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| Q&A: Dr David Hartman on Head Injuries (824 Posts)
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slightly silly thoughts that may work
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On 5/12/2004
Tom M.
wrote in from
(164.227.nnn.nnn)
I started using glucosaminm (sp?) several months ago. My prior symtoms: A LOT of clicking in my knees when I went into/outof a downhill sliding position (i.e., deep knee bends) which would -- if done enough -- result in a bit of pain in the knees for the next few days. I also had a terrible "POP" when going from "standing" on my knees to sitting on my feet (i.e., the typical slide-out position for the bowls, etc.).
IIRC, I take about 500mg morning and night. The same pill has some MSM? in it (don't remember how much). Get them from WalMart (Nature Valley??).
At any rate, I don't have the symptoms any more. No side effects AFA I can tell.
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slightly silly thoughts that may work
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On 5/11/2004 herbn
wrote in from
(152.163.nnn.nnn)
Man ,lyme disease can do that,now i really hate those little buggers,would cold climates help,getting used to hypothermia, or at least starting a session cold? Is there an actual increase in body heat, can you skate with sort of a body temp monitor(like a heart rate monitor). Off the subject , how do people feel about glucosaminm,i know a few lifers who swear by it, the three month start up time has got me a bit skypticalm,seems like they got 70 bucks of your cash before you can even judge it's effectiveness.
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Sk8 and nervous disorder
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On 5/11/2004
Haim
wrote in from
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Hi Dr. Dave,
I got the disturbing news that my MRI came back with foci looking like MS (or Lyme's). I'm not disabled at all - just some hearing loss in one ear. The Neurologist said she thought with the new MS drugs (ie. Rebif) I should lead a normal life EXCEPT not to overheat during exercise. Do you think it is possible to continue a mellow-kind of skating regimen? I tried it last week, expending about 25% of my normal session energy, drinking huge amounts, standing in the shade, and taking off the helmet between runs. The session was not so satisfying, but I felt normal the next days...Do you think I can keep this up as long as I can, or should I just forget the skating (which I love)?
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wobbles and my new floppier right ankle
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On 5/6/2004 herbn
wrote in from
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got some shimmying today at a considerable speedm, at least upper thirties. It might have been equipment but it brought out the weakness in my right ankle (effected by my cyatic nerve trama)it's all in the shin splints,so now it's back to rehabing it. I found if i sit on a set of steps and put my heels on a step and raise and lower the foot ,it works those muscles most directly. Any other suggestions? I do have access to safe(?)cortizone injections, what's the deal with that?
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G Thanks
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On 4/30/2004
Dr. Dave
wrote in from
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Thanks G. Hey, tell your doc that she has a good patient :)
You've got the recovery thing down. I couldn't tell you any better than what you're doing. The exercise-to-non-impact-to-slowly resuming the other stuff is the way to go.
If you tend to get injured in that area. . .see the advice for Ty. . .check out a sports podiatrist, who can give you advice on shoes, etc.
Keep your readers posted on your progress. . . drdh
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The Arch of Tyler
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On 4/30/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
Hey Ty,
So what ARE you doing when you get the pain? Is it that you are spending the day sk8ing and then it hits you at night? Does it happen when you change shoes? Stomp your feet at a concert? Go running in a set of cowboy boots? Inquiring minds want to know. . .
The more common specific causes of arch pain can be:
* plantar fasciitis (strain of the plantar fascia - a band-like ligament that supports the arch)
* tarsal tunnel syndrome (a pinched nerve at the ankle that sends pain into the arch)
* foot strain from a pronated foot or flat foot
* osteoarthritis of the joints in the midfoot that can cause arch pain.
The solution in the short term is to get out the ice to lower the inflammation, but that's not the real solution. You gotta see a sports podiatrist and let him or her x-ray your foot, look at how your shoes are wearing, and point you to some long-term solutions like different shoes, orthotics, etc. In the meantime, make sure that the shoes you *are wearing have good arch support for the midfoot and good cush in the heal and mid foot.
Keep us posted and good luck. drdh
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Update on Ankle Sprain
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On 4/28/2004
G
wrote in from
(135.214.nnn.nnn)
Hey Dr Dave, just a quick update. I'm at 3 1/2 weeks, the brace has come off and it's going well. The exercises really helped and I'm gonna keep with them. I'm putting off skating for another week. I'll try a little bicycling this weekend and go from there. Thanks for the advice!
