Bob
A Wonderful 'Magical' Animal
Friday, June 27, 2014
Thursday, June 12, 2014
Camping 2014
Camping reservations this year are in Massachusetts and New Hampshire. All 5 are Lakeside.
Lake Dennison Recreation Area, Site 106, Winchendon, MA June 20 - June 24
Lake Dennison Park InfoLake Dennison 2011 or 2012 |
Lake Dennison Campsite Photo
Been coming to this place for years. North central Massachusetts location; Northern New England feel. Few miles off Route 2. Easy to get to. Nothing special about this place but we've enjoyed it. The North loop has some great waterfront sites. Nice place to canoe, kayak, fish, swim & ride bikes. Not too far from Mount Monadnock. We'll probably hike it one morning.
Smokey Stands Guard Only YOU can prevent Forest Fires! |
Myles Standish Park Info
Myles Standish SP Barrett's Pond Area Map
Haven't camped here since I was a kid. It's down toward Plymouth, not quite on the Cape. Ground is sandy. Trees are stunted growth like you see on the Cape. Booked a rare waterfront site on Barrett's Pond for the Fourth of July (Fireworks in Plymouth). Most of the ponds in the park are kettle ponds. Kettle ponds are not fed by rivers or streams but are sourced from rainwater and/or natural springs. They tend to be circular and sandy all around.
Danforth Bay 2010 |
Danforth Bay Resort Info
Danforth Bay Resort Site Map & Photos
Ah the Camping Resort. It's become a summer tradition. Same site, same week every year since 2008 (?). Kids love this place. Waterfront site on a small lake that connects to Broad Bay & Ossipee Lake. Terrific canoeing, kayaking, fishing & swimming. Heated swimming pools, live entertainment, movie lounge, snack bar, lots of activities for the kids. Electricity, Wifi, Cable TV, portable fridge. Seriously roughing it! Close to Mount Chocorua. Half way between Lake Winnepasaukee and North Conway. Supremely Awesome!
Pawtuckaway 2013 |
Pawtuckaway Park Info
Pwatuckaway Campground Map
Pawtuckaway is a popular boating lake in southern New Hampshire. They dammed a river and the lake they created is clear and has many small islands. The campground has a lot of nice waterfront sites. Canoeing, kayaking, fishing & swimming are great. Hiking too. You're about 30 minutes from Hampton Beach sun, surf & nightlife. We've been here a few years running. Waterfront Baby!
Tully Lake Campground |
Tully Lake Campground Info
Tully Lake Campground Map & Photos
Never been here before. Nature Reserve. 20-25 primitive, walk-in campsites. Extra hard to get reservations. There's a central area for cars and a bathhouse. You take trails or canoes/kayaks to your site. Supposed to be pretty great. North Central Mass off Route 2.
Most of the sites accommodate multiple tents and many people. Join us!
Tuesday, April 29, 2014
Plantar Fasciitis
Found this one in the drafts folder. Thankful not to have had plantar fasciitis in a while, but I had it in the past and it was unpleasant. It brought my running routine to a quick halt too. It's usually caused by running in improper or worn out shoes, running overweight, and/or adding too many miles too quickly. Each of the times I've experienced it, these have been the causes. Somewhere I read that you should replace your running shoes every 300-450 miles, limit your mileage increases to 10% per week, and avoid running on pavement all the time. Anyway here are some recommended treatments if you think you might have it. - CJK
Plantar fasciitis is one of the most common causes of foot pain. The plantar fascia, a thick band of tissue that runs between the heel and the toes, acts as a shock absorber for the foot. If it becomes over-stressed, it becomes inflamed and painful, especially after periods of inactivity. The area affected is usually the heel or arch.
Plantar fascia Stretches
Before You Get Out Of Bed
Step 1
While lying in bed with both legs extended in front of you, bend the left knee so that it points to the ceiling. Place your right foot on your left knee.
Step 2
Grasp your right toes with your right hand and pull the toes back toward the shin until you feel a stretch in the arch. If this position is uncomfortable, loop a towel around the base of the toes, holding an end in each hand, and pull the toes toward you. Hold for 10 seconds. Repeat for a total of 10 repetitions.
Step 3
Switch positions so your left foot is on your right knee. Pull the toes back with your left hand until you feel a stretch in the arch. Or, if necessary, use a towel to pull the toes back. Hold for 10 seconds. Repeat for a total of 10 repetitions.
Arch Rolls
Step 1
Sit in a chair with your feet flat on the floor in front of you.
Step 2
Place a tennis ball or (frozen) water bottle on the floor and roll it under your right arch until you feel the stretch.
Step 3
Repeat with the left foot. Use this sequence several times a day to relieve pain.
Wall Pushes
Step 1
Stand facing a wall, with one foot closer to the wall than the other is. The sore foot should be the one further from the wall.
Step 2
Place both hands on the wall, and bend the knee of the leg closest to the wall. Lean into the wall until you feel the heel stretch, hold for about 10 seconds and release.
Step 3
Repeat up to 20 times for each sore foot.
Counter Squats
Step 1
Face a counter top, and grasp the edge of the counter.
Step 2
Place your feet at shoulder width, and one foot in front of the other. Bend your knees and slowly squat toward the floor.
Step 3
Again, the rear foot will stretch, hold for 10 seconds and release the stretch.
Night splints (braces) may be used to treat conditions plantar fasciitis. The splint holds the foot with the toes pointed up. This position applies a constant, gentle stretch to the plantar fascia. It also stretches the Achilles tendon at the back of the heel, preventing it from contracting. You can wear night splints every night for up to several months. Then you can gradually reduce how often you use them as your symptoms go away.
The brace usually is adjustable, so you can adjust it to the proper angle. There are many types of braces. This picture shows one style.
