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Pain Management Made Easy

For most, the term “pain management” creates haunting visions of pain medicine, drastic lifestyle changes and expensive doctor bills. In the sports medicine world, that same phrase paints a much rosier image.

“Not all pain is created equal.”  Different types of tissue in your body can generate varying types of pain. Here’s a list of body tissues, which can all be located in the same small part of a joint, and the different types of “pain” sensed in each:

Nerves – Burning, numbness, shooting, weakness.

Bone – Stabbing, deep ache, shooting.

Muscle – Cramping, stabbing, shooting, aching.

Ligament – Instability, snapping, stabbing.

Cartilage – Catching, stabbing, pinching.

I never really thought about how many different type of pain I can feel“, you’re probably thinking.

One of the biggest challenge facing a physical therapist, athletic trainer and doctor is asking the right types of questions and interpret their tests to find the source of pain in their patients.  Pain management starts with finding where the pain is coming from.

Think about it this way: If we, the sports medicine specialist, can quickly determine that 90% of your pain is coming from, say, your supraspinatus muscle of your shoulder’s rotator cuff, we can quickly develop a rehab plan to reduce your specific pain.

Pain Management Plan

It’s time to stop focussing on pain pills as the solution for reducing pain in orthopedic injuries.  Sure, check with your doctor to get his/her thoughts but know there are many safer, cheaper and effective ways to use physical therapy to reduce your pain.

Ice

Ice will reduce pain and swelling.  Ice will hurt at first but it works.  Toughen up and try icing your pain for at least 6 times before judging it’s results.  Ice can change your life.

Methods of icing:

Ice Bucket – Place the injured/sore body part into a bucket of ice water. It’s an aggressive way to ice but the benefits are quick and lasting. Timing: 10 minutes max.

Ice Bags/Packs – Wrap with an ace bandage to add compression.  Timing: 15 minutes max.
Ice Massage – Peeling down a paper cup filled with frozen water is the best way to ice a localized area of pain.  Timing: 10 minutes max.

Massage

Massage will increase blood flow into a body part while increasing the lymphatic drainage out of an area of discomfort.

Flexibility

Good old stretching will lengthen tissue such as muscles, joints and fascia to reduce the pressure on nerves and painful soft-tissue while enhancing the blood flow into your entire extremity.

Hydro Therapy

When it comes to reducing pain, hydro therapy can consist of using a hot tub, cold tub, hot show, cold shower, cold mountain stream or a combo of both hot and cold water. The benefits of hydro therapy can range from relaxing painful tissue, numbing a body part, tricking the nervous system, altering the blood flow to an extremity and/or blocking the sensation of pain.

That last sentence may sound out of character or even barbaric when discussing a “medical” topic. The truth is I’m a huge fan of hydro therapy because it has a way of healing the body in a peculiar manner when other more scientific techniques fail.

Ending Ice Bag….

In closing, pain doesn’t have to be part of your day. Challenge yourself to find safe and effective ways to put pain in your rearview mirror. Initially, eliminating your pain completely may not be a realistic option.  But just think how much better your lifestyle will be if you used these techniques to reduce both the intensity and the frequency of your pain by just 50%?!

NOW is the time to rewrite your Pain Management Plan.  Let me know how I can help you to beat your pain the smart way.

Cold Truth About Ice Therapy

To convince my patients, fellow #SpartanRace athletes and friend that ice therapy works, I simply tell them: “Ice is your best friend”!

Ice is cheap, easy to use, mobile, effective and, most importantly, ice therapy works!  Its time we all stop complaining how “ice hurts” and “it makes me stiff”.  Sure it hurts and it requires some warmup after the 10-15 minutes of ice treatment.  But if ice therapy works, isn’t 4 minutes of discomfort (that’s how long it usually takes for the area of treatment to go numb) a mild sacrifice to feel better?

Smart athletes put pain medicine down and pick up ice to manage their pain.  Follow their lead.

As a Sports Medicine Expert for Spartan Race, I write posts for fellow Spartan racers and SGX coaches related to important sports medicine topics.  Recent posts include topics such as wrist injuries, injury prevention, rehabbing an ankle injury, injury management, and resolving low back pain.

Here’s a link to a recent post I wrote on Spartan.com to keep you “In the Game”!

Click Here For:  THE COLD TRUTH ABOUT ICE THERAPY

Keeping you healthy, happy and a helluva lot easier to live with, Mike

Appreciating Assistant Athletic Trainers

John Norwig has the right to be proud.

Playoff football’s in the air. I’m here in Kansas City with NBC Sports’ Sunday Night Football crew to cover this weekend’s AFC divisional playoff game between the Kansas City Chiefs and the Pittsburgh Steelers.

Here’s one story line which probably won’t make the headlines: During Sunday’s clash at Arrowhead Stadium, Steelers’ long-time Head Athletic Trainer John Norwig will be working across the field from one of his former assistants Rick Burkholder, now the Chiefs’ Head Athletic Trainer.

Wait, it gets better.

Last weekend during Pittsburgh’s 30 – 12 Wildcard playoff win over Miami, John watched another one of his former assistants Ryan Grove at work on the opposing sideline. Grove is in his 3rd season as the Head Athletic Trainer for the Miami Dolphins.

