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| Q&A: Dr David Hartman on Head Injuries (824 Posts)
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Knee sac?
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On 2/18/2005
Jim Richardson
wrote in from
United States
(67.100.nnn.nnn)
Howdy .. I know this isn't head injury ,,, but it's definitley skate related..
About a month-five weeks ago, I slammed hard, straight on my kneecap in a ditch... didn't really hit anything else.. didn't scrape it.. just straight on impact. It was very swollen for a few dasy.. no real loss of mobility or pain on mobility.. took a few slams to my knees in a park with insufficient knee protection a couple weeks after the initial injury -- was wearing glorified gaskets with a cup but little real paddingn Anyway, in the last week I have notice what feels like a fluid sac about the size of 1/4 baseball on the kneecap in question. No redness or pain on motion.. if you press on certain parts of the patella it hurts like hell, but i just try not to do that ! Just wondering what I can do to make this go away and if I ought to be skating while it is like this??? thanks a bunch...
Jim
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Head Inury from vehicular accident
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On 2/17/2005
soc Domingo
wrote in from
(69.234.nnn.nnn)
We are insearch of a neuro-otologist in the Bay Area (San Francisco) to refer a client who sustained head injuries in a major accident. I was led to this web site. If you are, please let us know.
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Helmets for big heads
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On 2/17/2005
THOR
wrote in from
United States
(64.122.nnn.nnn)
Are the old fly away helmets any good? That is the only helmet I have ever owned that would actually fit on my dome. The old protects fit sort of only after many sessions and the foam gets compressed. The new helmets with the new hard foam don't even come close to fitting. What is a big headed guy to do that is religous about protecting my head. I smacked mine twice last summer with the old foam style helmets and I could tell the protection wasnt there. The problem with those old style foam helmets the extra large foam kits have half the padding. Who out there makes a xxxlarge helmet. I am desperate.
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Back 'n Knee
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On 2/14/2005
Dr. Dave
wrote in from
United States
(68.251.nnn.nnn)
Aaron,
Every hear of the lateral collateral ligament? Didn't think so. Injury to that ligament is associated with side knee pain. See your ortho or sports medicine doc for the real dx, and in the meantime, do the usual rest, ice, anti-inflammatories if you can take them and if you are getting increasing pain on the board, lay off until you know what's going on.
Betty,
Back pain is pretty commmon in the general population too but if you slam your spine into the ground a times, it's likely to be an unhappy spine. Causes can be irritated nerves, damaged discs, etc. If you have continued pain and especially if it's accompanied by numbness, shooting pain or movement limits in the arms or legs, get thee to an orthopod right quick or at least talk to your GP about x-rays. Otherwise, the usual anti-inflammatories if you can take them. I would go to the Orthopod before you set up treatment with a chiropractor.
Remember people, boarding is xtreme, but it doesn't require you to suck it in and live with pain. Consider pain symptoms as your bodies first warning to do something about it. Kind of like your car's engine knocking for a while before it blows up. So get it diagnosed and fixed earlier rather than later. Later it's usually harder, longer, less easy to fix.
Let us know how it turns out guys. DRDH
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chronic back pain
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On 2/14/2005
betty
wrote in from
United States
(24.170.nnn.nnn)
With the falls that come with skating, comes chronic back pain. I hear everyone I skate with complain about it. Chiroprators and massages might help, but what else?
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knees
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On 2/12/2005 Aaron
wrote in from
United States
(67.49.nnn.nnn)
My right knee hurts on the outside, it doesn't seem to stop for about 3 months, think it's time to see a doctor?
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RE: Jack up that ankle 2
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On 2/5/2005
Jack in Aurora
wrote in from
United States
(4.227.nnn.nnn)
Hi Dr. Dave,
I saw my doctor this past monday for a severe gout attack. He has me on lots of good stuff. After 6 days the pain is pretty much gone. The anti-inflams seem to be helping my ankle too. He said it might be a touch of tendenitis and it'll get better with some work. I'm putting in time a few days a week in the gym on the leg machines and working on my abs and glutes. Thanks for your advice.
