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Dr. Scott: Can my knees take ski season?

I worry more about skiing injuries. Is there anything you recommend to help someone like me to keep on skiing? 

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Q: I worry more about skiing injuries. Is there anything you recommend to help someone like me to keep on skiing? 

A: If your leg and hip muscles are just burning up on the runs, then realize that your skiing style is incorrect. Though you may have skied for decades, this may be a sign that you need a lesson in your technique. Proper conditioning before the ski season can make the big difference between a fun weekend on the slopes and one marred by injury. Several weeks before hitting the slopes, begin training with an elliptical trainer or stationary bike or walking. Build up to 30 minutes three times a week.

Stretching before skiing will protect you against injury and enhance freedom of motion; stretching afterward returns your muscles to their normal length.  Stretching is the single most important thing people can do for body health maintenance. Muscular tissue shortens with time. Stretching also maintains good alignment of the bones.

Severe muscular imbalances are very common in skiers. Schmid (1984) studied the main postural muscles in 8 members of the male Olympic ski teams from Switzerland and Lichtenstein. He found that among this group of apparently superbly fit individuals, fully 6 of the 8 had demonstrably short right iliopsoas muscles that flex the knee and leg onto the chest, while 5 of the 8 also had left iliopsoas shortness and the majority also displayed weakness of the abdominal muscles. Hurley (2004) found that the most common predisposing factor for osteoarthritis of the knee is weakness in the muscles that attach to the knee. The long term repercussions of such imbalances can be easily imagined. 

A common skiing injury we see frequently is damage to the hamstrings and/or quadriceps muscles (usually both), resulting from violent stretch or rapid contraction. Falls account for 75 to 85 percent of all skiing injuries, according to the American College of Sports Medicine. (2012) Most common is damage to the knee. Predisposing factors to a skiing injury include poor flexibility, fatigue, unbalanced reciprocal actions in the opposing muscle groups of the knee, imbalances between quadriceps and hamstring muscle strength, inadequate warm-up before skiing, restrictions in associated joints, and previous unresolved injuries, etc. Weakness in any of these muscles is a predictor of injury. (Reed, 1996) Many knee problems are the direct result of improper support to the knee from the muscles that attach above and below it.

For example, if the muscle(s) on the middle side of the knee is weak, there is little to keep it from bending further toward the center. If this condition is present and the individual strains his knee by canting in that direction, it may lead to injury. This can cause something as simple as a trick knee or a much more serious condition, such as a catching of the cartilage as the knee goes through its range of motion, causing a tear. Pelvic and low back structural distortions are also connected to weakness in the muscles of the knee. If you go into your ski season with imbalances in these joints or muscles, you are asking for trouble.

The foot and ankle, when functioning improperly, may cause strain in the skier too. The knee is one of the primary areas receiving strain from the foot. You can observe this by standing and making your foot go into a flat-footed position. Watch your knee roll inward. If a person has a pronated or flat foot, the knee receives shock with every cut or bump on the slopes. This is a mechanical strain that may cause leg and knee pain and possibly knee damage.

Skiing careers can be shortened by poor preparation and poor technique in the early years of a skier’s life. It is the responsibility of the coach, doctor, and parent to acknowledge the particular susceptibility of young skiers to injury. If a child is injured, parents should be alert and seek proper attention early on. Non-attention in the early stages is one of the biggest factors leading to permanent problems.

Fatigue is a big factor. If I had a dollar for every patient who got hurt on the last run I might be able to buy you that condo right off the slopes in Vail.


Dr. Scott Cuthbert is a chiropractor at Chiropractic Health Center in Pueblo, Colorado, as well as the author of two textbooks and multiple research articles. PuebloChiropracticCenter.com.

More information on his books on applied Applied Kinesiology can found at thepulp.me/drscottbooks

If you would like to ask Dr. Scott a question at email:  [email protected].

 

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Ask Dr. Scott: Straight-Up education about E.D.

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Q: Dr. Scott, I’m 55 years old and my sexual life has really declined. I have something my doctor calls erectile dysfunction. What are my options from a natural health care perspective?

