able to sleep in a nice straight line?

                                    Probably nil to none.

The reason is or the rather the trouble is is that, probably quite unconsciously, (does anybody sleep consciously...?) You’re going to sleep in some contorted shape or another all night so as to avoid rolling over onto the dog.

A patient was just in the office this evening complaining about her lower back continuing to bother her. She expressed to me that she always does everything I tell her to do at home to help herself.

Then I asked her about her sleeping position and that's when she revealed to me that she sleeps with her two dogs on the bed and that they really "rule" the bed - she has to twist herself into a prettzle so as to not disturb the dogs.

Here’s an experiment I want you to do to help me make my point:

Lay on your back with your right arm pushed as far under your back as you can reach - maybe reach all the way under your back so you can touch your left hip and now lay that way for a half an hour. Don’t move - just lay that way.

OK, now get up and... how does that arm and shoulder feel NOW!?!?

Now imagine sleeping all twisted up to avoid running into the dog all night and you can now stop wondering why your back hurts in the morning.

Answer: If you can’t keep the pets off of the bed then keep them outside the bed room. Close the door and get used to them laying outside the door whining - they’ll eventually get used to the new rules in time and stop.

What Your Posture Says About Your Golf Game

Have you ever noticed how the guy standing in line ahead of you has his head tipped to one side or one of his shoulders is tilted up a little bit higher than the other one? Looking more closely you might even notice that one of his hips is also raised up above the level of the other one and maybe even one foot is flared out.

Some people might notice these things and just say "So what... or who cares?..."

What is significant about your posture is that it is something of a window into your performance.

If you’re a golfer and one takes it at least somewhat seriously you’ll want to keep reading this -

When you’re playing golf (or many other sports for that matter), your form is all-important. In golf for example, it is of utmost importance that when you bring the golf club behind you preparing to swing at the ball, that you be able to rotate your shoulders a full 90 degrees to the right and then as you swing at the ball you must be able to swing fully through 180 degrees to the left.

That said, if your left hip and / or left shoulder is elevated above the level of the right one - you can’t bring your shoulder or the club fully to the right as you prepare to swing at the ball.

Can’t be done.

Sure - you can force it but you won’t do it properly. If it doesn’t actually hurt you it will, at the very least, be hindering and throwing off your swing.

And when you then bring your hand (and club) down as you swing - you are forced to twist your arms and hands and... you slice

If your left shoulder is elevated above the right one - that means that your neck is most likely inclining (maybe only slightly), to the left.

That means that when you swing the club to hit the ball and also rotate your head while you swing...you’re at risk of injuring your neck because your neck is leaning to the side while you’re attempting to rotate it.

Yes - you might be able to do it (and you probably do it every Saturday), but it will likely be hindering and, at the very least, throwing off your swing.

How's your swing? Is it so good and consistent that you can afford to have anything at all wrong with it?  

And these are just a few of many different postural imbalances that are possible -

How do you think imbalances like these will affect your game? ...your back ?

How is it affecting the speed, power and consistency of your swing?

Also - If you cannot (mechanically) swing as far as you want to, but you try and go for it anyway - do you think there’s a chance you’ll pull something and hurt yourself?

You betcha - this is where a majority of golf related back injuries come from.

Imbalances first - poor scores and injuries later

Wonder-Drug for Back Pain?

People frequently ask if there is some magic potion or wonder drug to "fix" their back pain.

                                       Good News! There is -

It’s called motion.

Unfortunately, those who need it most don’t get nearly enough of it so they want a pill to compensate for it.

I wish I could package some "motion" into a tiny little pill and sell it - I’d make millions

The really simple beauty and true essence of chiropractic care is that it restores lost motion.

Simply put - The chiropractic adjustment restores movement (moveability) to a spinal bone that has become "stuck" and out of alignment with it’s neighbor.

It is being "stuck" out of alignment that causes all of the problems.

You can eat a bottle of Motrin. You can go get a massage. You can go to the gym and work your butt off or you can go run a marathon. You can go see a Psychiatrist for a year and a half. You can go for surgery and have the "bad" parts removed. You can even go talk to the "Man on the Mountain"... and you’re still not going to be able to make it "un-stuck".

None of those things free a stuck bone.

It requires a small thrust from the outside to set a bone that is "stuck"...back in motion.

Pretty simple-

Yet a majority of people are still looking for the cure for so many common problems in a bottle of pills or under a moon-rock someplace.