Cheers,
Jack in Aurora
God rides a longboard.
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Nick
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On 1/27/2005
Jack in Aurora
wrote in from
United States
(207.69.nnn.nnn)
Thank you.
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Upper Extremity Amputees
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On 1/19/2005
Jack in Aurora
wrote in from
United States
(208.20.nnn.nnn)
This is posted on the bulletin board also. Sorry for the duplicate and its really not a question for Dr. Dave, but it occurred to me that this might be a good forum for this issue.
I'm looking for another upper extremity amputee or similar to compare skating notes with. While not technically an amputee myself, my physiology is classed as the same. I'm 45 with a birth defect from thalidomide resulting in one arm being very short and the other being nearly normal. Anyway it makes for some interesting technical problems when skating.
Cheers,
Jack in Aurora, Colorado
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Jack up that ankle 2
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On 1/16/2005
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Jack,
Make sure your doc knows about the gout. Gout can also be a cause of ankle pain, and you may need something stronger than homeopathy to deal with it. Let us know.
DRDH
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RE: Jack up that ankle
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On 1/16/2005
Jack
wrote in from
United States
(207.69.nnn.nnn)
Thanks Dr. Dave. I'll take those steps. Its been snowy and cold here in Denver for about the last week, so I've been on an enforced break due to nature. Can a person sprain an ankle just by pushing? I've taken a few falls but I can't remember rolling my ankle when I did it. I've got some problems w/ gout in my toes and I'm just starting drug therapy for that problem. I've been on cherry enzyme homeopathic therapy as a preventative for a number of years and it seems to help. I'm unable to take Indocin and I have to be careful w/ Ibuprofen. Thanks so much for getting back to me I'll go talk to my doctor this week and get a diagnosis and treatment plan.
Cheers,
Jack
"God rides a Longboard."
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Jack up that ankle
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On 1/15/2005
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Hi Jack,
Some good advice from allrefer.com below. Basically, you may have sprained it. You may need a brace but first you need to (1) find out what's really going on, and (2) stay off the board for a while. If the pain persists andn/or you have any arthritis or other bone related issues, talk to a sports medicine doc.
"Ankle pain is most often due to an ankle sprain. A sprain is an injury to the ligaments that connect bones to one another. In most cases, the ankle is twisted inward (inversion injury), and there are tiny tears in the ligaments that may make the ankle somewhat unstable. This tearing leads to swelling, inflammation, and bruising about the ankle, making it difficult to bear weight on the joint. Occasionally, bones can be broken from a severe blow or fall.
Once an ankle is sprained, the injury may take a few weeks to many months to fully heal. Often, the injured ankle remains a little weaker and less stable than the uninjured one. A proper rehabilitation program can prevent this problem. Other structures in the ankle that can be damaged, and thus cause pain, are tendons (which join muscles to bone), cartilage (which cushion joints), and blood vessels (which leads to bruising). Occasionally, adjacent areas can cause pain to be referred to the ankle -- these include the foot bones, lower leg bones, knee joint, and even hip joint.
* If you feel pain in your ankle, rest it for several days. Try NOT to move the affected area.
* If your ankle is unstable, support it, especially during weight-bearing activity (like standing or walking). ACE bandages work well. If this does not provide enough support, you may need to be fit for a brace by a health care professional. Crutches or a cane can help take the weight off a sore or unsteady ankle.
* For swelling, keep your foot elevated above the level of the heart, including while you are sleeping. Ice the area right away. Continue to apply ice for 10 to 15 minutes every hour for the first day and then every 3 to 4 hours for 2 more days.
* Try acetaminophen or ibuprofen for pain and swelling.
Even after the pain subsides, you will need to keep pressure off of it for up to 10 days for a mild sprain and up to 5 weeks for a more severe sprain.
