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 6^th 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 am sure there is a large collection of people out there that rain, sleet, or snow will be out running.  So, if you are one of those people here are a few tips to keep you out running and not limping into therapy:

1. Lots of Water - It seems hard to believe but you lose a considerable amount of water while breathing in cold weather.  Your lungs have to add moisture to the air entering you lungs, sucking it away from your body.  Just because you aren't sweating as much make sure that the water consumption does not go down. 

2. Check Those Shoes - Slicker conditions mean worn down shoes are more problematic.  Check the bottoms of your running sneakers: if the tread is gone, consider it a late christmas gift to yourself and get another pair.  Slipping and falling will definetly ruin your rountine more than the drive to the mall and $60 investment. 

3. Warm It Up - Cold muscles and cold weather equal big problems.  Start off your runs a little slower than in warmer weather.  This gives your body a chance to pump warm blood to all the muscles, tendons, and ligaments to return them to their proper elasticity.  You certainly don't have to do one hour of stretching and light jogging before hand but maybe coasting the first 5-10 minutes would be a good idea.

4. Stay Dry - Water takes heat away from the body 20x faster than air alone.  This little fact means if you get too sweaty and are exposed to the elements your body will chill really fast.  Layers is the best idea with wick-away clothing that does not collect moisture.  Costs a little more but skipping your next run because of freezing your tail off will ruin your routine. 

This time of year offers opportunity for reflection of the past, enjoyment of the moment, and a vision for the coming year.  To all a Happy New Year!

If anyone lives in a place that is cold and you got some black ice glazing the ground, the risk of falling increases dramatically.  We all have heard of accidents with cars but broken wrists, hips, and forearms are frequent ER visits during this time of year.  Here are a few thing to know to make sure you don't start racking up dollars on your insurance deductibles next year:

1.  Start with the Balance - Widening your base of support when walking over ice decreases your risk of falling.  Furthermore, doing the same by shortening you step will help.  In some cases you may still fall if over ice but it will increase the amount of time you have to react, thus, preventing seriously bodily crashes resulting in broken bones. 

2.  Pay Attention - Just because it doesn't look like ice is over concrete and ash fault surfaces doesn't mean it isn't there.  Make sure that if you go out in the dark pay attention and slow down.  Also, during the day areas that have a light amount of snow over it can give you a little more friction to work with but don't think that going out for your usual run isn't without risk.

3.  Take a Look At Your Shoes - We all have that pair of shoes we wear everyday (probably more than we should) that wears down to have the gripping equivalent of glass.  I am not saying go out and buy a pair of snow shoes to get the mail but be aware of what is on your feet.  If you have instances of slipping occasionally when conditions are good you might think twice about those worn out shoes.  Hiking and snow boots are a better bet......and you finally get to use them so break them out!

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.

In the clinic, I hear stories about how injuries happen all the time.  Some of them are instantenous, such as slipping down a flight a stairs.  Nothing there one could do to prevent breaking that ankle.  Or other times a combination of age, wear and tear, and bad genetics just does some people no justice.  The rotator cuff, for instance, can just wear away with time for no reason, leaving you at the mercy of the surgeon.  Furthermore, participating in higher risk activities, such as sports, extreme activities, or high intensity fitness exercises can also lead to possible problems.  Tearing a hamstring sprinting or landing funny while rock climbing is just part of the risk. 

So, after hearing all this, what is the one piece of advice that has the best chane of keeping your out of therapy: KEEP MOVING!  Of all the people that end up in therapy, the majority is not the unlucky, the bad genetics, or the extreme sports, it is the people who constantly do nothing for decades on end and just fall apart.  Your body has a mechanism built in that states, "Use it or lose it."  That applies to all the parts of your body, from your toes to in your brain.  Avoiding simple tasks such as walking on a daily basis, sitting in front of a computer screen all day, and making every effort to avoid anything physical is destroying your body everyday.  

Simple advice.............take it to heart.