A Message of Hope

As the holiday season is once again upon us, I thought I would share some of my own experiences of hope to provide those that need it some encouragement, understanding, and trust in a better tomorrow!

It’s sad, but the truth is many people struggle and experience pain during the holidays.  Whether it’s because of the loss of a loved one, or not having a loved one, occupational stresses, health, or financial struggles….the holidays can be the toughest! For me, I now smile and I am happy through this holiday, but for many years I was hopeless with tears! Losing my soul mate and angel in January 2004 left me devastated in pain, nowhere to turn to and nowhere to go! Everyday was difficult but the holidays were especially cruel.  I actually went as far as lying to my family and friends, telling them I was with other people, when the reality was I was at home crying…. terribly lonely and missing Brenda’s touch (Although I was never alone- she is with me always :) ) The phone calls and attempts by friends and family to extend love and warmth was always appreciated and definitely needed but unfortunately it just couldn’t numb the pain.  But one thing always stood true; I knew in my head and heart that Brenda would watch out for me and make sure I was happy one day. 9 years later I have a beautiful and remarkable wife Julie and a baby on the way!!! :)

Don’t give up and always believe. If you truly have hope for a better tomorrow, it WILL come.  It happened to me. Think right, be a good person, always want the best for others, and it will happen to you!

To those of you who find yourselves struggling through the holidays, my heart and prayers go out to you in hope that next year will bring you peace and much much more!

And to those who are in a great place, I wish you continued happiness….you deserve it….show your gratitude by reaching out to someone you know could use a simple “hello” or “we love you”! (pick up the phone).

Keep smiling!!!

Tip of the week: Drink water BEFORE you eat…

What’s the cause of your knee pain? By Dr. Stephanie Harris

There is no shortage of runners who present to our clinic with knee pain! This often results in those runners having to alter their routine or stop running completely. Understanding warning signs, being proactive and managing your schedule, may go a long way in keeping avid runners running… and therefore happy (you runners out there know what I mean!).

The knee is a very important and complex joint that has many mechanisms involved in running. The muscles surrounding the knee need to work in combination with cartilage, tendons, and ligaments to keep the knee supported and moving properly In fact, 42% of all over-use injuries to the body occur in the knee. This makes sense because the knees take on a lot of stress throughout the day and even more stress when running (or exercising). With each foot strike, a runner’s knee withstands a force equal to eight times his or her body weight — for a 150 lb. person, that’s about 1,200 lbs. of impact with every step.

 

Knee pain can be categorized into location and depending on that location (front, back, inside of outside of your knee), it will tell us what structures are involved and what is causing your pain. Lateral (the outside) of your knee is one of the most common areas for runner’s to experience pain.  Although there are a few different conditions that can result in pain on the outside of the knee, I want to focus on Iliotibial Band (ITB) Syndrome, something at our clinic we refer to as “runner’s knee”.

The ITB is a strong, thick band of tissue that runs along the outside of the leg, starting from the hip and ending on the outside edge of the shin bone just below the knee joint. The main job of this muscular band is to provide stability to the outside of the knee joint during movement. Because its role as a stabilizer, it can become irritated or inflamed from overuse (running too much, using improper foot wear, increasing mileage too fast/too soon, improper foot mechanics).

So…. how do you know if you suffer from ITB syndrome? Well first you need to ask yourself: where is my pain located? If it’s on the outside of your knee and you are a runner, there is a good chance your iliotibial band is involved. Next, you need to pay attention to when you experience the pain. Do you feel it when you are sitting down watching television, or do you notice the pain when you start running (or shortly after you start your run)? Do you feel the pain when you are descending stairs or upon getting up from a seated position? Those are both indicators that again your ITB could be involved in the cause of your pain. If you are a runner and are experiencing pain, it’s time to get your body checked out. Pain is your body’s way of telling you that something is wrong, so if you are feeling pain, you are already a step behind your body. Stay on top of your health and prevent the pain from starting in the first place.

