DrRic Building a Spiritual Yogic Practice to Neutralize Stress (slide share edition)
DrRic -Knee Pain in the Outdoor Athlete (slideshare edition)
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Transcript of DrRic -Knee Pain in the Outdoor Athlete (slideshare edition)
Knee Pain in the Outdoor Athlete
We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.
Ric Saguil, MDFirst Health Associates
Arlington Heights
Nutrition
Grounding
Movement
We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.
First Health Associates
2010 S. Arlington Heights Rd
Arlington Heights, IL(847) 593-3330
DrRic
The First Health Approach
We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.
Your Community of Care
Ric Saguil, MDJason Gruss, MDTom Jordan, RD
Katrina Christie, LCPCJennifer Green, NDJoe Musolino, DC
Emery Paredes, PTCourtney Day, EPYu Zhu, MD China
You
Staying injury free
Know your opponent
1. Pain receptors2. Inflammatory cascade3. Stretch receptors
4. Abnormally functioning nerves (Diabetes, Fibromyalgia, CF)
• Stay away from the light!
• The body is a miracle and can perform miracles…... if damage not too advanced and
body is healthy.
1. Pain Receptors
Learn the difference between good and bad pain signals
The Fibroblast
The fibroblast cell is the workhorse of healing in the joint…..if it is given the right tools! ( ….good nutrition, no toxins, no stress, no infection)
Every “knee” cell knows what to do….
…the brain has to be patient.
Ignored = further injury and longer healing . Pampered = fastest healing attained
1st prob
2nd prob
2nd prob
2nd prob
2nd prob
2nd prob
How to avoid 2nd prob’s
Step
Facilitate Healing
• R • I• C• E
est
ce
ompression
levation
Get Rescued
Step 1
Step 2
Your Rescue team:
1. Orthopedic surgeon
2. Sports medicine physician3. Primary care doctor4. Chiropractor 5. Physical therapist6. Exercise physiologist7. Kinesiologist 8. Trainer
MD or DOMD or DOMD or DO or NPDCPTEP ACSMT Cert ACSMT Cert ACSM
+ Acupuncturist LAc or Dipl. Ac
INTERMISSIONBest bang for buck
Better than nothing Over kill
Saguil Approach – Compressing Time
Rehab is mandatory!
2. Inflammatory Cascade
Knee In
jury
Swelling
Heat
Pain
BoneMuscle
Ligament
Blood Vessel
Caveat Emptor
Not Safe!
Safe
Really Safe!!!
DrRic Favorite
Black Pepper
Tumeric is an excellent anti-inflammatory for swelling and healing but take with black pepper
Natural Facilitators
• Vitamin D3 1000IU am/pm
• Omega 3 (Fish, Flax or Krill) 1000mg am/pm• Multivitamin am/pm• Glucosamine Sulfate Chondroitin 1500/day• Magnesium 200mg am/pm• Anti-inflammatory Diet for life!• Traumeel/PanAway topical 3-5times/d
Hint: Save money, take glucosamine 30 days on then 90 days off…..still works all year round!!
“Synthetic” Facilitators
• OTC NSAIDS motrin, advil, ibu, aleve, napro..• Script NSAIDS relafen, lodine, voltaren, indocin• Injectable NSAIDS toradol• Topical NSAIDS pennsaid• Oral Steroids medrol pack, prednisone• Injectable Steroids kenalog, celestone….• Muscle Relaxers flexeril, zanaflex, skelaxin• Narcotics tylenol #3, vicodin, ultram
Prescription medicines can help but watch the side effects!!
3. Stretch Receptors
Flat bag of fluidFu
ll bag o
f fluid
Fluid build up from Friction
Patellofemoral Syndrome
Normal tracking
Abnor
mal
track
ing w
ith
fricti
on/p
ain
Extra
fluid
Prolonged Friction = Cartilage “Abrasion”
weeks
Chondral Fracture
Chronic Friction =Cartilage and Bone Chip
Months
Osteochondritis Dissecans
High Q-angle rubbing/friction
Pes planus (pronation)
Flat feet causes a “high Q-angle”
Pes planus = “fallen arches”
Pronation “fixes” alignment
Shoe inserts
Or good shoes
“External Fixes”
• Stabilizing shoes• Low dye taping • Orthotics Custom• Orthotics Off Shelf
Avoid “Rocky” style shoes….(or ask an expert)
ask
Muscular Imbalance
1. Quads (usually big)
2. Hamstrings (usually tight)
3. ITB (Ileotibial Band) (slave to #1 and #2)
Ileotibial band syndrome
With big muscle comes tight ligament
Dominant forces win
ITB
Qangle
ITB Syndrome
The patella gets pulled by ITB Syndrome
ITB Syndrome causes Patellofemoral Syndrome
ITB Syndrome
Normal Pulled over
“Internal Fixes”
PT
ATC
MT
ALTERNATIVE
Surgical
Physical Therapy
• Covered by most insurance ($$$)• “Challenge” the therapist (find a sports tx)• Plan on graduation date/surgery (launch)• Modalities facilitate (u/s, phono, ionto)
Athletic Training
• Cheaper• Great at taping/DTM• Great at keeping you honest after PT• Maximize on conservative therapy
Ice Bath Ice Sleeve Kinesio Taping
Field Experience Self-careEducation
Massage Therapy/Alternative
Chiro Alignment
Yoga
Tissue Scraping
Acupuncture
Self Massage
Equipment
Your Life Changing Team:
• Trainer• Kinesiologist • Exercise physiologist• Physical therapist• Chiropractor • Primary care doctor• Sports medicine physician• Orthopedic surgeon
• Acupuncturist
Bottom line
• Rescue from damage• Reverse inflammation• Re-strengthen muscle• Re-balance kinetic
chain• Return to activity
Stop trainingMeds, supps, foodTherapy, acupunctureChiro, trainer, yoga, crossfitIdea of K E Y (knowledge..)
Community Health Project – YOGA?
We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.
Northwest Community Hospital Wellness Center
June 23rd (sat) 11:00-12:30pm(847) 618-3500Ric Saguil, MD
QUESTIONS?
COMMENTS?
CONCERNS?