Every day: back pain

It has been estimated that 80% of adults have an episode of significant low back pain in their lifetime. If you think you are in that 20% that hasn’t, then you better be doing everything you can to protect your back—the odds are stacked against you.

I suppose everyone that lives long enough will have some sort of back pain. I think I’m in that 20% but I’ve had an achy back from time to time, mostly when I’ve overdone it.

I had one of those man-on-the-street encounters last week that my wife has learned to tolerate as part of being my wife of over 47 years. We were in this fellow’s place of business when he asked if I had any advice for him in dealing with his back pain.

More specifically, he asked me if there were any stretches that he could do to help his back. I have no idea how many times I’ve been asked that exact question.

It doesn’t matter what body part it is, a lot folks think that the only physical therapy strategy for dealing with their physical complaints lies in a couple of stretching exercises.

Back to this guy—he’s a super nice guy who works too much. And part of his job is lifting heavy objects from time to time. So we chatted about how his pain behaves and what he has done in the past to control it—that sort of thing. Back to him in a minute.

I get stopped a lot and usually the conversation starts with “I know you must get tired of people asking you about their complaints, but…”

As soon as I can get a word in edgewise, I assure them that I don’t mind at all. I’m flattered that anyone wants my opinion at all (except maybe about religion and politics—two things I avoid discussing) but especially about their health.

My wife long ago figured out that this was part of makes me me. I’m still doing this stuff well into my senior years (I’ve been a physical therapist for 46 years now) because I love it. And most of that is helping people. It’s also part of what makes a physical therapist a physical therapist.

Anyway, it is rarely about stretching. Sure, tight joints and muscles can be a part of the problem but that is rarely the basis of the problem. For this fellow, his biggest problem is his core strength. That’s just not something many people pay much attention to.

What happens is that our life gets in the way of regular exercise and then we help our neighbor move or stack firewood or something else that we don’t do regularly and the next thing you know--BAM!--back pain.

My first aid formula for most injuries is the same. Ice and ibuprofen. Most of the time, it pays to keep moving. Curled up in a hot tub or bedrest and doing nothing is rarely a good idea.

To know what to do next, the best thing is to consult a spinal care expert, like a physical therapist. But that option is not always available. The best advice that I can give if that’s the case is to keep moving.

To prevent it from happening, you’ve got to develop good core strength and learn good body mechanics. Plank. Bird dog. Cat and Cow. Have someone that knows what they’re doing to watch your lifting techniques.

Lift weights. Stay in shape. Lose weight if you need to. Take the stairs. Park at the outer edge of the parking lot.

Above all else, keep moving.

ALS

 

ALS, or Amyotrophic Lateral Sclerosis, is also known as Lou Gherig’s Disease. ALS is not really a disease, but a progressive degenerative disorder of the nerves in the brain and spinal cord.

Lou Gherig was known as the Iron Horse of baseball, having played in 2,130 consecutive baseball games. When he was diagnosed in 1939, little was known about ALS.

On July 4^th, 1939, Gherig gave a speech that is one of the most memorable sports speeches in the history of sports. Knowing that he was going to die (he lived two more years) and knowing the horrors of ALS, he stood at home plate in Yankee Stadium and uttered the following words:

“For the past two weeks, you have been reading about a bad break. Yet today I consider myself the luckiest man on the face of the earth.”

For a small percentage (maybe 10%), it can be a genetic mutation. For those, it is known as Familial ALS. But for 90% of those that get ALS, there is no known reason. It hits men slightly more than women and onset falls into the range of 40-70 years of age.

ALS often starts in the hands and feet, with tingling and burning progressing to include weakness in the arms and legs. As it progresses, it encompasses any and all muscles, including the muscles used for swallowing, talking, and breathing. Cognitive functioning remains intact in most cases, which means that the person is fully aware of what is happening to their body.

ALS is not considered a sports injury, but there does appear to be a higher incidence of ALS in military veterans and athletes, particularly football players.

There is no cure for it. It is a devastating disorder, slowly robbing the person of all control.

