I Used To Play Basketball

I used to play basketball.

Yeah, I know...a lot of you used to play basketball.  But I played up until a couple of months ago and I'm 59 years old.

I love to play basketball.  For most of my life, I've been what some folks call a "gym rat."

I would play basketball any day, any time.  Indoors or out.  Half court, full court, it didn't matter.  I had a standing game at noon on Tuesday and Thursday for 25+ years and a traditional holiday game that dates back to when my children could barely walk.

At 40, I remember thinking "how cool would it be to still be playing at 50."

At 50, I thought that it would be great if I could just play until I was 55.

At 55, I decided that I would just play until I couldn't play anymore.

I love to play basketball so much that for years, it has been how I go to sleep at night.  I would imagine myself in a game, cross-over dribble, jump shot, nothing but net.

Fake right, pass to open man for easy lay-up.  Jab step, 3-pointer.  Drop step and leave 'em standing.   And I never miss.

Somehow, it relaxed me, took my mind off the day's events.   Next thing I knew (or didn't know), I was asleep.

But I don't play anymore.  Back in the early fall, I was having some stomach problems that forced me to be off ibuprofen for 3 months.  Vitamin-I (ibuprofen) was my friend.

The net result was that without ibuprofen, my joints hurt.  Lots of 'em.  Mainly when I played basketball.

So being the mathematician that I am, I figured basketball+no ibuprofen=pain therefore no basketball=no pain (and you thought that Algebra was worthless).

So I made the agonizing decision to give up the game that I love.   Besides, that joint pain was interfering with my bike riding.

I ask my patients all the time to make smart decisions.   Sometimes, it's little changes.

Sometimes, it's big ones.

Habits, activities, hobbies, the things we love are hard to give up.  

In some cases, we simply need to find a better way to do the same thing.  Like flattening your back and bending your knees to pick something up off the floor.

Or instead of setting your briefcase into the back floorboard by lifting it over the seat, you get out of your vehicle to do it. 

Tennis elbow can often be fixed by adjusting your stroke mechanics.  Golf elbow by adjusting your swing.

Back pain or hand numbness on a bicycle?  You need your seat adjusted and a bike fit performed by a pro.

Shin splints from running?  You probably need better arch support.

Shoulder pain from throwing?  It might be that you need better strength on the back of your shoulder.

But sometimes you just need to avoid the offending activity.

For me, it meant that I just needed to eliminate the jumping and cutting, the constant pounding on my knees that basketball produced.

 I will miss it but my body was sending me clear messages.  Messages that my brain just couldn't ignore.

  My advice for the day?  Sometimes (most times), you've just got to listen to your body.

Dads and Daughters

I'm going to talk about Dads and Daughters today.  Dads and sons are important and having a son has been one of the great privileges of my life.  But we have a real need in the world today for better relationships between fathers and daughters.  So here goes.

Remember  Dad, you're the first man your daughter ever loves and nothing can ever change that.  You might think you want a little boy first but when that first one is born and it's a girl, trust me, you'll be fine.

I remember everything about the birth of my first child, a little girl.  With her first breath, she owned me--had me wrapped around her little finger.  And still does.

My daughter was everything I could ever have wanted.   She loved me even though I really had no clue what I was doing.

She loved doing whatever I loved doing.   She tolerated me when I sometimes gave her reasons not to.  She was my shadow, willing to go anywhere with me.

She played sports when it might not have been fun.   She learned to love my hikes and camping trips when that might not have been her favorite thing to do.

She was perfect in every way.  And nothing has changed.

In middle school, she let me be a part of her life at a time when hanging around with your dad might not have been so cool.

In high school, she sought her own way and became her own person and that was wonderful.

In college, she applied herself fully and immersed herself into the college experience, becoming a scholar and a star athlete along the way.

She's tall and fit and moves with a grace and even at times with a little swagger that I could watch all day. She's smart and a good mom and has done some things lately that I find heroic (she'll just have to tell you about that).

I don't understand not being wholly devoted to your children, regardless of their gender.  I know of one grandad who has a distinct and easily observed preference for the boy-grandchild, even neglecting the girl-grandchild.   Maybe he never had a girl.

Dads, take care of your daughters.  Love them, honor them, protect them, cherish them.