Here are some tips for those of you who are experience lateral knee pain.

Tips:

  • Preventatively and regularly stretch the ITB, which is best achieved by using a foam roller
  • Proper footwear is imperative!! Make sure your shoes have enough support and have not worn done from usage!
  • Correct over-pronation. See if you are a candidate for orthotics (Refer to Dr. G’s previous post).
  • Avoid over-training. Slowly increase mileage in a safe and controlled environment. Stick to the 10 percent rule,  which states that you should increase your weekly mileage by no more than 10 percent over the previous week.
  • Cross train. Do other forms of cardio (bike, elliptical) to change things up.
  • Get adequate rest and recovery.
  • Listen to your body.
  • Get assessed to find out what is causing your knee pain. ITB syndrome is one of many issues that can cause these symptoms.

A Proper Diagnosis…is the key to fixing a problem!

Whether it’s via twitter, email, or general conversations, I get a lot of questions from people who are experiencing pain, weakness and/or dysfunction. They’re asking for HELP and suggestions! And as much as I would love to help them out, quite frankly it’s simply not that easy!

Before ANYONE (including me;)) can properly answer questions like: Why am I in pain? What is it? Why did it happen? What do I do to get rid of it? What are my treatment options? What exercises can or can’t I do? What strengthening/stretching exercises can I do to help it? What do I do to keep it from happening again? Etc…. you first MUST know what “IT” is, and to do so you MUST be given a diagnosis.  So what does a diagnosis consist of?

 

First off, “diagnosis” is defined as identifying the nature or cause of something.  The important word being “CAUSE”.  All too often, people deal with the symptoms and not the cause. If you just treat the symptoms you will at BEST get temporary relief (not sufficient in my world!).  But if you treat the cause, you can get rid of the problem and the symptoms. 

Therefore, determine the cause of the problem (diagnosis), then, and only then, based on the diagnosis a practitioner can help you develop a plan of action (i.e. treatment options, required rest, exercises, rehab, modification to workout program, etc.).

 

So now that you understand a diagnosis is needed, it is important that you receive a PROPER diagnosis; here are some simple guidelines that you can follow to help ensure you are being properly diagnosed:

  • The diagnosis must be given by someone who is qualified and licensed and specializes in the area of concern (don’t come to me for an eye problem).
  • A proper diagnosis can not be given without a proper examination. A proper examination must contain at least 2 things: 1) a thorough history (during which the doctor asks you questions about your injury/condition) and 2) a physical examination (during which the doctor runs you through a series of tests which I refer to as orthopaedic tests which examine muscles, nerves, ligaments and joints to decipher where the problem is coming from and what structures are involved).

Note: In a small percentage of cases (10 percent of the cases that I see in my office) additional tests are required, which may include: x-rays, diagnostic ultrasounds, MRI, or blood tests.

 

So if you have a problem, and you want to be helped, Step 1 is getting a proper diagnosis! The sooner the better! Find the problem…fix the problem!! Remember, without a diagnosis, its just a guessing game….

Stay Healthy!!!!

“No Pain, No Gain”…. words NOT to live by!! (regarding exercise)

It’s unfortunate that so many active individuals who are passionate and dedicated to exercise fail to recognize the warning signs of a problem…PAIN.  The choice to ignore their pain often leaves them wishing they did not follow the mantra of “No Pain, No Gain”.  Trust me, there is no shortage of 50+ year olds (or younger) who, after many years of exercise, are now suffering (physically, psychologically, and emotionally) as they are unable to exercise or participate in the sports they once loved because their bodies will no longer allow them to. Sadly, it did not have to be this way….if they would have only listened to their bodies!! I am writing this entry in hopes that if you exercise for the betterment of your health, you will now be more aware and equipped to make wise decisions, allowing you to live healthy….and exercise for as long as your heart desires! :)

To illustrate my point I will use myself as an example. The Hints describe messages from your body that you should be listening to, and the Steps describe the systematic approach you should be taking to help ensure continued good health.