No one knows why it affects one group more than others, but there are some similarities in combat veterans and football players. It has been speculated that repeated trauma might make a person more likely to get ALS, but we really have no idea about that. Life expectancy is 2-5 years and ALS progresses at different rates for different people.

In other words, we just don’t know much about it. But research is ongoing and hopefully a cure will be found one day. It’s an ugly, nasty disorder that slowly robs the person of their body.

Last week, I mentioned the best football player I ever played with. A gifted athlete at whatever he did, he was especially good at football. He was most definitely a “natural,” but he coupled that with a strong work ethic to become the best of the best.

On offense, give him the football and watch him go. On defense, he was one of those players that was always around the ball. We used to say people like that “have a nose for the football.” He definitely had that.

Maryville native and football coaching legend Ollie Keller recruited him to play at Memphis State but circumstances prevented that from happening. I have no doubt that he would have been a college star and maybe a career NFL player. He was really that good.

His name is J.L. Millsaps and he had ALS. He died this weekend.  In his last days, he could hardly move his once strong body. He spoke only in a whisper and was rarely able to even open his eyes. He knew the end was near, yet, his spirit and his faith remained rock solid. RIP JL.

 

Living Vicariously

 

Everybody wants their kid to be the star of the team. Everybody wants to be on the winning team. It’s just human nature. Everybody, meaning parents.

Interestingly, kids don’t think the same way. Oh, if you ask them what they want to do when they grow up, a fair number of them will say that they want to be a professional athlete in one sport or more.

But if you really dig into it, you will find that they just want to have fun and be with their friends. No doubt, winning is important to them but boiled down to its essence, they want to enjoy their sports.

You have no doubt heard about parents living “vicariously” through their kids. The earth may shake and the dead may roll over, but I’m here to tell you that isn’t always a bad thing.

I have seen a lot of parents who either were never athletes themselves or never had the opportunity to be an athlete. I remember one local athlete that was phenomenal, but when you look at her parents, you wonder how that could have happened.

Neither of them had an athletic bone in their body. But their daughter sure did.  Sometimes those things happen. I’m sure those parents enjoyed their daughter’s success.

Then there are the folks that didn’t have the opportunity. A lot of that is economic. Some kids have to hold down jobs to help the family. My dad dropped out of school after the 6^th grade when his own father died. He went to work in a hosiery mill and never went back to school.

Think about that. He was 11, maybe 12 years old, and already working in a factory alongside adults. His family needed that to survive. Child labor laws would prohibit that from happening these days, but you won’t have to go far to find a family that depends on the income from their 16 year old’s job.

I remember one young very promising athlete. He played three sports until he turned 16. Then he got a job and never played sports again. He had an old truck but his family couldn’t afford the insurance on it so he got a fast food job so he could drive and help transport his siblings.

It was sad really. Unfortunately, if you look at the high cost of participating in some sports, you will see that it can be cost prohibitive. If you want to be competitive, it seems like you need to take private lessons, work with a personal trainer, travel all around the country, and dedicate pretty much all of your spare time to it.

Golf and tennis come to mind immediately. Volleyball and basketball aren’t far behind. It is just more than some families can afford.

There are exceptions. In football, pretty much all of the equipment is provided. And in running, for the most part you just go run.

I will still insist that there is a place for just going out and playing, without all the “extra” stuff.  Some of the best basketball players I ever knew just played. You could always find them on a court somewhere. They were always in the gym shooting. Before school. After school. In their driveway.

The best football player that I ever played with didn’t play until high school, rarely lifted weights, wouldn’t know a personal trainer if one was standing in front of him, and didn’t need much in the way of coaching. He was a linebacker and all you had to do was tell him to go tackle the one with the ball.

I have to believe that if you are talented and work hard, good things will happen. Back when I played a little softball, the best player that I knew could throw a wicked curve with a softball. No one ever taught him how to throw a curve.

So, if you can’t do all those extracurricular things, don’t give up. Work hard and follow your dreams. And if those dreams are your parents’ dreams as well, so be it. Let them enjoy what you do. Let them live a bit through what you do. It’s OK.

