Hi, I'm JG Preston in this is portfolio. Wondering how Gary guy Eddie is recovering from his recent knee surgery or wondering about a little soreness in your own me. Maybe you want to stick around for the next hour to hear from my guest Twin Cities physical therapist. Tom Copeland time is the team physical therapist for the Minnesota North Stars, and he's involved in helping. Mr. Guy Eddie return-to-form. It's been a regular guests over the years and is also able to dispense advice about what you should do about your own aches and pains as well. You have a question about health fitness exercise athletic call Tom Copeland here at 227-6002 to 76 thousand the number to call here on sportfolio.Flying kite area is a therapist to the Stars Tom Coughlin Isanti Back Time. Looks like the summer treated you a little while. Anyway, that's great to be here JG and with the North Stars not in season why I've had a chance to slow down a little bit and get some rest and get to know my family again. It's been kind of fun or if there's not a senior tell me that are going to training camp in 2 weeks 2 weeks. It's kind of hard to believe but we've had a number of players coming in the last month or so for that final tune-up few aches and pains Neal Broten Brian Lawton few of those guys. Just kind of get some tune-up making sure their shoulders and knees are fine before they get into the training camp and then she's going to a different for the stars. Were there actually an old the whole training camp in the Kalamazoo, Michigan the whole thing's going to be in Kalamazoo for about the first 10 days. That's right. You should be they did that out of Eden Prairie. I guess what about the community but this year they're they're going to Kalamazoo where the minor league team is. Yes. Just kind of wings. I think they're called.Normally do the preseason screening Max VO2 testing and some anaerobic testing way. I look at their flexibility body fat few few other factors and they've asked us to do in the past and they've asked us to do it again this year. And of course were there since you're going to Kalamazoo then we have to go where they are and are looking forward to testing about 60 or 65 guys coming into camp that many asset tremendous number of guys as bad as football. So almost almost but we're looking forward to it. It's going to be exciting. We've been in contact with the new Administration the new coaches of Pierre and Jack and I have got it all fairly well work out good or your name was in the papers this morning. Mr. Copeland talking about your upcoming work with Gary guy Eddie of the Twins and trying to get his knee back into shape after that arthroscopic procedure he had on at this week. I'll kind of open the floor for you Tom. And I know people are plenty curious about how much how much they really understand about what happened to Gary physically as far as the the trauma that caused the injuryWhat the injury is a now what happens when a guy's got to do to be able to play Major League Baseball with the condition like that again. Well, I think it was about two weeks ago to Gary slid into second base and twisted his knee and and the result in injury was a tear of the cartilage in his knee. We had a slight strain of the new but basically the major problem was a it was a tear of the cartilage and that's the stuff that actually connects the the bones in the knee cap down. There is no cartilage ligaments or what connects the bones together and Carly Just is the pad that's in the joint that serves as a cushion and helps guide the movement of the knee itself and sometimes it when this gets torn why it has to come out because it's sort of like putting sand in a ball bearing if it's torn it continually grinds a way Anthony and where is it out and also causes some instability so that you can't bend and twist stoop and do all the things you have to do to play Third Base and for the Minnesota Twins, and so the decision was made that it had to come out and it was done by a technique called arthroscopy.And that's the the latest technique that causes very little trauma to the knee and gives a lot better chance for Recovery in a in a faster amount of time. It's a surgical procedure that doesn't involve actually making a large incision. That's correct. Normally when people think of orthopedic surgery, they think of a physician making Cuts in the leg and or in the shoulder or whatever in and I'm going into a joint in and looking around and doing your thing arthroscopy really is just a few puncture holes that go into a joint and one of the instruments that they use is actually a little miniature TV camera with the light on me put it into the joint the light shows up the joint the TV camera records and shows you exactly what's there and as the surgeon is doing their arthroscopy has a television screen right in front of them, or he can see the joint in and see exactly what's happening in the knee unbelievable. They they usually arthroscopy is diagnostic procedure. So they know exactly what's going on as opposed to maybe some of the other indirect methods of of x-rays orExamining with your hands in the office. This tells me exactly what the problem is in there. So you can see everything then they have another instrument that in such as in Gary's case, if the if the college needs to be removed or torn portion, the cartilage needs to be removed. They can put that into another puncture hole and it's kind of like a mini Jaws apparatus with some suction on it and that will actually take the pieces of cartilage that are torn and and cut them off and bring them back through the instrument itself and clean that all out and from there. They go right back into the recovery and Rehabilitation fit the same day surgery, you know the real trauma to the knee with it not does cartilage grow back or does it need to grow back or you have to put something in there that question is asked quite a bit and there are some college is important for the day but you can function quite well without it doesn't grow back some some Scar Tissue will replace it and help it but it but typically not very much and you normally can function fairly well without the cartilage you try to keepHow much is a cartridges you can I know in the old days when they when the Scopes weren't around and they needed to go in and and make an incision. Typically, they took most of the cartilage out and people function quite well, they found out all over that in long-term follow-up studies that those knees with head Carla just totally removed. We're beginning to show some early signs of degeneration. The pad itself wasn't working as it should because it wasn't there and they start getting some early what they called osteoarthritis or degenerative arthritis from wear and tear you wanted with a bone on bone, right? It's pretty much so and so now it's what the new techniques are is it they're trying to just take the peace out and not take the whole Karlie child just take the peace out that was torn and save as much cartilage is possible so that they can have his normal a function used as they can