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HOUSE CALL WITH DR. SANJAY GUPTA

More Injuries In Amateur Athletes; Avoiding Injury During Exercise; Lance Armstrong Encourages Students To Get Fit And Healthy

Aired April 22, 2006 - 08:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


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Anger spilling over into the streets of Nepal. Hard-line protestors have rejected the king's proposal to return political power to the people. They say that they're just not going stop until the king just steps down. They're unhappy with the monarchy and they want it destroyed. Police say thousands of demonstrators marched toward the heart of the capital today.

And the attention, parents and weekend athletes. Dr. Sanjay Gupta takes a closer look at treating and preventing sports injuries. "HOUSE CALL" begins right now.

DR. SANJAY GUPTA, CNN SENIOR MEDICAL CORRESPONDENT: Good morning and welcome to HOUSE CALL. I'm Dr. Sanjay Gupta. And this morning, we're trying to help you with those nagging injuries.

As temperatures go up, millions of people are emerging from their houses. And they're running, they're biking, or maybe kicking up their existing workouts. This jump into fitness leaves some people limping toward summer.

And as Judy Fortin reports, those in sports medicine are seeing more injuries in amateur athletes.

(BEGIN VIDEOTAPE)

JUDY FORTIN, CNN CORRESPONDENT (voice-over): In the medical community, they're often called weekend warriors, amateur athletes who end up injured because they may have taken on too much, too soon.

DR. JOHN XEROGEANES, ORTHOPEDIST: Like anything else, you have to build your way up to it. You have to have a good foundation like a house.

FORTIN: Orthopedist Dr. John Xerogeanes cautions patients to start out slowly when getting back into an exercise or sports routine.

XEROGEANES: If you don't do that, if you go out and just run two miles, or you go out and bike for a long time, then you're going to get overuse-type injuries, i.e. blisters, tendinitis, which is inflammation of your - the connections of your muscles to the bone.

FORTIN: In a worst case scenario, Dr. Xerogeanes says some patients could develop cardiovascular problems. If you're over 40, he recommends you get a full check-up to make sure you're healthy. Then start off with an easy exercise routine, like walking for at least 20 minutes a day, five days a week.

Judy Fortin, CNN, Atlanta.

(END VIDEOTAPE)

GUPTA: All right, Judy, thanks. And there are approximately 10 million sports injuries every year in the United States. And this morning, we're showing you how to prevent and how to treat some of the most common ones.

So let's start with some of the basic tips, especially for those boosting their exercise this time of year. Remember to warm up and to stretch and use well fitting safety gear, as well, whether it's cycling or if it's soccer. Don't ignore pain or cramps, they could be a sign you're overdoing it and making injuries worse. And remember to drink up. It's easy to forget how hard you sweat when you're caught up in the game.

Lastly, and this is a tough one for a lot of people, respect your limits. Don't expect to run 10 miles when you haven't gotten off the couch all winter long.

Someone who sees the after effects of not following those tips is Marjorie Albohm. She's the vice president of the National Athletic Trainers Association. She oversees patients at therapy at Orthopedics Indianapolis as well.

GUPTA: Welcome.

MARJORIE ALBOHM, CERTIFIED ATHLETIC TRAINER: Good morning.

GUPTA: A lot of people obviously facing this now. The temperature's getting - weather's getting nicer outside. How does someone know when they should come to see you or that they've done too much to their bodies?

ALBOHM: Well, I think you're right. Everybody is getting outside and trying to get fit again. You know, I think there's a big difference between general muscle soreness, you know, soreness throughout the body that you have, because you haven't done anything all winter and specific pain. And people should be aware of specific point tender pain and in bony areas, muscle areas with symptoms that they haven't experienced before. That's a cue that then they should see their physician or see an athletic trainer.

GUPTA: And certainly apply -- not do any more of the same activity for a little bit.

ALBOHM: Correct. As long as you have symptoms, you should back off.

GUPTA: All right.

ALBOHM: And listen to your body, hear what it's saying, and respect that.

GUPTA: All right, lots of e-mails coming in on this...

ALBOHM: Good.

GUPTA: ... particular topic. Let's get to some of them if we can now. David in Connecticut's writing us this. "When gearing up for an active spring after a winter of non-activity, is there advice to help prevent a recurrence of the pain from old injuries? What about cortisone shots as well? Do they help with lingering injury pain?"

