The following
program presents principles
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designed to promote
good health and is not
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intended to take the
place of personalized
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professional care.
The opinions and ideas
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expressed are those
of the speaker. Viewers
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are encouraged to
draw their own conclusions
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about the information presented.
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Hello and welcome to
health for a lifetime.
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Today we are gonna
talking with Dr. John Clark,
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he is an orthopedic surgeon and
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one of the things you see a lot
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Dr. Clark and by the way
thank you for being here.
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Oh you bet,
thanks for having me.
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I know you have a
very busy schedule
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and of course because so many
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people have orthopedic problems,
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I mean back pain, arthritis, all
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these things
they come to see you,
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osteoporosis, but we're
talking about carpal tunnel,
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what exactly is
carpal tunnel syndrome?
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Well you know
carpal tunnel syndrome is a
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name we gave to a
set of symptoms people
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come presenting to us with,
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it's usually
numbness in the thumb,
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index finger, long
figure and this part
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of the ring
finger. So the thumb,
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the ring finger, or
the, then. Index finger,
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long finger, and this
part of the ring finger. Okay.
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And this numbness
often wakes them up
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at night they will
tell me about 3:00 am
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I wake up and my
hands are just numb
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and they hurt,
they say they have to
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shake him to try
to get them wake up
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they find they
tend to drop things,
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they can't feel
things as well as
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they should and
so they can't work
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with fine objects
as well, it often hits
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them when they're
driving, when their wrists
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are up like this
on the steering wheel
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or when they hold a
paper they'll drop it.
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A lot of different
things happen to them
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as a result of
basically losing feeling
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in those fingers and
thumb. Not good for a
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violinist, not good
for a flutist, not good
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for a computer
operator, not good for
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any thing with those
fine motor movements.
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That's right. So
you know I like to
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kind of know how
things works and you're
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kind of a handy
man, always have been.
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That's right.
How does this happen,
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is there some
impingement on a nerve,
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what happens? That's right.
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It all has to do with
what we call the median nerve
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and the median nerve travel's up
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the forearm and
goes into the palm
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through this area
right in the center. Okay.
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There is a canal
there and that canal
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houses all the
tendons that work your fingers
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and your thumb to flex them.
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That's like your like
your, like your little
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piece of conduit.
A piece of conduit,
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that's right. It's
only has so much room
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though and if the
room for all these
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structures starts to decrease,
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it's usually the nerve
which begins to complain
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about it. I see, so
that's what happens,
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any other causes for
that, I mean what causes it to
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shrink. The tissues here
are especially vulnerable
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to different types
of activity at work,
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one of things we found although
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some what debated is
that repetitive motion
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tends to cause carpal tunnel
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and that is
using the wrist a lot,
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doing the same thing
putting the same screw,
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in the same hole,
on the same object
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time after time,
assembly line work.
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I see. And then they
are certain positions
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we call them
ergonomics that are prone
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to carpal tunnel
syndrome. Like? Where you have
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your wrist, bent way over
when you to work or way back.
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And so where
would that be? Tennis.
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Well, not necessary
tennis, but if you're
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running a screw
driver like this or maybe
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you're working a knob like this,
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or you have to have
your wrist back like
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this or you're
working on the ceiling
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or something, any
place where your wrist
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is way flexed or way extended.
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Tends to decrease the
space in the carpal canal
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causing pressure
on the median nerve,
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and you get the
carpal tunnel syndrome.
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So, I mean my
sister had carpal tunnel
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and but you know
she's like a, she does,
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you know, parties where
she prepares a lot food,
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she does a lot of
mixing, she does all this
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so that's probably maybe
related to the situation.
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It can be, it very much can be.
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There's also other
factors that are related,
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people who have
stress on their job
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are more apt to get
carpal tunnel. Why is that?
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That's because this
is a nerve and of course
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stress affects your
nerves and some times
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we are not exactly sure why it
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happens that way,
there is one hypothesis
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out there and that
is that the sympathetic
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and parasympathetic
systems which control
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the blood supply of
the nerves shutdown the
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blood supply to the
nerve as a result of stress.
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The body is
shutting off the blood to
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periphery, and
we kind of see that,
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people who are
stressed out might have
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white fingers or cold hands,
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it's because the blood
supply has been shutdown
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to those areas. So
you're saying that the,
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in other words some emotional
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or stress related
factors ergonomics,
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or in other words
positions at work,
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repetitive trauma and
then you mentioned also
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confounding diseases
what do mean by that?
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There are diseases
that due tend to effect
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the tissues and thus
they effect the tissues
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surrounding the
carpal tunnel. Diabetes is a
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well known confounding diseases,
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it creates the
environment for carpal tunnel
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it makes the tissues
themselves stiffer they get
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glycosylated, or either they got
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lot of sugar
stuck in them. Okay.