and not have the degenerative changes take place and that in Gary's case. This is pretty much what they did. They just took out the piece that was torn and we're looking for a fairly good recovery on his part.Any unusual about the procedure itself time was it? Was it any better or worse than is normal for these kind of things or is there a normal for something like that? No complications should be evident and it'd be just a fairly routine recovery with the all the rehabilitation techniques that that we need to do to get him back on his feet when Gary goes back to play. He'll be he'll be back where his leg is 100% and he has his motion any strength and he's ready to play again. He's they're not going to let him back. We're not going to let him back and tell them that you tell that happened to me but because of the arthroscopy technique because of the arthroscope that's going to happen much much more quickly than it might have if it's some other procedures have been performed. This is not one of the big for a typical open knee surgery, whatever they call it a recovering from the incision was as big a problem with recovering from the procedure that happened inside well very much. So anytime you open up a joint like that. It's major trauma toIn itself in addition to the injury that's already happened. So if you've got the the trauma from the injury and the damage to the particular structures of the joint that's occurred and then you've got some Trauma from the actual surgery itself and that takes our body a while to recover from with your arthroscopy you that that second Trauma from the surgery is is significantly minimized and that gives us a chance to recover and come back quite quickly as what kind of things will Gary have to do over the next couple of weeks to to rehabilitate what what kind of procedures you haven't gone through. We need to have the knee moving with normal motion after any surgery or injury why there's some restriction of movement and will be working on trying to regain movement in but ultimately the big thing is to get his all of his strength back and he'll start carefully and gradually doing some strengthening exercises that are appropriate for the condition his knees in and as he progresses and get stronger and heels more why will increase the intensity of the exercise isAdd a few more and have him gradually work harder and harder specifically working on his knee and then eventually will have him working into some more General body conditioning types of work in and get him swinging a bat and throwing the ball again so that when he is ready to play he's got everything functioning he can throw a we can hit you can run you set to go this involve weights at all. He's part of this there'll be some weights involved. There will be some are very special isokinetics that we use with some of our computerized equipment. That'll come a little later in the program will use Muscle stimulators and ice packs and will help variety of things. But right now I spending about two hours a day with me in the procession. He's the kind of guy would be a very good rehab patient should really be dedicated to it and then would have a great capacity intolerance. He's very dedicated to the rehab but you know, Gary is a little impatient. I'm sure as we all would be in his situation and he wants it to happen right now, but we would all be like that but he is good about heHe's doing what he's asked to do and he comes for his appointment so you can carry through with his therapy very very well. He already walks without any difficulty is walking is fine. How we know when he's ready to come back? Well, there's a number of things that we look at, you know, we look at if he has all of his motion we look at if he's got all of his strength and we can measure those objectively, you know, subjectively week we look at whether he's got any discomfort or what or what and then as we get into some of our sophisticated equipment are carbide x's and are side effects types of work. We can measure the strength of his like compared is unaffected later. He's good one to the one that he's had injured and tell by by working at and testing it on the strike machine when he's recovered all of his strength and then of course, it's from that point that's sort of the objective scientific method from their it works in to gradually returning back to activity plane certain kinds of activities.That will lead him back into full baseball movement. So they'll certainly be taking a batting practice in Enfield poly for several days before actually playing it again. I would anticipate that yes in 10 days to two weeks. Is that kind of your best guess right now for when that would be when you be playing again, I guess I would hesitate to say 10 days to two weeks, but it normally happens faster than then it open type surgery. So I don't want to put myself under the gun, but you never know what that's right. I'm sure you that maybe you have some gas from past. There's a lot more there's lots of factors that enter into just exactly when he will be back. Should we found that if we if we make those kinds of statements that a lot of people hold us to them and sometimes there's some mitigating circumstances that they don't let us meet those goals. So we're going to play one day at a time and get him back as quick as we can have got to be that the tough part about the athletic training and inMedicine business is that having their big Financial considerations? And everything else is a lot of pressure from both sides just pressure to get the guy back in Action is also pressured to protect a very valuable investment that the that the team is in a guy on and not make it too soon. I think that alone trying to have to walk that line with maybe crack up in that job. I really do know that that's very true. If that's the particular working with professional athletes. That's the line that we have to walk every time with every athlete and it is after a while you do you understand how to do that and work within those guidelines, but it's something that's very critical part of the job Loop that were involved with when we're working with pro athletes and it's it's actually the same for the college athletes in the high school athletes and sometimes there's maybe not as much notoriety or is much pressure on a high school athlete as it would a pro athlete but the but the situation is typically the same just a little different level. That's true. The phones are ringing2276 thousand is our number here on sportfolio. It's 16 minutes after 12. I'm JG Preston and you're listening to ksjn 1339 Copeland's Our Guest to 276 thousand the phone number and we're going to Minneapolis. Hello, John Heather just had a couple questions. I wanted to ask. I've been having a little trouble with one of my knees and I was wondering how can I tell for sure without having to spend a lot of money since I don't have insurance if I'm going to need surgery or if it's going to you know, or if it's not quite as serious a problem the number to how much does this arthroscopic procedure cost? And is it for