Time For Change

Football’s in the air.  It has a way of making sports seem legitimate again.  The buzz of training camp and how “my team” will do this season has dominated social conversations and social media this week.

For me, the excitement for another NFL season is here but for very different reasons.

The year was 1987 and I was a junior in physical therapy school at UConn.  That was the last summer I didn’t spend in an NFL training camp up to now.  I had spent the previous 3 summers, starting in 1984, as the New York Giants summer athletic trainer intern.

In contrast, I spent that 1987 summer working as a physical therapy intern for the Visiting Nurses of Hartford (CT) as part of my physical therapy school requirements.  After 3 summers of living out my childhood dream of working with an NFL team, I was cleaning bed pans, cleaning infected wounds and rehabilitating disabled elderly patients in housing projects.  Career Plan: Get into the NFL…and FAST!

This past February I stepped down from my position as Head Athletic Trainer/Physical Therapist with the Jacksonville Jaguars to enjoy my important role as a father and husband.  It wasn’t an easy decision after 26 seasons in the NFL but when I see the joy in my two young children and wife’s faces when we have breakfast together every day, I know it was the right decision for the right reasons.

The Jags have their first training camp practice today.  I’m cheering for them to have a great season, as I always have.  Something will never change.  Sure, I’ll miss the guys, my staff, the laughs, the practical jokes, the rush of seeing players overcome injuries to get back on the field, the endless trays of food and, obviously, I’ll miss the energy of game day.

As for me professionally, exciting changes are here.  I’ve created a new company, Mike Ryan Sports Medicine, Inc., to manage my new physical therapy clinic and consulting business along with other fun sports medicine projects.  As for the details of those “other” endeavors, you’ll have to wait on that….

In the meantime, I’m thoroughly enjoying the change.  Change in my schedule, change in my involvement with my family’s lives, change in my stress level, change in my workout routine (!!), and a healthy change in my professional challenges.

Change is good when the passion is enhanced.  Mission accomplished.

Fun times are here and it’s only getting better!

Gratitude, Change & a Trusted Vision

Ryan Jags 2011aApril 25, 1988 was the day my childhood NFL dream came true.

Ronnie Barnes, the Head Athletic Trainer for the New York Giants and one of my mentors, asked me if I wanted to join his staff as a full-time assistant athletic trainer.  I was 25 years old and a month away from graduating from the University of Connecticut with a degree in Physical Therapy, my second degree in 7 years.

Nine years earlier, as a sophomore in high school, I had set my mind and heart on “being an athletic trainer in the NFL!” after “Miss G”, a caring guidance councilor at Mohawk Trail High School, showed me info on the profession of athletic training.  I still remember racing home that rainy spring day to share my powerful vision with my family.

End of a Dream

Friday, February 7, 2014 was my last day with the Jacksonville Jaguars.  It was the end of a 26 year career that encompassed 533 NFL games including 2 Pro Bowls and a Super Bowl victory.  It was a decision I made three weeks early to rebalance my life, allowing me to spend more time with my family.  With a loving and amazingly supportive wife and two children under the age of 6, I’m ready to prioritize my family for the first time the way they deserve after a long season where I work 7 days per week for 5 1/2 straight months.

Making the Call

I’m no fool.  I know I had only 1 of 32 jobs in the world’s #1 most profitable sports league.  It goes beyond that when it comes down to those that you love.

What does it take to make such a big decision?

  • Gratitude – I’ve lived a childhood dream for over half my life with so many memories, experienced amazing opportunities, met so many wonderful people and developed outstanding skills for the next professional chapter in my life.  I have so much gratitude and appreciation for my family, my assistants, my doctors, my athletes, my medical consultants and mentors who have helped me throughout the years.  As I always say: “I’m simply the result of so many wonderful people who were willing to help me along the way!”
  • Desire for Change – I’m ready for a change, as is my family.  I trust my skills and my abilities to make this change something special.
  • Trusted Vision of Purpose – We all need PURPOSE if we want to be a leader in our life.  I have a very strong sense of purpose in my life and I trust that vision wholeheartedly.  My Personal Mission Statement is: To Enhance the Health of Others.

My purpose in this next chapter is to take what my staff and I have created in a professional football athletic training room setting working with world-class athletes and share it with millions of non-professionals interested in decreasing their pain, increasing their physical function and maximizing their active lifestyle.  Now that’s something to get excited about, huh?!

Giving Thanks

I have so many people to thank and I’m not sure where to start so I won’t.  The tens of thousands of extra special people who I’ve come into contact with over the last 26 years in the NFL are all somehow on that list.

