The End Stages of Degenerative Disc Disease

End stage or advanced degenerative disc disease occurs when the intervertebral disc degenerates and the disc space collapses. This can result in herniation of the inner disc material through the disc wall. There also can be visible changes on the bony portion of the adjacent vertebrae as detected by MRI or CT scan. The resultant pressure of the disc material on neurological tissues is the source of pain and neurological symptoms.
Degenerative disc disease is a general phrase that describes the alterations which occur as the intervertebral disc ages. According to the Mayfield Clinic, the disc becomes less flexible and cannot effectively cushion the forces of the adjacent vertebral bones. The primary reason the disc loses its mechanical strength is due to water loss or dehydration. It causes the disc to shrink and puts more stress on the disc¡¯s outer wall. That stress creates small rips in the disc wall. When this occurs, the softer inner disc material can protrude through the rip, or herniate. When the herniated material pushes on the spinal cord or spinal nerves it can cause severe pain and other symptoms. Other features of advanced degenerative disc disease occur when the disc space becomes so narrow that the vertebral bones rub together. This produces abnormal bone growth on the vertebrae. These combined effects result in narrowing of the spinal canal, called spinal stenosis. Spinal stenosis can cause compression the spinal cord and spinal nerves, leading to even more pain and dysfunction.
The symptoms of advanced degenerative disc disease depend largely on which spinal level the pathology occurs and the amount of herniation or stenosis involved, according to the University of California San Diego Center for Functional MRI. Generally speaking, the most significant feature of the condition is pain. This pain is usually continuous and can radiate into the back, hips and legs. Flare-ups of the pain often occur, and when the spine is twisted or bent the pain frequently gets worse. Severe cases can result in more pronounced symptoms. Sensory dysfunctions, known as parasthesias may occur in the back, arms and legs, and may be so severe as to cause paralysis on one side of the body. Occasionally, weakness in one or both legs may occur, and walking behavior may be affected. Bladder and bowel function may also be disturbed, and there may be paralysis of part of the diaphragm muscles.
In general, nonsurgical treatments, also called conservative therapies are the first attempt to relieve symptoms of degenerative disc disease. According to the Mayfield Clinic, these include using nonsteroidal anti-inflammatory medicines, pain relievers and muscle relaxers. Corticosteroid drugs can also be injected directly into the spinal column to manage the pain. Rest, back braces, physical therapy, exercise, and chiropractic medicine are also frequently used. When such treatments fail or if the symptoms get worse, surgery is usually recommended. Surgery involves removing the degenerated disc in its entirety or the disc material that has herniated onto the neural tissues. According to MDGuidelines, removing the disc, called discectomy may result in interbody spinal fusion. This means the intervertebral space receives grafted bone material to encourage the vertebrae to grow together. Often, the bones are stabilized with metal hardware so the vertebrae do not move while they fuse.

How to Keep Your Shirts From Getting Holes in the Armpit

Holes commonly show up in the armpits of shirts, often appearing soon after the garment is laundered. Although some holes are created by normal wear and tear, antiperspirants and deodorants are usually the culprits. Combined with perspiration, the chemicals in the products weaken the fiber and cause damage to fabrics such as wool, silk, linen, cotton, rayon and some synthetics. The damage is often permanent, but proper care and a change in the way you use deodorants and antiperspirants can prolong the life of your shirts.
Dry your skin thoroughly before applying deodorant or antiperspirant, and then allow the product to dry completely before putting on your shirt. Use the products lightly, as heavy use causes a greater buildup that can damage your clothing.
Wash or dry clean your shirt after each wearing, according to the care tag on the garment. Regular laundering removes the sweat and chemicals and prevents buildup. To launder washable garments, soak the garments in an enzyme detergent or enzyme presoak before washing, to remove the substances, and then wash the shirt in the hottest water appropriate for the garment.
Wear an undershirt or a dress shield under your shirt to absorb perspiration and protect your shirt from deodorants and antiperspirants.
Ensure your shirts fit properly. Too-tight shirts strain the chest and underarms of the garment.

