Sweat Shop: You don’t know what a burn is until you’ve done this workout

Men’s Health
by Christopher McDougall

Welcome to Bikram’s torture chamber,” says Joel Pier, a gentle, gray-haired yoga instructor. He’s so peace-and-love looking with his bead necklace and owlish little glasses, that everybody smiles.

For about a second.

Then he clicks the door shut, sealing all 30 of us inside a third-floor walkup above a Philadelphia shoe store, with the furnace cranked to 110 degrees. We’re told to stand arm’s-length apart, lace our fingers under our chins, and huff and puff like fat guys moving furniture. After 90 seconds, the men are shucking their sweat-soaked shirts, and the women are stripping down to Jogbras. The sneaking desire I’d felt for the two women next to me, with their cute dancers’ bodies and Pacific-Island tatoos, has now become a last-canteen-in-the-lifeboat resentment of the air they’re using and the body heat they’re throwing off.

Keep in mind, all we’ve done so far is breathe.

ASSUMING THE POSITION
This is what can happen during a session of Bikram yoga, otherwise known, for obvious reasons, as “hot yoga.” Bikram yoga has been booming in the past few years. According to one estimate, some three million people worldwide are now sweatin’ and stretchin’, and paying an average of $10 to $12 a class for the privelege.

From the cool, incense-scented loung outside, things in the studio look pretty tame, especially compared with the Ashtanga, or “power,” yoga taught in health clubs. Where Ashtanga can twist you into endless varieties of headstands, lotuses, and backbends, Bikram has only 26 postures, several no more complicated than the head-to-knees you did in football practice. You don’t even hold them long–just about 10 to 20 seconds.

What kicks your ass, however, is the heat.

“Anyone chilly?” asks Pier, who’s one of the some 650 instructors certified in the United States to teach the Bikram method. “We’re barely over 100 degrees,” he taunts. “The earlier class hit 126.”

The only answer he gets is the sound of sweat plopping onto our plastic mats. We’re all too focused to respond, because after a few warmup positions, we’re in the midst of a real killer: arms straight out, up on the toes, then dropping into a squat with arms and thighs parallel to the floor, while still balancing on the balls of our feet. It’s brutal–little grunts and gasps are erupting all around the room as people fight for balance. “Lift up your heels,” Pier suggests, “until your legs are jittering like sewing machines.”

There are reasons–besides the sadistic– for conducting the class in a sauna. Fpr starters, you’ll lose weight. It’s estimated that a person can burn as many as 600 calories during a 90-minute class. You’d have to hit the treadmill for an hour and 15 minutes to melt that much flab.

Superheating the body will soften the collagen around the joints, too. “Collagen is a lot like plastic, and its rigidity eases when you warm it,” says Marc Darrow, M.D., director of the Los Angeles-based Darrow Sports & Wellness Institute. “Some athletes ride an exercise bike before stretching, which heats the muscles and softens collagen, but there’s no reason you can’t do the same thing by adjusting the thermostat,” says Dr. Darrow, who includes Kansas City Chiefs wide receiver Johnnie Morton among his patients.

Heat also helps “feed” the muscles by increasing the circulation of oxygen-laden red blood cells, says Lewis Maharam, M.D., president of the Greater New York Regional Chapter of the American College of Sports Medicine. It’s like working a bellows–as you pump more oxygen into your muscles, they’re able to burn more fuel. And the best way to let that rich, oxygenated blood into the inner recesses of your muscle tissue, Dr. Maharam adds, is to stre-e-e-etch. “Heat speeds up your metabolism,” he explains, “and the yoga postures will certainly assist by improving your circulation and elasticity.”

© 2002 Mens’ Health

Emerging Medical Therapy for Arthritis and Joint Pain

by Dr. Mohammad Khalid

Mohammad Khalid received his Ph.D. in chemistry from Loyola University of Chicago. His research has included the design and synthesis of peptides, which have far-reaching implications for maintaining health. In his position as Director of Research and Development at Gero Vita International, he is au courant on scientific advances around the globe.

Marc Darrow, a Los Angeles physician, is one of many doctors in the U.S. who offer an amazing new treatment called Prolotherapy. Its name is derived from the word “proliferation,” and its goal is to stimulate the growth of new tissue, repairing damage to worn-out joints and relieving pain and discomfort.

First, the exact location of the pain is found using an acupuncture needle. Then an injection of diluted dextrose and an anesthetic is given. The anesthetic relieves the pain, while the dextrose stimulates the body’s healing response. It does this by acting as a “shock agent,” drawing water from superficial cells and drying out the site. It induces slight, but controlled inflammation, and the healing process is set in motion.