everybody or is it pretty much just for athletes kind of that the basics what are the signs for the knee that maybe you'd want to go and I feel like you have to seek out treatment whether it's a physical therapist to physician or whatever. Well if you do have persistent problems with your knee and I think it'sImportant to seek some professional advice right up front because this may save you a lot of time and money in the long run if you got a problem and seems to persist and you try to let it go or work it out and it did it continues into persist as a problem. You're losing strength. You may be causing some degenerative changes in your knee a number of things that ultimately when you do get professional help will cause you to spend more time getting your leg back into kind of condition you'd like it to be in so I'm very much for what we call Early Intervention getting these things taken care of right away. And that that's one of the strong point stat that we have with professional athletes and getting them back as quickly as we do is that we're right there or we can give them treatment the minute the injury happens. That's when it starts. So it's it's the kind of thing you have to take a look at it getting taken care of right away. If on the other hand, sometimes we all have aches and pains and joint problems that seem to give us some irritation and persist for a while and then they go away and there's no problem with it.That's where you have to try to have some guidelines on how to decide when you want to go to a professional and when you want to just start to write it out yourself. Basically if you have as far as money is concerned if you've got some persistent problems that involve pain when you have movement of the knee when you're bending or stooping climbing stairs, if you have some swelling that persists for a. Of time that it doesn't seem to go away or if you got some problems where you need seems to give way when you put all your weight on it kind of kind of tries to let go and not support you those are some signs that you've probably should have some professional help and you can get the professional help either through a physician an orthopedist or physical therapist and physical therapist can see a patient and give you some recommendations as to what kind of procedure you should look at it and maybe where you should go to get it taken care of the cost for an evaluation. I think if you do it early enough eitherPhysician or with a physical therapist are going to be far less than maybe some expensive Rehabilitation procedures later on because you let it go too long it is there such a thing time is more or less of standard surgical procedure fee or those very pretty. Well that I wouldn't even pretend to start telling you what the different cost for surgical procedures are theirs, you know that a simple arthroscopy that it's a same day surgery that you're in and out in a few hours and on your way home is not going to cost nearly as much as something like a total knee reconstruction where they have to spend five or six hours in your knee and they use a lot of different graphs and replacing tendons and ligaments and and have you in the hospital for a few days. So there's a there's a very wide range of fees and I and I really going to suck at making a guess as to what those are as far as as is arthroscopy for everyone or is it just for athletes? Well, it's it's gained its notoriety through athletes, but it's used for anyone whoHas problems that's one of the beauties of arthroscopy, but they can be used on anybody that's got a problem with it involves a joint arthroscopy is not necessarily for every kind of problem. But one of the things that used quite regularly for is good diagnostic ability when you have the chance to look inside the joint when things are a little confusing or perplexing through an arthroscope, you can see exactly what's going on in there and what needs to be done. I know many times Physicians have done an arthroscopy ostrich graphic procedure basically just to see what's going on in the knee and found it there really wasn't anything major in there. They came right back and close things up and really didn't do any major procedure but knowing that knowing what's wrong is that is the major part of any treatment program or rehabilitation program. It has to start with knowing what the problem is and then you can deal with it and you can straighten things out and it's a lot easier to find out through the scope than for cutting somebody up with andX it's alright. Your scope is it is a very effective way to do that. You know that I don't get me wrong. It shouldn't be done for every particular problem. But it's it's one of the tools that can be used in addition to X-rays and MRI and some of the clinical exams are done in the in the doctor's office itself. When an arthroscopic procedure to become fairly widespread times at pretty recently it's fairly recently and in terms of size the medical field, I know with just within the last few years, it's become widely popular. I know it I would say probably without getting too specific is it was first introduced maybe seven or eight years ago, maybe a little longer than that might have been 10 hit. It seems like seven or eight years when you've been in this field for 10 or 20 years, you know, five or six years. Do you go by very quickly so it hasn't been all that long, but it's becoming more more popular and it started with knees and and the technique for knee arthroscopy has gotten very good and now they're starting to go.Brenda shoulders and wrists and elbows and ankles and all of the different joints of her body to 276 thousands are phone number with Twin Cities physical therapist Tom Copeland and we have a collar in Minneapolis. Hi Dennis. Hi. I have a question. I've had arthroscopic surgery twice on one of my knees once about 5 years ago in a second. I'm about 3 years ago in both hands part of the cartilage was removed. And since then I still have continual problems with the doctor have the same has recommended are basically said to do what you can and if you can't do anything then then don't do it while my concern is when I stopped participate in any type of swimming programs for exercise or stationary bike a regular bicycle or running to do you get sore and swells up somewhat. It doesn't hurt at all while on active but it's it's or later as long as you can recommend any type of a therapy program that I might use myself for strengthening the knee and I'll hang up and listen.I'm sorry, I hung up so quick because I had a question for you. The question the question would be as have you had any Rehabilitation whatsoever since the arthroscopy microscopic procedure because a lot of times in fact all the time as far as I'm concerned being a physical therapist that the success or failure of any surgery is depended on the kind of recovery that you have ended and the recovery should include some kind of therapeutic exercise or special exercises to fully strengthen and gain your range of motion back again after the procedure and solve my question