Thursday, February 28, 2008

cortisone v. laser

Reason #1: Cortisone Inhibits the Healing of Injured Connective Tissue
Pathophysiology 101 is that the body heals by inflammation. No inflammation, no healing. It is that simple. When a person sprains an ankle, the persistent swelling for one to three days is the body’s attempt to heal the area. If you want to stop healing, just stop inflammation. This is exactly what cortisone does.
One of the first people to determine the effects of cortisone on ligament, tendon, and joint healing was George S. Hackett, M.D. In the mid- 1950s, he did studies where he injected injured ligaments, tendons, and joints with various agents, including cortisone. He found that cortisone inhibited the healing of these stretched and torn connective tissues.
Reason #2: Cortisone Inhibits the Healing of Laser therapy
Modern medicine has forgotten the first rule of healing: The body heals by inflammation. The whole inflammatory cascade, including phagocytosis (immune cells cleaning up the area), angiogenesis (new blood vessel formation), and fibroblast formation (new collagen formation) is inhibited by cortisone. Cortisone also inhibits the migration of the immune cells to the injured area. This migration and repair process is what causes the pain. Cortisone inhibits this repair, so the person feels better. The person getting a cortisone shot sacrifices healing for pain control. This is a bad choice because they now have a weakened structure that they think is fine - so they continue to do sports and activities, not realizing that they are accelerating the degenerative process.
Reason #3: Cortisone Accelerates the Degenerative Process
Cortisone, by inhibiting the normal healing inflammatory reaction, accelerates the degenerative process in the tendons, ligaments, and joints in which it is injected. It also gives the person a false sense of security that the area is healed, when it is not. The combination of a cortisone shot and follow-up exercise is an exceptionally deadly combination for cartilage. Nothing but arthroscopic shaving will degenerate cartilage quicker. Studies on animals have shown that even one cortisone shot into an area has been shown to cause irreversible biochemical damage to joints and cartilage. One of the quickest ways to cartilage deterioration and/or a hip or knee replacement is a cortisone shot into these areas.
Reason #4: Cortisone Shots Mask the Pain and Injury
Cortisone, by blocking the healing, does not allow the injured structure to send off a pain signal that something is wrong and needs to be fixed. Cortisone, at best, then just masks the pain and injury. The injury continues, but because there is no pain signal, the person thinks everything is okay, when it is not. The only thing that can occur is that the injury continues and accelerates. If the cortisone shot was really “successful,” the injured structure may be permanently unable to fire a pain signal, and thus will not hurt anymore. What more commonly happens is that the structure further deteriorates to the point that it overcomes the inhibitory effects of the cortisone shot and starts to hurt. The problem is that the person runs back to their Orthopedist for another one of those “wonderful” cortisone shots; never realizing that the very shot is what is causing their pain and accelerated joint destruction. Such a person is on a slippery slope that could end their athletic career. What is forgotten are the thousands of people who are unable to enjoy their retirements and are in nursing homes because they have lost the ability to walk because of severe hip, back, and knee arthritis. The cause of most unhappy retirements is because of Cortisone Shots! Their cousins the anti-inflammatories, of course, are also to blame.
Reason #5: Cortisone Shots Cause People to Need Joint Replacements
Nothing can degenerate a joint quicker than a cortisone shot (except, perhaps, arthroscopy with cartilage and meniscus shaving). The number of joint replacements in this country will soon reach 1 million per year. Ten percent of people in the US will get a joint replacement. Guess what the percentage of those needing a joint replacement are those who have had a cortisone shot? Correct, just about 100%. You want a joint replacement? Just keep having cortisone or its cousins injected into your joints, ligaments, and tendons. Cortisone is a poison to the connective tissues of the body, including cartilage, muscles, ligaments, menisci, and tendons.
