Transcription of Summer Sports Injuries #47
Dr. Lisa: This is Dr. Lisa Belisle, and you are listening to the Dr. Lisa Radio Hour and Podcast show number 47, ‘Summer Sports Injuries’, airing for the first time on August fifth, 2012 on WLOB and WPEI Radio Portland, Maine.
Here in the studio with me today is my co-host and wellness editor for the ‘Maine Magazine’, Genevieve Morgan. Hi, Genevieve.
Genevieve: Hi, Lisa.
Dr. Lisa: Genevieve, sports injuries. You have two boys, I have three kids. Things are different on the summer time.
Genevieve: It certainly seems as if injuries are on the rise in kids, but also with our population like people weekend warriors and from all of us who are going out and maybe taking a jog after work. It just seems like a lot of people are having back issues, joint issues, more breaks and falls and concussions. I’m hearing a lot about it. How about you?
Dr. Lisa: My practice of course has got an acupuncture aspect to it and addition of Chinese medicine. Yes, I see a lot of injuries. I see people that go out and maybe just overdo it a little bit too much. As you said, weekend warriors, they don’t do much during the week and on the weekends, they are a little bit too intense. I also see people who want to keep playing adult team sports into their 40s, 50s and they just aren’t quite as careful as they might need to be.
I think that there are some things that people can do that aren’t that hard.
Genevieve: There’s prevention and then there’s rehab. Just a funny story yesterday, a friend of mine asked me if I’d go water jogging with her, something I had never done before. I guess it’s a great rehabilitation practice, and you put a little floated belt around your middle, and you go into a pool and you basically jog in the water for an hour, punching the water and stomping grates on the bottom. You do it for long enough time until you’re tired. It actually is quite tiring, but it’s impact-free.
Dr. Lisa: I am very familiar with water jogging when I had my multiple knee surgeries back 11 years ago. I also did water jogging and, yes, there are some really interesting ways that they go about doing rehabilitation. Today in the studio, we’re going to have Dr. John Herzog who is an orthopedic surgeon with a very interesting approach to injuries and sports and a very unique way of treating injuries.
We will also have Stephen Anderson from The Body Architect who’s going to talk to us about remaining strong and flexible, and what types of things we have to think about in the summertime with regard to our bodies.
Genevieve: I guess it’s slow and steady and strong that wins the race.
Dr. Lisa: Slow, steady, strong, flexible. I think all of these things are things that we need to take into consideration. In fact, one of our shows last fall, we talked about strength, and then we talked about resilience, and the fact that if you are going out and just doing weight lifting, that’s not going to be as helpful to you as doing weight lifting and stretching. In addition, you want to do some endurance work, and in addition, you want to do a little bit of speed stuff.
Stephen Anderson is very good with taking the whole body into consideration. In fact, he even teaches Qigong, and trying to help people get and stay balanced at his training facility up on the east end, The Body Architect.
Genevieve: It sounds like a really interesting show.
Dr. Lisa: I think it’s going to be a really fun show, and it’s nice that we’re able to offer this on our new station, WPEI. We know that there are people listening to WPEI who themselves are sports fans. Welcome to our listenership and we hope you enjoy the show.
The Dr. Lisa Radio Hour and Podcast is pleased to be sponsored by the University of New England. As part of our collaboration with the University of New England, we offer a segment we call ‘Wellness Innovations’. This week’s Wellness Innovation comes out of Chicago.
Neuromuscular warm-up is associated with reduced lower extremity injuries in adolescent female athletes. Integrating a coach-led neuromuscular warm-up prior to sports practice appeared to reduce the risk of lower extremity injuries in female high school soccer and basketball athletes according to a report in the November issue of ‘Archives of Pediatrics and Adolescent Medicine’. In the study, they sought to examine if lower extremity injuries in adolescent female basketball and soccer athletes could be reduced by incorporating a neuromuscular warm-up prior to every practice and game.
The authors invited coaches from Chicago public schools to participate. Coaches were randomly assigned to either the intervention group or control group. Coaches in the intervention group who instituted a neuromuscular warm-up attended a two-hour training session which included progressive strengthening, balance, plyometric and agility exercises, as well as an educational component where coaches provided feedback to athletes to promote safe jumping and landing techniques designed to help avoid strain on the anterior cruciate ligament or ACL which can cause knee injury.
There were 755 athletes in the control group and 737 athletes in the intervention group. The control group had 96 lower extremity injuries compared to 50 lower extremity injuries in the intervention group. Leading researchers do report findings that suggest neuromuscular training should be routine in girl’s high school soccer and basketball.
For more information on this Wellness Innovation, go to ‘Doctorlisa.org’. For more information on the University of New England, go to ‘Une.edu’.
Male: This portion of the Dr. Lisa Radio Hour and Podcast has been brought to you by the University of New England. UNE, an innovative health sciences university grounded in the liberal arts. UNE is the number one educator of health professionals in Maine. Learn more about the University of New England at ‘Une.edu’.
Dr. Lisa: As part of our ‘Summer Sports Injuries’ show, we have in the studio with us today Dr. John Herzog of Orthopedic Specialists in Falmouth. Thank you for joining us today.
Dr. John: It’s a pleasure to be here.
Dr. Lisa: The last time you came and talked about many things, but part of what you’re talking about was plant-based eating and Dr. John’s ‘Brain-ola’. I know you’ve had some interesting things happen in the plant-based eating world. Tell me about some of those before we talk about sports injuries.
Dr. John: I continue to be an advocate that diet is probably the most important thing we do next to breathing air. If we have a good diet, we’re able to heal up these sports injuries, and we’re able to be fit and keep a normal body weight and stop inflammation which is my enemy.
Dr. Lisa: Okay. Let’s talk about inflammation and summer sports injuries. What types of things are you seeing this time of a year?