Dr. Darrow emphasizes that inflammation “means the body is responding to an injury or stress to the joint by sending cellular compounds to the damaged area. It’s your body’s way of getting the healing process started.” Once these cellular compounds have done their job, they are replaced by fibroblasts, which begin repairing the damage and forming granular tissue that will become new collagen. Collagen is a major component of the connective tissue found between tendons and ligaments.

A few clinical studies have already confirmed the benefits of Prolotherapy. Researchers at the Bethany Medical Center in Kansas City observed a decrease in pain and swelling in the arthritic knees and fingers of subjects. And this year, Australian researchers at the University of Queensland saw “significant and sustained reductions in pain and disability” after Prolotherapy had been administered to 110 patients with lower-back pain. In the future we will be devoting a full article to Shoulder Arthritis rehab since Shoulder Arthritis rehab is a large topic.

Dr. Darrow discovered Prolotherapy after having undergone it himself. During his fourth year of residency at UCLA, while suffering pain from an injured wrist, he met Dr. Andrew Kochan, who used Prolotherapy. After a few weeks of injections, Dr. Darrow was healed. He now gets great satisfaction from helping other people live active lives free of pain, without the need for anti-inflammatory painkillers.

The list of notables who have successfully found relief after using Prolotherapy include former Surgeon General C. Everett Koop and baseball legend Ernie Banks.

This simple therapy has the potential to help many older adults walk and move as they did when they were younger, playing tennis again, traveling and shopping without having to rest, and frolicking effortlessly and joyfully with their grandchildren.

Back in business: Surgery Isn’t Always The Spinal Answer

Los Angeles Magazine
Jenna McCarthy
March 2002

OH, MY ACHING back.” Take a random, informal poll of friends or colleagues and, research indicates, 9 out of 10 of them will admit to having uttered this phrase, or one like it. Even though a bothersome back is rarely a life threatening condition, Americans spend between $20 billion and $50 billion a year trying to find relief.

One of the most common causes of posterior pain is a disc herniation, also known as a slipped or ruptured disk. Disks are the soft, rubbery cushions of cartilage nestled between the bones in the spinal column, and they allow the back to flex and bend. As we age, disks, like most other body parts, begin to shrink and lose their flexibility. When a disk degenerates, its outer capsule may tear, allowing the core (or nucleus propulsis, for the detail oriented) to squeeze outward and put pressure on the surrounding nerves. The disk has now slipped, and the pain can range from dull to excruciating.

Although surgery is a common treatment option, ifs safe to assume that most folks would rather avoid vivisection, given the choice. “If someone walks into a surgeons office with back pain and the surgeon does an MRI [magnetic resonance imaging] and finds a herniated disc, he’ll likely recommend surgery,” says Marc Darrow, M.D.,(www.jointrehab.com), a holistic healing center that Caters to L.A.’s busy bodies. “That’s how he pays his mortgage. But studies have proven that over 50 percent of people who have disk problems do not feel any pain at all, which means that a good percentage of the pain-free population would be told they need surgery unnecessarily. In our practice the goal is to rehabilitate and restructure the body so that surgery is not even an option.”

CHILL ON THOSE PILLS When pain flares up, popping a few Motrin apparently is not the wise move. “Anti-inflammatory pills relieve the symptom but do nothing to cure the problem,” says Darrow. “You may be winning the battle, but you’re losing the war. While these drugs may reduce inflammation, they also shut down the body’s natural healing process.”

The red-hot alternative at the Joint Rehab Center is Prolotherapy, a rather Orwellian name for a relatively painless and remarkably effective procedure. During a five-minute treatment, a benign combination of sugar water (dextrose) and a numbing agent (Lidocaine) is injected into trouble spots. The body recognizes the mixture as an irritant and responds by increasing collagen production in the area. This new collagen promotes healing by thickening and strengthening soft tissues while eliminating pain. “When a herniated disk is rubbing against a nerve, the way to stop the pain is to stabilize the back,” says Darrow. “Prolotherapy does this by increasing the strength and size of tendons, ligaments, and joint capsules. Ifs the same thing a surgeon would do with bone or metal, but we do it naturally.” Thus far insurance companies cover about 50 per, cent of patients receiving prolotherapy. While many feel relief from a single session, up to eight treatments ($250 each) may be required.

If the problem is muscular, the Joint Rehab Center uses an innovative computerized diagnostic and rehabilitative tool called MedX to determine precise points of weakness. Developed by Arthur Jones, founder and inventor of the Nautilus weight-training system, the MedX machine isolates and strengthens weakened muscles supporting the lumbar (lower) and cervical (upper) spine. “Insurance companies love MedX because it can detect fraud,” says Darrow, referring to the machine’s ability to determine whether a claimant is faking back pain. Patients typically are seen twice a week for 12 weeks, with little if any out-of-pocket expense.

