Depression and Pain: What We Can Learn From Retired Pro Football Players?

Wild Card Playoffs - Indianapolis Colts v Baltimore Ravens

Retired professional football players experience levels of depressive symptoms similar to those of the general population, but the impact of their depressive symptoms is compounded by high levels of chronic pain. The combination of depression and pain is associated with sleep disorder, problematic social relationships, financial difficulties, and problems with maintaining exercise and fitness. In particular, it is often observed that musculoskeletal disability and chronic pain interferes with the ability to maintain physical activity and fitness during retirement. The reduction in fitness, therefore, increases the risk of depression.

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Television programs like HBO’s “Real Sports” are replete with feature stories of the difficulties professional athletes have transitioning from a full-time elite athletic career to retirement. It is generally believed that the transition is difficult and traumatic because of the sudden cessation of the demands of elite athletic performance, compounded by the sudden loss of the athlete’s intense devotion to professional athletic competition and its attendant rewards. At the elite level, the athlete’s life is carefully organized around his or her performance, as are support personnel and extensive logistic and financial resources. Upon retirement, professional athletes have reported bewilderment in the transition to a life that is absent of such intense commitment. The resources and personnel that once organized and managed their lives are now gone, and the rewards, both emotional and financial, are diminished….if  not vanished entirely.

We are presented with all sorts of stories and studies in the popular media.  We see that a number of studies have described the risk of suicide in active college athletes, the risk of depression in college graduates who were previously varsity athletes. We are becoming familiar with the association between concussion(s) experienced during active professional football participation and the diagnosis of mild cognitive impairment later in life…or even Chronic Traumatic Encephalopathy (CTE).   We are even made aware of suicide in professional athletes or other injured athletes.  But despite all these  articles and reports, we hear little about the simple association between depression and pain among retired National Football League (NFL) players.

Yet it is the combination of depressive symptoms and pain that puts retired players at the highest risk of significant difficulties in retirement. The relationship between depression and pain in the general population, alone, is important and complex. A systematic review of almost 60 studies of the co-morbidity of pain and depression showed that roughly two thirds of patients with major depressive disorder had significant pain symptoms, and roughly half of patients seen in chronic pain clinics met criteria for major depressive disorder.

Given what we are seeing in the general population, the frequency with which retired professional football players report difficulty with pain seems to put them at additional risk of both developing depression and experiencing the associated difficulties with retirement mentioned previously. Depressive symptoms and pain interact to result in a strong tendency toward sleeping problems, difficulty with aging, loss of fitness and lack of exercise, financial problems, and  overuse of prescription and recreational drugs, as well as alcohol.

In summary, we can we learn the following (and more) from retired professional football players:

  1. If you have continuing pain or chronic injury, seek professional care to cure or reduce it. If previous treatments have failed to help you, get a second opinion…or a third or fourth.  Always press forward. Never underestimate what one motivated person can do to make him/herself better.
  2. Even if you have reached the pinnacle of achievement in one field of endeavor, always seek new challenges. Always seek to learn something new. Always find new avenues of improvement for yourself.
  3. If you are unhappy, seek help….or at least find someone to talk to.
  4. Always maintain your physical fitness. Always find a way to maintain a regular program of exercise or some form of physical activity, even in the presence of pain or physical injury…no matter how severe. Your physical fitness and health may be your best…or even only weapon, against circumstances that would otherwise work against you.  Always find some form of exercise or activity to do on a daily basis!!

We are a Sports Chiropractic and Rehabilitation facility located in Walnut Creek, CA. Feel free to contact us with your questions or concerns at (925) 945-1155 or info@performancesportcare.com.

http://www.performancesportcare.com

Understanding Hip Flexor Tendinitis And Finding Relief

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Hip and pelvis injuries represent 2 to 5% of all sports injuries. Among these injuries, groin and upper thigh area pain is the most common finding. The most common sports related injuries in the hip pelvis, and thigh are musculotendinous in nature. Among the most notorious of these is iliopsoas tendinitis, also known as “hip flexor tendinitis.”

