Thread: Popping Joints?
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Old 04-27-2002, 04:57 PM   #23
Join Date: Jun 2000
Posts: 915
Opps, , sorry Erik, I was snoozing... I don't know what to say about your doc, I always have my patients rest an inflammed tendon, maybe she believes differently, or maybe she just doesn't understand exactly what you do (most folks hear Aikido and think karate or something) or she may just think you're a big guy able to take some abuse. Since she is the one seeing you (and that physical exam is the essential key) I'll bow to her judgement, but you might try resting it. Also, the VIOXX may not have reached an adequate blood level yet while yo uwere seeing if the changes helped: I warn patients that they will need to take the medication as directed for at least X days (usually 3-7) before they should expect to see much difference. I also point out they didn't get to where they are in one day, so they won't get out of where they are in one day, to expect recovery to take as long as injury (from chronic trauma).

I was talking last night over sushi to an Aikidoka about tendonitis, and those funny snapping sounds. Often that snap is a tendon (connects muscle to bone) snapping as you move it over a joint. The occasional noise is usually fine (if it doesn't hurt), but where we often get in trouble is when we think 'hey, that's a funny sound, can I make it do it again??? ... we then proceed to snap it around fifty times, often going from person to person saying 'hey, listen to this, does your -whatever- do this?' pop-pop-pop, until we go 'hey, now it hurts '. We then go from person to person asking 'do you know why it hurts when i do this?' and continue to 'do this'. The noise often gets louder and more frequent. This is because the swelling in the now irritated tendon has made the tendon even tighter. For instance, for those of you who 'pop' ankles, wrists, etc... think about how you do it. There is the occasional pop from just twisting the joint, but to get that impressive sound, don't you tighten the muscles in the leg or arm? that is shortening the muscle and pulling the tendon tighter.

I had the table rolling in laughter as I relayed what how patients describe the problem, and I ask what makes it worse and better. Usually, they will have continued to so whatever makes it worse. Occasionally they will do what makes it better. Good rule of thumb: if it makes it worse, stop doing it. Even when I ask patients to show me with the uninjured extremity how they hurt it, or what makes it worse, they go for the one that hurts We are creatures of habit. I reinforced with an ex-Marine last night that one does NOT work though pain with more of what ever hurts, one just intensifies the problem until the tendon is so swollen that you just can't use it (mother natures way of enforcing rest).
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