Dr. John: Obviously, as we hibernated through the winter, we got on our skis a little bit and maybe snow shoe, but didn’t get outside and spend as much time as we do when the beautiful sun is out there. The thing you hear most about is overuse, repetitive stress, stress tendonitis, overuse of the plantar fascia, knee pain, hip pain, back pain and shoulder pain.
Genevieve: How about tennis elbow?
Dr. John: Tennis elbow oddly is not very common in tennis players, but it’s common in anybody that’s out there doing a project like you finally get to shingle the barn or you had to weed whack. I see that very commonly.
Dr. Lisa: What is tennis elbow?
Dr. John: Tennis elbow is really, the fancy word is ‘Lateral epicondylitis’. That means where the tendons that attach to the elbow that caused the wrist and fingers to bend backwards. They all attach in a very small area about half the size of a dime. Part of that attachment gets pulled off when you injure it, so you jerked your wrist back real hard when you were lifting up a stone or something. As it tries to heal, you keep doing it again and again. Instead of getting a nice, firm growth of the tendon back into the bone, you end up with a little bit of scar tissue which hurts like a loose tooth when you’re eating corn on the cob.
Dr. Lisa: This is also if people play tennis or if they use a hammer or they do anything repetitive which is the same motion over and over and over again with their hand or their arm, and this can cause this loose tooth pain.
Dr. John: Exactly. My job is to try to get that inflammation out of there, and either stimulate it to heal with a little mini surgical procedure or just let mother nature and father time, a little stretching, a little massage. There’s hundreds of ways to go. After about six weeks, if it’s still bothering you, we get a little more aggressive at least at Orthopedic Specialists in Falmouth.
Dr. Lisa: What about golf elbow? What is golf elbow?
Dr. John: Golf elbow is pain on the inside part of the elbow called the ‘Medial epicondyle’. As the golf swing goes which I don’t know much about, but as you swing down and you hit something hard, you can tear part of the muscles that cause the wrist and fingers to flex or bend. That gets pulled off, you continue to do that over and over, you get the scar tissue, the loose tooth pain, it will sore for six weeks, we get a little more aggressive. Hopefully, mother nature and father time will take care of it with just a little rest and massage.
Dr. Lisa: Dr. John, when I was training in family medicine, I learned about something called ‘RICE’.
Dr. John: Rest, ice, compression and elevation. That’s the first thing we do when we get hurt just naturally. You’re out of the game when you sprain your ankle, and you want to put it up in the air because your heart doesn’t pound so hard in your foot, and put ice on it. That makes it feel better and wrap an ace wrap around it. That’s where the elevation, compression, RICE acronym comes from.
Genevieve: Does this have anything to do with the straps that they sell in pharmacies or other stores that can go on the elbow?
Dr. John: I’m not a big strap guy. I think that if you’re putting a strap on top of skin that’s mobile, and you’re trying to hold a muscle that’s also mobile, it doesn’t do very well. What it does do well is remind you that something is wrong with you. Every time you go to do something, you go, “That strap is there. I won’t lift it so hard.”
Genevieve: Can you solve for me once and for all the ice versus heat argument?
Dr. John: It depends. If it’s acutely inflamed, ice, you’re going to put the fire out with the ice. If it’s something kind of chronic where you want more blood to get into it, get it circulating a little bit more, turn it pink, you’d use heat. After acute injury, ice is the best.
Dr. Lisa: Sometimes, it has to do with whatever feels the best on it.
Dr. John: That’s true. Anything goes after 24 hours. Usually, if you watch a football game on TV, someone’s laying on the sideline, they get ice on them for a reason. You’re trying to cool that injury down and decrease the circulation. If someone’s got to pull the hamstring let’s say, and that’s been going on for months, they heat it up before the game.
Dr. Lisa: Let’s talk about pulled hamstrings. Where is the hamstring and what types of things happen to it?
Dr. John: Hamstring is a longest complex of muscles in your body. It goes all the way down to below your knee all the way up to your buttocks. That one muscle is very easy to pull. When you pull up fibers, you can either disrupt them a little bit inside of a muscle. If you’re picturing let’s say a tenderloin steak, and if you pull those fibers, it gets a little gritty like a flank steak. You get a tendonitis muscle pull. That’s usually best treated with massage, rest, ice, it’s hard to elevate but you can.
Dr. Lisa: How do people usually pull a hamstring? What types of activities are they participating in that would cause that to happen?
Dr. John: Usually, a quick burst. Meaning that if you’re going to jump up to grab a ball or you’re going to chase after a pass or something, something quick or a fall. If you have an uncoordinated fall on the stairs, you can pull your hamstring that way too. You’re literally just stretching the longest muscle in your body.
In some cases, you can actually tear it right in half, and those are pretty devastating. They’re hard to repair.
Dr. Lisa: Have you seen that before?
Dr. John: Yes.
Dr. Lisa: How do you deal with that?
Dr. John: If it’s a younger person, hopefully a piece of bone will pull off with it, so you can just tact the piece of bone back onto the buttocks. If it’s right in the middle of the leg, it’s like trying to sow back two pieces of custard pie. It’s hard to do.
Dr. Lisa: Okay. What other kinds of injuries are you seeing in the summertime?
Dr. John: I see a lot of plantar fasciitis. People like to get out and run, and play tennis.
Dr. Lisa: Your plantar fascia is where?
Dr. John: It’s right on your heel, right on the bottom of your heel. Some people call it a ‘Stone bruise’. When that area is sore, you can’t do anything especially the first thing in the morning, when you get up, your heel hurts a lot, and by the end of the day it hurts, whenever you got up a chair, your heel hurts. It’s probably the number one thing I see after people get more active and tear their plantar fascia just like that tennis elbow thing and that golfer elbow thing. You tear a part of the connection of the fascia or the tendons to the bone, and that bone would be the heal bone.