Effects of Nicotine on Athletes

Nicotine is a stimulating drug that produces physical and mood-altering effects on the brain and body. Athletes using any form of nicotine may short-term performance benefits, but have the potential to develop long-term health complications. notes that use of nicotine by smoking leads to a host of diseases such as lung cancer, circulatory problems and respiratory infections. Use of nicotine patches, gum or sprays also causes considerable harm to the body.
Nicotine interacts with a similar chemical produced in the body referred to as nicotinic acetylcholine. According to BiomedCentral, this chemical is a receptor in the brain that mediates a process called neurotransmission, which is the communication of nerve impulses between chemical pathways. The significance of this in athletics is the stimulating effects that are activated when synthetic nicotine binds to naturally occurring nicotinic receptors in the body. The Body Building Tips Guide explains that adrenaline is released after nicotine enters the body, which can cause an immediate burst of energy.
Nicotine binds to the brain chemical dopamine, responsible for rewards and appetite suppression. The National Institute on Drug Abuse notes that the dopamine reward system further links to additional brain chemicals operating on glutamate, which plays a role in fat burning. Use of nicotine patches, gum or sprays can result in fat reduction, but other weight loss methods, such as a low-fat and high-protein diet, offer results without the long-term harmful effects of using nicotine.
Use of nicotine through smoking has detrimental effects on an athlete’s long-term endurance by causing shortness of breath. ActNowBC notes that smoked nicotine reduces the amount of oxygen available in the lungs for normal breathing. Smoking also decreases the amount of oxygen-rich blood received by the muscles for use in endurance sports such as running, cycling or body building. Use of nicotine long-term reduces the length of time an athlete may engage in a sport, due to shortness of breath, which consequently reduces overall athletic performance. The energy boosting effects of nicotine from initial use quickly resolves leading to lethargy or need for more nicotine.
The American Heart Association indicates that nicotine causes an increase in blood pressure, spikes in heart rate and narrowing of the arteries that bring blood to and from the different organs in the body. Blood vessel narrowing is possible with use of nicotine overtime, which contributes to the development of heart disease. Engaging in athletics requires stamina from a healthy pumping heart. Use of nicotine may quickly increase heart rate, but forced increase significantly impairs the role of the heart in maintaining regular function of the body.

