Summer Sports Injuries #47

Dr. John Herzog:

Good food, easily absorbed and placed in your arteries and in your vessels, in all your cells, helps reduce inflammation by not causing the residue to build up. If that makes sense. Like the soot in your chimney. If you don't clean your wood stove

Stephen Anderson:

pipes, if you just increase that water intake, it again can start knocking off all these things. So if people start sleeping better, then they make better eating choices, they make better movement choices, they make better stress management choices. So see, if you can just do one thing, just increase your hydration level, then I think a lot of those other little nagging things will start taking care of themselves.

Dr. Lisa Belisle:

This is Dr. Lisa Belisle and you are listening to the Dr. Lisa Radio Hour and Podcast Show Number 47, Summer Sports Injuries, airing for the first time on August 5, 2012 on WLOB and WPEI Radio Portland, Maine. And here in the studio with me today is my co host and wellness editor for the Maine Magazine, Genevieve Morgan. Hi Genevieve.

Genevieve Morgan:

Hi Lisa.

Dr. Lisa Belisle:

Genevieve, sports injuries. You have two boys, I have three kids. You know, things are different in the summertime.

Genevieve Morgan:

Well, and it certainly seems as if injuries are on the rise in kids, but also with our population, you know, people, weekend warriors and all of us who are going out and maybe taking a jog after work or it just seems like a lot of people are having back issues, joint issues, more breaks and falls and concussions. I'm hearing a lot about it. How about you?

Dr. Lisa Belisle:

My practice, of course, has got an acupuncture aspect to it in addition to Chinese medicine. So yes, I see a lot of injuries. I see people that go out and maybe just overdo it a little bit too much. As you said, weekend warriors, they don't do much during the week and on the weekends they are a little bit too intense. I also see people who want to keep playing adult team sports into their 40s, 50s, and they just aren't quite as careful as they might need to be. So I think that there are some things to do that people that aren't that hard, that people can.

Genevieve Morgan:

Well, there's prevention and then there's rehab. Just a funny story. Yesterday a friend of mine asked me if I'd go water jogging with her. Something I'd never done before. But I guess it's a great rehabilitation practice. And you put a little floated belt around your middle and you go into a pool and you basically jog in the water for an hour, punching the water and stomping grapes on the bottom. And you do it for long enough time until you're tired. And it actually is quite tiring, but it's impact free.

Dr. Lisa Belisle:

I am very familiar with water jogging. When I had my multiple knee surgeries back, you know, 11 years ago, I also did water jogging. And yeah, there are some really good, there are some really interesting ways that they go about doing rehabilitation. So today in the studio we're going to have Dr. John Herzog, who is an orthopedic surgeon with a very interesting approach to injuries and sports and a very unique way of treating injuries. But we will also have Steven Anderson from the Body Architect who's going to talk to us about remaining strong and flexible and what types of, of things we have to think about in the summertime with regard to our bodies.

Genevieve Morgan:

Well, I guess it's slow and steady and strong that wins the race.

Dr. Lisa Belisle:

Slow, steady, strong, flexible. I think all of these things are things that we need to take into consideration. And in fact, one of our shows last fall, we talked about strength and we talked about resilience and the fact that if you going out and just doing weightlifting, that's not going to be as helpful to you as doing weightlifting and stretching. In addition, you want to do some endurance work. In addition, you want to do a little bit of spirit speed stuff. And Steven Anderson is very good with sort of taking the whole body into consideration. In fact, he even teaches qigong and trying to help people get and stay balanced at his training facility up on the East End. The Body Architect.

Genevieve Morgan:

That sounds like a really interesting show.

Dr. Lisa Belisle:

I think it's going to be a really fun show and it's nice that we're able to offer this on our new station, wpei. We know that there are people listening to WPEI who themselves are sports fans. So welcome to our listenership and we hope you enjoy the show. The Dr. Lisa Radio Hour and Podcast is pleased to be sponsored by the University of New England as part of our collaboration with the University of New England. We offer a segment we call Wellness Innovations. This week's Wellness Innovation comes out of Chicago. Neuromuscular warm up is associated with reduced lower extremity injuries in adolescent female athletes Integrating a coach led neuromuscular warm up prior to sports practice appeared to reduce the risk of lower extremity injuries in female high school soccer and basketball athletes, according to a report in the November issue of Archives of Pediatrics and Adolescent Medicine. In this study, they sought to examine if lower extremity injuries in adolescent female basketball and soccer athletes could be reduced by incorporating a neuromuscular warm up prior to every practice and game. The authors invited coaches from Chicago Public Schools to participate. Coaches were randomly assigned to either the intervention group or a control group. Coaches in the intervention group who instituted a neuromuscular warm up attended a two hour training session which included progressive strengthening, balance, plyometric and agility exercises, as well as an educational component where coaches provided feedback to athletes to promote safe jumping and landing techniques designed to help avoid strain on the anterior cruciate ligament, or ACL, which can cause knee injury. There were 755 athletes in the control group and 737 athletes in the intervention group. The control group had 96 lower extremity injuries compared to 50 lower extremity injuries in the intervention group, leading researchers to report findings that suggest neuromuscular training should be routine in girls high school soccer and basketball. For more information on this wellness innovation, go to drlisabelisle.com for more information on the University of New England, go to une.edu

Dr. Lisa Belisle:

as part of our Summer Sports Injuries show, we have in the studio with us today Dr. John Herzog of Orthopedic Specialists in Falmouth. Thank you for joining us today.

Dr. John Herzog:

Well, it's a pleasure to be here.

Dr. Lisa Belisle:

The last time you came in and talked about many things, but part of what you were talking about was plant based eating and Dr. John's brainola. I know you've had some interesting things happen in the plant based eating world, so tell me about some of those before we talk about sports injuries.

