Posted: Monday, October 11, 2010 11:00 pm | Updated: 1:34 am, Thu Oct 28, 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 by clicking here. Email questions to Doc at askdoc@docdossman.com.
Strong Beach, stand up!!!
That means “Hello Long Beach!!!” or “What’s up, Long Beach?” or “If you’re proud to be from the LBC, put ya hands up!!!” Ok, so now you know. Well, here we are again! I’m still here! There are more questions to answer. Let’s get it started . . . Before we begin, remember to keep an eye out for the video blog. There’s some good stuff coming out! Educational and entertaining! EDUTAINING? ENTERCATIONAL?
This week we are covering another installment of “On The Road with Doc Dossman.” I worked a huge game out in Cleveland, Ohio last week: the Cleveland BROWNS vs. the Cincinnati BENGALS. Now this is a fierce regional rivalry like LAKEWOOD vs. POLY! It gets crazy out there!
You will really enjoy this one, so stay tuned!
Ok, here we go!
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Sometimes I get questions via my Facebook account. It’s usually a local high school athlete or more commonly a kid I have treated throughout high school who has now gone away to college. They seem to appreciate me more once they leave home. Here is an example of one of these situations:
Jessica B.-
Hi Doc!! This is a super random question, and I hate to ask for your advice via Facebook, but my friend is hurting and she doesn't know what to do. The inside of her leg, above the ankle, is in pain. On the same leg her toes and the ball of her foot are hurting as well. It hurts most when she runs. She also has a history of stress fractures in her shins. Do you have any idea what would cause pain in her leg and her foot? Thanks Doc, and sorry to bother you. If only you could be in every state! By the way, I'm racing in at Louisville tomorrow and so is Tia L.!!!! Thanks again!
Has she ruled out stress fracture? Is she flat-footed? Sounds like it. Can you send me pictures of exactly where it hurts?
Jessica B.-
I'm in Kentucky with no computer :( She's not flat-footed, and it hurts on the inside of her calf (between her muscle and her bone) above her ankle and below her calf muscle, if that makes sense. She's thinking it's either shin splint or stress fracture, but I don't know about the foot thing; I just wanted to see if it could be something different. Thanks doc! Sorry this is so random :(
She is right.... either shin splint or stress fracture. Either way, it sounds like she should probably sit out this race. Have her go to the doctor. They will take an X-ray to rule out what she already suspects given her established history of a previous stress fracture!
Hey Doc! People need to know why static stretching before an active workout/activity is not as helpful as dynamic stretching when it comes to injury prevention!
-Chucky H.
Funny you should mention that, Chucky! I have a two part series (video blog) coming out in about two weeks on this very topic! Stay tuned! ;)
Since I have started spinning I have developed a tight muscle in my gluteus maximus that extends down my leg to the back of my knee. I am constantly stretching the muscle and it hurts when I sit longer than 5 minutes.
-David M.
Spin class! Good stuff Mr. M! This is a good one. Good only because it’s not uncommon. In this class your feet are in stirrups and you are asked to stand up quite a bit. This works the glutes and quads a great deal. If you look at your handy anatomical chart, you will see how the gluteus maximus overlaps the hamstring musculature. See it? This explains the extension of discomfort down to the back of your knee (hamstring attachment).
Stretching is good. You can continue to do this but I’d recommend deep tissue massage or active release technique to the glutes/hamstrings. This is nothing to worry about. You will be fine. I just advise you to take care of this ASAP. Gluteal problems usually later become lower back problems (see anatomical chart again) due to their location. Good luck!
Hey Doc, my daughter had a partially torn hamstring this past track season and was misdiagnosed with just having a pulled hamstring! The MRI revealed that it was a lower tear. My question is if the doc doesn't want to do another mri because of cost, how will me as her coach and her as an athlete completely know she's ready to sprint in 6th gear?
-Corey F.
My friend, this is a loaded question, so this will be my final one for the day!
We as medical professionals often get mixed up with the terminology we use. In my office, a “pulled” hamstring is a “torn” hamstring. Some offices say “strain” while others say, “tear”. If I told you that her hamstring was “pulled” I would not want you to think I had misdiagnosed her if an MRI revealed it was indeed torn. I would think that I was right! Now if someone tells you that it’s “pulled” but still sends you back to the track, then “pulled” in that office doesn’t mean “torn”. . . I hope you are following me. I can’t connect with you and see your facial expression.
Nonetheless, nobody is perfect, so if he did misdiagnose, let’s focus on how to move forward. If she tore it this past season, it is unlikely that it is still torn. Even without treatment, the body would heal itself in a matter of about 6-8 weeks. It has been longer than that at this point. The issue isn’t about the muscle being torn or not. The question is whether it is rehabilitated and strong enough to hit “gear six”. At this point, this is very unlikely.
Therefore, I might agree with her doctor about the use of expensive testing such as MRI. This is the time where you must take time to properly rehabilitate that muscle. It must be strong enough and flexible to handle top speed. The only way to know if someone is capable, is to “push the envelope” during their training.
The majority of my patient base is under 18. I know kids. They are incredible healers. Even though her hamstring tear is probably mended by now, I’d take that time to get treatment for the muscle to remove any scar tissue (interior scabs) that could hinder maximal function and delivery of oxygen to the cells. I’d also make sure she gets her hips balanced so that she is not putting more stress on one leg more than another. After this is done, I’d begin the rehab and strengthening process.
When you get her on that track, the best thing you can do is PAY VERY CLOSE ATTENTION to her body and what she has to say. Gauge your progress off of this, as well as improvements made in the gym. As her coach, you know what she is capable of. Push her to her limit and then pull back. Let her push herself. She knows what she can handle. At this point, nobody knows this better than her. The hardest hurdle to jump is the mental crutch the athlete has after an injury. This is complex stuff, my friend. Feel free to write me or call me when you get to this point. I love that part!
Remember to send in your questions! Ask me anything! That was pretty fun—I love this stuff! Of course I always wish I had more information. Remember, my perception of things is limited to the information given so this is why you should 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. I like to know things 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!!
Doc Dossman
To visit Doc’s website, click here, and buy his book, What I’ve Learned From Your Kids by clicking here. Email questions to Doc at askdoc@docdossman.com.
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