For me, changing to running shoes with better arch support helped. Asics 2100 series were the perfect fit for me. Keeping weight off was important. And running on trails rather than roads saved both my feet and knees. I'd imagine treadmills and tracks would be better too. If you develop plantar fasciitis you need to stop running until it subsides. Continuing to run will make it worse and extend the recovery period. Follow the recommendations above, and make sure you wear shoes inside the house all the time. Going barefoot makes it worse somehow. When it goes away you can gradually resume running, hopefully after resolving whatever problem caused the problem in the first place. Probably a good idea to ice it after you run and continue with the stretches. Happy trails!
Plantar fasciitis is one of the most common causes of foot pain. The plantar fascia, a thick band of tissue that runs between the heel and the toes, acts as a shock absorber for the foot. If it becomes over-stressed, it becomes inflamed and painful, especially after periods of inactivity. The area affected is usually the heel or arch.
Plantar fascia Stretches
Before You Get Out Of Bed
Step 1
While lying in bed with both legs extended in front of you, bend the left knee so that it points to the ceiling. Place your right foot on your left knee.
Step 2
Grasp your right toes with your right hand and pull the toes back toward the shin until you feel a stretch in the arch. If this position is uncomfortable, loop a towel around the base of the toes, holding an end in each hand, and pull the toes toward you. Hold for 10 seconds. Repeat for a total of 10 repetitions.
Step 3
Switch positions so your left foot is on your right knee. Pull the toes back with your left hand until you feel a stretch in the arch. Or, if necessary, use a towel to pull the toes back. Hold for 10 seconds. Repeat for a total of 10 repetitions.
Arch Rolls
Step 1
Sit in a chair with your feet flat on the floor in front of you.
Step 2
Place a tennis ball or (frozen) water bottle on the floor and roll it under your right arch until you feel the stretch.
Step 3
Repeat with the left foot. Use this sequence several times a day to relieve pain.
Wall Pushes
Step 1
Stand facing a wall, with one foot closer to the wall than the other is. The sore foot should be the one further from the wall.
Step 2
Place both hands on the wall, and bend the knee of the leg closest to the wall. Lean into the wall until you feel the heel stretch, hold for about 10 seconds and release.
Step 3
Repeat up to 20 times for each sore foot.
Counter Squats
Step 1
Face a counter top, and grasp the edge of the counter.
Step 2
Place your feet at shoulder width, and one foot in front of the other. Bend your knees and slowly squat toward the floor.
Step 3
Again, the rear foot will stretch, hold for 10 seconds and release the stretch.
Night splints (braces) may be used to treat conditions plantar fasciitis. The splint holds the foot with the toes pointed up. This position applies a constant, gentle stretch to the plantar fascia. It also stretches the Achilles tendon at the back of the heel, preventing it from contracting. You can wear night splints every night for up to several months. Then you can gradually reduce how often you use them as your symptoms go away.
The brace usually is adjustable, so you can adjust it to the proper angle. There are many types of braces. This picture shows one style.
For me, changing to running shoes with better arch support helped. Asics 2100 series were the perfect fit for me. Keeping weight off was important. And running on trails rather than roads saved both my feet and knees. I'd imagine treadmills and tracks would be better too. If you develop plantar fasciitis you need to stop running until it subsides. Continuing to run will make it worse and extend the recovery period. Follow the recommendations above, and make sure you wear shoes inside the house all the time. Going barefoot makes it worse somehow. When it goes away you can gradually resume running, hopefully after resolving whatever problem caused the problem in the first place. Probably a good idea to ice it after you run and continue with the stretches. Happy trails!
Shoulder Pain
Been experiencing shoulder pain for a while. Right shoulder. From the point of the shoulder down my huge bicep (hah) to my elbow. It's not intense, just nagging. I can move it. I can reach over my head. I can lift things. I can throw things. Just feels uncomfortable, especially sleeping on it, reaching up and back, or holding my arm laterally. I remember a guy at work complaining about something similar. He ended up having surgery. So I did a little research and I learned a lot. Now I might turn out to be a self-diagnosing hypochondriac, but I think I have a torn rotator cuff. Hmm. Maybe it's just bursitis or tendinitis.
Here's what I dug up. Four articles I found on the web describing how the shoulder works and related problems and treatments. - CJK
Whether throwing a ball, paddling a canoe, lifting boxes, or pushing a lawn mower, we rely heavily on our shoulders to perform a number of activities. Normally, the shoulder has a wide range of motion, making it the most mobile joint in the body. Because of this flexibility, however, it is not very stable and is easily injured.
One of the most common shoulder injuries is a rotator cuff tear, which is the result of the rubbing and fraying of the cuff tendon after a long period of time. While a traumatic injury can result in a rotator cuff tear, they typically occur as a result years of wear and tear from everyday activities.
Bursitis and tendonitis are common conditions that cause swelling around muscles and bones, including the shoulder. Like a rotator cuff tear, they are caused by repetitive arm motions, but are less severe.
A rotator cuff tear is a common cause of pain and disability among adults. In 2008, close to 2 million people in the United States went to their doctors because of a rotator cuff problem.
A torn rotator cuff will weaken your shoulder. This means that many daily activities, like combing your hair or getting dressed, may become painful and difficult to do.
Your shoulder is made up of three bones: your upper arm bone (humerus), your shoulder blade (scapula), and your collarbone (clavicle). The shoulder is a ball-and-socket joint: The ball, or head, of your upper arm bone fits into a shallow socket in your shoulder blade.
Your arm is kept in your shoulder socket by your rotator cuff. The rotator cuff is a network of four muscles that come together as tendons to form a covering around the head of the humerus. The rotator cuff attaches the humerus to the shoulder blade and helps to lift and rotate your arm.