By all accounts, this is the first time in NFL history two head athletic trainers (AT) faced their professional mentor in back to back games. Seeing it happen in playoff games makes it that much cooler.

Some may read this and say; “So what!”

I’m willing to bet those same individuals have never spent any time in an Athletic Training Room or had an injury requiring the care of a certified athletic trainer. If he/she had, they would have a greater appreciation for the skills needed to keep elite athletes healthy.

Being Grateful

I could not have done my job as the head athletic trainer/physical therapist for the Jacksonville Jaguars for 20 years without the efforts of my loyal and hard-working assistant athletic trainers. I owe much of my success and blessings to my talented assistants and interns who, from July to January, literally spent more time with me than we did with our own wives and children.

My assistants and interns were part of my family.

Every “head guy” in a professional or college settings will tell you the same thing: Assistant athletic trainers are the backbone of the day-to-day work needed to keep athletes safe.

My Reward

I was thrilled to see two of my assistants – John Burrell (Washington) and Joe Sheehan (Cleveland) – move on to become head athletic trainers in the NFL. They worked hard for the Jaguars and me and I owed them my very best efforts to help them succeed in reaching their professional goal of becoming an NFL head athletic trainer.

I firmly believe this responsibility also applied to interns who have proven themselves worthy of becoming full-time AT’s in the NFL.  An NFL internship is not an easy job. The low-paying position is filled with long thankless days and endless To Do lists.

I’m proud of my two former interns – Marco Zucconi (San Diego….I mean the Los Angeles Chargers) and Doug Quon (Washington) – who are employed as assistant AT’s in the league. A 2009 Professional Football Athletic Trainers Society (PFATS) survey of its members found 88% of head athletic trainers served as interns in the NFL and 86% of assistants were previously NFL interns.  Needless to say, an internship is a proven path into an NFL athletic training room.

Time For Athletic Trainers to Move On

A common goal for most head athletic trainers who truly appreciate and respect their assistants is to help their loyal protégés to move up the food chain.  That means helping their assistants to become a head athletic trainer in the NFL or the college ranks. It’s only fair.

Most of us who were fortunate enough to lead our departments previously worked as interns and assistants doing the same crappy jobs no one else wanted to do. Who do you think is cleaning the storage rooms late at night, packing the travel trunks, taping a majority of the ankles, bringing the injured rookie ice bags at 3 AM and setting up the road game athletic rooms at 5 AM? It’s the assistant athletic trainers!

When I asked John Norwig to describe his feelings when he looks across the field to see his former assistants in the role of head AT in the NFL, his reply was filled with passion and admiration. It’s a common trait of John, which makes him so genuine and likeable. “Proud,” Norwig replied, “I’m so proud to have helped them become successful.”

I think Rick Burkholder, Chiefs’ Head Athletic Trainer and current President of the Professional Athletic Trainers Society (PFATS) says it best; “Assistant athletic trainers are the life blood of the sports medicine teams in the NFL.

Like Rick, I was an assistant in the NFL before I headed south to join the expansion Jaguars in 1994. I was so fortunate to learn and grow under the guidance of my mentor and friend Ronnie Barnes with the New York Giants for 6 amazing years.  It was a wonderful opportunity for me and I’m forever grateful to Ronnie for his trust and guidance.

Stay the Course

I applaud assistant athletic trainers at all levels of sports medicine. You work extremely hard for others. It may not seem like it at times but everyone from the head AT’s, players, coaches, families and co-workers see your tremendous efforts and appreciate the positive impact you have on your athletes.

Assistant athletic trainers Note-to-Self:  WHEN you become a head athletic trainer, take care of your assistants and help prepare them to someday move up the food chain as you have done.

Avoid Sports Injuries With 1 Simple Question

Tire big 87I flipped a giant tire today during my Spartan workout.  Flipped, as in singular.  One.  Uno.  Eins.  Once was enough. I’m allergic to sports injuries.

I didn’t need to flip it a second or a third time for both the physical therapist and the athlete in me to know the risk of an injury with this exercise was way too high.  I had plenty of other safer leg and low back strengthening exercises in my daily workout routine.  Checking my ego at the door while keeping my body injury-free was a much smarter plan than trying to keep pace with the impressively tough athletes I workout with, many of which are half my age.

“Fun”-ctional Fitness?

I quickly dropped my butt low and aggressively dug my fingers under the black beast as it angrily tried to anchor itself to the humid Florida asphalt. I hadn’t flipped a 400 lbs tire in about 15 years but I was ready!  Under the eager watch of my Spartan Race buddies, I pried the rubber behemoth from its nest with a loud groan and awkwardly wrestled it upward.  My low back creaked, my hips moaned and my knees griped as the round monster slowly rose to its tread.  As I thrust the dominated creature onto it’s back as it moaned a hollow “thud”, I convincingly announced: “….last #*@% time I’ll do THAT!”

Painful Hindsight

How many times have you injured yourself only to regretfully say: “What was I thinking?”  It’s a frustrating predicament and, as we age and hopefully we get wiser, it’s a situation we eagerly try to avoid.