A: As everyone sees on TV, other than trucks, beer, and chronic arthritis/joint/muscular pain ads, the most common direct-to-consumer ads are for sex-related issues, specifically, the very suggestive ads for erectile dysfunction such as Viagra, which in 2013 had revenues of $1.88 billion, with $133 million spent on advertising this drug. We’ve all seen these TV and magazine ads with gorgeous female models wearing provocative lingerie speaking seductively about erectile dysfunction while the background announcer warns, “If you have an erection lasting more than 4 hours, call your doctor.” Jeff Foxworthy quipped about these ads that “If I had an erection for 4 hours, I’d call everyone I know.”

Among the litany of “common, infrequent, and rare side-effects” from Viagra listed on WebMD.com, these advertisements purposely cite the rare side-effect of priapism, or prolonged erection. Since sex sells, every other warning after hearing “4 hour erection” falls on deaf ears!
What the Viagra ads don’t highlight are the other serious side-effects:

  • Cardiovascular side effects like heart attacks.
  • Ophthalmic side effects like ischemic optic neuropathy and retinal hemorrhage.
  • Side effects such as decreased hearing, and sudden hearing loss.
  • Reproductive side effects such as priapism, which is that prolonged erection.
  • Dermatological side effects such as erythema, or flushing.
  • Gastrointestinal side effects such as indigestion.
  • Neurological side effects such as headache and insomnia.
  • Ophthalmic side effects such as visual disturbance.
  • Respiratory side effects such as nose-bleeds, nasal congestion and rhinitis.

For most men, replacing testosterone does improve sexual function – both desire and erections – but for others it doesn’t help. Some of those who don’t respond may be suffering from atherosclerosis of the blood vessels that supply the penis and facilitate erection. Good, healthy nutritional practices and supplementation with aged garlic can reverse atherosclerosis.

Natural Options for Erectile Dysfunction

There are natural approaches and nutritional supplements that improve blood flow to the penis and really give your erections their old stamina. A dependable clinical tool is L-Arginine (inexpensive, in the powdered form) that works by dilating the arteries through which blood flows into the penis (Institute of Metabolic Disease at Baylor Research Institute, 2016).

When I recommend 5 to 8 grams (a single tablespoon) of arginine before sex, they regularly report waking up with firm erections in the morning. Arginine is inexpensive and non-toxic. Arginine is not only useful for erectile dysfunction, but also for angina and high blood pressure. It boosts nitric oxide levels in the blood vessels of the penis, making erections stronger and longer. Nitroglycerine, the traditional medication to relieve chest pains, is simply a drug form of nitric oxide. As we age we make less nitric oxide and this deficiency permits blood vessels to constrict and lose their flexibility, contributing to vessel stiffness, inflammation and plaque buildup, producing hypertension around the body and less engorgement of the penis during sex. Viagra does the same thing as arginine, it also promotes the action of nitric oxide to help relax blood vessels and vascular smooth muscle tissue in the penis. The result: increased blood flow and a harder erection.

Treating several other conditions that impair blood flow to the penis should be done if present, including atherosclerosis, diabetes, hypothyroidism, and alcohol abuse. Men who smoke have an increased risk of erectile dysfunction. Asian Ginseng (900 mg of concentrated extract) two or three times a day can improve libido and the ability to maintain an erection. Psychological issues can be a cause, or an effect, of erectile dysfunction, so counseling might be appropriate in this scenario. A standardized extract of Ginkgo (250 mg/day) can also increase blood flow to the penis. Vitamin B6 and zinc deficiencies also impair penis strength and function.

Saw Palmetto and Pygeum can improve urinary flow in cases of prostate enlargement, and have been shown to improve sexual performance in men.

A recent study found that elderly men who regularly used arginine saw their erectile dysfunction significantly improve – without the complications common to testosterone hormone use. I would initially advise taking 2,000 to 3,000 mg. of arginine a day, and about 8 grams (one full tablespoon) before sex.

Although DTC ads have been profitable for Viagra, drug marketing has had a tremendously negative influence on the care of chronic health problems and pain across the United States. Aggressive drug marketing has been a major driver of the opioid overtreatment, addiction, and mortality crisis that we are experiencing all over Southern Colorado. The ceaseless drug company advertisements to treat chronic pain with opioids have tragically played a role in up to 400,000 deaths across the country. Instead of referring patients to functional medical doctors and chiropractors as well as other nondrug providers, people have grown to expect prescription painkillers as the standard of care, not realizing the long term damage, addiction and ineffectiveness of these drugs.

