dr. jim vs kjetil1234

[kjetil1234]

I am seeing this more and more, especially in the Crossfit community. There seems to be new phenomena that we are completely throwing RICE to the wind and letting the body heal "naturally".

I think this is a gross misinterpretation though. As healthcare professionals, we have to be careful how we word things and make sure the patient and others listening to our advice fully understands what exactly it is you're trying to explain. For instance, when you cut yourself, you will bleed. It's natural, right? However, too much bleeding will cause anemia, and even death. "But I thought it was natural!". Same with swelling. SOME swelling is ok, but too much swelling will NOT allow rapid or efficient healing. Remember that, also, there is a standard of care. If you have a patient that has swelling, and you don't treat it appropriately according to the standards of care because of some newer information that hasn't been established yet as standard of care, you can get your ass in some hot water.

BTW, using the RICE method isn't concealing the symptoms. If ice makes it feeling better, then it's been shown, with well backed studies, that it is treating the problem.

On a final note, I tell people to use ice for 24-48 hours, then use whatever makes it feel better after that. Pain relief using heat or ice IS treating the issue (Pain caused by inflammation, which prevents proper range of motion, possible impingement etc. If it's an infection causing the swelling, well, that's a different story. Antibiotics are needed in that case, not heat or ice.

Pain IS a symptom. Think logically about it, your body is telling you to stop the activity so that you don't break yourself. You should have read the article, as too much inflammation is obviously not good- however WHY does your body overinflammate the area? The answer is poor hormonal balance between AA (pro inflammatory) and GLA/EPA (anti inflammatory). Too much Arachidonic acid (mainly from too much omega 6 fatty acids) WILL cause an abundance of pro vs anti inflammatory response available by the body. In which case YES you may need some help with ice or equivalent. However, most inflammation is natural and will HEAL the tissue. But how can it heal if you keep ripping the wound open?

All i've been saying is, rip the problem by the root and not one leaf at a time.

Regarding impingement, I don't agree with you, nor with jim (who claims wear and tear is completely normal). The poor ROM/stability/whatever is not stabilizing the joint properly, which actually causes the premature arthritis! Why do doctors keep perscribing anti inflammatory to so many patients with chronic injuries (shoulder, hip, knee), which are definitely not stemming from hormonal imbalance?

Lack of evidence, perhaps. But why? Does big pharma really want to cure chronic illnesses? The biggest culprit is lack of common sense and knowledge of MS problems IMO!
Example: patient with chronic anterior shoulder pain. Doc gave anti inflammatory, nothing has worked. MRI shows nothing, just some swelling and doc has given NSAIDS as a default. But manual testing shows that subscapularis isn't working properly. This would DEFINITELY indicate the possibility that the humerus is NOT stable in the glen cavity during movement, as it's not only a functional depressor of the humerus but also the pecs, lats and teres M will pull it more out of centration (synergist dominance!) This is a very common problem, and easy to fix. Why give drugs? Why REMOVE the inflammation desperately trying to heal the area?

Regarding icing again:

"Let me quote Dr. Nick DiNubile, Editor in Chief of The Physician And Sports Medicine Journal (physsportsmed.com) “Seriously, do you honestly believe that your body’s natural inflammatory response is a mistake?”

Well what does the research and literature say?

“When ice is applied to a body part for a prolonged period, nearby lymphatic vessels begin to dramatically increase their permeability (lymphatic vessels are ‘dead-end’ tubes which ordinarily help carry excess tissue fluids back into the cardiovascular system). As lymphatic permeability is enhanced, large amounts of fluid begin to pour from the lymphatics ‘in the wrong direction’ (into the injured area), increasing the amount of local swelling and pressure and potentially contributing to greater pain.” The use of Cryotherapy in Sports Injuries,’ Sports Medicine, Vol. 3. pp. 398-414, 1986"

http://www.mobilitywod.com/2012/08/people-weve-got-to-stop-icing-we-were-wrong-sooo-wrong/

Here

 

[Lizard King]

Speak for yourself. There are many of us who prefer and appreciate Jim's evidence based posts over those of the "bros" that like to play internet doctor but wouldn't know the difference between a peer-reviewed journal and some horseshit opinion piece by a meathead. While I fully understand that not everyone has the aptitude or education to understand journal articles and the statistics, I find it unfortunate that Mugzy's choice in moderators (some) aren't more accommodating towards it.

CBS

Did I insult you in some way, did I hurt your feelings for moving a dr jim post? I must be not educated with 4 years of Pharmacy school (no I didn't finish but I think I learned enough in the 4 years) working in the Healthcare Industry for over 20 years dealing with Chairmen, CEO's, CFO's and a multitude of others. I understand every one of his copied articles, and there is a rebuttal for every one of them with another article stating the opposite.
If you don't like it here, simply go post somewhere else there are plenty of other boards. Do I need to run a deleted post log to prove something to you? Nope, because nothing was deleted. I don't know who you think you are, but coming here and insulting the mod team is not a good way to start.

 

[woodswise]

Now see, I like Jim but you're DEAD wrong on this. There's absolutely no censoring on this board. Did you guys happen to notice YOU'RE POSTING IN THIS SUPPOSED DELETED THREAD??!! TID is the best ran board I've seen , we're pretty much left alone unless shit gets totally out of hand. And these are the best Mods and Admin period. Don't even start that shit here because NO ONE here is buying it

I have come to respect Jim, and the more he tones down his anger and writes in plain English (i.e. not talking down to us), the more I like to read his posts.

