General HealthPain


What do the viral pandemic and New Years Resolutions have in common?

Believe it or not, they both result in visits to your local orthopedic surgeon!

There was a brief period, early on after the onset of the viral pandemic, when most physician offices closed down, and only emergency services were provided. We geared up for telemedicine. A lot of medical services are elective, meaning you won’t die or lose a limb if you don’t have access to medical care. Orthopedic conditions run the gamut from life and limb threatening (like malignant tumors and hip fractures), to elective conditions, (like hammer toes, carpal tunnel syndrome and even ACL tears). And there’s everything in between. Soon our patients in pain began to demand to be seen in the office, even for the elective conditions. Telemedicine visits tapered off. Even our elderly patients wanted to be seen in person. We gradually opened back up, and it wasn’t long before telemedicine was being used in only a few cases. Let’s face it, orthopedic care is mostly hands-on. Visual inspection. Examination. X-rays. Injections. Casts. Put things back in place…

But we certainly assumed the number of patients would diminish, as folks didn’t injure themselves as much, and they would decide to put up with a lot more pain than before, just to avoid a trip to the doctor. But this hasn’t been the case. While it’s possible that some injuries have been prevented, and some pain has been tolerated as a result of our quarantine, another surreptitious disease has taken full advantage of our it: the adult repetitive strain.

Repetitive strain conditions are common in humans, particularly active individuals, and those over 40. I’ve written many posts about these disorders, and will not go into detail here. Suffice it to say, the viral pandemic has resulted in a sad influx of these conditions, as Americans try to figure out creative ways to exercise at home, and try to occupy the extra time they would normally have used to socialize and go to work. We’ve also been gaining a little weight, and this always puts extra strain on weight bearing bones and joints.

In any other year, I see an increase in these disorders shortly after the holidays, when folks have spent the fall/winter quarter, (starting around Halloween and ending on New Year’s Day), partying, baking, travelling, gaining a little weight, and perhaps not exercising as much as usual, due to the natural tendency to hibernate in the colder months. But then New Year’s Resolutions are made. People join gyms, start preparing for half-marathons held in February, and buy kettle bells. And they start making appointments to be seen for the repetitive strain injuries associated with de-conditioning, over-exercising, and poor preparation. It’s always frustrating for the patient, and frankly us docs as well, because short of resting, there are no quick solutions. Half-marathon sign-up fees are lost. Gym memberships put on hold, and we’re back to sitting around, eating and resting.

My readers know that I have been trying to keep you out of the ERs and the orthopod’s office with my series, “Staying Pain-Free During Covid-19.” Well, it’s still here, and although we are getting vaccinated, I predict it will be a while before we are comfortable getting back in the gym and joining large classes of deep-breathing, sweaty exercisers.

Let’s do things differently this year. Let’s lose weight by modifying our diets, every bit as much as we try to burn more calories through exercise. Let’s prepare for new exercise programs and goals. Let’s stretch, gently at first. Start with lighter weights and perhaps more reps. Let’s walk before we jog, and jog before we sprint. Sign up for a 5K before a half-marathon.

And most importantly, listen to your body.

Many of you are over forty. As we age, we begin to experience the results of not only aging, but also the liabilities we have developed or inherited. Things like arthritis, rotator cuff disease, old sports injuries, obesity.

Pain, other than the result of acute trauma, can be a sign of repetitive injury or a developing condition. Don’t work through it, unless it’s just the slightly sore muscle from a new exercise. A painful joint is never normal. A swollen or deformed joint or extremity is never normal. Don’t work through it. Back off and try to discover the offending activity. If you can figure it out (and so many of my patients do figure it out, once we go back through the activities of the weeks leading up to the onset of pain), then modify the offending activity: back off, lessen or stop, until the pain goes away. See what you can do then. Does the pain come right back after the first kettlebell jumping jack? Or can you now do a set of 5 jumping jacks with no weights? Maybe it was something transient, never to come back again. But maybe it’s a sign of an underlying condition. You can look through old posts of mine, to see if anything helps you with your pain, but If it does not get better, go see your favorite orthopod. We can help you with those New Year’s Resolutions!

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