Genevieve: There’s a lot of Advil and Motrin and Tylenol used, as well as more highly prescribed medication like Oxycodone and Hydrocodone. We seem to be in a society right now that’s in a lot of chronic pain, and probably a lot of it is injury induced. Are there are other ways people can treat pain?
Dr. John: I’m a big believer that knowing everybody wants to have a pill and get a quick fix, it’s not one of the best choices to make right out of the blocks. It seems ironic to me that an anti-inflammatory pill you take causes your stomach to become inflamed, and then it makes your blood thinner, and then it makes fractures, take longer to heal, sprains take longer to heal just by taking Ibuprofen. Everybody on TV and everybody seems to think, “Just take your Ibuprofen. That’s the thing you do when you have pain.” Granted, it might slow down inflammation a bit, but it actually slows down healing. I don’t personally take it myself and only recommend it for short-term use in people.
As far as the narcotics are concerned, there’s a place for everything. You get hit by a bus, you need narcotics after you have your leg screwed back on. If you have a low back pain and you’re taking narcotics, the first thing that happens is your body gets the narcotic which is very similar to what your body already makes, so your own pharmacy, your own bioidentical pharmacy that’s working in your brain and in your endocrine organs decides to turn off, so you’re counting on the pills, and then you get addicted. Everybody gets addicted in a couple of days to pain killers. Therefore, we have a lot of people on pain killers.
Dr. Lisa: What about Tylenol or Acetaminophen? Does that help with inflammation or does that have side-effects that we should be worried about?
Dr. John: It’s good for reducing a fever and it does help out with pain, but it also has side-effects like the liver, it causes the liver to become inflamed. It doesn’t hurt the stomach as much, but I’m not a big pill guy. I really tell people to have crazy things like flax seed and eat whole grains, and eat whole fresh food, and your body can handle the inflammation much more efficiently.
Dr. Lisa: Talk to us a little bit about that. Why does the diet help?
Dr. John: It’s just like putting good gasoline in your car. If you put in the cheap stuff that’s kind of water down, you’re going to spatter and you’re going to blow smoke and you’re going to get clogged up. Good food easily absorbed and placed in your arteries and in your vessels in all your cells helps reduce inflammation by not causing the residue to build up if that makes sense, like the sod in your chimney, if you don’t clean your wood stove pipes.
Rotten food, I hate to say rotten, but processed foods, over fatty foods, low fiber foods really clog us up. I mean, not to get gross but cause the patients a major problem when they have that kind of a diet. The food just doesn’t go through you as well. It’s not absorbed as well and it’s harder to burn, and we get chubby.
Genevieve: I recently went through about six months of severe back pain. One of the best pieces of advice I got, I can’t remember, it might have been from you, was to make as much of my movement as pain-free as possible. If there were poses or movements that didn’t hurt, try to prolong those periods of where I was out of pain. This is talking without taking any kind of pills.
Is that something that you recommend, because I know there’s a big controversy between how much you should rest when you should get back on your feet? I think it’s confusing for people. What’s your advice?
Dr. John: The human body is made to have function and movement. By utilizing your body using gravity or trying to avoid gravity, you’re stimulating your muscles and also your blood supply to increase. If you use something, it turns pink, that means more blood is getting into it, and that brings more energy. It takes more stuff away, it gets rid of the waste and it brings in the fuel if you use something, even if it hurts.
Of course, if you have a broken leg and it’s not in a cast, you don’t want to wiggle that around a lot and your body tells you to stop doing that. Generally speaking, you try to move as much as you can. If you’re having trouble on land, get in the water.
Genevieve: What actually is pain when someone feels a sensation of pain?
Dr. John: I think that’s extremely varied. In Maine here, I’m a Michigander, but the word spleeny comes to mind sometimes, where if I just touch somebody’s little toe and I have to give them a shot and a little neuroma, you think they were having triplets.
Genevieve: That’s what people call pain threshold. Some people have a low pain threshold, some people have a high pain threshold.
Dr. John: Right, and everybody has pain. We need to have pain as a protective sense or our hands would burn off when we put them on the stove. People I believe can be trained in condition to perceive pain much more acutely than others. That’s a whole another fancy concept called ‘Centrally mediated pain’. It’s almost like having a post-traumatic stress syndrome. You’ve had so much pain like everything just causes you pain even a mild irritant can cause you deep pain like in fibromyalgia type of pain which is very real. I believe in that.
Pain is all over the place. Some people can get all stove-up and halfway take their finger off, and it doesn’t seem to bother them.
Genevieve: In your practice, you have seen patients get severe reduction of pain with what you’re doing.
Dr. John: Sure.
Genevieve: With manipulation?
Dr. John: Yes, but with manipulation or actually putting something back in a socket, that always feels much better.
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Genevieve: What else do you do to alleviate pain that’s not the traditional route?
Dr. John: I try, my philosophy is to try to keep things as natural as possible. I always encourage people to have a good diet, breathe clean air and get exercise. For people who exercise, have 600% more endorphins and anti-inflammatories in their body so they can handle the pain and heal much faster.
To augment people that are in pain, I encourage massage type things, moving in light exercise, and when things get out of hand, I’ll go to an injection. I use a machine called an ‘Ultrasound’ just like you could tell if it’s a boy or a girl in OB. You can see tendonitis, you can see partial nerve injuries, hamstring pulls, etcetera, and you can very specifically inject some Cortizone in there perhaps or frequently, I use your own body’s platelet cells which we centrifuge and re-inject into areas that need to be healed. I know that was a plateful right there.
Genevieve: No, that’s very interesting. No. What’s that procedure called actually, the platelet?
