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Solving the Mystery of Headache Pain

May 13, 2013 in Lifestyle Tips, Rehabilitation, Sports with 0 Comments

There are currently 28 million headache sufferers in the United States. 21 million are female, and 7 million are male (www.americanheadachesociety.org).

People often attribute headache pain to allergies, food or other causes, but some headache pain often originates from the cervical spine. If the source of your headache pain is a mechanical diagnosis, it may be treatable with physical therapy.

If you answer “yes” to ANY one of the following questions, you could be a good candidate for physical therapy to address your headache pain:

  • Headache produced consistently with certain posture or activities (such as when you are propped up in bed reading)
  • Loss of range of motion of cervical spine when headache occurs (more painful/stiffer to turn or look up)
  • Unilateral or headache on one side of your head
  • Headache at base of the posterior portion of your head
  • Headache occurs more often when “still” versus “moving”

During my years as a clinician treating a variety of different patients, I have found alleviating a patient’s headache pain is the most rewarding. One of my former female patients arrived in my office six weeks post cervical spine fusion surgery. Two weeks after the surgery, she received an epidural injection that resulted in a constant headache. She attributed the cause of her headache to the injection. During the course of her mechanical exam, we were able to find a simple sustained head and cervical spine positioning that she could perform easily while sitting. During her first exam, this position decreased her pain from a 9 (on a 10-point scale) to a 2. She was instructed to perform this movement every 2 hours and with the occurrence of headaches. On her second visit, one week later, she reported that her headache had completely subsided within 24 hours from the initial visit. She also reported that when she felt the trace of a headache beginning to start that she could relieve it with the exercise.

If you are suffering from headaches, please don’t hesitate to tell your physician because you may be able to receive therapy as a conservative treatment option. At the St. David’s Spine and Sports Therapy Clinic, we can assess your headache and determine if it is a mechanical diagnosis that can be treated in an average of two to four visits.

-Susan Hennigan, DPT
St. David’s Spine and Sport Therapy Clinic

Boost Your Workout: Wear a Heart Rate Monitor

January 28, 2013 in Exercise, Heart, Lifestyle Tips, Outdoors, Sports with 0 Comments

FB-Teasers-JAN28Regular aerobic exercise may decrease your risk of death by 15% and add 3 years to your life.   Effectiveness of exercise depends on what you do—1 hour of walking versus P90X requires very different amounts of energy expenditure.  Heart rate monitors help gauge how much you are exerting yourself and potentially how much benefit you are going to get.   They can be purchased as watches that often have a strap that goes around the chest, although some newer ones may not need a strap.  Often they can be added as accessories to modern smartphones.   Most of these are now wireless, making them much less cumbersome.  Costs vary from under $100 to up to $500 depending on the features.  Higher end treadmills and ellipticals often have heart rate monitors imbedded into the handles.

These monitors can be helpful with any type of aerobic exercise such as jogging, biking, elliptical training and even swimming (find one that is waterproof not water resistant).   To use your heart monitor effectively you first need to know your maximum predicted heart rate.   This is estimated by subtracting your age from 220 for men and 226 for women.  You then know your theoretical maximum heart rate in beats per minute.  Now pick your sport and set up training zones.  These can help you achieve your goals and prevent both under and overtraining.

I’ll share how I use this.  I like running.  At 42 years of age, my maximum heart rate calculates to 178 bpm (beats per minute).  My training goal is to prepare for half/full marathons.  This requires endurance training (ability to go long distances with moderate energy expenditures).  So for most of my training I will want to be in the ‘aerobic zone’.  In this zone, the body’s primary energy stores are in the form of glycogen.  When you do aerobic exercise the body does not have to go into ‘back up stores’ to create energy.  Higher intensity training for long periods of time forces your body into the ‘anaerobic zone’ where the body then has to look for alternative sources of fuel which could result in muscle break down.

So if I go out on a training run I will want a target heart rate between 125 to 142 bpm.  Typically I will find a pace at which my heart rate remains around 135 bpm, and I feel comfortable.  Once I find that pace, it is amazing how constant the heart rate remains.  Because my main goal is endurance training, this is where the bulk of my exercise focuses, but say I want to work on speed.  This can help me finish a race or help on hills when the ‘extra push is needed’.  I will mix it up by running ¾ of a mile at a lower heart rate goal of say 120 bpm (67% or 2/3 of maximum) and then finishing the remaining ¼ mile at 160 bpm (90% of maximum), then repeating this for several miles.  This gets my heart rate into the anaerobic zone and allows me to work on speed but not long enough that I start to tear down my own muscle.