Although they assist in several different movements, the hip flexors are a group of skeletal muscles which contract in order to pull the knee upward or to bring the torso in closer proximity to the thighs. These muscles include the psoas major, psoas minor, and iliacus.

In basic terms, iliopsoas tendinitis is an inflammation of the tendon or area surrounding the tendon which anchors the hip flexor muscles to the thigh bone. The two major causes of iliopsoas tendinitis are acute injury and overuse injury.

The acute injury often involves eccentric contraction of the iliopsoas muscle or rapid flexion against extension force/resistance. Less commonly, it may result from direct trauma. The overuse injury may occur in any activity resulting in repeated hip flexion or an external (outward) rotation of the thigh (femur). Activities that may predispose to an iliopsoas injury include dancing, ballet, weight training, rolling, running (particularly uphill), track and field, soccer, and gymnastics.

This injury is usually first noticed with a gradual onset of frontal hip or groin area pain. Sometimes there is some accompanying lower back pain. As with many cases of tendinitis, pain may initially be noticed after an aggravating activity, but may go away soon thereafter. This condition may progress to pain that persists during activity, but subsides with rest. It may further progress to pain that persists during activity and rest. As a result, many people delay professional evaluation/treatment of this injury, which almost guarantees, in many instances, that the condition will become chronic .

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  • These injuries commonly produce pain with specific sports related activities, such as jogging, running, or kicking. Pain with simple activities, such as putting on socks and shoes, rising from a seated position with the hips flexed for some time, walking upstairs or inclines, or brisk walking may be experienced.
  • Pain may radiate down the anterior thigh toward the knee and may also be experienced in the lower back.
  • Some people may experience an audible “snap” or “click”in the hip or groin area which may be associated with a condition known as “Internal Snapping Hip Syndrome.”
  • Anterior knee pain consistent with patellar tendinitis or patellofemoral pain syndrome (“Runners Knee”) may also be the result of a tight iliopsoas muscle.

We have an answer for many that suffer with Hip Flexor Tendinitis, particularly chronic or recurrent cases.

Our office offers a distinctly successful protocol for many Hip Flexor Tendinitis sufferers that addresses most of the significant muscular/mechanical factors that are involved in this condition. In many cases, particularly those uncomplicated by advanced tendinosis or other co-existing medical issues, we often observe positive results in as soon as 3-5 treatment sessions. We invite those who are suffering with this injury to arrange a consultation with us to determine if our protocols might be right for you.

We are a Sports Chiropractic and Rehabilitation facility located in Walnut Creek, CA 94596. Feel free to contact us with your questions or concerns at (925) 945-1155 or info@performancesportcare.com.

http://www.performancesportcare.com

What is Achilles tendinitis?

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Achilles tendinitis is an inflammatory condition that involves the ‘Achilles tendon,’  the tendon that anchors the calf muscles on the back of your leg to your heel bone. This tendon is involved in walking, running, and jumping. Tendinitis is the condition in which the tendon becomes swollen, tender, painful, and/or inflamed as a result of  microtraumatic tears. If this continues on a chronic basis, the inflamed tendon may develop degenerative changes (tendinosis) that could  ultimately create conditions for an acute tendon rupture…. and the dreaded reconstructive surgery that would follow.

Achilles tendon problems frequently occur in athletes and are not uncommon in the general population. The frequency of Achilles tendinopathy in athletes has been reported in several studies. Elite long-distance runners have a lifetime risk of 52%, according to one study. Other studies have reported annual incidence rates of Achilles tendon disorders between 7 to 9% in top level runners. Among the military population, an incidence rate of 2.98 per 1000 person years was found.

But Achilles tendon problems are not always associated with excessive physical activity. They are  also seen in patients who do not participate in sports. When symptoms are confined to heel pain, the cause is most often due to overuse of the foot. Rarely is the symptom of just heel pain caused by an instant injury, per se.