But the Mods on here are all (each and every one of them) thoughtful and balanced. They work hard for the community for little or no thanks. And I take real exception to anyone accusing them of doing anything improper.

 

[IronCore]

Lack of evidence, perhaps. But why? Does big pharma really want to cure chronic illnesses? The biggest culprit is lack of common sense and knowledge of MS problems IMO!Example: patient with chronic anterior shoulder pain. Doc gave anti inflammatory, nothing has worked. MRI shows nothing, just some swelling and doc has given NSAIDS as a default. But manual testing shows that subscapularis isn't working properly. This would DEFINITELY indicate the possibility that the humerus is NOT stable in the glen cavity during movement, as it's not only a functional depressor of the humerus but also the pecs, lats and teres M will pull it more out of centration (synergist dominance!) This is a very common problem, and easy to fix. Why give drugs? Why REMOVE the inflammation desperately trying to heal the area?

So what is this solution? please tell us... and tell me again why you cant prescribe medicine... never mind... In know... your not a doctor... your a masseuse... Dont get me wrong here.. I am not taking sides... I dont like big pharma any more than the next guy... but I know when i hurt... my NSAIDS sure do help... and somehow I heal just fine.

 

[kjetil1234]

So what is this solution? please tell us... and tell me again why you cant prescribe medicine... never mind... In know... your not a doctor... your a masseuse... Dont get me wrong here.. I am not taking sides... I dont like big pharma any more than the next guy... but I know when i hurt... my NSAIDS sure do help... and somehow I heal just fine.

GJ missing the point. Why would I want to prescribe medicine to something that is better cured with corrective exercises?

Keep taking your NSAIDS if you want (which usually won't address the CAUSE of this type of problem at all). All I'm doing is offering an alternative. if you're not interested, no one is forcing you to try it.

 

[British Animal]

Gentleman for christ sake everyone has there own options that's what makes this board useful, but coming on to the forum after 3 days and seeing this tit for tat crappy, come on its not constructive or useful to anyone

 

[kjetil1234]

Gentleman for christ sake everyone has there own options that's what makes this board useful, but coming on to the forum after 3 days and seeing this tit for tat crappy, come on its not constructive or useful to anyone

Agreed. And contributing rather than obsessing about calling bullshit on others' opinions/contributions is far more beneficial both to atmosphere(respect) AND variety of advice given.

 

[IronCore]

like I said... dont get me wrong... not picking sides... and proper form and corrective exercise are always my first choice... but sometimes... SOMETIMES... shit just hurts... and for that... NSAIDS... While they are not always the answer... they work... and yes... I do go to a chiro too... so while I did kick you in the dick about not being a doctor... I appreciate you not getting all sensitive about it...

 

[kjetil1234]

like I said... dont get me wrong... not picking sides... and proper form and corrective exercise are always my first choice... but sometimes... SOMETIMES... shit just hurts... and for that... NSAIDS... While they are not always the answer... they work... and yes... I do go to a chiro too... so while I did kick you in the dick about not being a doctor... I appreciate you not getting all sensitive about it...

Alright, no offense taken.

Pain management is of course one important side of the matter. But NSAIDS will block the natural inflammatory response to heal the area. If shit hurts, you'll have to make a compromise (pain reduction or healing/healthy tissue). Usually it doesn't hurt too much to do corrective exercises, which in the end most of the time will leave the client with both a functional joint and a healthy soft tissue (while NSAID will only relieve symptom temporarily, USUALLY).

 

[BrotherIron]

Agreed. And contributing rather than obsessing about calling bullshit on others' opinions/contributions is far more beneficial both to atmosphere(respect) AND variety of advice given.

I don't know how you young kids are but respect is earned..... not given.

And this thread is nothing more than a dick measuring contest where both are coming up way short. One likes to copy and past everything in webMD and the other likes to use big words from books he's read but with very little real world experience.

Yes, wear and tear does happen. After you've lifted for 15 or more years maybe you'll gain some of that real world experience you're lacking right now which forces you to rely on books.

 

[kjetil1234]

I don't know how you young kids are but respect is earned..... not given.

And this thread is nothing more than a dick measuring contest where both are coming up way short. One likes to copy and past everything in webMD and the other likes to use big words from books he's read but with very little real world experience.

Yes, wear and tear does happen. After you've lifted for 15 or more years maybe you'll gain some of that real world experience you're lacking right now which forces you to rely on books.

Sorry to hear I'm perceived like that. I'm not saying wear and tear is a myth, but why the incline of hip replacements even in the general population? Just as your skin regenerates, don't you think a joint should also? Why can some people stay active all their life, and others need a new hip or shoulder at a young age? Coincidence? I think not.

"Big words" describe the problem in a manner of detail that is necessary to prove a point, if you're not sure what I mean then i'll gladly explain in a different way. I'm not in any way trying to enlarge my dick by using Latin words, just trying to be specific.

I'm not sure why you think I don't have any experience, as I work with people who have sports injuries every day, and quite often successfully treat the problem without drugs. But hey, I guess I need to modify my approach either way, as I don't like to come off as the "ignorant know it all".

https://m.youtube.com/watch?v=hKy2dIODrt4

https://m.youtube.com/watch?v=ScI1oN0jXYU

Watch this video, if you want some more insight to what I'm talking about. This is the method that I'm utilizing with my clients.

 

[IronCore]

*sigh* more copy and paste SMH