Reason #6: Cortisone Shots Cause People to Need Surgeries by the Same People That Gave the Shot!
Most cortisone shots for pain are given by Orthopedic Surgeons. Surgeons love surgery! When they give people cortisone shots, they are doing it in good faith, never realizing that the very shot they are giving will help land the person in the surgical suite. Cortisone helps land people in the arthroscopy suite to get their “damaged” menisci, ligaments, tendons, and cartilage shaved. The orthopedist and the patient never have a clue that it was the anti-inflammatories prescribed by the orthopedist and cortisone shots given by him/her that was the cause of the damage. You have a damaged joint or spine! Anti-inflammatories and cortisone shots are what are causing people to need laminectomies, discectomies, fusions, tendon repairs, and other salvage operations. Salvage your spine and joints before it is too late. Just say “no” to cortisone.
Reason #7: Cortisone Shots Cause Premature Aging
Healthy aging involves being active for life. Being 70, 80, or 90 does not mean “nursing home time.” As long as a person makes sure that injuries heal, there is no reason they cannot be active for life! Once cortisone enters a joint, tendon, ligament, cartilage, or menisci, then complete healing is inhibited. Suppressing an injury is a great prescription for later-in-life immobility, pain, anti-inflammatories, surgery, or in summation, premature aging.
Reason #8: Cortisone Shots End Dreams
They come in every day to Laser Pain Centers. Men and women who now can’t even walk without pain, but yet in their day they were “dream makers”. The superstars of yesteryear are now left hobbling along. Even sadder are the elite atheletes who come in to have their dreams dashed by a degenerated joint caused at the hands of their “team physician”. Everybody loves a star athlete, but take away that athletic prowess and then who loves them? Nobody, except mom, dad, significant other, and of course our Laser Therapists. That is it.
Laser therapists love to help people regain their dreams. The dream is playing in the NBA, PGA tour, or perhaps just getting back to the high school team pick-up games on the weekend, or the tennis matches on the weekend. Whether we want to admit it or not, athletic activities, exercise, and being active are very important to all of us. Sure guys watch too many athletic events on T.V. But take away the ability to be active for any of us, and panic hits. Most of the time this inability to play sports or exercise is in part due to a cortisone shot. Show me a chronically injured joint and I’ll show you where cortisone has been. Don’t end your dreams by getting a cortisone shot.
Reason #9: Cortisone Shots Keep People From Getting Healing Therapies
By getting a cortisone shot and masking the pain, people do not get the healing therapies they need. Any therapy that helps increase circulation to the area, helps healing. Therapies such as exercise, myofascial release, rolfing, magnets, massage, chiropractic physiotherapy, kinesiotherapy, acupuncture, herbs, vitamins, and a host of others help people truly heal injuries. When people pop anti-inflammatories and get cortisone shots - it is like taking the battery out of a blaring fire alarm while a fire is blazing. “No problem here.” “What do you mean? You dope, the alarm means there’s a fire!” This illustration seems silly. Who would take the batteries out of the fire alarm during a blazing fire and state “no problem here.”
Reason #10: Cortisone Shots Keep People From Getting High Power Laser Therapy
To heal an injury, a person needs to receive Laser therapy. Perhaps this is why I dislike cortisone shots the most. They keep people from healing their injuries. The only way healing can take place is if they allow the body to heal the area via inflammation. If the body can’t do it, then one has to receive Laser therapy, which will stimulate and accelerate the normal healing inflammatory reaction. The repair mechanisms of the body are thus stimulated and ultimately the traumatic, joint, spine, or sports injury is healed. High Power Laser therapy stimulates the body to heal the injured area quickly and naturally.

