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DrRic -Knee Pain in the Outdoor Athlete (slideshare edition)
This document discusses knee pain in outdoor athletes. It provides information on causes of knee pain like pain receptors, the inflammatory cascade, and abnormal nerve function. It discusses conditions like patellofemoral syndrome. It recommends treatments like rest, ice, compression, elevation, natural supplements, physical therapy, massage therapy, chiropractic care, and lifestyle changes. The goal is to rescue the knee from damage, reverse inflammation, re-strengthen muscles, and allow a safe return to activity.
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DrRic -Knee Pain in the Outdoor Athlete (slideshare edition)
- 1. Knee Pain inthe Outdoor Athlete Ric Saguil, MD First Health Associates Arlington Heights We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.
- 2. DrRic We didn’t inventthe practice of medicine…. we’re just changing the way it’s provided.
- 3. The First HealthApproach We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.
- 4. Your Community of Care Ric Saguil, MD Jason Gruss, MD Tom Jordan, RD Katrina Christie, LCPC Jennifer Green, ND Joe Musolino, DC Emery Paredes, PT Courtney Day, EP Yu Zhu, MD China You
- 5.
- 6. Know your opponent 1.Pain receptors 2. Inflammatory cascade 3. Stretch receptors 4. Abnormally functioning nerves (Diabetes, Fibromyalgia, CF)
- 7. 1. Pain Receptors • Stay away from the light! Learn the difference between good and bad pain signals • The body is a miracle and can perform miracles…... if damage not too advanced and body is healthy.
- 8. The Fibroblast The fibroblastcell is the workhorse of healing in the joint…..if it is given the right tools! ( ….good nutrition, no toxins, no stress, no infection)
- 9. Every “knee” cellknows what to do…. …the brain has to be patient. Ignored = further injury and longer healing . Pampered = fastest healing attained
- 10. How to avoid2nd prob’s 2nd prob 2nd prob 2nd prob 2nd prob 1st prob 2nd prob
- 11. Facilitate Healing • Rest • Ice Step 1 Step • Compression • E levation Ge t R e s c Stepe d u 2
- 12. Your Rescue team: 1. Orthopedic surgeon MD or DO 2. Sports medicine physician MD or DO 3. Primary care doctor MD or DO or NP 4. Chiropractor DC 5. Physical therapist PT 6. Exercise physiologist EP ACSM 7. Kinesiologist T Cert ACSM 8. Trainer T Cert ACSM + Acupuncturist LAc
- 13. INTERMISSION Best bang for buck Better than nothing Over kill
- 14. Saguil Approach –Compressing Time Rehab is mandatory!
- 15. 2. Inflammatory Cascade Bone Muscle Ligament Blood Vessel
- 16. Caveat Emptor Safe Not Safe! Really Safe!!!
- 17. DrRic Favorite Tumeric isan excellent anti-inflammatory for swelling and healing but take with black pepper
- 18. 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!!
- 20. “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!!
- 21.
- 22. Fluid build upfrom Friction Patellofemoral Syndrome
- 23. Prolonged Friction = Cartilage“Abrasion” Chondral Fracture
- 24. Chronic Friction = Cartilageand Bone Chip Osteochondritis Dissecans
- 25.
- 26. Pes planus (pronation) Flat feet causes a “high Q-angle”
- 27. Pes planus =“fallen arches”
- 28.
- 29. “External Fixes” • Stabilizing shoes • Low dye taping • Orthotics Custom • Orthotics Off Shelf ask Avoid “Rocky” style shoes….(or ask an expert)
- 30. Muscular Imbalance 1. Quads (usually big) 2. Hamstrings (usually tight) 3. ITB (Ileotibial Band) (slave to #1 and #2) With big muscle comes tight ligament Ileotibial band syndrome
- 31. Dominant forces win ITB Q a n g l e ITB Syndrome
- 32. The patella getspulled by ITB Syndrome Normal Pulled over ITB Syndrome causes Patellofemoral Syndrome
- 33. “Internal Fixes” PT ATC Surgical MT ALTERNATIVE
- 34. 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)
- 35. Athletic Training Self-care Field Experience Education • Cheaper • Great at taping/DTM • Great at keeping you honest after PT • Maximize on conservative therapy Ice Bath Ice Sleeve Kinesio Taping
- 36. Massage Therapy/Alternative Acupuncture Yoga Tissue Scraping Self Massage Chiro Alignment
- 37.
- 38. Your Life ChangingTeam: • Trainer • Kinesiologist • Exercise physiologist • Physical therapist • Acupuncturist • Chiropractor • Primary care doctor • Sports medicine physician • Orthopedic surgeon
- 39. Bottom line • Rescuefrom damage Stop training • Reverse inflammation Meds, supps, food • Re-strengthen muscle Therapy, acupuncture • Re-balance kinetic Chiro, trainer, yoga, chain crossfit • Return to activity Idea of K E Y (knowledge..)
- 40. Community Health Project –YOGA? Northwest Community Hospital Wellness Center June 23rd (sat) 11:00-12:30pm (847) 618-3500 Ric Saguil, MD We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.
Editor's Notes
- #3 Based on a survey of our patients, we found a consistent theme of what frustrates them about conventional medicine practices and why they felt First Health was different. Since identifying these 4 key areas, we have made a consistent effort to offer our absolute best to:Listen attentively to Patients concernsMake the patient the driving force as the center of careMinimize wait timesExplain all the options for treatment, and give the patient choices (medications, alternative medicine, nutritional medicine/supplementation, psychological medicine)
- #5 Design notes: list of providersWe want this to look much more inviting—these chairs are way too cold.Had thoughts about putting the actual providers in the chairs. Could be an actual live picture with a sample patient in the red chair or could be a group of providers sitting around the table.