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And then that also
effects little vessels
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small vessels
they go to the nerve,
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they go to the
tissues and so the tissues
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become stiff they
become glycosylated,
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they become hypoxic and as
result they become stiffer,
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they become more
acidotic and that
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is a problem for those tissues
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that surround the carpal canal.
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There's other
diseases, one associated
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with drinking too much
and that is amyloidosis,
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it is the deposition
of a extra tissue elements
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in the area we're talking about
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and when the canal
which is only so big
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has to have
something besides nerve and
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tendon, the space for
each structure become smaller.
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So how does that
alcohol lay that deposit down
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and go through the
blood stream and then that
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just kind of goes
into the third space
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and there and
leaves a refused, is that
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what you mean? No it's actually
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related more to the
kidneys and effective
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alcohol in the rest of the body,
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amyloid is kind of a
material that, that is
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collected in the
tissues as a result of breakdown
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in other body parts.
Okay so it's secondary
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to drinking and it's impact
on the kidney and all that
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That's right.
Alright, so how can I know
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for sure maybe you
know, some people have
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diabetic
neuropathy which is probably
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different than carpal
tunnel or maybe they have
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other reasons that
they have numbness,
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maybe they have
some kind of impingement
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in the joint or
something. But how can
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you tell for sure that
it's that it's a conduit
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here you're talking
about of carpal tunnel.
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First thing you
want to do is go see your
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doctor and they'll
do a diagnoses on you,
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there is a number
of different tests
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they use, physical
exam test that help them
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decide if what
you're feeling is really
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carpal tunnel or
not and when they get
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through with all
those physical exams
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they will also if
they want to know for sure
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order what's called
an EMJ this is a test
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that usually a
neurologist performs
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where they study
the nerve conduction
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across the carpal
canal, this test tells
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him if it's a
slowed nerve response
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or a normal nerve
response, if it's slowed
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across the carpal canal,
pretty sure, then they know
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that it's
carpal tunnel syndrome.
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Have you ever had
carpal tunnel syndrome?
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Well you know one day I was
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working out in
garage and I started
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feeling a little bit
of numbness in my fingers
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and I was wondering
if I was getting it.
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Of course if you just
have one incident where
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this happens we don't
call it carpal tunnel syndrome
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but I have had
that feeling before.
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So you know it's
like in being, you know,
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an orthopedic surgeon
that would be concerning.
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It sure is, I sure
was, I began to wonder
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what I should do
and, you know I had
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treated a number
of patients with this
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and so I tried
doing a few things
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that I teach them to do
to see if it work. Okay.
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And what I teach
patients to do who come
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to me with carpal
tunnel I tell them
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okay we have a
procedure we can do,
00:09:05.41\00:09:07.40
we can do an operation on you,
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but a lot of
patients I can cure using
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some more natural
methods, not so invasive,
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the first thing I
tell them to do is to drink
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lots of water, you
want to keep these tissues
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well hydrated, keep
the blood flowing to
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them very well and
so I teach them to drink
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plenty of water, the
second thing I had them
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to do is stretches.
Now when I have them
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do the stretches, I
have them do three stretches
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in particular, the
first stretch is one
00:09:35.77\00:09:39.67
where they put
their elbow out straight
00:09:39.70\00:09:41.54
and they grab the
last three fingers
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of the hand and
they bend those fingers
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back as far as
they can when you do
00:09:48.67\00:09:51.89
that you're
stretching, yeah, it's good.
00:09:51.92\00:09:55.68
It's something feel like
sticking needles in my hand
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at the same time,
you know. Keep your elbow
00:09:59.18\00:10:01.18
real straight while
your, alright done. Like that?
00:10:01.21\00:10:03.33
That's right. And when
you're doing that you feel the
00:10:03.36\00:10:05.66
stretch. I do.
All the way up here.
00:10:05.69\00:10:07.89
And that is important
for the muscles through
00:10:07.92\00:10:11.77
which the median nerve
travels up in the forearm
00:10:11.80\00:10:14.26
and also for
stretching out the ligaments and
00:10:14.29\00:10:17.20
tendons as they go
through the carpal canal. Okay.
00:10:17.23\00:10:20.52
So that stretch I'll
have them hold. For, how long?
00:10:20.55\00:10:24.09
For two minutes. Two
minutes It's a long time.
00:10:24.12\00:10:27.26
Oh Man. And they
do it twice a day.
00:10:27.29\00:10:31.19
Well you know. We can
stay here for two minutes.
00:10:31.22\00:10:35.05
I am gonna go on
to the next one. Okay.
