Participants: Don Miller, Agatha Thrash, Wynn Horsely
Series Code: HYTH
Program Code: HYTH000174
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00:01 Hello, I'm Agatha Thrash, a staff physician
00:04 at Uchee Pines Institute. 00:06 This is a place where we train students to teach 00:11 anywhere in the world how to take care of a lot of the 00:15 physical problems that people have in the home with just 00:19 ordinary things that people have available in their homes. 00:23 Skeletal injuries are some of those and we'll be talking 00:26 about skeletal injuries during the next half an hour. 00:29 We hope you will be able to join us, and that you will get a 00:33 blessing from what we teach you. 00:56 Welcome to "Help Yourself to Health" 00:58 with Dr. Agatha Thrash of Uchee Pines Institute 01:02 And now, here's your host, Dr. Thrash 01:06 I've never had a serious skeletal injury 01:10 ...although I've been very active all of my life. 01:12 I have been able to help other people, however, 01:16 who do have skeletal problems, to get relief of pain 01:21 and to have the opportunity to see themselves healed 01:25 by just the most simple things that one can do. 01:29 Now these kinds of things, skeletal problems, 01:34 fall in the realm of physiatry. 01:37 And a t Uchee Pines, we have a physiatrist on our staff... 01:40 and that's Dr. Winn Horsley. 01:42 And I've asked him to join me today so that we can 01:45 talk with you about some of the very simple things 01:49 that you can do in the home to relieve skeletal pain. 01:53 So we have some of our other helpers here... 01:58 One is Shannon Jenkins, just come right on here and 02:03 you're going to show us... or we're going to show on you 02:06 how to take care of the hip... hip pain. 02:10 Yes, now usually this wouldn't be in a young woman 02:13 Generally, this is much more common in people after 50, 60. 02:20 We're talking about the problem of osteoarthritis. 02:24 The gradual degeneration of cartilage that happens 02:28 through the years. 02:29 Doctors that look at this... that look at the joints 02:33 of the body, that's the radiologist, 02:35 say that someone, by the time they are 60 years old, 02:39 if you let them look at enough of their joints, 02:41 100% of the people will show evidence of osteoarthritis. 02:44 So, that means that the person is going to start 02:48 to notice what's going on... 02:49 It will be perhaps painful, and definitely limited. 02:52 Painful fingers... That's right. Painful hips... That's it. 02:55 Painful knees and painful feet... 02:57 I've heard those complaints hundreds of times... 03:00 and I always thank the Lord that I don't yet have those... 03:03 and I'm so grateful. 03:05 Well, in the hip, the person will begin to notice it walking. 03:10 Of course, it's when we're walking that you put your 03:11 pressure and you expect movement in the hip 03:14 So, if that occurs, one simple thing... 03:19 And it's certainly worthwhile to try... is a cane. 03:22 If you put the cane down right when you're putting that 03:27 foot of the painful leg, the painful hip on the ground, 03:30 Then you are helping to bear that weight. 03:34 It's not so much just the force... 03:36 By the way, you carry a cane on the opposite side in general, 03:39 to the painful side. 03:40 I already had it in my hand... the painful side, 03:44 so when I saw that you had it on the other side, 03:46 I shifted there... Okay 03:48 When every time a person takes a step, what holds your body 03:53 so that you can swing the other leg, is strong hip, 03:56 we call them abductor muscles. 03:58 Strong muscles out here that hold the body up 04:00 ...otherwise, the person would be falling over, like this 04:02 with every step... falling to one side and then the other side 04:05 Well this muscle holds it up... 04:07 BUT, at the same time, it's putting that much more force 04:09 through the hip joint... I see 04:11 So if the joint has degenerated, then you're applying perhaps 04:15 3 times body weight through the hip. 04:17 By degenerated, you mean that this cartilage part here... 04:23 ...the part that covers... 04:25 We don't actually have a model here of the cartilage itself 04:30 It would be a layer... oh, 1/4 of an inch, 04:33 or maybe even more, thick covering this head and giving 04:38 a socket for this head of the thigh bone, femur to fit into. 04:44 Is there cartilage also in the socket, 04:47 or just on the head of the femur? 