Dr. John: It’s called ‘Platelet-rich plasma’. Essentially, you take out let’s say cup of blood, and you spin it down into two tablespoons of platelet cells. Now, platelet cells are little cells that when you injure yourself, say you cut your hand, that’s what comes in immediately and starts to form the scab. It forms the matrix or like the goo immediately, and it attracts stem cells to come in and replace the skin, the nerve, the bone or tendon or whatever is injured.
We know that we can fool mother nature a little bit by concentrating those platelets and stick it into your rotator cuff or your tennis elbow or your plantar fasciitis, and initiate healing without surgery or drugs.
Dr. Lisa: Talk to us about osteopathic manipulative medicine or manipulative therapy, OMM and OMT.
Dr. John: Again, that’s all over the map too. I mean, you can have cranial sacral manipulation or you can have what I prefer a street fighting osteopath, and that I like to rack them and crack them, you know as they say in the old day.
Dr. Lisa: What happens when you put your hands on somebody and you rack them and crack them? What are you doing?
Dr. John: Basically, you can tell where something is in spasm, and you rub in the special area. Let’s say that you’ve fallen down the stairs and you twisted your back to the left, to have somebody know how to massage the left side of your back and then twist it back to the right to straighten you up, it just feels a lot better. It’s like a good yawn or a sneeze.
Dr. Lisa: This is something that needs to be repeated once you’ve done manipulative work on somebody once?
Dr. John: Sometimes, a few times, but the original osteopath, he had to sing. It was find the, fix them, and forget them. To have people sign up for the weekly treatments for everything, I try to get it done in one or two visits.
Dr. Lisa: Talk to us about if you have an injury, if you have a plantar fasciitis on your left side, what could happen to your right side or what could have happen further up your body?
Dr. John: If you start walking with a hitch, you definitely can overuse the other side because the other side hurts so much and then develop a similar situation on the opposite side. That’s why we would give somebody crutches if they had a broken ankle or something, if it’s a mild limp, generally speaking, your body can heal itself within the first three weeks, and after that point in time, you might want to see somebody for a little more direction.
I’m not a big believer that if you walk with a slight limp, you get a headache, but I hear that a lot. If you get a headache, rub your neck.
Dr. Lisa: Talk to us about the weekend warrior idea. I know you were talking about … you, yourself, you go out several times a week, but there are people who at summertime, they haven’t really done anything all winter or even any time of a year. They don’t do things during the week and then on the weekend, they need to hit it full force.
Dr. John: That’s never a good formula for not hurting yourself. If you’re not stretched out and in fairly decent shape, if you just jump off the couch and decided to run around Back Bay, you’re probably going to end up with shin splints and sore feet and a sore back. I think if you keep in a reasonable amount of physical conditioning at least three days a week for 45 minutes, you can probably go throw the football and the Frisbee around and be a semi-warrior, but picking up a lacrosse stick and going full blast would be a bad idea as you get older. I mean, yes, of course when we’re in our teens and 20s, and I think even our 30s would get away with a lot of stuff.
Genevieve: What can someone expect from this platelet treatment or what you’re calling PRP?
Dr. John: Basically, if you have this tendonitis, let’s say you have a tennis elbow that’s been plaguing you for months, I decide that on the ultrasound, I see that little loose tooth, that little piece of scar tissue. I say, “You know what? That little gummy bear is out of here.” I’m going to go numb it up, and after I numb it up with a little Xylocaine, very similar to what a dentist would use, although not as painful as with a dentist, pretty much painlessly. You can go in there and numb up the scar tissue. Using a small needle, you can scrape off part of the scar tissue, make little teeny holes in the bone, and then inject the patient’s platelet cells.
Here, I jumped a step. Before I do that and we have you sit down in a chair and take some blood out of your arm through a little ivy, that gets centrifuged or spun at a real fast rate of speed and it separates out into the platelet level. We put that in a syringe, and after everything is numb, we inject your own cells back into your body to re-grow the tissue, either the bone, the cartilage. It’s good for arthritis of the knee, the hip, and partially torn rotator cuffs.
Genevieve: How long does it take to recover from that?
Dr. John: It will show a re-growth within six weeks. I see you back in a month after I’ve done it, and we’ll see how much activity is going on, how many new cells are growing in the spot, and if it did work or not. It doesn’t always work. Sometimes, we have to repeat the process.
Genevieve: Can you use the limb or the spot where you’ve injected in that course of time?
Dr. John: Yes. I don’t want you to climb Mount Katahdin for four days after I do your heel or your Achilles, but generally, you’re sore enough that you don’t want to do that anyway so you’re going to have some pain. In particularly tough cases, I will get people the narcotic type of pain killers for three or four days.
Dr. Lisa: Dr. John, how can people learn about your practice?
Dr. John: The best way, I have a pretty informative website, it’s called ‘Orthocareme.com’. I’ve got tutorials on all these PRP or the platelet stuff, osteopathic treatments, diet, exercise, clean air and my basic philosophy of “Do no harm”.
Dr. Lisa: Your practice is located in?
Dr. John: Right in Falmouth, kind of behind of Wal-Mart, on Clearwater Drive.
Dr. Lisa: You’re in a beautiful building.
Dr. John: Yes. It’s a lead green building, certified and it looks right at the estuary. We have a nesting eagle right off the property and osprey and a bunch of deer that run around the front yard all the time, and occasional fox and coyotes stop by too. It’s beautiful.
Genevieve: You’ve been a terrific sponsor of our show, so we’d love it if some of our listeners, if they come and visit you let you know that they are Dr. Lisa fans.
Dr. John: That’d be great. Bring it on.
Dr. Lisa: We also encourage the people who have been long time listeners to maybe go back and download the podcast you were on previously. We’ll make sure that that’s linked on the Dr. Lisa page because you talked a lot more about your plant-based diet recommendations. I think people will find that interesting.