3 Ways Your Personal Trainer Steers You Wrong

When you hire the services of a personal trainer, you expect that he or she will provide you with a high value for your hard earned money. You expect instruction on how to safely and effectively use scientifically-proven training methods. You also expect a tailor-made exercise approach that best fits your specific training goal.
That¡¯s the utopian dream, anyway.
Here¡¯s the reality: Many of the common fitness training ¡°trends¡± that trainers use are based more on misconception, misinterpretations, and myth. The result: You pay good money for bad results. Here we¡¯ll show you three of the most common ways personal trainers unknowingly misguide their clients, and how you can work with a trainer to get the results you¡¯re looking for.
But wait: Don¡¯t Blame Your Trainer for Your Poor Habits
Before we get into our list, let¡¯s make it clear that you can¡¯t blame your trainer for you not losing body fat if you go home and eat like a lazy teenager. It also unfair to blame your trainer for not helping you make drastic muscle gains if you only work with the trainer once or twice a week and do absolutely nothing the rest of the time.
Training is not something a fitness professional does TO you; it¡¯s something they do WITH you. In other words, the trainer provides you with the best direction to take, based on your goals and needs. And, it¡¯s up to YOU to keep moving in that direction throughout each day.
In this article, we¡¯re not letting anyone off the hook. We¡¯re providing clear-cut practical solutions for what you and your trainer can do to ensure you¡¯re both finding the safest, most effective training direction to take.
So let¡¯s get into it¡­
There are many training approaches. Some trainers may follow a bodybuilding type philosophy where others are more into Pilates, while others do ¡° 3D functional training¡± and others may be more into kettlebells¡­ and the list goes on¡­
The Problem: In many cases personal trainers give advice based on their chosen training philosophy (i.e. bias) instead of delivering a true ¡°personalized¡± workout program. In other words, many trainers just end up giving their clients private lessons on what that particular trainer’s likes to do instead of using the best modalities for your goal.
The Solution: Fit the workout program to YOUR goal, not you to the trainer¡¯s specialty or bias.
Arm yourself with a set of informed questions you can ask trainers before you train with them:
– Here¡¯s my goal. What¡¯s the best way to achieve it?
– Why is that method better than other fitness training methods for helping me to achieve my goal?
– Do you use the same basic training method for everyone you work with? Why or why not?
– Have you ever worked with others like me (similar age, sex, body-type, medical history, etc.) who have the same goals?
– If so, did you use this training approach with them?
– If so, please show me some before and after pictures of these clients or at least provide some testimonials?
While you¡¯re interviewing trainers, be aware of how they talk to you. If they use jargon, complex terminologies, or speak to you in a way that you can¡¯t understand, find someone else. In one sense, speaking in jargon is a way of showing off. ¡°Look how much I know!¡± What you really need is someone who can communicate well and relate to you.
Additionally, the letters behind a trainers name (i.e. their qualifications) are no indication of their practical skills, so don¡¯t pick a trainer based on their schooling or educational certifications they can show you. Education helps, but it doesn¡¯t tell the whole story. Pick a trainer based on the RESULTS they¡¯ve gotten for others like you.
Let¡¯s face it, you wouldn¡¯t hire a plumber who¡¯s read every book ever published on plumbing, but who¡¯s never fixed a drain. You want the plumber who¡¯s fixed the nastiest clogs in human history.
Understand that ALL forms of exercise have their benefits and their limitations. And that certain training methods are best for certain goals, and no one method is best for all goals.
Example: Yoga is great for mobility and breathing, but if your goal is to gain muscle, bodybuilding methods will get you there faster and more effectively than yoga ever could. Now, if you¡¯re already big and strong and need better mobility, than yoga may be in order.
Kettlebell training is great for total body fat loss workouts, especially if you¡¯re short on time (you can string lots of kettlebell moves together into complexes). But, if you¡¯re trying to gain strength on your big lifts, powerlifting methods are better designed for that goal.
If you have a multifaceted goal, like gaining strength while improving athletic movement, then you need to train with a multifaceted approach. Practice your sports and perform some sports training drills. Add some weight lifting for strength.
Optimizing health, fitness and performance requires several different components, and no single piece of equipment or training method will be ever able to fully address all its complex demands.
This is probably one of the most misunderstood concepts among Personal Trainers and fitness enthusiasts alike.
The problem: Thinking that exercises have to look like the sport you¡¯re training for. Example: Attaching a resistance band to the end of a golf club or hockey stick and swinging it. Or, having a boxer punch against bands that are strapped around their back.
Why it¡¯s a mistake: The movement skills required in sports are EXACT, not similar – exact.
Case in point: Shoot 10 free throws with a regular basketball. Then shoot 10 more with a 2-kilogram medicine ball. You’ll quickly find that the motor pattern to throw the heavier ball is completely different, as your first few shots with the heavier ball will come up short until you adjust.
Now, after shooting 10 shots with the 2KG ball, go back to a normal basketball. Your first few shots will go over the backboard because your brain and body have to use a different muscle activation and movement sequence when shooting the medicine ball than when shooting the much lighter basketball.

