Shoulder Plague

Shoulder problems continue to plague us.  A lot of the blame goes on the widespread usage of computers.  So many jobs these days require us to sit too long at a computer.  More on that in a minute.

The vast majority of shoulder problems that I see are impacted by posture.  One of the first things I do when I evaluate someone with shoulder problems is to look at them from the front. 

When I look at them, do I see the back of their hands?  I look at them from the side. Are their shoulders inturned? I look at them from the back. Are their shoulder blades farther away from the spine than they need to be?

That’s the postural component that I’m talking about. So much of our world is in front of us these days. It’s not just the computers but a lot of the other things that we do, the way we spend our lives.

If you have shoulder pain, you may hear the term “impingement.” That’s a fancy word for “pinching” and has to do with the rotator cuff.

A little anatomy lesson. The rotator cuff is a group of flat, small muscles that surround the head of the humerus (the upper arm bone) and are essential to normal shoulder movement and function.

That postural component that I talked about earlier allows the head of the humerus to sit in the front of the shoulder joint, impinging on the rotator cuff. That hurts. If you ignore it long enough, impingement can lead to other, bigger problems.

So, for those of you that sit at a computer all day, you’ve got to take breaks. At least every 15 minutes, step away from the computer, stretch your arms backward, relax, shake, and then go back to it. That doesn’t take but 15-20 seconds and your work will still get done.

Another thing that I see on a regular basis is a shoulder problem that is caused by improper strength training form or misguided focus in the strength training program.

Bad form needs to be corrected by a strength coach.  The best advice does not come from your friend or from the guy down the street with big muscles.  Look for experts in the field and then listen to them.

I see way too much focus on the anterior chest and the front of the shoulders. I must admit that I’m not a big fan of the bench press.  I know it has its place but it gets way too much attention.

Particularly among young lifters, what’s the first question one asks another?  “How much can you bench?” It is their measuring stick when they should be more focused on performance and on a whole body exercise like power cleans.

There is no doubt that some athletes need the bulk and power that comes from lifts like the bench press, but over four decades of experience in this field tells me clearly that it is the source of shoulder problems in far too many people—people who really have no need for a big chest.

Same thing for the biceps. “Curls for girls” has been a motto since I was young. Focus on the biceps without similar focus on the triceps does nothing for performance or injury prevention.

Don’t get me wrong—strength training is essential, not just in athletic performance but in staying healthy. Unless you are a competing athlete, strength training is more important in your 40’s, 50’s, and older than it is in your 20’s.  You lose significant amounts of muscles mass as you get older and to combat the bad sides of aging, you need regular strength training.

That doesn’t mean just to hit the gym and do what sounds good. There are tons of local people that really know how to help you to better health through the weight room. Use them.

What do you do when you don't feel like it?

Don’t feel like getting up the in morning?  Do you have the luxury of sleeping in?  Folks tell me I’ll enjoy that part of retirement (no…not yet…not for a while).  But on days when I might sleep in, I wake up anyway.

Are you one of those that hit the snooze alarm every day?  Not me. I really have no idea how the snooze alarm on my bedside clock even works. Oh, I’m sure I could figure it out, but when the alarm goes off, I’m wide awake. You’ve got to find motivation to get up and get going.

Don’t feel like going to work? I’m not guilty of that one either. I know that I was lucky, extremely lucky, to discover a job that I truly love, that I look forward to each and every day. When that alarm clock does go off, I am blessed to not lie there and say “oh woe is me—another day at the old grindstone.”

Nope. For me it’s “oh man, I get to go do this stuff again today!”  If that sounds self-righteous at all, it’s not meant that way. I know what it means. It means I won the career lottery.

When kids come to me for college advice, my core recommendation is to find something that you truly love doing and build a career around it. As the cliché goes, if you find something that you love and make it your life’s work, you’ll never really work a day in your life.

I saw a meme one time that went something like this:  8 AM plans for dinner--baked chicken, salad, and two vegetables.  5 PM actual dinner—pizza and sodas.

