"The Exercise Economist"
As you get older, it is no surprise that parts of the body start to wear down some. The body is very resilient to healing itself on a daily basis but sometimes the system gets pushed past the “point of no return.” Fortunately, the world of medicine has created replacement parts for knees, shoulder, hips, and ankles (as well as other body parts) that allow full function minus the pain…..well, at least down the line.
If you are considering, are rehabilitating, or have had a joint replacement in the past there are a few things you should know in respects to you new hardware. As a therapist, I know the rehabilitation process hurts and seems like it will never end but keep in mind, a few decades ago a person with damaged knees would be in a wheelchair instead of up and walking. So, now that you are past the fact you are thankful for all that is modern medicine, here are the real facts:
1. It’s Mean Upfront – This is surgery….major surgery. The surgeon breaks open your joints, saws out the bad parts, and hammers/screws in the new ones. The physicality to simply put in the replacement is so great that many physicians stop doing them around 60 years old. The body part is going to swell up and send off every pain signal available in its arsenal. The outstanding benefit that you are to have is the parts currently damaged will heal and the parts that wouldn’t heal are gone.
2. Rehabilitation Takes a Bit – Going through rehabilitation to get the joint moving as soon as possible is the best bet. The joint will have a tendency to scar down and restrict overall motion. Most important things to consider: Reduce the swelling and Improve the motion. Take care of those two things and the rest will take care of itself.
3. Cold and Wet – You will become a human barometer. When it rains or is very cold the joint will hurt. This achy soreness can go on for the rest of your life so please don’t be shocked if hurricane season or winter brings your new body part some grief.
Now, I gave you some realizations about have a total joint replacement. Here is the overwhelming benefit that through all the time, money, pain, and aggravation: you have the opportunity to keep moving. Being limited to the point where you never leave the house because of knee pain is a far worse consequence that a little achiness when the weather turns bad. Physical pain is real but the emotional pain from being incapacitated by constant joint pain, isolation, and depression is far worse. So in respects to joint replacement, keep that mind focused on a future of getting your life back and most importantly keep moving.
Baseball culture will continue with the pace of “sports proliferation” and as parents it is important to draw the line. The following tips will ensure that you are doing the best for your child to make the most of baseball, but all sports in general:
· Each year make sure there are 3 consecutive months where there is no throwing. This is a guideline supported by Dr. James Andrews and followers of his work. This ensures that each child’s arm takes the appropriate time to heal and prepare for another season of competition.
· Switching sports on a regular basis not only develops a better athlete but reduces the risk of particular injuries. Even though playing basketball instead of training for baseball increases risk of sprained ankles, it significantly reduces the future risk of damage to the rotator cuff
· Make sure all strengthening and conditioning drills are appropriate. Talk to your pediatrician what elements are appropriate for growing bodies.
· If you child can point a finger to the pain, such as a tendon, ligament, or joint that is very specific, pay attention! Sore muscles happen with every sport but complaints of elbow joint pain on a regular basis needs to be addressed immediately.
· Ensure that you child is also going on vacations, participating in other school activities, and having a life out of sports. Obsession with athletics, particularly one sport, can lead to drop out before high school and a life-long hatred of the sport.
Why does baseball allow such a culture to exist? Consider the following:
· Lots of Games - Major League baseball plays 162 games a year. This number of games is considered an acceptable standard of play for adults for young athletes it is way too much. In respects to baseball, our culture has determined that “if more is good, the great than that must be better.”
· Training, Training, Training – The idea of conditioning for baseball was a scarce thought just 20 years ago. Young baseball players today are hitting the gym, drinking protein shakes, and participating in workouts more appropriate for a NFL linebacker….and they are 9 years old! Our cultural push to preparation has created a future of broken bodies, leading to broken dreams.
· Can Play for a Long Time - Baseball is a slow sport with moments of intense movement but rarely completely exhausts the athlete. The physicality of football, basketball, soccer, and even hockey will eventually completely exhaust the young athlete, sometimes forcing time to rest. Baseball players can take hundreds of explosive swings and throws before reaching exhaustion, all along damaging body parts to irreparable levels.
· Bringing the Game Indoors – In years past, when the weather got cold the baseball season ended. Recent pushes for indoor facilities, batting cages, pitching lessons, and use of warehouses for full team practices has allowed the athlete to throw year round.
· Obsession with the Now – I played baseball in little league, high school, and college and to this day I can never remember the intensity of parents and coaches today at such young levels. Dreams of being the best, scholarships, and big league contracts drive many parents, athletes, and coaches to only think in the now. A 6th grade weekend championship game is important but driving young athletes into the ground to get there is sacrificing the future.
