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| Q&A: Dr David Hartman on Head Injuries (824 Posts)
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laberinthitis (sp.?) ?
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On 2/20/2003
Leo
wrote in from
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Hey Dr, i was scuba diving 2 weeks ago and since that when i go to/get up from/to bed i get dizzy, and i have to sit cause it makes me lose my balance.
somebody says that i may have laberintithis (or some like that) but i dont feel water in my ears or anything,
what would u think about it?
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Making me Mongo!
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On 2/20/2003
Dan Hughes
wrote in from
(209.191.nnn.nnn)
I have what I call "pushing heel".
On my rear foot (normal pushing foot) my heel kills me at times. The tendons or muscles that run around my heel, need to be healed. It seems that when I push, I'm straining those muscles or something. The only thing that seems to help is pushing mongo, which is something I'm philosophically opposed to doing.
What are some good things I can do to help my heel heal?
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Osgood Schlatter's Knee Pain
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On 2/8/2003
Dr Dave
wrote in from
(12.249.nnn.nnn)
If you have bone fragments, have you seen a knee surgeon? Are you getting cortisone or other anti-inflammatory meds? See a sports medicine orthopedist - someone who consults for sports teams. "there's nothing we can do" really means "I don't know what to do." Find another opinion.
For those who don't know and need a good website about knee pain, see (of course) www.kneepain.com Here's what they say about OSGOOD - SCHLATTER'S KNEE PAIN
This section covers Osgood-Schlatter's Knee Pain that occurs as a result of overuse ("too much activity, too soon"). In order to better understand Osgood-Schlatter's Knee Pain it is important to understand the anatomy and function of the knee and the patellar tendon. Please review the section on knee anatomy before reviewing this section.
The patellar tendon is a thick rope-like structure that connects the bottom of the kneecap (patella) to the top of the large shin bone (tibia). The powerful muscles on the front of the thigh, the quadriceps muscles, straighten the knee by pulling at the patellar tendon via the patella. OSKP is caused by inflammation (irritation) where the patellar tendon attaches to the tibia.
Osgood-Schlatter's Knee Pain (OSKP), also known as Osgood-Schlatter's disease, is common in rapidly growing, active young teenagers and pre-teenagers. Pain from OSKP is usually felt 2-3 finger widths below the bottom of the patella. There may be swelling in the area and it can be sensitive to touch. The pain can be mild or in some cases the pain can be so bad that it prevents athletes from playing their sport.
OSKP is usually occurs as a result of overdoing an activity and placing too much stress on growing bones. Activities that include a lot of running, jumping or stopping and starting can make OSKP worse. OSKP can be prevented by easing into these types of activities and by using good training techniques. Off-season strength training of the legs, particularly the quadriceps muscles, can also help.
Examination techniques that detect tenderness and swelling at the attachment site of the patellar tendon to the tibia are helpful in determining if someone has OSKP. X-rays are occasionally done to make sure that the patellar tendon does not have any calcium in it. Other tests such as diagnostic ultrasound or Magnetic Resonance Imaging (MRI) are rarely required to rule out more extensive damage to the patellar tendon.
The treatment of OSKP may include relative rest, icing, medications to reduce inflammation and pain, stretching and strengthening exercises. Rarely is complete rest or the use of a knee brace or cast necessary. Sometimes OSKP will even go away on it's own. Doctors and physiotherapists trained in treating this type of overuse injury can outline a treatment plan specific to each individual.
Please visit the links section for additional information on Osgood-Schlatter's Knee Pain. Links have been provided to other websites as well as online medical journals. Other knee injury topics can also be accessed.
THE CONTENTS OF THIS WEBSITE AND THE LINKS ARE FOR INFORMATION ONLY AND ARE NOT A SUBSTITUTE FOR MEDICAL ADVICE.
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Osgood Shlater & my date with a curb
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On 2/8/2003 Shaun
wrote in from
(64.69.nnn.nnn)
Here's my story: I've had Osgood Shlater in my knee since grade 7 (I am now 22). Two years ago I smoked a curb knee first doing about 15-20mph. My knee is still swollen, hurts to touch the bump where the bone fragment is (from OS), and it gets sore when I ride for extended periods. I have been to many doctors & one knee specialist & they all told me there was nothing abnormal & that it would go away. They also said that there is no real therapy or remedy for my situation & that I can feel free to board as much as i want.
I board quite a bit, but it is getting worse/definitely not getting better. Any recdommendations? Should I stop boarding? When I take a powerslide I notice a tremenduos amount of pressure on the knee but no real pain...should I not do this?
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knee chronicles
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On 2/4/2003
joseph
wrote in from
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knee is not hot too touch swelling is going and the scabs lifting it's almost healed
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The knee chronicles
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On 2/4/2003
Dr. Dave
wrote in from
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Joe, if your knee is infected, swollen and/or hot to the touch, go see a doc, especially if the antibiotic creme is not working. You may need some systemic meds. drD
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my knee
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On 2/3/2003 joseph
wrote in from
(211.28.nnn.nnn)
yeah it's not that bad the green is probably because i got fuzz, i guess cant think of what else to call it, from my pants. not too bad but i put antibacterial anti infection stuff on it a couple of times a day.