is have you had this done because it the need depending upon what the problem is does not always recovers back to its normal activity or is normal movements. I should say was just normal activity it sometimes need some very special exercises to get your new back to that point, especially if you need or if you're looking at some kind of active life.Where you want to swim or run or ride the bicycle? Sometimes it takes some special work to get your knee to the point where it's conditioned and strong enough to be able to handle that kind of activity. So basically speaking I would say that that you need to take a look at exactly as we said before exactly what's causing the problems, you know, as we said before arthroscopic procedures is a basically a tool is not necessarily always the answer to all problems and just because you say I've had arthroscopic procedure and I'm still having trouble doesn't always mean that the that was the answer for you that exercise is proper treatment procedures or something. You should look to I would say that before you start doing any exercises. You should have it evaluated by someone who's a professional in that area such as a physical therapist to see if there are some exercises you should or shouldn't do based on what's causing you some aggravation.Some exercises for knees are the right things to do and sometimes it for certain problems will same exercises will be the wrong thing to do. So I might be a little hesitant to start saying do this exercise or that exercise 1 exercise. It usually is universal in all knee injuries. However would be just a simple straight leg raise where you lie on your back tighten your legs straight raise it from the floor about 6in hold it for three or four seconds, then lower it to the floor and let it relax then tighten it again, raise it again Lower it and let it relax and do about 50 of those reputations with just the weight of your leg 50550 and maybe every several days at a pound or two to your ankle doing Kris the resistance. That's what that's a fairly basic exercise. It doesn't cause most problems with any me most of the time and I would suggest that you might want to take a look at trying to do that anything more in-depth anything more advanced or anything That's Amore.Difficult in that then I think you should seek some professional advice to get this done. Tom Copeland Our Guest on sportfolio MJG Preston, this is ksjn 1332. 276 thousands are phone number at 26 minutes after 12. That's about all the numbers I can handle for now, but feel free to ask your health and fitness exercise questions to Tom at 227-6028 another scientific language in stuff all the time. We never talked about you. So let's talk about you for the last couple of minutes whether you like it or not. How can you measure you've been in this field for about 20 years now 20 years. I graduated from physical therapy school in 1969 University of Minnesota prior to that. I had some athletic training experience led to my interest in becoming a physical therapist and that that experience was through Macalester College in the work I've done over there. So as I went through physical therapy school learning light therapy. I was also working at Mcalister's or athletic trainer and spent a good fifteen years there in sports medicine in McAlester working with dr. William H a Watson. I like watching the top me many many things and got me started physical therapy. So I'm forever indebted to him for that very knowledgeable man, and taught me a very much about sports medicine and physical therapy. We still back in the dark ages of at least athletic training back in the 60s or we starting to see some some advances towards the kind of sophistication we have today. Well, it's interesting because I got oriented toward Sports Medicine very early and then I guess you would say the sports medicine Boomer excitement lately a lot of what we did back in the mid-sixties early 60s is still very much practice today, you know, we knew then about how important was the use ice packs and how often we should use them and you know, it seems like lately that seem tends to be a revelation to some people but we've for 20 years we've been using ice packs looking at the game range of motion and Strike Back an injured joints were something that we worked with what's happened over the last Years, maybe it's not so much a change in the philosophy of what we're doing but a change in the tools, we got to use Technologic ratification of before we had free weights and a universal gyms in sand bags. And now we've progressed his isokinetics and computerized technology and and some of the muscle stimulators and different things were using now we had ultrasound machines then we have ultrasound machines now and we had ice then we have ice now, but in a lot of the the same ideas about Progressive return to activity strengthening all those ideas were there then but what we're doing now is refining them but I think through the media through television through professional sports through some of the college sports becoming widely popular visibility of sports medicine is grown greatly in the last few years and people know more about it. There's there's becoming more and more excitement about it because Some of the new technology the arthroscope for instance, you know, that's something that's new and that's that's given positions in people in sports medicine the opportunity to be able to give better and more effective and more efficient treatment. But a lot of it is a lot of it is still the same ideas still the same principles that we were talking about learning about 20 years ago. If people talk about the the moon shots having spillover technology effects on the Society of some of the car manufacturers are auto racing units developing technology to go down to the consumer side. We do you see the same thing in sports medicine that a lot of advances that begin in sports medicine because there's the financial need for the nerdy economic push worked. Does that intern trailer over the rest of us very much. So and I think the otoscope is it again is another good example of them and all the question was do you just ask lights get to use an arthroscope all know he ain't all that may have been developed in something that's widely used in athletics and has gained a lot of visibility and a lot of notoriety through Athletics. Kind of thing. That is very good for everybody. Anyone who has a need for that type of procedure is is been able to benefit through so I think some of the things that we've learned through Sports another area. I think where there's a lot of benefits that can be gained through what we've learned in sports medicine is in the area of workers compensation in in in in Occupational Medicine. There isn't any reason why someone entered in a factory or on-the-job a musculoskeletal injury couldn't be taken care of as we take care of athletes and have their time from the from work be greatly reduced just like we have with athletes but having their time greatly reduced in giving them the same kind of Rehabilitation Specialties