If just starting an exercise program, you will want to start with a lower target heart rate like 50-60% of maximum and then build upwards as your body gets in better shape.  For weight loss, you can target 60-70% of maximum heart rate with exercise 4-5 days, per week 45 minutes at a time.  Then as you get hooked on fitness, you will want to increase to the aerobic zone at 70-80% of maximum to gain endurance and strength.  As I previously explained, pushing into the anaerobic zone at 80-90% can be helpful in building speed/finishing power.  But if you see yourself constantly in that zone, you will want to pull back a little to avoid overtraining, injury, or breakdown of muscle.

As you get in shape, you should also notice your resting heart rate decrease as your heart is now more efficient.  It may also take more effort to get in the right training zone which is a sign that your body is ready for more vigorous physical exercise.

All of this heart rate monitoring can lead to some compulsiveness.  I recommend 1-2 times per week that you just go out and exercise with the monitor off.  Exercise at a level where you feel good, and forget about the heart rate.  Enjoy staying healthy!

Jeffrey N. Whitehill, M.D.

 

The Game Plan: Preventing Youth Sports Injuries

November 20, 2012 in Children, Exercise, Outdoors, Sports, Tips, Urgent Care with 0 Comments

By Lewis Leibovich, M.D.

According to the National Alliance of Youth Sports, more than 30 million children participate in team and individual sports each year. The school year is peppered with sporting activities—from cheerleading and track to football and soccer. They are all fun ways to improve physical fitness and hand-eye coordination, while teaching children determination and teamwork. Unfortunately, these activities are also some of the most frequent causes of youth injuries.

Annually, more than 3.5 million sports-related injuries in kids require medical attention, according to the National SAFE KIDS Campaign. However, many of these injuries are preventable.

Since younger athletes are still growing, their bones, muscles, tendons and ligaments are more likely to be affected by minor accidents. As children get older, the rate and severity of sports-related injuries increases. The most common types of sport-related injuries in children are ankle sprains, shoulder strains, concussions, dehydration and patellofemoral pain syndrome, which is related to knee strain and injury. With proper precautions, young athletes can play sports knowing their bodies are in the best physical condition.

Below are some measures young athletes, their parents and coaches can take to prevent some sports-related injuries:

  • Ensure children get physicals before they begin practicing or playing sports. It’s important to know if there are any underlying health conditions that may interfere with the level of activity a child can achieve.
  • As with any physical activity, participants should drink at least 12 ounces of water 30 minutes before the activity begins. Continue to hydrate throughout, as well as 20 minutes following the activity.
  • Require at least a 10-minute warm up before any strenuous physical activity to raise the heart rate gradually—not suddenly—and increase blood flow to the muscles.
  • Athletes should stretch both before and after the activity. They should hold each stretch for 10 to 15 seconds for maximum effectiveness. Make sure they stretch their entire bodies—stretching the legs will only help warm up the lower body.
  • If athletes complain of exhaustion or pain, listen to them and do not force them to play through the pain. Adults are taught to listen to their bodies and know their limits—there is no exception for children.
  • Be sure someone on the coaching or training staff is certified in CPR and first aid.
  • Kids of the same age can differ in size, maturity and strength. Take extra caution when children are competing with kids who are more physically advanced, and avoid that situation if possible.
  • For younger athletes, make sure practices are suited to the sport they play. It’s critical to ensure they are receiving the proper conditioning that will allow their bodies to adapt so they can continue playing for years to come.
  • Ensure athletes are wearing and using the appropriate safety equipment, even during practice. Be sure to adjust the equipment to fit the child. If something does not fit properly, it will be less likely to prevent injury.

Keep in mind that contact sports have higher rates of injury, but individual sports injuries tend to be more severe. As soon as an accident occurs, appropriate action should be taken. For treatment of simple injuries, apply the R.I.C.E. technique—rest, ice, compression and elevation—but never hesitate to take an injured athlete to a hospital.

Even if an injury seems minor, listen to the child. If the child complains of persistent pain following an accident, or if their “minor” injury prevents them from performing at their normal level, it is time to see a doctor. The faster an injury is treated, the faster the body can begin to heal and recover.

Lewis Leibovich, M.D., is a physician with St. David’s Urgent Care Pflugerville.