00:10:35.08\00:10:38.16
It's basically the
opposite, again we're
00:10:38.19\00:10:40.69
keeping the arm out
straight, alright, and
00:10:40.72\00:10:43.06
I am grabbing the
last three fingers again
00:10:43.09\00:10:45.43
and I am bringing
them as close as I can
00:10:45.46\00:10:49.45
to the wrist, I am
bending the wrist as far
00:10:49.48\00:10:53.15
as it'll go, I am
bending the first joint
00:10:53.18\00:10:56.65
of the fingers as far as
it will go and I'm trying
00:10:56.68\00:10:59.07
to get the fingers to
actually touch the wrist
00:10:59.10\00:11:02.00
and you feel the stretch
up here and curl up here.
00:11:02.03\00:11:04.94
So I know it's usually
not touching your wrist.
00:11:04.97\00:11:07.70
I am not as
flexible as you I guess.
00:11:07.73\00:11:10.14
Well, I'm like some
kind of freak of nature
00:11:10.17\00:11:14.49
or something you know.
I won't call them that,
00:11:14.52\00:11:18.05
but go ahead and
pull those three fingers
00:11:18.08\00:11:19.87
toward you a little
further, there you go. Alright.
00:11:19.90\00:11:22.56
Alright. So that's
the second one. Okay.
00:11:22.59\00:11:24.53
Hold it for two minutes.
Two minutes. Twice a day.
00:11:24.56\00:11:27.21
Twice a day. And
that's a stretch,
00:11:27.24\00:11:29.08
now the third one is
probably the most important,
00:11:29.11\00:11:31.75
I guess I saved
the best till last and
00:11:31.78\00:11:33.72
maybe we say the
third is the charm.
00:11:33.75\00:11:35.50
Put the hand out
like this, grab the thumb
00:11:35.53\00:11:39.13
with from
underneath. Underneath.
00:11:39.16\00:11:41.75
It's kind of a,
this isn't yoga. Okay.
00:11:41.78\00:11:44.02
But I am grabbing
the thumb and then I am
00:11:44.05\00:11:47.03
pulling the thumb.
00:11:47.06\00:11:48.03
Now you gonna say
this was all a joke
00:11:50.83\00:11:52.91
right after this turns
here, okay. Good. Alright.
00:11:52.94\00:11:58.00
This is like carpal
tunnel twister alright.
00:11:58.03\00:12:00.55
And again for two
minutes twice a day
00:12:00.58\00:12:05.43
and now in that stretch
you're stretching out the
00:12:05.46\00:12:07.51
carpal tunnel. Okay.
Which is very important,
00:12:07.54\00:12:09.93
you're stretching
out a muscle up here,
00:12:09.96\00:12:12.21
pronator which the
nerve passes through
00:12:13.25\00:12:16.34
also and so
you're doing two things
00:12:16.37\00:12:19.17
that are very
important, for getting more
00:12:19.20\00:12:21.71
space for the median
nerve and so in studies
00:12:21.74\00:12:26.32
of patients who are
given stretches to do,
00:12:26.35\00:12:29.35
if they'll do their
stretches about of half of
00:12:29.38\00:12:33.16
them who'd otherwise
have had surgery can avoid
00:12:33.19\00:12:35.91
surgery.
Really? Yes. Now do most
00:12:35.94\00:12:38.44
orthopedic surgeons
share this with people
00:12:38.47\00:12:40.62
before surgery? No they don't.
00:12:40.65\00:12:43.09
Lot of time they'll
send him to a therapist
00:12:43.12\00:12:46.37
who are supposed to
share some of these things
00:12:46.40\00:12:48.26
with them. So a
physical therapist only
00:12:48.29\00:12:49.87
will share this.
Well I, not always,
00:12:49.90\00:12:53.78
no I don't think
this is generally thought
00:12:53.81\00:12:56.70
across the board but
physical therapist that
00:12:56.73\00:12:58.91
I have had in my
centers I have trained them
00:12:58.94\00:13:01.73
to show patients
this but there are
00:13:01.76\00:13:03.87
some physical
therapists that will do this.
00:13:03.90\00:13:05.88
It's called in some
other terms tendon gliding
00:13:05.91\00:13:09.92
and nerve gliding
exercises. So those three,
00:13:09.95\00:13:13.67
is there been any sturdy
says to the effectiveness
00:13:13.70\00:13:16.70
of those
exercises, that you gave us?
00:13:16.73\00:13:19.66
Yes, and patients are
given these exercises,
00:13:19.69\00:13:22.71
about half of them
can avoid surgery by
00:13:22.74\00:13:25.48
doing these exercises,
it decreases the number
00:13:25.51\00:13:29.00
that have
carpal tunnel syndrome.
