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Depression And Pain What We Can Learn From Retired Pro Football Players

Retired professional football players experience levels of depressive symptoms similar to those of the general population, but the impact of their depressive symptoms is compounded by high levels of chronic pain. The combination of depression and pain is associated with sleep disorder, problematic social relationships, financial difficulties, and problems with maintaining exercise and fitness. In particular, it is often observed that musculoskeletal disability and chronic pain interferes with the ability to maintain physical activity and fitness during retirement. The reduction in fitness, therefore, increases the risk of depression.

Television programs like HBO’s “Real Sports” are replete with feature stories of the difficulties professional athletes have transitioning from a full-time elite athletic career to retirement. It is generally believed that the transition is difficult and traumatic because of the sudden cessation of the demands of elite athletic performance, compounded by the sudden loss of the athlete’s intense devotion to professional athletic competition and its attendant rewards. At the elite level, the athlete’s life is carefully organized around his or her performance, as are support personnel and extensive logistic and financial resources. Upon retirement, professional athletes have reported bewilderment in the transition to a life that is absent of such intense commitment. The resources and personnel that once organized and managed their lives are now gone, and the rewards, both emotional and financial, are diminished….if not vanished entirely.

We are presented with all sorts of stories and studies in the popular media. We see that a number of studies have described the risk of suicide in active college athletes, the risk of depression in college graduates who were previously varsity athletes. We are becoming familiar with the association between concussion(s) experienced during active professional football participation and the diagnosis of mild cognitive impairment later in life…or even Chronic Traumatic Encephalopathy (CTE). We are even made aware of suicide in professional athletes or other injured athletes. But despite all these articles and reports, we hear little about the simple association between depression and pain among retired National Football League (NFL) players.

Yet it is the combination of depressive symptoms and pain that puts retired players at the highest risk of significant difficulties in retirement. The relationship between depression and pain in the general population, alone, is important and complex. A systematic review of almost 60 studies of the co-morbidity of pain and depression showed that roughly two thirds of patients with major depressive disorder had significant pain symptoms, and roughly half of patients seen in chronic pain clinics met criteria for major depressive disorder.

Given what we are seeing in the general population, the frequency with which retired professional football players report difficulty with pain seems to put them at additional risk of both developing depression and experiencing the associated difficulties with retirement mentioned previously. Depressive symptoms and pain interact to result in a strong tendency toward sleeping problems, difficulty with aging, loss of fitness and lack of exercise, financial problems, and overuse of prescription and recreational drugs, as well as alcohol.

In summary, we can we learn the following (and more) from retired professional football players:

If you have continuing pain or chronic injury, seek professional care to cure or reduce it. If previous treatments have failed to help you, get a second opinion…or a third or fourth. Always press forward. Never underestimate what one motivated person can do to make him/herself better. Even if you have reached the pinnacle of achievement in one field of endeavor, always seek new challenges. Always seek to learn something new. Always find new avenues of improvement for yourself. If you are unhappy, seek help….or at least find someone to talk to. Always maintain your physical fitness. Always find a way to maintain a regular program of exercise or some form of physical activity, even in the presence of pain or physical injury…no matter how severe. Your physical fitness and health may be your best…or even only weapon, against circumstances that would otherwise work against you. Always find some form of exercise or activity to do on a daily basis!!

We are a Sports Chiropractic and Rehabilitation facility located in Walnut Creek, CA. Feel free to contact us with your questions or concerns at (925) 945-1155 or

What Does An Antibiotic Resistance Mean

Antibiotic resistance refers to bacteria’s ability to resist the effects of an antibiotic and continue multiplying even while the antibiotic is still present. This usually occurs when the bacteria or the microbes change in a way that decreases the effectiveness of different types of antibiotics or chemicals that usually cure the infection.

Why do bacteria become antibiotic resistant?

Antibiotic resistance is a naturally occurring phenomenon as the resistant strains of bacteria have a higher chance of survival than the bacteria that is susceptible to the antibiotic. Although such a form of natural selection can be the cause of some further antibiotic resistance, the biggest reason for the currently high levels of antibiotic-resistant bacteria is the overuse of antibiotics. Each time that the antibiotics enter the body, they kill off all of the bacteria that is susceptible to it, but also run the risk of leaving the resistant bacteria alive, giving them a chance to grow and multiply. In many countries, people can purchase antibiotics without a prescription, or over the internet.