Lately for cardio, I’ve been walking hill intervals on the treadmill (running is hard on my body, so I DON’T run).  Walking hills is challenging but is not overly impactful on your joints and is a solid cardio workout that burns calories (which is my goal).

Last night, I started my workout (Step #1-start your workout), 10 minutes into the intervals, my right hip started hurting (Hint #1), but I didn’t feel it on my left side (opposite side has no pain Hint #2), so I kept walking for another minute or 2 but the pain didn’t subside (continuous pain- Hint #3). So I decreased the level and took the incline down to zero but it still hurt (made adjustments but pain still prevalent –Hint #4), So, I did what so many fail to do: I listened to my pain (and the 4 Hints) and got off the treadmill. I then immediately went on the elliptical machine (Step #2-make a change to your workout if you have pain) and gave it a try in the hope that I could complete my daily exercise goal (burn calories).  I had no pain, so I continued and went for 30 minutes with no pain.  To be clear, if at any point on the elliptical I would have felt pain, I would have stopped.  When I was done, I got off the machine, stretched for a few minutes and then laid on the Chi-Mat (Step #3-use management tools after exercise…if you don’t have a Chi-Mat get one! :) Otherwise I would have used ice).

Today, although I was NOT in pain, I got assessed (Step #4-when you experience pain, get assessed by a qualified practitioner) by my associate, Dr. Harris, and she diagnosed me with a mild strain of my TFL (hip muscle), she treated me (Step #5-get treatment when necessary) and she gave me a plan of action (Step #6-Have a plan)…over the next week, I will get a few more treatments, stretch, use a foam roller, stay off the treadmill, and continue to use the elliptical to satisfy my cardio goals.  Once I get the OK from Dr. Harris, I will then resume my hill workouts on the treadmill.

Key points….

I listened to my body and the hints it sent me, reacted appropriately to it in a systematic way (followed the Steps), and now have avoided making a mountain out of a mogul.  Do you listen to your body?? YOU SHOULD !!

 Dr. G’s Tips on how to avoid and react to pain:

  • Set goals for yourself (what is the reason you are exercising and what results are you aiming to achieve? i.e. build muscle, lose weight, alleviate stress etc). The Risks should never outweigh the Reward!
  • Listen to the hints your body gives you! If you feel pain during exercise, stop; try a different exercise, if pain persists, just stop!
  • Get assessed! Pain is your body’s way of notifying you that something is wrong. If you feel pain, don’t fight through it, consult a qualified professional, the earlier you address the pain, the easier it is to regain pain-free healthy status
  • If you exercise regularly, then you should be receiving some form of treatment regularly….your body needs it!
  • Take a minimum of one day off from exercise a week (than means NO exercise)… your body needs it!
  • Employ some “management tools” to support your exercise (i.e ice or heat, Chi-Mat, foam roller, etc.)
  • Stretch!!! Before AND After exercise!!!
  • Balance and Plan your workouts! That means mix things up…be sure to do some exercise that is less forceful on your joints (i.e. elliptical, bike, swimming), if you’re a runner- try not to run on back to back days, always make sure you do some form of cardio and weights (resistance training)

 

 

My personal thoughts…

 

Yesterday, with tears of joy, sadness, and reflection I started typing, I wrote it as a letter to my late wife Brenda.  I talk to Brenda every single day, but felt like writing, with the intention of sharing it with you:

 