00:13:29.03\00:13:30.65
So when I was out
working in my garage
00:13:30.68\00:13:33.87
I started getting that
tingling, I thought okay
00:13:33.90\00:13:36.37
I better do my own
stretches and so I went
00:13:36.40\00:13:38.09
to doing my own
stretches for two minutes
00:13:38.12\00:13:41.31
and the reason I did it
for two minutes is because
00:13:41.34\00:13:44.00
if you do it for
less than a minute it
00:13:44.03\00:13:45.89
tends to rebound
get tighter. I see.
00:13:45.92\00:13:49.42
But two minutes gives
it a chance to totally
00:13:49.45\00:13:51.70
stretch out, relax
and have the ability
00:13:51.73\00:13:54.72
to give more space
for the median nerve.
00:13:54.75\00:13:57.09
Wow I mean these are
the things you would try
00:13:57.12\00:14:00.79
and should try before
you contemplate surgery.
00:14:00.82\00:14:05.30
That's right. I've been
talking with Dr. John Clark,
00:14:05.33\00:14:08.63
we're talking about
carpal tunnel syndrome
00:14:08.66\00:14:10.38
but we're gonna talk
about some other things too,
00:14:10.41\00:14:12.08
have you ever
heard of tennis elbow
00:14:12.11\00:14:13.97
we are gonna talk
about when we come back.
00:14:14.00\00:14:16.12
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00:14:26.20\00:14:28.52
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00:14:28.55\00:14:31.04
common sense approach to health.
00:14:31.07\00:14:32.66
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Welcome back
we've been talking with
00:15:17.86\00:15:19.78
Dr. John Clark, we've talked
about carpal tunnel syndrome
00:15:19.81\00:15:23.08
and during the
break you were saying to
00:15:23.11\00:15:25.15
me you had a man that came and
00:15:25.18\00:15:26.77
just wouldn't do those exercises
00:15:26.80\00:15:29.34
he said he couldn't do
them and you know, they
00:15:29.37\00:15:31.66
are you know, you have to
have discipline to do that,
00:15:31.69\00:15:36.10
but he wouldn't do
them. That's right.
00:15:36.13\00:15:38.61
And the therapist I sent him to
00:15:38.64\00:15:42.06
was also
supposed to teach him the
00:15:42.09\00:15:43.74
exercises and the
therapist was kind of
00:15:43.77\00:15:45.63
being you know very
interested in the outcome
00:15:45.66\00:15:48.39
of this case he
showed up at my clinic
00:15:48.42\00:15:50.34
and so when I went
into see this patient
00:15:50.37\00:15:53.46
in the room the
therapist came with me
00:15:53.49\00:15:55.49
and we both walked in the room
00:15:55.52\00:15:58.21
I am the patient was
like okay, okay I didn't
00:15:58.24\00:15:59.94
do my exercises I am
sorry I am sorry I am
00:15:59.97\00:16:01.56
sorry and I told him
it's not a problem, I can
00:16:01.59\00:16:05.00
forgive you but
that won't make your
00:16:05.03\00:16:08.72
carpal tunnel
better, if you don't do
00:16:08.75\00:16:10.92
your part of the
work you won't get better
00:16:10.95\00:16:14.19
and I kind of
thought, you know as a
00:16:14.22\00:16:15.71
spiritual lesson
to it you know God can
00:16:15.74\00:16:18.45
forgive us only
once he's very forgiving
00:16:18.48\00:16:20.51
and unless we take
hold of Jesus Christ
00:16:20.54\00:16:23.30
for strength and
go and sin no more
00:16:23.33\00:16:25.90
we are gonna have
carpal tunnel syndrome
00:16:25.93\00:16:28.66
or worst things.
Interesting, those exercises
00:16:28.69\00:16:32.77
by the way I know
are gonna be a great
00:16:32.80\00:16:34.58
help but there is
another problem people develop,
00:16:34.61\00:16:37.09
I wanna talk about two of them,
00:16:37.12\00:16:38.65
tennis elbows and ankles,
lets start with tennis elbow.
00:16:38.68\00:16:41.41
Okay. Tell us
about tennis elbow,
00:16:41.44\00:16:44.03
why do people
get it? How they know
00:16:44.06\00:16:45.36
they really have
it, how you rule it out,
00:16:45.39\00:16:48.25
about what kind of
things, you probably have
00:16:48.28\00:16:49.87
some more
exercises, tell us about it?
00:16:49.90\00:16:52.04
Sure you know just
because we call it tennis elbow,
00:16:52.07\00:16:55.31
it doesn't mean only
tennis player will get it.
