Author Topic: The Medical Maladies Thread  (Read 55945 times)

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RUOkie

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The Medical Maladies Thread
« on: March 27, 2012, 10:02:29 AM »
Since I've been hijacking the get well umd thread so much, I decided to start this.  A place for questions/controversies in Sports medicine, etc.
 
This thread is for entertainment purposes only.  No actual medical advice for specific questions will be provided, and in no way should any information conveyed in this thread be considered a substitute for visiting your personal physician.

RUOkie

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Re: The Medical Maladies Thread
« Reply #1 on: March 27, 2012, 10:12:31 AM »
I'll Start with ygduf's question about NSAIDS.  He asked:
 
So, do anti-inflammatories help or harm? Like, is ibuprofen masking pain and causing injury, or reducing swelling and thereby preventing further friction/irritation.

 
This is a tough one, since the answer is "I don't know". 
 
IMO, for an ACUTE injury, the standard treatment is Rest, Ice, NSAIDS (ibuprofen), compression, and elevation.  Basically, DECREASING the inflammatory response. 
 
It gets more difficult when a tendon/muscle problem becomes more chronic.  The current literature suggests that in that situation, INCREASING the inflammatory response (and the associated growth factors) is more effective.  That is why treatments like PRP (platelet rich plasma) and needle tenotomies are being used more and more.  When we do those treatments we tell people to stop all NSAIDS and asprin during the healing time.
 
Now, in point of fact, most chronic "tendonitis" (in quotes because histologically, there is no such thing as tendonitis) is merely a problem with form.  For example:  I have chronic L Peroneal Tendon pain when I run more than 5K.  The problem is not my tendon.  The problem is my running form.  I need a running coach to analyze my gait pattern, and I will fix the problem.  I'm just too lazy to do it.  Same thing with IT band pain in runners/cyclists.  Change your gait pattern/pedal stroke and you will fix the overuse problem.

shovelhd

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Re: The Medical Maladies Thread
« Reply #2 on: March 27, 2012, 11:38:35 AM »
I don't take ibruprofen, I take naproxen (Aleve) as an nsaid. It's much more effective for me. Is it doing any more damage than other drugs of its type?

RUOkie

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Re: The Medical Maladies Thread
« Reply #3 on: March 27, 2012, 12:15:11 PM »
I don't take ibruprofen, I take naproxen (Aleve) as an nsaid. It's much more effective for me. Is it doing any more damage than other drugs of its type?
nope
 
Physiologically, they are all the same.  Although people respond differently. 

Offline ygduf

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Re: The Medical Maladies Thread
« Reply #4 on: March 27, 2012, 01:18:20 PM »
As a hypochondriac I approve this thread.


 :thumbsup:


I doubt kaiser will approve a needle-y tenotomy or PRP injection. They will tell me to stretch, ice, and maybe prescribe a course of prednisone or some other corticosteroid cream. If I understand correctly, that would help short-term but leave me prone to more long-term damage?


This all started not from cycling, but from running up crazy 30% hills in Costa Rica. I think I strained a calf or at least got it incredibly tight which then caused the irritation while riding.


I got a night-brace to stabilize the ankle while I sleep, and have been aggressively alternating ice/heat to the point where I'm being made fun of at work. I've also been hitting my calf with at least 10-minutes/day of foam roller and stick action. On a scale of 1-10, discomfort is like a 2, but the swelling in the area is noticeable and the tendon is tender to direct squeezing.


I've cut my hours on the bike back a lot the past 2 weeks, but do I need get a walking boot or something and completely isolate it for a week? :(

RUOkie

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Re: The Medical Maladies Thread
« Reply #5 on: March 27, 2012, 01:39:18 PM »
ygduf:  Possibly.  It sounds as if you COULD have had a partial tear of one of the tendons.  The treatment of that is rest, immobilization and more rest.  (like complete immobilization of the tendon for 6 weeks).  Then starting an eccentric strengthening program.  During the entire rehab I would restrict cycling to easy spins (NO HILLS!)
 