I’ve had a wonderful career and I don’t take that for granted.  I’m thrilled for what I will created in Phase 2 of my profession.  We only live once so I plan on making my life grand.  As for the professional life, it will be exciting and well aligned with my Mission Statement.  In regards to my athletic life, I’ll be working my ass off to be extremely healthy in aspect of my life with lots of crazy/challenging races to keep my body and mind razor-sharp.  For the personal life part, it will be filled with lots of love and laughter….just the way I like it!

Measuring Your Fitness Program With Gratitude

Measuring Your Fitness Program With Gratitude

How does an athlete measure his/her success?

High profile athletes have coaches, fans and ESPN to judge their performance.  Runners and bikers have the clock to gauge the results of their hard work.  The athletes determined to lose weight have the dynamic-duo of the mirror and the weight scale to determine if their efforts were successful.

I recommend a different measuring tool: Gratitude, defined as “a feeling of thankfulness and appreciation”.

The Busy Life Dilemma

Today’s typical lifestyle is crazy hectic.  Personally, I work seven (7) days per week from mid-July until the end of the season in early January or February.  If I’m real lucky, I will get two (2) days off during the Bye Weekend if the injuries are low and I can properly stagger the off days with my amazing assistant athletic trainers.  That sounds insane to most people but that’s the way it is in the NFL as a certified athletic trainer and physical therapist.  This is my 26th full-time season in the NFL, 521 games, and I’m very comfortable with that schedule.

With that being said, it would be very easy to say “I’m too busy to workout”.  That is an absurd thing to say because it’s the crazy schedule that makes the need for a workout extremely important to me.  I need some “me time” to workout away from everyone asking for my help.  Be it just 45 minutes at 4:30 AM, that workout time is exactly what I need to strengthen my body and my mind to handle my daily duties.

Happy Heart, Great Start

Stress management isn’t too high on most people’s priority list these days and that’s a problem.  Taking care of your body, your mind, your attitude and your heart will change your life….and it may ultimately save your life in the process.

Reality Check

Have you ever had an injury that kept you out of your favorite sport?  Standing on the sidelines sucks.  Soon you found yourself saying: “Man if I could only (fill in the activities) again, I’d be thrilled!”

It was about 1:00 AM, January of 1984 and I was laying on my back in a dark parking lot in Hartford, CT with a dislocated ankle and fractured leg.  I was a 3:58 1500 meter runner getting ready to start my indoor track season at Central Connecticut State University but now I was in serious trouble and I was scared.  In an instant I knew my life had changed when I heard the loud crack and I realized that both my right knee and the back of my right heel were both facing in the same direction.  I remember looking down at my mangled leg and wondering if I’d ever run again.

I have to admit, I was burnt out from running at the time.  I was often running over 100 miles per week as I trained and raced on the collegiate cross country, indoor track and outdoor track teams while working in the CCSU Athletic Training Room at least 20 hours per week along with a full class room schedule so I could graduate in 4 years.

Two surgeries later and with a very aggressive rehab plan, I was ready to try to run again.  It was exactly 10 weeks to the day of my accident.  I put my books down, limped down the bleachers where I was studying and walked onto the track.  I ran 1 lap, 400 meters, with a huge smile on my face.  It was March 13, 1984 and I was a runner again!

That accident was what I needed to truly feel grateful to be the athlete that I was then and what I am today.  It shouldn’t take a devastating loss of a physical ability or a blessing or a life to make us appreciate what we have.  Being grateful is my measuring tool and my “reality meter” for everything in my life.  I get on my knees every night to give thanks to God for what I have because I’m very grateful for what I have today and I know that tomorrow is never guaranteed.

Being Grateful…Now

NOW is the best time to appreciate your health.  Like everything else in your life, investing time and effort into your body and will reward you richly.  Stop taking your health for granted before you find yourself with an injury or ailment that puts you on the sideline watching others doing what you love to do.

The time to enhance your fitness is NOW.  It will test your patience so focus on getting better every day and celebrate your accomplishments along the way with passion.  There’s a new YOU out there and it all starts with you being grateful today while you work on being better tomorrow.

From Picking Up Cups to Living the NFL Dream

This Sunday’s Jaguars game against the Chicago Bears will be special for me for many reasons.  For starters, it’s my 500th NFL game.  At 49 years old in my 25th NFL season, I have so much to be grateful for.

Growing up in Massachusetts, the New England Patriots were the only team any of my brothers or I would even consider cheering for.  I can still remember the rainy spring day in 1979, during my sophomore year in high school, when I decided to be an athletic trainer to work in the NFL.

Fast forward 15 years……It was the summer of 1984 during my first summer internship for Ronnie Barnes and the New York Giants.  Our first pre-season game was in Foxboro to play the Patriots!  On a side note, although I had been skydiving a couple of times from smaller planes when I was in college, the 25 minute flight to New England was my very first time flying on a “real” airplane.

