• Knuckle Cracking

    In a recent article published by the BBC, researchers have concluded that there is no absolute conclusion to the myth of arthritis and knuckle cracking!
    The physiologic explanation is what I have been explaining to patients for years. Gas escapes the joint capsule, and it makes a funny noise…like a fart. “joint fart” to be more professional.
    If patients insist on “cracking themselves” and their knuckles especially, I ask that they pull their finger, as if to elongate the digit. This is a distraction of the joint, and leads to less hypermobility (too much movement). Flexing your fingers (so your fingertips touch your wrist) or extending your fingers (so your nails reach back towards your forearm) hyperflexes or hyperextends the joint respectively, causing stress on the joint.

  • If you have Legs, You Probably Have Tight Hamstrings

    ESPN highlights the few injuries keeping several competitors from performing at their best, we as amateur athletes and weekend warriors can identify with their injuries. Most of us have never felt the pain and frustration from withdrawing from the race of our life, but anyone who kicked a ball a little too hard, or landed unevenly can attest to the searing pain of a muscle injury.

    Hamstrings, the major muscle group in the back of our thighs, are commonly injured. The hamstrings are made up of the biceps femoris, semitendinosus, and semimembranosus muscles. These muscles start at the bottom of our pelvic bone, called the ischium. (When seated on a hard chair or the floor, you can often feel these bony prominences). The muscles attach at the back of the shin bone, behind the knee. The hamstrings collectively extend our thigh and flex our knee. Because it crosses two joints, it is more prone to injury. It is also one of the major muscle groups of the body, which means it is used for more movements than you might realize.

    In sports, the most commonly injured structures are the muscles, tendons and ligaments. Tendons attach muscle to bone. Ligaments attach bone to bone. A muscle strain occurs when minor tears develop in the fibers from overexertion. Strains can range from mild (just a few fibers affected) to severe (a tear through the full thickness of the tissue). Most injures heal within a few days to a week, more severe injuries can cause symptoms up to a month.

    After injury, RICE (Rest, Ice, Compression, Elevation) is the first choice of treatment. The best choice for prevention, however, is conditioning the muscle from the start.

    To stretch your hamstrings, put the heel of one leg on a step. Your standing leg should be straight. Your hips should be centered and squared. Lean forward from the hip, not the waist. You should feel a gentle tug in the back of your thigh. Hold the stretch for 20 seconds. Downward Dog, a very common yoga pose, is also great to lengthen your hamstrings.


    A great yoga pose to stretch out those hammies!

    To strengthen your hamstrings, air squats are beneficial for a warm up. Start from a standing position, squat while striving to achieve 90 degrees of knee flexion, and return to standing. No weight is necessary A great rehab exercise is single leg lifts for the hamstring. The exercise builds the muscle in an eccentric motion. This means the benefit comes from lengthening the muscle. Start in the standing position. Keep a weight in one hand (start with a 5 pound dumbbell, more advanced can try a small kettlebell).  Keep one leg planted. Lean forward at the hip, lifting the opposite leg straight behind you. Goal is to have your legs make a 90 degree angle. Return to starting position. Start with a set of 10. Switch sides. Walking lunges are fantastic too. Start with 10 down, and 10 back. More advanced can carry dumbells or kettlebells in either hand.

    If any of the exercises hurt, stop immediately and consult your doctor. An experienced doctor with a sports background will be able to correct any of the factors that may dispose a person to injury.


  • Not So Fantastic Gymnastics

    Gymnastics became more popular in the United States after the 1972 Olympics. Though few athletes make it to the elite level of international competition, high schools and colleges do have upper level competitors on their gymnastic teams.

    There is the potential for overuse injuries due to the amount of practice time, and attempt to perfect certain series of skills and tricks. Due to the physical demands placed on the body during landings, there is a high risk for injury (despite the copious amounts of mats and foam padding). According to the NCAA Injury Surveillance Survey for the 1997-98 Women’s Gymnastics Season, 87% of all injuries were during practice. Sprains and strains were the most common, but 7% of the injuries were head and neck trauma. During an event, such as a meet, the Floor Exercise held the highest amount of injuries. Most of these injuries were sustained during a manuever without the use of a spotter.

    Very common in gymnastics is the prevalence of hyperlordosis. Our lumbar spine (the lower segment of our spine) has a natural curve called a “lordosis” this develops approximately 10-18 months after birth as the infant begins to walk upright. When this curve is strongly accentuated, it is termed “hyperlordosis.” This is very common due to the nature of the hyper-extension positions of the athlete. These poses may lead to microtrauma to the spine, which could further lead to an increase in spondylolysis, a fracture of the pars interarticularis, a small portion of the vertebra.


    Spondylolysis is painful. Treatment protocols have been debated, but the agreed upon goal is to restore pain-free range of motion and normal function. Bracing may be suggested to assist in healing. Return to the sport is allowed after the athlete is pain-free, asymptomatic, and has done a series of rehabilitative exercises to restore function.

    Like any sport, there is an increase for injury when the athlete is not properly trained or performing through injury or fatigue. It is important for the athlete to know their own limit, and for coaches and parents to pay close attention to changes in physical behavior.


  • NFL Cares about Head Injuries

    According to the New York Times, the NFL is making progress in their attempt to decrease the number of hits to the head and neck of players during the season.

    Last year the league cracked down on hits by threatening suspensions for repeated violators. This change is starting to show progress. Concussions in preseason and regular-season games dropped 12.5 percent from 2010 to 2011, from 218 concussions reported in 321 games last season to 190 concussions in 320 games this season.
    The NFL is attempting to combat the image that players and coaches have deliberately hidden concussion symptoms so that players can continue playing. This may lead to more serious injuries (something called Second Impact Syndrome) and chronic debillitation.

    The last commercial in the 3rd quarter will show the improved safety in the league from its inception.
    For more, read:

  • Warning Signs for the Female Athlete

    According to a study conducted in St. Louis and to be presented at the American Academy of Orthopedic Surgeons in San Francisco, female soccer players are at an increased risk for the Female Athlete Triad. This triad includes: irregular periods, eating disorders, and osteoporosis.
    The study found that one in five elite soccer players had irregular periods, and 14% had stress fractures. Stress fractures is when the body’s physical demand is too much for the body’s supply of bone-building calcium to repair at an adequate rate. Stress fractures are overuse injuries. Rest is typically prescribed for this diagnosis.

    Sports chiropractors can help identify patient-athletes at risk, and help modify training so that the cycle of damage can be stopped.
    Warning signs include, missing periods, having irregular periods (especially during training), pain in the shins, feet or ankles after intense activity, and an unusual picky diet.