Endurance.Net Ridecamp Archives

Dear Laney--
 There is growing evidence that chondroitin and glucosamine (HCL) are beneficial
when used together. There is a key study underway right now that is testing
that theory further. The results aren't available yet, but millions of people
are taking these substances with only rare and minor side-effects, if any.
The results in horses may seem different, but then, horses can't talk and
tell us how they're feeling. We can only notice if certain lamenesses improve.
It's cheaper than meds, and safer. Additionally, the drug companies aren't
fully forthcoming about the side-effects of many NSAIDS. (Ya think?) Most
anti-inflammatory drugs actually impair the healing process. I know,
that sounds contradictory. They artificially and chemically suppress certain
key processes in the inflammation pathways, but they actually make it more
difficult for tissue to repair itself. You have all heard the classic example
of why you can't use too much cortisone, as it will rot your tissues if used
to excess. There is an excellent company called "Pure Encapsulations" who
is an industry leader in supplement quality and consistency. Whenever you
are purchasing supplements, I advise you to call the company and ask for
a copy of their "third party assay." Since supplements aren't regulated,
the better companies hire independent firms to "assay" their products for
purity and potency. Most companies you contact will tell you they don't have
an assay. Move on and use the companies that do. Pure Encapsulations is one
of the best. They have a website.
   I guess I'll address exercises here, also, as that comes up a lot. First
of all, when you injure your back, it's not a good idea to get busy doing
back exercises right away as a method of self-treatment. In my experience,
this has become a well-intended but ill-advised approach many patients use
to try to "work it out" or simply avoid a visit to a qualified health professional
for appropriate treatment. Most injuries to the neck and spine are part mechanical
and part soft tissue to varying degrees. They are almost never only one or
the other. The soft tissue component(strain or damage to muscles, ligaments,
blood vessels, cartilage, nerve endings) are addressed with ice, rest, manual
therapy, time and gradually increasing return to activity. If only
 these components are addressed, the mechanical portion of the injury (jammed
joints) will remain and lie dormant, and cause future problems, sometimes
with very little provocation. Over 23 years of treating patients, I can tell
you that the most acute patients we see--those that can't walk or dress themselves,
or have to be carried into the office, have usually hurt themselves from
some simple movement. Putting on their socks, reaching for a magazine, lifting
a 5 lb bag of groceries out of their trunk, rolling over in bed. It's fairly
rare that they hurt themselves by trying to lift 300 lbs, for example. There
are reasons for this, and frankly the simple act that causes the onset of
their pain isn't really to blame. Most people have long-standing dormant
mechanical dysfunction in their joints from living in a harsh environment
all their life. Walking on concrete surfaces, sitting at desks throughout
their school and working careers, sports, car accidents, computer work, mental
stress, deconditioning (only 17% of Americans exercise regularly) etc.,.
When they finally hurt themselves with a simple movement, the stage has been
set. Exercises are a part of recovery, but should come after treament and
when the patient has begun to improve. Flexibility exercises come first,
which help restore range of motion and increase local circulation to encourage
healing and remove tissue waste products. Most people have enough strength
in the "girdle" muscles that wrap around the outer abdomen and lower back.
There are tiny little muscles deep in the spine that become sluggish in many
people (because we sit so much in our society) and if they don't fire before
our larger muscle groups do, we can hurt ourselves with the simplest of movements,
as mentioned above. These muscles can be "re-awakened" with certain techniques,
one of which is to use an exercise ball. The ball is unstable, and can be
used to recruit many of those deeper fibers as the patient tries to perform
certain exercises on that unstable ball. It's difficult at first, but gets
easier with practice. I have seen people who can stand on a ball and swing
a golf club without falling off! A good personal trainer can teach you these
exercises, but again, after your problem has been treated. Exercises are
not treatment in and of themselves. 
  Ab exercises are often done incorrectly, and again, a personal trainer
can properly instruct you. Lots of people do ab exercises, I think for two
main reasons:1) They see their abs every day in the mirror and want a six-pack,
and 2) They think it will help their back.  Ab work is part of strengthening
the back but not the whole enchilada. And, if done incorrectly, can actually
aggravate certain back problems. Get with someone who knows what their doing
and get some instruction. The exercises should be painless if done right.
Incidently, you'll have to do aerobic exercise to burn off the fat and reveal
your abs. You won't see them only by doing crunches.
  Laney, the SI joint has no muscles that move it, so it can't really be
stabilized with exercises. I know that sounds odd, but it's true. It would
take an extreme injury to cause the joint to be "unstable" so I'm wondering
if the problem is something other than that diagnosis implies. Can you tell
me a little more about it?    Bruce