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Joe's gross knee
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On 2/3/2003
Dr. Dave
wrote in from
(12.249.nnn.nnn)
Joe,
Go to your doc if it's that gross or swab it with bacitracin and bandage it so your buddies won't have to look at it. Thanks for not sending us a picture.
drD
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my damn knee is still stuffed
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On 2/2/2003 joseph
wrote in from
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just bloody brilliant!!! my knee is infected, still sore has a giant green scab that leeks at school and now nobody will hang around with me because it grosses them out. just great.
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Mike's Knee
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On 1/30/2003
Dr Dave
wrote in from
(12.249.nnn.nnn)
Mike,
This is simple. You blew your knee in the fall and it's still stiff, painful and ACE'D? Dust off that HMO card and get yourself to an orthopedist. DON'T try to exercise and rehab it if you don't know what's going on inside. That's a bad knee recipe.
So make that appointment. Now. Don't mess around. If you wait, you're going to have to make up some romantic story about how you blew your knee in one of Bush's wars and that's why you need a cane.
Go get it checked out and let us know. Good luck. drD.
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Another Knee Injury
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On 1/30/2003
Mike Maysey
wrote in from
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Dr. Dave,
I know knees aren't your specialty but see if you can shed some light on this one. I was skating back on New Year Eve without any protective equipment on other than a helmet and slider gloves. Okay, so I'm going pretty fast down this hill and I realize my back wheels have slid out and I'm going down...hard. Mid fall I remembered I wasn't wearing pads...remembering I had on slide gloves and of course shoes, I flexed my quads to keep my legs as stiff as possible so I could hopefully slide on my toes and slide gloves. I saved my left knee, but my right knee hit the ground. It literally bounced off the ground, I think as a result of my keeping my leg flexed as it hit. The abrasion I sustained has almost completely healed, but my knee is still very painful to bend completely. I've been keeping it wrapped up with an ACE bandage, and am taking Advil...but I was wondering if I should consider going to the doctor. I don't have any feelings like the knee might give out of anything, it just hurts and becomes stiff if I sit at my desk with my foot under my chair. Any ideas on rehab excersizes I could do to get me back to normal faster than what I'm doing or not doing? I've even stopped riding my bike to work as the motion of pedaling hurts me.
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knee
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On 1/27/2003
joseph
wrote in from
(211.28.nnn.nnn)
yeah my knee is getting better (well not really just not getting worse) still quite sore but i've been iceing it and putting cream on it and the swellings gone just bruised now. thanks for helping out.
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Joseph's Knee
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On 1/26/2003
Dr Dave
wrote in from
(12.249.nnn.nnn)
Joe,
It's not my area of specialization, but try ice and Advil, Motrin or Aleve, if you can take those. Assuming you're not screaming in pain or unable to move, give it a few days of that. If it gets worse or you can't move it, or your leg gives out, get thee to an ortho guy or an ER, whichever is quicker. Let us know and buy some knee pads. Remember, Dr. Dave's rule: You will fall on whatever body part you didn't buy pads for. . . .
Good luck, drD
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sore knee
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On 1/25/2003
joseph
wrote in from
(211.28.nnn.nnn)
i fell on my knee (along with the rest of my body) and put a graze through the pants which isnt to big but when i got up it really hurt (not the graze that still stung but the knee hurt.) it's swollen, Bruising and hurts a lot to be streightened (sorry about bad spelling) could i have damaged the bone or something?
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aero-efarpe
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On 1/12/2003
Dr Dave
wrote in from
(12.249.nnn.nnn)
efarpe,
If you're that serious about speedboarding, get a helmet that's already aero-d for speedboarding. If you want a face shield, a mc helmet might work, but it won't be as aero as a special purpose helmet.
I'd advise Not doing a shield-o-plasty on your existing helmet. Problems could include: add-on parts coming off at speed or on impact and impaling you or someone else, add-on parts looking aerodynamic, but actually slowing down air flow or making your head prone to twist.
OK, if you have your own wind tunnel, machine shop and a degree in engineering, go ahead, but it's not something I'd recommend otherwise, because it's trickier than it looks.
sk8On drD
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aero helms?
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On 1/12/2003 efarpe down, SA
wrote in from
(198.54.nnn.nnn)
Aero plays a huge part in Speed boarding, and thus i have been thinking of adding to my AGV biker helm. possibly out of something lite(alu sheeting, carbon, kevlar or Fiber glass)i would not cut or pierce the origanel helm, attaching it only usin resins etc. so as it could break away or shatter in a collision, would this encrease or decrease my risk of injury, not accounting for the obviuos encrease in speed, hehe.
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skate vs. bike helmets
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On 1/10/2003 Mike
wrote in from
(209.28.nnn.nnn)
Thanks guys for the info. I'm definatly going to switch from my non-cpsc Pro-Tec 'Clasic' to the Giro Semi. I tried one on and they fit my head really well, much better than the Pro-Tec.