Dr. John Herzog:

Well, I continue to be an advocate that diet is probably the most important thing we do next to breathing air. So if we have a good diet, we're able to heal up these sports Injuries, and we're able to be fit and keep a normal body weight and stop inflammation, which is my enemy.

Dr. Lisa Belisle:

Okay, well, let's talk about inflammation then. So summer sports injuries, what types of things are you seeing this time of year?

Dr. John Herzog:

Well, obviously, as we hibernated through the winter, we got on our skis a little bit and maybe snowshoed, but didn't get outside and spend as much time as we do when the beautiful sun's out there. So the thing you hear most about is overuse, repetitive stress. You know, stress, tendinitis, overuse of the plantar fascia, knee pain, hip pain, back pain, and shoulder pain.

Genevieve Morgan:

How about tennis elbow?

Dr. John Herzog:

Tennis elbow, oddly, is not very common in tennis players, but it's common in anybody that's out there doing a project. Like, you find they got to shingle the barn or you had to weed whack. I see that very commonly.

Dr. Lisa Belisle:

Well, what is tennis elbow?

Dr. John Herzog:

Tennis elbow is really. The fancy word is lateral epicondylitis. That means where the tendons that attach to the elbow that cause the wrist and fingers to bend backwards, they all attach in a very small area, about half the size of a dime. Part of that attachment kind of gets pulled off when you injure it. So you jerked your wrist back real hard when you were lifting up a stone or something, and as it tries to heal, you keep doing it again and again. So instead of getting a nice firm growth of the tendon back into the body bone, you end up with a little bit of scar tissue, which hurts kind of like a loose tooth when you're eating corn on the cob.

Dr. Lisa Belisle:

And this is also. So if people play tennis or if they use a hammer or they do anything repetitive, which is the same motion over and over and over again with their hand or their arm, then this can cause this kind of loose tooth pain.

Dr. John Herzog:

Exactly. So my job is to try to get that inflammation out of there and either stimulate it to heal with a little mini surgical procedure or just let Mother Nature and father time. A little stretching, a little massage. There's hundreds of ways to go, but after about six weeks, if it's still bothering you, we get a little more aggressive, at least at Orthopedic specialists in Falmouth.

Dr. Lisa Belisle:

What about golf elbow? What is golf elbow?

Dr. John Herzog:

Golf elbow is pain on the inside part of the elbow called the medial epicondyle, and that, you know, as the golf swing goes, which I don't know much about. But as you swing down and you hit something hard, you can tear apart of the muscles that cause the wrist and fingers to flex or bend, that gets pulled off. You continue to do that over and over. You get the scar tissue, the loose tooth pain. And when it's sore for six weeks, we get a little more aggressive. But hopefully mother Nature and father time will take care of it with just a little rest and massage.

Dr. Lisa Belisle:

Dr. John When I was training in family medicine, I learned about something called

Dr. John Herzog:

RICE Rest, ice, compression, elevation. That's the first thing we do when we get hurt. Just naturally, you're out of the game. When you sprain your ankle and you want to put it up in the air because your heart doesn't pound so hard in your foot and put ice on it that makes it feel better and wrap an ace wrap around it. So that's where the Elevation, Compression, RICE acronym comes from.

Dr. Lisa Belisle:

Does this have anything to do with the straps that they sell in pharmacies or other stores that can go on the elbow?

Dr. John Herzog:

Well, you know, I'm not a big strap guy. I think that if you're putting a strap on top of skin that's mobile and you're trying to hold a muscle that's also mobile, it doesn't do very well. But what it does do well is remind you that something's wrong with you. So every time you go to do something, you go, oh, that straps there, I won't lift it so hard.

Genevieve Morgan:

Can you solve for me once and for all the ice versus heat argument?

Dr. John Herzog:

Well, it depends. If it's acutely inflamed ice, you know you're going to put the fire out with the ice. But if it's something kind of chronic, where you want more blood to get into it, get it circulating a little bit more, turn it pink, you'd use heat. But after acute injury, ice is the best.

Dr. Lisa Belisle:

And sometimes it has to do with whatever feels the best on it.

Dr. John Herzog:

That's true. I mean, anything goes after 24 hours. But usually if you watch a football game on tv, someone's laying on the sideline, they got ice on them for a reason, you're trying to cool that injury down and decrease the circulation. If someone's got a pulled hamstring, let's say, and that's been going on for months, they kind of heat it up before the game.

Dr. Lisa Belisle:

Well, let's talk about pulled hamstrings. Where is the hamstring and what types of things happen to it?

Dr. John Herzog:

Well, hamstring's longest complex of muscles in your body, it goes all the way down to your below your knee, all the way up to your buttocks. So that long muscle is very easy to pull. When you pull up fibers, you can either disrupt them a little bit inside of a muscle if you're picturing like a. Let's say a tenderloin stake. And if you pull those fibers, it gets a little gritty, like a flank stick, so you get a tendinitis muscle pull. That's usually best treated with massage, rest, ice. It's hard to elevate, but you can.

Dr. Lisa Belisle:

And how do people usually pull a hamstring? What types of activities are they participating in that would cause that to happen?

Dr. John Herzog:

Usually a quick burst, meaning that if you're going to jump up to grab a ball or you're going to chase after a pass or something, something quick or a fall. If you have an uncoordinated fall on the stairs, you can pull your hamstring that way, too. But you're literally just stretching the longest muscle in your body. And in some cases, you can actually tear it right in half. And those are pretty devastating. They're hard to repair.

Dr. Lisa Belisle:

Have you seen that before?

