The Rotor Cup (Rotator Cuff)

Rotator cuff problems hurt.  There.  I've said it.

I have a lot of people tell me how high their pain tolerance is  For most of them, it is quite the opposite.  uBt when their problems involve the rotator cuff,I can believe them.

I know...I've been there.  I had surgery on both shoulders to solve what was basically a rotator cuff problem.  Dr. Eric Morgan did one and Dr. Todd Griffith did the other.

Let's go over the rotator cuff a little bit.  The name really throws people off.

Think about the cuff on a shirt.  Ok, I know...most shirts don't have a cuff anymore.  But think of a men's dress shirt.  The cuff at the end of the sleeve  if unfastened looks sort of like a horseshoe, circling around the wrist but open on the end.

That's pretty much what the rotator cuff looks like. 

And it's made up of four muscles that form that cuff.   The Supraspinatus, Infraspinatus, Teres Minor, and Subscapularis.  (Don't worry about remembering those--there won't be a pop quiz at the end of the column.)

Those muscles may be small but they play a hugely important role in shoulder function.  Without them, the big muscles of the shoulder, the Deltoid, the Pectoral muscles, and others cannot do their job. 

It's sort of like "when momma ain't happy, ain't nobody happy."  If the rotator cuff isn't working well, you've definitely got an unhappy shoulder.

Injuries play a big part in rotator cuff problems.  Shoulder dislocations and partial dislocations (most often called subluxations) certainly can damage the rotator cuff.  So can falls.

Posture can be a huge part of chronic shoulder  problems.  Basically the upper arm bone (the Humerus) sits too far forward in the shoulder socket in bad posture and can pinch on the rotator cuff.   That's also where the term "impingement" comes from--it's another name for pinching.

If that goes on long enough, it will do damage to the rotator cuff.

Dr. Shane Asbury is an orthopedic surgeon at Maryville Orthopedic Clinic. In his practice, Dr. Asbury sees a variety of shoulder problems, some of which need surgery. 

According to Dr. Asbury, "most rotator cuff problems are best managed non-operatively with NSAIDs, PT, and steroid injections. Only after conservative treatment fails should a person be considered for a surgical intervention (the exceptions being younger patients and some traumas)."

Exercise is a big part shoulder rehabilitation, regardless of whether surgery is performed or not. 

But if surgery is necessary, the outcomes are good.  You can expect full function and a pain-free shoulder.  I can personally attest to that.

Parenting Success 101

I am a keeper of lists.  Grocery lists.  Lists of chores that need to be done. 

Lists of things that I need to do around work.  A revolving list of people that I need to reach out to.  

Things that I need to do on a personal level like say thank you more and think of things from the other person's perspective more.

I've got several lists that I've gotten from others about being a successful parent.  No, I don't have small children but being a good parent doesn't stop just because your kids are adults.  The game is just a little different.

One list that I saw recently that I liked enough that I copied it down was one titled "Parents of 

Successful Kids Do These Things."   I've changed the list around a bit and tweaked it a bit to maybe make it more appropriate for my inclinations.

So here goes.  Successful parents:

Make their kids do chores.  What?  Really?  Oh yeah.  Specific tasks that belong to them.  And most assuredly don't "pay" them for doing those chores.  You give them an allowance? That's OK, but their chores are the price they pay to live under your roof.

For my kids, a lot of it was farm chores.  I don't think they ever thought there was anything positive that could ever come from mucking out stalls in the barn but I'm betting that it taught them the value of work (and it allowed them to own horses).

Teach their kids social skills.  Positive, affirmative social skills.  You make sure they offer a firm handshake.  And make eye contact.  You don't let them retreat into their own world when in the presence of others.  You teach them to build others up, not tear them down.

Have high expectations.  Shoot for the stars.  Aim low and you'll get it.  Aim high and even if you miss, think of all that you will have accomplished.

Have healthy relationships with each other.  Make time for each other.   Your kids won't die (or even suffer) from spending an evening with a babysitter.  Respect each other.  Show affection for each other in their presence.

Teach their kids math early on.  And good grammar.  Nothing in life will hold them back as much as not being able to communicate effectively. Or the ability to balance their own checkbook.

Do things with their kids.  Even before they would seem to be old enough.  

I can remember that we used to take our small children to really nice restaurants.  Sometimes they misbehaved.  Oftentimes they spilled something.  But what they learned was how to behave.

Value effort over avoiding failure.  Reward effort.  Losing a game is not failure.  Failing to be in the arena is failure.  Failing to put forth the effort is failure.

I still don't believe we should reward simple participation.  Life keeps score.  We should too.  But games are games.  They're not life itself but life lessons.

Exercise as Lifestyle?

This is the month of resolutions.  This is the month where the gym is full.  Next month?  Eh...not so much.

I've said it here before.  Many times.  To truly be successful, you have to make exercise a part of your lifestyle.  But what does that mean, really?

It means that you do it every day.  Seven days a week.  Something.  Anything.

Walk.  Jog. Swim.   Go to the gym.  Ride your bike.  Paddle your boat.  Do that exercise video thingie.

It means that you do it regardless of circumstances. 

You exercise even when you feel bad.  You exercise after you stayed up too late. You exercise when it is inconvenient.  You exercise when you're just not in the mood.  You exercise (maybe especially) when you're having a bad day.

You don't exercise just to have a second piece of pie.  You don't reward yourself by indulging in junk food just because you worked extra hard at the gym today.   You really should disconnect eating and exercising anyway. 

Eating is a separate issue.  Nobody enjoys good food any more than I do and yes, I do indulge in some things that I shouldn't from time to time but most of the time food is simply fuel.  Fuel to get through the day.  Fuel to get me around on the bicycle.

