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| Q&A: Dr David Hartman on Head Injuries (824 Posts)
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Sorry doc
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On 11/23/2004
skatestarr
wrote in from
United States
(199.46.nnn.nnn)
Sorry about the redirection Doc, I guess when we see Dr. we tend to generalize. But there was some good feedback from other skaters...
Steve
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Slides & pads...
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On 11/22/2004
Tom M.
wrote in from
United States
(198.26.nnn.nnn)
NCL,
Sorry for the delay.
No, I wouldn't recommend the CrashPads for sliding.
Mine are for parks only.
Unless you can squeeze them under some leathers, they wouldn't last too long on asphalt.
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back pain
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On 11/18/2004
Barr
wrote in from
Israel
(212.179.nnn.nnn)
Herb - I totally sympathize. I had this stuff too, after taking a few too many mini-ramp hip slams...which led me to the crash pads. I did the orthopedist (vioxx - works great, but now a drug in disrepute), accupuncture (was also surprised, but then dismayed because the effects were short-term), and the best was the osteopath. I'm a scientist by profession and I tend to not take alternative medicine too seriously, but this guy definitely made me feel alot better. Physiotherapy-directed execise was also very important. If you want, I can try to describe some of the exercises...Bottom line was...lots of rest for the back, lots of down-time for the skating and MTB biking, and eventually back on my feet and my skate. I have not had a recurrence - and my back is pretty bad according to the X-rays. I think the pads are a key factor. Remember, most adults suffer from lower back pain - not just us adrenalin freaks.
Haim
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crashpad related ,sort of
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On 11/17/2004 herbn
wrote in from
United States
(205.188.nnn.nnn)
i may end up using them for skating,i already use them for DH mountainbiking. I took a spill on a indoor skatelite mini,in feb. Standard butt slam,if hard enough it usually gives me a sore back for a few days,usually annoying but i deal.This time it inflamed down my leg,(ouch)took me out of things for a month or so,i noticed some weakness in my shinsplint muscles. Sort of getting used to it and the strength was coming back a bit. Then i took a really dunb unusual slam,while bearing testing(last run) with tyler,is there anything but a "dumb slam"? A couple days sore and then slowly back into my usual activities,roadbiking ,mountainbiking ,DH mountian biking, and regular mountainbiking. OOps a bit to soon soreness/inflamation rears it's ugly head. Toe tingles ,calf tension ,butt tingles and mostly groin tension and tingles(like a bad wedgy with a wire) well nothing will stop you in your tracks quicker than tingles and pain in that area. progressively longer rests followed by cautious attempts at combacks,quickly lead to a total layoff,and this week i went for doctor style treatments,first chiropractic. That doctors choice after a bit of poking around was accupuncture, which worked ,more than i thought it would.Though i followed it up a few days later with massage therapy(by a friends wife)traded machine shop work for it(i have no health insurance),and lastly another friend with way worse back pain(DO NOT GET SEPTSOS)so anyway a couple days of mucsle relaxants,two doses of cortezone(a steroid) and a pain killer(kind of big bucks) I'm a lot better,the tingle in my toe just about gone,while in bed and surprizingly even the shin splint muscle is making another comeback.I have 5 more days on the steroid,tapering it off, and enough muscle relaxant to last through all that,but gym activities are totally curtailed,WAY light,and mostly stretches the ones reccommended by the chiropractor.A Three prong attack to treatment,i'd rank their effectiveness as 1 drugs 2 chriropractic and 3 Massage, though all seem to work . I'm gonna wear those crash pads for skating just to be safer and to try and avoid these major layoffs.
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Butt-Head
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On 11/16/2004
Dr. Dave
wrote in from
United States
(209.120.nnn.nnn)
Hate to redirect anyone from the butt to the head, but feel free to ask about injury effects *Above the neck. . .
The Doc
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Crash pads
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On 11/16/2004
Barr
wrote in from
Israel
(212.179.nnn.nnn)
I got a pair last year from a place called inlinewarehouse in Cali (ordered from the net). Price around $45, I believe. I wear them everytime I skate and since then no hippers (but I did break my leg - see below). I'm really satisfied EXCEPT now they are showing signs of wear - holes in the fabric between pads, etc. I only ride parks/ramps, so if you are using 'em for downhill, asphalt, etc. I am not sure how they will stand up. Bottom line -they are comfy and do the job. I'm going to get another pair soon.