Dr. John: Right. It seems to be catching on.
Dr. Lisa: I agree. It’s a good thing to have catching on. Thanks for coming in and talking to us today about ‘Summer Sports Injuries’ and really a broad variety of things.
Dr. John: it’s always a pleasure, and thanks again.
Male: A chronic ache, sleepless nights, a feeling of something being not quite right … You can treat these symptoms with traditional medications and feel better for a little while, and continue on with your busy days. Have you ever stopped to consider the what that’s at the core of a health issue? Most times, it goes much deeper than you think. When you don’t treat the root cause, the aches, sleeplessness and that not quite right feeling come back, but they don’t have to.
You can take a step towards a healthier, more centered life. Schedule an appointment with Dr. Lisa Belisle, and discover how our practice that combines traditional medicine with eastern healing practices can put you on the right path to better living.
For more information, please call the Body Architect in Portland at 207-774-2196, or visit ‘Doctorlisa.org’ today. Healthy living is a journey. Take the first step.
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Dr. Lisa: This is Dr. Lisa. In the studio today, we have with us Stephen Anderson of The Body Architect. Stephen came on before to talk to us about, I believe it was ‘Light’. Is that right?
Stephen: Yes it was.
Dr. Lisa: You’re on the light show.
Stephen: I was in the light show.
Dr. Lisa: The light show from last fall.
Stephen: Yes.
Dr. Lisa: You’ve subsequently been profiled in ‘Maine Magazine’.
Genevieve: With the Wellness issue in April.
Stephen: In April, yes.
Dr. Lisa: You’ve become a local celebrity.
Stephen: For a bit, yes.
Dr. Lisa: Yes, so we think it’s perfect that you’re going to talk with us about summer sports injuries, and the fact that we’re now on the FM dial on WPEI which has a sports affiliation. You have a very long history of interaction with athletes and being an athlete yourself.
Stephen: I do, yes. I do. A lot of my clients that come to me, they may come from referrals from physicians or they may have had their own injuries, so we look at each individual case and we develop a plan accordingly.
Dr. Lisa: Talk to me about what you see in the summertime, when people come in to The Body Architect. What types of things are they hoping to accomplish in the summer?
Stephen: We have a lot of members who are golfers. That seems to be a very popular sport. They’re looking for not only reduction of weight, but to improve performance in a sport. Obviously in the summer, a lot of the children are on vacation, so sometimes parents will bring their children in just to improve their performance. It’s a lot of rotational movement.
The things that I see that are really debilitating is hydration levels in the summer. With the heat, people don’t tend to drink as much as they normally do. Things that lead to hydration, injury is very prominent.
Dr. Lisa: What’s a hydration injury?
Stephen: Hydration, when people don’t have enough hydration is like a cycle. It starts and it’s a chain reaction. They start getting headaches and they may not eat as well. They may not rest as well. Their performance really starts to suffer. When we turn that around like I mentioned last time that I was here that oftentimes, a lot of people that come in, they say they’re quite hydrated, I get them on my scale and they’re quite dehydrated.
Even though they think they’re drinking adequate amounts, they’re probably not doing enough because their bodies are eliminating perspiration even when they can’t see it happening, so it’s going through the entire system. Things like headaches, stamina, endurance issues are really big.
Dr. Lisa: When you are an athlete and in training in the summer, there were probably other more significant things that were happening with dehydrated athletes as well.
Stephen: There were. I remember because I ran across country, so that’s something that’s even more aggressive I hate to say in those days, but we had to take salt tablets. Again, it’s not only the water, it’s the electrolytes in the water. The body has to be … I like things to be bioavailable so they can use their hydration. It may not be just enough for water, they may need to have some electrolytes.
However, in my opinion, most of the sports drinks aren’t the way to go. Adding a little pinch of good quality salt to your water could give you the electrolytes that you need to make that more available to the system so that can be transferred into performance.
Genevieve: Is one of the symptoms of dehydration muscle cramping?
Stephen: Yes, very good point. For some training sessions, sometimes as we get halfway through, there may be some cramping. To me, it’s a red flag. It’s about hydration. The body is just responding to that, is trying to give you a signal say, “Hey. You got to do something about this. Fuel me with the proper hydration or I’ll keep giving you a signal to make you stop the movement basically.” It’s a safety issue.
Dr. Lisa: In the news, we’ve seen athletes, I think football players tend to be in that group that don’t get enough water, and then that leads to heat exhaustion and eventually could be even heatstroke and death.
Stephen: Clearly. Yes.
Dr. Lisa: It’s a significant issue that people really do need to be paying attention to you.
Stephen: It is. It’s a very real thing, and you don’t have to be a professional athlete and a lead athlete. In those cases, they can be fairly severe, but nobody is immune from it so it can address anyone. It depends upon with their baseline is as well. As a normal baseline, I suggest to people they drink at least half their body weight in ounces. Knowing that they may not do that, but if there’s enough of a buffer zone, they’re going to get into a safety, a safer zone a well.
I’m a big fan of coconut water because of its electrolyte properties as well. The body really … it superflex that water. It takes it in. It really recognizes it as something that’s beneficial and healing. Even if you don’t like the taste of it and a lot of people don’t, they do make them flavored. That wouldn’t be my first choice, but it’s a better choice than other things, so there are some options out there.
Dr. Lisa: You mentioned that at your facility, at The Body Architect here in Portland, you have a machine that you use to measure people’s body water.
Stephen: We do. It’s called a ‘Bioimpedance machine’. People stand on this, we plug in specific information and it calls back out to us different information inclusive of body fat and BMI and total body water. For me, that’s the most important thing. I know people get pretty hung up on percentage of body fat. For me it’s what is your total body water, because if that is lacking like we were talking about earlier, that could be one of the side-effects, it may be difficult for one to let go of weight because their hydration level is so low that regardless of their attempts, they may not be able to shed those pounds that they’re looking to do.