Achilles tendinitis may be more likely to occur if:

  • There has been a sudden increase in the amount or intensity of an activity, such as hill running.
  • The calf muscles are very tight and inflexible.
  • You run on hard surfaces, such as concrete.
  • You run too often.
  • You jump frequently, such as when playing basketball.
  • When there has been a change in shoe wear or when wearing shoes with improper support.
  • When your foot tends to collapse inward or outward during normal standing (pronation or supination of the feet.

We have an answer for many that suffer with Achilles tendinitis, particularly chronic or recurrent cases.

Our office offers a distinctly successful protocol for many Achilles Tendinitis sufferers that addresses most of the significant muscular/mechanical factors that are involved in this condition. In many cases, particularly those uncomplicated by advanced tendinosis or other co-existing medical issues, we often observe positive results in as soon as 3-5 treatment sessions. We invite those who are suffering with this injury to arrange a consultation with us to determine if our protocols might be right for you.

We are a Sports Chiropractic and Rehabilitation facility located in Walnut Creek, CA. Feel free to contact us with your questions or concerns at (925) 945-1155 or info@performancesportcare.com.

http://www.performancesportcare.com

Did you know that running on a flat treadmill may actually harm your knees?

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Treadmills simulate running by using an electric motor to pull a moving belt across an immobile surface. This does not perfectly replicate running on level ground. In fact, running on a treadmill is easier than running outdoor for a variety of reasons.

As a result, the muscles involved in running receive less conditioning when performed on a treadmill. One reason for this is that the treadmill belt assists leg turnover, making it easier to run faster. So, most runners find that their pace on the treadmill doesn’t correlate to their road pace. The moving belt also reduces the workload on the buttock and hamstring muscles. As a result, these muscles get less conditioning in this exercise scenario than they would with outdoor running. Many serious runners also claim that much of the soft tissue conditioning or “hardening” that occurs with road running does not occur with treadmill running because the plate or base on the treadmill “gives” more than outdoor surfaces do upon foot strike.

And there is more to consider. The mechanics of treadmill running actually translate into running slightly downhill. As you may know, running downhill is harder on your knees and shins than running uphill.

So, for those that must rely on a treadmill for their running time/miles, try increasing the incline setting on your treadmill to just a 1 to 3% incline. Depending upon the treadmill manufacturer, this small increase will level out the surface below as you run, thus taking the strain off your knees and refocusing some of the workload to your buttock and hamstring muscles.

If your knees have been bothering you because of the treadmill, experiment with the 1 to 3% incline for a few days before you decide whether the changes are helping you or not. If your knees are still giving you trouble, it might be a good idea to take a break from the treadmill and hop on the elliptical trainer, which will give your knees a rest while allowing you to maintain your cardio routine. If that fails to help you, consider consulting a facility such as ours for an expert opinion and treatment of your condition.

When your knees start to feel better, hop back on the treadmill, but don’t forget to set your incline to 1 to 3%. Or better yet, do some outside running and enjoy some fresh air.

We are a Sports Chiropractic and Rehabilitation facility located in Walnut Creek, CA. Feel free to contact us with your questions or concerns at (925) 945-1155 or info@performancesportcare.com.

http://www.performancesportcare.com

“Runners Knee” : A New Contributing Factor Identified

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The correct term for runner’s knee is “patellofemoral syndrome.”  This is the most common injury in runners and it accounts for up to 30% of running injuries. It is characterized by dull knee pain located around or “behind the kneecap.” It usually has a gradual onset and is usually made worse with ascending or descending stairs, or running downhill. Patients with this condition often experience stiffness when straightening the affected knee following a period of prolonged sitting (the so-called “theatre sign“). In a previous article posted on this site, flat feet, hyperpronation of the feet, femoral anteversion, and an increased quadriceps angle (“Q-angle“) were identified as factors often associated with this condition.