and techniques that we've got with sports having those apply to the occupational medicine for Sunday the injured worker and have them more productive have them get a better recovery and back on the job a lot faster so that they're not losing money in the companies aren't Turn in a lot of money trying to cover for them and spend time on their Rehabilitation. So that's another spillover that we're starting to break through in the area of workers compensation getting the injured worker back on their feet using a lot of our Sports Medicine techniques. Sometimes we aren't going to expect at a factory worker to go out and and skate with a Neal Broten to run two marathons or try to run through a you know, a couple of linebackers but on the other hand they have to go do their job. They have to lift they have to stoop they have to bend and what we do is we modify the intensity of what of what we're giving to the individual to meet their needs with if their needs are not as great as a professional athlete then we we don't expect him to perform as a professional athlete but we're using the same philosophy and the same techniques were just maybe not giving them as much intensity hear you talk about how we had ice 20 years ago like we do today and I can members of kid who grew up in the sixties. He always saw the photos of Sandy Koufax. His arm dunked in ice after he pitched he had that terrible arthritis in his elbow and it would really help keep the information down. You've got a lot of publicity at the time and gives terribly terribly cold water all lights down and you just blundered by the agony that Koufax must be going through and I don't know but I think a lot of people from my generation are still that's what we associate with Isis terrible. Terrible injury. I mean Colfax equipment was 31. I can barely lift his arm or anything like that you go to the twins locker room after game and routinely used to guys who picked that night huge ice packs on their shoulder on the rail, but whatever you say. Oh my God, what's wrong with a guy? Could you take the least for me this maybe just stupid me talking but don't Copaxone he's about done but the problem was we knew about it and we were using for a lot of injuries. But when Colfax we start seeing his pictures of Colfax with ice pack on his elbow like that. That's where a lot of people start picking up on ice and and the use of ice Very popular and you're right as we get more and more into the study of the effects of ice in and how good Isis in terms of musculoskeletal injury. We're finding that it not only works when we have an injury, but also works very well to help prevent something from happening such as throwing or pitching for the whole baseball game and then you pack your shoulder with ice. It may not have any pain. It may not have been injured but that will do is they'll help prevent some of the chemical substances from being released that may cause soreness and may cause them to take a couple extra days recovery. The ice will slow down that and give him a much quicker and much better recovery. So we're learning to use ice in different ways and becoming more sophisticated in and what will use it for your now we put it on everything we put on burns we put on bee stings, you know, it's not just Sports types of injuries and there were there was Tommy Kramer after his lost in the Vikings game last night was all packed in ice and again, no problem is just routine just maintenance, but that's right. Going to do it for emotional Nelson hear Jeffrey. Let's do that. We got some phones lighting up here people. Wanted to talk to Tom Copeland usual. 12:30 Rush has begun that is 26 minutes before one you left in this portfolio on ksjn. 1330 Minneapolis-Saint Paul. Good afternoon. This is Mark. I said, I hope to stay tuned to ksjn throughout the day today coming up at 1 this afternoon. It's the weekend review our weekly 2 hour look back on the week's big news stories coming up at 3 this afternoon. It's the new American Gazette and then it for National Public Radio All Things Considered live from Washington those programs still to come all this afternoon here on ksjn 1330. TG Preston here along with Twin Cities physical therapist Tom Copeland to 276 thousand. Our number were talking about health exercise fitness athletic injuries. You name it and we're going to go do Edina next tell him thank you for waiting for taking my call. I'd like to know if what about carpal tunnel surgery, which I just have so I ever be able to return to sports and and and the ball playing tennis in the end of like as I did in the past was the name of the procedure again, I think probably like any other problem. There's a there's degrees of severity and trying to say what will you ever be able to return to activity? There's some people that with carpal tunnel problems return two jobs to their job or two activities or Sports without any problems. There's other people that don't and I do depends on the severity of the carpal tunnel before you had the surgery if there was a lot of damage in Call Doug and a lot of swelling in a large Scar Tissue. That's created. Now. What? Weeks now is it? All right for me to be able I went back to work. I'm not getting involved in any sports right now because of this but I'm having some recurrence of paint and stuff will pay that you had before is this a normal situation again it did, you know, it depends on what kind of recovery procedures you had if you had some guy dancing and maybe modify modification of what you're doing is producing the carpal tunnel depends on if you've had some therapy afterwards to help restore some of your motion and activity + 8 weeks is a relatively quick time to go back and start doing a lot of real strenuous Saints. Although it's important to get back on the job as quickly as you can and start performing those tasks again so that you don't lose your mobility and strength dancer jaygees question as to what is your car? What is carpal tunnel? Carpal tunnel is it is in the wrist? It's on the palm side of your hand right between it at the heel of your hand. Right in the middle. There's a little bit of an indentation there. That's that's not where they call the carpal tunnel. When you have your hand facing outer on the palm side, you'll look at it your forearm in the tendons from the muscles of the forearm is run down your wrist and they run underneath with what we call the carpal tunnel, which is made up of some ligaments in some fashion that sort of form of bridge over the top of these like a mensch as they run into your hand and they supplied movements for your fingers in your wrist. That's the carpal tunnel because the number of tendons kind of compressed in a smaller space that there are encompassed by the wrist bones. Sometimes a lot of activity a lot of strain types of movements will cost some irritation in that particular spot caused some swelling caused some aggravation in Creative syndrome just called carpal tunnel syndrome. Sometimes it gets to the point where surgery is required to relieve the pressure and maybe clear some