Archive for May, 2012

Steroid Injections Can Reduce Recovery Time from Sports Hernia

If you play tennis, soccer, or flag football, you may have felt the painful groin injury known as a sports hernia.

This sports injury, called athletic pubalgia by sports medicine doctors, is a weakening of the muscles or tendons of the lower abdominal wall, causing debilitating pain and discomfort in the groin area.

Sports hernias occur most commonly among professional athletes, however, weekend warriors and athletes making extreme, repeated twisting-and-turning movements are also susceptible to a sports hernia.

In sports such as tennis, soccer, football, hockey, and skating, twisting and turning while moving forward is a necessary athletic skill.

Yet, the repetitive motion may result in sports hernia.

The recommended treatment option has been surgery, however, ultrasound-guided corticosteroid injections are a promising alternative, according to a new study presented at the American College of Sports Medicine’s 59th Annual Meeting in San Francisco, CA.

That study indicates the minimally invasive injections of this powerful anti-inflammatory may be a viable option to speed up recovery time.

“Rehabilitation from surgery can take on average eight weeks,” said Alex Fokin, MD, lead author of the study conducted at the University of Miami/Jackson Memorial Hospital in Miami, FL.

“Since the injury is so common, knowing ultrasound-guided injections are another option for treatment will be beneficial for patients looking to speed up the recovery time with something effective, yet less invasive than surgery.”

For the study, 12 patients, average age 31, diagnosed with sports hernia had ultrasound exams of their painful groins, all revealing damage or a tear around the insertion site of the abdomen or hip.

The patients were treated with an injection of a corticosteroid and anesthetic mixture under direct visualization using ultrasound.

Following treatment, all 12 patients completed a questionnaire to evaluate pain, stiffness, and physical function.

Their overall average scores were low, showing the treatment had been effective.

Based on the objective outcome scores, the researchers suggest the study shows that ultrasound-guided corticosteroid injections are a viable treatment option for patients with sport’s hernia.

Symptoms and Treatments

So how do you know if you have a sports hernia?

A sports hernia will usually cause severe pain in the groin area at the time of the injury.

The pain typically gets better with rest, but comes back when you return to sports activity, especially with twisting movements.

A sports hernia does not cause a visible bulge in the groin, like the more common hernia, what doctor’s call an inguinal hernia.

Over time, a sports hernia may lead to an inguinal hernia, and abdominal organs may press against the weakened soft tissues to form a visible bulge.

Without treatment, this injury can result in chronic, disabling pain that prevents you from resuming sports activities.

See a doctor for a physical exam and imaging tests, such as x-rays or magnetic resonance imaging (MRI) scans, to help determine whether you have a sports hernia.

According to the American Academy of Orthopedic Surgeons, treatment of sports hernia includes rest for about a week.

If you have a bulge in the groin, compression or a wrap may help relieve painful symptoms.

Two weeks after your injury you may begin physical therapy exercises to improve strength and flexibility in your abdominal and inner thigh muscles.

Your doctor may recommend non-steroidal anti-inflammatory medicines (ibuprofen or naproxen) to reduce swelling and pain.

If your symptoms persist over a prolonged period, your doctor may suggest a cortisone injection.

In many cases, 4 to 6 weeks of physical therapy will resolve any pain and allow you to return to sports.

If, however, the pain comes back when you resume sports activities, you may need to consider surgery to repair the torn tissues.

More Screen Time Means Less Fit Kids

As the father of two electronically stimulated teens, I’m keening aware of the countless hours they spend in front of their laptops listening to music, chatting with friends, watching TV shows, or surfing the Web.

Now there’s more evidence that kids who spend more time in front of electronic devices are less likely to be fit.

The study was published in the June edition of Medicine & Science in Sports & Exercise, the official journal of the American College of Sports Medicine.

Researchers followed more than 5,000 children from age 12 to 16 to determine changes in their sedentary behavior.

Each child recorded his or her screen time and completed a shuttle run test to provide a measure of fitness.