Let's start with the first part of that question, preventing old injuries. Maybe he's had old knee pain or something like that. How can he make this spring and summer less painful?

ALBOHM: Well, I think, you know, the body's been in hibernation for a lot of people over the winter. So a lot of stretching, a lot of very specific gradual conditioning. Don't try to go out in one weekend and do everything, or play the softball game, a pick-up basketball game. Gradually get into it.

And go to the gym before. Spend the winter in the gym, keeping your level of conditioning the same, keeping the muscles strong so you don't have this big gap of fitness that you haven't done anything and now you're back trying to do everything.

GUPTA: And David mentioned the cortisone shots as well. What about those? What do you think?

ALBOHM: That's really a physician's call. But generally, the cortisone shots are for very acute symptoms, something that's very flared up, more severe than the chronic long-term kind of condition that you may have.

GUPTA: Quick question. Stretching, because I -- people go back and forth on this. Should you stretch always before a workout?

ALBOHM: Always. Always.

GUPTA: It's a cold muscle, though.

ALBOHM: It is and some people recommend a little light jogging, a little, you know, maybe general body warm-up before you do that. And that's good, but stretching is essential, and not just two, three minutes. You know, people think you stretch a long time. They say I've stretched long time. Never enough.

GUPTA: Never enough.

ALBOHM: A long time.

GUPTA: OK, I know some people that spend as much time stretching as they do working out. And that might be good advice.

ALBOHM: That's great.

GUPTA: Let's get to another e-mail now. Someone trying to start exercising. Of course, we encourage that here on HOUSE CALL.

Audress in Colorado writes this. "After many years of not having a regular exercise routine, I'd like to try jogging. I've heard horror stories about people who severely damaged their knees by running or jogging. What I can do to stay safe?"

You know, there are some docs out there who say absolutely no jogging, no running. You know, orthopedic surgeons will tell you...

ALBOHM: Right.

GUPTA: ...it's just too bad for your ankles and or your knees. What do you think?

ALBOHM: I think a combination. I think anybody doing all weight-bearing, pounding activities is in for trouble. It just doesn't make sense.

So combine, modify your activities. Do jogging, do swimming, do swimming, do cycling, do elliptical, modified weight bearing. Blend all of that, cross-train, and you'll have a great workout and a great pattern in your workout and have lots of - less stress on your knees.

GUPTA: And anything specific for Audress? I know she's worried about hurting her knees or ankles if she starts running.

ALBOHM: Well, I think, again, start walking, if she hasn't done anything. You know, get some good cardiovascular activity through walking. And then, I would not - I would maybe go two days a week with the jogging program or one, and build those other activities in.

GUPTA: There's a theme there. Don't overdo it as people start to get outside for the first time.

ALBOHM: That's right.

GUPTA: We're finding out what you can do to stave off those spring-time injuries, saving yourself from shin splints, all sorts of other pains. That's coming up on HOUSE CALL.

UNIDENTIFIED FEMALE: They're the first thing to hit the ground and keep you moving all day long. How to care for those aching feet, coming up.

And later, Tour de France champion Lance Armstrong weighs in on creating a Fit Nation. First, take today's quiz . True or false, sprains and strains are the same injury? Stay tuned for the answer.

(COMMERCIAL BREAK)

UNIDENTIFIED FEMALE: Before the break we asked, true or false, sprains and strains are the same injury? The answer, false. Sprains occur around joints and strains occur in muscles and tendons.

GUPTA: But sprains and strains do have something in common. They're the most common complaints made by sports enthusiasts overall. And for all those weekend warriors out there, another reason to be watching the show. Experts say six out of 10 people who start exercise programs sustain a sports injury within six weeks.

Most of those can often be prevented. And helping us to do just that is Marjorie Albohm. She's the vice president of the National Athletic Trainer's Association and has coordinated medical coverage for several major sporting events as well, including the 1996 Summer Olympics right here in Atlanta.

We have a lot of people asking questions about this stuff this morning. Michael in New York asked a good question I thought. Whenever I try and get in shape, I develop shin splints. I have tried stretching, different types of warm-ups and changing the types of shoes I wear. Is there anything I can do to stop this injury?

And I have to tell you, Marjorie, I get the same thing. And it can be quite painful.

ALBOHM: Very painful.

GUPTA: Don't feel like running for a while. And it only throws me out of whack.