There is a lubricating sac called a bursa between the rotator cuff and the bone on top of your shoulder (acromion). The bursa allows the rotator cuff tendons to glide freely when you move your arm. When the rotator cuff tendons are injured or damaged, this bursa can also become inflamed and painful.
When one or more of the rotator cuff tendons is torn, the tendon no longer fully attaches to the head of the humerus. Most tears occur in the supraspinatus muscle and tendon, but other parts of the rotator cuff may also be involved.
In many cases, torn tendons begin by fraying. As the damage progresses, the tendon can completely tear, sometimes with lifting a heavy object.
There are different types of tears.
There are two main causes of rotator cuff tears: injury and degeneration.
Because most rotator cuff tears are largely caused by the normal wear and tear that goes along with aging, people over 40 are at greater risk.
The most common symptoms of a rotator cuff tear include:
Tears that develop slowly due to overuse also cause pain and arm weakness. You may have pain in the shoulder when you lift your arm to the side, or pain that moves down your arm. At first, the pain may be mild and only present when lifting your arm over your head, such as reaching into a cupboard. Over-the-counter medication, such as aspirin or ibuprofen, may relieve the pain at first.
Over time, the pain may become more noticeable at rest, and no longer goes away with medications. You may have pain when you lie on the painful side at night. The pain and weakness in the shoulder may make routine activities such as combing your hair or reaching behind your back more difficult.
After discussing your symptoms and medical history, your doctor will examine your shoulder. He or she will check to see whether it is tender in any area or whether there is a deformity. To measure the range of motion of your shoulder, your doctor will have you move your arm in several different directions. He or she will also test your arm strength.
Other tests which may help your doctor confirm your diagnosis include:
If you have a rotator cuff tear and you keep using it despite increasing pain, you may cause further damage. A rotator cuff tear can get larger over time.
Chronic shoulder and arm pain are good reasons to see your doctor. Early treatment can prevent your symptoms from getting worse. It will also get you back to your normal routine that much quicker.
The goal of any treatment is to reduce pain and restore function. There are several treatment options for a rotator cuff tear, and the best option is different for every person. In planning your treatment, your doctor will consider your age, activity level, general health, and the type of tear you have.
There is no evidence of better results from surgery performed near the time of injury versus later on. For this reason, many doctors first recommend nonsurgical management of rotator cuff tears.
In about 50% of patients, nonsurgical treatment relieves pain and improves function in the shoulder. Shoulder strength, however, does not usually improve without surgery.
The chief advantage of nonsurgical treatment is that it avoids the major risks of surgery, such as:
The disadvantages of nonsurgical treatment are:
Your doctor may recommend surgery if your pain does not improve with nonsurgical methods. Continued pain is the main indication for surgery. If you are very active and use your arms for overhead work or sports, your doctor may also suggest surgery.
Surgery to repair a torn rotator cuff most often involves re-attaching the tendon to the head of humerus (upper arm bone). There are a few options for repairing rotator cuff tears. Your orthopaedic surgeon will discuss with you the best procedure to meet your individual health needs.
“Most people find it hard to find the time to fit a weight training program into their already busy schedules,” explained Lawrence Gulotta, M.D., a sports medicine orthopedic surgeon at Hospital for Special Surgery. “When time is made, it is usually limited and therefore we tend to focus on the muscles that give us the biggest bang for our buck – namely the biceps, triceps, pectoralis major, and deltoid. But taking this abbreviated approach to strengthening can lead to muscle imbalances that cause pain.”
Here's what I dug up. Four articles I found on the web describing how the shoulder works and related problems and treatments. - CJK
1. Common Injuries of the Shoulder
Whether throwing a ball, paddling a canoe, lifting boxes, or pushing a lawn mower, we rely heavily on our shoulders to perform a number of activities. Normally, the shoulder has a wide range of motion, making it the most mobile joint in the body. Because of this flexibility, however, it is not very stable and is easily injured.
The shoulder is made up of 2 main bones: the end of upper arm
bone (humerus) and the shoulder blade (scapula). The end of the humerus is
round, and it fits into a socket in the scapula. The scapula extends around the
shoulder joint to form the roof of the shoulder, and this joins with the collar
bone (clavicle). Surrounding the shoulder is a bag of muscles and
ligaments. Ligaments connect the bones of the shoulders, and tendons connect the
bones to surrounding muscle. Four muscles begin at the scapula and go around the
shoulder and attach to the humerus, these are the rotator cuff.
When the shoulder moves, the end of the humerus moves in the
socket. Very little of the surface of the bones touch each other. Ligaments and
muscles keep the humerus from slipping out of the socket and keep the clavicle
attached to the scapula.
Rotator cuff tear
The rotator cuff is a group of 4 muscles of the upper arm that
raise and rotate the arm. The muscles are attached to the bones by tendons. The
job of muscles is to move bones. The tendons of the rotator cuff allow the
muscles to move the arm. If the tendons tear, the humerus can't move as easily
in the socket, making it difficult to move the arm up or away from the body.
As people age and their physical activity decreases, tendons
begin to lose strength. This weakening can lead to a rotator cuff tear. Rotator
cuff injuries occasionally occur in younger people, but most of them happen to
middle-aged or older adults who already have shoulder problems. This area of the
body has a poor supply of blood, making it more difficult for the tendons to
repair and maintain themselves. As a person ages, these tendons degenerate.
Using your arm overhead puts pressure on the rotator cuff tendons. Repetitive
movement or stress to these tendons can lead to impingement, in which the tissue
or bone in that area becomes misaligned and rubs or chafes.
The rotator cuff tendons can be injured or torn by trying to
lift a very heavy object while the arm is extended, by falling, or by trying to
catch a heavy falling object.
Symptoms of a torn rotator cuff include tenderness and
soreness in the shoulder during an activity that uses the shoulder. A tendon
that has ruptured may make it impossible to raise the arm. It may be difficult
to sleep lying on that side, and you may feel pain when pressure is put on the
shoulder.