Erectile dysfunction is angina of the reproductive organs…lifestyle and dietary improvements that help your heart will also improve your strength and stamina in bed.

Dr. Scott Cuthbert is the chief clinician at the Chiropractic Health Center in Pueblo, Colorado, as well as the author of two new textbooks and over 50 peer-reviewed research articles. PuebloChiropracticCenter.com.

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Ask Dr Scott: I can’t believe I’m using margarine

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Q: Dr. Scott, is it safe for our family to use margarine instead of butter?

A: One of the most prevalent nutritional myths of our time is that margarine is superior to butter as a source of fat.

Liquid oils are artificially hydrogenated in the manufacturing process, which produces a “hard fat” that is partially saturated. The molecular structure of the oils is changed in the manufacturing process, creating a more stable molecule. Unfortunately these “stable” molecules — called “trans fats” — have been shown to be involved in many health problems. Trans fats are fats that have been altered or damaged by high heat. These are a man-made type of fat not found anywhere else in the natural world.

Essential fatty acids (EFA) are components of larger fat molecules. These molecules are essential for the production of hormones and cell membrane components. Essential fatty acids are not produced by the body and must be supplied by fats in your diet. EFAs are found in many foods, but they are most richly concentrated in the oils of certain nuts, seeds, and fish. Nuts, seeds, and beans aren’t important items in the diets of most Americans. Partly because of this, and partly because we eat much less fish than we used to – and over process most of what we do eat – one whole group of EFAs has been virtually eliminated from our diets.

Another major function of EFA is the formation of prostaglandins, which are short-lived hormones that function at the tissue level. These prostaglandins control local tissue effects such as the inflammatory reaction, platelet aggregation (involved in blood clots), response to hormones, and tumor growth.

EFA found in natural vegetable oils lower serum cholesterol and decrease blood pressure. People whose diets are high in olive oil have a much lower incidence of coronary artery disease than do people eating the typical American diet. Olive oil has been a human staple for 5,000 years! Artificially hydrogenated oils (“trans fats” like margarine, shortenings, and spread blends) supply less EFA than meats and dairy products, and contain more saturated fats than butter, whole milk, and meat. They contain few, if any, of the nutrients necessary to metabolize these fats.

The dietary need for EFA increases with increased intake of hydrogenated fats. The “trans” fatty acids found in hydrogenated fats actually elevate serum cholesterol. These trans fats are absorbed by the body, but are not used as readily in cellular metabolism. When these foreign fats are metabolized, they may actually impair cellular function. Their presence in heart and smooth muscle may be a factor in cardiovascular disease. These foreign fats are incorporated into the cell membrane, altering the cell membrane structure and making the membrane more susceptible to damage. Peskin warns that “Trans-unsaturated fat, as the man-made stuff is called, is 14 times more potent as a disease risk factor than the saturated fats the public has been warned about for years – the kind in marbled beef, butter, and cheese” (Peskin, 1999).

The Hydrogenated Oil Menace

Hydrogenated oils should be eliminated from your diet because they are stressful to your liver and to your red blood cells. The free radicals in hydrogenated oils can cause damage to the red cell membranes and leave the cells susceptible to invasion by toxic substances
You should read labels to detect hydrogenated oil or partially hydrogenated oil. It is not something that you will find by itself in a bottle; it will be listed as one of several ingredients. Some of the most common sources are:

  • margarine of all kinds, even from the health food store
  • mayonnaise
  • salad dressing
  • breads
  • cookies
  • ice cream desserts
  • any dry-packaged foods, especially treats
  • corn and potato chips

Besides all of these problems with margarines and hydrogenated oils, studies have shown that margarine actually coats the stomach wall, rendering foods indigestible.