Based upon research recently published in the British Journal of Sports Medicine comes concerns about gluteal muscle strength and the balance of strength between the component gluteal muscles as it pertains to certain ultimate stresses on the patellofemoral tracking mechanism.

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It appears that tests using electromyography (EMG) to measure electrical activity in muscle demonstrated that a delayed and shorter duration of electrical activity in the gluteus medius muscle may indicate impaired ability to control frontal and transverse plane hip motion. Further, the research study showed moderate-to-strong evidence that gluteus medius muscle activity is delayed and of shorter duration during stair ascent and descent in individuals with Patellofemoral Syndrome. Additionally, limited evidence indicates that gluteus medius muscle activity is delayed and of shorter duration during running, and that gluteus maximus muscle activity is increased during stair descent.

We may have an ‘answer’ for those with “Runners Knee” (Patellofemoral Syndrome)

Our office offers for many,  a distinctly successful protocol for “Runners Knee” sufferers that addresses some of the significant muscular/mechanical factors that cause this condition to be problematic. In many cases, particularly those uncomplicated by co-existing medical /orthopedic disease, we have observed positive results in as soon as 3-5 treatment sessions. We invite those who are suffering with this injury to arrange a consultation with us to determine if our protocols might be right for you.

We are a Sports Chiropractic and Rehabilitation facility located in Walnut Creek, CA. Feel free to contact us with your questions or concerns at (925) 945-1155 or info@performancesportcare.com.

45% of People With Chronic Neck Pain Attribute Their Pain To a Past Car Accident

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People hurt in car crashes, especially rear impact crashes, often complain of neck pain, headaches, dizziness, memory problems, unsteadiness, fatigue, and low back pain.  Very often, these symptoms do not appear immediately but are delayed 24 to 48 hour, or more. Although this phenomenon is poorly understood on a physiological basis, it has been well documented in the clinical literature and is well understood by clinicians in private practice.

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Usually, the first symptoms following the so-called “whiplash” injury is neck stiffness and a feeling of muscle spasm or tightness. This is often accompanied by a reduction in range of motion of the neck. In many cases, people involved in these car accidents experience pain radiating into the shoulders or down the arms. In other cases, various neurological complaints such as numbness or tingling in the arms or hands may be present. While these symptoms may be brief and eventually resolve by themselves, they could also be signs of more serious injury to discs, joints, ligaments, muscles, or spinal nerve roots that may erupt in symptoms or more extensive problems months or years down the road.

Be wary of insurance adjustors that suggest or infer which Doctor you should see or what treatment you need.

It is very important to seek treatment from a doctor who understands the complexities of whiplash injuries and who knows how to treat the condition properly. Very often, people who have been injured in an accident have no prior experience with such situations.  Of course, the appropriate doctor to treat whiplash injuries depends on the nature of your injuries, and could include a chiropractor, an orthopedist, or a neurosurgeon….or some combination depending on the circumstances.  But, again, how would you know what is best if you have not been in this situation before?

Very often, people simply go to their local Hospital Emergency Room for evaluation/treatment of their car accident related symptoms. To be sure, if you have sustained a head injury, lacerations, broken bones, dislocations, signs of internal injury, inability to move, or signs of brain, spinal cord, or nerve injury your local Emergency Room is the best place to be. The Emergency Room is a very good place to go soon after a car accident if you want to be certain that you have not sustained such injuries and just want the peace of mind of having them ruled out.

But, fortunately, the injuries arising from most day to day car accidents usually don’t reach that order of magnitude. And that is the problem: the Emergency Room is the best place for treatment of high magnitude injuries, but it is not so well geared towards optimum treatment or documentation of the lower magnitude or so-called “soft tissue” injuries.

Unfortunately, all too often, patients are told that they only need to rest, take pain medications for a short period of time, and their symptoms will go away on their own.  But often this is not the case, and, unfortunately, the patient does not get proper care right after their injury, when the proper treatment is most critical.