Treatment depends on the severity of the injury. If the tear
is not complete, your health care provider may recommend RICE, for rest, ice,
compression and elevation. Resting the shoulder is probably the most important
part of treatment, although after the pain has eased, you should begin physical
therapy to regain shoulder movement. Your doctor may prescribe a nonsteroidal
anti-inflammatory drug (NSAID) for pain.
2. Common Culprits of Shoulder Pain
http://community.mainlinehealth.org/Blogs/Well-Ahead/March-2012/Common-Causes-and-Treatments-of-Shoulder-Pain.aspx?feed=blogs
Years of reaching for the can on the top grocery shelf, shampooing your hair and even reaching for the car radio have begun to take their toll. Many Americans are now affected by shoulder pain, especially middle-aged men and women in their forties, fifties and sixties. Unfortunately, alleviating this pain isn’t as easy as taking a pill every four hours. Instead, depending on the cause, shoulder pain often requires a surgical solution.
Below, Dr. Kevin Mansmann, orthopedic surgeon at Paoli Hospital, explores the causes and treatment options for three common culprits of shoulder pain.
Rotator Cuff Tears
One of the most common shoulder injuries is a rotator cuff tear, which is the result of the rubbing and fraying of the cuff tendon after a long period of time. While a traumatic injury can result in a rotator cuff tear, they typically occur as a result years of wear and tear from everyday activities.
“Rotator cuff tears are most commonly associated with active patients, often males, affecting the dominant arm,” says Dr. Mansmann. “The majority of tears come from years of overuse or moving your arm in a repetitive motion.” Athletic weekend warriors are at a high risk for rotator cuff tears.
Treatment: Partial rotator cuff tears can heal with physical therapy, and often don’t require a surgical solution. However, partial tears with continued pain and full thickness tears often require surgery.
Bursitis and Tendonitis
Bursitis and tendonitis are common conditions that cause swelling around muscles and bones, including the shoulder. Like a rotator cuff tear, they are caused by repetitive arm motions, but are less severe.
Bursitis occurs when a bursa, the fluid-filled sac that acts as a lubricant between a bone and muscle, skin or tendon, becomes inflamed.
Tendonitis is an inflammation of a tendon. Both problems are caused by excessive use, exceeding conditioning, with repeated, minor injury of the affected area, and can lead to a rotator cuff tear if left untreated.
Treatment: Both bursitis and tendonitis are typically easily treatable issues. Resting, stretching before and after an activity, and applying ice to the affected area can often help to alleviate pain. Injections are very helpful if activity modification is unsuccessful.
Conditions like these can happen to anyone, so Dr. Mansmann offers some advice for those looking to avoid shoulder problems in the future.
“Stay reasonably fit,” he says. “The best prevention of shoulder pain is to participate in an exercise program and avoid weekend warrior activities that exceed your level of conditioning.
"Don’t push through the pain either, says Dr. Mansmann. Exercising through shoulder pain can make injuries worse, so don’t push through activities, that you may have been able to do easily before, like shoveling snow. Pace yourself.
If you find yourself experiencing shoulder pain regularly, make an appointment with your physician to determine the cause.
3. Rotator Cuff Tears
http://orthoinfo.aaos.org/topic.cfm?topic=a00064A torn rotator cuff will weaken your shoulder. This means that many daily activities, like combing your hair or getting dressed, may become painful and difficult to do.
Anatomy
Your shoulder is made up of three bones: your upper arm bone (humerus), your shoulder blade (scapula), and your collarbone (clavicle). The shoulder is a ball-and-socket joint: The ball, or head, of your upper arm bone fits into a shallow socket in your shoulder blade.
Normal anatomy of the shoulder.
There is a lubricating sac called a bursa between the rotator cuff and the bone on top of your shoulder (acromion). The bursa allows the rotator cuff tendons to glide freely when you move your arm. When the rotator cuff tendons are injured or damaged, this bursa can also become inflamed and painful.
This illustration more clearly shows the four muscles and their tendons that form the rotator cuff and stabilize the shoulder joint.
Reproduced with permission from The Body Almanac. (c) American Academy of Orthopaedic Surgeons, 2003.
Description
When one or more of the rotator cuff tendons is torn, the tendon no longer fully attaches to the head of the humerus. Most tears occur in the supraspinatus muscle and tendon, but other parts of the rotator cuff may also be involved.
In many cases, torn tendons begin by fraying. As the damage progresses, the tendon can completely tear, sometimes with lifting a heavy object.
There are different types of tears.
- Partial Tear. This type of tear damages the soft tissue, but does not completely sever it.
- Full-Thickness Tear. This type of tear is also called a complete tear. It splits the soft tissue into two pieces. In many cases, tendons tear off where they attach to the head of the humerus. With a full-thickness tear, there is basically a hole in the tendon.
A rotator cuff tear most often occurs within the tendon.
Cause
There are two main causes of rotator cuff tears: injury and degeneration.
Acute Tear
If you fall down on your outstretched arm or lift something too heavy with a jerking motion, you can tear your rotator cuff. This type of tear can occur with other shoulder injuries, such as a broken collarbone or dislocated shoulder.
Degenerative Tear
Most tears are the result of a wearing down of the tendon that occurs slowly over time. This degeneration naturally occurs as we age. Rotator cuff tears are more common in the dominant arm. If you have a degenerative tear in one shoulder, there is a greater risk for a rotator cuff tear in the opposite shoulder -- even if you have no pain in that shoulder.
Several factors contribute to degenerative, or chronic, rotator cuff tears.
- Repetitive stress. Repeating the same shoulder motions again and again can stress your rotator cuff muscles and tendons. Baseball, tennis, rowing, and weightlifting are examples of sports activities that can put you at risk for overuse tears. Many jobs and routine chores can cause overuse tears, as well.
