T Nation

Prime Time - Any Questions

Prime Time is now underway, does anyone have a question? Fire away.

Doc, why don’t you “credentialize” yourself, so people know which direction to go in as far as questions.

You know, give your background because you’re relatively new to T-Nation.

Thanks!
TC

Well, there is something I have been wondering about Doc. My seasonal allergies have been going crazy for the past few weeks, lots of fluid in the nose, that’s about it, I seem to blow my nose about every 5 mins! Anyway, I got some 24 hour Claritin-D and it seems to help a bit, any reason I should not take this stuff(be it realted to training, bad for recovery, ect)?

Credentialize myself huh. That’s always fun.

Well I’m not really a doctor, but I did stay at a Holiday Inn Express last night…

Seriously, I have a BS degree in Exercise Science from The Ohio State University and did an internship in the Exercise Physiology/Fitness program at NASA’s LBJ Space Center in Houston.

I graduated Summa Cum Laude and received my Doctor of Chiropractic degree from Texas Chiropractic College in 2000. I did an orthopedic surgery rotation through the Baylor Sports Medicine Institute with Dr. Bill Bryan, one of the Houston Astros physicians.

I’ve taken 1 year of diplomate level Clinical Nutrition coursework.

I’ve served as an on-site doctor as well as sports nutrition/medicine advisor for the USA Fit marathon training programs (I know marathons, ugh)

I am currently practicing in Kingwood, TX a suburb of Houston.

That is my background, please feel free to ask me any questions, particularly regarding injuries, rehab, clinical nutrition.

I have been training for about 14 years now. I am 5’ 10" weigh 195 at about 8-9% bodyfat.

Claritin-D is a combination product containing Loratidine (antihistamine) +pseudoephedrine (sympathomimetic).

The pseudoephedrine can effect blood pressure, heart rate etc. If taken late in the day it can sometimes cause difficulty sleeping, although some people get the opposite effect.

Try www.drugdigest.org, that site has plenty of information regarding medications/side effects,etc.

Take care,

Ryan

Hey Dr. Ryan I have been having shoulder impingement for a while now, dealing with it for over a year now, I did many things to rehab it,such as many of Eric Cresseys rehab. exercises in the articles posted here ART, went through close to 12 sessions of that,I dont know how familiar you are with it, but does it ever heal its been over a year, felt great, but still hurts, I do lift heavy sometimes but am careful and work with the head trainer at work, i know that surgery is a last resort but im to the point where it would be worth not dealing with pain anymore what are your thoughts, I have used alt. methods as well which help.

analog_kid,

If your symptoms are primarily nasal, you may want to try a nasal spray instead. Ask your doctor their opinion.

This may also sound like a insane question I know you may not be a MD but what do you think about someone with ADD, suffers from depression, i think hes overmedicated and am worried about him, he seems to be happier but goes through these crazy mood swings up and down was just diagnosed with Adult ADD, few months ago, depression takes welbutrin, zanax for the panicm isnt it pretty dangerous to take stuff that is basicall an upper and downer, also ambien to help sleep.

I told him to go get tested hes in great shape about 6’ 215 lbs. takes protein, ZMA, multimineral, and multivitamin, fish oil, EPA/DHa, HOT-ROX, Post workout drinks as well after he works out, i know this maybe the wrong board for this question im just worried about my friends health

Hey Dr. Ryan, thanks for taking time out for us!

I have a problem called Chronic Standing. Its caused by working as a security guard in places where you are required to stand in pretty much the same position and place for upwards of 35 hours a week.

Aside from the obvious solution of quitting this crap job, do you have any information on injuries and such caused by too much standing? And hopefully some recommendations on how to fix problems caused by it?

Right now im noticing that my hip flexors are extremely tight, and sometimes I get low back spasms… Not too long ago I was deadlifting a bit more than 315 for 3 reps, so its not like I’m extremely weak. It just seems like I’ve lost all flexibility in my lower body.

Also, my right knee is starting to crack a lot, and my right quad sometimes gets that weird tendonitis/osis (I forget which it really is) feeling of the constant, dull, tight pain.

Any ideas???

Doc,
I’ve been having some serious neck/upper back pain for 5 years. It relates to an accident where I was bonked on the head pretty hard and knocked out. I’ve tried various neck stretches and have had no pain relief. Recently I’ve added some additional trap and rear delt work to my workout and the pain has subsided a little. I’ve also seen chiropractors, PT’s, and athletic trainers in the past to no avail.

Specifically the pain is lower cervical and upper thoracic region. It’s feels like a dull ache that gets progressively worse throughout the day.

The pain is present nearly everyday. The strange thing is, when my neck feels good I have sharp pains in my mid back between my shoulder blades.

I would like to live pain free sometime in the future. Do you have any advice as to what I might do to relieve the pain?

Hey doc,

I just had surgery to repair a bad fracture to the tibia and fibula as well as a dislocated ankle.

How soon 'til I walk ?

When can I start squatting again?

Ejonesunt,

Have you had an MRI of your shoulder? If not, I would suggest that you look into getting one done given the length of time you have been dealing with the problem and the fact that treatment has not solved the problem.

If you get an MRI get it done with contrast, since current info indicates that regular scans without contrast can miss some problems.