Importantly, the researchers adjusted for time spent in high-intensity physical activity.

“In this technology age, children spend more time in sedentary behavior,” said lead author Jonathan Mitchell, Ph.D., then at the Arnold School of Public Health at the University of South Carolina.

“We wanted to see if high screen-based sedentary behavior affected cardiorespiratory fitness levels in childhood, and if this effect was independent of physical activity levels.”

As you might expect, the kids who had more screen time completed fewer shuttle run laps.

The association was strongest for the children who had mid-to-high fitness, and was independent of physical activity levels.

The researchers suggest that if the kids spent less time being sedentary, that is, had less screen time, their fitness levels would increase.

“The results are interesting and add to the evidence that spending too much time sitting is hazardous to children’s health,” said Mitchell. “If children limit the amount of time spent sitting in front of a screen, then this could help to combat declining levels of cardiorespiratory fitness in youth.”

I encourage my kids to get outside and be active whenever possible.

Luckily, they are both athletic and love to skateboard, shoot hoops, kick around a soccer ball, or play catch.

I try to keep up with what they are doing on their laptops so I’m in touch with what they like, however, there’s only so much dub step music one can take.

I suggest they practice the guitar or drums instead of mindlessly listening to tunes, and I am moderately successful.

And now I have even more motivation to get them to limit their screen time.

10 Steps to Treating and Preventing Prostate Disease

If you have been diagnosed with prostate cancer or benign prostatic hypertrophy (BPH), you may have more options than you think.

In addition to traditional pharmaceutical drugs, surgery, and radiation therapy there are a number of dietary and lifestyle changes you can make, says Aaron Katz, MD, Vice-Chairman of Urology and Director of the Center of Holistic Urology at Columbia University Medical Center in New York.

Dr. Katz is the author of Dr. Katz’ Guide to Prostate Health: From Conventional to Holistic Therapies.

In the May issue of American Legion magazine, I provide Dr. Katz’s 10 dietary strategies and lifestyle choices for treating and preventing prostate disease.

Dietary Strategies

1. Cut the fat.

Studies suggest that dietary fat intake and prostate cancer incidence are intimately related.

Eat a diet composed of less than 30% fat and favor unsaturated fats such as olive and canola oils over saturated and trans fats.

2. Improve your omega-6/omega-3 ratio.

Omega-3 fats (found in fatty deep-water fish and flax seeds) appear to protect the prostate, while omega-6 fats (found in vegetable oils) may have a disease-promoting effect.

Eat lots of salmon, sardines, cod, and ground flax seeds, and avoid foods made with vegetables oils like corn and soy.

3. Go organic.

Your best chance of avoiding contaminants in your food is to eat a largely organic and vegetarian diet.

Organic foods are raised, grown, and produced without the use of chemical pesticides, hormones, or drugs.

4. Fill up on fiber.

Research shows an inverse relationship between prostate cancer incidence and intake of dietary fiber.

Up your fiber intake by eating one big green salad every day, breakfasting on a bowl of steel-cut or slow-cooked oats, and switching from refined to whole grains.

5. Eat your antioxidants.

Free radical damage to DNA has been linked to many cancers, including prostate cancer.

Eat lots of foods rich in antioxidants – which protect cells against free radicals — such as leafy greens, cruciferous vegetables, and deeply colored fruits, especially berries.

Lifestyle Choices

1. Reduce your stress.

Stress amplifies the production of free radicals, hampers the function of the immune system, and has been linked with premature aging.

Try stress reduction techniques such as progressive relaxation, deep breathing, visualization, or meditation.

2. Laugh.

Researchers at UCLA are currently studying the ability of humor to blunt stress-induced physiological changes.

Laughter also releases the body’s natural opiates into the bloodstream, dulling pain and improving mood.

So head to the video store and pick out some funny movies.

3. Exercise regularly.

Moderate exercise increases the body’s production of antioxidant substances and mildly boosts immune function.

Try to fit in three or more workouts per week.