- Lack of blood supply. As we get older, the blood supply in our rotator cuff tendons lessens. Without a good blood supply, the body's natural ability to repair tendon damage is impaired. This can ultimately lead to a tendon tear.
- Bone spurs. As we age, bone spurs (bone overgrowth) often develop on the underside of the acromion bone. When we lift our arms, the spurs rub on the rotator cuff tendon. This condition is called shoulder impingement, and over time will weaken the tendon and make it more likely to tear.
Risk Factors
Because most rotator cuff tears are largely caused by the normal wear and tear that goes along with aging, people over 40 are at greater risk.
People who do repetitive lifting or overhead activities are also at risk for rotator cuff tears. Athletes are especially vulnerable to overuse tears, particularly tennis players and baseball pitchers. Painters, carpenters, and others who do overhead work also have a greater chance for tears.
Although overuse tears caused by sports activity or overhead work also occur in younger people, most tears in young adults are caused by a traumatic injury, like a fall.
Symptoms
The most common symptoms of a rotator cuff tear include:
- Pain at rest and at night, particularly if lying on the affected shoulder
- Pain when lifting and lowering your arm or with specific movements
- Weakness when lifting or rotating your arm
- Crepitus or crackling sensation when moving your shoulder in certain positions
A rotator cuff injury can make it painful to lift your arm out to the side.
Tears that develop slowly due to overuse also cause pain and arm weakness. You may have pain in the shoulder when you lift your arm to the side, or pain that moves down your arm. At first, the pain may be mild and only present when lifting your arm over your head, such as reaching into a cupboard. Over-the-counter medication, such as aspirin or ibuprofen, may relieve the pain at first.
Over time, the pain may become more noticeable at rest, and no longer goes away with medications. You may have pain when you lie on the painful side at night. The pain and weakness in the shoulder may make routine activities such as combing your hair or reaching behind your back more difficult.
Doctor Examination
Medical History and Physical Examination
Your doctor will test your range of motion by having you move your arm in different directions.
Reproduced with permission from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010.
After discussing your symptoms and medical history, your doctor will examine your shoulder. He or she will check to see whether it is tender in any area or whether there is a deformity. To measure the range of motion of your shoulder, your doctor will have you move your arm in several different directions. He or she will also test your arm strength.
Your doctor will check for other problems with your shoulder joint. He or she may also examine your neck to make sure that the pain is not coming from a "pinched nerve," and to rule out other conditions, such as arthritis.
Imaging Tests
Other tests which may help your doctor confirm your diagnosis include:
- X-rays. The first imaging tests performed are usually x-rays. Because x-rays do not show the soft tissues of your shoulder like the rotator cuff, plain x-rays of a shoulder with rotator cuff pain are usually normal or may show a small bone spur.
- Magnetic resonance imaging (MRI) or ultrasound. These studies can better show soft tissues like the rotator cuff tendons. They can show the rotator cuff tear, as well as where the tear is located within the tendon and the size of the tear. An MRI can also give your doctor a better idea of how "old" or "new" a tear is because it can show the quality of the rotator cuff muscles.
Treatment
If you have a rotator cuff tear and you keep using it despite increasing pain, you may cause further damage. A rotator cuff tear can get larger over time.
Chronic shoulder and arm pain are good reasons to see your doctor. Early treatment can prevent your symptoms from getting worse. It will also get you back to your normal routine that much quicker.
The goal of any treatment is to reduce pain and restore function. There are several treatment options for a rotator cuff tear, and the best option is different for every person. In planning your treatment, your doctor will consider your age, activity level, general health, and the type of tear you have.
There is no evidence of better results from surgery performed near the time of injury versus later on. For this reason, many doctors first recommend nonsurgical management of rotator cuff tears.
Nonsurgical Treatment
In about 50% of patients, nonsurgical treatment relieves pain and improves function in the shoulder. Shoulder strength, however, does not usually improve without surgery.
Nonsurgical treatment options may include:
- Rest. Your doctor may suggest rest and and limiting overhead activities. He or she may also prescribe a sling to help protect your shoulder and keep it still.
- Activity modification. Avoid activities that cause shoulder pain.
- Non-steroidal anti-inflammatory medication. Drugs like ibuprofen and naproxen reduce pain and swelling.
- Strengthening exercises and physical therapy. Specific exercises will restore movement and strengthen your shoulder. Your exercise program will include stretches to improve flexibility and range of motion. Strengthening the muscles that support your shoulder can relieve pain and prevent further injury.
- Steroid injection. If rest, medications, and physical therapy do not relieve your pain, an injection of a local anesthetic and a cortisone preparation may be helpful. Cortisone is a very effective anti-inflammatory medicine.
A cortisone injection may relieve painful symptoms.
Reproduced with permission from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010.
The chief advantage of nonsurgical treatment is that it avoids the major risks of surgery, such as:
- Infection
- Permanent stiffness
- Anesthesia complications
- Sometimes lengthy recovery time
The disadvantages of nonsurgical treatment are:
- No improvements in strength
- Size of tear may increase over time
- Activities may need to be limited
Surgical Treatment
Your doctor may recommend surgery if your pain does not improve with nonsurgical methods. Continued pain is the main indication for surgery. If you are very active and use your arms for overhead work or sports, your doctor may also suggest surgery.
Other signs that surgery may be a good option for you include:
- Your symptoms have lasted 6 to 12 months
- You have a large tear (more than 3 cm)
- You have significant weakness and loss of function in your shoulder
- Your tear was caused by a recent, acute injury
Surgery to repair a torn rotator cuff most often involves re-attaching the tendon to the head of humerus (upper arm bone). There are a few options for repairing rotator cuff tears. Your orthopaedic surgeon will discuss with you the best procedure to meet your individual health needs.