Wednesday, February 20, 2008

weight training

As a formal personal trainer and now a doctor I am constantly asked "should I lift weights". The short answer is yes. The benefits are endless but most important is to prevent injury. If you are a runner, cyclist, golfer, or tennis player the primary way to get better at your sport is to perform that sport. Weight training can make the supporting muscles strong enough to maintain your form. Sport specific exercises are the way to go, if you want to complete an ironman heavy flat bench workouts are about as useful as a banana seat. Unbalanced body weight movements would serve you much better. Stay tunned for more details.

Tuesday, February 19, 2008

intensity

No Time? Go Hard.
Stay conditioned with intensity training.
By Chris Carmichael
The next four weeks will make or break my season, and maybe yours too. This winter I put in a lot of miles on the bike while coaching at several weeklong Carmichael Training Systems camps, but I know from experience that late spring and early summer can be my downfall. I get busy with work and my kids' activities, and my cycling fitness just disappears. But I have a solution to get me to the height of summer in peak condition, and you can use it too: intensity.Even when you're busy, you can sneak out for short, fast workouts to maintain your fitness. Remember, intensity and volume are inversely related--the less riding you do, the more intensity you can pack into your training. The fortunate few who have unlimited riding time can cruise at a moderate pace most of the time and throw in a few intervals. But if you're short on time and still want to keep up with the Sunday group ride or do some racing later in the season, then high-intensity workouts are the only way. Not all intensity is the same, however. There's a big difference between doing a sprint workout (15-second efforts) and doing repeated one-minute max efforts. Both are hard, but because the power outputs are so drastically different, these workouts that seem similar won't yield the same results weeks from now. For this plan, stick with the longer intervals, which work your sustainable power at threshold while at the same time stressing your aerobic engine, so you're killing two birds with one stone. Later in the summer, when you have more time to ride, you can do shorter efforts to quickly regain your explosive sprinting power. To put this theory into practice, I'll do three one-hour rides during the week. If I'm lucky, I'll also be able to swing a three-hour endurance ride on Saturday or Sunday, but if I can't, it's not a huge deal. Because these workouts are so intense, you'll want to take a recovery day between each interval day. For me, this means a Monday, Wednesday, Friday interval-workout schedule with the bonus endurance ride on the weekend. Keep in mind that this schedule is intended only to get you through a three- to five-week crunch time when other important aspects of your life cut into your available training time. After that, you should go back to a typical seven-to-10-hour training week, and enjoy your summer.
1 and done: Three workouts you can do in an hour to get fit when time is short.
Over Unders: During the "over" portions of these intervals, hit the gas as hard as you can. During the "under" portions, ride at your maximum sustainable pace (92 to 95 percent of time-trial heart rate, 85 to 90 percent of time-trial power). There's no rest between the "over" and "under" portions. Warm up for 10 to 15 minutes, then ride for two minutes "under," then one minute "over." Keep alternating for nine minutes. Rest 10 minutes, then complete a second interval. Advanced riders can increase these to 12-minute intervals. Cool down and you're done.Descending Intervals: Hard intervals and short recovery periods yield big boosts in power output. These intervals are max efforts, and the interval times are the same as the recovery times. Warm up 15 to 20 minutes, then do the following set: two minutes hard, two minutes recovery, 90 seconds hard, 90 seconds recovery, then 75, 60, 45 seconds for the next three. Spin easy for 10 minutes and repeat the set. Cool down and you're done.Hill Accelerations: Find a climb that takes five to eight minutes to complete. Warm up for 10 to 15 minutes, and then ride the first three to six minutes of the climb at your maximum sustainable climbing pace. From there, gradually accelerate to the top so you're riding all-out by the time you finish. Recover for 10 minutes and do it again. Cool down and you're done. If you don't have a hill nearby, you can do this workout on flat to rolling terrain; just increase the intensity from max sustainable to absolute maximum in the final two minutes of an eight-minute interval.

Wednesday, February 13, 2008

What does exercise do?