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Foot issue
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On 4/27/2004
Tyler
wrote in from
(170.148.nnn.nnn)
What's up Doc, Here's the deal: For a few years now I've been getting some pain and swealing every now and again on the verticle inside of my right foot right above the apex of my arch (i believe it is right by the Navicular or First Cuneiform Bone) Like I said, this hase been happening for years and it comes and goes with no real pattern. I'll skate or ski or run a ton and have no problem, but then out of nowhere it will swell up a bit and hurt for a week or so. Any idea as to what causes this and any possible solutions? Thanks a ton, Tyler
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Ankle sprain
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On 4/13/2004
G
wrote in from
(135.214.nnn.nnn)
Thanks Doc,
I have been doing minimal walking with the air brace on. (Doc said it's okay). Yeah, she's pretty cool, she's a snowboarder, so she has the stoke. :) My stats, blood pressure and pulse are great, so she's encouraged me to keep with skating.
I'll keep being good about not overdoing it and am glad you said not to work thru the pain, I wasn't sure about that when doing my exercises.
I had to laugh when you said to build a new board, I have been stripping the paint off a new deck and cutomizing the paint job already. :)
Thanks again!
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Standing instructions for G
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On 4/12/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
G.
Thanks for the props on helmets. I'm all about good advice, as best I can. Let me give you some thoughts on your sprain. (1) You've got a real good doc. In the land of boxed docs whose idea of treatment is to tell you to give up skating, you've got a keeper. (2) Sprains heal slowly - 4 weeks is a good time to see where you're at but don't go right back to skating yet. You didn't say whether you're walking with or without the brace but take it easy. If anything you do hurts DON'T PUSH THROUGH THE PAIN. Look at pain as your first warning about possible reinjury. And if you re-sprain, your body will make you pay attention the second time by making the reinjury more serious and longer lasting. (3) "Hardly any swelling" means you still have swelling. Take it easy. You'll skate a lot longer and more pain free by waiting until your doc gives the O.K. Keep using your doc's Sprain Surprise pak until she says so. I'll bet most of the skaters here wish they had your doc.
Let us know how you're healing. Use your time to build a new board and rent a few skate videos. When you do get back on the board, remember the pads, and ask your doc about whether more supportive shoes or other protection might help.
drdh
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Ankle Sprain
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On 4/12/2004
G in Seattle
wrote in from
(63.187.nnn.nnn)
Hey Doc,
I sprained my ankle 9 days ago. I did ice, elevation and ibuprofen right away. It's a mild to moderate sprain. I saw my doc and she gave me this fabulous box o' ankle sprain tricks. I have theraband, exercises, cold pack and an air brace. For the last week I have been able to walk using the air brace, am still icing after doing my stretching and prescribed exercise. Now, how long before I can skate? I'm a mellow carving skater, no air, tricks. Doc says 4 weeks healing time total. I have good range of motion, hardly any swelling and can walk and climb stairs like a champ. The clouds have parted here in Rain City and I'm dying to get back on my board.
PS: kick a** last post on helmet use.
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Brady's @%#
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On 4/7/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
Brady,
Your comments pretty much sum up the opinion of anyone who knows anything about riding, helmets and head injury. The problem, as I see it, is that there are lots of people who are unable to see the difference between "freedom" and "rights." IMHO, riding either MC's or skateboards is not a "right." Otherwise, why prevent drunks or 3 year olds from doing it?
To those who say it's their "right" not to wear a helmet and if they die, that's their problem, I'd say, 'what about your wife/partner/kids etc?' Is it their 'right' that they live on without you? And what if you have to live your next 30 years as a quad in the back ward of a nursing home? You smell pretty bad strapped into a bed with tubes stuck in every orifice. And my taxes pay for it because you can be sure that your insurance company is not going to comp you for deciding to be a vegetable for the rest of your life.
So wear the helmet. Whether or not it's the 'law.'
drdh
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Liviu's pants
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On 4/7/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
Liviu,
You might be interested in a study by Dr. Malvinder Parmar, medical director at the Timmins and District Hospital in Ontario, who found that three of his patients complained about a bewildering sensation in their upper thighs. Physical examinations revealed nothing unusual, but the women shared a proclivity for tight, hip-hugging pants.