Garbage in, garbage out: Sports Performance!

 

You’ve probably heard the nutritional advice “garbage in, garbage out.” If you’re really interested in athletic performance, you will pay attention to that.

For that matter, if you’re really interested in good health, you will heed that advice. But, you might ask, “what is garbage” when it comes to what you eat?

It’s easy to jump on the fast food companies in this category but with a little effort, you can eat decent at fast food places. Look for those places that have grilled offerings. You do have to pay attention to the sodium content in a lot of fast foods but there are possibilities out there.

A lot of places provide customers with a list of ingredients and nutritional value on their menu. Several years ago, an attempt was made to require that, but somehow that set of information was squashed.

The hidden salt and sugar in a lot of restaurant items and condiments is absurdly high. And that’s coming from a condiment guy. I love my condiments. I share a genuine love of ketchup with one of my grandsons. He wants it on everything.

Salt, sugar, and flour. If what you’re eating is high in any of those three, you probably qualify for the “garbage in” category. Don’t get me wrong, it’s impossible to avoid all three and I don’t. Moderation is the most we can ask for, most of the time.

I do believe that food is there to enjoy. Big Ed’s pizza. Zaxby’s chicken strips. What my wife cooked for Thanksgiving. A burger from Smalltown BBQ. I do have my weaknesses. Anything from the Italian Apron.

But for the most part, I eat smart. Vegetables. Fruits. Lean meats. I go to the grocery store and look for items with only one name. Asparagus. Carrots. Chicken. Bananas. Bacon (OK, I guess that last one was wishful thinking).

Athletes too often neglect the nutritional aspect of training. On one stint working at the Olympic Training Center in Colorado Springs, I was amazed at the volume of food many of the athletes consumed. Mass quantities of mostly healthy food to replace the incredible amount of calories they were burning off in training.

Most athletes aren’t working that hard. Most tend to respond to hunger by eating anything that won’t move. What they’re missing is that what they eat is the fuel for their performance.

Athletes need a balance of protein, complex carbohydrates, and fat. We ignored the fat part for a long time, thinking that all fats were bad. Fats are essential but they have to be good fats. That means avocados, not French fries. 

No one diet is the best for every athlete. You either have to be open to learning on your own (which takes a lot of trial and error) or seek the advice of a nutritionist. What we do know is that the right food can help you compete and to train (we often forget that part).

A pre-game meal used to be whatever you had available. Now, a lot of teams have organized pre-game meals so that their athletes get lean meats, vegetables, and some carbs. Eating a light snack right up to game time works for a lot of people. You can’t run on an empty tank.

Food at halftime used to be taboo. We now know that it is important. Eating a high glycogen meal soon after competing or a hard training session is also important to give you the energy to go again the following day.

You have to find what works for you but it’s safe to say that the burger and fries is not your best option.

You Might Be 70...

 

As I’ve said before, I get ideas for this space from a variety of places.  As my wife pointed out, I got a little too historical last week. She suggested I leave that to Christy Martin, who writes a regular column (and whose writing I look forward to).

A former educator, she is a walking library of Blount County history. I’m not from here but I’ve been here 44 years and definitely have a appreciation for the history of the area.

My point last week was to encourage everyone to get outside and partake! Hike, bike, walk, paddle—whatever. Exercise, history, and culture are available around every corner. There’s a ton of history in tiny Jarvis Park.

This morning, a patient made a comment that has put me off on one of the wildest tangents of my tangent-filled life. Maybe the reason I keep coming up with ideas for this space is that my brain travels wildly.

I blame part of that on growing up with the Encyclopedia Britannica. Those vast volumes were my travel agent, my historical perspective, my window to a world I thought I would never know. I read them with the passion and fervor that I do now with any new John Grisham novel.

A little background, amid all this rambling. I’ve told the story before about how important Boy Scouts were to me. I remember well one Scout leader that had a little knife and could carve the most wonderful of things out of any block of wood.

I was fascinated by it and made many meager attempts at duplicating his work through the years. I was particularly fond of his ball inside a cage and his chain links. It became what I did to occupy times on backpacking and canoeing trips.

