Sports Medicine: Things You’re Too Embarrassed To Ask A Doctor


[MUSIC PLAYING] You are listening
to Things You’re Too Embarrassed to Ask a
Doctor, a production of UChicago Medicine. Each week we’ll
feature one physician and ask them your most
searched questions in their areas of expertise. For more information
on our episodes, visit us at www.UChicagoMedi
cine.org/podcast. Have something you’re too
afraid to ask your doctor? Tweet us at TYTEPodcast. I’m your host Kat Carlton. Hello, and welcome
to the final episode of season one of our show. To round out the
season, I thought we should have a
little fun and invite on the Chicago Sky women’s
basketball team physician. His name is Aravind Athiviraham. I’m an orthopedic
sports medicine doctor. So what that means is usually,
you know, treat athletes. Some examples of
the injuries that I see are knee ligament injuries,
cartilage or meniscus injuries, and, then, shoulder injuries,
including shoulder instability or injuries to the rotator
cuff are pretty common injuries I see. This episode, instead
of focusing solely on athletic injuries, I thought
we could more generally discuss common ailments faced by pretty
much anyone and everyone. I was particularly inspired
to do this episode because over the last couple
of years, I noticed my knees started clicking
while I walk down the stairs of my
office building. Now, I don’t know
how obvious this is, but I’m just rounding the
corner toward turning 30, and this is something I
really didn’t expect to happen until I was much, much older. But the more I’ve shared
my experience with friends, the more common
I realize this is than I had initially thought. And a lot of you are
searching about knee clicking and popping online. So let’s turn to
the doctor for more. What causes knee clicking? And does it ever go away? So that’s a good question. So it’s somewhat of a
non-specific symptom because many things
can cause clicking. One possibility is something
called the meniscus tear, which is a shock absorber
injury in the knee. And you know, it depends on what
type of tear it is, in terms of if it’ll persist, or if it
can be treated with just, like, strengthening
exercises around the knee. Other things that
can cause clicking include minor irregularities
in the cartilage. Again, it would depend on,
again, strengthening the knee and trying to get that
better to hopefully improve. So again, nonspecific finding. But if it persists,
and not getting better, and it’s causing pain,
then it’s something that should be looked at. At some point in our
lives, a lot of us also experience arthritis. So, what causes it? Typically, it’s wear
and tear phenomenon. And there might be some
genetic contributions, as well as weight
contributions as well. But overall, it’s more of
a wear and tear phenomenon that we see. And next, can
arthritis being cured? I’m sure the person
who discovers the cure for arthritis will
win the Nobel Prize one day. And we have not
discovered that yet. But there are a lot of
options to manage it. And that’s kind of
what we try to do, is try to manage the symptoms. And usually we start
off non-surgically. And when that fails, then we
proceed to surgical options. When I was doing research
for these questions, something that kept coming up
related to knee injections. Now, what are knee
injections used for? And also, are they painful? So again, knee
injections are part of the non-operative treatment
for arthritis of the knee. And the most common
type is what’s called a corticosteroid, or
steroid shot in the knee. And the way I think
of it, it’s kind of like an anti-inflammatory. So part of the
symptomology of arthritis revolves around
some inflammation, which causes pain. And the cortisone
shots are designed to try to alleviate inflammation
and hopefully alleviate the pain. It doesn’t last forever. It doesn’t work for everybody. So it’s one of
those things where you have to try it to
see if it works or not. And it does tend to wear off
in about three months or so. In terms of whether or not
it’s painful, it depends. I think if it’s slightly
more uncomfortable than a flu shot or a blood draw. Let’s move onto shoulders. A lot of questions around
shoulder pain, shoulder sockets. And we’ll start
with shoulder pain. One question is,
can shoulder pain be related to other issues
such as heart and lung problems or even migraines? Well, it’s something
that you really want to make sure that it’s not
a guess, So if a patient has, you know, chest
pain that radiates to the shoulder, especially
the left shoulder, I’d recommend they
go immediately to the emergency room. Because sometimes a heart
attack can present that way. Similarly, a
tension headache can present with some neck
pain or stiffness that can radiate to the shoulder. But by and large, most patients