The real part of life is that sometimes you just don’t feel like cooking. And that healthy meal became junk food out of necessity.  I get it. I really do. My wife and I do that from time to time.

Planning your meals helps. Laying out that chicken in the morning makes it more likely that you will not stop by for fast food on the way home.

But the big ticket item on this topic is exercise.  What do you do if you just don’t feel like exercising?  I said something last week about not always enjoying biking on the hills that are everywhere around here or the strength training that I do 2-3 times per week.

A buddy and I have a saying about all that. “Are you riding or are you hiding.”  That may be all about the weather or maybe I just don’t feel like it. With few exceptions, once I get out there or get started with a ride or a workout, I’m glad I did. You know in your head that you need to exercise (or eat right or sleep enough) but your heart just isn’t in it.

What do you do? Listen to your heart and ignore your head? An Accountability Partner helps. Traveling the path to better health is easier with someone in your life to go with you. To hold you accountable.

There is no doubt that an exercise partner helps, especially on those days when you might not feel like exercising. There’s just something about knowing that someone else is counting on you being there that will make you get out of bed in the morning.

For years, I exercised with the same group of people. If somebody missed, they were likely to get a text message. “We missed you” is common. Sometimes it was more like “get your lazy butt out of bed.” In any case, it helped.

Maybe you made a New Year Resolution. To get healthier. To exercise more. Gyms are usually full in January, taper off in February, and are back to the regulars in March.

If that’s you, then let me offer you a suggestion. Establish a new mindset. Decide that this is going to be long term. Decide that this is going to be your lifestyle from now on. 

And then find an excuse to get out of bed in the morning.

Why is fitness important to you?

 What is the purpose of fitness? Why do you exercise?  What do you hope to accomplish?

Are you doing it to prepare for a sport?  We know for sure that exercise and good fitness are important for whatever sport that you might happen to be playing. And regardless of your age.

Sports-specific programs are important not only to help you be better at your sport but also to prevent injuries.  How does fitness prevent injuries, you might ask.

Lots of injuries happen late in the game.  Fourth quarter. Last ski run. Those kinds of things. Fatigue is definitely a factor. As you get tired, your technique deteriorates and your focus wanes. 

Your body’s ability to a change in direction (think about planting your foot to cut to your left) or to react to outside forces (think about getting bumped while you’re running) lessen with fatigue.

Performance is the goal for a lot of people. I took up CrossFit in 2008 because I could see that the emphasis on core strength would help me on the bicycle, particularly the mountain bike.

I can remember when Pete Rose broke down barriers in the 70’s by lifting weights.  Back then, baseball players avoided strength training fearing that they couldn’t perform well with big muscles. We now know how wrong that was.

Now we know that strength training, stretching, and sport-specific training are all essential to successful sports performance (along with eating right, getting adequate sleep, and listening to your body) regardless of the sport.

Weight management is another great reason to seek better fitness levels.  Dieting without exercising is futile. You just can’t get the results that you want.

Maybe you exercise to look better. That’s OK. Whatever drives you. I’ve said often that the best exercise program that you can do is the one that you WILL do.  Same here. It doesn’t matter as much WHY you exercise as it does that you DO exercise.

Kids need to exercise so that they become active adults. That’s a proven fact. And it’s also a fact that if their parents will exercise with them, the kids are even more likely to participate and to continue an active lifestyle into adulthood.

You might exercise for the way it makes you feel. Although I have never ran far enough or hard enough to achieve a “runner’s high,” I do know that regular exercise keeps me feeling better.

I’m not going to lie and tell you that it feels good on some of the long hills on my bicycle or that the strength training that I do is always fun. But I can tell you that as soon as it is over, it feels great. Exercise causes the release of endorphins in your system that will leave you almost euphoric.

Exercise is a key ingredient to living longer or, at the very least, living well in you later years. Again, study after study has indicated that.

I know people my age that feel like they’ve reached the age when it is time to slow down…that it is the natural progression of aging. That is most certainly a slippery slope.   If you let it, age becomes an excuse for getting lazy.