I’m not very good at it but I do like to do it and when I told this patient/friend about it, he made the comment “you know, if you’ve taken up whittling, you might be 70!”

Well, uh, yeah. I’m 70 now (although it still doesn’t feel like it). What transpired next was a typical screaming train of thought and now you get to hear all about it. With all due respect to Jeff Foxworthy, here we go

If you take up whittling, you might be 70. Ok, I’ve been whittling my whole life but that new scroll saw is opening a lot of new carving doors.

If you were your family’s remote control when you were a kid, you might be 70. And there weren’t but three channels and ABC was on channel 26 and didn’t come in very well.

If you remember using the card catalog at the library, you might be 70. These days, we just jump on the computer and libraries have become so much more than just a repository for books.

If you ever visited the airport to watch planes take off, you might be 70. We did that. Old McGhee-Tyson Airport. It was fascinating. And now I’ve flown in one enough that it’s almost like riding in a bus.

If you remember who Mr. Green Jeans was, you might be 70. And Howdy Doody. And Dudley Do-Right. Spanky and Our Gang. The Three Stooges.

If you can’t really remember the last time you literally “hopped” out of bed in the morning, you might be 70. Now you stop, stretch, make sure you have feeling in your feet, then slowly pull yourself up.

If you’ve ever bragged about your lawn mower, you might be 70. OK. Guilty. And for the record, it’s a Scag that feels like it is fast enough to compete on the NASCAR circuit.

The Meigs Line

 

I love our Smoky Mountains. Always have. I’m sure it started with my parents, who made regular trips into the Smokies.  I have early memories of those trips and photos that predate my memories.

When it came time to go through my mom’s stuff, I kept all her photos. In going through those, I found a photo that I hadn’t seen before. It was my much younger parents standing in front of their car with the Newfound Gap monument in the background.

It appears that my parents attended the dedication ceremony opening the Great Smoky Mountain National Park in 1940. They never told me that. My dad was about to head to World War II so I guess it faded into a distant memory.

I have a photo of myself when I was probably about three.  I’m standing in snow up to my waist, somewhere in the Smokies. I remember my dad would put chains on the tires of his vehicle and go anywhere.

Boys Scouts just perpetuated my love for these mountains. And when it came time to pick the place to live the rest of my life, there wasn’t but one choice. Along the way, I built a house on a high ridge out in the county with a spectacular view of my beloved mountains.

I’ve always had an interest in the history of the area.  I remember when Durwood Dunn’s book, “Cades Cove-The Life and Death of a Southern Appalachian Community 1818-1937” came out. I was fascinated. Later, I found “The Cades Cove Story” by Dr. Randolph Shields, who grove up in the Cove, graduated from Walland High and Maryville College, then later was Biology Professor at Maryville College.

 

A couple of weeks ago, in one of my columns, I mentioned the Oak trees on Big Springs Road that were part of the Hawkins-Pickens Line of 1797. These trees marked the southern boundary of America and the northern boundary of the Cherokee Nation. You may remember that the Hawkins-Pickens Line later became the Meigs Line, which runs from the Southwest Point Fortress near Kingston straight through Blount County to Meigs Mountain in the Smokies and then on into North Carolina.

How cool is that?!? I have since delved deeper into that story, first reading “Meigs Line” by Dwight McCarter and Joe Kelley, then inhaling a series of books about these mountains.

Among the other books I couldn’t put down are Horace Kephart’s “Our Southern Highlands” and Inez Burns’ “History of Blount County.” And I’m only getting started.

My point is this: There is a rich cultural heritage here, literally in our back door. Durwood Dunn pointed out that this wasn’t an area of dumb hillbillies. Indeed, it was filled with intelligent, resourceful people with integrity and ambition.

And we get to explore it. Pretty much anytime we want to. I can leave my office and be in the foothills in 10 minutes and the national park in another 15. Easy.