Walking onto the field for the pre-game warmup was a dream come true.  My job was to carry the Gatorade cups to the bench and I was on Cloud 9 with a huge smile on my face……until I realized that the cup bags were open and I had just left 50 yards of cups trickled all the way to the tunnel!   embarrassed, red-faced and humbled, I made the walk of shame picking up the cups with the rough Boston crowd rightfully belittling me.  I laughed and said out load: “Welcome to the NFL, Mike!”

How many people have the opportunity to get into a dream job which they envisioned when they were 16 years old and then be fortunate enough to make that dream a long-term career?  Not many and I remind themself every day.  I always remind myself:  I’m simply the results of so many that were willing to help me to reach towards my dreams.  I owe it to them and myself to work hard and to help others as they pursue their carrots.

From my caring mother to my loving wife to my supportive family to my athletic training mentors Carl Krein and Ronnie Barnes, they all shared their love, support and wisdom to help me to help others.  I have so many to thank, including the Giants and Jaguars organizations themselves.  I am forever grateful.

Sunday’s game marks another reason to enjoy life.  Three of my dearest lifetime friends, Scott Mackie, Bill Thomson (a Bears fan) and Bob Kelly will be in town for the weekend.  Of my 25 season in the NFL, these friends have come to visit me for a home game for approximately 19 of those seasons.  Having loyal and caring friends like Bob, Bill and Scott is special and their friendship is priceless.

The sports medicine profession is an exciting field and it makes me want to come to work every day.  The friends I’ve made, the experiences I’ve had and the happiness I’ve found in the NFL are too many to list.  Although the work is serious, the fun and laughs are plentiful in this energetic environment.  The days may be 12 to 18 hours long but if that’s what it takes to be excited to get out of bed every day, I’ll pick up cups all day long!

Mastering NFL Injury Reports for Fantasy Football Owners

I have to admit, I’m very impressed with the popularity of fantasy football and how many football fans are involved in fantasy leagues around the world.  As the Head Athletic Trainer/Physical Therapist for the Jacksonville Jaguars, I can see why fantasy football is so appealing resulting in an elevated interest in NFL stats each week.

It makes each and every game exciting because fans are now interested in the  “players’ numbers” and not just the final score.

Rule #1

I’ll tell you right up front, I have never been involved in any fantasy football leagues.  When it comes to medical information about NFL players, my Rule #1 is to never discuss any details about an NFL player’s injury that hasn’t already been reported in the newspaper.

It’s a simple rule I learned from one of my mentors, Ronnie Barnes, Head Athletic Trainer of the New York Giants.  I don’t discuss details about medical injuries involving my players with my wife, my best friends or my family.  It’s easy to understand why and, as a full-time employee of the NFL for the past 24 seasons, it protects the private medical issues of my players.

Reading Between the Lines of an NFL Injury Report

With that being said, sharing how the medical reports are created within an NFL team would be helpful for fantasy football owners as they prepare their game plans for weekend roster moves.  Each NFL team has their own philosophy on how they practice injured players, how they manage an injury during the week and when they test injured players during the weekend.  A few years ago the NFL standardized how each team reports injuries to the league office to help avoid surprises when it comes to disclosing medical issues involving players.

Knowing how to read between the lines of these reports can make your job as a fantasy football owners’ job so much easier and make you look like a genius.  While the new guy in the league is drafting a kicker, you’ll be benching the player who is simply a medical decoy being used to confuse the opposing team’s game planning.

Trust me, it’s a chess match on this side of the fence.  I’ll share with you tips on how to “crack the code” to use NFL injury reports and player statuses as a huge advantage for your fantasy football team.

Common Questions

What’s really the difference between questionable, doubtful & probable?”

If someone is limited in practice, is that player just playing the role of a backup for the starters during practice?”

If player X has a concussion, will he typically be cleared to play in the game the following weekend?”

These are some of the questions that many of you ask yourselves as you prepare for the weekend games.  Here’s the inside scoop on the manner in which the injuries are managed by the clubs.

Inside the Percentages

Probable – 75% chance of playing in the game.

Questionable – 50% chance of playing in the game.

Doubtful – 25% chance of playing in the game.

The Golden Reps

The number of reps that the starting offense and defense has on Wednesday, Thursday and Friday are very limited.  These reps are treated like gold by the offensive coordinator (OC) and defensive coordinator (DC).  Therefore, players that take “snaps with the number ones” are expected to play on Sunday.

If a team doesn’t think the star veteran corner back will be ready for the game, they surely want their young corner to “get the reps” with the starters to be ready for the game.  Those quality reps with the other 10 starting players on that side of the ball are very valuable and are usually given to the player expected to play on Sunday.

So if you read that an injured player is only taking “some of the reps” and is “rehabbing on the side”, especially late in the week, it’s more than likely you’ll see him on the field Sunday…..in street clothes.