This little demonstration shows that human movement skills are EXACT. Adding load to a sports-specific skill in the gym is, in reality, training a different skill, which can potentially throw you off your ability to perform the original sports skill.
Understand that ¡°sports specific¡± training doesn¡¯t happen in the gym. It happens when you work with a coach to practice the specific skills required in your given sport. So, tennis practice and your tennis lesson are where you go for ¡°sport-specific training.¡±
Anything you do in the gym to get in better shape is just plain ¡°training.¡± Strength and conditioning workouts simply give you the physical fitness to do what you need to do when you practice for your sport.
(Also, understand that getting into better shape will only go so far if you stink at your sport!)
Sure, there are a few ¡°specific¡± things that you can focus on in the gym depending on the sport. Examples: If you¡¯re in a grappling sport, grip strength can help you better control your opponent.
If you¡¯re in an impact sport like wrestling or football, neck strength is important. And, if you¡¯re a tennis player or golfer, increasing your rotational strength and flexibility can help you improve racquet or club speed. Still, those are small additions to a general focus on total-body strength and power training.
In truth, any and all athletes can benefit from adding strength and increasing explosive power, which can help you to run faster, jump higher, etc., and also transfer more force to an implement, like a swinging bat or tennis racquet or golf club or simply throwing a punch.
General strength training can also help athletes better protect their connective tissues, which could help decrease injury risk.
Does your trainer have you lifting weights while standing on unstable surfaces like wobble boards, a Bosu, or a Fitness ball to improve your ¡°functional strength¡± or ¡°core stability?¡±
The problem: In order to improve strength you must produce high amounts of force. And in order to build muscle, you must overload your muscles. Neither of these can be done effectively on an unstable surface, according to Juan Carlos Santana, owner of the Institute for Human Performance.
¡°Unstable base training is not ¡®functional¡¯ for sports or life activities because movement and sports are about transferring energy from the ground to something, like a swinging a baseball bat to lifting up a child. You need a stiff core to effectively transfer force,” he says.
“Think of a flat-bottomed triangle vs. an inverted (point side down) triangle. The inverted triangle is balanced, but it will topple over very easily as soon as force is applied to it from almost any direction. That¡¯s like standing on an unstable surface and trying to apply force to anything. But, the flat side down pyramid is not only balanced in nature, it¡¯s very stable and capable of resisting and transferring forces from any direction.¡±
The Solution: Don¡¯t blend strength training with unstable surface training.
If your goal is to improve your overall strength, core strength, or to gain muscle; lift weights on flat, stable ground in the traditional style.
Unstable surfaces can be great for improving balance and for rehabbing ankle, knee or hip injuries. So if you also want to improve your balance, or simply enjoying using unstable surfaces, there¡¯s no reason you can’t incorporate some balance training using unstable surfaces in-between sets of strength training exercises, or as part of a cool-down at the end of your workouts.
Better understand three key concepts: Science, Specificity and Safety in regards to strength training on unstable surfaces¡­
According to a 2004 study by the National Strength and Conditioning Association (NSCA), ¡°The performance of resistance exercises on unstable equipment has increased in popularity, despite the lack of research supporting their effectiveness.
Resistance exercise performed on unstable equipment may not be effective in developing the type of balance, proprioception, and core stability required for successful sports performance. Free weight exercises performed while standing on a stable surface have been proven most effective for enhancing sports related skills.¡±
According to another 2004 study also by the National Strength and Conditioning Association (NSCA), ¡°The diminished force output suggests that the overload stresses required for strength training necessitate the inclusion of resistance training on stable surfaces.¡±
If your goal is to improve sports performance, unless you¡¯re playing your sport in an earthquake, the ground your playing on is stable. Also, don’t confuse a slippery surface (like playing in the rain) with an unstable surface.
Since functional training is about transfer, it¡¯s more ¡°functional¡± to train on the same stable surface you play and practice on.
Additionally, it¡¯s no secret that if you want to gain muscle and improve your explosive power, you must create overload on the muscles. However, when lifting weights while on an unstable base, as the saying goes, ¡°you can¡¯t fire a cannon from a canoe.¡± So, when using unstable surfaces, you can’t be as explosive as you need to be in order to improve your explosive capability.
Some studies have shown increased core muscle activity when lifting weights on fitness balls. However, if your goal is core strengthening, there are many core specific methods to use, which can be found in my article, THE SCIENCE OF AMAZING ABS.
Let¡¯s go beyond science. Lifting weights on a Swiss Ball can be down right dangerous. In 2009, the NBA¡¯s Sacramento Kings found this out the hard way when starting forward Francisco Garcia, whose contract was worth $29.6 million over 5 years, missed a huge chunk of that season after an exercise ball accident broke his right wrist.
Garcia, who weighed 195 pounds, was lying on his back on an exercise ball, lifting 90-pound weights in each hand (doing a chest press), when the ball burst.
Following this event, the Sacramento Kings¡¯ removed all the exercise balls from their weight room and Kings co-owner Joe Maloof ordered an e-mail sent to the NBA¡¯s other 29 teams, hoping to spread the word about unforeseen dangers that can arise when performing even basic workouts with an inflatable exercise ball commonly found in many gyms and homes.
Even if you don¡¯t agree with the science discussed above, common sense tells us that the risks involved every time a client is place on a Swiss ball while holding free weights far out-weight any supposed benefits.
Have you had a bad experience with a personal trainer? Or have your experiences all been positive? Tell us in the comments.