Parmar suspected nerve constriction. To confirm his diagnosis, he recommended the women switch to loose-fitting dresses. After four to six weeks, their symptoms disappeared, he says.
Parmar says the lateral femoral cutaneous nerve, which runs beneath both sides of the hipbone, is compressed by the hip band of the pants. This produces "meralgia paresthetica," or burning, tingling thighs, Canada's Globe and Mail newspaper reports.
The nerve damage doesn't seem to be permanent, Parmar says. Still, "people who suffer these symptoms should not wear these tight pants," he says.
You can compress the sciatic nerve by wearing tight pants or even putting a wallet in your back pocket. In many people the pain will go away on its own, but in some adults, permanent pain has been reported. You could try over-the-counter anti-inflammatory medicines if you can stomach them but mainly, wear loose fitting clothing. Hey, baggy is still 'in'
drdh
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Off the Board
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On 4/5/2004
Dr. Dave
wrote in from
(68.74.nnn.nnn)
Hey people,
Sorry about any delay in responding last week. Was snowboarding the last snow this season in Beaver Creek Co. Great ride BTW. 11,000 feet up, your brain just shuts right down in the low oxygen and leaves the fun stuff from the neck down. Will get to the new stuff ASAP.
Thanks, drdh
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helmet injury vs non helmet statistics
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On 4/3/2004
Brady
wrote in from
(68.158.nnn.nnn)
I found this study to be an interesting read...
http://www.sasnet.com/bro/statistics/goldstein/reviews/1.html
What I find insidious is in my state, the helmet law was repealed. But conversely, we have a law that enforces wearing a seat belt. Don`t get me wrong, I always wear one. But the law has been changed from an infraction that could only be cited after another offense has occured (speeding ticket, accident, etc.) to now be that is will be a regular moving violation.
So you can ride around without any sort of protection on a motorcycle, yet get pulled over and cited for not wearing a seat belt. What the F#@& ??
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my pain
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On 3/28/2004
Liviu Ghitescu
wrote in from
(80.97.nnn.nnn)
i used jeans one number under my usual size(in winter i get some more pounds over) wearing leather strong belt.
at the begining (autumn),i felt a pinning sensation after driving or after eating more;puting down pants my pain (inconfort)was dissapearing.
now it is burning sensation in the hip -thigh zone,left foot.
from about one week i wear only large trousers but this pain still persist
it is clear for me that i damagged my sciatic nerve...
now,what doing more ?
thank you a lot for answers....
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Shoulder injury
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On 3/28/2004
Lenny
wrote in from
(205.188.nnn.nnn)
I sprained my right clavical a couple days back and, of course, want to get back to skating ASAP. The doctor at the ER's only advice was, with my size and strength, I should've gone into boxing. The LPN who cleaned up my wounds and gave my the sling said I should work on range of motion. She said it would hurt, but then gave me no specific exercises. Right now: I leave the sling off when I'm at home, can now shave with a little pain, can touch my forehead and both shoulders with some discomfort and last night, could hold a dinner plate almost straight out before calling it quits due to pain.
Especially with The Gathering right at a month away (not to mention summer vacation and the new park in Athens, OH), ANY helpful hints would be grand. Thanks
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MSM/DMSO
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On 3/25/2004
Rob
wrote in from
(216.249.nnn.nnn)
Dr. Dave:
Recently an othropedic surgeon gave me a sample of Pensaid - which contains DMSO - for a recontructed knee that I have been experiencing swelling in. He told me the knee is stable and the swelling is due to arthritis??
In university, almost 15 years ago, I wrote a paper on DMSO (the time when it was only available in animal grade) and there was a lot a concerns about what kind of contaminents it could bring into the blood stream. I found it suprising that it is now available in an perscription.
My personal experience with Pensaid - is that is works very effectively in reducing swelling.
I would be interested in knowing what concerns there are with DMSO and what other anti-inflamatories that you would recommend.
Thanks
Rob
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Might Be Broken Means Fix It
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On 3/18/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
In case it wasn't clear, "possibly broken" bones need to be evaluated. If they are set wrong, you are going to problems later on. Get it evaluated now. Please.
drdh.
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"might be broken"
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On 3/17/2004 herbn
wrote in from
(152.163.nnn.nnn)
it's a tough call,if you wait to long ,it could set wrong. Look for an actual physical change in shape/ conture of the body part in question. The free clinics sound interesting. There are places that just do imagining(x rays ect) they're supposed to be much cheaper than hospitols.