00:16:55.34\00:16:57.87
Tennis elbow is pain in
what we call the lateral
00:16:57.90\00:17:02.85
aspect of the elbow
is over here where the
00:17:02.88\00:17:06.66
muscles that extend your wrist.
00:17:06.69\00:17:09.02
You will feel them
when you do it like this.
00:17:09.05\00:17:11.13
Yeah exactly Don,
you can feel them right
00:17:11.16\00:17:14.25
there, you can feel the
bony prominence of your elbow.
00:17:14.28\00:17:17.32
I got it. On
this side. Where those
00:17:17.35\00:17:19.97
muscles are hooked
to the bone. Alright.
00:17:20.00\00:17:22.55
That is where the
tennis elbow takes place,
00:17:22.58\00:17:25.40
we call it in scientific
term or medical terms,
00:17:25.43\00:17:28.42
lateral
epicondylitis. No wonder, we
00:17:28.45\00:17:32.66
call it tennis elbow.
Let's call it tennis elbow.
00:17:32.69\00:17:34.68
And what happens
there is the patient gets
00:17:34.71\00:17:38.11
pain there, now we
would think it would
00:17:38.14\00:17:41.20
be from
inflammation or something like
00:17:41.23\00:17:43.32
that, but
actually scientific studies
00:17:43.35\00:17:46.31
have shown that the
pain is due to a lack
00:17:46.34\00:17:49.93
of blood supply, we
call it ischemic pain,
00:17:49.96\00:17:54.11
kind of like pain
you get in your heart
00:17:54.14\00:17:56.15
when you lose blood
supply to your heart,
00:17:56.18\00:17:58.38
a heart attack or a
myocardial infarction.
00:17:58.41\00:18:01.63
This area is
especially prone to that
00:18:01.66\00:18:06.33
because the vessels
there aren't very big
00:18:06.36\00:18:08.83
there is not a
good blood supply,
00:18:08.86\00:18:10.84
and so a area of
the tissue tends to be
00:18:10.87\00:18:15.64
vulnerable what
happens is a person over
00:18:15.67\00:18:18.02
uses that area, the
body's ability to keep up
00:18:18.05\00:18:21.87
with this pain. The
lactic acid that build up there.
00:18:21.90\00:18:24.51
Yeah, the lactic
acid, the pain, the strain,
00:18:24.54\00:18:27.84
and pretty soon you
end up with the sore area.
00:18:27.87\00:18:30.85
Now it's not
necessarily easy to treat,
00:18:30.88\00:18:36.11
and there's a
lot of things in the
00:18:36.14\00:18:38.67
literature that
have discussed thing,
00:18:38.70\00:18:40.24
anything from
injections of both steroids
00:18:40.27\00:18:43.36
or even blood
to doing surgery on
00:18:43.39\00:18:46.93
the area. I see these people who
00:18:46.96\00:18:48.60
wear these big
bands. Yes and the bands are
00:18:48.63\00:18:52.10
also used. So, talk
about those different things
00:18:52.13\00:18:55.76
with us, you know you
have listed hydro therapy,
00:18:55.79\00:18:58.57
stretching, icing, all
these different things.
00:18:58.60\00:19:00.33
That's right, when
a patient comes to me
00:19:00.36\00:19:03.15
and they have a
pain in their elbow
00:19:03.18\00:19:06.63
that I decide is
tennis elbow, I put them on
00:19:06.66\00:19:09.54
a program designed to
re-establish good blood
00:19:09.57\00:19:13.23
supply to that area.
Okay. And so I will do
00:19:13.26\00:19:16.95
the stretching just
like we talked about
00:19:16.98\00:19:19.03
for carpal
tunnel, but mainly the one
00:19:19.06\00:19:21.49
where you're taking the
fingers and pulling them
00:19:21.52\00:19:24.10
to the wrist. Okay, this
is causing the stretch on
00:19:24.13\00:19:28.22
the muscles that's attached
to the lateral epicondylitis.
00:19:28.25\00:19:31.95
Right. The area, where
the. Two minutes again.
00:19:31.98\00:19:34.11
Two minutes
again. Okay, but then
00:19:34.14\00:19:36.34
I have them do what the
therapists call contrast bath.
00:19:36.37\00:19:42.19
Contrast bath. We
call it hydrotherapy
00:19:42.22\00:19:45.27
or hot and cold. What
that consists of is I have them
00:19:45.30\00:19:49.18
put their elbow in
a bucket of hot water,
00:19:49.21\00:19:52.78
get up as high as I
can. How long? For two,
00:19:52.81\00:19:56.52
for three minutes. How
hard? As hard as they can
00:19:56.55\00:19:59.57
stand or if you want
to check the temperature,
00:19:59.60\00:20:01.99
somewhere around
104 degrees is fine.