Can Athletes Improve Performance With Raw Food?

Love ’em or hate ’em, there’s no denying that the New England Patriots are a pro football powerhouse. Arguably, much of their fate rests on the right arm of Tom Brady.
And Tom Brady¡¯s right arm rests on a body that’s quickly approaching 40 years old.
The quarterback has reached the age when other players are often forced to invoke the ¡°North Dallas 40¡± mantra of ¡°better football through chemistry¡± (i.e. pain pills and injections of painkillers).
For Brady, however, better football involves eating a diet that includes more raw foods.
Brady employs a chef who prepares raw foods. The chef was referred by Matthew Kenney, himself a chef, author and restaurant owner whose expertise is raw food.
But can a raw food diet enhance athletic performance?
Kenney swears it can. Brady obviously thinks so. And New York Yankees’ first baseman Mark Teixeira, tennis star Venus Williams and the Los Angeles Lakers are believers, at least to a certain extent.
Elite athletes have long incorporated raw foods into their diet, but for many it¡¯s becoming a conscious choice¡ªa strategy, even.
When antioxidants are not present, free radicals can slam into tissues and weaken them, causing pain and soreness and preventing muscle growth.
Want to add more raw foods to your athletic diet? The experts we spoke with recommend these for starters:
Raw cheese
Chia seeds
Hemp protein
Seed vegetables
Goji berries
Fresh vegetables
The raw food diet entails eating plant-based food in its purest form, containing all enzymes, nutrients and minerals. These foods are comprised largely of fruits, vegetables, nuts and cheeses that are never heated above 115 degrees Fahrenheit.
Like many practical raw food advocates, Kenney urges a diet that blends raw and non-raw foods. Some athletes who eat raw 100 percent of the time swear by their diet.
But most athletes add in raw foods while subtracting some cooked foods, dairy products and highly processed foods from their diets. They still might have a steak Saturday night, but on Sunday morning, they¡¯re opting for fruits, vegetables, nuts, juices and superfoods.
Cate Shanahan, M.D., a nutrition consultant for the Los Angeles Lakers, views all humans as athletes. Yes, you, me and Kobe Bryant, we¡¯re all the same. Humans are partly carnivorous, she says, which means we¡¯re designed to hunt and run in order to survive. Shanahan says raw foods benefit athletes in a number of ways, and antioxidants provide the clearest lift.
¡°Serious athletes have all kinds of inflammation in their muscles through the work of oxidizing,¡± Shanahan says. ¡°That inflammation has the ability to do some damage if it gets out of control. One of the mediators of the damage is free radicals. The job of antioxidants is to capture these loose free radicals that are basically ricocheting around in our tissue and damaging us.¡±
When antioxidants are not present, free radicals can slam into tissues and weaken them, causing pain and soreness and preventing muscle growth. A diet filled with raw foods, particularly pungent greens and herbs, is loaded with antioxidants.
Shanahan works with the Lakers’ athletic trainer Gary Vitti, strength and conditioning coach Tim DiFrancesco and team chef Sandra Padilla to ensure the team eats healthy while at home and on the road. They make sure the team isn¡¯t consuming the wrong foods while also ensuring they eat the right ones.
Vitti and DiFrancesco both invoke the saying: ¡°You can¡¯t out-train a bad diet.¡±
¡°We want to avoid the chefs inadvertently poisoning them,¡± Shanahan says. ¡°They do that inadvertently because the processed oils that are in the deep fryers and in the sauces are toxic and contain trans fats and other fats that promote free radicals. If you could wave a Geiger Counter showing whether food that is good or bad over something like fries or deep-fried prawns it would go off the scale,¡± Shanahan jokes.
The diet the Lakers team members are allowed to eat is loaded with raw foods as well as fermented and sprouted foods, nitrate-free products and pasture-raised animal fats such as butter, cream, cheese and cottage cheese. Boneless and skinless meats are out. Meat on the bone (cooked on the bone) and natural fats from ribs and braised meats are in.