Dr. John Herzog:

Oh, yeah.

Dr. Lisa Belisle:

And how do you deal with that?

Dr. John Herzog:

Well, if it's a younger person, hopefully a piece of bone will pull off with it. So you can just tack the piece of bone back onto the buttocks. But if it's right in the middle of the leg, it's like trying to sew back two pieces of custard pie. It's hard to do.

Dr. Lisa Belisle:

Okay, what other kinds of injuries are you seeing in the summertime?

Dr. John Herzog:

Well, I see a lot of plantar fasciitis. People like to get out and run and play tennis.

Dr. Lisa Belisle:

And your plantar fascia is where it's

Dr. John Herzog:

right on your heel, right on the bottom of your heel. Some people call it a stone bruise, but when that area is sore, you can't do anything. Especially the first thing in the morning when you get up, your heel hurts a lot. And by the end of the day, it hurts. Whenever you get out of a chair, your heel hurts. That's probably the number one thing I see after people get more active and tear their plantar fascia. Just like that tennis elbow thing and that golfer elbow thing, you tear part of the connection of the fascia or the tendons to the bone. And that bone would be the heel bone.

Genevieve Morgan:

There's a lot of Advil and Motrin and Tylenol use, as well as more highly prescribed medication like oxycodone, hydrocodone. And we seem to be in a society right now that's in a lot of chronic pain and probably a lot of it. Is injury induced. So are there other ways people can treat pain?

Dr. John Herzog:

Well, I'm a big believer that, you know, knowing everybody wants to have a pill and get a quick fix, it's not one of the best choices to make right out of the blocks. It seems ironic to me that an anti inflammatory pill you take causes your stomach to become inflamed and then it makes your blood thinner and then it makes fractures take longer to heal. Sprains take longer to heal just by taking ibuprofen. But, but everybody on TV and everybody seems to think, oh, just take your ibuprofen. It's just, that's, that's the thing you do when you have pain. Granted, it might slow down inflammation a bit, but it actually slows down healing. So I don't personally take it myself and only recommend it for, you know, short term use in people. As far as the narcotics are concerned, you know, there's a place for everything. You get hit by a bus, you need narcotics after you have your legs screwed back on. But if you have a low back pain and you're taking narcotics, the first thing that happens is your body gets the narcotic, which is very similar to what your body already makes. So your own pharmacy, your own bioidentical pharmacy that's working in your brain and in your endocrine organs decides to turn off. So you're kind of counting on the pills and then you kind of get addicted. Everybody gets addicted in a couple days to painkillers. Therefore, we have a lot of people on painkillers.

Dr. Lisa Belisle:

And what about Tylenol or acetaminophen? Does that help with inflammation or does that have side effects that we should be worried about?

Dr. John Herzog:

Well, it's good for reducing a fever and it does help out with pain, but it also has side effects like the liver. It causes the liver to become inflamed, doesn't hurt the stomach as much. But I'm not a big pill guy. I'm really tell people to have crazy things like flaxseed and eat whole grains and eat whole fresh food and your body can handle the inflammation much more efficiently.

Dr. Lisa Belisle:

Well, talk to us a little bit about that. Why does the diet help?

Dr. John Herzog:

Well, it's just like putting good gasoline in your car. If you put in the cheap stuff that's kind of watered down, you're gonna sputter and you're gonna blow smoke and you're gonna kind of get clogged up. Good food, easily absorbed and placed in your arteries and in your vessels and all your cells, helps reduce Inflammation by not causing the residue to build up, if that makes sense. Like the soot in your chimney, if you don't clean your wood stove pipes. Rotten food. I hate to say rotten, but processed foods over fatty foods, low fiber foods really kind of clog us up. I mean, not to get gross, but constipation is a major problem when we have that kind of a diet. The food just doesn't go through you as well. It's not absorbed as well, and it's harder to burn and we get chubby.

Genevieve Morgan:

I recently went through about six months of severe back pain. And one of the best pieces of advice I got, I can't remember it might have been from you, was to make as much as my movement as pain free as possible. So if there were poses or movements that didn't hurt, try to prolong those periods of where I was out of pain. And this is talking without taking any kind of pills. Is that something that you recommend? Because I know there's a big controversy between how much you should rest, when you should get back on your feet, and I think it's confusing for people. What's your advice?

Dr. John Herzog:

Well, the. The human body is made to have function and movement. And by utilizing your body using gravity or trying to avoid gravity, you're stimulating your muscles and also your blood supply to increase. You know, if you use something, it turns kind of pink. That means more blood's getting into it and that brings more energy. It brings more. It takes more stuff away. It gets rid of the waste and it brings in the fuel. If you use something, even if it hurts. Of course, if you have a broken leg and it's not in a cast, you don't want to wiggle that around a whole lot. Your body tells you to stop doing that, but generally speaking, you try to move as much as you can, and if you're having trouble on land, get in the water.

Genevieve Morgan:

I mean, what actually is pain? When someone feels a sensation of pain?

Dr. John Herzog:

Well, I think that's extremely varied. You know, in Maine, here, I'm a Michigander, but the word spleeny comes to mind sometimes where if I just touch somebody's little toe and I have to give them a shot and a little neuroma, you'd think they were having triplets.

Genevieve Morgan:

Right? And so that's what people call pain threshold. Some people have a low pain threshold, some people have a high pain threshold.

Dr. John Herzog:

Right. And everybody has pain. I mean, we need to have pain as a protective sense or our hands would burn off when we put them on the stove. But people, I believe, can be trained and conditioned to perceive pain much more acutely than others. And that's a whole other fancy concept called centrally mediated pain. It's almost like having post Traumatic stress syndrome. You've had so much pain, like everything just causes you pain. Even a mild irritant can cause you deep pain, like in fibromyalgia type of pain, which is very real. I believe in that. So pain is all over the place. Some people can get all stove up and halfway take their finger off and it doesn't seem to bother them.