Play ball with them.  They won't break.  In fact, it's just as important (if not more so) for you to run and hit and throw with your daughter as it is with your son. 

Tell her how beautiful she is.  I don't tell my daughter often enough.  I hope she knows it.

Dad, love her and she'll love you like no other.  And then one day she will fall in love with the new most important man in her life and that's OK too.

Happy Father's Day to me. 

Enjoy your summer but be smart about it

It might not officially be summer yet but we've had enough hot days that it sure seems like it's already here. So let me take this warm weather opportunity to share some basic summertime facts with you.

First, hot weather should be taken seriously.  People die from this stuff.  Heat-related illness kills over 400 people in the United States every year.

Know the signs of heat-related problems.  A red face, lots of sweating, and labored breathing are all signs of heat stress.  There may not be a problem yet but it's definitely time to be watching out.

If that same person becomes dizzy, lethargic, or confused--you have a problem.  Get them cool in a hurry.  Immersing them in cold water is the best first aid.  If that's not available then anything you can do to cool them off is good.

Ice packs, wet towels, and shade are all important.  Moving air helps.

If they stop sweating, you have a medical emergency on your hands.  Call 911 and tell them to please hurry.

If it's an option, plan your outdoor activities around the times of day that are cooler.  If that's not an option, wear loose fitting, light-colored clothing.  And drink lots of fluids--sports drinks if you're going to be outside for more than hour.  Water is OK if your time outside is going to be short.

Acclimatization is hugely important.  You just can't go from being in air-conditioning 24/7 to exercising in the heat without expecting problems.  If you really want to enable your body to exercise or play in the heat, then you might even consider turning off the air-conditioner altogether.

Back in my day as a football player (yes, another old fogey moment is upon us), we had far fewer heat-related issues.  We also had far fewer air-conditioners.

Those two are definitely connected.  I remember well the first car we had that had an air-conditioner and the only air-conditioner in our home for most of my growing up years was a small window unit in my parents' bedroom so my dad could sleep during the day when he worked all night.

We also didn't drink much and we now know how stupid that was.

With the sun closer to the earth (after all, that's what makes it summer), we also need to be aware of damage to our skin.  Always remember that sunburn is bad so do whatever it takes to avoid getting sunburned.

If you're going to apply sunscreen and then go exercise, do it early and make sure it's the type not affected by sweating.  And even then, stop, dry off, and re-apply every couple of hours. 

Pay particular attention to those high exposure areas like your nose, neck, and the tips of your ears.  I use the highest SPF I can find on those areas.

Sunburn leads to skin cancer which, if untreated, can lead to other, deadly cancers. 

Too much tanning leads to skin damage which leads to early aging.  Yes, I know I'm perpetually tanned but that's due to being outdoors too much but that's my job and my hobbies and my yard.

And don't forget your eyes.  Sunglasses in the bright sun are always a good idea.  And hats.  Hats are always good (visors help but not if you've got a donut hole--and if you're old enough and male, you know what I'm talking about). 

Enjoy your summer but be smart about it.

Exercise for everyone

A physical therapist buddy of mine just recently coached his 240 pound banker through a bike ride that would challenge any of us.   He rode alongside him, encouraging him all along the way, and although it took the two of them a bit long to get there (5 hours and 15 minutes to go 50 miles and climb 5000 feet), there really aren't too many fit/slim people that could make that one.

The photograph of this guy crossing the finish line is awesome.  And it got me to thinking:  There's got to be room for exercising at all levels.

I'm really proud of our local Cherokee CrossFit team that did great in the Regional CrossFit Games, and those individuals are probably the most fit people in our community, but there's got to be a place for everybody else.

 I'm fit but I'm not in their league.

 I do exercise daily but I'm probably not real normal (I just heard my wife say Amen).    I HAVE to exercise.  It's like breathing and eating to me.   Oh, there are days when I'll take a rest day because I've beat my body down but otherwise it's every day, year-round.

If I come across as self-righteous, I'm not.   It just isn't in me not to exercise.  If I come across as hard core, well, yes I am.   But that's what works for me.  It might not work for you.

Regular exercise is an important part of being healthy.  Yet, there has to be a place for that person that really doesn't want to exercise every day.