Staying a Step Ahead of Aging

By GINA KOLATA
Published: January 31, 2008
YOU know what is supposed to happen when you grow old. You will slow down, you will grow weak, your steps will become short and mincing, and you will lose your sense of balance. That’s what aging researchers consistently find, and it’s no surprise to most of us.
But it is worth remembering that the people in those studies were sedentary, said Dr. Vonda Wright, a professor of orthopedics at the University of Pittsburgh.
Dr. Wright, a 40-year-old runner, decided to study people who kept training as they got older or began competing in middle age. She wanted to know what happens to them and at what age does performance start to decline.
Their results are surprising, even to many of the researchers themselves. The investigators find that while you will slow down as you age, you may be able to stave off more of the deterioration than you thought. Researchers also report that people can start later in life — one man took up running at 62 and ran his first marathon, a year later, in 3 hours 25 minutes.
It’s a testament to how adaptable the human body is, researchers said, that people can start serious training at an older age and become highly competitive. It also is testament to their findings that some physiological factors needed for a good performance are not much affected by age.
Researchers say that you should be able to maintain your muscles as you age, including the muscle enzymes needed for good athletic performance, and you should be able to maintain your ability to exercise for long periods near your so-called lactic threshold, meaning you are near maximum effort.
But you have to know how to train, doing the right sort of exercise, and you must keep it up.
“Train hard and train often,” said Hirofumi Tanaka, a 41-year-old soccer player and exercise physiologist at the University of Texas.
Dr. Tanaka said he means doing things like regular interval training, repeatedly going all out, easing up, then going all out again. These workouts train your body to increase its oxygen consumption by allowing you to maintain an intense effort.
“One of the major determinants of endurance performance is oxygen consumption,” Dr. Tanaka said. “You have to make training as intense as you can.”
When you have to choose between hard and often, choose hard, said Steven Hawkins, an exercise physiologist at the University of Southern California.
“High performance is really determined more by intensity than volume,” he added. “Sometimes, when you’re older, something has to give. You can’t have both so you have to cut back on the volume. You need more rest days.”
Dr. Hawkins, who says he no longer runs competitively, adds that he tries to put his findings into practice. “I run a couple of times a week and I try to make it as fast as I can,” he said. “I’m not plodding along.”
He also has been amazed by some people who seem to defy the rules of aging, people he describes as “those rare birds who get faster.” Some subjects in Dr. Hawkins’s research study, which followed runners for nearly two decades, actually had better times when they were 60 than when they were 50.
“We really don’t know why,” Dr. Hawkins confessed. “Maybe they were training harder.”
Then there are people like the 62-year-old man who suddenly took up running and began running fast marathons. That man’s inspiration to become a runner, said James Hagberg, an exercise physiologist at the University of Maryland, was watching a lakefront marathon in Milwaukee. “He got all fired up,” Dr. Hagberg recalled.
And there are people like Imme Dyson, a 71-year-old runner who lives in Princeton, N.J. She took up running when she was 48 and loved it, she says, from the moment she put on a pair of running shoes. Her daughter, who had been a college triathlete, told her how to train.
“She said, ‘Mom, if your workout didn’t hurt, you didn’t work hard enough,’ ” Ms. Dyson said.
“Working consistently really is the recipe,” she said. And it has made a difference for her, allowing her to run races, from 5K to marathons, so fast that she is consistently among the best in the nation in her age group. She has run a 15K cross-country race in 1:19:08, a pace of 8:29 a mile. And she ran a 10K race in 51 minutes 50 seconds, a pace of 8:20 a mile.
Not every aging athlete does so well. But Dr. Hagberg found that studies of aging athletes sometimes were distorted because they included people who had cut back on or stopped training. That’s understandable; there is no reason, researchers say, to exhort everyone to maintain an intense effort decade after decade.

Tuesday, February 12, 2008

UNC Charlotte Baseball

Brad McElroy
First-Team All-America
I just wanted to thank Dr. Duffy for helping me get to the all american team injury free. I have never felt this strong and able to train at full speed

Class:Senior
Hometown:St. Thomas, Ontario, Canada
Bats/Throws:L/R
2007 First-Team All-America by Pro-Line Athletic NCBWAAt Kellogg CC - 2006: Third-team Junior College All-American... First-team All-MCCAA and All-Region XII... Led team in stolen bases, second in batting, RBI... 2005: Second-team All-MCCAA selection... Third in team batting average third in home runs, seventh in RBI... As a youth, he played on the Ontario under-17 team and the Ontario Summer Games club...

Saturday, February 9, 2008

LASER HEALING

The new lasers have been researched in European countries for several years, and it has been discovered that specific wattage and modulation are now used for specific conditions, never before available until now. The perfect blend of chiropractic and laser therapy produces phenomenal results in extremely short periods of time.The number of treatments required depends on the nature of the problem and the length of time the patient has been affected by it. Some problems are resolved with as little as one treatment. Chronic and/or deep-seated conditions may take as many as 10 treatments but most patients find relief much sooner. There are no known side effects from laser therapy. Though laser therapy is contraindicated for patients taking light sensitive drugs, use in areas injected by steroids within 7 days, and is not to be used over the Thyroid gland or in the eye. The laser works by creating vasodilatation, bringing in oxygen to the cells. It stimulates the lymphatic system, pulling edema and inflammation from the area. ATP (Adenosine triphosphate) production is stimulated in the cells helping them have the energy to function normally. The pain reflex is broken, offering immediate relief of pain. In other words, "it brings in the good stuff and gets rid of the bad stuff".What is laser or light therapy?The word "LASER" is an acronym for Light Amplification by Stimulated Emission of Radiation. Laser Therapy or "photobiomodulation", is the use of specific wavelengths of light (red and near infrared) to create therapeutic effects. These effects include improved healing time, pain reduction, increased circulation and decreased swelling.

Friday, February 8, 2008

Azalea Tri

As sponsors for North Carolina Tri Series we will be giving away slot to everyone of the 15 races including Latta and Lake Norman. For the Azalea festival just stop by the office and sign up.