Once you have healed adequately, you can start exercises to strengthen your ankle and avoid injury in the future. Do not begin these exercises until a health care professional tells you it is safe to start. One exercise, for example, involves balancing on your healing foot and hopping.
For arthritis of the ankle, take medication exactly as prescribed. When the pain and swelling begin to decrease, gently begin to exercise the joint again. Swimming is good, followed by stretching. Walking can be added later. Exercises can be done several times a day; but DO NOT overdo it. Pain is a message from your body to stop.
So taping it is probably the last step, not the first. Let us know what happens.
Good luck.
DrDH
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Ankle hurts
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On 1/14/2005
Jack
wrote in from
United States
(192.35.nnn.nnn)
Hi Dr. Dave,
I'm 45 and I've been skating again now for about 6 weeks. After sessions I've been having pain low on the outside of my right ankle (pushing foot) right below the bone after skating. Seems to be cumulative. More I skate the more it hurts. Would an ankle brace help?
Cheers,
Jack
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put that dremel away
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On 1/14/2005 herbn
wrote in from
United States
(64.12.nnn.nnn)
oh well ,the doc says ,i have a slight impingement on one disk,nothing close to worth risking an operation,as dr dave said,"last resort". How do you feel about inversion tables, i made a homemade one. Is it worth the space?or should i drag it out to the woods and ride my moutainbike over it:)
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get out the dremel
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On 1/4/2005 herbn
wrote in from
United States
(205.188.nnn.nnn)
I've tried albiet unofficially a round of prednizone,though now that i think a bout it ,i was REALLY hurt'n at the time,i'm alot better right now,xept for the toe numbness and prickly saddle feeling,it's been like two months and another round of those roids might do some good,but i just feel as though this injury is becoming easier to flame up and longer in duration and just more severe ,beyond just normal aging. If those spurs are digging into something that's transfering inflamation to the nerves,the spurs gotta go ,even if it's a setback. At least i can make a cool come back in the spring.
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Ah got spurs. . . .
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On 1/4/2005
Dr. Dave
wrote in from
United States
(68.74.nnn.nnn)
Welcome back, Herbn,
Bone spurs are often just a part of normal aging. You may not have done anything in particular to get them except grow older. Treatment options include steroids, physical therapy and sometimes surgery. Generally the less invasive methods are tried first, but your doc can give you the word on what's the best option. Let us know how it goes. . . .
drdh
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herbn's back
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On 1/3/2005 herbn
wrote in from
United States
(205.188.nnn.nnn)
x rays showed bone spurs off the sides of the lower vertibra,apparently no mushed(official dr'r speak:) discs. MRI tommorrow,i guess the dr will figure out how much and exactly where he's gotta go in to grind those pesky sucka's away. That is what is usually done,right? I hope my toe tingling/minor numbness goes away after said surgury. Bone spurs are built up over time and repeated injurys,i think i remember the steel mini ramp session that started these,like 7 years ago. well maybe it was something else before that.
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Helmets to Die For
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On 1/3/2005
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Craig,
I would avoid ANY helmet that had a either a point or cone on the back OR an extended face/jaw point, a la BMX helmets. The problem with non-rounded helmets for boarders is that if you fall forward or backward (as we do) on the point, you will push the helmet into the front or the back of your neck, or if you fall just slightly to the side of the point, the helmet's aero "feature" will twist your neck and possibly break it.
The consequences would be paralysis, like Chris Reed, if you twist your kneck and damage or break your spine, or death if the brainstem is damaged.
I'm not affiliated with anyone, or advertising anything. I have nothing to gain personally from this advice. But I'm a (non competitive) longboarder/carver and I personally wouldn't wear one of the pointy or BMX style helmets if it was padded with 100 dollar bills.
I question whether those helmets even have any real wind tunnel aero benefit. I doubt that the developers spent the $$$ to do formal aerodynamic testing. Remember, lots of things that look aero are not. The Corvettes in the '60's are good examples. They looked sleek and slippery, like they'll cut through anything. When engineers actually got around to measuring their aero properties, they had about the same aerodynamics as a plumber's van.