of the scar tissue and and some of the aspects of the Are the carpal tunnel out of that particular area that can be very painful indeed. It's it's a it's a fairly common problem with people to do a lot of repetitive work with their hands. Helen I hope you're able to help you out a little bit there to 276 thousand or number here on sportfolio and next up for going to Saint Paul High Steve Last year, I was busy with my bike putting regular 15 a lot over the road and have had a long-standing stop writing and I myself am overweight and out-of-shape 46 years old and there's a nutrition weight Pace. There's a Reconditioning fee Cinema in probably an emotional support that seems like what I really need is some Kishore Gupta. Kidney have a suggestion about a way to put all those pieces together in one package that would that would work for me. It's a pretty widespread concern because people feel they've already been in pretty good shape as Steve was in a falling out or just have never been in good shape, but there's so there's so many questions to answer about so many different things people. I think they look for guidance and look for support what kind of places can they turn? Well that you're right there. It's JJ there is some problems a widespread problem like that where there is a need for the for the kind of facility that that Steve is asking about and the one that I know about this isn't in St. Paul itself. It's that United Hospital has a program called Extra Care, and I think if you get in contact with those people as United, I don't have a number for your I'm sorry, but they have the kind of services that you're looking for to help give you the advice. She needs it got the nutritional Counseling in the and the psychosocial counseling and it and it Fitness counseling the things that it would help you with the problem you're looking at and I would say that you know, if you've had to quit because of some medical condition that you do get into some professional help and guidance before you get back into any intensive exercise program such as you describe to us. Can you talk at all time about the asthma itself and how it affects exercise programs or anything like that? Well as move courses is it is a difficulty in breathing in a transfer of of some of the benefits of exercise at the oxygen consumption that you need to do to to be able to exercise well, and if you've got an interference in your system of delivering that oxygen to the working muscles, then it's going to interfere significantly with your ability to exercise and exercise strenuously. So it's the kind of thing that we're not I'm not saying that you don't exercise with the kind of thing that needs to be Properly controlled and properly a guided by a professional who understands the components of not only the lung problem but is also the musculoskeletal problems that go along with it. And it's it's a condition that you can't just pretend isn't there in fried exercise through what you got to modify the program to know it's it's very important when you got asthma to make sure that's a problem is is a monitored by a professional pulmonary specialist Tom Copeland Our Guest on sportfolio. He's a physical therapist with the several offices in the Twin Cities the team Fair therapist for the Minnesota North Stars currently working with twins through a certain answer your questions about all these kind of issues to 276 thousand White Bear lake is next. Hi Dennis, and I'm curious as to why you're discussing it as to if it's done properly. How can help strengthen a knee knee injuries are real, and sports. I have a 3.4. Can I use I've been lifting weights for what 18 20 years. Lauren just recently. I have three things that I do. I keep my feet flat on the floor. I keep my back perpendicular to the floor and I go down to the point where my thighs are parallel to the floor going to come up would you discuss this? And I think that's a question. That's a good question. And it's something that needs to be discussed in terms of of squatting activities and strengthen him to like what you described was not a full Squad. What you described was about a half squat full squat is when you perform the maneuver in the position that you described only instead of going to wear your thighs are parallel with the floor you go over practically all the way to your heels and back up again. Would you want to do that on the balls of your feet is a potion with your foot flat on the ground or well Bowser Fusion gauge some other muscle group, since I have your feet flat concentrates the muscles in the upper thigh in the thigh muscles, you're trying to develop typically the reason that full squads have gotten a bad rap is is because they were performed in properly. What year Telling me is is fairly close to a good type of a squat going to you're going to the point where your thighs are parallel. Will the floor is is probably a little further than I usually recommend. I would rather see a third Squad rather than a half Squad because it when you get to the half squat, you're you're starting to get into some of the areas that had caused problems in the past with a full Squad type of maneuver these problems again are associated with the knee a full squat does a couple of things to the knee joint that are probably liable to cause it some problems one is the compressive forces to the knee joint itself as you begin to squat and bend your knee and go into that position with weights on your shoulders or on your hips or however you producing that the movement the forces the magnitude of the force is to the knee joint itself are tremendously magnified and it causes a tremendous amount of compression and pressure on the joint which as you can could see Protect me from some of our discussions about guy Eddie recently. Is that a good costume wearing of the joint it could go if there was some twisting a slight twisting or turning of the maneuver it can cause some problems with the Carthage itself the other problem that the squats we encounter with doing a squat or a full Squad activity is the pressure on the soft tissues the ligaments in the muscles in attendance that hold the knee joint together as you go into the full Squad this tremendous amount of force. And again, it's magnified because of the leverage principles involved with the legs and and the wait out on the end of a lever. It causes a lot of strain almost a shearing force on the knee joint itself as you go into the squat and it tends to cause the need to sort of the thigh bone of the are the female that we call it to basically try to ride forward off the knee joint and it puts a tremendous amount of pressure on the cruciate ligaments in the collateral ligaments in the soft tissues of the knee and this Caution problems caused him to be over stretch too particular if you do it repetitively or if you lose your balance or or used too much weight cause a major acute injury on the spot. So we we try to discourage the use of a full squats squatting is a good activity to strengthen the legs and more recently. We found it up to a third Squad and