Wednesday, February 9, 2011


Posted: Tuesday, February 8, 2011 1:15 am
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.
Hello Strong Beach! I hope you had a great weekend; I know I did! The weather was awesome, it was Super Bowl Sunday, I am happy to be alive, and all the other good stuff!  I didn’t really have a team in the game, but I enjoyed it because it was a great battle! 
I want to give a shout out to the Long Beach Poly Boy’s basketball team and thank them for letting me bring my cameras out on the road with them this past weekend. Their game against Bishop Gorman from Las Vegas, Nevada was featured on ESPN2.  My next video blog releases very soon and it highlights the behind the scenes action of that amazing game. Stay tuned! Now, lets answer some questions!
Dear Doc Dossman,
I am not an athlete or a weekend warrior. I am just a mother of three. I cannot give you any full description of my problem because I don’t do much [in terms of activity] to experience or become familiar with my pain. My one issue is that whenever I attempt to slide my shoes off, I get this pain inside my knee joint. I can’t even pinpoint it. Sometimes it seems like it is in the outside rear knee. Other times it feels like it is deep inside of my knee.
To give a better description of my shoe removal technique, I typically do not untie my shoes.  While standing, I take my heel and butt it up against the other shoe to pin it against something. Then I pull my heel out of the shoe. I get the pain upon pulling up my heel. It really bothers me and I hope you can help.
Just Mom
Hi Mom!
I think I can help you out. There are several things that could be an issue, but I will tell you the most common thing that I see. Yes, I have seen this problem quite a bit (by athletes as well as mothers).  It seems that you have a tight Iliotibial band. We call it an I.T. band. When it is short, it can actually change the orientation of your lower leg bone (tibia or shin) with the thigh bone (femur).  The short band can place a rotational torque that causes almost the exact pain that you describe.
It is typically an easy problem to fix with several options of treatment. Here are my suggestions:
1- Massage Therapy- Deep tissue massage to the I.T. band and thigh muscles will help release tension from this area.
2- Active Release Technique- Visit a certified practitioner. This option might work faster and be less painful that option #1.
3- Foam Roller- D.I.Y. (Do It Yourself)!!!  Go to your local sporting goods store and purchase a foam roller. You can work out the tension on a roller at your own pace. A foam roller is a great investment and you can use it on various other body parts, too!
Those are my recommendations. I sincerely hope that you (or any of my other 12 readers) have found this information helpful! If I am wrong and my suggestion is not helpful, let me know and I will share with you the other options in a future column.
Hello Dr. Dossman!
My back aches from time to time. It’s really nothing serious but I like to put an ice pack on it. My wife and kids all seem to think that I need to be putting heat on it instead. I just don’t find the heat to make that much of a difference but my son is an assistant athletic trainer at school, so he knows he is right. My wife did her Internet “research” and seems to agree with him.  I was wondering what your opinion might be on this topic. Maybe you can give us some clarity or maybe you can help me shut them up?
Annoyed and Grumpy Old Man
Hey Old Man!
 There are so many theories on ice and heat. If you want, you can even look in my section of the website to find the video blog I did based on this question of ICE vs. HEAT. 
I will tell you this: in my humble opinion, this debate is beyond overrated. At the end of the day, neither will kill you. It is all about comfort. If you find that ice packs give more relief than heat, then go with ice! That’s it! Heat is typically recommended for chronic cases such as yours. Ice is usually beneficial when something is new or acute (0-72 hours), but not everyone reads the textbook!
This is what I say to interns, “Go with what works for you my friend!” Maybe you should go get your back checked out too? It’s just a suggestion! I’m on your side!
What’s Up Doc?
I don’t really have a sports injury or health related question. I’m actually a fan of yours now that I have read your book! It was so awesome! I have two children of adolescent age and I found it to be very enlightening. It was such an easy read because I felt like I was just having a conversation with you. I feel like I know you and I just wanted to thank you for writing this. I felt like it was written just for me.
With that said, I read about and understand your motivation and inspiration behind it all but want to know more about the process. How long did it take to pen? Was it a difficult process? I think you mentioned that it is your very first book. Is there another one on the way?
Keri F.
Hi Keri,
Thanks so much for the positive feedback! I really appreciate hearing feedback from parents because I know that my observations and advice in the book stepped on quite a few toes. Some of the topics made people uncomfortable. I am happy you had a positive experience by hearing what I had to say straight from my heart!
The process was very tedious. It required a ton of work. It was easy to put together the rough draft. The information came from all of my experiences with these kids over the past decade. I know that stuff inside and out. It was the editing process that made me want to gouge out my eyeballs with a jagged spoon! At one point, I thought I was going to go insane. I am grateful for that process now, because I created a resource that is like no other product. I am very proud of this contribution.
As far as other publications, yes, I am working on one right now.  I do have plans for a sequel to What I’ve Learned from Your Kids .  In this upcoming project, the kids are the intended audience. My current project is an exposition on the lifecycle of an athlete from pop Warner to professional and beyond. I have a co-author working with me this time, so I hope to share the load and stress during the next editing process! Thanks again for the love!