Auto insurance companies love such minimalistic treatment recommendations because it allows them to settle claims quickly, for low value, before patients realize they have an unresolved or worsening problem that requires further investigation or treatment….or experience the other  “stealth ” costs of reduced productivity and a reduced quality of life.

Be wary of health care providers that seek to obligate you, in advance, to weeks of multiple treatments or other services that are unfamiliar, or of uncertain value to you.

Over-utilization of health care services for injuries is just as bad as under-treatment of injuries while also bearing a societal cost. Quantity does not necessarily equal “quality,” especially if the treatment is not delivering the results you want.  Enough said.

Doesn’t it make more sense to treat someone with a car accident injury like a Pro athlete?

Imagine if you were a professional athlete and that you injured YOUR neck in a car crash. Imagine consulting a health care provider who saw you just one time and told you that you only need to rest, take pain medications for a short period of time, and that your symptoms will go away on their own…everything will take care of itself. (Do you even believe that a ‘Pro” athlete would be treated in such a minimal fashion?)  Would you be satisfied with that recommendation or would you want to make sure that your healing and recovery is complete?

Of course, you don’t need to be paid millions of dollars a year or need to be a “Pro” to be treated like a Pro. All you need is to know what is best for you….and start asking for it.

We specialize in the assessment and treatment of painful musculoskeletal injuries and sports related problems. But, our understanding of the methodologies utilized for peak performance, injury prevention, and rehabilitation with elite professional athletes has inspired us to provide many of these same  methods to everyday people who seek an active and pain free life, including those who have sustained injury from a car accident.

Using proven, problem-focused principles, we are able to apply effective strategies and techniques to develop customized care that help our patients achieve their physical performance goals. We also have referral relationships with some of the best neurologists, orthopedic surgeons, physical medicine specialists, and neurosurgeons in our community…and, when appropriate, we will not not hesitate to bring them on to a case to serve the best interests of our patients.

With our performance based treatment protocols, our patients know that we seek the fastest possible results. They also know that through these means we seek a lower TOTAL cost to them to actually resolve their problem than what they might experience elsewhere when EVERYTHING is factored in.

If you have any questions about your injury/problem(s) or are interested in knowing if our services are right for you, feel free to contact us at (925) 945-1155 or info@performancesportcare.com. We are a Sports Chiropractic and Rehabilitation facility located in Walnut Creek, CA.

http://www.performancesportcare.com

You Don’t Have To Be A “Pro” To Be Treated Like A “Pro”

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If you have developed pain or injury while exercising, at the gym, at play, or at sports it is very likely that we can determine what is wrong and how to make you better.

We specialize in the assessment and treatment of painful musculoskeletal injuries and sports related problems. Our understanding  of the methodologies utilized for peak performance, injury prevention, and rehabilitation with elite professional athletes has inspired us to provide many of these same  methods to a wide spectrum of weekend warriors, recreational athletes, and everyday people who seek an active and pain free life.

Using proven, problem-focused principles, we are able to apply effective strategies and techniques to develop customized care that help our patients achieve their physical performance goals, regardless of their competition level. By doing so, our patients know that we seek the fastest possible results. They also know that through these means we seek a lower total cost to them to actually resolve their problem than what they might experience elsewhere when everything is factored in.

Again, our mission is a simple one: to resolve problems as quickly as possible.  Problems we successfully treat include, but are not limited to, the following:

  • Headaches of muscular/mechanical origin
  • Neck pain/stiffness
  • Shoulder pain: rotator cuff or other functional problems involving muscles/tendons
  • Tennis/Golfers Elbow
  • Back pain
  • Hip flexor tendonitis, bursitis, and/or myofascitis
  • Groin injuries
  • Hamstring and quadricep injuries
  • Knee pain: patellofemoral pain/stress syndrome, iliotibial band syndrome
  • Shin splints
  • Achilles tendonitis
  • Plantar fascitis
  • Other overuse injuries arising from exercise or sports

Feel free to contact us at (925) 945-1155 or at info@performancesportcare.com with any of your questions or concerns.

http://www.performancesportcare.com