ALBOHM: Very painful. And I think you have to look at the origin of the problem. The foot, the arches in the feet are the shock absorbers. And look to those and look to good shoes, look to custom orthotics, inserts in the shoe that support the arch. So shock is absorbed more effectively in the lower leg.

If you stop the problem at its origin, or address it at its origin, then the shin splints may be controlled. However, you know, they all can't be controlled. So sometimes you may have a shin splint that turns into a stress fracture. And you really don't know quite what's going on. And you can't relieve it with ice or modifying your activity. Then you need to see your physician.

GUPTA: Ice first, right?

ALBOHM: Ice always. Ice first, yes. Whenever you have an ache or pain after working out, put the ice bag on. You don't need a fancy ice contraption. You need ice cubes and a Ziploc bag. Put them on there.

Or another effective way is Styrofoam cups filled with water in your freezer. My freezer's filled with ice cups. Walk in the house, grab an ice cub, rub it on there. When it's done, you've had your treatment.

GUPTA: That's a good idea. I mean, that's something everyone can do.

ALBOHM: Simple, yes.

GUPTA: Today, in fact. It's all about the feet, it seems. Lots of questions about this, which brings us to a question from Joan in Colorado. "I've had plantar fasciitis last July. I do Achilles stretches, but if I do any running I am back to square one. Should I quit running entirely?" Are there other people out there who just shouldn't run?

ALBOHM: Well, we hope we never get to that point. We hope we never have to say stop everything. And plantar fasciitis is a big problem. With all overuse problems, my philosophy is just don't do one thing at a time. Throw it all at it.

So stretching is good. Back to the arch system. Good arch support in the feet. Do modify your activity, non weight bearing. Don't put all that stress on that arch. Make sure your shoes are good.

And there's a thing that we call a night splint that keeps the foot and ankle in a certain position to help that also. Your physician can prescribe that.

GUPTA: OK, so we know that obviously if you're in a lot of pain still, you probably shouldn't go back to exercising, but how do you know when it's OK to start exercising again?

ALBOHM: Great question. So you have to be without symptoms. So if you go out, if you think you're pain-free in your daily activities. You can't feel the plantar fasciitis, you can't feel your shin splints, then start trying to do your activity again. And if the symptoms start to come up again then back off, or modify, or go to swimming or cycling.

But any time there are symptoms, you're really irritating that area again. And although the condition might not be more serious because of that, it delays recovery. And all you're doing is creating a cycle of pain and inflammation and delayed recovery.

GUPTA: So symptom free, off pain medication.

ALBOHM: Symptom free, yes.

GUPTA: OK, good point.

ALBOHM: Yes.

GUPTA: An awful lot of people are listening to that.

Let's get to another e-mail now. Stephen in Michigan writes this. "I'm 23, I'm athletic, and have been suffering from shoulder problems for five years. I found an article and my condition was labeled 'shoulder instability'. What do you know about it, if anything, and how can it be treated?"

ALBOHM: Kind of a catch all phrase.

GUPTA: Yes.

ALBOHM: Shoulder and stability. The shoulders are very vulnerable joint to injury. It's not very stable. So if you get it in an awkward position, muscles could be strained, tendons could be sprained -- ligaments could be sprained.

So the first thing is a good diagnosis by your physician. Again, if you have pain, get away from the heavy weights. A lot of people look at shoulder and upper extremity. And a lot of men think well, I can strengthen this by getting in the weight room, barbells, heavyweights. Go back to rubber tubing, bands, light resistance, many repetitions rather than heavy, heavy weights with few repetitions.

GUPTA: And swelling or any fluid around the joint may be a clear sign?

ALBOHM: Key symptom.

GUPTA: Yes.

ALBOHM: Key symptom. Any time there's swelling, something's going on. Anytime there's swelling in any joint, back off, go back to ice. Watch your symptoms two to three days. You know, we don't encourage everyone to come running to us with a little problem...

GUPTA: Right.

ALBOHM: ...but if your symptoms don't resolve and we say three to four days, or certainly if they get worse, call your doctor.

GUPTA: Good. Good advice. More of your questions coming up on HOUSE CALL.

UNIDENTIFIED FEMALE: Coming up, from baseball to soccer and every league in between, it's the season for kids to be hitting the fields and the time for parents to beware of injuries. They're on the rise in kids.

But first this, week's medical headlines in "The Pulse."