Shanahan¡¯s regime is similar in many ways to the Paleo Diet. Cooking the meat takes the diet out of the “strictly, 100-percent raw” category, but it ensures food safety for the athletes.
Plus, Shanahan is a big proponent of the health benefits that come from cooking meats with the bone, end of the bone and joint material, and skin and collagen.
¡°Do you watch ¡®Game of Thrones¡¯? Imagine what they would eat,” Shanahan says. “They would not have boneless, skinless chicken. They eat the whole chicken on a spit. Whole animals, rotisserie-slow-cooked, like what you could imagine coming out of a medieval castle.¡±
There are risks associated with raw foods, some obvious and some hidden.
The danger of pathogen infection, particularly E. coli, is increased from raw meat and raw dairy consumption. If you¡¯re going all-in on raw and want to include meats and dairy, do your research on safe food handling and preparation. And do your research on where your meats and dairy are coming from. Be sure to find a safe, reputable source.
It¡¯s widely believed that completely raw fruits and veggies have higher vitamin and mineral contents, but Colorado State University professor Loren Cordain¡ªthe founder of the Paleo Diet movement¡ªsays that the difference between cooked and uncooked isn¡¯t always dramatic, and sometimes there is no difference at all.
In fact, cooking enhances the nutritional value of some foods. Heating tomatoes lowers their vitamin C, but it also makes lycopene¡ªa cancer-fighting compound¡ª more absorbable.
Cordain points out that not cooking foods can limit one¡¯s diet, as many grains, legumes, beans and root vegetables are inedible in their raw state. But cooking food before it’s eaten is hardly a modern concept. According to most archaeological evidence, humans have been cooking with fire for at least 400,000 years.
Shanahan coordinates with hotel chefs wherever the Lakers stay on the road, and she runs through the menu for the team meal ingredient by ingredient.
Must be nice to have a personal nutritionist and chef, right?
Unfortunately you can¡¯t guard Kevin Durant or hit a 20-foot jumper with Metta World Peace in your face, so you do not have this luxury.
What can you do?
If you¡¯re interested in increasing the amount of raw food in your diet, start slowly.
¡°We¡¯re talking about changing habits,¡± Shanahan says. ¡°The best time to introduce new foods is when you¡¯re hungry. Pick a salad or partly germinated nuts or raw nuts or raw dairy cheeses or pickles. Introduce just a little bit of these raw foods, and it has to be a little bit because your digestive system works in baby steps.¡±
And when you¡¯re ready to increase the amount of raw food in your diet, Kenney¡ªwho is also an active runner¡ªhas a few suggestions.
To get the calories you need for your active lifestyle, eat healthy fats such as avocados, nuts, coconut large fruits and cheese (though Kenney himself sticks to a plant-based diet). Rather than eating 16 ounces of meat or a plate of pasta, you can get calories from whole foods such as a coconut shake with maca.
To get the proteins you need, eat sprouted grains. Quinoa is a good source, as are vegetables, nuts and seeds. As for carbohydrates for energy, choose fruits and vegetables as well as superfoods such as raw cacao, maca powder, goji berries and maqui berry powder. Chia is good for endurance. Add hemp, cacao, maca to smoothies and shakes. Maca is famous for its preference by Incan warriors.
To get started: Keep it simple.
Many new raw food eaters try to prepare gourmet food, which can be a lot of work. Instead, start by adding a liquid component to your diet. Make green juice or fruit smoothies. You can get 600 or 1,000 calories in a blender full of smoothie with some super foods and healthy fats like coconuts. Smoothies are nutrient-dense, and they only take a few minutes to make.
And avoid this mistake: When it comes to a raw food diet, people often don¡¯t appreciate balance. They¡¯ll eat a big bowl of raw carrots for dinner, and they¡¯re missing the essential fats. Or they¡¯re missing the proteins from the seeds and nuts. Or they¡¯re missing all the minerals and iron you can get from seed vegetables.
Eating raw foods successfully means understanding where you get the energy your body needs, because it¡¯s not always obvious.