4. How to Avoid Injuries to Your Rotator Cuff: Impingement Syndrome
http://www.hss.edu/conditions_rotator-cuff-injuries-impingement-syndrome.aspIntroduction
Shoulder pain is common in men and women who remain physically active in
their thirties and forties. There are many potential causes, but one of the more
common is something called impingement syndrome.
Impingement syndrome is
a condition that causes pain in the front of the shoulder, particularly with
overhead activities, resulting from bursitis and tendinitis in
the rotator cuff tendon. Middle-aged men and women who lift weights regularly
are particularly prone to this condition because of muscle imbalances that can
develop around the shoulder with improper training. This can result in anterior
shoulder pain when lifting the arm above the shoulder or across the chest, often
with aching at night that makes it difficult to sleep.
The good news is
that this syndrome can largely be avoided by understanding the anatomy and
biomechanics of the shoulder, and following proper training techniques.
Using Proper Training Techniques
“Most people find it hard to find the time to fit a weight training program into their already busy schedules,” explained Lawrence Gulotta, M.D., a sports medicine orthopedic surgeon at Hospital for Special Surgery. “When time is made, it is usually limited and therefore we tend to focus on the muscles that give us the biggest bang for our buck – namely the biceps, triceps, pectoralis major, and deltoid. But taking this abbreviated approach to strengthening can lead to muscle imbalances that cause pain.”
Workout enthusiasts know that if you strengthen one muscle, you should also
build comparable strength in that muscle’s antagonist – or the muscle that works
in the opposite direction. For example, most people understand that biceps
strengthening should be balanced with triceps strengthening in order to keep the
muscles around the upper arm that flex and extend the elbow at comparable
strength and tone.
But when it comes to the shoulder, the antagonist muscles become less
obvious, because many of them are buried beneath other structures and cannot be
seen by just looking at the shoulder.
Learning More about How the Shoulder Works
In the shoulder, the deltoid muscle elevates the arm to the level of the
shoulder and above; while simultaneously, the rotator cuff muscles contract to
keep the head of the humerus (the ball of the joint) from elevating and tightly
centered in the shoulder socket as the arm is lifted.
The deltoid and the rotator cuff are antagonists - that is, they perform
actions that are opposite of each other. When the deltoid muscle gets stronger
than the rotator cuff muscles, the head of the humerus is not pulled to the
center of the joint, migrates up out of the socket, and pinches (or “impinges”)
the rotator cuff tendon and surrounding soft tissues (the bursa) that cross
above the humeral head. The rotator cuff tendon is pinched in the limited space
between the shoulder joint and the boney “roof” of the joint (the acromion).
This repeated impingement causes progressive inflammation, swelling of the
tendon and bursa, and pain, the combination of which is called impingement
syndrome.
Treating and Preventing Impingement Syndrome
A key to treating or preventing impingement syndrome is to train the rotator
cuff muscles as effectively as you train the deltoid muscle, so that strength
around the shoulder remains in balance. You would never work your biceps without
triceps, or quads without hamstrings – so why work the deltoid and not the
rotator cuff?
The number one piece of advice Russell Warren, M.D., team physician
for the Giants, provides to aspiring footballers echoes similar advice heard
from doctors and strength coaches everywhere: “Get in shape. Work out hard, but
always learn good techniques.”
Athletes should always listen to how their body responds to the activity they
engage in, and if they do have problems, they should adjust to them. “Just don’t
push through them,” advises Dr. Warren, who is a sports medicine orthopedic
surgeon at Hospital for Special Surgery. “It works the same way with a rehab
program – if something bothers you, shorten the duration, change the angle, or
give it up entirely. There are many different ways to do these exercises. A good
trainer or therapist will help make those adjustments.”
“At Hospital for Special Surgery we’re not only concerned with patient care,
but with bringing our knowledge of new conditions and treatments to others
involved in both professional and amateur sports medicine. It’s a large part of
why I became interested in doing this,” said Dr. Warren.
Friday, April 11, 2014
Race Series 2014
Race #1
Dunning Dash 5K
2nd Annual 5K Road Race & Fun Run
Saturday, April 12, 9AM
Charlotte A. Dunning Elementary School
48 Frost Street, Framingham
Race Report: Wonderful Spring Day. Lots of families having fun outside.
I ran well for a mile or two but ran out of energy. Fun time! Room to do better next time.
Time: 24:12 Pace: 7:47
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Race #2
McCarthy/Fuller 5K & Fun Run
Annual 5K Road Race & Fun Run for
McCarthy Elementary and Fuller Middle Schools
Sunday, May 4, 10AM
Miriam McCarthy Elementary School
8 Flagg Drive, Framingham
Race Report: Nice race. Fun crowd. Felt comfortable the whole way. Let up at the end so I wouldn't overtake an over-achieving 10-year old. Meanwhile, an opportunistic PTO mom blew by me at the finish line. Hah!
Time: 24:20 Pace: 7:51
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Race #3
Walsh Middle School 5K
12th Annual 5K Run Walk & Track Events
for Best Buddies and Technology
Saturday, May 17, 10AM
Walsh Middle School
301 Brook Street, Framingham
Race Report: Easy run after heavy overnight rains. I didn't do as well as hoped, but my kids dominated. My 13 year old son ran an amazing 22;24 to win the middle school boys division and my 10 year old daughter finished in a super fast 29:30 to win the elementary girls division. That's awesome baby!