3 Things You Can Do to Help Avoid West Nile Virus

September 9, 2012 in Children, Community, Exercise, Outdoors, Rehabilitation, Sports, Tips with 0 Comments

via flickr

West Nile virus illnesses in Texas continue to rise dramatically, with the number of cases this summer rising to 1,013 — with 40 deaths. That is a 58 percent increase in cases and 74 percent increase in deaths. State officials warned that the infections may continue until the first hard freeze of the year. To protect yourself and your family from exposure to mosquitoes infected with West Nile virus:

  1. Be sure to wear long pants and long sleeves during dusk and dawn.
  2. Apply a repellant with DEET.
  3. Remove all standing water from the yard.

West Nile virus is asymptomatic in 80% of those infected. 20% of patients present with clinical disease. West Nile virus can cause a neuro-invasive disease or West Nile fever. In addition, a recent research study completed by Dr. Art Leis indicated that 40% of West Nile fever patients also had markers for the more serious West Nile illness indicating the effects of West Nile fever may be more extensive than previously thought.
In the more severe cases, patients can develop a variety of neurological deficits including meningitis, encephalitis and polio-like limb weakness. Rehabilitation at an intensive rehabilitation hospital and the expertise of neurology may be required. Patients may require physical therapy for strengthening and training to learn to walk again, occupational therapy to relearn activities of daily living such as bathing, dressing and toileting and speech therapy to address any deficits in cognitive function, memory, swallow or communication.

There is no cure or treatment for West Nile virus. Until our first hard freeze, remember to protect yourself and your family from exposure to mosquitoes.

Diane Owens, PT, FACHE
Assistant Administrator
St. David’s Rehabilitation Hospital

Dietary Guidelines for Fueling the Athlete Within

June 29, 2012 in Community Outreach, Diet, Exercise, Recipes, Sports with 0 Comments

Tarie addresses the class on fueling your body for athletic performance.

Tarie Beldin spoke to the topic of Fueling the Athlete Within yesterday evening at the St. David’s Round Rock Health and Wellness Center, lecturing on the dietary needs of athletic performance levels, dispelling myths and demonstrating several cooking recipes. Along with some tasty samples and recipes, attendees left with some of the following dietary guidelines.

Carbohydrates

  • 55%-70% of total calories
  • Best sources: fruits, vegetables, whole grains, dairy products
  • 2-3 g per pound for light to moderate activity

Protein

  • Repairs but does not BUILD muscle!
  • 1.2-1.4 g per kg needed for daily activity
  • Need adequate protein but excess is unnecessary

Fluid

  • Body is 60-65% water
  • 75% of population is chronically dehydrated
  • Needs depend on weather, activity, intensity, medical conditions
    • 2-3 cups prior to activity
    • ¼-1 cup every 15-20 minutes
    • 2-3 cups post activity (*each pound lost with ~2 cups water)

Vitamins/Minerals

  • Do not provide energy but help your body to function better.
  • Taking more than daily recommended value does not equal better. It won’t make you healthier.
  • Eat food first before taking your vitamin so it settles better on your stomach.

Join us July 26th for the next cooking class with Tarie, Healthy Grilling where Tarie will demonstrate unique ways to grill and how to do it in a healthy and safe manner. The next seminar at the St. David’s Round Rock Health and Wellness Center will be July 12th where members of the Trauma Team will address all the ways you and your family can stay safe this summer during the Summer Safety seminar. You can register for both of these events by calling 512-487-3627.

Holly Krivokapich
Health and Wellness Coordinator

Don’t Let your Child be the ONE

June 5, 2012 in Children, Community, Community Outreach, Exercise, Heart, Outdoors, Sports with 0 Comments

June officially kicks off the summer months and for thousands of young athletes, an intense schedule of practice, games and tournaments. While often times the health and vigor of young athletes is taken for granted, each year a number of adolescents suffer from Hypertrophic Cardiomyopathy (HCM). The leading cause of sudden cardiac arrest in young athletes, HCM affects approximately 1 in 500 student athletes. While it’s often hard to diagnose HCM without proper screening, some of the symptoms include:

  1. Shortness of breath)
  2. Chest Pain
  3. Heart palpitations
  4. Light-headedness
  5. Fatigue

As daunting as the possibility of HCM can be St. David’s Round Rock Medical Center is here to help. On June 14, we will be hosting a seminar discussing The Importance of Adolescent Heart Screening at the St. David’s Round Health and Wellness Center at the CHASCO YMCA. Come learn the symptoms, risks and what you can do to protect your child through screening. As an added benefit, St. David’s Round Rock is hosting a FREE Adolescent Heart Screening on July 14th for children between the ages of 14-18. Sign up for both of these by calling 512-478-3627. We hope to see you there!

Holly Krivokapich
St. David’s Round Rock Medical Center
Health and Wellness Coordinator