The Stats Killers: Hammys & Groins

As you’ve read in my recent sports medicine blog postings on hamstring and groin injuries, these are difficult injuries to return from quickly for skilled positions such as RB, WR and DB’s.  Until the reports say he is running at least 85% by Wednesday and “full speed” on Friday, don’t expect that player to impress you on Sunday.  When a skilled player with a lower extremity soft tissue injury is being interviewed and he gives you the “day-to-day” quote, Sunday might not be his breakout performance.

With both of these injuries, the player’s top end speed is always in question.  The opposing players know it too and they use it to their advantage.  That’s why a player coming back from a strained hamstring or a strained groin may be playing in the game but their stats will be watered down for the first week or so.

The X Factor

You know that you want it.  They want to find it just as badly as you do.  It’s the “X Factor” that gives you the huge numbers come Sunday night.  It’s the tips which help you put the perfect fantasy football team on the field each Sunday.  That’s how you make the key roster move which results in having the WR who has a career day or how you trade for the young QB mid-week who turns out to be a hometown hero with a monster game.

Understanding NFL medical reports and using sports medicine tips will help you think like an NFL GM and give you the X Factor advantage in your fantasy football league.

Where Are You Getting Your Sports Medicine Advice?

I read a great article this weekend in the Health section of the Wall Street Journal titled: “As Sports Medicine Surges, Hope and Hype Outpace Proven Treatments”.  It exposed a very common problem for today’s amateur athletes.

The insightful article written by Gina Kolata gives examples of motivated mature athletes with orthopedic injuries and no clear direction to assist their efforts to get back to their sports.

In an effort to regain their health, the trend is for some desperate athletes to chase expensive fads and unproven recovery techniques.  In doing so, they’re spending way too much money and wasting lots of time.

Deciphering and interpreting the massive amount of sports medicine info available is not easy for anyone.  If you Google search “low back pain” you’ll have 22,200,000 articles to read.  Search for “treating knee tendonitis” and you only have 418,000 websites to peruse. Good luck trying to find a simple solution for the chronic knee pain that keeps you from losing that extra 20 lbs.

Are you looking for simple answers to your sports related injuries?  Sure you do…..and you’re not alone!

Why I Created MRF

Marshall, Director of Enthusiasm

The reason why I created MikeRyanFitness.com is to help people.  Besides, my free sports medicine website has saved me dozens of calls, texts and emails from family and friends from all over the world seeking medical advice.  The MRF website has proved to be helpful in reducing the number of sports medicine questions asked by neighbors while I run with my happy dog Marshall.

MRF is a fun sports medicine resource designed to help optimistic athletes like YOU to avoid both simple and complex injuries.  How many athletes, young and old,  are in need of a easy-to-use sports medicine resource to help them to quickly recover from an orthopedic injury?

It’s more than you can imagine. This website fuses my passion to help people with my passion for sports medicine. I’m lucky that I’ve spent my lifetime doing both.

 Pain Has No Geographic Limits

I’ve received dozens of great emails a month from athletes in pain and highly motivated to get back to the sports that they love.  The emails range from a professional soccer player in Croatia with chronic knee pain following 2 ACL reconstructions and a microfracture surgery to a field hockey player from Tasmania, Australia who was excited to read my article on knee fat pad pain on the MRF website! Injury prevention and promoting sound and proven injury recovery programs is a high priority for MikeRyanFitness.

 Keeping it Simple

My motto for the information provided on MikeRyanFitness.com remains the same:  Provide sports medicine information that is simple to understand, easy to use and it creates FAST results.  I’m a firm believer that this approach helps athletes understand their injury better and allows them to work more effectively with members of their healthcare team.

I’ve learned from over 23 years as a certified athletic trainer/physical therapist in the NFL that if I ask an injured athlete the proper questions, 90% of them are simply trying to find ways to:

1.  Decrease their pain

2.  Enhance their ability to move with less effort

3.  Increase both their muscle strength & joint range of motion

If the sports medicine world were to stay focussed on those goals, athletes at any age would be active and healthier much faster.  I can promise you that MikeRyanFitness will do just that.  Sign up for our newsletter and let me help YOU!

Share the Love

This website is a hobby of mine motivated by my passion to help others to enjoy a lifestyle of positive health and fitness.  In an effort to enhance the lives of 1,000,000 people in the next 2 years, I need your help.  Please take a moment to pass on my message, my website and my information to others for FREE sports medicine info to help improve the quality of their lives.

Thank you for caring to share!

Tame Heel Pain Flareups From Plantar Fasciitis

Tame Heel Pain Flareups From Plantar Fasciitis

Understanding Plantar Fascia Strains

Plantar fasciitis causes localized pain in the backside portion of the arch that attaches to the underside of the heel bone, or calcaneus.  It often results from overstretching, overloading or tearing in the arch origin that runs from the heel to the front portion of the foot, under the toes.