Atherosclerosis begins with damage to the cell membrane, and thus the lining of the blood vessel walls. The normal use and metabolism of cholesterol does not cause atherosclerosis. Many factors damage the cell membrane, among these are the intake of artificially hydrogenated fats like margarine. Cholesterol is a factor in atherosclerosis simply because it becomes incorporated into the fibrous scar tissue that forms over the damaged tissue lining. Natural cholesterol mobilizers are found primarily in naturally occurring vegetable oils and butter.

Additionally, the mitochondria of the heart muscle contain high concentrations of essential fatty acids, the composition of which mirrors that of the diet. You are what you eat – and if you eat fake phoods and fats – your body reflects this. The mitochondria are the “power houses” of the cells in which ATP is produced – our “energy currency.” A diet high in “trans” fatty acids alters the lipid (fat) composition and interferes with oxygen uptake and the production of ATP, i.e. you lose your endurance and your energy using margarine.

To put it simply, artificially hydrogenated fats such as margarine and shortening are a health menace. Hydrogenated and partially hydrogenated oils are found in practically every processed fake phood product on the market. Avoid these in your diet, and use unprocessed vegetable oils such as safflower, sunflower, and olive oil. Use butter and not margarine!

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Ask Dr. Scott: Wheeeeeeeee! I need more coffee

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Q: Dr. Scott, I know I drink too much coffee. What are my health risks from drinking so much coffee?

A: Americans run on caffeine and other stimulants. Americans now drink more than half of the coffee produced in the entire world. Coffee is served everywhere, every day and for almost every event. When patients tell me that they don’t drink coffee, they usually say that they drink tea or some type of caffeinated soda or pop. Caffeine is really used as a ‘medication’ to help overcome one’s own growing fatigue and to sharpen mental functioning.
In small doses, the immediate effect of caffeine increases metabolism, increases body temperature, acts as a diuretic, and stimulates the secretion of gastric acid.
But in large doses, coffee can produce headaches and jitters, and over-produce insulin (hunger hormones). Consumption of over 600 mg/day (more than 2 cups) may cause insomnia, anxiety, depression, and stomach upset. Drinking caffeine is related to heart palpitations and high blood pressure.
Caffeine also interferes with the absorption of minerals, and leaches out B vitamins from the body, particularly thiamine, which is needed for stress control.
Some people experience headaches while drinking coffee, while other people experience headaches after trying to withdraw from coffee drinking. Coffee is also linked to PMS symptoms in women. It’s possible that blood sugar or liver problems are made worse by an increase in caffeine intake, thereby upsetting a woman’s delicate endocrine balance. (Medford, 1999)
Additionally, for years I’ve noticed that patients who quit drinking coffee lose weight much faster than those who don’t.
Caffeine as an artificial stimulant increases arousal and alertness — that’s 1-2 cups of coffee per day. But it’s often followed by an energetic depression, or a dip in performance.
If you are unused to consuming caffeine, the stimulant effects may be very noticeable
But if your body is accustomed to large quantities of caffeine you may experience withdrawal effects if you stop consumption (tiredness, lack of energy, headaches). This means YOU ARE ADDICTED to coffee!
The brain becomes accustomed to a certain level of caffeine, consequently more and more is needed to prevent fatigue. The effects of caffeine may last as long as 5–8 hours after ingestion
While we think of coffee as a way to get our day started, it also has effects on our sleep, if according to some studies. Taken prior to sleep, caffeine usually delays or shortens sleep. It also reduces the overall amount of REM sleep a person receives.
Stephen Cherniske’s book “Caffeine Blues: Wake Up to the Hidden Dangers of America’s #1 Drug”, (1998) shows a definite link between the amount of caffeine you drink and your risk of disease. His bottom line is that if you drink between one- to three-hundred milligrams a day (1 or 2 cups) you are already putting your life and health at risk. If you drink 300 to 900 milligrams a day, you are addicted. If you drink 4 or more cups of coffee a day, your heart disease risk factors are significantly increased.
Cherniske offers coffee drinkers a quick nervous system test: extend your arms out in front of you, palms down. If there is any noticeable trembling, caffeine has damaged your nervous system.
The caffeine in coffee, chocolate, sodas and tea is a legal stimulant drug. When we can’t get our early morning dose of caffeine, we experience symptoms typical of withdrawal from any drug: headaches, anxiety, and the jitters.

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