I see with shoulder pain have pain mostly related
with the shoulder itself. And in rare cases,
related with neck pain. So fortunately, we
haven’t seen patients that have had a heart
issue or lung issues that have had shoulder pain. But something to definitely
keep in mind if patient’s had a history of either
heart, lung problems. How do I know if I’ve dislocated
my shoulder or any other part of my body? So hopefully– you
know, for most patients, dislocating the shoulder is
a pretty painful experience so they’d know. But they usually feel like
the ball of the socket will shift out of the socket. And usually it’s in the
front of the shoulder. And they’ll feel a fullness
in the front of the shoulder. It’ll be difficult for the
patient to move their shoulder. Usually, this occurs
in an athletic setting where there’s an athletic
trainer or a coach that’s usually experienced
reducing that shoulder. And there are methods to
reduce the shoulder, especially if the athletic trainers are
trained in those maneuvers. But usually it’s a
pretty painful experience and the patient would
be able to pick it up. And hopefully it’s able
to be reduced right away. And if it’s not,
the patient will need to go to the emergency
room to get it reduced back into the joint. Hey, again. Another experience many of
us have had at some point, probably within the last
year, is bumping our elbow. You know exactly the
kind of pain this causes. It’s the kind that radiates
all the way down your arm and through to your hand. Which leads me to
our next question, why does my pinky finger
hurt when I bump my elbow? So the nerve that
supplies the pinky finger is known as the ulnar nerve. And this crosses the
inner aspect of the elbow. So when you bump the
inner aspect of the elbow, you’re irritating
the ulnar nerve. And that shoots down to where
the ulnar nerve distributes, which is the pinky finger. Now, I don’t know about you and
what your exercise habits are, but personally, I hate running. And oftentimes when I
run, I get ankle pain. What might it mean if my
ankle hurts from running? So, it depends on the
region that is hurting. So, for example, we talked about
the Achilles tendon earlier. And if it’s in the
region where the Achilles tendon is inserting, this can
be due to Achilles tendinitis. Versus, if it’s due to some
subtle instability in ankle where it’s because the ankle is
inverting when the patient is running, this can be
due to again laxity of certain ankle ligaments. And the other cause
could be inflammation of some tendons that surround
the ankle joint as well. So, again, the
treatment for this depends on what’s causing it. So it could range from
rest, to anti-inflammatories to strengthening the
tendons around the ankle. We talked a little bit
about this already. But what’s the difference
between an ankle sprain, and a fracture, or a break? OK, so the ankle sprain
involves injury to ligaments. And there’s different
gradations of it in terms of how
severe the injury is. But sprains in general relate
to injury of ligaments. This is contrasted with, for
example, a fracture or a break, which is essentially the same
thing, which involves the bone. So again, in relation
to the ankle, an ankle sprain would be
injury to the ankle ligaments. Versus an ankle fracture
would be related with fracture to the bones around the ankle. That’s all the questions
I have for today. Is there anything
else you wanted to add, maybe to
people who were unsure if they should be seeing their
doctor for a pop, or an ache, or a pain? I would just say, you know,
it just depends on the nature and how it happened. So again, if a
patient or an athlete comes down from a
high contact injury, feels a pop and
swelling in their knee, and is having trouble
weight bearing, I think that’s a
pretty clear-cut need to be seen by a doctor. Versus if they’re just
minor popping on occasion, something they’ve always
had for the last 10 years, associated with no pain– I think something they
can tolerate with, I don’t think that’s
as concerning. And if they can manage with
self-directed exercise, I think that’s
certainly something that they could try beforehand. So again, it depends
on the acuity, whether or not they’re
associated with a lot of pain, if they’re swelling or not. So it just depends on
all of those things. But again, if you’re not
sure, it’s always better to be seen by a provider. There’s no downside on that. Once again, I’m Kat Carlton. And you’ve been
listening to Things You Are Too Embarrassed
to Ask A Doctor. Music from today’s episode
is by Blue Dot Sessions. For more information on our show
or to submit your own question, visit www.UChicagoMedi
cine.org/podcast. Or tweet us at TYTEPodcast. [MUSIC PLAYING]

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