This band of tissue helps stabilize and propel the foot forward during movement and stretches each time weight is applied when standing or walking. Plantar fascia strains occur when the band experiences excessive trauma or if the arch is exposed to persistent stress. A plantar fascia strain usually gives rise to sustained inflammation in the front of the heel and back portion of the arch. This creates a high level of localized pain, particularly after a prolonged period of rest during non-weight bearing activities such as sleeping and sitting.  The band simply tightens when not in use, and if left untreated, a plantar fascia strain can become a chronic and troubling ailment.

Causes: The most common cause of plantar fasciitis is wearing inadequate footwear while running, walking and/or jumping. Additionally, beginners who go overboard doing new physical activities may inadvertently overstretch the band.   Additional factors include obesity, sudden weight gain, flat feet, and excessive exercise with insufficient levels of progression.  Heel bone spurs may also result as the band continues to pull on the heel bone, causing chronic arch pain.

Signs & Symptoms of Heel Pain From Plantar Fasciitis

  • Burning, stabbing, or dull aching pain in the front of the heel and along the tissue band in the backside of the arch
  • Difficulty placing weight on the foot while barefoot
  • Arch pain that occurs with heel raises or flat-footed squatting
  • Localized swelling and tenderness under the heel and arch

Professional Treatment for Plantar Fasciitis

Plantar fascia strains usually respond well to conservative treatment methods. However, recovery time does vary from individual to individual. Be sure to:

  • Rest and avoid weight-bearing activities to lessen heel pain.
  • Utilize the latest physical therapy modalities and rehab devices to reduce swelling and decrease pain.
  • Ice the arch and toe flexor tendons in a stretched position on a consistent basis to reduce inflammation and pain while elongating the sore plantar fascia tendon. 
  • Always wear the proper footwear for your sport(s).
  • Tape the foot to assist in arch support, reduce inflammation and decrease the risk of further injury.
  • Massage the posterior arch with progressive, aggressive transverse-friction, applying more moderate pressure to the ankle and lower shin.
  • Perform strengthening and stretching exercises for the neighboring arch and calf muscle.
  • Buy arch support shoe inserts.
  • Properly tape the arch to provide effective support and reduce heel pain when performing weight-bearing activities.
  • Minimize weight-bearing activities.
  • Work to shed excess pounds, if overweight or obese.

Ask the Right Questions like a Pro

Here’s what smart pro athletes would ask their sports medicine specialist to ensure a fast and safe return to their beloved game or sport:

1)   Is this heel pain related in any way to my pelvis, lower extremity or foot alignment?

2)   Which types of physical therapy are best to quickly resolve this problem so I can get back to my sport(s), pain-free?

3)   Are non-surgical treatment options available?

4)   Can this problem cause any long-term complications?

5)   Will anti-inflammatory medicines provide relief?

6)   Is my painful heel a result of some other biomechanical abnormality that must be addressed?

Elite Sports Medicine Tips from Mike Ryan

  • Fast Treatment=Fast Recovery: The sooner you address plantar fascia strains, the sooner they resolve.  Seek treatment quickly to avoid a chronic problem.
  • Defy Sir Isaac Newton: Aggressive weight-bearing activities prolong recovery time and increase the risk of long-term complications.
  • Embrace that Après Workout Life: Immediately following your workout (or related treatment):
    • Elevate your foot for 3 minutes
    • Stretch for 5 minutes
    • Ice your arch and heel for 7 minutes
  • Unleash Your Inner Gumby: Aggressively stretching your calves, arches, big toe and toe flexor tendons will go a long way toward maintaining healthy tissue in the entire foot.
  • Eat and Drink Right: It’s easier and safer to control inflammation and promote healing by staying well hydrated and maintaining a healthy diet rather than popping pills to manage the problem.

Outsmarting Heat Illness

With the recent heat wave that has gripped the country, many of us are struggling to tolerate the brutal heat and humidity.  It’s one thing if you decide to run in the hot summer heat but with this kind of heat, simply walking the dog or working in the yard is putting anyone at risk for health problems.

Help is here!  I’m a modest guy but I can say when it comes to heat illness prevention, I know it well.

Working with the Jacksonville Jaguars in the Sunshine State is a great start.  Athletically, I’ve competed in the three hottest Ironman Triathlons in the world.  Those three 140 mile races are in Brazil, Hawaii and Lanzarote and I finished each of them with my personal best times at that time.  Interestingly, the Lanzarote Ironman in the Canary Islands is labelled as the “toughest Ironman triathlon in the world” for over 15 years and no other race has challenged them for that title!

It’s safe to say that I know heat and how to safely exercise in a hot environment.