There has to be a place for that person that prefers a much more casual approach to their exercise program than a 70 mile bike ride, a 10 mile run, or 100 burpees  (trust me, that last one is definitely not for everyone).

You do need to do it right.  I can tell you that there is a lot that I see that just doesn't work.   Sitting on a stationary bicycle, casually pedaling while reading a book probably isn't going to make you fit.   There is a better way of strength training than biceps curls and bench presses.

But the person that is out there regularly, walking to the point of breathing hard, exercising to the point that their heart rate is elevated, has to be respected.  There has to be a place for that person.

My advice if you want to get serious about it?  Seek professional help in the form of a personal trainer that comes recommended by people you trust and who happens to not be the most muscular person in the gym. 

If that personal trainer spends more time trying to impress you with what they know instead of trying to find out where you want to go...well, just say "no thank you" and walk right out the door. 

Whatever you do, find what works for you.  

Mellow? Not me!

I've mentioned before that I get a lot of ideas for this space from my pastor.   I also occasionally get one from the lady that cuts my hair. 

Last week, she mentioned that I had grown "mellow" in my column.   I didn't really see that one coming.  Mellow?  Me?  

Well, she knows me pretty well.  Heck, she's been cutting my hair for almost 30 years.   I tell her all the time that it's up to her to make a silk purse out of a sow's ear.   I don't really think she does that but I can at least blame the gray on her regular intervention (not really).

Anyway, she said that yes, I had mellowed, but that was a good thing.  People of a certain age (my age and older), have choices:  they can become grumpy old men or they can be happy little grandfathers.

OK.  I can live with that.  

Still, I want there to be a little edge to what I preach.  I want to challenge folks to make better choices; in life, in health, and in how they relate to other people.

I want you to take responsibility for your actions.   I want to discourage you from blaming someone else for the mistakes that you made.  

I still haven't gotten over someone else being responsible for you spilling hot coffee in your lap.   And that I have to take my shoes off when I go through airport security simply because one person tried to set off a shoe bomb (although I will never argue with anything those folks do to make flying safer--it's just that one seems almost humorous--millions of people have to take their shoes off because of one crazy guy)?

I want to end hunger, homelessness, and child abuse.   I don't even like to use the term "wife-beater" to describe that sleeveless t-shirt because that phrase is so abhorrent to me.  

I want to end obesity, particularly in our children and if no one is smoking, well, that would be just fine with me.  I think everyone should practice preventive health care because it is the best tool we have for solving the health care crisis.  

I want us to raise our children to be wonderful, loving, responsible adults and in turn help shape our grandchildren in the same way.  I think I have some ideas how to do that and I occasionally share those ideas with you.

In the past couple of years, I've even let politics creep into this space, despite being told by folks much wiser than me to never go there.   I just want us to all get along and that seems especially important (and glaringly absent) in the political arena.   We seem to penalize those that reach across the aisle to communicate and corroborate in order to get things done.   I'm sorry but that is exactly how the government gets things done.

Politics have become so incredibly partisan partly because we have become so incredibly partisan.  There's too much "if you disagree with me, then you're wrong."   There's not only two sides to every issue but there is often "more than one way to skin a cat" (whoops--is that a cliché?---sorry).

I do want to be an instrument for change but not at the price of being just plain ol' unpleasant to be around.  I guess you can be grumpy or you can be happy.  It's mostly a choice. 

Mellow?  Nah...more like an iceberg, where there's a whole lot more that you don't see than what you see.

Getting all the cliche's out of my system

I actually find cliché's interesting.  I gather cliché's throughout the year but try and keep them out of my column.   But then they start tumbling out of me like a spring waterfall. 

So here you have my sort-of-annual "cliché" column.  Maybe it's an attempt to purge them from my system.

A penny saved is a penny earned.   My dad used to say "pass a penny, pick it up, all the day you'll have good luck."  I don't think that's a cliché but today it seems that a penny is so devalued that it hardly seems the effort.  

I think the practice of saving money, whether it be a penny or a dollar, is good fiscal policy.   Something we should all do.  Are you teaching your kids the importance of saving?

And I must add that through the years I've seen lots of folks with back problems that started with bending over to pick up something, maybe even a penny on the ground.   My advice is that you need to use good body mechanics (bend your legs, flatten your back) regardless of what you're lifting.