Men undergoing treatment for cancer or BPH may be better off sticking with very gentle exercise like yoga, tai chi, or chi kung.

4. Detoxify your home.

Trade out your conventional cleaning products for non-toxic alternatives, your garden pesticides for pest-eating bugs, and your synthetic carpets for natural ones like wool.

5. Design your space.

When colors, light, decoration, sounds, objects, and overall design are pleasing to our senses, it’s much easier to relax and enjoy yourself.

Feng shui is an effective tool for making your surroundings less stressful and more health-promoting.

Avoiding Back Pain in Your Own Backyard

Now that Spring has sprung, you may get the urge to prepare your garden beds, clean up your yard, and maybe plant a new tree or shrub.

Just don’t try to do it all in one weekend, or you may wake up Monday morning bent over with back pain and a stiff neck.

But it doesn’t have to be that way if you’re smart, says Dr. Jay M. Lipoff, a chiropractor, certified fitness trainer, and nationally recognized expert in spinal injury prevention.

Dr. Lipoff is also the author of Back at Your Best: Balancing the Demands of Life With the Needs of Your Body, and an executive board member of the ICA Council of Fitness and Health Sports Science.

Here are some techniques from Dr. Lipoff that can save your spine while performing these four common backyard chores:

Raking and Hoeing

Raking is a one-sided chore because you tend to turn to one side and predominantly use one arm.

Try to engage both sides of your body when performing the motion.

Hoeing also puts more strain on one arm and hand.

With both raking and hoeing, switch sides every few minutes, even though it will feel awkward.

If you’re working a large area, give yourself a break every 20 minutes with a rest, a glass of lemonade, or switch to a different type of activity.

Always walk to where you need to be–don’t reach with the hoe or rake, which will cause more stress to the muscles of your lower back.

Digging and Shoveling

Whether you’re digging a hole or shoveling compost into your wheelbarrow, the key to avoiding back injury is to take it slowly and don’t overload the shovel.

Wear heavy-duty boots so you can step down hard onto the shovel, letting your body weight do much of the work.

Bend your knees when lifting the shovel so those big muscles in your legs and buttocks are doing the heavy lifting, and you’re not bent over, straining your back.

If you have to shovel something heavy, such as gravel, use your thigh as a fulcrum (think of the shovel as a seesaw) by placing the handle of the shovel onto it about three quarters of the way down.

Now all you have to do is push down on the handle to lift up that heavy gravel.


If you can’t afford a lawn service and don’t have kids who can do this chore for you, the next best thing is a riding mower.

Make sure it has a comfortable seat, because all that bouncing on a bad seat wrecks your back.

If you can’t get your seat replaced, try sitting on a boat cushion.

If you mow slowly, it will diminish any unevenness in the terrain.

If you prefer a push mower, try to get one that is self-propelled, which reduces strain going up hills and around curves.

With any push mower, self-propelled or not, pushing is better for your back than pulling; try to limit back-and-forth yanking.

Stay close to the mower to avoid overreaching.

Trimming and Weed Whacking

A trimmer and a weed whacker are terribly designed machines.

(A quick aside: whenever I see or hear the words “weed whacker” I think of Carl Hiaasen’s wacky character Chemo, the hit man with the weed whacker attached to the stump of his arm. Puts a smile on my face!)

Both machines require you to hold them in front of your body while leaning forward.

The weight in front of you is multiplied by 10-15 times the actual weight of the trimmer or weed whacker.

In addition, just leaning forward creates 200 pounds of additional pressure per square inch on the discs of your spine.

If your trimmer comes with a shoulder strap to minimize back strain, use it.

Otherwise, Dr. Lipoff recommends strategic stonewalls, flower gardens, a neighborhood kid, and mulching to reduce the need for trimmers at all.

If you use one, be careful so you’re not sore the next day.

One final piece of advice from Dr. Lipoff: “Before launching into any big outdoor project, whether it’s stacking firewood or moving patio furniture out of the garage, take a few minutes to loosen up.

Do some stretches to warm up your muscles.