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Free LA Clinics
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On 3/16/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
halfbreed,
First there are probably city hospitals which will treat you if you are a resident. Call and ask. Otherwise, look into these.
Free Clinics in LA
The Los Angeles Free Clinic
o Beverly Clinic
8405 Beverly Blvd.
Los Angeles, CA 90048
(323) 653-1990
Services include: General Healthcare, Women's Health and Wellness, Dental Care, Legal
Services, High Risk Youth Program, Mental Health and Social Services, Prenatal Care,
Family Planning, Education & Outreach
o Hollywood Center
6043 Hollywood Blvd.
Los Angeles, CA 90028
(323) 653-1990
Services include: General Healthcare, Women's Health and Wellness, Dental Care, Legal
Services, High Risk Youth Program, Mental Health and Social Services, Prenatal Care,
Family Planning, Education & Outreach
o Hollywood Wilshire
Health Center
5205 Melrose Avenue
Los Angeles, CA 90038
(323) 653-1990
Services include: General Healthcare, Women's Health and Wellness, Dental Care, Legal
Services, High Risk Youth Program, Mental Health and Social Services, Prenatal Care,
Family Planning, Education & Outreach
Los Angeles Mission Community Clinic
Monday through Thursday, from 7:00 AM until 4:00 PM
Call for appointment
(213) 893-1960
303 East 5th St.
Los Angeles, CA 90013
Health Care Free of Charge to All In Need
General adult medical care, TB screening and prophylaxis, Health screening (including diabetes,
blood pressure, cholesterol), Cancer screening (including cervical, breast, colon and prostate),
Sexually transmitted disease screening and treatment, Dental care - both on-site and by referral,
Chiropractic care, Subspecialty clinic referrals, HIV prevention classes held twice a week at the
clinic, Confidential and anonymous HIV counseling and testing, Spiritual counseling for those
living with HIV and AIDS, HIV-specific referrals for housing and medical care.
Website: http://losangelesmission.org/about/lamcc.html
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Arroyo Vista CHC (AVFHC-Highland Park)
Locations:
o 6000 North Figueroa Street, LA, CA 90042
o Lincoln Heights, 2221 North Broadway, LA, CA 90031
o El Sereno, 4815 East Valley Blvd., LA, CA 90032
o Estrada Courts, 1305 S. Concord, Unit 12, LA, CA 90012
o Ramona Gardens, 1424 Crusado Lane, U#168, LA, CA 90033
o William Mead, 268 Bloom Street, U#322, LA, CA 90012
(323) 254-5291
prenatal, pediatrics, adolescents, adult medicine (including women?s health), and geriatric
medicine. Specialty and ancillary services such as dermatology, podiatry, dental, optometry,
laboratory, radiology, ultrasound, mammograms, pharmaceutical, and health promotion and
disease prevention are also provided. Free on-going health screenings, annual adult and
children?s health fairs, and regularly scheduled health education classes are provided.
Web Site: www.arroyovista.org
Chinatown Service Center Family Health Clinic
Alpine Tower
767 North Hill Street
2nd Floor, Suite 200
Los Angeles, CA 90012
(213) 808-1718.
Monday - Friday 8:30 am - 5:30 pm
Saturday 8:30 am - 12:30 pm
Closed on Sunday and other public holidays
All services are low-cost to free depending on income level.
Primary family health care, women?s health care, men?s health care, and senior health care.
Clinica Msr. Oscar A. Romero
123 South Alvarado Street, LA, CA 90057
(213) 989-7700
318 South Alvarado Street, LA, CA 90057
2032 Marengo Street, LA, 90033
(323) 987-1030
Free medicines, Pediatrics, prenatal, post-partum care and family planning,
Chronic Disease Management, including but not limited to diabetes, asthma and hypertension,
Immunizations, Cancer screening, Health Education and Prevention,
Limited specialty care such as cardiology and ophthalmology,
Emotional support groups and one to one counseling and mental health services,
Leadership training and neighborhood organizing around quality of life issues
Website: http://www.clinicaromero.com/
Hollywood Sunset Free Clinic
3324 Sunset Blvd, LA, CA
(323)660-7959
Free medical and counseling services residents of Echo Park, Silverlake, East Hollywood and
downtown communities of Los Angeles. Services include tattoo removal, primary care for
children and adults, mammogram screening, HIV/AIDS services, and counseling.
