Hit Your New Year’s Goals

By Dev K. Mishra, M.D., President, Sideline Sports Doc, Clinical Assistant Professor of Orthopedic Surgery, Stanford University

Key Points:

  • New Year’s goals can be achieved with the right set of guidelines to help you
  • Pick a relatively small goal and go bigger when you succeed with the smaller one
  • Use a visual key like a big red X on a calendar for each day you succeed
  • Reward yourself for successful days and weeks
  • Go easy on yourself if you miss a few days and then get back on track

This is the time of year when patients will come in to the office for a “tuneup” prior to starting an exercise regimen. This commonly happens for my 40-60 year old patients but it’s an occasional teenager who has the same objective. They’ve made getting fit and losing weight a New Year’s resolution. Unfortunately, the majority of those folks will fail, and will fall off their new program within a matter of a few weeks.

One of the keys to sticking with any new exercise or lifestyle change is to turn it into a habit.

Creating a new habit and then making that habit permanent can be tough but with some key steps it can be achieved by anyone. If you’re interested in making a major habit change I’d strongly encourage you to read Charles Duhigg’s book: The Power of Habit. In the introductory video you’ll see him describe the three parts of any habit, whether a good habit or a bad habit. There’s a cue (the stimulus), an action (that’s the habit), and a reward (the thing you get from the habit).

It’s interesting to think that a bad habit is associated with a “reward” but Duhigg provides compelling evidence. And so it is with diet and exercise. If you resolve to cut out processed sugar you need to make this a habit. Ditto if you have a resolution involving fitness.

Of the three parts of a habit, I find that the “reward” part is really underappreciated. Too often there’s a feeling that there has to be substantial pain involved in making a new habit but that’s not the case at all. On a daily basis you could give yourself a tiny reward for accomplishing a goal, and perhaps a bigger reward for a larger accomplishment. Just don’t make the reward something that undoes your hard work! For example, if your goal is to eliminate processed sugar during the day don’t reward yourself with a nighttime candy bar!

There are a lot of great people writing about the best ways to pick goals and change habits. Besides Charles Duhigg, I also really like Tony Robbins. There’s also a very nice set of guidelines by Jen Miller in the New York Times.

Here are my overall keys to success for any goal:

  • Pick the right goal. The acronym associated with good goal setting is “SMART”, which means pick a Specific goal and not something vague, make it Measurable, be sure it’s Achievable, choose something Relevant to your life, and put a Timeline on it.
  • Start small. This is related to picking the right goal. You’ll feel empowered to continue if you succeed in very small goals initially, then build with new goals. Many folks pick huge audacious fitness goals but this can be a setup for problems, especially if it’s something totally new for you. I find this is particularly true surrounding exercise. If you’re coming from a place of minimal activity, start with a 20 minute walk rather than a half hour fast run.
  • Use an actual calendar to mark off your progress. Believe it or not, paper actually works best. Keep a calendar where you see it every day. For every day you achieve your daily goal put a big red X on the day. Keep making X’s.
  • Reward yourself on a daily, weekly, and monthly basis for keeping your new good habit going.
  • Go easy on yourself if you have a setback. Things happen that are out of your control and even with the best of intentions you might miss a day or a few days with your new habit. This is not a failure, just a speedbump.

Here’s to your success- Happy New Year!

SideLineSportsDoc

THREE-SPORT ATHLETE GETS BACK IN THE GAME AFTER TISSUE TRANSPLANT

By AlloSource: Doing More with Life

JAKE
RECIPIENT OF: BONE AND CARTILAGE

Jake’s life was never without sport: as one season ended, another began. Soccer became basketball, basketball became track, and he enjoyed the athletic challenge of each sport. However, constant knee pain threatened to put Jake on the bench.

Jake’s knee pain started three years ago and doctors suggested he try stretching and physical therapy to remedy the problem, but the pain persisted. When running or playing soccer, his knee would sometimes give out and it became clear to Jake and his parents that more medical attention was necessary.

“I didn’t feel that I was able to compete to my full potential,” said Jake. “I had an obvious limp when running, but I didn’t know what was causing it.”

After an MRI, Jake’s doctor diagnosed him with Osteochondritis dissecans, a joint condition in which cartilage and bone in the knee become loose. Though he was in the midst of a basketball season and looking forward to track, Jake’s diagnosis forced him to stop playing.

Jake and his family sought a second opinion after his diagnosis and they met Dr. John Polousky of HealthONE Rocky Mountain Hospital for Children in Denver. After weighing his options, Jake and his doctor moved forward with surgery. During the procedure, Dr. Polousky used bone and cartilage allografts to replace the damaged tissue and realigned the weight-bearing line in Jake’s leg.

Jake understood prior to his surgery that a deceased tissue donor made the bone and cartilage allografts possible.

“My immediate reaction was sadness. Today I am very appreciative that the person chose to be a donor and wanted to help someone beyond their own life.”

Part of Jake’s recovery included the use of  an external fixator with metal pins anchored into entry points in his leg. “After the surgery I noticed all of the attention I received from strangers. I don’t think they had ever seen an external fixator, and it did look strange,” he said.

Jake recently had the external fixator removed and has started his exercise regimen again. He rides his bike 12 miles per day and does not have any pain.