If you just increase that water intake, it again can start knocking off all these things. You see, the better it gets, the better it gets. If people start sleeping better, then they make better eating choices, they make better movement choices, they make better stress management choices. The whole chainsort of like it can spiral down, but it can spiral back up as well.
When I look at that chart, that little ticket that the machine gives me, my most concern is the total body water, so I look at that. Men should be in a range of between 60 and 70%. Women, 50 to 60%. Most people are well below that. See, if you can just do one thing, just increase your hydration level, then I think a lot of those other little nagging things that are poking up people will start taking care of themselves. That’s what we want to do.
Just want to basically put the body in an environment where it can heal itself. It knows what to do, sometimes, they just have to get out of the way and allow that to happen. Something as simple as hydration could really affect to so many other problems.
Dr. Lisa: I know that you recently return from the Kripalu Institute, and you received additional training in Qigong.
Stephen: Yes. Correct.
Dr. Lisa: This is something you’ve been doing for a long time, you just mentioned the body healing itself.
Stephen: Yes.
Dr. Lisa: Remind people who didn’t get to listen to your ‘Light’ show the fall what is Qigong and why does that help the body heal itself?
Stephen: The thing I like about Qigong, and I think in one word, balance and equilibrium. If the body can start to harmonize, get back into a sense of equilibrium and balance, then the energy pathways open up. It’s very similar to the work that you do with needles. You’re opening energy pathways so that the energy can of course freely and unobstructed through the body.
Qigong, chi stands for breath or vital energy. Gong is practice or work. In essence, it’s breath, work, breath, practice, energy, practice. Qigong is just a series of movements and there are 10,000 forms. I’ve been doing it for probably 15 years. I would consider myself an infant in terms of being a Qigong. It’s funny, we’re talking to this gentleman who is teaching this class, and he says, “We use the term master way too much in the western.” They don’t do that in China or in the east as much. Everybody just assumes that.
For me, it’s a continual growth process. I really come to experience the benefits so I speak from someone who has a knowing about it. I first started Qigong because in my profession, my body was way too stiff, and so it was blocking of a lot of my vital energy. I was introduced to Qigong as a way to create suppleness and let flow go through my body. I was better able to use my breath because my philosophy has always been effectiveness and efficiency.
Qigong is really economy of effort, economy of movement. It teaches the body how to move correctly, and you start saving your energy instead of spending it. Now, I’m just as guilty as everyone else because I also tend to spend my energies a little too much, so Qigong has been a savior for me. I think one who is more active or more external, they need more internal work.
The saying goes that “The more internal you do, the less external you’ll choose”, or at least you’ll prioritize that. I know for me personally, as I have of all, I would always choose Qigong first because Qigong is about longevity and feeling good, and internal that’s going to be with you, whereas the physical portion is also very important, the body changes regardless age does take its toll.
It’s not about extending, it’s about quality movement. When I do Qigong exercises, it just places the body in positions where the energy can open up, then the body can take care of itself, because again, the greatest healing instrument is our body. It knows what to do. We just want to get it in that place and the reason according to my reading and my past research, the Sages, who developed these movements, they were into meditation, creating stillness.
Stillness has a lot of magic. They found the stillness alone, their bodies got too weak, so they weren’t able to hold the positions as long to gain all the magic from the meditation poses. They developed Qigong as a compliment to get their bodies strong so they could stay in meditative postures longer.
When I do a Qigong class, it always consist of a preparatory phase, then the exercises and then the stillness. We do the exercises to get to a point where we can create stillness in the body, and that’s where the magic happens. It also happens to feel good. It’s far more user friendly than a cousin like Tai Chi which tends to be more choreographed or sequenced. Qigong is just a little more user friendly. You really can’t do it wrong because it’s your body interpretation.
I’ll oftentimes tell people that it doesn’t matter what your expression looks like. If you just come in, if you are not feeling well, and you wanted to come in and sit down while we’re doing a Qigong class, you will benefit from the Chi that’s being created because Chi, being vital, being life essence, there’s nowhere that it’s not so it permeates all around. If you’re just in the environment, you’ll start to feel good, you may not know why. Once you start to feel good, then you make better decisions on again how you move and how you sleep and what you eat.
That’s the magic because there really is no one magic bullet. It’s the combination of all these things. You put them all together and you have wellness or well-being, and that’s what we’ve been professing. You do it in your practice, I see it, and it’s just another way to do it.
Dr. Lisa: Stephen, I know that one of the things that you keep talking about is the benefit of a healthy environment. That’s what you have at The Body Architect.
Stephen: Yes.
Dr. Lisa: I mean you really have made an effort to be mindful about your space.
Stephen: Yes.
Dr. Lisa: One of the things that happens in the summertime is you expand out onto your deck.
Stephen: Yes.
Dr. Lisa: Was it purposeful or did you just happen to think, “It’s pretty out there”?
Stephen: It was purposeful. We really enjoyed being outside. Doing Qigong or anything is really wonderful to really take in that fresh air. We are very fortunate in that our direction faces the mountains, and it faces a body of water as well, and there’s a lot of greenery so we have a perfect storm. If I do Qigong when the weather permits, I have people focused on strength of the mountain, fluidity of the water, the gentleness of the trees and the warmth of the sun. That’s very helpful.
However, people will just go out and do their own exercise patterns. When we first moved in, we saw that this was available and we thought it would be just a wonderful addition.
Dr. Lisa: They also do yoga out on your deck. Is that true?
Stephen: They do. They do. Yes, some of the classes. Middle part of the day is a little oppressive out there depending upon, but who knows? We’re getting in the fall, that’s really wonderful. Everyone that comes in after a class on the deck, they really report a greater sense of euphoria. It just feels good to them. I think because most of the movement, most of exercise is conducive to deep breath, and we can take in deep breath and is fresh. Boy, that’s so magical for me because Qigong is all about breath. Exercise is all about breath as well.
If people focus on the deep breath and I’ll say during the session with me which typically last an hour, you’ll probably take a couple of hundred deep breaths. I think that in and of itself is the most important thing you can do. The exercise portion I believe, you’ll read the benefits of that, but in my estimation or in my opinion, it’s secondary. The breath is fist. We need the breath first.
Male: We’ll return to our program after acknowledging the following generous sponsors. The Body Architect was founded on the belief that mindful exercise improves the health of the mind, body and spirit. Housed in an open light filled space in Portland, Maine, The Body Architect offers a cutting edge fitness center, expert personal trainers, nutrition counseling, and a full class schedule. Visit ‘Thebodyarchitect.com’ or call 207-774-2196 and get started with The Body Architect today, and by Dr. John Herzog of Orthopedic Specialists in Falmouth, Maine. At Orthopedic Specialists, ultrasound technology is taken to the highest degree. With state of the art ultrasound equipment, small areas of tendonitis, muscle tears, ligaments, instability and arthritic conditions can be easily found during examination.
For more information, visit ‘Orthocareme.com’ or call 207-781-9077.
Dr. Lisa: How do you feel about stretching to prevent injury?
Stephen: Stretching, another great question. This time of year, people need to systemically warm their bodies. I prefer that people stretch from a warm to position, and I also, just like I like functional training, I like functional stretching that simulates the movements that we do. I’m not a fan of just doing only static stretching, and I also don’t shy away from movement stretching. There’s a lot of a movement, and I also think about the body as a whole. I’m not trying to isolate a part when I stretch because you don’t simulate that in every day activity.
When I do a stretch and perhaps the hamstring which is very popular, maybe my primary objective, I’m stretching the whole body to accomplish that so nothing is left out, and that’s the way that I strength train as well so you’re able to use it. People who are participating in a sport, the best way to prepare is to simulate the sport at a lower level intensity. That’s the best way to prepare and try to I think avoid injury is a very strong word.
There are no guarantees. All we want to do is reduce the likelihood of an injury, as well as, if somebody does receive an injury, the severity may not be as much have they not prepared for it, and so therefore their recovery is a lot quicker.
Dr. Lisa: We’ve spoken about yoga, we’ve spoken about Qigong. I know you have also massage at The Body Architect?
Stephen: Yes.
Dr. Lisa: We’ve talked about bioimpedance and drinking water.
Stephen: Yes.
Dr. Lisa: I think I’d like to remind listeners that you have a very integrative approach. You also have TRX machines.
Stephen: Absolutely.
Dr. Lisa: You have other machines that are very traditional, I’ll just call it a ‘Fitness facility’ or a gym.
Stephen: Right.
Dr. Lisa: Having been through a training session with you, I can attest to the fact that you draw a lot from a lot of different areas.
Stephen: Yes. I think the main philosophy and the main purpose is that we want to work the body in an integrated fashion, and those pieces of equipment that you just listed really help us, as well as, that’s not the only answer. That’s a very small piece of the pie. Things like massage really help to alleviate any lactic acid. It’s just as important as other pieces of being well. Cardiovascular, the wonderful work that you do as well, just opening people up, placing them in wonderful position so the healing can take place.
We wanted to create that environment at the studio, and we still get reports today when people come through the elevator, they feel good about being in the environment. To me again, that’s the most important thing because anybody can do movement, anyone can do exercise, but it’s the environment in which you do that in and your interpretation of that that’s most important.
Having a great team that has this philosophy of which you’re now a part of, and I’m very grateful for that, it’s really helpful because congruency for me is huge. I want to make sure things that I say or things that I do and things that I believe in, and people that we have at The Body Architect share that same vision.
Dr. Lisa: I also noticed that in my workout with you, it was fun. I mean, not all of it is fun, but the Kettlebells.
Stephen: Yes. Yes. Yes, and I apologize for those moments.
Dr. Lisa: No, that’s all fine. The Kettlebells, the ball, the balance ball, I mean, you actually incorporated things in. I am a long time runner, so my workout was upper body, and it was something I was a little intimidated by.
Stephen: Yes.
Dr. Lisa: When I came in, you were very gentle, you made it interesting, and I think I’m somebody who gets very bored from doing weights, but you integrated a lot of things and you did it in a very efficient manner, so fun and efficient. Talk to us about efficiency.
Stephen: It’s very important because I like to talk about being in the moment. When a person is doing their workout, it’s their time, so that also has a lot of healing property. If they’re thinking about other distractions, it takes away from the physiological benefits or gaining from the workout. It really puts you in the moment.
When you are trying to balance on a ball, oftentimes, I’ll try to take balance away so that the body comes back to running reflex. It knows what to do again, but you’re not thinking about those things. You’re thinking about survival in a fun way. It’s like an adult playground. We have all these wonderful toys, and we’re just trying to unbalance you a little bit and can you come back to center. It’s equilibrium, because again, as you’re moving in space, the better balance you can get, then the likelihood of you getting the injury really starts to diminish.
I try to keep it fun in those, but not for sake of variety, because it has to have a purpose. Your response is very typical. A lot of people come and say, “Gee, we just did an upper body today.” The legs were involved in a lot of it, but you just didn’t realize that. It was just happening. It’s sort of this global sensation that happens. That’s a very typical response.
Dr. Lisa: I can tell you, it wasn’t my legs that were sore after the workout.
Stephen: Ouch. Yes.
Dr. Lisa: It’s something that I think about a lot, because I turn 41 in January, and I have pretty good endurance, I can bike, I can ski, I can run, but I think not unlike many women, the upper body and the arms is something that I’ve never really focused on.