Website: http://www.hollywoodsunsetfreeclinic.org/
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Northeast Community Clinic
o 5809 N. Figueroa St.
(323) 256-3884
o 1810 S. Fair Oaks, Suite 300
South Pasadena, CA 91030
(626) 403-8080
Children?s Health and immunizations
QueensCare Family Clinic
o Hollywood (323) 953-7170: 4618 Fountain Avenue, LA, CA 90029
o Echo Park (213) 380-7298: 150 North Reno Street, LA, CA 90026
o Wilshire District (213) 368-9779: 3242 West 8th Street, LA, CA 90005
o East Los Angeles (323) 981-1660: 133 North Sunol Street, LA, CA 90063
o Eagle Rock (323) 344-5233: 4448 York Boulevard, LA, CA 90041
Monday-Friday 9am to 6 pm
Care for all patients regardless of ability to pay.
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no health insurance
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On 3/16/2004
halfbreed
wrote in from
(63.198.nnn.nnn)
well about 5 days ago i fell and im pretty shure i broke my hand right before the first joint of my left hand. im wondering if doctors can do any thing for it if its broken, and is it worth geting checked out. more importantly im wondering if you know of any place in los angeles where a person like me (with no insurance that is)can go to get free or cheep health care with out having to go to county. and if i do have to go to county what is the drill on going there?
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The Stink about MSM
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On 3/12/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
Hey Lands-End, Welcome! Glad this site is helpful to you. There's a mixed answer to your question: Glucosamine/Chondroitin is pretty well supported for helping joints heal. There's some good medical literature out there and I think it's worth using. MSM is another matter. MSM is a sulfer-compound similar to DMSO. It may work to reduce inflammation from the available sulfur, but nobody really knows if and how it works. It was originally used as a horse balm if that's any help. There's nothing good in the medical literature and if you are allergic to sulfur-containing compounds DO NOT try it. I don't think there's any synergistic benefit from using G/C and MSM together. Anyway, except if you are allergic, it doesn't seem to be toxic, and if you think it helps, there doesn't seem to be any reason to stop using it. Lukewarm recommendation? Yeah, but if I can't find the research or science to back it up, I'm not going to fall over backwards recommending it.
Readers, have you tried MSM? What was your experience with it?
sk8on DrDH
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Glucosamine Chondroitin and MSM
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On 3/11/2004 lands-end
wrote in from
(208.200.nnn.nnn)
Hello all,
I am re-habbing a ruptered achilles and noticed the glucosamine comments a page or so back, I can definetely say this has helped me heal quicker from my surgery and has eliminated my back and shoulder pains as well(these have been ongoing). The brands of this I used that seemed to work the best for me were the ones that have MSM in them. Dr Dave do you have any opinions about MSM and GC?
Snoball: FYI my 92 year old Grandpa and 91 year old Grandma both take this,have had no issues and both love what it has done for them. May be great for your Dad, check it out, it might really help.
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those seats, endo balence boards.............
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On 3/4/2004 herbn
wrote in from
(152.163.nnn.nnn)
Endo balence boards are cool, you could make one pretty easy,i cound make a really nice v lam fiberglassed flexy camber or rocker endo in a snap,i probabely will, but if your not a crafter and you're in need of ankle/hip knee rehabthey seem to be doing the trick, just buy one. As always, you gotto know your body,this type of thing could easily do damage if you get on it to early. I would say ,if you "need" pain killers you are probabely pre habing except of the lightest stretching,if your not sure see your doctor...... and gel seats ,Pa leez. Those holey seats where sort of a fad,i had one for a short little while... and i have some theorys. Different people may have that particular nerve in a more perilous location,a fraction of an inch one way or the other may make the difference.Pressure on that nerve could be measured in pounds per square inch, a heavier person puts more pounds on an area on seats that's maybe one square inch. I BMXed everywhere as a kid and even had a short stint of roadbiking back then, skipped out for maybe two or three years and started mountainbiking when no one had suspension. If i havn't had thee nerve problem (and all the msherbns have never complained) and the nerve problem is not happening now either,so it won't.Right now the last hilly 30 miles i did felt like 60m, but a day off and i'm jonsing to get out tommorrow at dawn, and check some of my skating hills out for wintery damage,to be skated at a future time.
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