For me, there’s certain days in the calendar that aren’t and will never be normal days…they signify way too much.  October 5, is one of those days! On October 5, 2001 my life changed forever when my beautiful wife Brenda was diagnosed with breast cancer.  I can remember that day as if it was yesterday; we walked into the doctor’s office as an amazingly in love, happy and newly engaged couple.  At 26 years old with the mention of 1 word, Cancer, our lives were forever changed.  It’s10 years later, and boy have I been through a lot!! Brenda, I owe so much to you! You truly take care and watch over me everyday and have brought joy back into my life! As Julie (newly married :) ) would say…”wowie”.  Can’t believe you’ve blessed me with Julie, such an amazingly spiritual woman with the kindest heart that has no boundaries, not to mention CRAZY hot;)  As I write this10 years later, I’m so happy your wings are free to fly, thanks for staying close to me, I would not be where I am today if it wasn’t for you, your infinite wisdom, your love for life, and your passion for what matters in this world we live in. ! I love you Brenda, as much as I did on October 5, 2001(actually more because our love continues to grow) and I’m so honored and blessed to have you as my angel!! I remember frequently saying one thing to Sarah(my therapist who loved and adored Brenda)…no matter how much pain, suffering, and loneliness I endured,  I always knew and BELIEVED you wouldn’t let me suffer forever…thanks for bringing me joy, happiness, and peace back into my life!  Can’t wait for all of us to meet the beautiful baby in Julie’s belly :) :) :)  Wowee!

 

If you read this, thanks for reading it! Inspire others and love like Brenda did. Make a difference!! Today, tell someone you love them, call someone and let them know you care, It’s amazing the power we have as humans, you just have to express it!

 

For those who are struggling in life, speaking from experience I leave you with this, hope it makes a difference! When you are stuck in the tunnel, its hard to see the light….take a few minutes each day to close your eyes and SEE that light, it’s there, believe it and you will achieve it…I DID :) Wishing you peace, love, and light! Keep smiling!


 

AskDrG: Are ice baths good or bad?

In my first instalment of ‘AskDrg’ I am responding to a great question tweeted to me by @loganwelding, a young aspiring hockey player:

“Dear @yourDrG , how long should you stay in an ice bath? Also, how often should you ice bath?”

 

The first question you need to ask yourself is not how long and how often, it is actually if you should even use an ice bath at all. And that depends on how you are feeling and what your intended outcome is.

There are many pro athletes who take an ice bath after a game or practice, and quite frankly they don’t even know why they are doing it and what the benefits are.  Jumping in a cold tub because you heard “pros” do it or because a veteran athlete in the locker room does it, doesn’t necessarily make it right for you.  There’s a proper reason why one uses ice and please refer to my March 2011 blog as I discuss the usages for both ice and heat.

 

To answerLogan’s question here are the highlights taken from that blog:

The reason you use ice is not because it feels good, but rather because it is a proven tool against acute, painful and inflammatory conditions.  Simply stated, ice will decrease swelling/inflammation, decrease blood flow, reduce muscle spasms and alleviate bruising and pain…..

When using ice, apply the ice to the area that is the problem. Going in a cold tub or generally applying the ice to a larger area will not have the same affect (remember the goal of using ice is to decrease swelling and blood flow to the affected area, this can not be achieved if ice is applied to a larger more general area).

 

Therefore, if you have an area of complaint, a new injury, a chronic injury that flares up after activity, or a nagging problem, then you should be applying ice ONLY to that specific area and NOT going in an ice bath.  In the case of an athlete, the reality is that he/she is likely battling through aches, pains, bruises, or injuries throughout the season, so an “ice bath” is not the most effective way of managing your body; ice to the specific area is!  As such, I don’t often, if ever, recommend my patients use ice baths.  However, like most things, there are exceptions to every rule. There are two situations in which I am ok with someone using an ice bath:

 

1)    If your entire body is achy after your game, or if you have MANY chronic achy joints that are irritated following activities. Then going in an ice bath for 10 minutes may be helpful.

2)    You actually like the way your body (and mind) responds to the ice bath.  If there is a specific problem area, then prior to going in the ice tub, ice that area for 10 minutes, and then submerge your body in the ice bath.

 

I hope this answers your question.  Wishing you continued health and success!

Keep flying!!!!!!

Weight training…before or after cardio?