04:49 Well, it's in-between the 2 bones, 04:51 BUT, actually a layer of this bone is cartilage 04:57 and a layer of the pelvic bone is cartilage, 04:59 so you've got 3 layers of cartilage needing each other. 05:02 So if it gets degenerated, it may be in several places? 05:05 That's true... and you may have a lot of debris. 05:09 Just little pieces... little pieces, or even just junky sand 05:16 Well, a cane like that really can give some relief. 05:21 But most people aren't aware that there's a simple procedure 05:25 that helps sort of push that material back into place 05:30 And if you get it into place, and rest it a while... 05:33 perhaps it kind of glues a little bit together too. 05:36 It's a simple traction maneuver and so... 05:40 I think we should try and do it right here... All right 05:42 Very good... Yes, I'm glad that Shannon has agreed to be 05:47 helpful in this way. 05:48 So we'll just have her lie down here and 05:51 you tell me what to do. Okay! 05:53 Now we're going to be pulling her leg, not to fool her, 05:58 but to literally pull her leg... 06:01 And when we do this, we do it with enough force so that she 06:04 would just be pulled right off here, or even off a bed. 06:06 Now, we've already seen how easily you can slip here, 06:08 so Shannon is putting her arms at the back of the table 06:13 there to hold herself from being pulled off. Okay. 06:15 Dr. Agatha... Yes... you want your leg to be 06:18 loose so the knee and the hip are just as loose as can be. 06:21 You don't apply any force there, and that's the way... 06:24 You grab behind the knee, and perhaps a little further up 06:26 with this arm, and now start some pulling force 06:29 right in the direction that the thigh is in. 06:32 And, good... are you feeling it, Shannon? Um hm 06:35 Okay! And considerable force can be 06:38 applied like this 50 or even 100 pounds. 06:40 I know you won't want to stay there too long... It's 130! 06:44 Okay, well that gives you the idea. 06:47 To do that for about a minute? 06:49 Yes, if you can do that for a minute... 06:50 I've done it a number of times for... well, I never did watch 06:54 my watch, but I would say 1/2 a minute to a minute or 06:57 I'm sure it wasn't more that 2 minutes. 07:00 I'll do it for a while, and then stop and then do it again. 07:02 And people that get help with this, that's a good number 07:07 ...will say that it gives them relief hours and sometimes 07:11 a day or 2... In fact, I think even longer I've seen at times 07:14 So it's certainly worth a try. 07:16 People can have surgery put off for quite a while 07:21 just by a simple maneuver like that. 07:23 Now I felt as if I were actually putting a little suction 07:32 almost on her hip joint... Was that actually happening? 07:35 I think that it literally true. 07:38 We don't have here, in visual form, 07:43 what actually is around here. 07:44 There's a whole joint capsule... Ah ha 07:47 You mean, in addition to this part, there is also... 07:51 It's like it encases the whole joint. 07:53 This is not the cartilage, it's an actual capsule. 07:57 Ligaments and tendons... 07:58 The ligaments would be like thickenings of the capsule. 08:01 But that capsule is what separates the hip joint 08:05 from the rest of the body. 08:06 So when you put that traction on you're stretching the capsule 08:09 ...and sort of pulling the things in towards the center 08:12 of the joint. Um hm 08:13 Now, I think you DID this but I think it's worth saying it... 08:15 just for anyone that's watching... 08:18 That this is not just a matter of pulling because if Shannon 08:22 had tightened her muscles any, 08:24 all you're doing is pulling against muscles, 08:25 and we don't want to do that. 08:27 We want to really stretch the joint. 08:29 That's why you sort of jiggle it a little bit. 08:32 Jiggle it to make sure she has relaxed it... That's right. 