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Skate vs. Bike Helmets
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On 1/10/2003
Duane G.
wrote in from
(198.178.nnn.nnn)
Mike,
I was using a (admittedly ill-fitting) Pro-Tec skate-only helmet up until a couple of weeks ago, when I suffered a very mild concussion skating at Vans here in Colorado. I immediately decided to pick up a proper-fitting "skate-type" helmet from Bell, the Trailrider model, which is actually intended for BMX, but has a hard shell, coverage in back like the Pro-Tec, but is also CPSC certified with EPS foam. Yes, it will only survive 1 good impact, but I don't want to take any more risks, and in addition, it was only $25 at REI (Recreational Equipment, Inc.).
Good luck,
Duane
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Mike's Helmet Types
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On 1/10/2003
Dr Dave
wrote in from
(12.249.nnn.nnn)
Mike,
Four things about helmets:
1. Any helmet is better than no helmet.
2. Helmets that have the CPSC or Snell seal are better than those that don't.
3. A sk8 helmet should be shaped for how boarders might fall, which means good protection for the back and sides of the head too. This may be different for some bike helmets, because they expect you to fall forward. The Semi looks a lot like a skate helmet as far as protection, so if it has the shape and the seal, it's a good deal.
4. If you take a big hit on a helmet and crack or dent the outside or inside, get a new one. It saved your brain once. Retire it with honor. Don't worry too much about the technical differences between helmets. It's gotta fit and you gotta wear it. That's it.
SK8Safe drD
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Skate vs. bike helmet construction
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On 1/10/2003 Mike
wrote in from
(209.28.nnn.nnn)
There seems to be two different philosophies in helmet design. One is the classic “skate helmet” which has a hard shell but the padding consists of foam neoprene padding. The other is the “bike helmet” which has a thinner outer shell but much better internal padding, usually expanded polystyrene with foam sizing pads. The skate helmets are usually rated for multiple impacts while the bike helmets are rated for a single impact. It seems like the skate helmet itself can take more of a beating but it transfers more of the shock to your head than the bike helmet.
My question is would a helmet with the skate design but the bike type construction (such as the Giro semi) provide more protection that the traditional skate helmet even though it won’t last as long as a skate helmet?
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NYTimes: Snowboarding and helmets
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On 1/9/2003
Dr Dave
wrote in from
(12.249.nnn.nnn)
from 1/9/03 New York Times: http://www.nytimes.com/2003/01/09/sports/othersports/09SKII.html?8hpib
. . . Skiing is still relatively safe and a head injury is fairly rare," said Dr. Stewart Levy, a Denver neurosurgeon who has extensively studied skiing and snowboarding head injuries. But preventing a vast majority of head injuries is so easy, it doesn't make sense not to wear a helmet.
As Levy and others point out, a helmet is not a license to ski recklessly, and no helmet can eliminate the effects of some catastrophic collisions, but Levy's studies indicate that the risk of a head injury can be reduced by 75 percent by wearing a helmet. It is those injured in what he classifies as simple falls — people hitting their head on the snow or those injured when they collide with another person on the mountain — who are substantially better off if they are wearing a helmet, Levy said.
We don't even see those people coming into the hospital, he said. "If they are wearing a helmet, the chances are they will not have a head injury. At the same time, we admitted a 19-year-old snowboarder yesterday who was not wearing a helmet when he fell and hit his head. He is in a deep coma and I don't know if he's going to make it. He was not going fast; he did not collide with anyone. He just fell.
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Adam's Helmet
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On 1/5/2003
Dr Dave
wrote in from
(12.249.nnn.nnn)
Adam,
Falling off a board at any speed, even standing still, can fracture your skull and/or cause brain damage, or that dying thing. If your board hits a rock, stops, and you don't, your head smashes into the ground like an egg on a catapult. All that kinetic energy that was traveling forward is redirected into your falling head. Bottom line. Get a cool helmet and save your life.
Best, drD
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Skateboarding helmets
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On 1/5/2003 Adam
wrote in from
(64.12.nnn.nnn)
Are skateboarding helmets necisary in riding around your neighborhood on the side walk not doing tricks
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Doug's knees
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On 1/1/2003
Dr. Dave
wrote in from
(12.249.nnn.nnn)
Doug,
There are lots of possible causes for knee pain including injuring a tendon, trauma, arthritis, not having shock-absorbing-enough skate or running shoes, bone growth (hey, at 13, you're not done yet). But if your knees are swollen, or painful or the pain is not relieved by light stretching, ice, etc., it's doctor time.
Don't try to "skate through it." I once knew a guy in a health club who thought that if his knees hurt during squats, he just had to add more weight and "build them up." Wrong. Knees don't "build up" or toughen with use. He wound up snapping a tendon and sucking ether while they sewed it up.
Anyway, best of luck and let us know how it goes.
drD.
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knees
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On 12/31/2002
doug
wrote in from
(209.150.nnn.nnn)
I do a lot of soul carving and sliding and recently my knees have been hurting when i go up stairs and when i start a run. is this permanant damage and what can i do to help it. by the way im only 13 so could i just out grow it? thanks
doug
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