Avoiding Sports Injuries Start With One Question

My solution: Before engaging in a new exercise, activity or event I ask myself one powerful question:

“Is the RISK worth the REWARD?”

It’s that simple.  Only you can answer the question because only you have to live with the outcome.  For me, the reward of flipping a tire was minimal because the risk of an injury was at way too high of a cost.  It was an easy answer for me.

Reward Outweigh Your Risk of a Sports Injury?

Looking back at previous injuries in your life, how would you have answered the Risk – Reward question prior to the injury?  With some overuse injuries or freak accidents there is no way to predict something in your body was going to tweak, pop or tear.  But more times than not, we do have an opportunity to alter our path to the doctor’s office.

Ask the Question

By no means am I trying to divert any of us away from cross training workouts to avoid all risk.  Lord knows most couches in today’s society have reached their seating capacity!  My message is to think before you blindly jump into new exercises or workouts to help reduce your risk of an injury.  Asking yourself the powerful Risk – Reward question before you start will help you avoid careless injuries as you gain strength and conditioning while you enhance your health.

Smart Exercises

Maximizing the long-term benefits of your workouts starts with avoiding sports injuries.  As you increase the volume of your workout routines, it’s wise to substitute lower risk activities for higher risk exercises such as tire flipping.

Here are some smarter alternatives for athletes interested in reducing the risk of more aggressive exercises:

   Higher Risk     >>     Lower Risk

Tire Flipping   >>   Body Squats, Kettle Bell Swings, Med Ball Wall Throws

Box Jumps   >>   Lunges, Burpees, Star Jumps, One-Legged Box Squats

Dead Lifts   >>   Wall Sits, Dumbbell Cleans, Bear Crawls

Hanging Knee Tucks   >>   Crunches, Leg Flutters, Med Ball Throws

The Bottom Line

Asking yourself the question “Is the RISK worth the REWARD?” before major changes in your workout and your life can help you avoid sports injuries and heartache.  It’s a simple way to help you to stay in the game of life by saving you pain, $$, stress, downtime and sleep.   MDR

Thanks for sharing this blog with active friends like you!

How to Get a Massage with a Happy Ending Every Time!

Come on, who doesn’t love a great massage with a happy ending?!

I can see you smiling now just thinking of that satisfied feeling at the end of a massage with all the worries of the world and the aches and pains of a long week gone. Whether it’s a caring shoulder rub after a hard day at work or a therapeutic sports massage before a big game, the results are almost always positive.

Have you ever wondered why massage is so beneficial to the body and mind?  I have and my “research” on the benefits of sports massage continues to this very day. In other words, I receive massages on a regular basis. As a physical therapist and athletic trainer who works with elite athletes, I almost always incorporate some type of massage therapy into my athlete’s rehabilitation protocols.

Think of the different types of massages you’ve received. Have you ever been given a massage that was so rough that it made you feel sore and achy for days? Or maybe you’ve been the recipient of a massage that so light and easy that you found it to be a waste of time? I have been through both of these scenarios and it taught me a very valuable lesson.

In order to optimize the benefits and positive results of my sports medicine massage, I suggest that you clearly determine the objectives of your massage beforehand.

Determine the objectives of your massage

Here are the four simple questions you and your massage therapist need to answer before your treatment.

  1. What areas of my body am I interested in treating?
  2. What are my symptoms and limitations in these areas?
  3. What is my desired outcome of this massage and how do I want it to improve my symptoms?
  4. What types of massage techniques will be used and what can I expect to feel during this massage?

Identifying the answers to these questions will help get you and your health care professional to be on the same page and significantly enhance the positive results of your massage.

Types of Massage

Here are some of the most popular types of massage used in the field of sports medicine:

  • Sports Massage
  • Swedish Massage
  • Deep Friction Massage
  • Trigger Point Therapy
  • Neuromuscular Therapy
  • Hot Stone Massage
  • Reflexology

Benefits of Massage

Massage has been around for thousands of years and has become an important healing tool in many cultures for good reason.

The benefits of massage and its ability to heal various ailments are well documented. Human touch is a natural healer. It offers support and conveys compassion as it soothes away aching muscles, eases pain and relieves stress. In fact, medical experts estimate that up to 90% percent of all disease is stress-related, regardless of your age.

Healers from all around the world have created and applied countless types of therapeutic techniques utilizing touch. Today, modern medicine has scientifically proven and continues to support the many benefits of massage, which include but are not limited to:

  • Increased muscle and join flexibility immune system
  • Improved immune system
  • Reduced emotional stress
  • Relaxing muscular and spine tension
  • Improved circulation
  • Increased endorphin production to reduce pain
  • Enhancing a general sense of well-being
  • Decreased blood pressure
  • Reduced depression and anxiety

The Happy Ending?

Massage therapy does more than just relax your body and mind. It can actually affect your physiological (body chemistry) and psychological (mind related) state of being.

By utilizing massage therapy in both your injury prevention and rehabilitation plans, you’ll get the best “happy ending” by accelerating your return to being active and enjoy a healthy lifestyle!