Such an easy availability leads to people buying and taking more antibiotics than they really need to, sometimes for illnesses as simple as the common cold, which are viral and not meant to be treated with antibiotics. Thus, it’s the frequent and sometimes improper use of the antibiotic drugs that creates more and more antibiotic resistant bacteria. Likewise, proper use of antibiotics is the way to prevent the spread of antibiotic resistance.

How do the bacteria become antibiotic resistant?

Scientists have determined that bacteria can become resistant to antibiotics through mutation .The mutations occur very rarely, approximately in one in a million cells, but they do occur. Some such mutations can get rid of the cell target that the antibiotics are designed to attack, while others create resistance through giving the bacteria the ability to produce enzymes that inactivate the antibiotics. The second way that bacteria can become resistant is by receiving that resistance from another bacterium. The bacteria can transfer their antibiotic resistance genes to other bacteria through conjugation, a bacterial mating process, or through a virus’s help. The resistant strains of one bacteriumget stored in the virus’s head and then get injected into another bacterium. Whether the bacteria gained such resistance through virus injections or through mutations, they can now resist one or more specific antibiotic. Later that antibiotic resistance can spread both vertically and horizontally to affect more bacteria.

What are the dangers of antibiotic resistance?

Antibiotic resistance is believed to be one of the world’s biggest health problems. The reason for this is that most of the bacteria have already become stronger or more resistant to antibiotics in some way. There is no longer a guarantee that an antibiotic will be effective when it is really needed. Moreover, the bacteria can easily travel from one person to another, soon putting the whole community and the world at risk. It is antibiotic resistance that is the main cause of many new infectious diseases that scientists find so difficult to treat.

Botox Training For Physicians The New Craze

Cosmetic dermatology has been very important to dermatologists who are its primary innovators. During the 1900s, dermatologists used dermabrasion to improve acne scarring and fat micro-transfer was utilized to fill in cutaneous effects. In recent times, dermatologists have developed safe and effective employment of lasers as well as new filling agents such as collagen and also Botox®, non-ablative laser rejuvenation processes and intense pulsed light systems. To use Botox® in the treatment of wrinkles and a few other ailments, one needs to be qualified and for this there are many Botox® training courses for physicians.

No Longer Just for Dermatologists and Plastic Surgeons

The focus of Botox® training for physicians lies in demonstrating to the students how they can learn which wrinkles may be improved as well as learning specific injection techniques as well as effective treatments. The times have changed and what was once the preserve of plastic surgeons and dermatologists has now allowed trained physicians to offer Botox® and other similar cosmetic procedures to patients. The main reason for this sea of change may be attributed to the lucrative market that has opened up for those who can treat wrinkles and blemishes, which brings in a lot of money to the physician treating it.

More and more medical spas are being invaded by non-core providers (non-dermatologists and plastic surgeons) and have helped the spa industry grow tremendously. More and more doctors are including Botox® treatment in their services. And so, there are correspondingly larger numbers of places where one can get Botox® training for physicians.

Web-based Training Modules

There are also many Web-based modules such as the Treating Primary Axillary Hyperhidrosis by Chemodernervation of Sweat Glands using Botox® which provide the physician with a detailed look at the various processes used in the administration of Botox® injections to treat excessive sweating. This module contains step-by-step overview of how to perform starch-iodine tests as well as how to properly place the injections and is designed to aid the physician in his or her preparation for even further training in using Botox® for treating axillary hyperhidrosis or even for reviewing after training.

Education Programs

With the increasing use of Botox® as well as other hyperhidrosis treatments becoming widely used, it is imperative for obtaining Botox® training for physicians and to aid this, the Hyperhidrosis Society is conducting a number of continuing education programs.

There are a growing number of general practitioners, anesthesiologists as well as dentists who are dropping medical work and taking to cosmetics. The reason for this is surely the amount of money that can be earned with Botox® treatment and this is evident from the large amounts of Botox® literature present in doctors’ waiting rooms as well as stories about general practitioners who shutter their practice and focus on injectables instead.

