FAQ Category: General

Complementary therapies are non-medical treatments for diseases, illnesses, and injuries. They are also called complementary and alternative medical (CAM) therapies.

CAM includes a wide range of choices. The most commonly used forms of CAM include chiropractic, massage, biofeedback, yoga, acupuncture, and herbal medicines. There are many other kinds of CAM from prayer to homeopathic remedies to art therapy or aromatherapy and much more.

Insurance companies don’t pay for most of these therapies. More and more patients are spending their own money for CAM. In fact, patients spend more money for non-medical treatments than for medical care. For example, more money is spent on CAM by cancer patients than for non-traditional treatments for all other diseases and conditions added up!

Reducing disability and costs are the first goals. Rising costs and disability is a major problem for Worker’s Compensation. Companies are also interested in reducing the number of work-related time-loss claims.

Ways to “change the work” include schedules that rotate workers and reducing the lifting loads. Some tasks can be changed to make them faster or less likely to cause injury. This is part of a program called ergonomics.

The goal is to improve worker safety without cost to the company. This includes not affecting the company’s productivity.

Direct studies of the effects of exercise with and without a coach aren’t available yet. More and more exercise-based research is being done, so this type of information may be reported in the near future.

There are several ways to help yourself keep up the desired pace. Music with a steady beat can keep you on task. Using a metronome is another way to keep the right timing. Another option is to time yourself so that you complete each set of exercises in the same amount of time each session.

Keeping a personal log or exercise journal is also helpful. In this way, you can keep track of how many repetitions you’ve done. By recording your daily workout, you can slowly build up without losing ground. Monthly or even semi-annual (every six months) check ups with an exercise expert may not be a bad idea.

There are two main kinds of arthritis: rheumatoid and osteoarthritis. Rheumatoid arthritis (RA) is a systemic disease that can affect the joints and other organs in the body. There is a painful inflammatory process with this type of arthritis. The larger joints such as the hip or knee can be affected. However, it’s usually the smaller joints of the wrist, hands, and feet that are damaged by RA.

Osteoarthritis (OA) affects the hips and knees most often. Swelling may be present, but there isn’t an inflammatory response in the joint. The lubricating fluid is gone and the joint surface is worn away. The majority of total hip and total knee replacements done are for OA.

Patients with RA are more likely to need joint replacement for the fingers of the hands.

Some doctors view these two conditions as two points on the same line. They are similar problems that cause pain, local signs of inflammation, and loss of motion.

In both cases, bone forms in and around soft tissue (usually muscle). Myositis ossificans (MO) occurs after trauma to the muscle or a broken bone. New bone cells form between the torn muscle fibers. This happens most often around the elbow or thigh. Children and young adults are affected most often.

Heterotopic ossification (HO) is more likely to occur after joint replacement surgery. Men over the age of 65 are affected most often. There are some known risk factors for HO. These include patients with ankylosing spondylitis or Paget’s disease. Hip joint replacement without cement is a risk factor. Both MO and HO occur after a stiff joint is manipulated under anesthesia.

Concentric muscle contraction means that the muscle is getting shorter. The force against the muscle is more than the muscle’s ability to resist against it. An example of this exercise is to hold a weight and do a biceps curl. The biceps muscle contracts and shortens as it bends the elbow.

Eccentric muscle contraction means that the muscle is getting longer. It starts from a position of contraction (shortened) and lengthens. Lowering a weight held in the hand after doing a biceps curl is an example of this. Both types of muscle contractions are used to improve strength.

Each method has a purpose. Moving slowly through an arc of motion allows more muscle fibers to get involved. This slower speed gives the individual muscle fibers time to be activated. Speed of movement and number of repetitions both make a difference. The overall effect is to build strength and endurance.

Moving quickly through an exercise causes the muscle to use up oxygen and metabolize quickly. The nervous system’s response to the muscle’s needs is faster. Fewer muscle fibers are used. Intense training of this kind is usually done with fewer repetitions.

