T Nation

Dr. Ryan - Prime TIme 8/20-21


Check out your Fiber Type Confusion thread.


Hey Dr.Ryan,

I asked you on the last thread about the problem with the blood in the urine, I dont think I got to reply back in time. I had a +4 blood count (I don’t know what else to call it, but the number is right) in my urine. It was taken once about three weeks ago, and again last week, and remained unchanged. It has been this way for about a month and a half.

I have been told by some folks to stop weightlifting, as this may have something to do with it. However, I have had no trauma to the kidney that I remember, and have no pain anywhere. Is stopping lifting a good idea? It’ll kill me, but if I have too I will. I am going to a urologist next week, but I wanted your opinion. Thank you!

[quote]Dr. Ryan wrote:

Temperature can relate to stiffness. Are your feet exposed to the open air while you sleep?

I would also try to check and see what position your ankles are in while you sleep.

Do you have any history of ankle injuries?[/quote]

Doc, I sleep mostly on my side, and as far as i know, my feet are not exposed. no reccent ankle injuries except for minor sprains while i was a teener…

i just thught it could be that i was getting older, and they would just stiffen up, i am guessing now this is not the case… my training consists of Waterbury programs mostly, not alot of running but i skip rope for cardio and did have a case of shin splints awhile back, i just let it heal on its own…

your response is greatly appreciated!

I suspect that I have a subscapularis tendon inflammation (tendonitis, bursitis whatever you want to call it). In other words I experience a burning sensation on the front humeral head (the insertion of the subscapularis right?).

I balance my ER/IR work and as a result of recent events have adopted a rehabilitation program that includes A LOT of ER work.

I progressed my push exercises and experienced no pain at weighted push-ups, cable cross-overs, floor presses but yesterday I went back to flat DB Press with good weight (only 5% less than at my peak) for 10 reps and felt strong. However this morning the pain returned. It was not unbearable and far less intense then before but I am still no very happy about it.

My form, ROM and technique are good, my posture is good (I do not have an off center humeral head). I have asked other trainers about my technique/posture/ROM and have done muscle test for all rotator cuffs and long head bicep and everything seems to be in order. But evidently something is wrong.

The question is, what should I do? I ordered ?release your pain? but it will only get here in a few weeks time? Should I try Active Release Technique? What is it? Should I go see a physiotherapist? Is icing enough?
How long does it take for a tendon to heal if it’s torn?

Dr Ryan,
I have what I believe is Piriformis Syndrome. It is to the point that lifts like squat, deadlift, leg press, and even clean are impossible with just body weight because the second I bend at the hips, my left knee has extreme pain when flexed.
I went to my doctor (primary care physician) and his response was: don’t lift for 2 weeks, then we’ll x-ray you.
What would you recommend?
Obviously, I need to get away from this doctor and have him refer me to a specialist, but what type?
What type of stretching can I do on my own?

I’m back for more tonight.

Hi Doc,

You were going to get back to me on Pettibon chiropractic. Anything to report?

Thanks for your willingness to help.


Well in some instances strenuous physical activity can cause RBC casts to appear in the urine.

If you are in need of a week off of training, get your urine rechecked at the end of the week. That should be enough time to rule out physical activity as the problem.

They should try to rule out any primary renal disease, tumor, trauma (which you indicate isn’t a factor), kidney stones, bladder and prostate problems or bleeding disorders.

When is your follow-up and what are they planning on doing?

Keep me posted.

Take care,



Age could be a factor, but its not like you are old. Do you notice if your symptoms are worse on mornings the day after you jump rope?

Take care,



Well, shoulders can be tricky. I think it would have been better to start back with a load that wasn’t as close to your peak training load.

The fact that you didn’t have pain during the exercise is a good sign. Your pain today is probably related to inflammation.

I would see a chiro or physio that specializes in sports injuries. If they are ART certified, that would be good. However, many more docs can perform ART or related techniques than are certified to do so.

If you have insurance, an MRI would be the best diagnostic test to identify any significant tendon or joint injuries.

Depending on what the MRI showed, that would determine what the most appropriate treatment would be.

Healing tears of the muscles or tendons can take a significant length of time depending on the severity of the tear and the treatment given.

Let me know if you have any other questions and keep me posted on what you decide.

Take care,



Did the doc rule out a low back problem?

Try to find a good chiropractor in your area. Find one that specializes in sports injuries. They should be able to give you a thorough exam and provide some treatment to help.

Let me know if you have any other questions.

Take care,



I’m reading through the web-site, but I didn’t have the chance to research it much since last night. I will PM you tomorrow after I have a chance to get more info.

Take care,


[quote]Dr. Ryan wrote:

Age could be a factor, but its not like you are old. Do you notice if your symptoms are worse on mornings the day after you jump rope?

Take care,


Hi Dr.

no i have not noticed significant symptoms after the days i skip rope.
i am guessing this might be due to the temperature. will try and cover up with socks or something to see if i can notice a difference.
thanks for you replies!