Time: 24:25 Pace: 7:53
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Race #4
Ashland Trail Race
5K and 10K Trail Races thru Ashland State Park
Once around the lake for 5K, Twice for 10K
Saturday, June 7, 8AM
Ashland State Park
162 West Union Street. Ashland
Race Report: Beautiful sunny day. Awesome course that totally kicked my butt. So many roots & rocks, short ups & downs. Made it difficult to take full strides and find a rhythm. Ran the first loop without holding back. 29:55. One fall that I rolled with nicely. Second loop I tried to hold it together. 32:12. One bounce off of a tree that gouged my arm a bit. Extremely slow time, but I finished. Plunged into the lake imediately on completion. Nice! Want to run this course again!
Time: 1:02:07 Pace: 9:59
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Race #5
Marathon Sports Five Miler
39th Annual
Thursday, July 24, 7:00PM
Weston High School
444 Wellesley Street, Weston
Race Report: Perfect evening for a run. Best organized race ever. Great race shirt and sponsor freebies. Lotsa free food. Easy parking. No traffic. Water stations. Race began on a football field, went down a super street hill and then followed a maze of rolling hill roads. The end was a stretch of grass before the high school track finish.
Splits: 7:25 8:30 8:00 8:30 8:10 ... Just a little erratic.
Time: 40:45 Pace: 8:09
Starting Line |
--------------------------------------------------------------------------------
Race #6
Barbieri 5K & Fun Run
3rd Annual
Sunday, October 5, 1:00PM
Barbieri School
100 Dudley Road, Framingham
Race Report: We always have a lot of fun at this one. Francisco & Mariana are both proud alumnae of Barbieri and have cleaned up at the awards over the years. This year's race coincided with a fair across the street so it was especially fun. Beautiful weather brought out extra runners. Maybe they came to hear the fantastic rendition of the national anthem. I was trying to finish under 24 minutes but it didn't happen. Instead I nearly matched my previous 3 5K times of 2014: 24:12, 24:20, 24:25. Not much improvement, but how about that consistency?
Time: 24:24 Pace: 7:52
Anthem Singers |
Starting Line |
Big Finish |
Race #7
Laborious Labor Day Ten Miler
Annual Labor Day morning tortuous ten mile run through the stunning back roads
of Marlborough and Hudson
Monday, September 1, 8:00AM
Ghiloni Park
125 Concord Road, Marlborough
Race Report: Love the simplicity of this race. Instead of a race fee, runners bring a sack of food to be donated to a local pantry. No swag, but there are water stations and volunteers to keep you on course and time you. Nice group of people at this race. The morning we ran was especially hot & humid. Tough conditions for ten-miler. I was in a group of four early on running around 8:30 pace. It felt good. But the weather and gentle hills sapped our energy and we fell off one-by-one. There's a mile long hill around mile 8 that I'll never forget. Managed to keep going and finished in just under 90. Not great, but damn it was hot!
Time: 1:29:53 Pace: 8:59
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Race #8
Ashland Half Marathon
Half Marathon and 5K at historical Marathon Park
Sunday, October 26, 10:00AM
Marathon Park
375 Pleasant Street, Ashland
Race Report: Overcast fall day. Temps in low 50's. Hilly course. Breezy. Race wasn't particularly well organized. I ran to plan, 8:50 pace for first four or five, then we hit ridiculous hills and I slowed. Still under 90 minutes at 10 miles, then struggled for last 3 miles through a slight drizzle. Race was close to home. Weather could have been worse. Enjoyed a cold beer at the VFW after the race. Oh well. I finished!
Time: 2:00:22 Pace: 9:10
What is the kid doing there? |
Monday, March 31, 2014
Dexter
Thanks for the good times old friend. See you on the other side.
Wednesday, March 26, 2014
Championship Ours
My son's CYO basketball team played for the league championship Sunday afternoon. This is a fun group that loves basketball and is very motivated.
The core of the team is a group of 8th graders who lost in the finals last season. As we moved up from the 6th & 7th grade league to the 8th & 9th grade league, we picked up a couple of new players. This season the guys won 8 of 11 regular season games to take 3rd place of 18 teams. In this year's playoffs they needed to win 3 straight to get back to the finals. They played well in the first round to beat a competitive Bulls team by 6 points. Then in the quarterfinals, after falling behind early, they won against a very talented and physically big team of 9th graders from Framingham. And in the Friday night semifinals they faced a Lakers team that had beaten them by 22 points earlier in the season. Though the guys started off well in the semifinals they found themselves down by 11 in the second half. Things seemed to be slipping away. But they never doubted themselves. They rallied together. Somehow they found the strength to overcome the deficit and win.
In the Saturday afternoon championship game, they faced the Suns, who'd won six straight and were playing with great confidence. Before the game, the Marian guys were more pumped than I've seen them before any game in the last two seasons. They came out flying. They were pushing the ball up court, passing, and rebounding. Midway through the first half they were up by 12 points and playing extremely well. But the Suns weren't going to let the game get away from them so easily. They used outside shooting to get back into the game. At the half, Marian led 26 -22.
In the second half Marian stretched the lead to 8, only to see the Suns regain their hot hand from outside. The Suns hit an amazing 11 3-point shots in the game. Not only did the Suns shoot their way back into the game, they took a 6 point lead of their own. In the last 5 minutes the lead changed hands a few times, with Marian dominating inside and the Suns scoring from outside. With under a minute left, and the game tied at 49, the Suns rebounded a Marian missed foul shot and decided to hold the ball for the last shot. They'd either win it at the buzzer or miss and send the game into overtime. But it didn't work out that way. Marian's super-quick guard stole the ball at half court and sprinted to the basket for an uncontested layup. That put Marian up by 2 with 10 seconds left and brought the Marian crowd to their feet roaring! The Suns inbounded at half court with 6 seconds remaining. Marian's defense forced them into a difficult shot, but the Suns rebounded the miss. Their tenacious rebounder, who hadn't scored a basket all day, shot quickly in desperation. The ball left his hand an instant before the buzzer sounded. It went off the backboard and around the rim, seemed to be falling out of the basket, and then inexplicably dropped through the net, tying the game at 51. The Suns home crowd went wild! Overtime.