possibly a has to go out. But again, I recommend just 3rd Squad causes some compression and some pressures on the knee joint that actually are good for it to help it with some re-strengthening types of activities remoulding as a joint and and a strengthening The Joint but if you go beyond its the oldest the old adage if a little Bittle B Goode a whole lot more will be better will that that definitely is not the case in doing squatting activities to strengthen the knee? So those are my thoughts. Those are my opinions. It is a good exercise to build a strength in the leg both of the thigh of the quadricep muscles in hamstring muscles, but it has to be done correctly and it has to be done. The proper movement and in the position that you described as is a is a fairly good position for this particular exercise, but I'll bet it's also a fairly common misperception to his people might think that's what exercises are for the knee. When really what you're saying is what they strength are the five most. Well, that's right and the thigh muscles the hip part of the thigh muscles are strengthened. But remember that the thigh muscles also cross the knee joint by strengthening the thigh muscles you are strengthening the knee joint itself, but at the same time the the knee is our weakest link in the chain of that kinetic chain from the hip all the way to the foot and if we put too much strain or too much stress on that knee joint. We're going to be counterproductive. We're going to weaken the joint as opposed to strengthen it. Okay. Thanks for call Dennis. I appreciate it. Go and take some more your phone calls for Tom Copeland Twin Cities physical therapist Iran's portfolio. And our next stop is in Minneapolis. Hello, Sandy. Concerning a problem. My son has hit the basketball player is 15 years old in every year. He has a great deal of pain in his heels. And I just wonder if this is a common problem among children this age of basketball players and if there's anything we can do about it. That is a problem that you said that pops up from time to time with people who Run and Jump particular in the heel area. Like you described there's a number of things that that could be there's a there's a a fat pad on the bottom of our heel bone is called the calcaneus for you know, the technical term and that fat typepad. Sometimes could be confused. It could be bruised many time you land on it why it's going to cause some problems also repetitive stress has to the to the heel particularly if the hill is not properly protected or padded with good shoes are good or well padded shoes could cause some a repetitive hemorrhaging which then translates into maybe some scar tissue or some calcification then again, that's like putting a little Pebble in your shoe and try and walk on it that's going to cause problems the third thing and and taking a look at the age of your son may be something to look seriously at his is it maybe some of the girls place in the heel area may not be Form sufficiently are properly in that mate. He may have some strains on that particular fuse drawing relatively rapidly and hasn't had a chance to maybe mature in his bone growth. There might be some problems along those lines if it's a problem again is basketball get started again this year than I would say would be important to see a good Orthopedics have him do some examinations in and do some special testing to see if there isn't a significant problem that the he could be involved with sometimes it's alignment of the Footwear in a good orthotic will straighten it up and change some of the pressures on the foot. So there's a number of ways to deal with the problem. But again, you've got to know whether it is you've got to know what's causing it and then you have a chance to deal with it, but it's worth taking a look at but it's worth taking a look at can heal problems also come from improper running or jumping techniques or is that much of a factor with the he'll obviously it is if you land in correct. On your heels, if you're not running properly do a good heel-toe relationship or have a good arch support in your shoe. It's the mechanics of how your foot strikes the ground is very important and if it's altered in any way and you start running other than you should be that could cause some problems. Our phone number here on sportfolio is227 6000 and we're going to Saint Paul next for Tom Copeland Richard. Thanks for being with us a stair-climbing machine or climbing stairs could not cause problems in the New Year if that's normally that would be okay. Typically in a knee that doesn't have any problems the stair climbing climbing machines is an excellent exercise for strength of the lower legs as well as getting some good aerobic fitness and good aerobic conditioning. However, there are times when stair climbing is something you shouldn't be doing for the need because of what's going on with the knee joint itself. There are several conditions of the knee that that probably would preclude you from doing stair climbing activities. The one that's most commonly known about it is a condition called chondromalacia patella another one of those $0.75 in medical terms. What it means is that under the kneecap. There's some rough opening of that knee cap that as you bend and straighten your knee with resistance, which is what you find in stair climbing that that has a tendency to rub back and forth on the knee joint and cause aggravation. This was the cause more trauma will cause more wearing of the knee joint discomfort swallowing and in all of those factors should Cosm would cause you some pain and some problems of with with a knee joint itself. Another factor of course would be if you had cartilage problems or if you had knee joint problems themselves from whatever Pride previous condition you may have that would be an aggravating factor that would cause wearing and tearing of the joint again cause some swelling possibly and again would be something that would preclude doing stair climbing activities to strengthen the knee when you have those kind of conditions, then it's important to look for another method of gaining conditioning and strengthening. They can be done different ways without doing stair climbing but overall stair climbing is a good activity. It's a good strengthening for the hips and knees. It's a good aerobic work. But if you've got some pre-existing condition that would contraindicate or are preclude you from stair climbing then that's something you should take a look at if you're getting pain from it. Then you need to take a look at what again is causing the pain in. He took a lot take a look at a different form of activity. I guess I wouldn't notice as I get taking not when I'm exercising, but but during the day while you know lime, you know, I haven't been active and I stand up and I can feel a aching in my joints. They could be something and caught it if you do stair climbing exercise is it could be something that's more joint related again there. There may be some condition going on in your knee that would cause this to appear a bit later. And