Good fuel.  Tasty fuel. You don't have to eat cardboard to eat healthy.

For sure, you never count the calories burned in a workout and then try and match that with calories consumed at the dinner table. 

If you're going to do anything about your diet, cut back on your carbs.  America consumes way too many carbs.  I know I did...until October of 2014 when some vascular testing prompted me to finally cut way back on the carbs.  If it has white (refined) flour or white (refined) sugar in it, I generally run and hide.

I don't have much trouble following that one and fully expect to eat that way the rest of my life.  Following a low carbohydrate diet has become part of my lifestyle. 

So let's look at that term "lifestyle" a little more.  Webster (for the old folks) defines lifestyle as "the typical way of life of an individual, group, or culture."

Wikipedia (for the young folks) defines it as "the interests, opinions, behaviors, and behavioral orientations of an individual, group, or culture."  OK.  About the same thing.

I would think that lifestyle is what you do consistently.  Things that you do that are part of your daily routine, like brushing your teeth, going to work, bathing. 

If it is part of your lifestyle, then you do it without pain or regret.  It means that you don't really think about it, you just do it.  It really isn't something that you make a conscious decision to do or not do--it's just part of your day.  Part of what you do.  Part of who you are.

If you want to live longer and live healthier, you will make exercise part of your lifestyle.  And that is no resolution.

The Farmer's Parable

Do you remember the parable about the farmer and the travelers?  It goes something like this. 

A traveler was walking down the lane and came upon a farmer working in his garden.  "What sort of people live in the next town" asked the traveler.

"What were the people like where you've come from" answered the farmer.

"They were a bad lot.  Troublemakers all, and lazy too.  The most selfish people in the world, and not a one of them to be trusted.  I'm happy to be leaving the scoundrels."

To which the farmer answered "well, I'm afraid that you'll find the same sort in the next town."

Not long after, another traveler passed by this same farmer and asked the same question.  "What sort of people live in the next town?"

Once again, the farmer asked "what were the people like where you've come from?"

The traveler answered "they were the best people in the world, hard working, honest, and friendly.  I'm sorry to have to leave them."

"You'll find the same sort in the next town" answered the farmer.  Of course the farmer was talking about the same destination.

I could drop into a whole long list of cliché's here, but I won't.  I'm just going to talk about a couple of athletes that I've encountered.

One of them always complained about his teammates.  He wondered out loud if he was going to have to win this game by himself.  Even went on social media after a close loss complaining that he was the only one who really gave full effort in that game. 

He "led" by yelling at others.  Not really encouragement but I guess not all negative either.  And woe be to the player that made a mistake.  He was in their face, ranting loudly.   Of course, he never made a mistake.

This other player walked onto the field and seemed genuinely surprised at his good fortune.  A starter but maybe not a star, he thought he must be truly lucky to have earned that coveted starting position.

Despite that, he remained the hardest worker on the team, coming early, staying late, and always giving all he had.  When a teammate made a big play, no one on the field was more excited than this kid. 

He thought his teammates were the greatest people in the world.  When he was injured for a brief time, he was his replacement's biggest supporter. 

Now which of these kids do you think is going to be the best leader?  Which one do you think will be most successful in life?

What were the people like where you came from?

Concussion, The Movie

I saw the movie "Concussion" last week. I wasn't real sure I wanted to see it.  My wife and I headed to the theater without having made the choice between two movies that happened to be showing at the same time. 

It was only as I stepped up to buy the tickets that I realized why I had been reluctant to see "Concussion."

If you don't know the story behind the movie, it's about Dr. Bennett Omalu, a forensic pathologist in Pittsburgh who had discovered that concussions in the NFL were causing huge, long-term mental problems for former players.

It all started with the Steelers' legendary center Mike Webster, who was found in his truck, dead at 50 from what Dr. Omalu discovered was cognitive dysfunction likely due to concussions suffered during his NFL career.

Dr. Omalu called this disorder Chronic Traumatic Encephalopthy.  To say that the NFL was not real thrilled with these findings is putting it mildly.  And there is the rest of the story (which I'll leave for the movie).

I know all about concussions.  I deal with them routinely.   It's part of my job.

What I feared about this movie was that it would just be a big attack on the game that I love.  The game that I played, that changed my life (for the better) forever.  The game that my son played.  The game that is a big part of my life and which has been so very good to me.

What I also feared about this movie was that it would be medically incorrect.  My wife will tell you--I refuse to watch any kind of medical show on television.  The liberties that those shows take with facts just blows my mind. 

So I'll cut to the chase.  I had nothing to fear.  "Concussion" addressed a very real problem in sports, that being concussions.  But we've known this for a while.  It's why we take them so seriously.  More on that in a minute.

"Concussion" was amazingly accurate from a medical standpoint. 

I know Dr. Omalu's work and his story.  I know the research.  I LIVE the research.  This movie was true to the research and true to Dr. Omalu's story. 

Football can be a graceful, amazing sport that can provide incredible life lessons.  It can be life changing in many good and positive ways.    But we know that concussions are a problem and cannot be taken lightly.  The long term effects demand our full attention.

And we know that concussions are a problem in lots of sports, not just football.  It's why we focus so much attention on concussion recognition, treatment, and very careful return to sports participation. 

All of our schools have athletic trainers whose job is to know how to deal with concussions and coaches who understand what needs to be done.  We are blessed around here.  Not every place is so lucky.

For all those that still think that you just need to get tough and play through getting "your bell rung," this one's for you.

Go see the movie.  It's a good one.