Genevieve Morgan:

But in your practice, you have seen patients get severe reduction of pain with what you're doing?

Dr. John Herzog:

Oh, sure.

Genevieve Morgan:

With manipulation.

Dr. John Herzog:

With manipulation or actually putting something back in a socket, that always feels much better.

Genevieve Morgan:

What else do you do to alleviate pain? That's not the traditional route.

Dr. John Herzog:

Well, I try. My philosophy is try to keep things as natural as possible. I always encourage people to have a good diet, breathe clean air and get exercise. For people who exercise have 600% more endorphins and anti inflammatories in their body so they can handle the pain and heal much faster. To augment people that are in pain, I encourage massage type things moving it light exercise. And when things get out of hand, I'll go to an injection. I use a machine called an ultrasound, just like you could tell if it's a boy or a girl. And in ob, you can see tendinitis, you can see partial nerve injuries, hamstring pulls, etc. And you can very specifically inject some cortisone in there, perhaps, or frequently. I use your own body's platelet cells, which we centrifuge and re inject into areas that need to be healed. I know that was a plateful right there.

Dr. Lisa Belisle:

No.

Genevieve Morgan:

That's very interesting though. What's that procedure called? Actually, the platelet.

Dr. John Herzog:

It's called platelet rich plasma. And essentially you take out, let's say a cup of blood and you spin it down into 2 tablespoons of platelet cells. Now, platelet cells are little cells that when you Injure yourself, say you cut your hand, that's what comes in immediately and starts to form the scab. It forms the matrix or the goo immediately and it attracts stem cells to come in and replace the skin, the nerve, the bone or tendon or whatever is injured. So we know that we can kind of fool mother nature a little bit by concentrating those platelets and stick it into your rotator cuff or your tennis elbow or your plantar fasciitis and initiate healing without surgery or drugs.

Dr. Lisa Belisle:

Talk to us about osteopathic manipulative medicine or manipulative therapy. OMM and omt.

Dr. John Herzog:

Here again, that's all over the map too. I mean, you can have cranial sacral manipulation or you can have what I prefer, a street fighting osteopath, in that I like to rack em and crack em, as they say in the old day.

Dr. Lisa Belisle:

So what happens when you put your hands on somebody and you rack them and crack them?

Stephen Anderson:

What are you doing?

Dr. John Herzog:

But basically you can tell where something's in spasm and you kind of rub in a special area. Let's say that you've fallen down the stairs and you twisted your back to the left. To have somebody know how to kind of massage the left side of your back and then twist it back to the right to kind of straighten you up. It just feels a lot better. It's like a good yawn or a sneeze.

Dr. Lisa Belisle:

And this is something that needs to be repeated once you've done manipulative work on somebody. Once.

Dr. John Herzog:

Well, sometimes a few times. But the original osteopath, he had a saying was find them, fix them and forget them. So to have people sign up for the weekly treatments for everything, I try to get it done in one or two visits.

Dr. Lisa Belisle:

Talk to us about if you have an injury, if you have a plantar fasciitis on your left side, what could happen to your right side or what could happen further up your body?

Dr. John Herzog:

Well, you know, if you start walking with a hitch, you definitely can overuse the other side because the other side hurts so much and then develop a similar situation on the opposite side. But that's why we would give somebody crutches if they had a broken ankle or something. If it's a mild limp, you know, generally speaking your body can heal itself within the first three weeks. And after that point in time, you might want to see somebody for a little more direction. But you can. You know, I'm not a big believer that if you walk with a slight limp you get a headache, but I hear that a lot. So if you get a headache, rub your neck.

Dr. Lisa Belisle:

Talk to us about the weekend warrior idea. I know you were talking about you yourself. You go out several times a week, but there are people who, it's summertime. They haven't really done anything all winter or even any time of year. They don't do things during the week, and then on the weekend they need to hit it full force or.

Dr. John Herzog:

Well, that's never a good formula for not hurting yourself if you're not stretched out and in fairly decent shape. If you just jump off the couch and decide to run around back bay, you're probably going to end up with shin splints and sore feet and a sore back. But I think if you keep in a reasonable amount of physical conditioning at least three days a week for 45 minutes, you can probably go throw the football and the Frisbee around and kind of be a semi warrior. But picking up lacrosse stick and going full blast would be a bad idea as you get older. Of course, we're in our teens and twenties, and I think even in our thirties, we get away with a lot of stuff.

Genevieve Morgan:

What can someone expect from this platelet treatment or what you're calling prp?

Dr. John Herzog:

Okay, basically, if you had this tendonitis, let's say you have a tennis elbow that's been plaguing you for months, decide that on the ultrasound, I see that little loose tooth or that little piece of scar tissue, I say, you know what? That little gummy bear is out of here. I'm gonna go numb it up. And after I numb it up with a little Xylocaine, very similar what a dentist would use, although not as painful as a dentist, pretty much painlessly. You can go in there and numb up the scar tissue, and using a small needle, you can scrape off part of the scar tissue, make little teeny holes in the bone, and then inject the patient's platelet cells here. I jumped a step before I do that. We have you sit down in a chair and take some blood out of your arm through a little IV that gets centrifuged or spun at a real fast rate of speed, and it separates out into the platelet layout level. We put that in a syringe, and after everything's numb, we inject your own cells back into your body to regrow the tissue. Either the bone, the cartilage, you know, it's good for arthritis of the knee, of the hip, and partially torn rotator cuffs.

