Posted: Tuesday, November 23, 2010 12:00 am | Updated: 12:18 am, Tue Nov 23, 2010.
Welcome to Ask Doc Dossman, a weekly column where you can ask Long Beach’s pre-eminent sports therapist…whatever you want! If you already forgot who Doc is, click here to read our introduction. To visit Doc’s website, click here, and buy his book, What I’ve Learned From Your Kids. Email questions to Doc ataskdoc@docdossman.com.
What’s up Strong Beach? I hope that all is well for you as we move into this time of Thanksgiving. Speaking of food, keep an eye out for the next video blog. We will begin a two part series on pre-game nutrition. I get questions every day on this topic. “What should I eat on game day?” “What should I eat before a workout?” “What is carb loading?” “Is carb loading for me?”
If you have ever asked any of these questions, if you have sent in questions regarding this topic, or if you are just plain curious then check these videos to find the answers—you will not see them addressed in the column. Now lets get down to business!
What’s up Doc!
I absolutely love the “Strong Beach” movement. I have to get some t-shirts and bumper stickers to support and keep it growing! I have a question about orthotics. My doctor wants me to get casted for orthotics to help correct a knee and hip issue that I have been suffering with. The problem is I may have to pay about 800 bucks out of pocket! Is this typical? He says that I am not exactly flat-footed but my arch is considerably low. Are custom orthotics that much better than over-the-counter orthotics? Do you cast for orthotics? What should I do?
- Tim J.
Tim!
Thanks for the love! T-shirts and bumper stickers are on the way! Stay tuned! It sounds like your doctor is barking up the right tree so you seem to be in good hands there. The majority of hip and knee issues originate from faulty foot biomechanics. If it were up to me, the entire U.S. population would be wearing orthotics!
Because today’s shoes are often designed more for style, look, and sometimes for comfort, foot biomechanics are oddly deleted from the equation. Proper foot alignment is low on the priority list. We wear these shoes from an early age and set ourselves up to fail. I am happy to see that he recognized the origin of the problem, rather than treating the symptom.
On another note, while 800 bucks isn’t out of the typical surgeon’s range rate, it’s still a bit steep. Yes, we do orthotics here at my office ($300), but I do have to tell you one thing before you go spending the big bucks. There is not a single research study that proves that the custom orthotic reigns supreme compared with the over-the-counter orthotic found in the stores. Really!
As a matter of fact, studies show that over-the-counter orthotics are just as effective as custom orthotics. I work with a lot of athletes and sometimes they need a modification here and there, so custom is often the way to go for them. I think you should do a six-week trial with an over-the-counter pair before taking the $800 plunge. I am sure your doctor will understand. Thanks for your question! I get this one quite a bit, so I am sure you helped out a few people today!
Hello Doc Dossman,
Thank you for sharing your knowledge with the Long Beach community. I have been watching your videos and reading the columns. Knowledge is powerful. I feel empowered! My question is regarding my lower back. I am not an athlete. I am a graphic designer (nice website by the way).
I sit in front of a computer screen all day long and many hours at night as well. When I get up from my desk, I have difficulty standing up straight! I feel bent over like an old lady. I’m only 47 years old! I was hoping you could give me a stretch or an exercise that I can do at home/work to take the edge off. I don’t like to take pain medications and they don’t seem to be effective with this back thing anyway. Please help! I promise to come see you one day. I just need some self-help advice right about now!
- Kathryn H.
Hi Kathryn!
Thanks for the kind words! I appreciate them very much! Yes, I can help you with your “self-help” question. I see this all of the time. People who sit for hours with a forward lean tend to place a disproportionate amount of pressure on the front of their lumbar disc. I’d like you to picture a jelly-glazed donut. Now I want you to apply pressure with your thumb on the front end of this donut. Where do you think the glaze will migrate? Would you say, perhaps to the rear of the donut? You would be correct! If you were to apply pressure the rear end of the donut, the jelly-glaze would move forward.
Your lumbar disc is similar in function when we sit with a forward lean. This puts pressure on the front end of the disc. The stuff in the middle of your lumbar disc tends to migrate to the rear. When you go to stand, all of the stuff inside of the disc has moved to the rear, causing increased pressure when attempting to put further pressure on the rear (by standing). This is why sitting back down is easier. The front part of the disc is relatively empty!
Here is an exercise that you can do to take the edge off when this happens again. You might want to make it part of your daily routine. It is called the “McKenzie Protocol.” Click on the attachment at the top of the column to read the file. I recommend you try exercises one, two, and three! I hope this helps. Please let me know how it works for you. By the way, if you sit for hours, it’s likely that your hamstrings could be rather tight. Take some time to stretch the hamstrings!
Hi Doc,
My son falls off of his skateboard every day. It drives me insane but I have come to the realization that this is just part of the sport. Yesterday he came home complaining about his “butt bone.” He says it hurts to sit down. It doesn’t seem to stop him from wanting to skate or remain active, but sitting seems to be the ultimate chore. He can’t eat at the dinner table and even our couch isn’t a comfortable place for him to sit. What should I do? Should I be concerned? Will this just go away?
- Concerned Mom
Hello Concerned Mom,
This is just wild! I was doing a video blog yesterday with Pro Skater Eliana Sosco. She was teaching me how to skate. I was going down a small hill and lost the board from under me! I was airborne and landed on my tailbone. I immediately thought about you and this very unanswered question! In my mind I was thinking, “I guess I will be addressing that one this week!” I am typing this to you in pain. Ironically, my “butt bone” hurts, too. I can’t sit down either. I can literally feel his pain!
Fortunately, the “butt bone” (tailbone/coccyx) isn’t the most important bone when it comes to functional biomechanics. It serves as an attachment site to a few ligaments for the bottom of the pelvis but is typically known as the bone we sit on. He should be fine to continue moving about. Sitting will be a problem for a little while. I recommend getting him a donut pillow to sit on. I also recommend that he sit leaning forward during this time. Most of the weight is placed on the tailbone when you sit leaning back. Typically, the donut pillow and time to heal is the way to go. That is what I am doing! Best wishes to your son. He is my partner in pain!
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Well that was pretty fun! I love this stuff! Of course I always wish I had more information. My perception of things can be limited to the information given so be careful when taking my recommendations over your own physician who actually sees you regularly. The more information you give me, the better I can help. It helps me to give you the best recommendations when you provide information like age, sex, date of injury, past injuries, and things of that nature. Well that is all we have time for today folks! Until next week, stay STRONG BEACH!!!
To visit Doc’s website, click here, and buy his book, What I’ve Learned From Your Kids. Email questions to Doc ataskdoc@docdossman.com.
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