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Hip Protection
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On 11/15/2004
North Carolina Longboarder
wrote in from
United States
(63.167.nnn.nnn)
Tom M:
Dude, I just saw your post! Thanks for that link. That is exactly what I am looking for in hip protection.
Have you slid very far on your pair? Did it tear or shred? I want hip protection for sliding. I am working on learning some more complicated slides and those hip pads look like they would work but I wonder if I went hard down on a slide how they would hold up.
Email me or post any advise you might have.
Thanks,
North Carolina Longboarder
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Hipper
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On 11/15/2004
Skatestarr
wrote in from
United States
(199.46.nnn.nnn)
Thanks for the info. The bruise is gone but I still have a little knot and a little pain. I found a company that sells hip pads that you can sew into a pair of shorts so I should be set. Things sure take a long time to heal when you start getting up there in years...
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hipper
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On 11/15/2004
Tom M.
wrote in from
United States
(198.26.nnn.nnn)
I'm not Dave, but I've had a few hippers. Last one (Sept. 4th), grew to a half a football in shape, required me to wear a size bigger pants (in "baggie" style) for 1.5 weeks, and has still not completely gone away. Over the past month it has gone from a "knot" about half the size of a softball to about 1/2 inch now.
I recommend Arnica cream or gel as a topical as soon as possible (after the ice).
Possibly, followed up by Arnica tablets (not sure of their effectiveness, though -- I didn't start them until a couple week afterwards).
At almost 51 years, I've gone back to wearing Crashpads and full gear again -- after getting too brave for my own good over the Summer.
The only older guy I've seen at our park (who's 59), wears foam football hip pads with plasic inserts. He said he got the whole setup for less than $20. It didn't look too comfy to me, but he says it works.
I'd rather take precautions and enjoy skating than be sidelined with a hipper (or other injury).
Good luck!
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What we used to call a "hipper"
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On 11/4/2004
skatestarr
wrote in from
United States
(199.46.nnn.nnn)
Hey Dr. Dave, I was skating a park last Saturday that has a pretty fun (wood)bowl but it is starting to get trashed. Anyway, I came off a grind and was on my way down when a loose board decided to swallow my front wheels. I landed with all of my 210 lbs. right on my hip. It is now Thursday and the bruise that covers the area from where my waist is half way down my leg is going away but it still protrudes an inch or so and is kinda numb. Should I be alarmed or should I do what I've been doing and ride it out? By the way I'm 41 and I sure fall alot harder than I used to... Also, is there some kind of hip pad I can wear that won't make me look like I'm wearing diapers? I always fall on the same hip. Maybe I should start skating goofy foot.
Thanks
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Possible Tendon Injury
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On 10/18/2004 Sketchmaster
wrote in from
United States
(4.22.nnn.nnn)
One of the guys that skates the Wedge has a problem with his arm near the elbow. The pain is relatively minor but has persisted several weeks. I believe there was swelling initially but that has long since subsided. The injury is due to impact not to hyperextension. He had x-rays done and the doc did not find anything. I can feel a hard moveable chunk in his arm that does not have a symmetrical twin in his other arm (one of my favorite clues for injury is lack of symmetry). We both pressed hard enough to tell that the chunk is softer than bone. My best guess is that one of the tendons is partially torn from the ulna near the elbow and what we are feeling is the anchor point that is partially broken free. I recommended further analysis by the paid pros but preferably not the same ones that missed this the first time when he was telling them he had a problem. I think the doctors thought he was just a whining baby but I've seen this guy wreck and he's no sissy; So if he says he has a problem then I believe him.
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SM's S&M Rehab
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On 9/18/2004
Dr. Dave
wrote in from
United States
(67.163.nnn.nnn)
Sketchmaster. Hey, good job on the homebrew rehab! I do want to caution readers who might think "the more pain the better" for rehab, that it ain't necessarily so. Don't do stuff that causes you bad pain unless you get the O.K. from the PT or the doc. I'm totally for do-it-yourself, just buy the plan from The Man first.
As to what you are actually doing to yourself, SM, maybe breaking through some scarring or adhesions to increase mobility. Do yourself a favor at some point and have your work critiqued by your favorite Ortho guy.