Are Hack Squats Bad For Knees

The modern “hack squat” machine is a unique piece of weight training equipment that puts you in a fixed position in order to carry out the squat exercise. Your feet are fixed by virtue of the fact that your body bears weight while your feet are positioned on a footplate. (The footplate may vary in angulation depending upon the equipment manufacturer.) Your shoulders are fixed not just by the weight carriage that rests on your shoulders but also by a backrest that is attached to a sliding track. (The track also varies in angulation among different equipment manufacturers.) Therefore, the backrest follows a fixed path regardless of who uses the machine or how his/her body is constructed, and it is this that can create problems, like knee pain, for certain people.

Knee pain from squats commonly originates between the kneecap (patella) and the thigh bone (femur),in an area that is called the patellofemoral joint. Health-care providers refer to persistent knee pain in this area as “patellofemoral pain syndrome” (PFPS).

PFPS has several causes. The back side of the patella is lined with articular cartilage that allows it to slide smoothly against the surface of the femur, and the femur has a groove through which the patella slides. The groove is also lined with articular cartilage. Sometimes wear and tear, which is called degenerative joint disease or osteoarthritis, roughens the cartilage surfaces, and, when two roughened surfaces glide across each other, friction is created and pain ultimately results.

Some of our patients have what is known as a patellar tracking problem. In this case, the kneecap doesn’t move up and down in the groove as normally as it should. That causes wear and tear and uneven compression of the joint that also can cause pain.

Besides the various anatomical and pathological factors, differences in lifting techniques and movement patterns can influence the development of knee pain. And in this regard, there are certain mechanical factors that are difficult for some people to avoid with hack squats. For instance, when your knees move forward over your toes during the descent, the mechanical forces are greatly increased in your patellofemoral joints, and that causes increased compression. If any wear and tear is present, there will be more friction on the joint surfaces, which can lead to inflammation…and, ultimately, pain.

Unfortunately, the hack squat backrest does not allow the trainee to lie farther back, which would reduce the knee angles, compression/friction, and pain. Nor do most hack squat machines allow adjustment of the footplate angle. Certainly, in regard to knee stress, hack squat machines are not created equally so it is helpful to take note of the different exercise brands. Over many years of experience, this author has noted that the BodyMasters and Cybex brands seem to impart more knee stress than the hack squat machines manufactured by Flex/StarTrac or Icarian. However, because of individual differences in height/body type, this is not a universal truism.

One way to reduce knee pain on this exercise is to change your foot placement. If your feet are placed more directly underneath you, your knees will move farther forward, which INCREASES the force on the knees and causes MORE pain and MORE wear and tear. BUT, if you place your feet farther forward on the platform, your knees won’t move so far forward, and that, of course, will DECREASE the stress on your knees.

Of course, some of the more hardcore bodybuilders may respond to these suggestions by saying: “But if I move my feet farther forward on the footplate, I won’t feel it as much in my lower quads.” Well, that may be true for some, but sometimes you have to modify an exercise or your exercise technique in order to keep it in your exercise routine

Another strategy to reduce knee pain with hack squats is to attach powerlifting bands to both sides of the machine. Attach one end of a band to a fixed member at the base of the machine and attach the other end to the weight holding bar. This creates a more “knee-friendly” variable resistance, controls repetition speed, and provides a missing element of eccentric contraction which assists strength and muscle development.

If you have a patellar tracking problem, another modification is to keep your feet pointed relatively straight ahead, rather than turning them inward or outward significantly. Some people may find that this “evens out” the compression on the patella and affords a reduced level of pain when performing this exercise.

Again, a modified performance is better than not doing an exercise at all..especially if you are “gung-ho” to keep it in your routine. And there are certainly circumstances that make it wise to completely discontinue an exercise and replace it with another one. Fortunately, there are other exercises that effectively work your quads with less strain on the knees. Stay tuned because they will be featured on this site in the future.

But, for now, remember that training smart will keep you training hard longer—and bring you the greatest gains possible.