Genevieve Morgan:

And how long does it take to recover from that?

Dr. John Herzog:

It'll show regrowth within six weeks. So I see you back in a month after I've done it and we'll see how much activity is going on, how many new cells are growing in the spot and if it did work or not, it doesn always work. Sometimes we have to repeat the process.

Genevieve Morgan:

And can you use the limb or the spot where you've injected in that course of time?

Dr. John Herzog:

Yep. I don't want you to climb Mount Katahdin, you know, for four days after I do your heel or your Achilles. But generally you're sore enough that you don't want to do that anyway, so you're going to have some pain. And in particularly tough cases, I will give people the narcotic type of painkillers for three or four days.

Dr. Lisa Belisle:

Dr. John, how can people learn about

Dr. John Herzog:

your practice the best way? I have a pretty informative website. It's called orthocareme.com and I've got tutorials on all this PRP or the platelet stuff, osteopathic treatments, diet, exercise, clean air, and my basic philosophy of do no harm.

Dr. Lisa Belisle:

And your practice is located in.

Dr. John Herzog:

Right in Falmouth, kind of behind Walmart on Clearwater Drive.

Dr. Lisa Belisle:

You're in a beautiful building.

Dr. John Herzog:

Oh yeah, it's a, it's a LEED green building certified and it looks right at the estuary. And we have a nesting eagle right off the property and osprey and a bunch of deer that run around the front yard all the time and occasional fox and coyote stop by. Too Beautiful.

Genevieve Morgan:

And you've been a terrific sponsor of our show. So we'd love it if some of our listeners, if they come in to visit you, let you know that they're Dr. Lisa fans.

Dr. John Herzog:

That'd be great. Bring it on.

Dr. Lisa Belisle:

We also encourage the people who have been longtime listeners to maybe go back and download the podcast you were on previously. So we'll make sure that that's linked on the Dr. Lisa page. Because you talked a lot more about your plant based diet recommendations. I think people, people will find that interesting, right?

Dr. John Herzog:

It seems to be catching on.

Dr. Lisa Belisle:

I agree. It's a good thing to have catching on. Thanks for coming in and talking to us today about summer sports injuries and really a broad variety of things.

Dr. John Herzog:

Well, it's always a pleasure and thanks again.

Dr. Lisa Belisle:

This is Dr. Lisa and in the studio today, we have with us Stephen Anderson of the Body Architect. Stephen came on before to talk to us about I believe it was light. Is that right?

Stephen Anderson:

Yes, it was.

Dr. Lisa Belisle:

You were on the light show.

Stephen Anderson:

I was on the light show.

Dr. Lisa Belisle:

The light show from last fall. And you've subsequently been profiled in Maine

Genevieve Morgan:

Magazine with the wellness issue in April.

Stephen Anderson:

Yes.

Dr. Lisa Belisle:

And you've become a local celebrity for a bit.

Stephen Anderson:

Yes, yes.

Dr. Lisa Belisle:

So we think it's perfect that you're here to talk with us about summer sports injuries and the fact that we're now on the FM dial on wpei, which has a sports affiliation. And you have a very long history of interaction with athletes and being an athlete yourself.

Stephen Anderson:

I do, yes.

Stephen Anderson:

A lot of my clients that come to me, they may come from referrals from physicians or they may have had their own injury. So we look at each individual case and we develop a plan accordingly.

Dr. Lisa Belisle:

Well, talk to me about what you see in the summertime when people come into the Body Architect. What types of things are they hoping to accomplish in the summer?

Stephen Anderson:

We have a lot of members who are golfers. That seems to be a very popular sport. So they're looking for not only reduction of weight, but to improve performance in a sport. Obviously, in the summer, a lot of the children are on vacation, so sometimes parents will bring their children in just to improve their performance. So it's a lot of rotational movement. The things that I see that are really debilitating is hydration levels in the summer. So with the heat, people don't tend to drink as much as they normally do. So things that lead to hydration injuries are very prominent.

Dr. Lisa Belisle:

Well, what's a hydration injury?

Stephen Anderson:

Hydration, when people don't have enough hydration, is sort of like a. It's a cycle. It starts and they. It's sort of like it's a chain reaction. So they start getting headaches and they may not eat as well, they may not rest as well. Their performance really starts to suffer when we turn that around. I think I mentioned last time that I was here that I oftentimes will have people that come in, they say they're quite hydrated. I get them on my scale and they're quite dehydrated. So even though they think they're drinking adequate amounts, they're probably not doing enough because their bodies are eliminating perspiration even when they can't see it happening. So it's going through the entire system. So things like headaches, stamina, endurance issues are really big.

Dr. Lisa Belisle:

And when you are an athlete and in training in the summer, there were probably other more significant things that were happening with dehydrated, dehydrated athletes as well.

Stephen Anderson:

There were, and I remember because I ran cross country. So that's something that's even more aggressive in. I hate to say in those days, but we had to take salt tablets. So again, it's not only the water, it's the electrolytes in the water. So the body has to be. I like things to be bioavailable so they can use. Use their hydration. So it may not be just enough for water. They may need to have some electrolytes. However, in my opinion, most of the sports drinks aren't the way to go. Adding a little pinch of good quality salt to your water could give you the electrolytes that you need and make that more available to the system so that can be transferred into performance.

Genevieve Morgan:

Are one of the symptoms of dehydration, muscle cramping?