that would I think Linda evidence to the fact that it may be a a joint problem is getting somewhere and tearing it to gradually has some swelling. It starts losing into the area several hours after the activity and will cause some stiff feelings probably a sign that should be looked at at least before doing a lot of serious stair climbing in the future. Huh. You did very important to have that done. Did you know what time it is still running still fairly commonly used by coaches as a conditioning technique staring is still something that is used quite a bit again, if it's done appropriately then it's a good exercise. If it's over done that I think this probably causing some wear and tear on the knees. It isn't necessary. I think one of the things that were fine Not as we get more more into learning about conditioning is refining it may be as much work that we've been doing. Is it necessary to gain Peak efficiency? Sometimes run too far too hard is is being counterproductive running stairs too much may be counterproductive and it's just as important to give the body a chance to recovery to recover as it is to give it some good quality work and I think we're learning more about that about what's good quality work. When's the appropriate timing on that? And when it's time to quit you don't run downstairs do you or should you as part of the conditioning program will running downstairs is another way to do some condition. Of course, it has its inherent problems if you know tripping and falling but when you think about it, if you're running stairs from conditioning, you've got to get down he had also sometimes running downstairs is a way to do it. It's probably is probably safer in a better technique to run up and then walk down. I was also worried about Nino impact problems with the knee and the ankle and the heel and I'll Kind of stuff that's not a big concern though. You don't think if done properly if it's done properly. It's not too big of a concern coming down as a different type of exercise. It's a day for muscle. It's it it's an eccentric exercise is opposed to a concentric exercise which is running up and that controls that it's at the lengthening contraction vs. Shortening contraction and that has some problems inherent. But again, it's also a type of strengthening technique that needs to be put into programs got a few more minutes. It's been here with Twin Cities physical therapist Tom Copeland time to take a couple more calls on Sports folio to 276 thousand here on ksjn 1330 Champlin is next. Hi Julie room with him when I got it maid I had I hurt my knee 20 years ago, and it used to only bother me if I slalom speed water-ski lately. It started to hurt me. Biking or walking for long times. I wonder if I never had a checked when I heard it. Could it be fixed still yet? I mean after so many years. I have you had a lot of problems with it off and on over the years or is it just recently that it started to bother you on this one leg that I hurt. But then now it's more more in every related exercise ice skating her biking is something that I hate to be repetitious but it's something that probably should be evaluated to tell you exactly what's going on. But I think generally speaking 20 years of activity starts to produce some wear and tear on all of her joints and depending on how intense her activity is U-joints. We're out more or less faster than than other types of intensity of work and it may be that a new problem in itself is is starting to to rear its head. I guess it's something that maybe you want to see what it is. It's causing it. It could be that the old injury that you had was a structural injury with something that's causing you to maybe be off-kilter a bit and over the years. It's slowly starting to take its Poland costume wearing and tearing by wonder if it could still be repaired after all this time. That's a tough one to possibly possibly but it's something you have to just take a look at no reason to assume that at least, you know, if it's as if it's some wear and tear and some degenerative changes in the knee joint and most likely know that won't be able to be repaired. But if it's a tear of a piece of cartilage that needs to come out or something like that that may be something that could be fixed syndrome. And if I did how long would it take should I use a nice sort mail and I get sore wrist a lot of the problems from carpal tunnel from the swelling that happens in in the carpal tunnel itself. And as in any swelling situation by using ice you can decrease the amount of swelling it's there you can prevent the irritation aspect of the tunnel of the attendance. Can back and forth through the tunnel by by putting ice on it. The length of time for the ice is is as any other usage of ice and that is to leave it on until the area is totally numb that way, you know particular if it's sore that when it becomes them that the the ice is penetrated to the level of the injury and is being effective ice is effective for a number of things for a number of reasons. I should say, you know, it's a great ascetic because when it gets numb the pain goes away even though it may be a little cold in the beginning, you know, you can put up with that cuz you've already got some pain but by putting the ice on and having it get to the point where it starts to get numb then I'll take the pain away from you for you want one of the major aspects of using ice is it is when you've used it properly and it's it's penetrated to the level that you wanted to go to. It also has an effect on the chemical reactions that are going on that causes swelling it slows down. We call the metabolic processes. Of the inflammation and has you have less swelling and because of that it's it. It's a chemical chemical action that we all learn about in chemistry class. If you put heat on a reaction at speeds it up and things go very fast. If you cool it down and put ice on it why it slows down and all and goes a lot slower so that when you put ice on something that's been irritated or has a tendency to swell you'll float down and it will go much more slowly and to the point where you don't have nearly as much problem when you use the ice. Thanks for the call preciate it what time once again the hour food by was the educational entertaining and all the things that this is supposed to be freezing my pleasure wishing you success in your new Ventures and when it is time for football season any busier never for the next six or seven months I'll bet it's going to be a fun but it's going to be busy, but good luck with guy any good luck with the North Stars and no pressure on you, but it already healthy. Okay. Thanks a lot. Start yes to reims portfolio. My thanks to David O'Neill who did the fine job of doing the engineering in the technical stuff here. That's the kind of guy. He is next Saturday at noon Force portfolio here on ksjn. And just a matter of seconds. It'll be one coming up next world and national news from the Associated Press. And then Mark I stood is back with the week in review. You're on ksjn. 1330 Minneapolis-Saint Paul.