Stay active, stay strong, and don’t let birthdays dictate how you feel or what you do. You are neither too young nor too old to pursue fitness. And let me repeat what I already said:  It doesn’t matter nearly as much WHAT you do as it does that you DO it.

In My Lifetime

In my lifetime, there was a time when football helmets didn’t have facemasks. I can barely remember it but I know when I got my first football helmet, before I started playing youth football, it had a clear plastic facemask and was something of a novelty item.

Thank goodness everything about the game of football has gotten better. Equipment is better. Training is better.

I have seen concussions as something you shook off change to where we now know that they can be life threatening events with horrible consequences. I shudder at the thought of some of the advice we gave in my earliest professional days. But we’re better now.

In my lifetime, I have seen sports medicine go from hot tubs and analgesic balm to high technology and evidence-based practices. But we’re still taping ankles, pretty much the same way.

In my lifetime, I’ve seen backpacks go from bulky canvas to featherweight nylon. My first backpack was a Boy Scout issue with a wooden frame that I made myself. My current backpack, which isn’t the latest and greatest but good nonetheless, is aluminum and nylon and weighs nothing.

Same for my sleeping bag. I use a three-season bag that can be comfortable in winter with the addition of clothing and which can be used if it gets wet. If my first sleeping bag got wet, it was useless for days.

My boots are Gore-Tex and sturdy. I once hiked the portion of the Appalachian Trail inside the Smokies in canvas Converse All-Stars! And a friend started that trip (we were 12) with an iron skillet and a fishing rod.

And speaking of which, in my lifetime, I’ve seen basketball shoes going from those same canvas Converse All-Stars to Air Jordans and beyond.

I’ve seen rules changes in basketball where dunking was made illegal and then later it was embraced as part of the show. I’ve seen girls’ basketball go from a 3-on-3 half court game to a full court game. That half court game was a thing until I was in college. Hard to believe now.

Regular, five-on-five basketball was supposedly too strenuous for girls. How wrong we were!

In my lifetime, I’ve seen the polio epidemic.  It was scary but mostly because of the iron lungs that some children were forced to live their lives in.

I have had more of a chance to be scared this time. I was just a kid then but those iron lung things were the items of nightmares. Still, I’ve had friends and family members die of Covid-19. I’ve probably preached enough on that sermon so I’ll move on.

In my lifetime, I’ve seen Jim Crow America.  I can remember separate facilities for non-whites.  Separate bathrooms, separate water fountains, separate entrances to stores, separate seating sections at events.

Us kids were all thrilled when schools were integrated (I was in the seventh grade) because it meant that we got to go to school with our friends who happened to be a different skin color. And we got to play on the same sports teams.

Old people talk about the Good Ol’ Days. Were they? Certainly parts of life then were simpler, maybe easier. But I would never go back.

Look around. Embrace the world as it is today. Love one another. Take care of the environment. Take care of each other. This is the Best of Times. Have a Happy New Year. I’m sure you’re like me and ready to put 2020 behind you.

Just sayin'...it's Christmas

 Do you remember the little Maple tree behind my clinic? I’ve written about it several times. It’s the one that was planted when we built the Cherokee sports complex. It must be a dwarf Maple because it really hasn’t gotten very big. 

It sits beside where I park. I like to wax philosophically based on the condition of that tree. In spring, when it buds, I think about life renewed. In full leaf, it bursts with life. My favorite is the fall when it turns yellow. Brilliant, vibrant yellow.

Right now, my little tree has lost most of its leaves. There are a few dull yellow leaves on the bottom but it’s mostly bare. Winter is arriving.

I told you about the passing of my friend Rat last week and it would be easy for me to muse on the winter of our lives. The week before that I told you about my last MHS football game so it might be easy for me to get all melancholy on you.

But that’s not me. I love life. I love what I do. My 67 year old self spent an afternoon this week bombing down mountain bike trails with a 70 year old friend and I defy anyone to guess our ages by how we ride.

