Saturday, September 20, 2008

Cross Training

OK, so we all have heard of cross training but do we know what it means. The beauty of cross training is that it gives our muscles a different set of instructions and that will give certain overused muscle a break and enable others to develop. We see this with all sports now. Pro football players doing yoga. Swimmers like Gary Hall Jr. using boxing training as part of their dryland routine. And who could forget the prototype for cross training, Bo Jackson?
I think that many times people develop overuse injuries because they fail to give their bodies a change of routine and intensity.
It is also good for the psychology of training .More later... You know I read this book that said that it takes reaching about a hundred people to find one person thats willing to contribute an idea. Well here's hoping that this finds that one. Let me know your ideas.

Sunday, September 14, 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:

Fatigue and Injury

We all know the effects of individual muscle fatigue on injuries, your leg muscles get tired and all of a sudden you injure your knee. EMG studies have shown that the anterior shin muscles fire 85 % over their fatigue threshold in running. Hence it is no surprise that many runners develop shin splints. It turns out that over all fatigue plays an important role just as localized muscular failure to an area. No one has been able to prove decisively why this happens but it is probably multifactorial. As our
form degrades we are in a less stable position to prevent injury. It is also reasonable to assume that as you fatigue the brain's ability to execute precise movement patterns also degrades. What to do? Develop the core and support muscles. Heighten the body's spatial awarenes with agility drills. This is why track work deconstructs the running stride and uses drills to help perform more efficiently.

Monday, September 8, 2008

Balance, Injuries and Tom Brady

I watched the replay of Tom Brady's ACL injury on his left knee and it struck me that he was somewhat tentative before he through the pass. Was it because he didn't take reps with no exhibition games under his belt or was he still favoring his injured right foot from last year. Even he may not fully know. We make a lot of small adjustments in athletics subconsciously. One thing is for sure is that he has a steep road to recovery in the NFL with that type of injury. He is a professional and you can't second guess starting a star like Brady in the season opener. Most of us do sports for fun and the lesson here is that one injury can impact another injury even when you don't realize it. I did not scream when I tore my acl and had a bucket handle tear when I hurt my knee playing soccer so I can only imagine the other structures that were damaged with his injury. Many pro skiers continue after a torn acl because their leg muscles are so strong but with football there will be no choice but a full reconstruction.

Thursday, September 4, 2008

Remembering 9-11 and St. Paul's Chapel

Standing on the viewing platform of the World Trade Center site, I was not fully prepared for the deep emotions I experienced nearly six months after the devastation. In March of 2002, I spent a weekend volunteering at the medical clinic located in St.Paul's Chapel, which was spared by the September 11 blast and served as the immediate triage station after the disaster. I still get chills when I think about the time I spent at the chapel and ground zero. The chapel continued to serve as a medical clinic and source of refuge for the firefighters, police officers and recovery workers. Before my shift began, I went to the excavation site. Around the perimeter,the heat-seared midsection of a skyscraper served as a painful reminder of the lives lost. Huge banners lined Broadway, honoring the firefighters and police officers for their heroic acts. Shrines set up by the victims' friends and families surrounded the chapel.
Inside the chapel, the clinic coordinator explained that the workers sought relief not only for their feet; they needed someone to talk to. The chapel also served as community where workers could pray, rest on cots, or have a warm meal served by volunteers. The spirit of the police officers there spanned all emotions. Many officers shared jokes. Others, more solemn, sat reading children's letters of encouragement. One officer was stoic until a group of children sang and then hugged each of the civil servants in the chapel. I'll never forget how he let go of some of the pain if only for a few moments as he closed his eyes and smiled in their embraces.
The people I treated appreciated the convenience of having care available at a moment's notice. Most of my patients worked grueling 12-hour shifts. Some workers improvised their own podiatric supports: one construction worker came in limping with a makeshift splint made out of tape slung from behind her heel to the base of her toes, holding them upright.

Near the end of the shift, a protocol officer asked me if a calling had brought me to the clinic. I told him I considered it a privilege to help make his fellow officers more comfortable. While reflecting on the conversation on the drive back to D.C. I thought about my friend Jimmy from college who made it out of one of the towers on the march down the stairs and a doctor from Arlington I knew with a young family on a west bound plane who did not. I thought about my cousins who I stayed with across the river in Brooklyn who were living with the traces of the aftermath in the faces of their friends and neighbors. It occurred to me that the "calling" he was talking about is the reason most of us in healthcare embark on a career in medicine. Sometimes it takes an experience like this to remind us why we started the journey in the first place.