I saw one of the staff of the Chicago Bears Organization today. Funny, I met him a the Naperville Mercedes dealership in the parts department. So this huge guy that reminded me of a professional wrestler, had a 3-4 week problem with his nondominant hand. The guy exercised regularly till the injury and it showed with the size of his deltoid alone. (All during the time I was talking to him, I was thinking to myself, if I had to use and acupunture needle to his shoulder, I would have to order a special long one just to get through that muscle.) Well, it wasn't in his training he was injured but in a 20 second move of a firepit. (Again my mind wandered....was it a firepit or an entire chimmney he moved?) Problem was that since it was a small muscle in the forearm, it prohibited grip, pinch, and wrist rotation. A "dud" left arm ment he couldn't do symmetrical lifts in any of his exercise movements. Not good to be off a lifting program if job performance depends on size whether to use force or just intimidate. (Alas my mind wandered on to think... if I didn't come up with a diagnosis, he could pick me up and throw me to the otherside of the Mercedes dealership!)
I always tell my lecture audiences that 80% of the diagnosis to a problem will be in the history of the ailment. Thus a good reason to seek a doctor that listens and isn't pushed to be out of the room in the "magic 10"-(the 10 minutes it takes to listen, feel and write out a prescription with most of the talking being on the side effects of the medicines being given). Well, same here with this BEAR of a man; the sudden pull, the degree of twist the fist was in while he reproduced the motion he went through while pretend pulling the firepit and the lack of anyother defects in mechanics for this "athlete" pointed me to a common ailment in the forearm......tennis elbow. It is acutally a misnomer, you don't have to play tennis to get it. It so happens that tennis players often get this from trying power backhands. The front hand on the racket gets alot of vibratory stress suddenly with impact and the muscles don't like it. Stress leads to microscopic tears in muscle and blood acumuluates to start healing but the forearm can never be truly rested so we continue to tear it in everyday activities. In summary, it's the initial sports shock that usually causes the injury but its everyday actions that keep it going. Here we have a single pull in a very muscular arm (that is used to lifting enough iron to make a little mercedes c class) being used the wrong way. Now that little muscle is shutting down the motion of the entire beefy extremity. He's rested it for 3-4 weeks already so now its time for me to step in.
Here The Saguil Approach is to actually, leave him in the hands of a capable therapist with further suggestions of continuing his multivitamin, taking an antiiflammatory medicine, cross training for now to keep cardio up and substitute the endorphin rush he is used to, adding herbs like turmeric, boswellia, white willow bark to the diet, and stretching the forearm in positions Steven Segal would be pround of. If all else fails, I bring out the acupuncture needles but I may have to order to extra extra long needles from china.
Something for me to stress to those interested, just going which ever physical therapist is covered by insurance isnt an option. In my experience with college level, olympian or just average joe athletes, a therapist can make or brake a musculoskeletal problem. Just like doctors, there are ok therapist and there are great ones. For something easy like an ankle or a knee, standard PT is ok. For something complex like a neck or a shoulder(-my favorite), if the therapist isn't used to measuring scapular slide or can't do manual therapy to a trigger pointed trapezius, the 2-4 weeks in therapy may just result in a failure and it's one step closer to pod cutting, (orthopedic surgery)
GO BEARS!