On Monday, I celebrated 43 years working as a physical therapist. It’s still the best gig in town. And despite rumors to the contrary, I’m not retiring. Not yet, anyway. One day. Maybe.

At the end of the day, when I go home and my wife greets me with “Joesie!” my life is complete. And when a grandchild does the same or use my other grandfather moniker Daddy Joe…well, it doesn’t get any better than that.

So in the spirit of reflection and meditations on life, here are my Christmas words for you. Not advice. Not wishes. Just my thoughts.

Live the life you love. Don’t work just to pay the bills and get to the day when you can finally retire. Things don’t matter. Yes, money matters when you don’t have enough but I can honestly say I’ve never worked for money.

If you play a sport, put everything that you’ve got into it. Don’t let anyone outwork you. If you’re not passionate about it, find something else. It can be one of the most rewarding things you’ll ever do with life lessons that can permeate everything you ever do.

When I played, I was a pretty good football player. Later, I played a lot of basketball and I got pretty good at that too. I’m pretty decent on the bicycle these days. But don’t mistake me for a good athlete. I’m not. I was not. I’ve never been.

By working hard, being persistent as all get out, and never quitting, I became good at those things. Anybody can do the same. I’m absolute proof of that. And I did learn those life lessons from sports that have served me well for a very long time.

In school, never accept anything but your absolute best. My only distinction in high school was that I was the smartest football player. Academics meant little to me. Yet, along the way, I discovered that I was smarter than they had told me that I was. After that, the sky was the limit.

Seek out people that support you and support your dreams. I was told “you can’t do that” so many times that eventually I just removed it from my lexicon. If you’re around positive people, you can’t help but be positive yourself. Same thing about negative people. It’s hard to be happy around Eeyore.

Wake up every morning and take assessment of all the good things in your life. Think about all the opportunities for changing your world and then go take advantage of them. If you’re looking for them, they’ll be there.

Live happy. Live full. Live blessed.

RIP Rat

His name was Rat. I did a column years ago about him and I had to call and ask him what his given name was. He told me George Long but that no one knew him by that. I don’t know when he became Rat, but I’ve never known him as anything else.

He died last weekend from Covid. Let me tell you about my friend Rat. He would do anything for anybody. He loved people and he loved life. His smile was contagious. And he loved riding bicycles.

I first met him maybe 20 years ago while riding in the Tour de Blount. I saw this biker sitting under a tree next to the parking lot of Cedar Grove Baptist Church on Nails Creek Road. For some reason, I will always remember the spot where I first met the Rat.

He appeared to be having some difficulty so I pulled in to check on him. He had just started biking and had succumbed to heat and humidity. The Tour de Blount was his first big ride and he was struggling a bit. He was OK, just needing a break and some fluids, so I went on my way.

Over the next few years, we became great friends because of our common love of bicycling and (more importantly) of bicyclists.  We spent many hours biking together, climbing The Wall on Montvale Road many times and covering thousands of miles around rural Blount County.

And we rode year round. On one particularly cold winter morning, I remember Rat and I checking out the icy slush in our water bottles. As he got older, Rat dropped out of our regular Saturday rides and then switched to a bit slower group on the weekly Cycology rides. A wonderful friend named Jackie Taylor took Rat under her wing about that time and made sure he was safe.

Once there was a local guy whose bicycle, his only means of transportation, was destroyed in a collision with a car. Rat bought him a new bike. When he heard of a kid in East Knox County that needed a bike, a kid none of us knew, Rat bought him a bike.

When I admired the bike rack in the back of his truck, he found my truck parked at Coulter’s Bridge, measured the truck bed, and the next thing I know I’ve got a new bike rack in the back of my truck. When I traded trucks, he built another to fit the larger bed. When there was a fundraiser, Rat was there with a checkbook. He would literally give you the shirt off his back.

For his 80^th birthday, there was a large group of riders that met and rode from the bike shop to Elkmont where his family had prepared a party for all. Rat, Jackie, and a few others rode from Townsend to Elkmont, a respectable distance for anybody. But remember, Rat was 80.