Any parent with a young athlete in baseball would be hard pressed to miss all the warnings these days with youth baseball. The following is a list of things that have become main stream in the past decade to make a real difference:
· Little League has instituted pitching rules that limit the number of pitches per game and time in between starts on the mound
· Greater awareness that breaking pitches, such as curveball and sliders, are not good for a developing shoulder and elbow
· Use of safety equipment, such as helmets, that have reduced the number of concussions and other head injuries considerably
These pushes by the parent, association, and medical communities have made a great difference but the question remains: Why do injuries continue to rise in youth baseball? The answer is not what “we are doing” to reduce the problem but more what “we are becoming” in our sports culture. Years ago, young athletes would play a variety of sports, go on vacations with the family, and have times termed the “offseason.” Nowadays, it is not unusual to see a 10 year old playing 100+ baseball games in the summer, cramming in $60 personal training sessions 2x a week, hitting a pitching lessons 3x a week, and then sprinkle in some conditioning a practice during the dead time.
I realize everyone that is a workout fanatic or concerned about putting on a few pounds because of egg nog, mass quantities of desserts, and being too cold for an after lunch run feel this time of year is an "obstacle" to staying fit. There are also those of you that see the new year coming as fresh start, buy some new workout clothes, get a gym membership, and maybe hire a personal trainer. Here is a simple piece of advice for both ends of the spectrum,....BE REASONABLE!
This part is for my workout crazy people, yes you....the person who feels guilty about looking at pumpkin pie or trims every bit of flavor off a piece of pork because you worry that cellulite will jump out and strangle all your weight loss success. That is absolutely nuts! If you are a person who has been committed for years to staying active and healthy a few parties where you splurge will do you no harm. In fact, heavily stressing out about food could even affect your psychological well being, elevating levels of long lasting cortisol increasing chances of holding onto winter weight. CALM DOWN....DON'T RUN FOR THE TREADMILL! Enjoy this time of year and the fact that you are physically, psychologically, and emotionally addicted to exercise, therefore ensuring that next year will be another good one.
Alright....for the people whose idea of working out is to the fridge and back. If you honestly believe that you are going to now start working out 5 days a week for 2 hours a day just because it is now January 1st, you are obviously suffering a serious case of the "delusions." Yes, you may make it a couple weeks, maybe a month but to have long lasting results the changes have to be gradual and committed. Going out and spending money on ways to stay healthy is not the answer. Changing your lifestyle to perhaps being more "fitness" or "health" centered is where it is at. You can't go from couch to beach model overnight.....I know the bottle of weight loss pills says you will lose weight but in between your ears do you have the strength to keep it off? Be reasonable, try maybe doing pushups in the morning, adding a walk or two a day, and cutting back on the soda and sweets. Find something you know you can do for 4-6 weeks and stick with it, slowly adding more exercises, hours, and money to the equation as you become more committed. The number of people with pristine basement bound gym equipment is staggering, collecting dust a you collect pounds.
Be reasonable and your fitness goals will last you well into the next New Year's Resolution. And as always stay healthy so you don't need to go to physical therapy.....you will just hear someone like me give you same speech while pushing on a painful hamstring. Blog advice is just so much easier.....
Everyone is very aware that the younger you are, the faster you heal. A sprained ankle during a soccer game that would have hobbled mom and dad for a couple weeks is barely noticeable in a few days with an 8 year old. As a parent, there are a number of things you must consider why you young athlete heals so fast:
PROS
· Adolescents spend a considerable amount energy and bodily resources to build muscles, bones, and organs. This same mechanism fixes the "broken" parts with expediency.
· Younger bodies are more "elastic" meaning the various tissues throughout the body are able to bend more without braking. At very young ages, sprained ankles can commonly occur in bone avulsions (tearing away of bone from bone) because the ligaments are stronger than the surrounding bone.
· Athletes are generally more active and fit, therefore, they have improved cardiovascular systems that get more blood to heal damaged body parts.
Knowing these advantages, parents may have a tendency to push young athletes back into competition faster. The belief "they are young, they will heal" has a truth but it also has an uglier side that is often overlooked.
CONS
· While tissue is building new parts, it is developing a system that will last for the many decades to come. If this building process is severely or constantly interrupted your child's maximum development will never be achieved. Thus, one ankle will be 100% at age 18 and the other from constant sprains and playing hurt for years will be at 70%, foundationalizing a future of ankle weakness and instability.
· The "elasticity" of tissue at this age is great for reducing risk of minor injuries but can increase the risk of major injuries. Dislocated joints, such as the shoulder and hip, can occur because the muscles are not developed and the forces on them can be too great. Creating unstable joints because the body is too worn down or exasperated can lead to a future of severe arthritis and joint pain.
· This improved blood supply to various body parts is fantastic to heal but only to a point. Young athletes with Osgood Schlatter's that constantly press through the pain can create a large boney callous that builds in the irritated area. This area can create a weakened bridge for the patellar tendon an lead to a life of patellar tendonitis or patellofemoral dysfunction.
Just because children can heal faster doesn't mean they should be put back into play before they heal. Remember, given the time they will still heal much faster than adults but don't always think in the now. Getting back to the championship 8 year old soccer match is important but there are many more years of sports ahead and a child that will develop into an adult. Play in the now...look ahead to the future.... and every game will be the greatest one played.