08:35 ...While you're applying that force. Ah ha, yes. 08:38 I did a little bit to see if she was still relaxed 08:43 and she did very well. 08:44 Thank you so much... appreciate that! 08:47 And I have a little bit more appreciation for 08:50 the hip joint now, and for the debris that can accumulate 08:56 in there... and so the idea is to bring that debris 09:01 to the center, so that it won't be here where the 09:05 major part of the pressure is going to be. 09:06 You know, I think what often happens when you've gotten 09:10 that cartilage worn down thin and made into debris, 09:14 that it goes out into the folds of the capsule 09:18 where it's not really functioning... 09:19 It's not between the 2 bones. 09:21 When you PULL like this, the capsule tightens up and it 09:24 pushes these things back up... That's it 09:27 That's very good, and you can get pain relief then for 09:31 a long time, or? 09:33 I don't want to say that routinely, you'll get it 09:35 for days and days, but we've seen people where 09:41 they'll get it... Well I've heard therapists 09:43 tell me that quite often, a day or 2 and perhaps several days, 09:47 I think I've seen people where it will last up to 09:49 a week or so. 09:50 People are very happy with this simple maneuver 09:53 and so then they don't have to be taking drugs and so on. 09:57 Well that's good and, considering the fact that 10:00 a drug which might be harmful to us, might not last 10:06 more than 3 or 4 hours also... That's routine 10:09 is pretty respectable pain relief. Um hm 10:11 Now, this is a model of the knee. 10:14 What kind of problems can we get? 10:17 Every time I kneel to pray, I thank the Lord that I 10:21 don't have pain and have a knee that will still work. 10:26 If you do a lot of kneeling, like someone doing floors, 10:31 there is a bursa that they can compress here below 10:38 along here on the patellar tendon, as it is called. 10:41 By the way, these white, tough structures 10:47 are the ligaments of the knee... 10:48 And I should call this one a tendon because 10:52 because this actually connects to a muscle here 10:55 But these ones are ligaments. 10:57 Well there are a number of injuries... 10:59 In fact, we're simplifying all along. 11:01 There is not just one injury at any one joint 11:03 but, at the knee, you have plenty of things 11:07 that could happen. 11:08 Perhaps it's worth mentioning that one of the most common 11:14 type of injuries to the knee would be from sports. 11:17 I think many people will have heard of sports people... 11:23 football players injuring their meniscus. 11:26 And, when you're talking about meniscus, we're just talking 11:29 about one of those cartilage structures again. 11:31 Now at the knee, here you can see it... 11:35 It's the white in-between the bones here. 11:37 This is cartilage. 11:39 And, the thing about cartilage that is unique is... 11:45 It is the only tissue in the body that has no blood flow. 11:48 I better correct that... The cornea doesn't have any either. 11:52 But, the cartilage, you have a fair sized.. 11:57 I mean a lot more tissue than in the cornea. 12:00 And, its nutrition has to come from whatever bit of fluid 12:04 that came from blood flow, but now not has blood flow, 12:08 just seeping into the cartilage to maintain it. 12:10 And if you injure that cartilage ... because you don't have 12:13 that rich supply the blood gives to other tissues, 12:16 it's very difficult to heal. 12:18 It takes an AGE to get it to heal. 12:21 It does, and often it doesn't do well, even getting 12:26 any kind of healing... 12:28 And so, what's routinely done, when one of those meniscus 12:32 injuries happens to the knee, is they will 12:34 go head and do surgery and take out a piece... 12:37 Take out the entire meniscus? 12:39 That, or take out the torn part anyway... 12:43 And it's really... Yes, it will take away their symptoms, 12:47 but the person will not be 100% because as time goes on, 12:54 see, this was part of the weightbearing 12:57 structure of the joint. 12:58 They now don't have part of it and this joint will develop 13:02 degenerative changes, osteoarthritis, 13:04 sooner than a normal knee. 13:06 Is there some kind of little prosthesis or something 13:12 they could put in there artificial? 13:13 You know, one would think that... 13:15 For instance, in the back, the biggest pieces of cartilage 13:18 in the body are the disks there. 13:20 Well, couldn't one just put in something that would 13:22 take the place of that disk? 13:24 It's been tried, but I haven't heard a whole lot of follow-up 13:28 This has been mentioned years and years ago. 13:30 When you don't hear a whole lot, it let's you know 13:32 ...probably it was a failure. 