00:20:02.02\00:20:04.41
Okay, just don't burn the elbow.
00:20:04.44\00:20:05.97
Don't burn the elbow. Right.
00:20:06.00\00:20:07.81
And then after it's been
in there for three minutes,
00:20:07.84\00:20:21.71
I'll turn around
and have them put it
00:20:21.74\00:20:22.71
in a bucket of ice
water, Oh! Preferably
00:20:22.72\00:20:23.69
with a few ice
cubes floating around.
00:20:23.70\00:20:24.67
Okay. And then
back to hot water again
00:20:24.68\00:20:25.65
for three minutes,
cold water for one,
00:20:25.66\00:20:26.63
hot water for
three, cold water for one
00:20:26.64\00:20:27.61
and they end with the
cold water, and they do that,
00:20:27.62\00:20:29.87
For three times?
Three times,. Okay.
00:20:29.90\00:20:32.08
And do it two or
three times a day.
00:20:32.11\00:20:34.78
So, how many
minutes again in the hot?
00:20:34.81\00:20:36.56
Three minutes on the hot.
00:20:36.59\00:20:38.10
And, how many in the
cold? One minute on the
00:20:38.13\00:20:39.86
cold. Three, one, three,
one, okay, that's three time.
00:20:39.89\00:20:43.42
Yeah, okay three times a day.
00:20:43.45\00:20:45.80
Three times a day would be good,
00:20:45.83\00:20:47.59
at least twice a
day. Okay, and then what
00:20:47.62\00:20:50.57
next you do? Well,
let me talk a little bit
00:20:50.60\00:20:53.00
about why that works
because it's important
00:20:53.03\00:20:55.44
to understand, so
that people don't think
00:20:55.47\00:20:57.31
this is hocus
pocus, and that is because
00:20:57.34\00:21:00.25
when you put your
elbow in the hot water,
00:21:00.28\00:21:02.88
it tends to turn
red, it brings the blood
00:21:02.91\00:21:06.27
to that area, it
washes out the inflammation
00:21:06.30\00:21:09.37
and it tends to bring
in the healing factors.
00:21:09.40\00:21:12.71
Okay, when you
switch over to cold
00:21:12.74\00:21:15.04
for a shorter amount of time,
00:21:15.07\00:21:17.17
it tends to
construct the surface vessels,
00:21:17.20\00:21:19.79
driving the blood
deep, down where the
00:21:19.82\00:21:23.04
avascular tissue is,
down where you need the
00:21:23.07\00:21:25.45
blood supply,
down where that sore
00:21:25.48\00:21:27.58
tendon insertion
is. When you go back
00:21:27.61\00:21:31.55
and forth, it tends
to pump the tissue a bit,
00:21:31.58\00:21:34.82
hot, the vessels
expand, cold, they constrict,
00:21:34.85\00:21:38.18
hot, they expand,
cold, they constrict,
00:21:38.21\00:21:40.33
also it wakes up
the white blood cells.
00:21:40.36\00:21:42.50
In fact, Mayo Clinic
showed, if you did this
00:21:42.53\00:21:45.71
to your whole body,
you could raise your
00:21:45.74\00:21:48.63
white count to
four times normal,
00:21:48.66\00:21:51.24
that's quite high.
So, you could really fight
00:21:51.27\00:21:56.29
the infections off. That's
right, that's kind of like
00:21:56.32\00:21:58.76
the polar bear club
you know, the guys that
00:21:58.79\00:22:00.50
get in the sauna and
then go jump in the lake
00:22:00.53\00:22:02.24
that has ice on it.
Well, and that's getting their
00:22:02.27\00:22:04.85
white count up,
but the white cells
00:22:04.88\00:22:06.69
are ones that help
reduce inflammation,
00:22:06.72\00:22:09.49
they control inflammation,
they work with healing,
00:22:09.52\00:22:12.68
they recruit fiber glass,
which are the healing cells
00:22:12.71\00:22:15.85
that come in and
work on that area.
00:22:15.88\00:22:17.46
And then when you end in cold,
00:22:17.49\00:22:20.25
the body goes Oh!
It's cold down here,
00:22:20.28\00:22:22.07
and it goes and
warms that area up.
00:22:22.10\00:22:24.97
And all of that
process stimulates
00:22:25.00\00:22:28.28
vascular activity,
and that's what you need
00:22:28.31\00:22:32.87
for lateral
epicondylitis 'cause that's an
00:22:32.90\00:22:35.29
avascular, a
problem without vessels.
00:22:35.32\00:22:37.62
The vessels have not
covered that area well.