What Are the Treatments for Foot Lymphedema?

Lymphedema is a specific type of swelling that involves the lymphatic system and lymph nodes. Lymphedema in the foot can be reversible, which is curable, or irreversible, which is incurable. Irreversible lymphedema can be treated, but it requires lifelong maintenance. For both types, the doctor often prescribes a safe and effective treatment regimen, called complete decongestive therapy, or CDT, which involves several processes. The prognosis, granted the patient is compliant with the sessions, is excellent. However, it is important that the medical diagnosis of lymphedema is correct before the patient undergoes CDT; faulty treatment of lymphedema is detrimental to a patient’s health.
The doctor’s prescription for foot lymphedema treatment might include CDT with manual lymphatic drainage, or MLD. MLD is a special massage performed by a licensed, certified lymphedema therapist, or CLT. CLTs are often medical doctors, nurses, physician assistants or physical, occupational or massage therapists. MLD helps effectively decongest, or decrease swelling, in the lymphedematous foot by directing the flow of the lymph fluid to drain in the body. If performed incorrectly, however, the massage can lead to more swelling and detrimental side effects, such as pooling of fluid in the toes or skin breakdown. Once the massage is performed, the swelling in the foot may immediately decrease; however, it may also take a longer amount of time for any changes to take place. After the massage, the CLT may wrap the foot in short stretch bandages to maintain the decongestion. The pressure of the bandages will help squeeze lymph fluid in the skin back into the body’s draining system. The residual lymph fluid in the skin causes the lymphedema. In simple terms, the pressure from the bandages prevents the foot from becoming any larger or more swollen.
Every day, when foot lymphedema decongestion occurs, the patient should wear a compression garment. Compression garment types include special compression pantyhose, tights, knee-highs or thigh-high stockings. The pressure of the compression should start at 30 to 40 mm HG, a Class II garment. The compression garment should fit snugly, like a layer of second skin, but it should not be too tight at any given area. If the compression garment is too tight, the patient may lose circulation in her toes and develop more lymphedema. When a patient does not wear a compression garment daily to maintain the decongestion, the foot may become more swollen. When the patient exercises without wearing a compression garment, the lymphedematous foot will have increased swelling. At night, the patient should remove the compression garment and sleep with the foot elevated on pillows. She can wear a special night compression foam garment or bandage her own foot if her therapist has taught her how to self-bandage. A doctor can prescribe a special night compression foam garment; however, as of 2010, most insurance companies do not cover these.
Skilled exercises are highly recommended for treatment of foot lymphedema. Swimming is recommended because water acts like a compression garment, adding external pressure to the patient’s skin to squeeze lymph fluid back into the body’s draining system. The patient should exercise regularly when wearing the compression garment. He can ride bikes, run or jog. As long as he wears a compression garment, he can perform all his regular physical activities.
Long-term self-maintenance is important for treatment of foot lymphedema. Self-maintenance includes good skin hygiene. A patient should not cut or hurt her foot. She should avoid pedicures at nail salons and visit a podiatrist to cut her toenails if she has trouble doing so herself. She should not sprain her ankle, and she should moisturize her foot daily so fungi and bacteria don’t grow on the skin. Skin infection includes cellulitis, which may require intravenous antibiotics and hospitalization. Patients should keep hydrated with water and maintain a healthy diet and lifestyle. They should eat fruits, vegetables and foods rich in fiber. Excess alcohol, drinks with caffeine and smoking should be avoided.