Stephen Anderson:

Yes, Very, very good point. And in personal training sessions, sometimes as we get halfway through, there may be some cramping. And to me, it's a, it's a red flag. It's about hydration. So the body just responding to that, it's trying to give you a signal, say, hey, you got to do something about this. Sort of fuel me with the proper hydration or I'll keep giving you a signal to make you stop, stop the movement, basically. So it's a safety issue in the

Dr. Lisa Belisle:

News we've seen athletes, I think football players tend to be in that group that don't get enough water and then that leads to heat exhaustion and eventually could be even heat stroke and death, clearly. So this is, it's not, it's a, it's a significant issue that people really do need to be paying attention to.

Stephen Anderson:

It is it's a very real thing and you don't have to be a professional athlete and an elite athlete in those cases. That can be fairly severe. But nobody is immune from it. So it can address anyone. Depends upon where their baseline is as well. So as a normal baseline, I suggest to people they drink at least half their body weight in ounces, knowing that they, they may not do that. But if there's enough of a buffer zone, they're going to get into a safety, a safer zone as well. I'm a big fan of coconut water because of its electrolyte properties as well. The body really, it sort of reflects that water. It takes it in and really recognizes it as something that's beneficial and healing. So even if you don't like the taste of it, a lot of people don't. They do make them flavored. That wouldn't be my first choice, but it's a better choice than other things. So there are some options out there.

Dr. Lisa Belisle:

And you mentioned that at your facility at the Body Architect here in Portland, you have a machine that you use to measure people's body water.

Stephen Anderson:

We do. It's called a bioimpedance machine. So people stand on this. We plug in specific information and it calls back out to us, different information, inclusive of body fat and BMI and total body water. And for me, that's the most important thing. I know people get pretty hung up on percentage of body fat. For me, it's what is your total body water? Because if that is lacking, like we were talking about earlier, that could be one of the side effects. It may be difficult for one to let go of weight because their hydration level is so low that regardless of their attempts, they may not be able to shed those pounds that they're looking to do. So if you just increase that water intake, it again can start knocking off all these things. So you see, the better it gets, the better it gets. So if people start sleeping better, then they make better eating choices, they make better movement choice, they make better stress management choices. So the whole chain sort of like, you know, it can spiral down, but it can spiral back up as well. So when I look at that, that chart, that little ticket that the Machine gives me my. My most. My most concern is the total body water. So I look at that, men should be in a range of between 60 and 70%, women 50 to 60%, and most people are well below that. So see, if you can just do one thing, just increase your hydration level, then I think a lot of those other little nagging things that are poking at people will start taking care of themselves. And that's sort of what we want to do. Just want to basically put the body in an environment where it can heal itself. It kind of knows what to do. Sometimes we just have to get out of the way and allow that to happen. So something as simple as hydration could really affect so many other problems.

Dr. Lisa Belisle:

I know that you recently returned from the Kripalo Institute and you received additional training in qigong, correct? This is something you've been doing for a long time. You just mentioned the body healing itself. Remind people who didn't get to listen to your light show in the fall. What is qigong and why does that help the body heal itself?

Stephen Anderson:

The thing I like about qigong and it, I think they, in one word, balance and equilibrium. So if the body can start to harmonize, get back into a sense of equilibrium and balance, then the energy pathways open up. It's very similar to the work that you do with needles. You're opening energy pathways so that the energy can course freely, unobstructed through the body. Qigong. Qi stands for breath or vital energy. Gong is practice or work. So in essence it's breath, work, breath practice, energy practice. Qigong is just a series of movements and there are 10,000 forms. I've been doing it for probably 15 years. I would consider myself an infant in terms of being a qigong. And it's funny, we're talking to this gentleman who was teaching this class and he says we use the term master way too much in the Western. They don't do that in China or in the east as much. Everybody just sort of assumes that. So for me, it's a continual growth process. But I've really come to experience the benefit. So I speak from someone who has a knowing about it. I first started qigong because in my profession, my body was way too, way too stiff. And so it was blocking off a lot of my vital energy. And I was introduced to qigong as a way to create suppleness and let flow go through my body. So I was better able to use my breath because my philosophy has always been effectiveness and efficiency. So qigong is really economy of effort Economy of movement. So it teaches the body how to move correctly. And you, you kind of start saving your, your energy instead of spending it. Now I'm just as guilty as everyone else because I also tend to spend my energies a little too much. So qigong has been a savior for me. So I think one who is more active or more external, they need more internal work. And the saying goes that the more internal you do, the less external you'll choose, or at least you'll prioritize that. So I know for me personally, as I have evolved, I would always choose qigong first, because qigong is about longevity and feeling good and internal. That's going to be with you. Whereas the physical portion, while is also very important. The body changes regardless. You know, age sort of does take its, take its toll, but it's not about extending, it's about quality movement. So when I do qigong exercises, it just places the body in positions where the energy can open up and the body can take care of itself. Because again, the greatest healing instrument is our body. It sort of knows what to do. We just want to get it in that place. And the reason, according to my reading and my past research, the sages who developed these movements, they were into meditation, creating stillness. Stillness has a lot of magic, but they found that stillness alone, their bodies got too weak. So they weren't able to hold the positions as long to gain all the magic from the meditation poses. So they developed qigong as a complement to get their bodies strong so they could stay in meditative postures longer. So when I do a qigong class, it always consists of a preparatory phase, then the exercises and then the stillness. So I said, we do the exercises to get to a point where we can create stillness in the body. And that's where the magic happens. It also happens to feel good. It's far more user friendly than a cousin like Tai Chi, which tends to be more choreographed or sequenced. Qigong is just a little more user friendly. You really can't do it wrong because it's your body interpretation. I'll oftentimes tell people that it doesn't matter what your expression looks like if you just come in, if you are not, not feeling well and you wanted to come in and sit down while we're doing a qigong class, you will benefit from the chi that's being created, because chi being vital, being, being life, essence, there's nowhere that it's not. So it permeates all around. So if you're just in the environment, you'll start to feel good. You may not know why, but once you start to feel good, then you make better decisions on again how you move and how you sleep and what you eat. That's the magic. Because there really is no one magic bullet. It's the combination of all these things. You put them all together and you have wellness or well being. And that's what we've been professing. You do it in your practice. I see it. And this is just another way to do it.