Heat illness is a dangerous problem but it’s important to note that heat illness is a very preventable problem.  If an athlete is smart in his/her approach to exercising in a hot environment, most problems can be completely avoided.  Educating athletes and others involved with their activities is the key first step to avoiding problems and even death related to heat stroke.

Common Results of Heat-Related Illnesses

Heat Cramps – Persistent involuntary muscle contractions and pain that continue during and after exercise.

Heat Exhaustion –  Symptoms can include dizziness, nausea, fainting, muscle cramps, headache and poor of coordination.  This is a moderate level of heat illness which can progress to a life threatening condition if left untreated.  This is usually a results of an elevated body core temperature and a loss of fluid or sodium.

Exertional Heat Stroke – Symptoms may include nausea, vomiting, headache, seizures, confusion, and potentially a loss of consciousness.  This is a life threatening condition that can progress rapidly if the body core temperature reached 104F.  Immediate medical care is needed if heat stroke is suspected.

 Mike Ryan’s Tips to Beat the Heat

  • Know Your Enemy – Know the warning signs of heat illness: dizziness, nausea, confusion, a sudden urge to cheer for the NY Yankees, headache and/or fainting.
  • The 50/50 Rule – The rule of hydration I use is what my Jaguars players call the “Ryan 50/50 Rule”.  Consume 50% water & 50% sports drink before, during and after the workout/race.
  • Take the Time – Your body needs time to acclimate to the heat.  Your body is adjusting with hundreds of bodily changes and that takes time to properly prepare.  Gradually increases both the duration and the intensity of physical activity. This process typically takes 10 to 14 days.
  • Know Your Carbs – When it comes to helping to keep the body core cool, simple carbs (sweets, soda, cakes,…etc.) are BAD while complex carbs (pasta, grains, sports drinks,…etc.) are GOOD.  Asking your body to cool itself in a hot environment is not the place to be trying a new diet or limiting your caloric intake.
  • Sleep is Key – Sleep deprivation limits the body’s ability to dissipate heat.  Get your sleep & you’ll tolerate the heat much better on race day.
  • Small Chunks – Take breaks and rest period when exercising in a hot environment.
  • Other Factors Contributing to Heat Illness – Knowing what factors predispose you to having problems in the heat is extremely important.  These include fever, stimulants including caffeine, prolonged air flight due an average humidity level in an airplane of only 5%, menstruation, cold medicine, diuretics, recent heat illness, dehydration and recent weight loss.
  • Open the Salt Mine– You need salt (sodium) and you need it early.  Start consuming salty snacks like pretzels and tortilla chips 24 hours before the start of the race.  Continue with the salty snacks up to and during the longer bouts of exercise and exposure to the heat.
  • Cool the Core – If you can keep your body core (the torso and abdomen area that contains your kinda important organs) cool, your body will tolerate the heat better and enhance your performance.  It’s that simple.
  • Adjust Your Pre-Race Routine – Minimize your exposure to the excessive heat and humidity just prior to your workout or race.  Two tips are to move some of your pre-race warming up into an air-conditioned area or shorten your pre-race routine when exposed to the heat and direct sunshine.
  • Look Cool – A valuable lesson that I learned during a brutal race in Ironman Brazil….Wear light colored clothing and hat because they absorb less heat and keep your body cooler.
  • Keep a Cool Head – Ice and cool water in your hat is a great way to get an upper hand during the Dog Days of Summer.
  • Burn is Bad – Sunburned skin is very inefficient in protecting you in the heat.  If you’re sporting that red lobster sunburn look, know that you body will not be at it’s best to handle the heat even if that sunburnt skin is not exposed.

Cool Closing

Taking care of yourself before you exercise in the heat is a smart start.  If you’re sick, taking stimulants or experiencing any of the previously noted conditions, you need to hyper-hydrate early and often and limit your time in the heat.

Most individuals from the professional athletes to the weekend warriors who have problems in the heat can trace the main reason for their problems back to a relatively simple cause.  Common sense is often missing.

Plan ahead, closely monitor how you feel, eat right, drink with the “Ryan 50/50 Rule”, limit your exposure with frequent breaks and you’ll be fine.

Remember, heat illness is very preventable with a few smart steps.  It’s time to get out and enjoy getting healthy!

Tackling a Lateral Meniscus Tear of the Knee

Understanding a Lateral Meniscus Tear

“I tore my cartilage” is the term most athletes use to describe the possible source of their knee joint line pain.  About 40% of the time, they’re correct.  Now ask them to identify culprit, aka “the cartilage”, in a police lineup and they’ll probably have the look of a cow staring at a fence.

The medial (inner) and lateral (outer) menisci are made up of very resilient cartilage.  Their design and cellular structure allows them to assist in the stability of the distal femur (thigh bone), distribute body weight forces across the joint surfaces and absorb compressive forces as we move.