Stephen: Yes.
Dr. Lisa: The way to go in there and rebalance was very helpful.
Stephen: Very important because if you focus on those activities, and you put time on that repetitive motion, but other pieces are missing, then it’s just a matter of time before the triangle collapses. When we start focusing on the strength, then it will allow you to do the running for longer, for more enjoyment, also to really try to cut back on the likelihood of an injury.
Oftentimes, in women in particular, I see strength training as a missing link oftentimes because I think it’s just been very intimidating in our culture and our society, and the traditional facilities may have something to do with that. This gets you back into playing. Things are strengthening and again, I always go back to “You’re only as strong as your weakest point”, so when we get that weak point stronger, the organism gets stronger. Everything becomes easy.
Again, I think the most important part is not the time that you spend there in the exercise or in the actual activity. You want to prepare so that your life flows smoothly all the time no matter what because it’s a 24-hour day basically, it’s not a one or two so you get it all.
Genevieve: It’s been such a warm sunny summer this summer, kind of different for a lot of us who’ve grown up in the summers here. Is there a better time to exercise in summer with all the things we’ve been talking about, hydration, warm body …?
Stephen: Right. There probably is I find that is very unique to the individual. It really has to meet their lifestyles. When it’s really warm, obviously in cooler parts of the day are going to be best, so a lot of people are morning exercises, others like evenings, so it becomes a personal preference. What I’ve also experienced over the years that if people for the most part, if they don’t get their exercise done in the morning, in the A.M., then they find too many excuses get in the way. Life gets in the way as it does. We suffer from the human condition, so it’s important.
I think once you make it an integral part of your lifestyle, then just see how it fits in and make sure they get it done, and also realize that everything counts. You wouldn’t also have to do the full exercise. There are different components, you have the cardiorespiratory and then muscular strength and endurance and flexibility. Oftentimes, they can be woven together, but you wouldn’t necessarily have to do them in the same setting.
In other words, if you wanted to go out for a run in the morning and then do your resistance training in the late afternoon, that would be okay as well. They’re different categories. They don’t have to be sandwiched together. It really comes down to personal preference and when it fits your lifestyle. Clearly, when it’s that hot, you really want to be careful because the quality of the air isn’t greatest, and when you’re exercising, obviously you’re grabbing for more air.
Dr. Lisa: Stephen, how can people find out more about you and The Body Architect?
Stephen: They can go online now which is ‘Thebodyarchitect.com’. They can give us a call. Our number is 207-774-2196. We have a virtual tour on our website as well, and that’s been revamped. Again, I’m not the one to ask for the technology portion of it. However, it will give the people a virtual tour and all the information that they need.
They can also stop by and see us at any time. We’re in hours of operation facility.
Dr. Lisa: Genevieve, how do they read more about Stephen?
Genevieve: The profile came out in April, 2012 issue of ‘Maine Magazine’ which is online. I feel as if we’ve written a lot about you.
Stephen: You have. Very appreciative. Thank you so much. It’s great.
Genevieve: I think there’s going to be an article about Dr. May coming out soon.
Stephen: Wonderful. Great.
Genevieve: I think just logging on to ‘Themainemag.com’ and typing your name into the search facility.
Stephen: Yes. Good connection. It’s great.
Dr. Lisa: We’ve been talking with Stephen Anderson of The Body Architect who is again local celebrity, but you heard him first here. Go back and download the podcast from the fall on ‘Light’ and hear what he had to say on that topic. He happens also to be one of my colleagues now as that’s where my acupuncture and Chinese medicine practice is located.
If you stop by and visit Stephen, then you can visit with me too and we thank you for being here today and talking about sports injuries.
Stephen: Thank you for having me.
Dr. Lisa: This is Dr. Lisa Belisle, and you have been listening to the ‘Dr. Lisa Radio Hour and Podcast’ show number 47, ‘Summer Sports Injuries’, airing for the first time on August fifth, 2012 on WLOB and WPEI Radio Portland, Maine.
Today’s guests have included Dr. John Herzog of Orthopedic Specialists in Falmouth, and Stephen Anderson of The Body Architect in Portland discussing ‘Summer Sports Injuries’. We hope that you have gained some information and insight, and perhaps inspiration to go out and prevent your own summer sport injury, or perhaps rehab from one that maybe you already have.
For more information on our guests, go to ‘Doctorlisa.org’. Let us know what you think of this show, and perhaps give us a few ideas for future shows by going to the Dr. Lisa page on Facebook, liking us and sending us a message, or email us at ‘[email protected]’.
Please take a moment to thank our sponsors who enable us to be with you every week offering you insight, inspiration and a way to go out about having a more bountiful life. This is Dr. Lisa Belisle. Thank you for being part of our world. May you have a bountiful life.
Male: The Dr. Lisa Radio Hour and Podcast is made possible by the support of the following generous sponsors, ‘Maine Magazine’, Mike LePage and Beth Franklin at RE/MAX Heritgage, Robin Hodgskin at Morgan Stanley Smith Barney, Dr. John Herzog of Orthopedic Specialists, Booth, UNE the University of New England, Tom Shepard of Shepard Financial, and The Body Architect.
The Dr. Lisa Radio Hour and Podcast is recorded in downtown Portland at the offices of ‘Maine Magazine’ on 75 Market Street. It is produced by Kevin Thomas and Dr. Lisa Belisle. Editorial content produced by Genevieve Morgan. Audio production and original music by John C. McCain.
For more information on our hosts, production team, ‘Maine Magazine’, or any of the guests featured here today, visit us at ‘Doctorlisa.org’. Download and become a podcast subscriber of Dr. Lisa Belisle through iTunes. See the Dr. Lisa website or Facebook page for details.