Receiving donated tissue affirmed Jake’s belief in donation. He registered as a donor when he got his driver’s license and hopes that others will consider registering too.

“I have felt the impact of what it really means to receive something from someone you don’t know. I would be interested in knowing about my donor’s life because
they are a part of me now. He or she made it possible for me to be healthy, so that I can do the things I like to do.”

Coming Back From: Knee Meniscus Surgery

By Dev K. Mishra, M.D., President, Sideline Sports Doc, Clinical Assistant Professor of Orthopedic Surgery, Stanford University

Key Points:

  • Recovery is highly variable, but generally speaking most young athletes can return to sprinting, cutting, and jumping sports at about 6 weeks after partial meniscus removal surgery
  • Generally speaking, most young athletes will return to sprinting, cutting, and jumping sports at about 4 months after meniscus repair with stitches
  • Beware about claims to return fully to sports at 2 weeks after surgery (or less…) – this is very rare
  • Success rates are very high with properly followed rehab

College football fans recently witnessed the strange sideline incident where Ohio State quarterback JT Barrett reportedly injured a knee when colliding pregame with a photographer. But from my standpoint as an orthopedic surgeon the most incredible part was that Barrett had knee surgery on the Sunday after that game and then played in the Big 10 championship game against Wisconsin only 6 days after surgery. I have no details about exactly what was done in Barrett’s knee, but media reports indicate it was surgery to trim a torn meniscus. Furthermore, the stats from the Wisconsin game show that not only was he effective as a passer but he also rushed for 60 yards! This is uncharted territory.

Most orthopedic surgeons would honestly tell you it would be incredibly unusual for a player that relies on speed, quickness, and the ability to turn on a dime to be fully ready that quickly.

So how long should it realistically take?

The meniscus is a shock absorber in the knee, a horseshoe shaped structure situated between the two major knee joint bones. There are two menisci in each knee, and either meniscus can be torn in patterns generally like the ones shown in the photo (from OrthoInfo, the American Academy of Orthopaedic Surgeons).

If surgery is done for a torn meniscus it will most often be a partial removal, which is somewhat like trimming a hangnail from your toe. It’s a relatively quick procedure (usually about 15-20 minutes) and weightbearing is allowed immediately after surgery. The second possible procedure is called a meniscus “repair” where stitches are placed in the meniscus to sew it back together. After a meniscus repair there is usually a period of partial weightbearing on crutches that lasts several weeks.

The type of surgery performed has a major influence on the speed of the rehabilitation. With the commonly performed partial meniscus removal there is an early emphasis on minimizing swelling and regaining motion. Comfortable walking generally takes about a week or two. The highly variable part is return of power, speed, and the ability to cut hard or pivot. This is the part that takes the longest time and will usually take 2-4 weeks. So if we add the weeks up it will be a minimum of 3 weeks and perhaps up to 6 weeks for full return to sprinting, cutting, and jumping.

With meniscus repair with stitches there could be 4-6 weeks on crutches, followed by regaining full walking ability, and finally getting the knee sport-ready with strength, power, and speed. There is some overlap in the phases but when all the time is added up you’re looking at 3 to 4 months until the player is ready for unrestricted sprinting, cutting, and jumping.

In the discussion above I’ve focused on return to sprinting, cutting, and jumping. So the timeline for return to sports will depend on whether you need to do those things in your sport. If you are a cyclist or swimmer you should expect a faster return to your sport. Distance runners will generally return to full training faster than sprinters but likely longer than cyclists.

Young athletes should expect a high chance of successful return with proper rehab and time after surgery. But it’s only a very rare few who can come back as fast as JT Barrett.

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Health Coaching vs Nutritionist; Helmet Safety

Episode 17.22 

Segment One (01:56): Karen Malkin from Karen Malkin Health Counseling talks with Steve and Dr. Cole about customizing your diet to your own physiology and biology. With all the options-resources available today and information overload, Karen helps to simplify decisions on “Whats Right for Me”.

For Special Savings with Karen please visit:

14daytransformation.com and use the Coupon Code ESPN1000


Segment Two (16:03): Samantha Cochran from Athletico Physical Therapy discusses helmet safety when participating in various sports, proper use and fitting of helmets. While all leagues and teams require helmets, many coaches, players and parents don’t know exactly how to choose a helmet that will provide the right protection. Athletico has developed a step-by-step guide to educate parents, athletes and coaches on selecting and wearing helmets.

Proper Fitting Tips for Protective Equipment

  • Always follow manufacturer’s guidelines when fitting any helmet2017 national athletic training month
  • Hair should be wet when fitting any helmet
  • Each part of the helmet serves a purpose
  • Attention to detail and wearing every helmet properly ensures maximum protection
  • Never cut corners
  • Replace any helmet that has been damaged
  • Look for the NOCSAE seal of approval
  • Comfort is key
  • If your helmet is fitted properly but not comfortable, explore other options

Samantha Cochran is an athletic trainer with Athletico Physical Therapy at Malcolm X College within the City Colleges of Chicago. She received her Master of Science degree with a concentration in Kinesiology in 2014 from Texas A&M University – Corpus Christi. In her time at TAMUCC she served as a graduate assistant athletic trainer for Islanders’ athletics from 2012-2014.

Helmet Fitting Tips from Athletico Physical Therapy