Best,
DrDH
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My injuries
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On 9/17/2004 Sketchmaster
wrote in from
United States
(4.22.nnn.nnn)
Thanks for everything, Dave. The knee seems to be back to 100% but I haven't done any serious climbing on it yet. Also, I have a little info to share regarding rehabbing my right shoulder for the second. The first thing is what I call the "painful massage". I work in deep all around the injury so hard that I can barely stand the pain. That little baby is what got the shoulder mobile enough that I could make it through the day. The second one goes like this: Stand upright with the arm naturally hanging against gravity. Rotate the wrist 200 or so degrees back and forth so the entire arm is rotating around its long axis. If you cup the shoulder with the opposite hand you'll get better control of being able to do this with less pain. This is the one that really helped me get the shoulder pretty much cleaned up. I was just screwing around trying top figure out something I could do to get some mobility and this one really worked for me. The mobility that it assists for me is pushing forward at a 45 degree upward angle. I was OK at the forward push and vertical push but that angled push would kill me. Maybe Dr. Dave has some insight into what is actually happening with this and maybe someone else has some other stretching type recovery for a shoulder dislocation?
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Ben n' Boyd
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On 9/11/2004
Dr. Dave
wrote in from
United States
(67.163.nnn.nnn)
Ben. Your GF needs to go to her doc and find out why she's swelling up her ankle. All the ibuprofen and ice in the world is only going to patch the problem until you know what it is. Unless the idea of a girlfriend in a leg cast heats up your ball bearings, tell her to do it sooner rather than later, since re-injury makes it more difficult to heal.
Boyd. Look into timeshipracing.com which has a pair of slide gloves that let you put on wrist guards underneath. Best of all possible world IMHO.
DrDH
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gloves vs braces
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On 9/9/2004 boyd
wrote in from
Australia
(203.23.nnn.nnn)
hi there, i have started using the gloves and they are great, thanks to cliff and the san jose site.
should i try to fit wrist guards/ braces underneath the gloves or is it not going to make any difference?
is there going to be a difference between the potential impact of skating parks and getting air over jumps and carving and sliding the road that would necessitate changing between the splint action of wrist guards or the deflection of slider gloves?
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ankels
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On 9/9/2004 ben
wrote in from
United States
(216.89.nnn.nnn)
dr. dave
i have recently convinced my girlfriend to skate with me because All my other friends who skate are wankers, anyway. After we attended a longboard clinic in fairfax Which rocked) she must have really stressed her ankle because it swells every time we skate. she puts on the ace bandge after i threaten on to go skate (bluffing) what can we do so she can skate healthy again. thanks
ps schools out!!
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Gear
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On 9/1/2004
Haim Barr
wrote in from
Israel
(212.179.nnn.nnn)
Thanks for the tips. Yoghurt is a mainstay for me. Also, I always wear the standard protection stuff - helmet, knee/elbow/wrist pads and padded shorts (Crash Pads (tm)). I was thinking more along the ankle-brace type of thing. Someone suggested Ace bandage, but I know there are more sophisticated devices out there. The doc did not bring up bone-density, but he did notice that I have a calcaneotalar tarsal coalition. This is present in ~5% of the poulation, and means certain rotations of my foot are limited. He suggested that this may explain the break (I guess as opposed to just a sprain or a twist). Usually, they discover it in kids who complain about pain and recurring sprains. I never suffered from either, so I never knew I had it. It is possible to correct surgically, but I think that is over-kill. High-top skate shoes, and a light ankle-brace is what I'm thinking...
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Gear to consider
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On 9/1/2004
Dr. Dave
wrote in from
United States
(67.163.nnn.nnn)
Unsolicited props to www.timeshipracing.com both for their slide gloves and also for a neat idea: "Bomber" skate shorts. Tough outside and fitted inside with plastic hockey pads to protect your hips and upper legs. And they pass the Dr. Dave NoDork test - they look pretty cool. Not cheap but recommended and no, I'm not affiliated with them.
DrDH
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Gear is the last question.
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On 9/1/2004
Dr. Dave
wrote in from
United States
(67.163.nnn.nnn)
Before you go Gear, Haim, ask your doc a few questions. First,find out whether your bones are in reasonable shape and if you should get a bone density scan (DEXA). If your bones are weak (osteopenic) you may need special medication to make them thicker/stronger.