I don’t take advantage of it as often as I would like to. I love Cades Cove, but I don’t go there. Too many cars. I love Jarvis Park but I’ve only been there a couple of times and it could not be any more convenient. Indian Flats Falls. Messer Barn and the old Smoky Mountain Hiking Club Cabin along the Porter's Creek Trail. The Walker Sisters Cabin.

We are surrounded by so much glory and grandeur that I couldn’t list all the places on my short list in this little space. You just need to go out and check them out for yourself.

You will be healthier, happier, better adjusted, and a better partner. You have problems that are stressing you out? Go for a walk. Need to clear your head? Find a quiet spot by Little River. Life just seeming to be overwhelming? Go to the forest and be absorbed in the sights and sounds.

But here’s my best advice: Go where the people aren’t. You will figure it out.

Blue Jeans & Running Shoes

 

I love my blue jeans. Blue jeans and a t-shirt are my favorites. Alas, you don’t see me in that attire much. It just doesn’t fit with my lifestyle. Or at least not as much as I would hope it would.

At work, my uniform is khakis and a polo. Every day. (Can you say “boring?”) When I finished physical therapy school, the uniform was etched in stone. White jacket. Dark pants. Shirt with tie. To wear anything else was blasphemy.

Along the way, I abandoned the dress shoes for running shoes. Makes sense, if you think about it. Exercise and an active lifestyle are ingrained in physical therapy. Then I shed the tie and white jacket. To me, a more casual look is more compatible with the work we do of encouraging fitness and healthy choices.

When I visit Nashville for legislative purposes, it’s a suit and bow tie (a Tennessee bow tie, no less). Same for our big national physical therapy meetings. People there don’t recognize me without the bow tie.

So, where am I going with this? Have you checked out sports clothing these days? I guess it started with shoes. I believe that the shoe industry was the first to embrace technology.

There is a local fellow who is a retired UT Professor of Exercise Science, Dr. Ed Howley. At one time, Dr. Howley did research for Nike, at a time when their shoes were taking advantage of the science of running and running shoes.

When I was a teen athlete, there was one athletic shoe—canvas Converse All-Stars. You may not know it, but you’ve seen them around. Kids today have discovered those shoes and wear them all the time. They were as basic as you get and we referred to them as “tennis shoes” or “sneakers.”

About the time I was in high school, Adidas came out with running shoe that by today’s standards was pretty crude. Ronnie McNabb and I bought the first pair of those at the old Athletic House on Gay Street in Knoxville.

Along came Reebok’s aerobics shoes and some shoes made specifically for tennis, then the shoe industry seemed to explode. I remember when Michael Jordan’s basketball shoes came out. Everyone wanted them.

Now, there is a shoe for every sport and every subset of sports. For runners, you’ve got shoes for sprinting, hurdling, jumping, distance running, and everything in between. You’ve got different shoes for discus throwing, depending on which technique you use. Tennis shoes are made to be specific to the surface you’re playing on.

Somewhere along the way, hiking boots were these incredibly stiff shoes, built for rigorous trails. Those sometimes took years to break in. Now we have hiking boots based on running shoe technology that can take you most anywhere you want to go and be comfortable the minute you put them on.

When I first started rock climbing, we climbed in whatever was handy. Now there are shoes for whatever type of climbing you are doing. There seem to be shoes for everything. I can remember when, where, and who was wearing the first set of shoes made specifically for heavy weight lifting.

So how are we to know what shoe to wear? Do we need a different shoe for everything that we do?

No, not really. Most of us aren’t going to run a four minute mile so a good, basic running shoe is all we need. Maybe you need a shoe that works better for your foot or running style, but a good shoe store can help you with that. You can use that shoe every day, for every day activities.

You don’t need boots that allow you to climb Mt. Everest. I’ve seen plenty of people climb Mt. LeConte in running shoes which proves only that you just need a good pair of all-purpose hiking boots to hike almost everything around here. And I wear those to work from time to time.

My shoes supposedly made for tennis aren’t that much different than the running shoes I wear to work. You just need to look at what is comfortable and suited to your abilities.  And no prejudice intended, but if your shoe salesperson doesn’t look like they could do the activity you are buying for, maybe go someplace else.