My next question would be, what kind of symptoms do you have? What movements, positions,exercises, etc. bother you?

Next step, what exercises do you do for it? How long and how consistently have you performed them. Also, any postural imbalances? What positions or activities do you prform all day?

Obviously surgery would be your last resort, and would be indicated when all conservative methods fail and there is a documented lesion that could explain your symptom complex.

Further info, will help me give you more useful info.

Take care,

Ryan

Hi Doc,

Like about half the population of T-Nation, I have a ruptured disc in my back (the lowest one - L5-L6?). I ruptured it back in 1997, and apart from a few set backs here and there, it has been going fairly well. I originally saw a couple of specialists who told me “lifting weights is bad for you anyway - give it up”. My lower back is a weak spot, however, that does need to be strengthened considerably. Any tips on what to look for as part of a rehab routine?

I have been doing back extentions and reverse hypers, along with power cleans from about 3 inches below the knee and rack pulls from the knee. The goal for all of these exercises is to load the lower back while having it in a more neutral position. I find that the closer my chest gets to my knees (eg OLY squat and PL Squat), the more trouble I have with discomfort/pain the next day/week.

All in all, I’ve made good progress - should I keep with the current routine, or is there anything you could suggest to look out for or incorporate into it?

[quote]Dr. Ryan wrote:
Seriously, I have a BS degree in Exercise Science from The Ohio State University and did an internship in the Exercise Physiology/Fitness program at NASA’s LBJ Space Center in Houston.
[/quote]

  1. Do you know if NASA still offers that internship? I’m an Exercise Science major at THE University of West Florida. I’ve heard rumors about it, but that’s it. I’m interested in doing an internship next summer?

  2. I was doing front squats about 7-8 weeks ago and I got a sharp pain in my upper middle back, at an intersection centered medially on my spine and superiorly between the middle of my scapulas, in the area of the medial rhomboideus major. It’s tight in the morning but loosens up throughout the day and it doesn’t bother me when I lift (including front squats). What’s my problem?

Dr Ryan,

Fellow OSU alum here hoping you can help. I’ve had lingering costochondritis for the past two months or so. I’ve been undergoing physical therapy for a few weeks (stretching, light exercise, heat, ice) as well as taking a perscription anti-inflammatory, 15-20 fish oil caps a day, and some daily glucosamine, chondrotin, and MSM. I even have my second ART treatment coming up in another week. I’ve also used most of the techniques Christian Thibaudeau suggested in his article about various recovery methodologies. The injury is SLOWLY healing. It doesn’t necessarily hurt when I do specific movements, but rather at quirky and unpredictable moments like when I sneeze, reach across my desk, or bend over to pick something up.

I hope/know this will heal in time, but can you recommend any other rehabilitative strategies I can take advantage of? Also, are there any specific precautionary measures I should look into to make sure this doesn’t flare up again? Is this an injury that I’ll always have with me, to some degree?

Thanks.

Go Bucks!

Yes, I had a MRI almost a year ago when the pain was much worse, most of the exrecises that bother it inclued lat pulldowns, mostly over head db presses, bench press, its posterior delt pain, The ART has helped a lot, I also noticed pushing overhead, like reaching outward would cause some pain, such as reach for a box on a top shelf that is heavy, or putting it up high.

Ejonesunt,

Does he take ADD med along with the Wellbutrin and Xanax?

Hey Doc,
I am an OSU grad myself! anyway, i have mild scholiosis and my lower back tends to ache after doing heavy deads, all of the O-lifts and all types of squats. could this be realted or is it just muscualr soreness? sometimes it is so bad it takes my breath away and it is a very sharp, sustained pain that sticks around for 3 days. thanks for your help.

enterthedojo,

Chronic standing…cute.

Actually it definitely can create problems. All the postural/anti-gravity muscles are placed under prolonged loading, which can lead to problems. Also, with prolonged standing, you can actually ‘lock in’ to a position that requires very little muscle effort to maintain, however, this causes more stress to be placed onto the ligamentous support, joint capsules, etc. Which can create fatigue or pattern overloado n these tissues as well.

Within the confines of your job, I would try to change positions as often as possible. Even if it is just shifting from side to side, squatting down, doing some standing extensions, get a foot stool and place one foot up on it and change legs frequently.

Also, make sure that if you have proper foot support, because low arches or flat feet can cause problems all the way up the chain.

You can do some easy quad/ham/gastroc/hip flexor stretches while standing without being too conspicuous.

PM me if you have more specific questions.

Gatordoc,

Are you in school or are you practicing somewhere?

For future reference “bonk” and “unconscious” should not be used in the same sentence :slight_smile:

Have you had an MRI done on your neck?

In order to give you better rec. it would be helpful to know what movements, positions/posture, exercises, etc make your symptoms better/worse. What kind of positions do you spend your day in.
Do you get any numbness or tingling in your arms/hands, etc?

I usually get great results with a combination of myofascial release, stretching, spinal manipulation, home stretching and rehab exercises for the Csp and Tsp as well as modifying ADL’s to decrease perpetuating factors.

When these don’t work, an MRI is ordered to find out how extensive the problem is and then co-management is warranted pending the results.

Take care,

Ryan