Then ask your doc whether your type of fracture puts you at increased risk for rebreakage at that site and if he has anything in his black bag to protect that part of the leg.
Finally, are you taking Calcium? Eating high calcium foods like Yogurt? Talk to your doc about the best supplements to keep your bones strong.
NOW. . .you are ready to think gear. Shin and knee pads are stiff and light. Give those a try when you've resolved the other issues. Sk8ing is an "extreme" sport for a reason. It's inherently risky and you can only reduce the risk, not get rid of it entirely (Well, I suppose you could SK8 inside an inflatable bag, but it wouldn't be much fun, and you'd look like a melon rolling down the street). Learn the Coleman slide as the great Master has enlightened us a few posts ago.
Let us know what happens. Good luck and fast healing.
DrDH
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Ankles....
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On 8/30/2004
Haim Barr
wrote in from
Israel
(212.179.nnn.nnn)
I'm nursing that busted-fibula. Now, I'm out of the cast and wearing a plasticy sort of brace ("Aircast") and doing the physiotherapy stuff. Each day it gets much better and I'm already thinking about skating again (soon, but not too soon...). So, what kind of gear should I get to keep the leg from breaking again? This was a real pain in the ass (and other places) and I'm lucky I did not get fired or/and divorced.
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Real Doc
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On 8/23/2004
Dave H.
wrote in from
United States
(68.74.nnn.nnn)
Yes and No:
I'm a Neuropsychologist - a doctoral specialist, particularly in head injuries and in this case, particularly for consequences of concussion and head injury. I'm a helmet advocate because of what I know about how easy it is to scramble your brains if you ditch without a helmet. I'm not employed by any board company or sports business. I am a boarder (snow and skate) and a runner and am also pretty well up on musculoskelatel injuries because my patients typically don't come in with just a broken head. No I don't write scripts, but I'm the author of "Neuropsychological Toxicology" a textbook published by Kluwer on the effects of drugs, alcohol and industrial substances on the brain and behavior. K? Thanks for the op to put up a mini-CV :)
Best, DrDH
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are you a real doc?
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On 8/21/2004 in pain
wrote in from
United States
(152.163.nnn.nnn)
are you a real doc can you write
scrips to the right person for a real
reason? huh
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Last post edit.
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On 8/12/2004 North Carolina Longboarder
wrote in from
United States
(63.167.nnn.nnn)
"so that I was sliding on my knee pads"
(post edit)
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Slider Gloves! I am a believer!
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On 8/12/2004
North Carolina Longboarder
wrote in from
United States
(63.167.nnn.nnn)
Dr. Dave and The Man Cliff Coleman:
I bought my first pair of slider gloves this year after reading about them on this website. Up until then I had always used heavy leather work gloves. The always kept the skin on my hands but were not very helpful in a hard forward fall. My slide gloves now have saved me some major road rash twice when I beefed it hard in a high speed turn. I was able to confidently put my hands down and control my fall with my hands allowing me to rotate my body around so that my knee pads (hard plastic outer shells) and "slide" the fall out.
I agree with Mr. Cliff- Slider gloves are more than worth then investment.
Wear a helmet, wear your knee pads, and wear them slider glove things!
Roll on Brothers and Sisters! Roll on Roll on....just wear the stuff!
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The Sprain and Pain
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On 8/11/2004
Dr. Dave
wrote in from
United States
(68.74.nnn.nnn)
G,
First, ice is good. Second, many doctors recommend over the counter anti-inflammatories like Motrin, but only you and your doc should decide about taking them. Third, if it's a "bad" sprain as you say and you try to race 1) you're likely going to trash both the race and your leg. You can't "work through" a sprain. It means there's an injury that has to heal. If you add another injury onto it, or even just aggravate the existing injury by working the site, you could make things worse. It would be like trying to "work through" a broken arm.
Yes, you might lose a little muscle tone by laying off skating and racing until you are pain free and your doc says its O.K. But you'll get it back. If you race and you rip a tendon on an already injured ankle, you'll be looking at an immobilizing cast and months of recovering.
So, unless the Ankle Fairy or Jerry Falwell miraculously heals you, I'd stay on the sidelines and cheer the others on for this race. And see your doc if you've got weakness, severe pain, limitation of movement or it doesn't get better.
Best of luck. Let us know how it goes.
DrDH
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