Injuries to the menisci can significantly impair knee functions. Because of their relationship with other structures in the knee joint, the lateral meniscus is less prone to injury when compared with the medial meniscus. The lateral meniscus has less direct attachments to other structures in the knee. However, the long-term impact of a lateral meniscal injury is more concerning due to the high weight-bearing forces in the lateral compartment of the knee.  In other words, if you have a lateral meniscal injury, your likelihood of needing to have it addressed surgically increases and the presence of accelerated arthritic damage rises with time when compared to the medial meniscus.
The types of injuries to the lateral meniscus vary in location and severity, ranging from splitting into two segments to tearing around its more “C” shaped borders. Over time, meniscal micro trauma can result.

The lateral meniscus has minimal blood supply around its periphery.  With no direct blood supply to its central region, one can typically expect minimal healing with injuries involving this region of the lateral meniscus.

The two most common causes for meniscus tears are direct trauma and degenerative conditions. More often, the traumatic injuries involve twisting of the knee with the knee in a bent position.  This is commonly seen in contact sports. With this mechanism of injury, the foot is fixed to the ground resulting in a stretching of the meniscus. A direct blow to the inner part of the knee joint can also injure the lateral meniscus.

The degenerative damage is more commonly seen in the older population and is often associated with underlying arthritic changes. As the meniscus lose significant blood supply and weakens, it becomes more prone to injury. In this population, simpler twists and forces associated with daily activities may prove to be the cause of a meniscal injury.

Signs & Symptoms of Lateral Meniscus Tear

  • Excruciating pain and swelling immediately or up to 3 days after the activity in question.  Lateral joint line pain increases with rotation of the knee and weight-bearing.
  • Difficulty walking, bending or rotating the knee against resistance due to lateral knee pain.
  • The knee joint may become locked or “catch” if the loose piece of the meniscus is in a position of pain within the joint.  This flipping of the flap or unstable section of the cartilage will typically prevent full extension more often than it will limit full flexion.
  • Joint stiffness and tenderness around the outer edge and back ridge of the lateral joint line.
  • A general sense of insecurity with the knee with increased activity contributing to what older athletes tend to refer to as a “trick knee” due to its unpredictability.

Professional Treatment for Lateral Meniscus Tear

The best treatment is often a treatment of the symptoms and not the injury itself due to the limited healing capability of the meniscal tissue.

  • Ice the knee at least 4 times per day and immediately after all athletic activities.
  • Utilize the latest physical therapy modalities and rehabilitation equipments to control the pain, swelling and tenderness in the in and around the joint.
  • Strengthen the muscles directly influencing the knee joint. Strengthening exercise should be mostly pain-free. Muscles of the thigh, quads in front and the hamstrings in back, should be the main focus along with the hip rotators and the calves.
  • Soft tissue massage and stretching of the surrounding muscles and fascia needs to be included. This encourages the muscles to stay pliable which will accelerate the recovery time.
  • Surgery?  Let the doctor and YOU determine the answer to this question.  Closely monitor your symptoms and your activity level before you decide to “go under the knife”.  If unsure, gradually test your knee with functional activities along with the watchful eye a sports medicine specialist.
  • Eat right and drink right.
  • Be cautious of activities that twist the knee to avoid aggravating the injury.
  • Rest as needed.

Asking the Right Questions Like a Pro

Here’s what a smart pro athlete would ask his/her sports medicine specialists to ensure a fast and safe return to sports:

  1. Is this injury related to my athletic activities?
  2. What structures in my knee are damaged?
  3. Do I need further diagnostic test like an MRI?
  4. Do I need to have a knee scope and/or a micro fracture surgery?
  5. What kind of exercises do you recommend?
  6. Are there any long-term complications that we should discuss now?

Elite Sports Medicine Tips from Mike Ryan

  • Train With “Training” Specifications: Train smarter.  You can be aggressive and keep your knee pain-free by minimizing the twisting motions during your training.
  • Surgery is Just One Option on the Menu:  Many doctors may tell you otherwise but here is the truth: Just because you have a meniscal tear does not necessarily mean you need to have surgery.  The location of your injury, your pain level, the present knee limitations and your past medical history are the most important factors in determining whether you need to be walking around the surgical center trying to look cool in one of those drafty Johnnies!
  • Grocery Choices: You know when it’s junk or healthy. Help yourself to a healthy diet if you’re serious about getting back to competing like you did 10 years ago.
  • Ride Your Way Up: Don’t play “hero” on day #1 with your agility drills and running.  Bike riding is a great way to get your range of motion back and to start the leg strengthening process the smart way.  It’s time to change your mindset and getting on the bike and in the swimming pool is a great way to start.
  • Employ Proper Techniques: You accidentally did something wrong to incur the meniscal tear so now your focus should be to doing it right. Proper techniques and progression are the keys along with getting in with the right physical therapist.