(BEGIN VIDEOTAPE)

CHRISTY FEIG, CNN CORRESPONDENT (voice-over): How many babies you have and how often may affect their health. According to a study published in the Journal of the American Medical Association, women who have babies less than 18 months or more than five years apart are more likely to go into pre-term labor or have children with low birth weight. A Mediterranean diet may be good for the body and the mind. A new study finds eating vegetables, fruits, legumes, cereals, a little dairy, and the occasional glass of wine may reduce your risk of getting Alzheimer's Disease.

Previous studies have found a similar diet reduces your risk of cancer and heart disease.

Christy Feig, CNN.

(END VIDEOTAPE)

(COMMERCIAL BREAK)

GUPTA: We're back with HOUSE CALL. We're talking about preventing and treating sports injuries. More and more kids are participating in sports, sometimes many at a time. And experts are seeing an increase in adult-type injuries in children.

Judy Fortin now with some things that parents should look for.

(BEGIN VIDEOTAPE)

FORTIN (voice-over): The crack of a bat or the swoosh of a soccer ball can be heard all over the country this time of year. From school yards to backyards, the American Academy of Pediatrics estimates close to 26 million high school boys and girls will take part in a team or recreational sport. It also means that doctors like pediatric orthopedist Robert Bruce see more injuries.

ROBERT BRUCE, DR., EMORY SCHOOL OF MEDICINE: Boys tend to develop more acute traumatic-type injuries, fractures, broken bones. and girls are more susceptible to overuse injuries.

FORTIN: Injuries like torn knee ligaments. Dr. Bruce also sees younger kids, who aren't ready to participate in certain sports.

BRUCE: If the child's not physically fit enough to participate at the level required, then they have a great deal of difficulty.

FORTIN: Dr. Bruce says that's when a parent needs to step in and make a decision on whether their child should be playing this sport. Dr. Bruce also puts the burden on parents to spend time at practice. Get to know the coach, make sure your child has the proper equipment, gets adequate rest, and most importantly, stays hydrated by taking plenty of water breaks.

Judy Fortin, CNN, Atlanta.

(END VIDEOTAPE)

GUPTA: All right, Judy, thanks.

And we're talking with Marjorie Albohm. Now she's the vice president of the National Athletic Trainers Association. She also oversees patient therapy at Orthopedics Indianapolis. And Marjorie, let's get back to our inbox now. A question from a worried parent. A lot of them out there watching the show today. "My 13-year-old son plays basketball, baseball, and football and has recently acquired a popping or cracking sound in his ankle when he walks. He claims it doesn't hurt, but it does seem to be getting more noticeable. What can we do?"

And just first of all, I mean, he's playing a lot of sports.

ALBOHM: Active kid, very active.

GUPTA: It's a lot.

ALBOHM: Probably isn't unusual. You know, and may be too much. And that's something for another show.

GUPTA: Right, right.

ALBOHM: But I think there are such things as growing pains. And I think there are some things you need to watch for to make sure that you don't underestimate this.

Is there -- has an injury happened? Ask your son or daughter, do you remember an injury happening? Did you have to stop? Did you have to come out of the game or practice? We call that a mechanism of injury.

If there's no mechanism of injury, then you don't need to worry too much. Look also for swelling, discoloration, and movement impairment, limping, favoring in daily activities or when they go back to sports.

If all of those things are negative, it just may be growing pains.

GUPTA: Right.

ALBOHM: So just keep monitoring it.

GUPTA: So maybe the popping really nothing specifically to worry about?

ALBOHM: Correct.

GUPTA: Keep an eye out for those areas.

ALBOHM: Keep an eye on it.

GUPTA: That's good advice. We're talking with Marjorie Albohm. And we're talking about sports injuries. But first, the last stop in our Fit Nation tour.

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: In the past, I've asked kids to do a lot of things. And looking at me, it was evident I was not practicing what I was preaching.

(END VIDEO CLIP)

UNIDENTIFIED FEMALE: How parents are reaping the benefits of getting kids active.

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

MARIA SHRIVER, GOVERNOR'S WIFE, CALIFORNIA, AUTHOR: I try to eat with my kids. I try to talk to them about portion control. I try to talk to them about drinking water. I try to talk to them about not drinking too many sodas. Now that doesn't mean that we're eating healthy all of the time in my house, because we're not, but we try to be active.

(END VIDEO CLIP)

GUPTA: And thanks, Maria Shriver, who headlined our Fit Nation stop at U.C. Berkeley.