So Think. Don't get suckered by fast looking helmets. Look inside instead, for the label: Best is Snell. Search the list for the other official labels. And as one writer commented, it looks like some of the cheaper helmets just put a piece of paper in the box saying it's certified but don't put a label on the helmet. The cert. label has to be inside the helmet, otherwise you're being scammed. Look for that label.
SK8 Safe,
DRDH
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Helmet cone
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On 1/1/2005 craig
wrote in from
South Africa
(168.209.nnn.nnn)
Thanks Doc
More q's re lloyds cone...
It wasn't much of a cone on his helmet. The back of the helmet just wasn't round, it had a slightly pointy shape...no modifications, just as it came from the shop.
I believe all the talk about the "cone" on his helmet being the cause of the injury to be largely unfounded guesswork. Are you familiar with the Charly Insider paragliding helmet shape?? I'm wondering if that was truly the problem.
Was the helmet just badly designed? Should we simply avoid the helmets with the whatever rating the paragliding helmets have??
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Dred Mods
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On 12/28/2004
Dr. Dave
wrote in from
United States
(68.74.nnn.nnn)
Craig, coupla more things for your helmet-challenged buddy:
1. DON'T take the padding out of a helmet or mess around with it by moving, cutting replacing with something else. You are basically trashing the engineering and safety stats of the helmet if you do that. If the helmet doesn't fit with your hairstyle, get a bigger helmet or get a smaller hairstyle. Don't mod the helmet on the outside either. Any add on "aero" scoops or cones changes the way you could fall, and you risk twisting or breaking your neck and/or severe brain injury.
2. Repeated concussions tend to have an additive effect, so tell your buddy to be extra careful. For evidence of that, look at boxers who have their heads slammed around during their career. They can develop what is called "dementia pugilistica" or boxing dementia just from having the brain whacked around a lot. Unconsciousness is not necessary.
DrDH
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Helmets and Dreads and Blood Clots Oh My!
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On 12/27/2004
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Craig,
There's nothing wrong with dreadlocks if the helmet fits over them closely. They would be an additional, but minor shock absorbing layer. The one thing you should tell your blood clot buddy is to give that helmet a proper burial and buy a new one. You can't re-use them with any assurance of safety.
DrDH
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shoulders
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On 12/23/2004
slim
wrote in from
United States
(68.126.nnn.nnn)
I dislocated/separated my shoulder in a motorcycle crash in '91 and needed to have it repaired surgically. I couldn't move the arm at all but after the surgery and several months of rehab I was fine. And like the say, chicks dig scars. The worst was not being allowed to surf/swim for six months (even though I felt strong enough earlier). I have about 80-90% motion and almost never have any pain. Why am I writing this? Just to say that though it's a short-term bummer, in the long run the surgery can fix you right up so you don't have to worry about it anymore. And I want to recommend waiting the full time before skating, surfing, whatever that the surgeon recommends and doing all the rehab. Friends have rushed back to activity too soon and just ended up reinjuring themselves.
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Brainstem
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On 12/22/2004
Pat Chewning
wrote in from
United States
(24.21.nnn.nnn)
Brainstem - The lower extension of the brain where it connects to the spinal cord. Neurological functions located in the brainstem include those necessary for survival (breathing, digestion, heart rate, blood pressure) and for arousal (being awake and alert).
See diagram here: http://www.waiting.com/brainstem.html
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blood clot guy
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On 12/22/2004 craig
wrote in from
South Africa
(168.209.nnn.nnn)
The guy with the blood clot and fracture smashed in the front of his mtb helmet a year ago, resulting in concussion, with a very scary loss of memory. The helmet was made to look pretty again and the padding was taken out to fit a head of big dreadlocks.
Are dreads and helmets a deadly combo??
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Brain stem
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On 12/20/2004 mikez
wrote in from
South Africa
(198.54.nnn.nnn)
Where, precisely, is the brain stem located?
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