This is called interval training. It’s a method used more often by athletes engaged in middle-distance events. Endurance (longer) activities require a different approach. You can find more information on exercise training through the American College of Sports Medicine (ACSM)[On-line at http://www.acsm.org]. Click on “Health and Fitness.”

Most soccer injuries occur in the legs, especially the hip and groin area. A study of professional soccer players in Belgium found that the hamstrings and quadriceps are most important. Tightness or lack of flexibility of these two muscles can increase a player’s risk of injury.

Researchers are still debating whether stretching prevents injuries. Data from some new studies shows that stretching after a workout is actually better. Watch here for more details of these studies.

Amazingly good! Physical therapists use a tool called a goniometer to measure joint motion and muscle length. Studies to answer your question have been done. These compared goniometer measurements by therapists with X-rays showed these to be correct, reliable, and valid.

Therapists worldwide are trained to measure each motion and muscle the same way. The goniometer is lined up with various bony landmarks on the body. The axis of this tool is placed at the same point for each patient.

For a low-tech solution, goniometric measurements offer good information.

EMG or electromyography or electromyogram is a measure of the electric activity in a muscle. Electrodes are placed on the skin or needles put directly into the muscles. These record the sound and pattern of electric activity.

EMG activity shows the condition of the muscles. This test tells if there is more or less activity than normal … or even sudden activity when the muscles aren’t contracting.

EMG findings are grouped as either mild, moderate, or severe. For example, one record of sudden activity in one or more muscles is mild. Moderate is two or three sudden spurts of electrical activity in two or more muscles that aren’t moving. Other changes will also be seen in these patterns. Findings of severe EMG activity mean too much electrical activity in two or more muscles.

Thanks to today’s modern technology, EMG studies are much improved now. It’s possible for an EMG unit (the size of a modern desktop or laptop computer) to study many muscles at the same time.

Information from EMG about muscle function is fast and accurate. It can also be used as a biofeedback tool. This means that a patient who can’t contract (or relax) a muscle can see and hear what is the muscle activity and try to change it.

This refers to studies done on human cadavers. A cadaver is a body saved for study after death. Doctors and researchers use cadavers to improve diagnosis and treatment. Knowing where each nerve, tendon, muscle, and blood vessel is located is important when doing surgery.

For example, doctors in the Netherlands and Italy teamed up to find a safe way to do ankle surgery. Mapping out the location of nerves and measuring their distance from bones is helpful. Anatomic research gives doctors directions on where and how to place surgical tools.

Anatomic research also gives doctors an idea of the sizes and shapes of each body part. Understanding how these tissues are the same or different from person to person is very helpful. Using this information, doctors can carry out operations with little risk of hurting important structures.

The hamstring muscle behind the thigh is actually a group of muscles. They extend from the back of the knee up to the buttocks. Their main function is to extend the hip and bend the knee.

There are many different ways to stretch the hamstring muscle. The best way is to place it in a position opposite of its function. In the case of the hamstrings, this is a position of hip flexion and knee extension.

Here’s one way to do this. Lying on your back, bend both knees and place your feet flat on the floor. Lift one leg and position it with the hip and knee at a 90-degree angle. Your kneecap will be facing the ceiling and your foot will be toward the wall.

Place your hands behind your knee and straighten it. The toes are now moving toward the ceiling. Find a position where you feel a stretch or uncomfortable tightness and hold the leg. It shouldn’t be painful, numb, or tingling. Remember to keep breathing and relax as much as possible.

Keep your buttocks firmly on the floor with equal weight on both sides. It’s very easy to twist the hips to avoid the stretch or to get more motion. If you can straighten your knee easily, then slide the other foot down until the opposite leg is flat on the floor. Again, keep the buttocks and pelvis level on the floor.

To view other methods, visit www.google.com and type in the words hamstring stretch. This will bring up several other ways to stretch the hamstrings.

Patients who get better without being given any “real” treatment are thought to be helped by a placebo effect. Examples of this are pills that have no active ingredient or the use of electrical therapy that isn’t turned on.