One of the most frequent questions I get is “Should I do weights before or after cardio”?  Although my quick answer and general rule is do weights first and then cardio after, in many cases the answer is not that simple and requires a more in-depth answer.  And in the case of the professional athletes I consult with, the answer is definitely not that simple. So, whether you’re exercising casually, a fitness enthusiast, pro athlete, or somewhere in between, here are some questions that will help you to determine the answer:

1) What is your desired outcome and what goals are you trying to achieve?

2) What form of “cardio” and “weights” are you doing.?

(There are many different definitions and subcategories for “cardio” and “weight-training”.  If the cardio you are talking about is an actual sport, the answer is very different then if it was simply cardio on an elliptical machine to burn calories, burn fat, and enhance your cardiovascular health.)

 

I have broken the answer down into two categories with two opposing answers.  Establish which category you fall under, and there lies  your answer:

1. If your goal is to: get fit, stay fit, get lean, avoid injury, have a good work, burn calories, get stronger, etc. AND if your cardio is the elliptical, walking, jogging (moderate intensity, duration less than 1 hour), running (moderate intensity, duration less than 1 hour), biking (recumbent, stationary, or outside, duration less than an hour) then your answer is:

Do your weights first and then your cardio after!

Why:

Two reasons.  The first is safety/injury prevention.  You are more likely to get injured when your muscles are fatigued and generally you are more likely to have a mishap doing weights then moderate cardio.  So, it makes more sense to do the weights when your body is fresh and you are focused!  The second reason is results. Weight training yields better results when the body has ample energy stores.  However, you can effectively do cardio when your muscles are fatigued.

 

2. If your goal is: to play a sport (hockey, basketball, football, tennis etc); achieve optimal performance; OR endurance related (generally longer than 1 hour), AND your cardio is therefore running, skating, jumping, etc. your answer is:

Do your cardio (sport) first and then do your weights!

Why:

When you weight train, you are contracting your muscles against resistance.  The resulting affect: your muscles will be in a shortened and tighter state…not to mention fatigued. When you play sports involving speed, agility, explosive movements, reaction time, etc., your performance and safety is predicated upon lengthening muscles, flexibility, quick response time, and pliability, all of which can NOT occur properly when your muscles are shortened/tighter.

Unfortunately the reality is, that many injuries to athletes (at all levels, including professional) occur because of improper planning and training on the field, ice, or court.  If you are an athlete or participate in sports at a competitive level, NEVER do weight training directly before you play your sport; this will help you avoid injuries and perform at the highest level! That being said, weight training is key, but training properly with the right scheduling is VITAL to an athlete’s success, health, and longevity.  The right scheduling involves when, what, why, and how…that will be my next postJ

 

Be Aware! Stay Healthy! Achieve Your Goals!

 

 

Tip of the Week: Sitting at your desk… the right way!

There’s a reason why many people feel better while on vacation, and its not just because of decrease in stress.  Occupational stresses and bad habits in the workplace are a big contributor to back pain. At the top of the dreaded list of reasons why people’s backs “kill” at work is  sitting at a desk for hours during the day.  So here’s a few tips we tell our patients:

1) Get up every hour! Even if its just to stretch out and walk around your office for 1-2 minutes..it will help you tremendously

2) Recline in your chair and use your back rest.

3) Keep your feet on the ground and avoid crossing your legs.



 

Tip of the Week: Is your computer screen bright enough?

A proper workplace environment and workstation is vital to a healthy lifestyle. If your computer screen is not positioned properly, or illuminating a proper amount of light, overtime it can lead to problems.  With respect to brightness of your computer screen, it should equal (or slightly exceed) the rest of the lighting in the room.  If it does not, and the screen is duller, you will unconsciously squint to see the computer screen.  When you squint, your neck automatically flexes (moves) forward to assist your vision.  This puts unnecessary stress on your neck and leads to neck and upper back issues/pain, which is a common finding in the workplace.  A few tips to ensure your computer is bright enough include:  adjusting the setting on the computer screen until you find comfort, dimming the lights in your office, or shutting the blinds during peak sun hours.

Be aware and stay healthy!!!

 

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