13:35 Well, in sports injuries, you often, in addition to the 13:42 meniscus getting injured, often you do injure one of 13:46 the major ligaments. 13:47 On the knee, this knee... let's see, is a right knee 13:53 This extra little bone is on the outside of the knee. 13:57 And what happens, for instance, football, they'll attack 14:01 of course, from the side, and when they do that, 14:05 they may damage... you'll be putting a force like this 14:12 They may damage this meniscus but you may, at the same time, 14:15 damage the ligament way out here by stretching it. 14:17 You pull this way. That's right. You're pulling this way. 14:20 And so, it can be a bad sprain. 14:23 This ligament, as well as the outside one, are 14:26 called "collateral ligaments. " 14:27 This would be the medial collateral ligament. 14:29 Well, treating sprains is something that's worth 14:35 talking about for a little bit. Okay. 14:37 Maybe we can talk about the most common sprain in the body. 14:41 And that's a sprained ankle. 14:44 Yes, I've had one of those. 14:46 There's an ankle... Okay. 14:49 Well, which way do people get sprains on their ankle? 14:52 They get it from twisting their foot. 14:54 And which way do people twist their foot? 14:58 Well, I can tell you the common way is that the foot is 15:03 turned in and you come down hard here. 15:06 Now this skeletal model doesn't have on 15:09 the ligaments like this did. 15:11 But, just like in the knee here, 15:13 you have ligaments on both sides. 15:16 So you have strong ligaments here along the outside, 15:19 or as we say in medicine, the lateral aspect of the ankle. 15:22 And, you have other strong ligaments on the 15:24 medial side, the inside. 15:26 Since we're talking about twisting the foot this way, 15:31 it's the outside of the ankle that most commonly 15:34 gets rather badly sprained. 15:36 Now I did this one time, doing some running on the spot. 15:40 And I think it was a paying-me-back for being 15:50 a little bit show-offy to a fellow that was a 15:53 smoker and I was trying to show him how much 15:54 nonsmokers can do, you see. 15:56 But there I went and sprained my ankle rather badly. 16:01 And, by the time I had calmed down enough to look closely 16:04 at the ankle, it had swollen to about twice 16:07 the size of the other ankle. 16:08 And I, right away, did what really is part of a reasonable 16:13 treatment approach for acute sprains. 16:18 Maybe we could write this up on the board. All right. 16:22 There is a nice little memory device for this... 16:28 It's the letters... R I C E 16:40 The "R" stands for REST... Well, that's kind of obvious. 16:47 You want to let the part rest, and yet some people 16:52 will push on... especially in sports. 16:55 People will just push right on against pain. 16:58 And, no, we need to learn that that pain is there... 17:02 It's God's signal to us that something's gone wrong. 17:04 You need to rest it. 17:06 The "I" stands for the same as the rest of the word... 17:08 It's ICE... Now it doesn't have to be ice that applies the cold 17:14 You can use other things, but something 17:17 that will apply cold to the joint. 17:18 The "C" stands for COMPRESSION 17:26 And the "E" stands for ELEVATION 17:33 Elevation I've seen used quite routinely after hand surgery. 17:41 They do the surgery and surgery of course, is inflicting wounds 17:44 And, after any wound, you'll get inflammation. 17:49 And just so it isn't excessive, they'll raise the hand... 17:53 have the person's hand up some. 17:55 Well, I had just injured my ankle, and I didn't want 18:02 to fool around with ice... that seemed too bothersome to me 18:05 And I wasn't anxious to rest either, I had some things to do 18:07 where I was visiting a city where this happened. 18:11 So, I zeroed in on compression as my treatment means. 18:16 And yours was this kind of injury... It was, that's right 18:21 And so, compression, I know you're going to use this 18:24 I actually used something similar... it's Ace wrap 18:28 which I'm sure many viewers have seen... that tan-colored 18:32 sort of elastic wrap... This is more rubbery material 18:35 but the same idea. 18:37 And so this was wrapped around. 