The patient has a physical or emotional change because he or she expected to get better. The placebo effect also occurs if the health care worker giving the treatment expects it to help.

Researchers agree that there is a definite placebo effect in many cases. Studies have shown this occurs in 20 to 90 percent of all patients. No one knows for sure how this happens or how to make it happen. Scientists continue to study it with great interest.

The placebo effect (getting better without any “real” treatment) is present to some degree in almost everyone. This has been proven in many studies. Scientists don’t know why it’s stronger in some patients compared to others.

Older adults, women, and nonwhites tend to have the best results. They expect the treatment to work and it does. Most likely, these patients are responding to the doctor’s “authority.” Patients who have had pain a long time are less likely to expect good results.

Scientists are studying this, trying to find out what makes it happen and who’s most likely to respond. Maybe there are certain conditions that respond the most to the placebo effect. Maybe personality traits decide who will have the strongest placebo.

For researchers, there are many advantages to doing studies on volunteer athletes. First, most athletic programs require a physical exam. This provides researchers with “baseline” or starting information that isn’t always available for the general population. Second, working with college athletes gives researchers access to large numbers of volunteers. Finally, college athletes are more likely to comply with research requirements. In other words, if 30 to 45 minutes of exercise is required every day, this group is more likely to do it.

Making exercise recommendations based on young, athletic adults gives us a “best case scenario.” That is, healthy, active adults who follow this advice are more likely than the general population to have good outcomes. That isn’t to say older, less active adults won’t benefit from these recommendations. The effects may simply take longer to achieve.

Neuro refers to the nerves and praxia means “to act or function.” Neuropraxia is a condition in which a nerve remains in place after an injury, but it no longer transmits messages or impulses.

Neuropraxia can result from a mild stretch or direct trauma to the nerve. The nerve loses its function because of a loss of blood supply and damage to the lining around the nerve. This is usually a temporary situation. Unless there is complete disruption of the nerve cells, the nerve can recover.

Stress fractures are common in sports that require vigorous, repeated motion. When muscles and tendons pull on the bone to which they attach, the outer layer of bone can lift up in response to this stress. Most stress fractures occur in the lower half of the body and tend to occur from sports that involve prolonged running and jumping.

Occasionally, stress fractures occur in the arms. These have been reported in sports such as weight lifting, gymnastics, competitive bowling, tennis, and table tennis.

X-rays are electromagnetic radiation of shorter wavelength than the light seen with the eye. X-rays are produced when electrons travel at high speed and strike certain materials such as heavy metals. They can also go through bone onto photographic film. This leaves a picture that can be examined for fractures and other problems.

A fracture shows up on an X-ray because the bone has been disrupted and no emission passes through that spot. In the case of a stress fracture, or a reaction of the bone to repetitive motions, there may not be enough damage to show up on an X-ray.

In this case, a bone scan may be used. With a bone scan, a radioactive substance is injected to produce images of the bone. The radiation shows up in the bone in varying amounts. Areas of increased activity are called “hot spots.” These are seen where bone growth from a tumor, fracture, or other stress on the bone has occurred.

There are many different terms to describe types of transplants. These terms can refer to anything transplanted, such as bone, eyes, or body organs. Allograft transplants are between individuals of the same species (human to human). Autologous transplants are within the same individual. For example, a skin graft can be taken from a person’s leg to use on the person’s hand. Blood or bone marrow can be stored for later use by that same person.

There are other kinds of grafts. Xenogeneic transplants, sometimes called heterografts, are between individuals of different species. For example, pig skin is often used for people with large burns on their bodies.

Allogeneic transplants come from matched donors, usually siblings. Syngeneic transplants are between genetically identical members of the same species, or identical twins.

Extracorporeal means “outside the body.” Irradiation or radiation is a treatment for cancer. When something is radiated outside the body, it is called extracorporeal irradiation.

You may wonder how something in the body can be radiated outside the body. This can be done, for example, when a piece of cancerous bone is removed. Radiation is then applied to the bone before returning it to the body. This method is used only occasionally and usually in places where donor bone is not available.