Thanksgiving 2016

I hope you had a good Thanksgiving this week.  For me, it was a time to count my blessings. 

I'm thankful for my health.  I don't take it for granted.  It's what gets me up every morning and to the gym or out on the bike.  It's why Dr. Kevin Turner knows me on a first name basis. 

I'm thankful that my kids chose Blount County to live their lives.  That means those six wonderful grandchildren live here too. 

I'm thankful that Blount County is the kind of place where they want to spend the rest of their days.  The schools.  The community.  The mountains, lakes, and land.  

I'm thankful that I get to share my life through this space.  I used to be known as "Joe Black, the physical therapist."  Now I'm mostly known as "Joe Black, that guy that writes in the newspaper."

I'm an educator at heart (which was my first college degree) so this column serves as my main avenue to fulfill that.

I'm thankful for friends.  Lots of people criticize social media and smart phones but both of those allow me to stay in touch with those friends far and wide.

I'm thankful for football.  The sport I love above all others is under fire.  Interest in the NFL is declining.  Lots of parents are prohibiting their children from playing football.

Most of that has to do with injuries.  Chief among those are concussions. 

I get it.  I have those same concerns.  I played one game in high school that I don't even remember.  My son tells about getting slapped in the head so hard by a Florida State defensive lineman that he didn't remember  anything until he got to the sideline.

But I still believe it is the best sport out there (not the only sport by any stretch) for learning about teamwork and how hard work is rewarded.  Football helped make me the man I am today.

Interest waning?  I don't think so.  Tell that to college football fans all across the nation that continue to pack stadiums.  And I'll still insist that high school football games on Friday nights during the fall are the best place to be.

It's just up to me (and others) to do everything we can to make the sport as safe as possible.  Rule changes happen almost every year, almost always with the intent of making the game safer.

I'm truly thankful for all sports.  They teach life lessons, help create active adults, and make exercise fun. 

On a day where we are thankful for so many things, family, friends, food, the many blessings we all have, it is important to remember those not so fortunate.

Like the hungry.  The number of hungry people in the world exceeds the combined populations of the United States, Canada, and the countries of the European Union.

And the homeless.  33% of the children in the world don't have adequate shelter.

And those in poverty.  80% of the world's population get by on less than $10 per day.  And 3 billion people survive on $2.50 or less.  That's amazing.

So in this holiday season, share of your bounty.  Love everyone--we are taught that.  Pay It Forward.  Hug a stranger.  Be thankful not so much for a full belly but for a full heart.

What are your priorities?

In sports, we ask that our athletes place their sport at a high priority.   To be successful, it has to be that way. 

For a lot of athletes, it's pretty much a full time gig.  During the season, there may be no other priority (often to the detriment of their grades, their families, and their personal growth).

They have to practice, of course, but they also have to train.  That will likely include strength training and maybe stretching, yoga, conditioning, running, study, or some combination of any or all of the above.  Many young athletes have personal trainers and personal coaches.  Weekends might be spent on travel teams. 

The best athletes  understand the sacrifices that you make to be good.  At some levels, those sacrifices are monumental.  Athletes can sacrifice their relationships, their education, even their health in the pursuit of athletic success.

We all prioritize our lives.  We do what we think is most important to us.

I have a friend that tells a story about juggling.  Some of the balls that she juggles are made of crystal.  Those are the things most important to her.  Those are her highest priority.  The others are made of rubber. 

Obviously she pays closer attention to those crystal balls.  She definitely doesn't want to drop one of the.  They might be family, health, religion...any number of things.  She takes great care to preserve and protect them.

But some of those life priorities are like those rubber balls.  She has decided they are less important.  So if she drops one of them, it's OK.  She has learned that there have to be places where you can drop the ball.

 So what are your life priorities?  And where do you put your health on that list?

Do you exercise regularly?  Back in the days of using slides in a presentation, I had one that asked  "what fits your busy schedule better, exercising one hour a day or being dead for 24 hours a day?"

Is your diet a nightmare?  Do you get regular physicals?  Better yet, do you have a relationship with your Primary Care Physician to the extent that when you walk in their office, they know you by name and not by your chart?

Do you smoke?  You know where I feel about that one.

OK, let's look at this from a different direction.  How many "favorite" TV shows do you have?  Are there shows that you build your personal schedule around to avoid missing? 

All of us need some "down" time but how much time do you really need to spend on mindless pursuits? 

Are you willing to do the planning and food prep that is necessary to eat healthy all the time?  Or is it just too easy to drop by the fast food place for lunch and then again for take-out on the way home that evening?

Life, like sports, is all about your priorities.

Ride For Lucas

First of all, this isn't at all about the bicycle.  It might seem that way but it isn't. 

I haven't forgotten the late great Jim Dykes admonition "I like your column but get off that (expletive deleted) bike fetish."  So every time I start to write something about biking, I remember that.

No, this is a love story.  But let me back up a bit. 

There was a bike ride last weekend.   It all got started about 9 AM Saturday morning from Cycology bike shop.  About 220 people attended and another 20 or so completed a 5K run/walk.

The bicyclists had the choice of 25, 42, or 62 mile routes, mostly through south Blount County, traversing our beautiful back yard.  It was a gorgeous day too.  A little cool at first but once it warmed up a bit, it was glorious.  The fall colors are definitely off this year but our mountains are still just as majestic.

Bike pro Nina Laughlin joined the ride from her home in Brevard, North Carolina. She rides for the Visit Dallas DNA Pro Cycling Team and coaches for Carmichael Training Systems.  Oh, and she's from Maryville!

Tour de France pro Matthew Busche had tried to get here for the ride but when he couldn't get here, he sent an autographed jersey.

The ride was called The Ride for Lucas.  And that's where the story really starts.

Lucas Jones is an 8 year old boy battling Alveolar Rhabdomyosarcoma.  Alveolar Rhabdomyosarcoma is a cancer primarily affecting children and can be particularly aggressive.  Lucas is currently undergoing a combination of therapies in his fight. 

The ride was a combination of a fundraiser for the Jones family, an opportunity to lift Lucas and his family up, and an opportunity to call awareness to childhood cancer.

A couple of months ago, Kadena Hodson didn't know Lucas or anyone in the Jones family.  She certainly didn't have any idea what Alveolar Rhabdomyosarcoma was.  She actually discovered the story of Lucas on Facebook.

But Kadena has got a heart the size of your house and has an 9 year old son of her own.  She wanted to do something for Lucas and his family.  That's where the idea for a bike ride came up.

She knocked on doors.  She found sponsors.  She got her biking friends to help.  And then on November 5th, the Ride for Lucas happened.  And oh my, it was a huge success.  In so many ways.

Every Blount County business that Kadena contacted donated something.  250 people participated.  The Jeff Roth Cycling Foundation folks were there.  Cycology donated 10% of the day's proceeds.  A community came together.  People got to meet this brave little boy. 

At the end of the day, $10,00.00 was collected for the Jones family.

But this story is not just about Lucas.  It's not just about Kadena.  It's also about strangers that came together showing love for a boy and a family that none of them knew. 

That's the kind of place where we live.  That's the kind of neighbors we have.  And it didn't really have anything to do with a bicycle. 

"High" Ankle Sprain?

You've probably heard the term "high ankle sprain" before.  I don't really like that term very much. It doesn't really tell us much and it just seems like we should also have a "low ankle sprain" too (maybe we do, but it is never referred to as that).

So let's start today with a bit of a lesson on injuries and anatomy.

Most ankle injuries are the same thing. The foot is turned to the inside, maybe from jumping up and coming down on somebody's foot, quick changes of direction, or landing on some other object.  But in any case, the foot turns in, injuring the outside of the ankle.

Specifically, it is in the area in front of and just below that bony prominence on the outside of your ankle, known as the lateral malleolus.   The tissue most often injured is the Anterior Talo-Fibular Ligament or ATFL. 

It will hurt.  It will probably swell.  In most ATFL injuries, there is some microscopic tearing of the ligament but it remains intact.  All it needs is the proper treatment and rehab and it is just about as good as new. 

More extreme injuries to the ATFL can occur but rarely is surgery needed to get good results.  Often it is just time spent in a boot or brace.  The worse the injury, the longer the immobilization. 

Treatment is ice, compression (if there is swelling--and there almost always is some), and protection. 

A "high ankle sprain" is actually a syndesmosis sprain.   The syndesmosis of the ankle is the connective tissue connecting the fibula and the tibia where they meet at the ankle.

OK, maybe I better back up a minute.  The tibia and fibula are the bones of the lower leg.  The Tibia is the big one, the fibula is the long, thin one on the outside of the lower leg. 

They come together and form the roof of the ankle.  The lateral malleolus that I mentioned above is actually the bottom end of the fibula while the medial malleolus (its counterpart on the inside of the ankle) is the bottom end of the tibia.

Connecting them just at the ankle is a really strong band of connective tissue called the syndesmosis.

It takes a lot of force to injure the syndesmosis.  Most of the time it happens when a lot of force is placed upward into the ankle, usually when landing on a dorsiflexed ankle (that's the position when your foot is bent up toward your knee as far as it will go.

What happens in most of these is that the bones that form the base of the ankle are pushed upward into the roof of the ankle, sort of wedging apart the tibia and fibula and injuring (you guessed it) the syndesmosis.

Syndesmosis sprains are nasty creatures simply because any weightbearing aggravates the sprain.  In the most extreme cases, we take them off any weightbearing on that ankle through crutches.  They will at least get a boot to protect the ankle.  Again, ice and compression are essential to the post-injury care.

Syndesmosis sprains tend to linger because weightbearing can be difficult until those tissues are completely healed.  Running and landing hard on that foot are also impossible, sometimes for several weeks.

Right now, I'm dealing with one athlete that has injured both.  He has a syndesmosis sprain and an ATFL sprain.  It makes getting better even harder.

In either case, you need an athletic trainer or sports physical therapist to help you get back on the playing field quickly, safely, and efficiently. 

Taking Care of Those That Took Care of Us

My mom died last week.  Oh, it's OK.  She lived 97 full, robust years.  And her health had declined quite a bit in recent years.  More on that later.

You wouldn't know it to look at her, all 5'2" and 104 pounds but she played basketball.  She was a senior in 1936 and girls in Sweetwater, Tennessee played that old half court game.  She was a guard which means she never got to score. 

My favorite story about my mom is about a trip to Philadelphia that she took.  The year was probably 1943 and World War II was going on.  She was headed to Philly to visit with my dad who was stationed there. 

She got on the train in Sweetwater with a sandwich and $2.00 that her mother had given her, headed to Pennsylvania to see the man she had not too long before married.  She had only the dress that she was wearing and knew nothing more than that she was headed to Philadelphia.

She had no idea how to reach my dad and surely didn't realize what a big place she was visiting.  Somehow, she found my dad, secured a place to stay, and had a couple of weeks of glorious sightseeing with my dad and some friends she made.

What an adventure!

My parents were married for 54 years when my dad died in 1997.

In recent years, my mom had developed a progressive case of Dementia.  I've talked about my mom in this space on several occasions but have never mentioned that fact because she would occasionally read my column and I didn't want to embarrass her.

When she died, she had been living in the Memory Unit of the Morningview Assisted Living Center.  This is a wonderful place that deeply cares for their residents who face so many challenges. 

Despite advancing Dementia, she often knew who people were.  It really wasn't often that she didn't know me when I walked into her room but she did sometimes mistake me for my dad.

There's a lot more of this out there than you really can imagine.  That's why I'm writing this.  There are a lot of Pat Summitts out there.

It hurts to walk in and not be recognized.  My mom would sometimes get lost in her own residence and walk for hours looking for home.  She had no idea where she was.  One day it was Chattanooga, another Sweetwater.  She always wanted me to check on her mother for her and asked often about her long deceased brothers.

It's hard to deal with even family members when they can't function as we would expect them to.  There are not adequate resources available to take care of everyone that needs that care.  My mom was one of the lucky ones. 

We need more research.  We need more compassion.  We need more resources dedicated to those that can't remember basic functions like how to eat and where to use the bathroom. 

If you get a chance, show some love not just for these most vulnerable of our senior citizens but for those that care for them.  And if you get a chance, be generous with your checkbook to those organizations helping to fight Alzheimer's and Dementia.

Making The Team

I have a bit of a confession to make.  Sometimes I'm not quite what I seem.  Don't jump to too many conclusions there.  

Some people consider me a pretty good biker.  I do spend a lot of time on a bicycle.  It's really nothing to take off and do 40 miles or 60 miles or whatever distance my buddies want to do that day.  I'm well acquainted with The Wall and Butterfly Gap.  Foothills Parkway is just a training site.

But next to my friend Steve Bright, I might as well have left my training wheels on.  Steve and another buddy, Emil Herran, are in a totally different league.  They ride with me because, well, they like riding with people.  Group rides are a lot more fun than riding by yourself.  But they can leave me in the dust any time, any day.

Most people consider me pretty fit.  I've been doing CrossFit workouts for about eight years now.  David Spence and I started down this path and have found it to be a great way to get and stay fit.  Three days a week, our small band of buddies get together at Cherokee.

But next to Shila Newman, I am a slug.  This girl is incredible.  I have no doubt that she is one of the most fit people in Blount County.  She does it all and does it well.  She had a baby and was back at it like the next day (well...maybe not the next day...but soon after).  I am in awe.

I'm probably pretty strong (for a man of my advanced age).  I can knock out pullups and pushups until you're tired of watching.  Around the farm, I can do pretty much anything that needs to be done.

But next to Amanda Cagle, I'm a kick-sand-in-my-face weakling.  The girl is STRONG!   I've known her since she was a 9 year old gymnast.  She was one of my student trainers when she was in high school which led to her current career as an Athletic Trainer (she's the Head Athletic Trainer at Heritage High School and one of our Total Rehabilitation clinicians).

When she returned here to work, I told football coach Tim Hammontree that she was probably stronger than most of his football players.  She was.  And is.  She recently worked to get slim and trim (which she is) but she's still just as strong.

And then there's Ken Bell.  Some people might consider me a pretty good athlete.  Road biking, mountain biking, basketball, skiing, scuba diving--I do a lot of things pretty well.

But next to Dr. Bell, I'm a bumbling wanna-be.  I introduced him to rock climbing several years ago.  Before the first day was over, he was climbing places I had tried and failed.

We did a tennis camp together one time.  By the end of the first day, he was the best tennis player at the camp.  And don't even get me started on what he can do on the back of a mountain bike.  I could die today trying to keep up with him.

Last year he qualified for the World Championship in the Half-Ironman competition. 

So here's the take-away:  You don't have to be the most fit, the strongest, the most athletic.

If you can't be the fittest person in the arena, be the most persistent.

If you can't match strength with others, be the most dedicated.  Outwork your opponents.

If you can't be the most athletic player on the team, be the hardest working.

If you want to be in the game, be coachable, be a great teammate, eat right, get enough sleep, and pay attention to the not-so-little things like preparation and practice.

Why Play Sports?

I was listening to a podcast the other day and the physical therapist speaking made the statement that "the vast majority of ACL (Anterior Cruciate Ligament) injuries occur in sports."  Keep in mind, he was talking about my world.  Sports.   ACL's.  Injuries.

I had never really stopped to consider that without sports, we wouldn't have near as many ACL tears.  And then I thought about concussions.  As I write this, I've got three football players on the team that I serve that are being held out because of concussions. 

Without football, we wouldn't have as many concussions.  As much as I hate to admit it, those are truths that I have to deal with.  Which leads to the obvious question, why play sports?

Anyone that knows me knows where I stand on this.  Sports are Life Lessons.  But out of respect to my athletes, my patients, my community, and to sports, it is a question that still has to be asked.

So here goes my answer. I'm going to try and avoid clichés and I bet I offer some reasons you might not have thought about.

Sports are fun.   Well, at least they should be.    With my own kids, there were dad's three rules for school:  Be happy, be smart, play something.  And when it stops being fun, do something else.

Sports builds relationships.  Some of the best friends you'll ever have are your teammates.  Under the duress of competition, you also discover what being a friend is all about.  I've said in a variety of contexts "if you want a friend, be a friend." 

Active teens become active adults.  That one is well proven.  And since we live in the 3rd most obese state in America, producing active adults should be among our highest priorities.

Sports teach us how to perform under pressure.  Welcome to the real world.  Deadlines, cut-off dates, quotas, productivity...all those things are factors of the every day work world.  

Sports brings families together.  Some of my family's fondest memories are some of those AAU basketball trips.  It goes back to that relationship thing.  

Ask any family with kids about getting to all the practices, games, events, and everything else that goes along with playing a sport.  It takes an efficient family effort to get it all in.  You've got to work together to make it work--learning family dynamic lessons along the way.

Sports teach youngsters dedication, persistence, and respect.  Hard to argue with those.

Sports teach us how to deal with a boss.  That's something that they will definitely need some day.  It's different than dealing with parents.  Learning to deal with a boss early is a good Life Skill.

Sports help us develop leadership skills.  Growing up, two things gave me lessons in leadership:  Football and Boy Scouts.   Most anybody can lead subordinates.  How good do you lead peers?

Sports give us the opportunity to be part of a team.  Any successful team has parts that work well together.  One of the best lessons often learned is that you sometimes have to sacrifice personal goals for the good of the team.  If you learn the lessons of sports well, you become  a good teammate and that is another extraordinarily valuable Life Skill.

So, do the risks of injury warrant sports participation?  For our children to become successful, productive adults, I believe they do.  I believe that sports provide us with Life Lessons so essential to all that.  In few other places do we learn those lessons so completely.