How to Deal With Pain After a Marathon

April 20, 2015 / Thomas Cohn, MD

The Boston Marathon is underway, and although the winners have already crossed the finish line, thousands of other runners will soon complete their own 26.2 mile trek. Even if you’ve trained for months, running a marathon is sure to leave you feeling aches and pains in the coming days. To combat post-race pain, we’ve come up with a few tips to help prevent and alleviate pain after a long run.

Right After The Race

Although you’ll likely be looking for family and friends after you cross the finish line, there are also some steps you’ll want to take to within a few minutes of finishing. The first thing you’ll want to do is refuel, but it’s easier said than done. Your body isn’t going to be able to handle a big meal, but if you can get your hands on a banana, orange or energy bar, you’ll be able to help prevent post-race cramping. Once you’re back home, consider taking a cold bath to help destress your muscles. After that, you’re due for some much needed R and R, but try to get up and walk around a bit to keep your legs loose.

The First Few Days After The Race

You’re going to be pretty sore in the first few days after your marathon. To keep your muscles loose, soak in a warm bath for 10-15 minutes every day, and do some light stretching once you’re out of the tub. Feel free to use a muscle roller to massage your muscles as well. As for nutrition, reach for fruits, proteins and a few carbs. The fruit will help boost your immune system, and the carbs and protein will help your muscles mend.

A Week After The Race

Now that you’re a week out, you’re probably itching to get back out there and go for a run. If you’ve followed the above tips, you’re probably feeling pretty good, but you’re not quite fully back. The first thing you’ll want to do a week after the race is to continue eating a healthy diet. Avoid a bunch of junk food and stick to fruits, veggies and a balanced diet. Get a lower body massage, pour yourself a warm bath, and soak for 15-20 minutes. Once that’s complete, do some stretches. If everything feels good, feel free to try a short 3-5 mile run.

Those are some good tips to follow, but if you know something is wrong after a race, swing on in to a doctor. A professional will be able to conduct a full examine and tailor a rehab plan to your exact injury.

1 in 4 Misuses Chronic Pain Meds

April 15, 2015 / Thomas Cohn, MD

New research published in the journal PAIN suggests that approximately 20 to 30 percent of opioids prescribed for chronic pain are misused. Additionally, the current rate of opioids addiction hovers around 10 percent.

“On average, misuse was documented in approximately one out of four or five patients and addiction in approximately one out of ten or eleven patients,” who were prescribed pain pills as part of their treatment for chronic pain, said Dr. Kevin E. Vowles and colleagues. They added that the new findings provide “updated and expanded” estimates of the opioid problem in America.

Increased Prescriptions, Increased Addictions

To see how increased opioid prescriptions have fueled pain pill addictions, researchers analyzed 38 reports to measure three separate opioid-related problems:

Misuse
Abuse
Addiction

Researchers examined documented cases of dependence, withdrawal and overdose to come to their conclusion. Opioid misuse was classified as “using opioids contrary to instructions, regardless of harmful or adverse effects.” After adjusting for variables, researchers concluded that between 21 and 29 percent of people who are prescribed opioids misuse them.

“If it is accurate that approximately one in four patients on opioids display patterns of opioid misuse, but not addiction, then perhaps more efficient targeting of treatment resources would be of benefit,” said Dr. Vowles.

As for opioid abuse, which is classified as continued opioid use with actual or potential harmful effects, researchers suggested that about 8 to 12 percent of patients abuse their medications.

Dr. Vowles and colleagues concluded by saying that physicians should seriously evaluate if a patient is a good candidate for an opioid prescription, as the dangers seem to be outweighing the benefits.

“We are not certain that the benefits derived from opioids, which are rather unclear…compensate for this additional burden to patients and health-care systems.”

Related source: Medical News Today

Tiger Woods is Great, But…

April 13, 2015 / Thomas Cohn, MD

The Masters is over, and for first time in a long period Tiger made the cut and finished a tournament. To no one’s surprise, Tiger did not make a run for the leaderboard on Sunday, but he certainly opened some eyes by finishing tied for 17th. At 38 years of age, he is no longer in his prime and now appears fortunate when he makes the cut and finishes. In the future he may have a few more outstanding tournaments, but they will likely be few and far between, and it is likely he will only win a few more tournaments throughout the remainder of his career.

Tiger has now had lumbar back surgery, knee surgery, and may have hip problems besides the above, not to mention he injured his wrist in Sunday’s final round. He pulled out of a tournament earlier this year when he aggravated his back. Most likely, for him to play well, the conditions must be perfect, and he has to have a good day when his pain is controlled. To play at a high enough level routinely is unlikely since either his back or joints will cause just a slight issue such that he will not be good enough to play against the younger and healthier players.

Gold is a Young Man’s Game

To win at a professional level, one must be a top athlete in perfect physical and mental health. All sports at this level require one to be in the best physical shape to master the skill necessary to play a perfect game. After having the physical skill, one needs to have absolute mental concentration for the game. If one has physical pain, the concentration for the perfect game is not present. If one has had back and knee surgery, one also does not have the perfect physical balance to be at the top of one’s game.