The Marian guys weren't phased by the improbable turn of events. They were hungry to win this thing. They amped up their effort at both ends. In overtime Marian scored on drives to the basket and put-backs of missed shots. They clamped down on the Suns outside scorers and aggressively rebounded every missed shot. Marian brought home the championship 57-51. Oh what a game!
The core of the team is a group of 8th graders who lost in the finals last season. As we moved up from the 6th & 7th grade league to the 8th & 9th grade league, we picked up a couple of new players. This season the guys won 8 of 11 regular season games to take 3rd place of 18 teams. In this year's playoffs they needed to win 3 straight to get back to the finals. They played well in the first round to beat a competitive Bulls team by 6 points. Then in the quarterfinals, after falling behind early, they won against a very talented and physically big team of 9th graders from Framingham. And in the Friday night semifinals they faced a Lakers team that had beaten them by 22 points earlier in the season. Though the guys started off well in the semifinals they found themselves down by 11 in the second half. Things seemed to be slipping away. But they never doubted themselves. They rallied together. Somehow they found the strength to overcome the deficit and win.
In the second half Marian stretched the lead to 8, only to see the Suns regain their hot hand from outside. The Suns hit an amazing 11 3-point shots in the game. Not only did the Suns shoot their way back into the game, they took a 6 point lead of their own. In the last 5 minutes the lead changed hands a few times, with Marian dominating inside and the Suns scoring from outside. With under a minute left, and the game tied at 49, the Suns rebounded a Marian missed foul shot and decided to hold the ball for the last shot. They'd either win it at the buzzer or miss and send the game into overtime. But it didn't work out that way. Marian's super-quick guard stole the ball at half court and sprinted to the basket for an uncontested layup. That put Marian up by 2 with 10 seconds left and brought the Marian crowd to their feet roaring! The Suns inbounded at half court with 6 seconds remaining. Marian's defense forced them into a difficult shot, but the Suns rebounded the miss. Their tenacious rebounder, who hadn't scored a basket all day, shot quickly in desperation. The ball left his hand an instant before the buzzer sounded. It went off the backboard and around the rim, seemed to be falling out of the basket, and then inexplicably dropped through the net, tying the game at 51. The Suns home crowd went wild! Overtime.
Wednesday, March 19, 2014
Monday, March 10, 2014
Perfect Season
My son's recreational middle school basketball team won their league championship yesterday afternoon. The guys went 8-0 in the regular season and 3-0 in the playoffs. The championship game was broadcast on Framingham Cable TV. After the game came the league banquet. The guys chowed down a bunch of pizzas and collected their hardware. Great job Leprechauns!
.
.
Congratulations on your Perfect Season!
Leprechauns TBA Hoops
Wednesday, February 5, 2014
Kids' Basketball 2013-2014
We're at it again. For the past several years I've coached my son's and daughter's basketball teams. It's always a great experience. This year we have three teams.
At one end of the development spectrum is my daughter's 4th and 5th grade girls' rec team. This team I co-coach with one of the moms. We emphasize fundamentals and fun. A few of these kids are quite athletic and have played before. Some of the others are developmental and new to the sport. All of them have great energy and enjoy being part of a team.
The Flaming Red Platipi are currently 3-3 and are looking to finish the season strong.
Next up is my son's middle school rec team. This league includes 3 grade levels and the range of size, strength and talent is broad. The boys are far more competitive and aggressive than the girls. It's a challenge balancing their drive to win and developing new skills.
The Leprechauns stand in first place at 6-0 and are chasing a magical perfect season.
https://tbahoops.shutterfly.com/
Third is my son's 8th grade CYO team. This league is more competitive. Most of these guys played on my 7th grade team and have been playing for a while. We have skilled guards, strong forwards and guys who can score. These guys want to win above all else, but they also need to work on fundamentals.
The Mustangs are 5-2 so far and have high hopes for making a deep playoff run.
https://mariancadets.shutterfly.com/
Coaching the three teams takes a lot of time. It is rewarding to spend time with the kids, help them get better, and accomplish things as a team.
At one end of the development spectrum is my daughter's 4th and 5th grade girls' rec team. This team I co-coach with one of the moms. We emphasize fundamentals and fun. A few of these kids are quite athletic and have played before. Some of the others are developmental and new to the sport. All of them have great energy and enjoy being part of a team.
The Flaming Red Platipi are currently 3-3 and are looking to finish the season strong.
Next up is my son's middle school rec team. This league includes 3 grade levels and the range of size, strength and talent is broad. The boys are far more competitive and aggressive than the girls. It's a challenge balancing their drive to win and developing new skills.
The Leprechauns stand in first place at 6-0 and are chasing a magical perfect season.
https://tbahoops.shutterfly.com/
Third is my son's 8th grade CYO team. This league is more competitive. Most of these guys played on my 7th grade team and have been playing for a while. We have skilled guards, strong forwards and guys who can score. These guys want to win above all else, but they also need to work on fundamentals.
The Mustangs are 5-2 so far and have high hopes for making a deep playoff run.
https://mariancadets.shutterfly.com/
Coaching the three teams takes a lot of time. It is rewarding to spend time with the kids, help them get better, and accomplish things as a team.
Tuesday, January 7, 2014
Specialization is for Insects
A human being should be able to change a diaper, plan an invasion, butcher a hog, conn a ship, design a building, write a sonnet, balance accounts, build a wall, set a bone, comfort the dying, take orders, give orders, cooperate, act alone, solve equations, analyze a new problem, pitch manure, program a computer, cook a tasty meal, fight efficiently, die gallantly. Specialization is for insects.
-Robert A. Heinlein. The Notebooks of Lazarus Long
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