00:22:37.65\00:22:40.33
And the majority
of patients I've never
00:22:40.36\00:22:42.88
had operate on a
patient, who is willing
00:22:42.91\00:22:45.55
to follow these
instructions, and do the hot
00:22:45.58\00:22:48.00
and cold stretching,
so it's very effective
00:22:48.03\00:22:50.51
at dealing with
lateral epicondylitis.
00:22:50.54\00:22:53.61
Now, the bands there
they work for some people.
00:22:53.64\00:22:57.37
And why do they
work? There's a couple
00:22:57.40\00:22:59.66
different reasons why they work?
00:22:59.69\00:23:01.13
One is that if I put a
band here then I can reduce
00:23:01.16\00:23:06.39
the amount of tension
back here at the elbow,
00:23:06.42\00:23:08.77
when I move my fingers,
it basically reduces the
00:23:08.80\00:23:11.76
length of the
tendon or the muscle.
00:23:11.79\00:23:15.46
I see. It's like putting
your finger on a violin string.
00:23:15.49\00:23:17.85
The part between
the point that you put
00:23:17.88\00:23:20.87
your finger on and
the top of the violin
00:23:20.90\00:23:22.85
doesn't vibrate, the
part over there. Right.
00:23:22.88\00:23:24.76
Yeah, so you have
this whole area that is
00:23:24.79\00:23:27.13
isolated. The other
thing is, when you put a
00:23:27.16\00:23:28.96
band here, it may
serve to back up the blood
00:23:28.99\00:23:31.78
into this part of the
arm, getting more blood
00:23:31.81\00:23:34.62
supply to that area.
We may not know all the
00:23:34.65\00:23:37.75
reasons why that band works?
00:23:37.78\00:23:39.08
Now, if you have
tennis elbow truly have it,
00:23:39.11\00:23:42.20
should you keep
playing with it or doing
00:23:42.23\00:23:45.48
repetitive motions
with it, if no why not,
00:23:45.51\00:23:48.20
if yes, why? Good question, Don.
00:23:48.23\00:23:50.83
You know, it would be
good to give it a rest,
00:23:50.86\00:23:52.90
if you have been
playing tennis and that's what's
00:23:52.93\00:23:54.62
stressing it, you
might try playing some other
00:23:54.65\00:23:56.80
game for a while.
And then you know,
00:23:56.83\00:24:01.51
if you have trouble
still after that, then you
00:24:01.54\00:24:04.39
might try changing occupations?
00:24:04.42\00:24:06.08
Or if you want, you can
have somebody operate on it,
00:24:06.11\00:24:08.95
but doesn't always
guaranteed to fix the problem.
00:24:08.98\00:24:11.62
What about injections?
Injections have been tried;
00:24:11.65\00:24:16.56
there's been a lot or
discussion about that.
00:24:16.59\00:24:19.09
They've tried steroid
injections, sometime it
00:24:19.12\00:24:22.35
works, sometimes it
doesn't, it hasn't had a great
00:24:22.38\00:24:24.05
deal of success.
And then some people
00:24:24.08\00:24:26.41
knowing that it
was ischemic, i.e.,
00:24:26.44\00:24:28.69
wasn't a good blood
supply there, started taking
00:24:28.72\00:24:31.71
a patient's blood
and shooting some of the
00:24:31.74\00:24:33.82
patient's blood in there.
In order to stimulate vessels
00:24:33.85\00:24:37.04
to grow into the
area. And that' had limited
00:24:37.07\00:24:40.09
success also.
So, I mean if I'm a
00:24:40.12\00:24:44.20
professional tennis
player watching and I,
00:24:44.23\00:24:46.25
you know, don't
want to switch jobs and
00:24:46.28\00:24:47.98
different things
and maybe prevention,
00:24:48.01\00:24:49.89
if I know how to get
out of this, would it be
00:24:49.92\00:24:52.25
good to every, so often
be doing these exercises
00:24:52.28\00:24:55.26
and what not so, it
doesn't comeback on?
00:24:55.29\00:24:56.77
That's right, it will be
good to do the stretching,
00:24:56.80\00:24:59.16
but even as
important, the more important
00:24:59.19\00:25:02.20
in that is keeping
well hydrated. Okay,
00:25:02.23\00:25:05.26
we don't have much
time two minutes or three
00:25:05.29\00:25:08.15
to talk about my
ankle that's sprained.
00:25:08.18\00:25:10.04
Well, it's not really
sprained, but let's say,
00:25:10.07\00:25:12.68
what do you do for
the sprained ankle?
00:25:12.71\00:25:14.60
Well, when you
sprain your ankle, you know,
00:25:14.63\00:25:16.27
Don I sprained my
ankle a few months ago.