"Take it one game at a time."  We hear this one from coaches all the time.  Basically it's sound advice that we should never take any opponent for granted.  But most successful coaches look at the entire season and "looking at the big picture" works.  Like in basketball.  You can oh-fer during the regular season but catch fire in the playoffs and win championships.

"The truth hurts."  Does it?  Really?  I guess it can but in the long run, it sure doesn't seem to work out.  I think it was my mom that always used to say "be sure your sins will find you out."  Lies tend to compound themselves.  You tell one then you have to tell another to cover it up.  "Honesty is the best policy" really applies.  But "if the truth hurts, maybe it should."

"You can't judge a book by its cover."  This one is meant to tell you that you can't let appearances tell you the nature of someone's character--who they really are.   I don't know...I'm a firm believer that first impressions are important.   Maybe the secret is to always make a good first impression.

"The early bird gets the worm."  It might depend on what worm you really want.   Nightcrawlers might only come out at night.   I definitely prefer to get up and get my day started but I'm sure not after worms.  Maybe "early to bed, early to rise, makes a man healthy, wealthy, and wise."  The only problem is that I've never been one to go to bed early either. 

"Better to be late than never."   I tend to be early for everything.   I don't tolerate being late at all.  I get to airports 2 hours when they recommend an hour.   But never?  OK, maybe late is better than that.

"You can't save someone from themselves."   Yeah, but you should try.

"You can't be too rich or too skinny."   I always wanted to try that too rich part but it isn't likely to happen.  I could win the lottery but I suspect you have to buy a ticket to win it and I don't really go there.  

As for being too skinny, well yes you can.   Eating disorders are real and they are dangerous.   Obesity may kill you slowly but skinny can kill you quick.  Maybe I just created my own cliché.

"Life isn't fair."   Oh I think life is plenty fair.   I wouldn't want to live a life where I got what I deserved. Sometimes you get what you need, not what you want (wouldn't that make a good song?).

 "Wherever you are,  be there."  I can do that.   And not even be existential about it.

Old Dog/New Tricks

You've probably heard the old adage "you can't teach an old dog new tricks."  Well, I'm definitely the old dog (or on the verge of being one) and I would hate to think I'm finished learning new tricks.

I'm much more likely to buy into the idea that "if you're not moving forward, you're getting behind."  I still haven't learned to fly an airplane or speak a foreign language but there's always tomorrow.  

I just got back from a really intense, really great learning experience.  In my twin worlds of physical therapy and athletic training, we call it continuing education and it is important.

Because if you aren't paying attention to new information, current research, and emerging concepts, you will indeed get behind in a hurry.

When I graduated from physical therapy school in what my kids see as the Dark Ages (yes, it was a long time ago but we weren't using charcoal on a slate, for crying out loud), we were treating most back problems with passive modalities like heat and ultrasound and a set of exercises called "Williams Flexion Exercises."

We now know that stuff doesn't really work for most back problems.  Research has long since taught us that ice is almost always preferable to heat and I'm here to tell you that if your back care doesn't focus on a wide range of exercises you might ought to look elsewhere for your care.

Anyway, ongoing research keeps us looking critically at the way we are doing things.  What we know with certainty today may be improved on or disproved tomorrow.  So you gotta pay attention. That's why this meeting I attended was so good (OK, it was in a pretty spot too, but that's beside the point).

Basically, thirty  of us, almost all both physical therapists and athletic trainers and from all around the world, meet every summer to argue and discuss for two days.  The critical process and open forum prompt innovative thinking from which new ideas emerge.  

So what does that mean to you?  Hopefully those ideas yield useful evaluation and treatment concepts that change for the better the way we do rehabilitation.  I know that I will be sharing many of those ideas with my colleagues in the clinic.  I can also tell you that flat feet can be a factor in everything from plantar fasciitis to shin splints to kneecap (patellar) problems to ACL tears.

That hamstring injuries are hard to get over (but you may know that already) and  that we need to be patient and thorough with them because they tend to return.  We also have improved treatment concepts that should help considerably.

And that far too many female athletes are missing important nutrients in their diet.  If there is a major food group that you are excluding from what you eat, you may be jeopardizing your health.

Yep, I'm proof positive that old dogs can learn new tricks.  And if they can't...well, they might as well stay under the porch.