Browsing the internet today I found this fantastic article in the NY Times, full article HERE
Dynamint is an ideal sports muscle rub for both before and after sport
YOU have been playing a lot of tennis recently, and now you think you have tennis elbow. Or you’re a swimmer with an aching shoulder. A cyclist with sore knees. A runner with pain in your heel.
Filip Kwiatkowski for The New York Times
Do you go to a doctor, or tough it out?
Now, before you read on and decide I’m a therapeutic nihilist, I have to tell you that the idea for this column was suggested by a doctor-athlete, Paul D. Thompson, who is a marathon runner and cardiologist at Hartford Hospital in Hartford.
And his answer to his own question?
“I think most folks should not go, because most general doctors don’t know a lot about running injuries,” he said, adding, “Most docs, often even the good sports docs, then will just tell you to stop running anyway, so the first thing is to stop running yourself.”
In fact, he said, since you probably will have to make a co-payment if you see a doctor, you will be adding insult — the fee — to your injury.
Dr. Volker Musahl, an orthopedist at the University of Pittsburgh Medical Center, had the same sort of response. He competes in marathons and triathlons.
“If you want to continue to run, don’t see a doctor,” Dr. Musahl said. He, like Dr. Thompson, said that if you were one of his patients, coming in with a sports injury like a sore knee or hamstring or heel or hip, he would just tell you to rest.
Dr. Musahl added a caveat, however. When he recommends staying away from doctors, he is talking about staying away if you have the usual sort of aches and pains that plague almost everyone who exercises regularly. But there are red flags that should prompt you to get medical attention, Dr. Musahl said: pain that gets progressively worse, pain at rest or at night, joint swelling or bruises that do not get better, and knees or elbows or other joints that lock or seem unstable.
Dr. Thomas Best, the president-elect of the American College of Sports Medicine and director of the division of sports medicine at Ohio State University, advises seeing a doctor if you are not recovering in your usual period of time from whatever injury or soreness you typically get. For example, he said, every weekend after his usual 10-mile run his knees are sore. He is not sure why.
“Lord knows what’s going on in there,” Dr. Best said. But the pain goes away in a day or so, and he has grown used to it. That’s his usual recovery time for that kind of knee pain.
“Know how you typically recover,” he said. “When you are not recovering as you typically do, that’s the first warning that something more is going on.”
The problem with rushing to see a doctor for common injuries, according to Dr. Musahl and others, is that doctors have a limited arsenal. For a typical sports injury — pain or tenderness in a muscle or tendon — they can’t make you get better faster. And some of the treatments doctors dispense, like cortisone shots for injured tendons, can actually slow recovery, albeit providing temporary pain relief.
There are some helpful treatments for run-of-the-mill injuries, but they often do not require a doctor, and doctors often know nothing about them.
Rigorous studies have shown that eccentric contractions, in which a muscle lengthens as it works, seem to speed the healing of tennis elbow and of injuries to the Achilles tendon, which attaches the calf muscles to the heel. They involve, for example, doing heel drops for an Achilles tendon injury — standing on a step and dropping your heel, then raising your heel to the level of the step again. In one recent study testing an experimental treatment, which turned out not to work, heel drops were used as the standard of care — the presumed-to-be-effective alternative to the treatment being tested. Participants getting the experimental treatment, as well as those who did not get it, did 180 heel drops a day.
Sometimes going to a doctor for a diagnostic workup can be a precarious thing, with scans that can show all sorts of apparent abnormalities and injuries that are not really causing any problems.
For example, in a study reported at a recent meeting of the American Orthopedic Society, Dr. Matthew Silvis, an orthopedist in Palmyra, Pa., did M.R.I.’s of the hips of 21 professional hockey players and 21 college players. They showed abnormalities in 70 percent of the athletes, even though these hockey players had no pain or only minimal discomfort that did not affect their playing. More than half had labral tears, rips in the cartilage that stabilizes the hip.
“M.R.I.’s are so sensitive,” Dr. Musahl said. “They frequently show little tears or fraying everywhere. And it is very, very common to have a small labral tear in your hip — it doesn’t mean you have to have the particular symptoms.”
The same is true for rotator cuff tears, rips in the tendons that help stabilize the shoulder. Studies have found that about half of all middle-age people with no shoulder pain have these tears, although they are unaware of them and have no symptoms