You know, we've seen a lot of great examples. And we're getting some creative ideas on these college campuses.

This week, we headed to the University of Texas at Austin that marks the end of our eight week Fit Nation tour. And who better to inspire students to get fit and get healthy than seven-time Tour de France champion and cancer survivor, remarkable guy, Lance Armstrong? He made sure to point out the link between obesity and cancer.

(BEGIN VIDEO CLIP)

LANCE ARMSTRONG, TOUR DE FRANCE CHAMPION: The two are so integrated that it's scary, but it's the easiest thing to fix. I mean, if you consider cancer, 50 percent of all cancers are preventable. If you consider obesity and lack of exercise and all these things that lead to unhealthy lifestyles, which ultimately will lead to cancer potentially, very easy to fix.

(END VIDEO CLIP)

GUPTA: Easy to fix, but not so easy to do. So 10 years ago, Lance joined up with one woman who got kids and parents energized by doing a marathon.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): It wasn't an Olympic ceremony, but for these medal recipients, it was just as inspiring. Some kids ran, some walked, fast kids, slow kids, overweight kids, disabled and blind kids. All of these kids completed a 26.2 mile marathon, not in one day, but over a period of six months. All of these marathon kids were gold medallists.

EDUARDO SANCHEZ, DR., TEXAS HEALTH SERVICES DEPT.: I congratulate each one of you kids for running, walking, 26.2 miles, for eating those fruits and vegetables.

GUPTA: Founder Kay Morris says the idea is to have young kids embrace healthy fitness in the everyday lives.

KAY MORRIS, EVENT FOUNDER: Our mission is to move kids who are at risk of being sedentary. And a lot of - we do already recognize that a lot of children are just not out there moving around as much as they used to. So this gives them a vehicle that really resonates with them and with their families. And we're trying to build a habit.

GUPTA: Kay held the first event 10 years ago with about 10,000 kids in Austin, Texas, led by the man who went on to win seven Tour de Frances, Lance Armstrong.

Today, some 100,000 kids across Texas in the United States have registered to be marathon kids.

JORDAN HAYS-BAKER, RUNNER: I used to eat like white bread and unhealthy cereals at my house, but now we're eating like really healthy.

JOURDAN TUCKER, RUNNER: When I'm at school, sometimes we go to the track. And when I'm on the playground at school, then sometimes I run around there a lot.

GUPTA: And for Jeff Tucker, being a marathon kids dad had fringe benefits.

JEFF TUCKER, PHYS. ED INSTRUCTOR: I started being active a little bit at a time, adding to it, making -- changing my food from less healthy to more healthy. And to this day, I've lost 88 pounds in about six months.

I feel like now I can really teach from my heart, because in the past, I've asked kids to do a lot of things. And looking at me, it was evident I was not practicing what I was preaching.

UNIDENTIFIED FEMALE: Awesome job, guys. What a strong finish! Way to go!

GUPTA: Every marathon kid is a winner.

(END VIDEOTAPE)

GUPTA: And that is a great program down in Texas. And Lance is starting to train for a marathon himself. So look for that later this year.

I want to thank all of the people like Lance, the students, the doctors, the educators, the business leaders who came out for all of our Fit Nation events. I hope we'll be seeing the ideas we generated actually turned into action. That's the plan.

More HOUSE CALL, coming up.

(COMMERCIAL BREAK) GUPTA: If you want more information on an injury you're struggling with, go to orthoinfo.aaos.org. You'll find information on injury prevention, as well as detailed pages on specific injuries and sports as well.

Marjorie Albohm, you've been our guest today. Great stuff. Good advice. Do you have a final thought you'd like to share with our viewers?

ALBOHM: Well, I think the best advice is to listen to your body. Pay attention to what your body's telling you during physical activity. If you have symptoms that are lingering, pay attention to those, see a physician, but your body gives you a lot of information. Tune into it.

GUPTA: I think that's a great way to end the show. Thank you so much for being our guest today.

ALBOHM: Thank you, my pleasure.

GUPTA: Marjorie Albohm has been our guest. And I want to thank you all at home as well for answering all of your great questions. It's been good stuff. Have an injury free day as you enjoy the warm weather.

Tune in next weekend for another edition of HOUSE CALL. Don't forget to e-mail us your questions at housecall@CNN.com. Thanks so much for watching. I'm Dr. Sanjay Gupta. Stay tuned now for more news on CNN.

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