He was incredibly fit for a man of 80 and although he had a few health problems, he was definitely a tough bird. But this Covid thing doesn’t pay any attention to all that. It strikes indiscriminately and sometimes viciously.

For those of you that think that this Covid virus was going to take only those that were weak and frail, shame on you. For those of you that think that Covid isn’t really more dangerous than the flu, how dumb can you be?

It took my healthy friend before his time. It snuffed a life that knew only love and giving. It killed a truly good man.

Wear that mask. Wash your hands. Keep your distance. Don’t deny the possibilities if you feel sick. Protect others. People like Rat don’t need your virus.

Rest in Peace Rat.

My Last MHS Football Game

In a perfect world, I would be celebrating another MHS football state championship this morning. Alas, we ran into a buzzsaw in the semifinals and the season came to a sudden end.

Still, it was a great season and I’m honored to have served this team as their athletic trainer and sports physical therapist. I’m especially proud of this group of young men. If you had told me when this senior class was freshmen that they would lead us to the success we’ve had this year, I would have doubted you.

But if I’ve learned anything from MHS football through the years, I’ve learned to never underestimate them. In 2000, we started the season 0-4. There was talk of a moving van showing up at Coach Quarles’ house. We won the next 11 in a row including the state championship game.

In 2001, we replaced 16 starters from the year before. Rebuilding year? Nah. Another state championship. This year, we replaced 17 starters. Reloading? Obviously!

I’ve now been a part of the MHS football program for 39 seasons. My first game was in 1982 when Dr. Bob Haralson asked me to cover for him. Here’s what I remember from that game--Maryville’s best player came to me during halftime saying that he had hurt his jaw.

I examined him and decided that he had actually broken his jaw. Obviously, that’s not an injury that you can play through. When I told him that, he said that he had played the first half with it so he was OK to play the second half. It seems that he had been punched at school that day, breaking his jaw on both sides. He hadn’t told anybody about it.

But here’s what I remember most…MHS Head Football Coach Don Story looked at me, a complete stranger at that time, and asked if he should play. I said no. Coach Story turned to the player (remember, he had played the first half with a broken jaw) and said “go put your clothes on.” The fact that Coach Story trusted me and supported my decision made a lasting impression on me. To this day, he is one of my heroes.

Through the 80’s, I didn’t just cover Maryville—I covered all our local schools. Most days during football season, I would leave my office, head first to Heritage, then to Alcoa, drop by Maryville, and finish at William Blount. If Coach Bill Satterfield at Greenback had somebody for me to check, I would head that way. Sharon Wood of Maryville College would help out on Friday night but I would usually end up at the biggest game, especially if it was between two county teams.

In the early 90’s, we began adding Athletic Trainers and eventually got to where we had an Athletic Trainer at each school. Tracy Martin at William Blount. Terry Byrd at Heritage. Peggy Bratt at Alcoa. That’s when I was able to focus on just Maryville High.

By the time my son was playing, I was covering only sports at Maryville. It was a great pleasure being on the sidelines with my son in 1997 and 1998 when they competed and then won the first of the current string of state championships.

I’ve been a part of a lot of incredible teams and memorable games but it’s over. The semifinal game was my last game on the sidelines of MHS. Athletic Trainers David Ivens and Amanda Cagle are now in charge.

It’s time. Football takes such a huge amount of time. My wife has put up with this for 40 years and she and my grandchildren deserve more of my time.

Thank you for all the coaches that have made me a part of the staff. Thank you to all the players that have been a part of my life for so long. Thank you to all the student trainers that have kept me young. A huge thank you to the parents of my athletes that have trusted me to take care of their kids. The greatest compliment I’ve ever received may be the oft repeated comment that “I feel better knowing that you are there for my child.”

Oh, and by the way, I’m not going away completely. I’m not retiring, I’m just giving up MHS football—you can still find me every day at Total-Rehab at Cherokee seeing patients and doing what I do. And if you need me, I’m easy to find.