18:39 I don't think we'll do a whole demonstration here of this, 18:44 but you can see the idea... you wrap around several times 18:48 You wrap it snug but obviously, you don't do it 18:50 so tightly that you're going to be... 18:51 I've heard that you start all the way down here at the bottom 18:54 Well, you might, although when you're not going to apply 19:01 a whole lot of pressure... 19:02 It isn't bad to do it moderately snug up here. 19:08 Now, you always want to check on the status of the circulation 19:13 and of nerves. 19:15 Orthopedic surgeons, when they come and check patients, 19:17 after they've operated and any injury, they always talk 19:22 about the NV status... neurovascular status of the limb 19:25 ...so you go down and check the toes 19:27 and see if their color is good and so on. 19:29 If you're going to apply a major amount of pressure, 19:32 it's exactly like you said, you should start 19:34 down at the toes and actually decrease the pressure as you 19:38 come up... I see 19:39 But here, you want a moderate amount, not a lot of pressure 19:42 That's right. A moderate amount just on the sprained part. 19:45 You know, I didn't need a whole lot of pressure. 19:47 The effect was really quite dramatic. 19:49 I put it on and, maybe half an hour later, 19:54 I took it off just to see, and it was right down to 19:56 pretty much the same size as the other ankle; 19:58 whereas it had been VERY swollen. 20:00 So the compression DOES really act against that swelling. 20:05 Now to me, a very interesting thing about this... 20:11 was what happened a few years later. 20:13 Now, I got over the acute problem and was walking around 20:18 after limping for a few days, but I noticed that at times, 20:24 that the ankle wasn't very strong. 20:26 I went to a conference put on by osteopaths 20:31 at one of their schools up in Michigan, and 20:35 it was an excellent presentation in which they presented 20:38 manual treatment of joints. 20:40 And there, they gave the diagram of the ankle 20:43 and then they immediately had us pair off to treat... 20:46 work with each other... 20:47 And the man that worked on my ankle, he right away said... 20:51 "What's wrong? This is a sloppy joint" 20:54 And it then occurred to me... that this sprain 20:58 had left my joints weak... 21:01 And I can't help but think that I was, even without applying 21:05 any terrible pressure, I was counteracting with this 21:08 compression, the natural inflammatory response of the 21:12 body for healing... Yes 21:13 So it didn't get as firm a healing as you should have 21:19 gotten... That's right. 21:21 You know, you look at these... 21:24 Here I am wanting to avoid all the drugs and when I see 21:28 treatments that are not drug- based... I think, great! 21:30 These are the ones I can use. 21:32 But you know, it teaches us that we really have to be 21:35 rational... We really have to think carefully about what we do 21:38 Think about the physiology of the thing involved. That's right 21:42 Very good... Well, I'm happy for this explanation of sprain. 21:47 And, you mentioned about a bursa under the knee that 21:51 people like carpet-layers and others who kneel a lot 21:55 might get... How would you treat a bursitis? 21:58 A bursitis pretty near anywhere, a standard treatment 22:04 would, in fact, be injections and injections of steroid 22:08 which cut OUT that whole inflammatory process. 22:11 Now if the inflammation has carried on for quite a while, 22:18 the pain that's rather bothersome, then I think 22:22 a reasonable approach would be to try some cold. 22:26 And I've seen how this can often give relief that isn't 22:30 just for the time of cold, but it can give relief 22:32 that will be rather long-lasting ... That sounds good. 22:36 Now another thing that I would like to bring up is 22:39 that of plantar fasciitis. 22:42 And I've had plantar fasciitis in my family... 22:46 And one of the things that we have used for that 22:50 has been these little heel cups. 22:53 Sometimes some people get a little benefit from that. 22:56 But I think most of the time, they have not gotten 22:59 a LOT of benefit from the heel cups for plantar fasciitis. 23:04 How would you treat plantar fasciitis? 23:07 Well, plantar fasciitis is worth explaining a little further. 