00:25:16.30\00:25:18.78
And I thought I had broken it,
00:25:18.81\00:25:21.81
I could not walk,
I was crawling around
00:25:21.84\00:25:24.59
the house, I'm thinking oh no,
00:25:24.62\00:25:26.21
I'm gonna be in a
cast, what am I gonna
00:25:26.24\00:25:28.18
do? I got to work,
well there was a problem.
00:25:28.21\00:25:32.73
So, I started doing
the same thing of hot
00:25:32.76\00:25:36.52
and cold we just
described on the ankle.
00:25:36.55\00:25:39.04
I put it in hot
water for three minutes,
00:25:39.07\00:25:41.78
ice water for one
minute, back and forth
00:25:41.81\00:25:44.77
three times. Okay.
You know, I did that
00:25:44.80\00:25:46.52
for couple days,
and it felt so good,
00:25:46.55\00:25:49.75
I could walk on
it. I turned around
00:25:49.78\00:25:51.65
sprained it
again. So, I went back to
00:25:51.68\00:25:53.48
the hot and cold
again, but it worked.
00:25:53.51\00:25:55.07
The same principles
applied there as well.
00:25:55.10\00:25:57.80
Of course the
best thing is probably
00:25:57.83\00:26:00.75
not to sprain your
ankle to begin with.
00:26:00.78\00:26:02.45
That's right. What
about ACE bandages,
00:26:02.48\00:26:05.54
anything else like that?
ACE bandages are alright,
00:26:05.57\00:26:08.46
they tend to put a
little back pressure on
00:26:08.49\00:26:10.17
the ankle and give you a
little bit more insulation.
00:26:10.20\00:26:12.10
The hot and cold is
probably the best thing
00:26:12.13\00:26:16.46
you can do. Some
people wonder if you should do
00:26:16.49\00:26:18.84
hot and cold, if it's
really swelling bad and
00:26:18.87\00:26:21.41
looking purple. Then
you might just wanna ice it,
00:26:21.44\00:26:23.98
and if you ice it,
what you wanna do is take a
00:26:24.01\00:26:26.74
large chunk of ice that
you can hold in your hand
00:26:26.77\00:26:28.95
and put ice
right on the bare skin.
00:26:28.98\00:26:32.05
And rub it over
the most swollen areas
00:26:32.08\00:26:35.01
for 12 to 20 minutes.
And this is very effective
00:26:35.04\00:26:39.67
for the first little
bit, it'll hurt, it'll feel
00:26:39.70\00:26:42.72
a lot of aching pain,
but when you get out about
00:26:42.75\00:26:45.79
12 minutes, it
will totally go numb.
00:26:45.82\00:26:47.72
And it'll bring
back and then we'll have
00:26:47.75\00:26:51.30
to rebound circulation
to the area to help heal it.
00:26:51.33\00:26:53.97
And ice massage is very
effective for a sprained
00:26:54.00\00:26:58.18
ankle.
Fascinating, we've talked about
00:26:58.21\00:27:02.16
carpal tunnel, we've
talked about tennis elbow,
00:27:02.19\00:27:04.96
we've talked
about sprained ankles,
00:27:04.99\00:27:06.72
we have got, you
know, a few seconds left,
00:27:06.75\00:27:10.38
is there any parting
thought you would like to
00:27:10.41\00:27:12.85
leave, any spiritual
lesson you've learned
00:27:12.88\00:27:14.76
in dealing with
these bone issues?
00:27:14.79\00:27:17.06
You know Don, the biggest thing
00:27:17.09\00:27:20.06
I want to say here.
Is that God does not
00:27:20.09\00:27:23.86
want us to suffer;
often I tell my patients
00:27:23.89\00:27:27.24
especially when I pray
for them before surgery.
00:27:27.27\00:27:29.46
God doesn't want you
to suffer, we want you to,
00:27:29.49\00:27:32.96
God wants you to get
back to doing the things you
00:27:32.99\00:27:35.37
enjoy doing without
pain. What a wonderful thought,
00:27:35.40\00:27:39.50
we're glad that you
have been with us today;
00:27:39.53\00:27:42.06
whether you have
carpal tunnel syndrome,
00:27:42.09\00:27:43.71
or know someone who
does, you have a game
00:27:43.74\00:27:45.35
plan for that.
Tennis elbow the same thing,
00:27:45.38\00:27:47.28
sprained ankle,
the same thing what a
00:27:47.31\00:27:49.81
useful program this has
been, but it's only useful,
00:27:49.84\00:27:52.28
if you do it. So, we
encourage you to do that,
00:27:52.31\00:27:55.22
try these things
out and as a result
00:27:55.25\00:27:56.90
we hope you have health
that lasts for a lifetime.
00:27:56.93\00:27:59.72