How to Break in Soccer Shoes

Players look forward to breaking in new soccer shoes at the beginning of every season. This is necessary to mold quality leather shoes to your feet over the life of the shoes. Top-end kangaroo leather, thin yet strong, makes an ideal soccer shoe upper to take the shape of your foot. These shoes require care and preparation before you can use them in live game play.
Purchase soccer shoes that are a half size to a full size smaller than what you normally wear. Check that the shoes are made of leather that will stretch to mold to your feet. You want the leather to hug the curves of your foot so that you have a better touch on the ball.
Wear the shoes on soft grassy ground with the same equipment you would wear in a game. Put on your soccer socks and shin guards, so that when the shoes start to take shape, they will form to the shape of what your foot will look like during the game. Do light exercises, such as walking, jogging, dribbling and juggling to begin to break in the leather.
Shower with your cleats and soccer socks on. Use warm water, as this will help to loosen up the leather. Keep the shoes on as they begin to dry, as this is when the leather will begin to form to the shape of your foot. Stuff the inside of the shoes with balled-up newspaper when you take them off, which will absorb excess water and retain the shape of the shoe.
Rub petroleum jelly or leather food onto the uppers to keep the leather soft and help prevent the formation of blisters.
Wear the shoes to practice before wearing them for a game. Bring an extra pair, so that you can wear the new cleats for a short period of time and then switch out of them. It will be much more difficult to change cleats if they begin to create blister during a game as opposed to a practice setting.

Early Stages of Shingles

Herpes zoster infection, or shingles, is the reactivation of the same virus that causes chickenpox, also known as varicella-zoster. Shingles is characterized by a painful blistering rash that can appear anywhere on the body, however is more common on the abdomen, chest or near the eye. Since 98 percent of adults in the U.S. have had chickenpox, all of them are at risk to develop shingles. In the U.S., there are approximately 1 million cases of shingles per year. Of those cases, about half occur in people 60 years of age or older. Shingles occur in 2 stages.
The early stage of shingles — called the prodromal stage — begins 3 to 4 days before the rash appears. Early symptoms resemble those of the common cold, including headache, nausea, general achiness, abdominal pain, fatigue, fever and chills. As shingles progresses, more severe symptoms begin to develop.
The next stage of shingles is called the eruptive stage. Pain is usually the first symptom. For some, it can be excruciating and may include burning, itching, numbness or tingling in the area where the rash will form. The pain may be felt penetrating from front to back, especially in the chest or face. In the absence of a rash, these symptoms can be confusing for both patients and physicians, and the disease may be mistaken for an ulcer pain, heart attack, migraine, appendicitis or a lower back disorder. For most people, the pain associated with the rash decreases as it heals.
A few days after burning and tingling occurs, a rash consisting of fluid-filled blisters on a red base appears on the skin, which is highly inflamed and tender. A slight touch can be extremely painful. Typically, shingles rash occurs on one side of the body in a band-like distribution and may wrap around one side of the chest. The blisters are clear. It takes two to four weeks before the blisters will no longer contain the virus.
Antiviral drugs such as acyclovir, valacyclovir or famciclovir, in combination with tapering doses of steroids, are used to treat shingles. These can significantly decrease long-term nerve pain, but they do not decrease pain duration or produce a more rapid resolution of the rash. A shingles vaccine is also available as a preventative measure, and is typically recommended for people age 60 and older. Shingles can lead to permanent nerve damage — seek immediate medical attention if you suspect you have shingles to decrease your risk of serious side effects.