If you take care of your back when doing outdoor chores, your back will take care of you.”

How to Get In the “Flow” and Be Happier

Positive emotions have been linked with better health, longer life, and greater well-being in numerous scientific studies.

To help you get into and maintain a healthy, positive emotional state, Harvard Health Publications has a new publication called “Positive Psychology: Harnessing the power of happiness, mindfulness, and personal strength,” which is based on the latest research.

One situation that may stand out for you when you were feeling positive emotions is during a moment of effortless action.

This sense of “flow” is what athletes refer to as being “in the zone.”

“The more flow experiences you have in life, the happier and more fulfilled you will be,” says Margaret Moore, founder and CEO of Wellcoaches Corp. and co-author of Organize Your Mind, Organize Your Life with Harvard psychiatrist Paul Hammerness and writer John Hanc.

Here’s an excerpt from “Positive Psychology” on how you can get into the flow.

Flow: Becoming more engaged

Have you ever been so immersed in what you were doing that all distractions and background chatter just fell away?

Nothing existed except the music and your guitar, your skis and the slope, your car and the road.

Mihaly Csikszentmihalyi, distinguished professor of psychology at Claremont Graduate University in Claremont, Calif., calls that state of intense absorption “flow.”

For decades, he explored people’s satisfaction in their everyday activities, finding that people report the greatest satisfaction when they are totally immersed in and concentrating on what they are doing.

In studies by Csikszentmihalyi and others, flow experiences led to positive emotions in the short term, and over the long term, people who more frequently experienced flow were generally happier.

Researchers have also found that people vary in how much they value having flow experiences, and in how easy they find it to enter flow.

No matter what your natural tendency, recognizing how flow occurs (or doesn’t) in your life and creating opportunities for more flow experiences can be a potent route to increased happiness.

Defining flow

How do you know if you’re in flow?

According to the research, Csikszentmihalyi and others found that flow experiences have several common characteristics.

You lose awareness of time.

You aren’t watching the clock, and hours can pass like minutes.

As filmmaker George Lucas puts it, talent is “a combination of something you love a great deal and something you can lose yourself in — something that you can start at 9 o’clock, look up from your work and it’s 10 o’clock at night.”

You aren’t thinking about yourself.

You aren’t focused on your comfort, and you aren’t wondering how you look or how your actions will be perceived by others.

Your awareness of yourself is only in relation to the activity itself, such as your fingers on a piano keyboard, or the way you position a knife to cut vegetables, or the balance of your body parts as you ski or surf.

You aren’t interrupted by extraneous thoughts.

You aren’t thinking about such mundane matters as your shopping list or what to wear tomorrow.

You have clear goals at each moment but aren’t focused on the goal line.

Although you may be working toward an ultimate goal, such as earning a graduate degree, making a wedding cake, or winning a chess tournament, that goal is not your primary motivation.

Rather, you find the activity itself to be rewarding — mastering or explaining a line of thinking in your academic work, creating tiers of beautiful icing, or visualizing your way out of a sticky chess situation.

You are active.

Flow activities aren’t passive, and you have some control over what you are doing.

You work effortlessly.

Flow activities require effort (usually more effort than involved in typical daily experience).

Although you may be working harder than usual, at flow moments everything is “clicking” and feels almost effortless.

You would like to repeat the experience.

Flow is intrinsically rewarding, something you would like to replicate.

In a 2005 study, presented at the Northeastern Recreation Research Symposium, researchers reported that 60% of people hiking the full length of the Appalachian Trail reported experiencing flow, usually on a daily basis, and more than 80% expressed a desire to hike the trail again.

In rating the things they enjoyed, the hikers said they enjoyed the experience and activity itself, as well as using their skills.

In contrast, external factors, such as competition with others and the prestige of completing the trail, were rated dead last in what made the experience enjoyable.

Enhancing your ability to experience flow in multiple domains can lead to greater happiness.

You can’t force flow, but you can invite it to occur more often, even in areas of life where it might seem unlikely.