Dr. Lisa Belisle:

Stephen, I know that one of the things that you keep talking about is the benefit of a healthy environment. And that's what you have at the body architect. I mean, you really have made an effort to be mindful about your space. And one of the things that happens in the summertime is you expand, expand out onto your deck.

Stephen Anderson:

Yes.

Dr. Lisa Belisle:

Was that purposeful or did you just happen to think, oh, it's pretty out there?

Stephen Anderson:

It, it was purposeful. We, we really enjoy being outside and doing qigong or anything is really wonderful to really take in that fresh air. We, we are very fortunate in that our direction faces the mountains and it faces a body of water as well. And there's a lot of greenery, so we kind of have a, a perfect storm. So if I do qigong, when the weather permits, I have people focus on strength of the mountain, fluidity of the water, the sort of gentleness of the trees and the warmth of the sun. So that's very helpful. However, people will just go out and do their own exercise patterns. But when we first moved in, we saw that this was available, we thought it'd be just a wonderful addition.

Dr. Lisa Belisle:

And they also do yoga out on your deck, is that true?

Stephen Anderson:

They do. They do, yes. Some of the classes, middle part of the day, it's a little oppressive out there, depending upon, but, you know, as we get into fall, it's really wonderful. Everyone that comes in after a class on the deck, they really report a greater sense of sort of euphoria. It just feels good to them, I think, because most of movement, most of exercise is conducive to deep breath. And when you can take in deep breath and it's fresh, boy, that's some, that's, that's so magical for, for me, because qigong is all about breath. Exercise is all about breath as well. If people focus on the deep breath, and I'll say during this session with me, which typically lasts an hour, you'll probably take a couple hundred deep breaths. I think that in and of itself is the most important thing you can do. The exercise portion. I believe you'll reap the benefits of that, but in my estimation or my opinion, it's kind of secondary. The breath is first. We need the breath first.

Genevieve Morgan:

How do you feel about stretching to prevent injury?

Stephen Anderson:

Stretching? Another great question. This time of year they people need to systemically warm their bodies. So I prefer that people stretch from a warmed position. And I also just like I like functional training, I like functional stretching that simulates the movements that that we do. So I'm not a fan of just doing only static stretching and I also don't shy away from movement stretching. So there's a lot of movement and I also think about the body as a whole so I'm not trying to isolate apart when I stretch because you don't simulate that in everyday activity. So when I do a stretch and perhaps the hamstring, which is very popular may be my primary objective, I'm stretching the whole body to accomplish that so nothing is left out. And that's the way that I strength train as well. So you're able to use it. People who are participating in a sport, the best way to prepare is to simulate the sport at a lower level intensity. That's the best way to prepare and try to I think avoid injury is a very strong word. There are no guarantees. All we want to do is reduce the likelihood of an injury as well. As if somebody does receive an injury, the severity may not be as much had they not prepared for it and so therefore their recovery is a lot quicker.

Dr. Lisa Belisle:

We've spoken about yoga, we've spoken about qigong. I know you have. Also massage of the body architecture. We've talked about bioimpedance and drinking water. And you have this. I think I'd like to remind listeners that it's a very integrative approach. You also have TRX machines and you have other machines that are very traditional to a. Well, I'll just call it a fitness facility or a gym. But having been through a training session with you, I can attest to the fact that you drop a lot from a lot of different areas.

Stephen Anderson:

Yes. And I think the main philosophy and the main purpose is that we want to work the body in an integrated fashion. And those pieces of equipment that you just listed really help us as well as. That's not the only answer. That's a very small piece of the pie. So things like massage really help to alleviate any lactic acid. It's just as important as other pieces of being, well, cardiovascular. The wonderful work that you do as well, just opening people up, placing them in wonderful positions so the healing can take place. We wanted to create that. That environment at the studio. And we still get reports today when people come through the elevator, they feel good about being in the environment. And to me, again, that's the most important thing, because anybody can do movement, anyone can do exercise, but it's the environment in which you do that in and your interpretation of that that's most important. So having a great team that has this philosophy of which you're now a part of, and I'm very grateful for that. It's really. It's helpful because congruency for me is huge. I want to make sure things that I say are things that I do and things that I believe in. And people that we have at the Body Architect share that same vision.

Dr. Lisa Belisle:

I also noticed that in my workout with your. You, it was. It was fun. I mean, not all of it was fun.

Stephen Anderson:

Yeah, yeah. And I apologize for those moments.

Dr. John Herzog:

No, that's all fun.

Dr. Lisa Belisle:

The kettlebells, you know, the. The ball, the balance ball. I mean, you actually incorporated things in. And I am a long time runner, so, you know, my workout was upper body, and it was something I was a little intimidated by. But when I came in, you made it. You were very gentle. You made it interesting. And I think I'm somebody who gets very bored from doing weights. But you integrated a lot of things and you did it in a very efficient manner. So fun and efficient. Talk to us about efficiency.

