Friday, May 23, 2008

diagnostic ultrasound

About 10 years ago imaging with diagnostic ultrasound became available for identifying muscle and tendon and ligament tears, soft tissue lesions such as cysts and general review of anatomy. Unlike an MRI it is a real time study much like an ultrasound study to visualize the heartbeat of a baby. You can actually see a tear in a tendon when you stretch the tissue. One common injury we see is plantar fasciitis. The thickness of the fascia can be measured which can help to tack swelling and progress. When the achilles tendon is scanned you can see the cross section of the tendon and find out if there is damage inside the tendon sheath. The benefit of the study is determined by the experience of the sonographer. You can see some examples at

Wednesday, May 21, 2008


Arnica has bee used to treat arthritis,muscle soreness and inflammatory conditions in Europe and is now gaining more wide spread use in the US. A 2007 study by Widrig out of Switzerland compared arnica favorably to NSAIDS for osteoarthritis. By contrast on healthline arnica has a grade of C for pain associated with osteoarthritis. The NIH did not find any difference with respect to bruising versus placebo. I found one study on arnica taken by mouth from a double blinded placebo controlled trial from the Oslo Marathon which demonstrated decreased soreness but no measurable changes in enzymes.
I have not used the oral version for my patients but have had anecdotal success with the topical gel. The oral version at certain
levels can have side effects. Currently the oral is not approved for use by the FDA. I carry a 12% version of the gel made in Germany in my practice and have seen 7% available at drugstores.

Friday, May 16, 2008

Power Yoga: For better balance and strength

Power yoga is one mode of training that creates strength along with flexibility and balance. Although yoga videos are useful, the optimum environment to learn yoga is in a studio or class. The difference between yoga and stretching is that yoga is more dynamic and is a closer simulation of athletic activity. You are moving through the poses in many positions and transitioning between the positions. In the coming months I will put together a visual article of 4 yoga stretches with the assistance of my yoga instructor that can be used as a supplement for a yoga class when time does permit attending one. Until then many classes will offer introductory sessions so that you can find the right pace and intensity that is right for you. For me, yoga has helped me avoid a second surgery on my knee, eliminated my previous back pain, and helped me with better balance and strength with skiing and soccer in particular. Many of my patients have exhibited dramatic improvements after attending yoga classes. So go do it! Take a yoga class! For info on power poses here is a link: