Eatin' Possum

I read a piece in the newspaper a couple of weeks ago about Possums.  You could tell that the author wasn't  from around here because he kept referring to them as O-Possums.   I haven't heard them called that since...well, never.

But here's the part that blew my mind.  The article said that Possums are eaten commonly in the South.  Are you kidding me?!?   We don't eat possum. 

Now I must admit that I did taste Possum once.  The dad of my good friend Killdee Johnson cooked one up one time just to show us boys what it was like.

So, you ask, what was it like?  Awful.  Greasy.  Really beyond awful.

I grew up eating wild game.  Rabbit shot by my dad was a staple at our table.  Crappie.  The occasional squirrel.  We even made rabbit burgers.  I have friends that love deer meat.

Us boys were always out hunting or fishing something.  Killdee's dad would cook whatever we brought in.  Carp?  Yep.  Nasty.  Tasted like bad mud.  Barbecued groundhog hams weren't too bad.  Wouldn't touch the crow he cooked one time.  I think it was part of a joke.

But there has never been a time when Possum was on the table.  Not at my house or any house I have ever known then or since.

So let's just throw out all the rest of those Southern stereotypes. 

Like that we talk funny. 

I'll admit that growing up, one of the things that bothered me was when somebody would say "you-uns."  It embarrassed me for a family member to use that term.  If you're from around here, you know what I'm saying.  If not, ask somebody.

Then I found out that this really has its origins in Scotland and that since much of this area was settled by the Scottish, it was actually true to our heritage to say "you-uns."

Or that we're kinda, you know, slow.  That one may have come from the way many of us are slow to respond, deliberate in our answers.  I don't know about you, but many of the mistakes in my life have happened when I didn't slow down to think things through.

Spouting out the first thing that comes into your brain just isn't wise.  I've got a buddy from well north of the Mason-Dixon line that just spouts out whatever he's thinking.  His mouth keeps him in trouble and makes him few friends.

If slow means dumb, well I think we've pretty much answered that one.  Some of the world's greatest artists, writers, scientists, doctors, architects, you name it, have come from the South.   

That we're all "backwoods hicks."  Or "country bumpkins." Call us what you want to, nobody (and I do mean nobody) retires and moves north.    We already had that part figured out.

Dealing With Shin Splints

With the track season being in full swing and with better weather pushing people outside to run and hike, I'm seeing a lot more problem with Shin Splints.  Shin Splints are best described as aching pain on the front part of the lower leg.

Shin Splints are a very complex problem, influenced by a number of things, but at the core of most cases are impact forces.   What are impact forces?  Basically, it is pounding on the legs from walking, jumping, or running. 

There is a lot of speculation and no small amount of research that has looked at exactly what a Shin Splint might be.  Many studies have offered that it is an injury at the point where the tendons that attach to the front of the shin.

Others have indicated that it is an injury to the bone (tibia) itself.  I would suggest that it is likely both. 

In my experience, the consistent common denominator are impact forces on the lower leg.   So let's look at those.    

Most of the people that get Shin Splints are runners.  If you think about it, the running gait is really just a series of hops from one leg to the other.  If one is running a marathon, that's about 33,000 hops.  

Hikers get Shin Splints too and a big factor there is descending, when you are really sort of falling forward and catching yourself with your leading leg.  A load (backpack) on your back just makes it worse.

In both of those, you are really pounding on your feet, ankles, and lower legs.   But lots of people run lots of miles and there are hikers all over these hills every single day and none of them are any worse for the wear.

I would suggest that there are two problems that can lead to the development of Shin Splints.  The first of these are the "too's."   Too many miles.  Too many hills.  Too fast.

Big changes in your running program are almost always a mistake.  Any good coach will tell you to increase your mileage gradually.  You don't run 2 miles at a time, several days a week and then suddenly double your mileage.  The extra impact forces can lead to problems...like Shin Splints.

The other big factor is the way the foot hits the ground.

I'm not a big fan of running barefoot or with the thin foot covering popular today.  I'm not much of a fan of the "minimalist" running shoes either.  I do know that a lot of people do well with these things but most people need the support that good running shoes give them.

And more people than you could possibly imagine have mechanical issues at their feet that increase those same impact forces.  Flat footed people, for sure.  Just listen to them run.  Slap, slap, slap--the sound is revealing.

A lot of runners and hikers are also "pronators," which can best be explained as an inturning of the middle of your foot during the middle of the stance phase of gait. 

One of the things that I do in my clinic is to do a video analysis of the running gait, video-taping a runner while they run barefoot on a treadmill.  Often, it is only in stop action that you can see how much pronation you get in a foot that appears to have a really great arch.  I've been surprised more than once.

The solution then comes from more support to the arch of the foot.   The first choice is the "over-the-counter" arch support.  I recommend them almost every single day.  Look for one that isn't really spongy.  It really should have some firmness to it.

If the OTC arch supports don't work or if the problem is too complex, it may take custom orthotics to fix the problem.  With custom orthotics, a mold is taken of the foot and an orthotic is made from that mold that only fits that person. 

With good orthotics, those insufficiencies in the way the foot hits the ground can be corrected and those darn impact forces can be minimized. 

Please Let Me Introduce Myself...

In case we haven't been formally introduced, let me introduce myself.  My name is Joe Black but it is usually spoken as though it were only one word, as in JoeBlack.   Growing up, I never got to be called "Joe."  It was always my full name.  Such is the life of someone that goes by a single syllable first and last name.

I am a physical therapist and an athletic trainer.  Among that bucket load of acronyms after my name is "SCS," which stands for Sports Clinical Specialist, something that physical therapists can get after working in a sports setting for several years and passing a day-long exam (I took it 30 years ago and don't really want to take it again).

Also in that list is "DPT," which stands for Doctor of Physical Therapy.   Until 2003, most physical therapy degrees were Masters degrees.  In 2003, those changed to the Doctoral level program.  At 52, I entered the University of Tennessee-Chattanooga's Doctoral program, graduating in 2008. 

So yes, it is now Dr. Black but about the only time I invoke that one is when a patient is being particularly difficult. 

Throughout my career, sports have been the primary focus of my practice.  I've worked with the Maryville College athletic department since 1982 and with Maryville High School since 1984.  My sub-specialty has been extremity orthopedics.  For most of the last 20 years, most of what I have seen has been  knees, shoulders, and feet and ankles.

Oh, in sports, you have to treat everything so I've seen my share of concussions, hip problems, and yes, back and neck problems.  And that's where I'm going with today's column.

I have been taking care of Blount County folks since 1977 (with a 2 year gap to go to West Virginia) and have appeared in this spot for 29 years.  I've spoken to dozens of civic groups and have been a part of athletic health care for many, many years but there are still a lot of folks that simply don't know what I do.

Just last week, I got stopped in a restaurant (I'm always getting stopped in restaurants) and asked a question about a young athlete.  This parent told me that the young man, a football player, was having back problems and wanted to know where he should take him.

This fellow is a local physician but didn't seem to know that back care is a big part of what physical therapists do.  In fact, the #1 problem seen by physical therapists is back pain.

This may seem like a self-serving piece but  I would like to suggest that it is simply educational.  There are just too many gaps in what people know about physical therapy.  And the bottom line is that physical therapists are highly trained in the care and treatment of those with back and neck problems.

Although some might like to reduce us to the modalities that we sometimes use, my profession is SO much more.  We use a wide variety of techniques, all based on evidence--evidence that proves that physical therapy is an effective approach to treating back and neck problems.

Exercise is a huge part of what we do but manual therapy techniques, biomechanics, and education are all important parts as well.  Our goal is to get you better and then to give you the tools to stay better. 

I work for Blount Memorial and manage our Total Rehabilitation outpatient clinics. At each of our clinics, we have one person that is designated as a "spinal care specialist" but in reality, the basic training for all physical therapists covers care of the spine.

 I also don't mind telling you that there are now several other physical therapy clinics around here that do good work.  And the #1 diagnosis that we all see is back pain.   I'd believe that it's because we get good results.  

So the next time that you are looking for a place to take care of your back or neck problem, let me respectfully suggest that you consider the physical therapist.

Not Quite Thanksgiving

It's not Thanksgiving but I'm feeling thankful for a lot of things.

I'm thankful for a job to go to.  6.7% of Americans that are looking for a job can't find one, while 17.4% are underemployed, which means that they are working but are working in jobs that are well below their skill level or are working part-time and seek full-time.

Dang.    That means that over 21 million Americans are unemployed and 55 million Americans fall into that unfortunate category of underemployed. That's a lot of people. 

Add to that the fact that I really like my job and my employer.

I'm thankful for healthy kids and grandkids.   Imagine the pain that the parents of Will McKamey are going through right now.  

There is no greater feeling than walking in the room and a grandchild screams out your name (or whatever name that they've come up with--for me it varies between Daddy Joe and Joesie).  Nothing beats that.

I'm thankful for being able to walk and talk and even breathe on my own.  I've got friends and family that right now can't do any of those things.   It certainly makes you appreciate what you do have.

I can't play basketball anymore--or, more accurately, choose not to because of the havoc it wreaks on my knees--but that's OK.  I've still got the the bicycle.

I'm thankful to live in Blount County.   I'm not a native but I've lived here almost 35 years, which is well over half my life. 

If there is a greater place to live in America, I'm not looking for it.   Here, you've got smart, friendly people.  Great restaurants (you've heard the list here before).  Perfect climate--I like it that we have four seasons.  Mountains, rivers, lakes.  Recreational opportunities on every corner. 

Every time I see some magazine do a piece on the greatest places in America and they don't include Blount County, I figure they just haven't been here.

I'm thankful for my health.  I have several friends battling cancer.  Such an ugly disease.   It isn't always the result of bad health habits and sometimes it happens despite good health habits.  

But I will continue to rely on my dermatologist (Dr. Unkefer) and my gastroenterologist (Dr. Brown) to give me an edge in the ongoing battle against cancer. 

I'm thankful for a healthy heart.  I've never taken that one for granted.  My dad had his first heart attack when I was 5 years old.  I've built a lifestyle around heart health.  So far it seems to have worked.

When I get to the top of a really hard climb on my bicycle, I've been known to say something like "I might die today but it won't be of a heart attack."

Never forget that the most important muscle in your body is the one in the middle of your chest.  You can live without a biceps muscle but you can't live without a heart muscle.  Take care of it people.

And speaking of that bicycle, I'm thankful for a sport that I can love and still do well at my advanced age. 

I'm doubly thankful for the vast majority of those drivers of motorized vehicles that respect our right to be on the road.   It is, after all, the law, folks.