23:14 We've got our skeleton here with the foot. 23:18 Plantar means on the sole of the foot. 23:22 This is the palm of the hand, palmar. 23:25 And plantar is the sole of the foot. 23:27 And it is... the plantar fascia is a whole sheet of strong 23:33 connective tissue running from these bones, 23:38 at the base of the toes... Right here just at this point? 23:42 I would say along in here, sort of behind this 23:45 joint where the toes start. Um hm 23:47 Running along here and coming back and attaching 23:51 to the heel bone. 23:52 So they sort of attach to the undersurface of these bones 23:56 That's right... Right here at the beginning 23:58 of the toes and go all the way back to the heel.. That's right! 24:03 And in my experience, in fact, just by the pain 24:09 of plantar fasciitis, it seems to me like they attach 24:12 very much right to the point of the heel. 24:14 So, to explain the function of that... that's what keeps a foot 24:20 in kind of an arched position and gives a spring to the foot 24:24 I see... so it's not just there for insulation 24:27 It there actually for support. Absolutely! 24:30 And what happens, as people get older, there's a tendency 24:39 for this strong connective tissue coming in and attaching 24:43 to the bone... to start loosening. 24:45 Like a ligament being pulled away from the bone 24:50 And what can happen then, it can actually cause 24:54 some extra bone formation, a spur forms there 24:58 And people often talk about a heel spur and how it's painful. 25:02 Well it can be painful without the spur. 25:03 And sometimes the people that have the spur don't 25:05 have pain, so those of us that work with it 25:08 a fair bit, tell the people... don't worry about the spur 25:11 What's much more diagnostic is what happens when you 25:15 press on the area. Um hm 25:16 So if you press right around here, 25:19 usually just about at the point of the heel, 25:23 if they don't jump a bit in their chair, 25:26 then they probably don't have plantar fasciitis... I see 25:29 So the pain then of plantar fasciitis is right in here 25:33 Yes, it can radiate. 25:35 Some people have it even towards the forefoot but much more 25:37 commonly, it's right here by, or right on the heel. 25:40 The plantar fasciitis that I've had in my family, 25:44 when they would put the foot down; say, after they've been 25:49 sitting in a chair and they stood up, or when they've 25:52 been in bed and they stood up... A sudden sharp pain! 25:54 ...A sudden sharp pain 25:56 It was bad enough they couldn't walk. 25:58 That is absolutely typical. 26:00 It's when it's been resting, and THEN you put the 26:02 weight on it, that it REALLY cries out. 26:04 A lot of treatments have been tried. 26:08 These kind of heel cups is just one of many various 26:15 foot supports, orthoses, things that will apply 26:23 pressure here in the plantar fascia and 26:28 high heels even have been tried. 26:31 And all these various things... it's kind of difficult to 26:34 really get good relief. 26:37 One of the things that we tried was having the person 26:42 stand against a wall and lean into it with the heels 26:45 flat on the floor which would stretch the backs of the legs 26:49 and, hopefully, stretch the plantar fascia... 26:53 Do you think that would work? 26:54 Yes, that is probably the most useful treatment 26:57 that's noninvasive... is to stretch those heel cords 27:00 this muscle and the tendon and also it stretches the 27:04 plantar fascia when you have the foot behind you 27:09 and then also doing toe-rises... Oh yes 27:11 Doing toe-rises may be helpful. 27:15 We found also that putting this red pepper extract 27:20 Oh... just Zostrix... Ah ha... Zostrix which you 27:23 can buy at a drugstore. 27:24 We just paint that on the bottom of the foot 6 times a day 27:27 And then after they got pain relief, then once or twice a day 27:33 from then on and sometimes they get pain relief for 27:36 a LONG time. 27:37 Well, we have by no means, covered the entire gamut 27:41 of skeletal problems in the lower extremity 27:46 But what we have covered, we hope will be a 27:48 great blessing to you. 27:49 We hope that you and your family will receive 27:53 and eternal blessing from these very simple things. |
Revised 2014-12-17