“I’ll Never Take My Good Health For Granted Again”

He’s back and no one is more excited than he is today.

Not long ago this amazing cyclist had to dig deep to simple ride his bike around the block.

For the past two years my friend Bill has been dealing with his personalized version of hell.  Suffering with a great deal of pain, joint stiffness, muscle weakness and, most difficult of all, battling unanswered questions about his health.  Poked and prodded with too many tests to count, he grew tired of doctors unable to clearly determine what the future had in store for this 40+ year old athlete.

To respect Bill’s privacy, the specifics of his medical issues will remain private.  We can all learn a valuable lesson from Bill and I appreciate his permission to include him in my sports medicine blog.  I have a tremendous amount of respect for Bill as a person and a biker.  The manner in which he has handled this daunting challenge has impressed me beyond words.

As a highly successful cyclist on a national level, Bill’s recovery road back was an uphill climb.  With a physically demanding occupation and a strength oriented sport, he feared his life would never be the same if he failed to out duel his declining health condition.

In talking to Bill three days ago, he said something that stuck in my head and is the reason for this blog post.  As he humbly discussed his recent workouts, I was pleasantly surprised how hard he is training based on the type of symptoms and limitations that he dealt with only a few short months ago.  After which Bill solemnly stated:  “I’ll Never Take My Good Health For Granted Again”

How many of us take our health for granted?  Should we simply assume that we will be able to run and jump and golf and do whatever it is that we want to do forever?

The 400 Meters That Changed My Life

Personally, my lesson on appreciating my athleticism took place during my junior year in college.  I was a 2-time All-State middle distance runner in high school and I continued my running career at Central Connecticut State University while I pursued my degree in Athletic Training.  With a personal best of 3:58 in the 1500 meters during my sophomore year in college, I was well on my way of reaching my life-long goal of running a sub-4:05 mile.

Just before the start of my indoor track season during my junior season, I dislocated and fractured my right ankle.  My running career was in serious jeopardy.  I have to admit that with a schedule that consisted of a full academic class load, working my mandatory 20-25 hours per week in the athletic training room and running on the Cross Country team in the fall, the indoor track team in the winter and the outdoor track team in the spring, I was pretty burnt out with running.

What I quickly learned was that I didn’t just “like” running……I LOVED to run.  I will never forget the day: March 12, 1984.  Exactly 10 weeks and 3 surgeries after my injury, I ran for the first time.  It was a mere 400 meters around the track at CCSU and I was thrilled.  It took me about 7 minutes but it made me truly realize how important running was to me as an athlete and as a man.  I sat on the lone muddy bench next to the finish line and cried.

Taking Control of His Health

What did Bill do?  First and foremost, he locked his attitude into a positive and healing mode.  He knew exactly what he wanted his body to do and his mind never let go of that image.  This is a very powerful step for the healing body and mind commonly found is highly successful individuals who overcome difficult obstacles.

He found the best medical specialists available to gain direction and insight.  Next Bill returned to working out and eating very healthy.  Addressing the needs of his recovering and healing body are enhanced by the right thoughts and nutritional fuel for an injured athlete.

Bill battled back one pedal stroke at a time.

Take Home Point

The important Take Home Point of this story is Bill’s positive attitude and his appreciation for his active and healthy lifestyle.  He has plenty of other activities in his life to keep him busy and no one would have ever questioned the reasons if Bill did not return to bike riding.  His Excuse Flag was right there waiting for him.  All he had to do was accept his illness, pick up his Excuse Flag and get used to the fact that he was no longer an athlete.

Instead, Bill focussed on the carrot (riding his bike very fast) and started working very hard.

What’s your excuse?  Is it REALLY that strong of an excuse to keep you from your dream of an active and healthy lifestyle?

Sports Medicine Tips for a Successful Recovery

Challenge Your Medical Team – Remember, they work for you not the other way around.

Always Room For Change – Medicine is not an exact science.  Miracles happen every day in the medical community so why shouldn’t it happen with you?

Visual the Outcome that YOU Want – Don’t simply accept a label or a projected outcome as a 100% guaranteed slam dunk if it’s less than ideal.  Whenever the mind is involved, your ability to change the results is always an option.

Challenge Yourself – In my opinion, the #1 reason for bad recovery results and poor fitness is “Feeling Sorry for Yourself“.  If you allow yourself to feel sorry for yourself, you’re giving in to negative thoughts.  Don’t do it!  Challenge yourself to get back to doing what made you happy during your “younger” days.

The time to appreciate your health and your abilities is TODAY.  Throw down the Excuse Flags and stop taking your health for granted.

It will be well worth the effort.