Well that was pretty fun! I love this stuff! Of course I always wish I had more information. My perception of things is limited to the information you give me, so be careful when taking my recommendations over your own physician who actually examines you regularly. The more information you give me, the more 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.

Posted: Tuesday, February 1, 2011 12:15 am
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.
Hey Strong Beach! How are you? I’m excited as I watch two of my Long Beach guys in Hawaii at the Pro Bowl (DeSean Jackson & Marcedes Lewis). This is Marcedes' first Pro Bowl. He got to start and he just scored a touchdown! You gotta be happy for the local guys! Well, this week I have two great questions. I am keeping my column down to 1,000 words or less so that means I will be more brief with my responses. It’s a challenge when my goal is to give you all the information that I can, so I apologize in advance if it seems like it is taking forever to get around to your question. Please keep them coming. Without your questions, there would be no “AskDoc!” Let’s get started!
Hey Doc, how's it going?  I want to ask for your help. 
So it seems by body decided to remind me I'm not young anymore. I got up from the couch one afternoon and have had this ongoing pain in my left hip since then. I've walked with a limp all weekend. It feels like it slipped out of position or something.
I, too, am in the healthcare field. I work as a physician’s assistant in Internal Medicine, so I might be out of my element here. To give you some more detail, I have pinpoint tenderness along the region of the greater trochanter. Just internal to this is an area that hurts more with internal rotation of my hip. It gets slightly worse with hip flexion.
I’m pretty confident this isn’t internal! I've tried stretching to "pop" it back in but nothing works. Any suggestions? This is embarrassing. LOL.
Old at 33, 
Nulma C.
Hey Nulma!
It certainly helps to know your anatomy! You just made this a slam-dunk diagnosis for me. This is virtually all the detail I need to figure this out!
The pinpoint area over your hip is where the muscles that rotate your hip in and out are located. The fact that you have pain when rotating your hip in means you’re placing tension on the muscle that does the opposite movement. When your hip rotates in, you stretch your external hip rotator. This muscle is called the piriformis and the muscle belly is just internal to the greater trochanter. So…it’s the piriformis muscle that is causing your trouble.
I have two recommendations. I would get a softball and put it on the ground. Sit on the softball, positioning it right over the piriformis region. Roll around on it and let your bodyweight apply pressure to the muscle. It will hurt, but it should “hurt good.” Roll around on the ball until you can’t take anymore.
Second, learn how to stretch the piriformis. There are many ways to “skin a cat” so I won’t give you just one way to go about doing this.  My suggestion is to go to YouTube and enter “piriformis stretch” into the search box.
Between the ball workout and the stretch, you should be fine! Let me know how that helps. Write me back okay?
Hi,
Can you tell me why I keep having hamstring pain? I have been receiving treatment on them for almost two months now. I’ve tried everything from cold laser therapy to deep tissue massage to acupuncture. I rested it for three weeks straight and with all the work done, nothing seems to make a difference!  I am confident in my therapist. She has amazing hands. The trainers at school work really hard for me and I think that they are just as frustrated as I am.  I just don’t know what to do.
By the way! I am a sprinter. My main event is the 200-meter dash. I never really had any accident or major precipitating event that I can recall. This is just something that has worsened over time. I feel helpless to the point of depression. Please help.
Desperate Sprinter
Hi there!
Thank you for your detailed statement. Though I can feel your pain as I read, your description is very helpful to me. I will keep this very simple. Unless there is some type of trauma directly to a muscle, never limit your treatment to the area that hurts. Always be willing to look above and below the area of complaint. In your case, you can have the greatest hands on your hamstring and it will not matter if you are not properly diagnosed. This is why it is of great importance that you are accurately diagnosed before treatment. You need to see your doctor for an initial examination. Once you know exactly what problem you’re dealing with, you can more forward without wasting time.
Now, about your situation, it’s an easy one because I see this all the time. There are two main areas that need to be checked when there is a hamstring complaint. One of these areas is your calf region. The gastrocnemius muscles run across the knee joint and overlap the hamstrings. When this muscle is short or restricted, it causes problems and a feeling of “grabbing” on the adjacent hamstrings. Have your trainer assess for gastrocnemius tightness and spend time there if needed.
The other area to check is the gluteal region. The gluteal muscles cover the attachment point of the hamstrings. When the glutes lock up, they also lock down the hamstrings. If your practitioner releases your gluteal muscles, your hamstrings will feel better. Even if you have no issues with your legs, releasing the glutes and calves will always make your hamstring feel better. This is a good place to start!
Be encouraged. As I said before, I have seen this problem many times. Believe it or not, I actually see it more than I see true hamstring strains. You will bounce back from this. With no history of trauma, it’s highly unlikely that you have an actual muscle strain. Even if you did, it would’ve healed by now. You just have to get the right diagnosis so that you don’t waste any more precious time. Let me know how things work out for you. I am confident you will be just fine!
Well, that was pretty fun! I love this stuff! Of course I always wish I had more information. My perception of things is limited to the information you give me, so be careful when taking my recommendations over your own physician who actually examines you regularly. The more information you give me, the more 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.