Stephen Anderson:

It's very important because I like to talk about sort of being in the moment. So when a person is doing their workout, it's their time. So that also has a lot of healing property. If they're thinking about other distractions. It takes away from the physiological benefits they're gaining from. From the workout. So it really puts you in the moment when you are trying to balance on a ball. Oftentimes, I'll try to take balance away so the body comes back to writing. Reflex kind of knows what to do again. But you're not thinking about those things. You're thinking about survival in a fun way. It's kind of like an adult playground. We have all these wonderful toys, and we're just trying to unbalance you a little bit. And can you come back to center? It's equilibrium. Because again, as you're moving in space, the better balance you can get, then the likelihood of you getting an injury really starts to diminish. So I try to keep it fun in those, but not for sake of variety, because it has to have a purpose. And your response is very. Is very typical. A lot of people come in and say, gee, you know, we just did upper body today when the legs were involved in a lot of it, but you just didn't realize that it was just happening. So it's sort of this global sensation that happens. And so that's a very typical response.

Dr. Lisa Belisle:

Well, I can tell you it wasn't my legs that were sore after the workout. But it's all. It's something that I think about a lot because I turned 41 in January and I have pretty good endurance. I can bike, I can ski, I can run. But I think not unlike many women, the upper body and the arms is something that I've never really focused on. So the way to go in there and rebalance was very helpful, very important,

Stephen Anderson:

because if you focus on those activities, then you. Then you put time on that repetitive motion, but other pieces are missing. Then it's just a matter of time before the triangle collapses. So when we start focusing on that strength, and it will allow you to do the running for longer, for more enjoyment, also to really try to cut back on. On the likelihood of an injury. So oftentimes in women in particular, I see strength training as a missing link oftentimes because I think it's just been very intimidating. And our culture and our society and the traditional facilities may have something to do with that. So this kind of sort of gets you back into playing. Things are strengthening. And again, I always go back to, you're only as strong as your weakest point. So when we get that weak point stronger, the organism gets stronger. So everything becomes easy again. I think the most important part is not. Is not the Time that you spend there in the exercise or in the actual activity you want to prepare so that your life flows smoothly all the time, no matter what. Because it's a 24 hour day, basically it's not a one or two. So you get it all.

Genevieve Morgan:

It's been such a warm, sunny summer, this summer. Kind of different for a lot of us who've grown up in the summers here. So is there a better time to exercise in the summer? You know, with all the things we've been talking about, hydration, warm body.

Stephen Anderson:

Right there probably is. I find that it's very unique to the individual. It really has to meet their lifestyles. When it's really warm, obviously in cooler parts of the day are going to be best. So a lot of people are morning exercisers, others like evenings. So it becomes a personal preference. But what I've also experienced over the years, that if people, for the most part, if they don't get their exercise done in the morning, in the a.m. then they find too many excuses sort of get in the way. Life gets in the way as it does. We suffer from the human condition. So it's important. I think once you make it an integral part of your lifestyle, then just see how it fits in and make sure they get it done and also realize that everything counts. You wouldn't also have to do the full exercise. So there are different components. You have the cardiorespiratory and then muscular strength and endurance and flexibility. Oftentimes they can be woven together, but you wouldn't necessarily have to do them in the same setting. In other words, if you wanted to go out for a run in the morning and then do your resistance training in the, in the late afternoon, that would be okay as well. They're different categories, they don't have to be sandwiched together. So it really comes down to personal preference. And when it fits your lifestyle, clearly when it's that hot, you really want to be careful because the quality of the air isn't greatest. And when you're exercising, obviously you're grabbing for more air.

Dr. Lisa Belisle:

Stephen, how can people find out more about you and the Body Architect?

Stephen Anderson:

They can go online now, which is TheBodyArchitect.com they can give us a call. Our number is 774-2196 and we'd be happy to. We have sort of a virtual tour on our website as well. And that's been kind of revamped so they can. And again, I'm not the one to ask for the technology portion of it. However, it'll give people a virtual tour and all the information that they need. They can also stop by and see us at any time. We're in hours of operation

Dr. Lisa Belisle:

facility. And Genevieve, how do they Read more

Genevieve Morgan:

about Stephen well, the profile came out in April 2012 issue of Maine Magazine, which is online, and I feel as if we've written a lot about you.

Stephen Anderson:

You have. I appreciate it. Thank you so much.

Genevieve Morgan:

And I think there's going to be an article about Dr. May coming out soon.

Stephen Anderson:

Oh wonderful.

Genevieve Morgan:

And so I think just logging on to themainmag.com yes, and typing your name into the search facility.

Stephen Anderson:

Good connection. Great.

Dr. Lisa Belisle:

Well, we've been talking with Steven Anderson of the Body Architect, who is again local celebrity, but you heard him first here. Go back and download the podcast from the Fall on Light and hear what he had to say on that topic. He happens also to be one of my colleagues now. That's where my acupuncture and Chinese medicine practice is located. So if you stop by and visit Steven, then you can visit with me too. And we thank you for being here today and talking about sports injuries.

Stephen Anderson:

Thank you for having me.

Dr. Lisa Belisle:

This is Dr. Lisa Belisle and you have been listening to the Dr. Lisa Radio Hour and Podcast Show Number 47, Summer Sports Injuries, airing for the first time on August 5, 2012 on WLOB and WPEI Radio Portland, Maine. Today's guests have included Dr. John Herzog of Orthopedic Specialists in Falmouth and Steven Anderson of the Body Architect in Portland discussing summer sports injuries. We hope that you have gained some information and insight and perhaps inspiration to go out and prevent your own summer sport injury or perhaps rehab from one that maybe you already have. For more information on our guests, go to drlisabelisle.com let us know what you think of this show and perhaps give us a few ideas for future shows by going to the Dr. Lisa page on Facebook, liking us and sending us a message. Or email us@infooctorlisabalial.com Please take a moment to thank our sponsors who enable us to be with you every week, offering you insight, inspiration and a way to go about having a more bountiful Life. This is Dr. Lisa Belisle. Thank you for being part of our world. May you have a bountiful life.