As we age, there are many changes that occur in the body, and after age 25, for most sports, we are slightly past our prime for physical ability. By the late 30’s we are definitely past our prime for almost all intense sports, especially individual events. There are a few older athletes who are competitive later in life, but this is generally a rare event. The best athletes perform as well as they do because their bodies and minds are in perfect condition for their sport.

For professional golf, a new leader is likely to emerge in the future, and that leader could easily be 21-year-old Jordan Spieth, who ran away from the competition at Augusta this weekend. Tiger was the first very young winner to take the stage. Now, it will likely be someone who is in the young twenties and has great mental strength to deal with the pressure of winning, which sounds a lot like Spieth or Rory McIlroy. I think they’ll be the face of professional golf for the next 5-10 years.

5 Tips To Prevent Joint Pain While Exercising

April 10, 2015 / Thomas Cohn, MD

Regular exercise is extremely important, especially if you are dealing with a pain problem. Although it can be difficult to find the motivation to work out, exercise will help build strength in your muscles and actually provide some temporary pain relief. Some people have the motivation to work out, but exercise causes their joint problems to flare up. Today, we provide five tips to help prevent joint pain during your workout.

1. Stretch – Jumping straight into your exercise routine is a quick way to trigger your joint pain. Much like a car in the winter, it takes some time for our joints to start moving fluidly. Just like it’s not good to floor it five seconds after starting your car when it’s -10 degrees outside, it’s not smart to jump on the treadmill without letting your joints warm up.

2. Switch up your routine – Try to work out different areas of the body throughout the week. Going for a run every day is fine, but you’re leaving yourself open to overuse injuries, and you’re putting a lot of stress on your feet and knees. Instead, work out your upper body on Monday and Thursday, and strive for a lower body workout on Tuesday and Friday. This gives your joints some time to recover between workouts.

3. Find what works – This may sound obvious, but find a workout that works for you. If you have joint pain in your knees, consider exercising on a stationary bike or in a pool to help with weight bearing. If your back pain flares up while biking, try going for a walk or a run. Keep a log of what works best for you so you can create a pain-free exercise routine.

4. Try alternative methods – There are plenty of ways to get your exercise in without going for a run or a swim. Some more popular alternatives for people with joint pain are yoga and Pilates. These low-impact activities help increase joint mobility and flexibility. Additionally, yoga has been shown to ease pain and swelling in people with rheumatoid arthritis. If other exercises are causing too much joint pain, give yoga or Pilates a try.

5. Don’t overdo it – The right amount of exercise if great for your body, but overdoing it can actually make pain problems work. When developing a workout plan, start slow and progressively work your way up to longer routines. Additionally, if you begin to feel pain, stop your workout or transition to a different exercise that doesn’t impact that part of your body.

Back Pain Can’t Keep Tiger Woods From The Masters

April 8, 2015 / Thomas Cohn, MD

Tiger Woods will end his nine week hiatus from professional golf this week as he prepares to tee up for the Masters.

Tiger’s 2015 season got off to a rough start when he missed the cut in his first event and withdrew from his second event with back pain. After withdrawing in his second tournament, Tiger decided to take some time off to get his head and health in the right position to complete for a major championship.

I actually predicted that Tiger would take some time off after withdrawing from a tournament in early February. After that tournament, Tiger had withdrawn from 7 of his last 9 tournaments, which is unheard of in today’s game. Instead of continuing to play through the pain and just hoping things got better, Tiger decided to step away from the game and focus on getting his body right.

When asked about his rehab and strength conditioning leading up to the Masters, Woods said that he “worked his ass off. That’s the easiest way to kind of describe it. I worked hard.”

The Importance of Exercise As We Age

Exercise is important at any age, but it’s even more important as we get older. Tiger Woods turns 40-years-old this year, and he can no longer get by on his talent alone, especially when his body is breaking down from years of strenuous twisting and torquing. He’s had documented problems with his back, knees and shoulder, and although he would ideally take more than nine weeks off, he made the right choice to leave the tour and re-work his health and his game.

As I always tell my patients, there is no magical pill or injection that will completely cure you of your condition. Many options provide short-term or temporary relief, but patients also need to put in work in the form of exercise, physical therapy and rehabilitation. It’s not going to be easy, but it’s going to be worth it. This quote from Woods perfectly exemplifies that notion.

“People would never understand how much work I put into it to come back and do this again,” Woods said. “But it was sunup to sundown, and whenever I had free time; if the kids were asleep, I’d still be doing it, and then when they were in school, I’d still be doing it. So it was a lot of work.”

Despite his return to the course, I stand by my prediction from back in February. I believe Woods is more likely to withdraw or miss the cut than to be in serious contention in Sunday. Based on his quotes, it truly sounds like his health and his game are in their best forms of the year, but he’s still not 100%. I believe the tournament means a lot to Tiger, and barring significant back pain, I think he’ll go without withdrawing at Augusta, but the competition is fierce, and I just think Tiger will be fighting to make the cut instead of trying to get in Sunday’s final grouping. I wish him and the rest of the field the best of luck at the Masters this weekend.

Related source: Bloomberg