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Health & Wellness Strategies
March 2009

Happy March! 
 
Did you know the name of March comes from ancient Rome, when March was the first month of the year and named Martius after Mars, the Roman god of war?  And for all you sports enthusiasts out there, you'll probably be looking forward to college basketball's March Madness!  So here's hoping the luck of the Irish helps you with your bracket!
Tennis Injuries: Cutting Edge Treatments and Prevention Strategies
 
 
      Tennis elbow (lateral epicondylitis) is by far one of the most prevalent injuries in tennis.  It is caused by the micro-tearing of the extensor group muscles of the elbow.  These muscles are located on the thumb side of the elbow and allow us to bring our wrist back and side to side.  Scar tissue can form in the muscle belly which can compress important nerves and blood vessels.  It typically occurs secondarily to the use of an aluminum racquet, incorrect grip measurement, improper backhand technique, excess weight of the racquet, and due to too much tension in the strings.   
      Rotator cuff tendonitis is also caused by micro-tearing in the belly of the muscle. The muscles involved are the rotator cuff muscles of the shoulder which originate in the shoulder blade (scapula) and attach to the upper arm (humerus).  Typically we see this occur with players who serve with an elbow to side angle of less than 90 degrees.  Due to the improper mechanics of the serve it typically also requires the player to serve repeatedly.
      A byproduct of the constant running and cutting in tennis is anterior (front) knee pain located deep, beneath the knee cap (patella).   The patella fails to track or move correctly within the knee resulting in frictional forces applied to the lower femur bone and subsequent braking off of small pieces of cartilage.  This can lead to a condition called chondromalacia patella.  Pain is usually experienced when going up stairs and stopping abruptly while running. 
      The primary goals in treating these disorders are to reduce inflammation, break up the fibrotic adhesions (scar tissue), strengthen surrounding musculature and neurological pathways, and restore proper joint motion.  This entails some simple procedures including myofascial release, passive and active mobilization, isometric and isotonic strengthening, and joint manipulation (adjustment).  New cutting edge procedures involve the use of mirrors in a technique termed mirror imaging technique which attempts to strengthen the neurological and immune pathways in the affected limb.  In addition, cross cord applications and eccentric fast stretching are novel procedures which decrease the healing time. 
In terms of nutrition, supplementing with proteolytic enzymes and essential fatty acids will help to reduce inflammation and break down scar tissue.  Sticking to an anti-inflammatory, low glycemic index diet will also help to reduce inflammation and insulin surges which can promote neurological degeneration
Lastly, prevention is the key to avoiding injury all together. Here are some key tips to increase your longevity and effectiveness on the court:
1.      Utilize a ceramic or graphite racquet which reduced vibration.
2.      Choose a lighter racquet-10.5-11.5 oz.
3.      Make sure you have a correct grip measurement.
4.      Use natural gut strings, which have tension 3-5lbs below what athlete is used to.
5.      Use proper backhand technique.
6.      Warm up prior to playing.
7.      Focus on core muscle training.
8.      Keep your spine in correct alignment.
9.      Strengthen lower extremity musculature.
10.  Take multivitamin with plenty of anti-oxidants.
A real cutting edge procedure is termed motor imaging technique.  In essence the athlete visualizes in sets and repetition format, a learned movement such as the various movements on the tennis court.  The visualization must be very detailed in nature.  Scientifically, the neurological pathways involved in the particular movement are enhanced and other non-pertinent pathways inhibited.  This activity is gaining great notoriety as many of the top athletes in the world are incorporating this into their treatment regimen.  Please contact our office for more detailed information on how to get started with some of these revolutionary techniques.   
Exercise of the Month: Ball Squats
 
Ab Crunches
 
 
What it's for: Quadriceps, hamstrings and buttocks

How to do it: Stand with your back to a wall, feet shoulder-width apart, and place the ball between the wall and your lower back. Squat, letting the ball roll along your back, until you are in a "sitting" position with your knees forming a 45-degree angle. Return to starting position.
Recipe of the Month: Colcannon
Although this traditional Irish dish is usually served on Halloween, we thought it could bring you some luck (and some always essential calcium) this Saint Patrick's Day.  If you don't care for the bitter taste of kale, substitute spanich without losing the nutritonal power!. Enjoy!
 
Ab Crunches
1 pound kale
1/2 cup finely chopped onions
4 cloves garlic, diced
2 teaspoons olive oil
2 pounds potatoes, chopped
1/2 cup soymilk, vegetable broth or cream
salt and pepper, to taste 

Wash and trim the kale, removing the hard stems and tearing into bite-sized pieces. Saut� with the chopped onion and garlic in olive oil until the kale is tender. Set aside.
In a large pot, boil the potatoes in lightly salted water until the potatoes are soft, about 20 minutes. Drain and then add the soymilk or vegetable broth. Mash well. Mix in the saut�ed kale and onions. Add salt and pepper to taste.
Serves 5.

(Leftovers? Form the colcannon into pancakes. In a lightly oiled, nonstick pan, fry both sides until lightly browned.)
Brain Teaser of the Month: Color Confusion
How quickly can you say the following colors, not the words themselves, but the color they are written in? 
All the Pretty Colors
MassageMarch Massage Madness 
 
All through March relax with discounted Massages! 
$35 for 1/2 Hour; $60 for 1 Hour
 
 
Contact Us
Dr. John Conde is a Board Certified Chiropractic Neurologist.  He holds diplomate status through the American Chiropractic Neurology Board.  His office is located at the Atlantic Grove in Delray Beach, Florida.  For more information, or to make an appointment, please contact 561-330-6096 or [email protected]