I'm sending you a pm as well.

Offline LAJ

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Re: The Medical Maladies Thread
« Reply #6 on: March 27, 2012, 01:39:56 PM »
Not looking for a cure, I just want to whine. Co-worker brought a cold in almost 3 weeks ago, and of course, I got it. Zinc, *****ing him out, nothing helped... Still have it, but it is finally leaving.
Always be careful of the zealot.  Most zealots are hiding something

Offline ygduf

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Re: The Medical Maladies Thread
« Reply #7 on: March 27, 2012, 07:02:21 PM »
ygduf:  Possibly.  It sounds as if you COULD have had a partial tear of one of the tendons.  The treatment of that is rest, immobilization and more rest.  (like complete immobilization of the tendon for 6 weeks).  Then starting an eccentric strengthening program.  During the entire rehab I would restrict cycling to easy spins (NO HILLS!)
 
I'm sending you a pm as well.


It's soooooo minor in the pain department, though. Should I get a walking boot or something? My visit to Kaiser went as I predicted, but at least I'm on the record now and can request further referral if I choose to do so.

Offline ygduf

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Re: The Medical Maladies Thread
« Reply #8 on: March 27, 2012, 07:06:06 PM »
Zinc, *****ing him out, nothing helped... Still have it, but it is finally leaving.


Oh, *****ing! I was so confused.

Offline LAJ

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Re: The Medical Maladies Thread
« Reply #9 on: March 27, 2012, 11:15:04 PM »

Oh, *****ing! I was so confused.

My mistake! I totally spaced out the censor thing. It looked right when it was written. *****ing=Telling him he better knock that crap off. He has enough sick days saved that he doesn't have to infect the whole crew. 
Always be careful of the zealot.  Most zealots are hiding something

Offline rando

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Re: The Medical Maladies Thread
« Reply #10 on: March 28, 2012, 12:19:56 AM »
RU, I believe that you do sports injury medicine.  If you were a 17 year old woman who was just coming out of recovery from a substantial injury to your less dominant shoulder.  What would you pursue for sports since Rugby is no longer viable?  She is quite probably a national quality athlete who is yards above the ability of the school coaches and her peers comprehension.  Her mother asked for my thoughts on how to direct her overabundant ambitions since it is causing problems in her school work and home life.  I won't go into the depth of my answer but it reflected the social needs of a teenage girl not being conducive to pursuing outside activities that would exclude her.  I suggested pole vaulting given the crushing fitness needs and likelihood of a track program at her school.

Offline WCroadie

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Re: The Medical Maladies Thread
« Reply #11 on: March 28, 2012, 08:27:00 AM »
Same thing with IT band pain in runners/cyclists.  Change your gait pattern/pedal stroke and you will fix the overuse problem.
I thought IT Band issues were caused by tightness in the IT band?
WC is the Debil.

RUOkie

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Re: The Medical Maladies Thread
« Reply #12 on: March 28, 2012, 09:13:56 AM »
Why do you have tightness in the it band?   

Usually from over recruitment of tensor fascia lata. 

Offline K. Olsen

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Re: The Medical Maladies Thread
« Reply #13 on: March 28, 2012, 09:48:09 AM »
I have a problem with my skin breaking out when I sweat, it's not causing any problems other than discomfort and I look like I have chicken pox for about an hour after exercise. I don't think it is diet related as I eat mostly veggies and lean meats. Anyone else have a similar problem and/or a remedy to try?

Offline WCroadie

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Re: The Medical Maladies Thread
« Reply #14 on: March 28, 2012, 10:13:28 AM »
Why do you have tightness in the it band?   

Usually from over recruitment of tensor fascia lata.
IDK, I have bigger then most, calves and quads from years and years of ice hockey and soccer, back in the early 2000's when my IT Band issues first started I was given a stretching routine by a PT to help loosen up my tight hamstrings/calves/hips.  As long as I stretch and use the foam roller, IT Band issues stay away.
WC is the Debil.