“The first thing we do when a patient walks in the door is take away their diagnosis,” says Darrow. “People say, `I have arthritis,’ or `I have a herniated disk.’ Who cares? That diagnosis usually has nothing to do with the problem. We give our patients the visualization that the body is healthy to move them into a healing consciousness. We don’t put a Band Aid on problems, we fix them.”

COPYRIGHT 2002 Los Angeles Magazine, Inc.
COPYRIGHT 2002 Gale Group

Placebo Effect

ESPN MAGAZINE 3/29/2004

Just because an athlete shoots up doesn’t mean he is on juice. Could be he is hooked on sugar. That’s the idea behind Prolotherapy, an alternative to surgery that is catching on with jocks and celebs alike. From turf toes to torn rotator cuff, Prolo patients receive anesthetic-laced sugar-water injections directly into an injury once a week for four to eight weeks. Theoretically, these $250 sessions stimulate the immune system and cause proliferation (hence “Prolo”) of collagen and cartilage. The results? “Ligaments that are 50% thicker and as much as 400% stronger,” says LA physiatrist Marc Darrow, whose clients include Chiefs wideout Johnnie Morton (pelvic pain) and actress Sally Kirkland (knee and foot).

Dr. John McShane, a sports-medicine specialist who works with the Phillies is dubious. “There are no studies to back up these claims,” McShane says. “If a ligament is injected, it become inflamed, and scar tissue is created.” Which doesn’t mean it is stronger. Still, Dr. Darrow is hardly discouraged by detractors-or by cancel appointments. “A lot of my patients I never see again,” he says. “That either means they’re healed or they hate me.” Heavyweight Lamon Brewster is firmly in the former camp. “My knees, my back-everything feels great,” he says. “The best recovery I’ve ever had.” Sweet!—EDDIE MATZ

When You Feel Below Par

While playing golf may not be as dangerous as Australian rules football, anyone who’s played the game for any length of time has woken up with aches, pains and strains. It’s a non-contact sport that beats the heck out of you. So, if you want to be able to walk fairways for the rest of your life, you should be aware of potential injuries and how you could prevent and treat them.

First of all, golf is not as sedate as you might think. Dr. Marc Darrow, a Physiatrist (a doctor of physical medicine rehabilitation) at the Darrow Sports & Wellness Institute in West L.A., says, “Surprisingly, golf probably causes more injuries than most sports. Swinging a club at a hundred miles an hour creates great torque (twisting) on your body.”.

This is particularly dangerous for the senior golfer because, as he notes, “collagen, the basic material for ligaments, cartilage and tendons, starts drying out as you get older. Stressing the joints causes strains and tears.”

Dr. James Fox, a senior partner at SCOI (Southern California Orthopedic Institute) in Van Nuys, agrees. “The tissues have lost elastic fibers,” he says, “and don’t stretch. Because they’ve lost some water content, they tend to fragment more easily.”

Okay, the fact that you’re more vulnerable to injury as you get older is not exactly a news bulletin. But, what are the golf injuries that occur most frequently and how can you avoid them?

Dr. Darrow ominously warns, “Golf can affect every joint in your body” while Dr. Fox says, in his experience, “the most common injuries affect the elbow, shoulder, back and knee.” Dr. Jeff Anthony, a sports medicine specialist at San Diego State University, sees “more lower back, elbow and shoulder injuries.” In other words, most of your body is at risk.

While each injury may present unique problems, Dr. Fox classifies injuries into two basic categories. “One, I call the “macro” injury,” he says. “This is the sudden injury, like when you fall into a sand trap. The other is the “micro” injury where repetitive actions add up. The muscle or tendon is constantly stressed, causing little tears. When someone says, `I only hit one drive and my back is killing me,’ it’s usually the result of long-term damage.”

“To prevent the macro injury,” Dr. Fox cautions, “use some planning and forethought. Look out for branches or walk out of the shallow side of the bunker. Sometimes we’re too competitive and take chances.”

To prevent the micro injuries, he says, “Warm up before the round. Stretch. Get in good shape, particularly cardiovascular shape.” And– where have we heard this before?– “Keep your weight down,” he warns. “Every extra pound is multiplied six times across the knee. If you’re ten pounds overweight, that’s an extra 60 pounds per square inch of pressure on the knee.”

Dr. Darrow agrees, “Work out, stay in shape. Don’t be a weekend warrior. That’s how you get hurt.”

If you’re at all not sure what to do, Dr. Anthony advises, “There are several good books available on exercises specific for golf. They show you how to stretch and warm up before playing.”

Stretching is probably the most important and the most overlooked exercise for golfers. Instead of getting to the course late, rushing to change your shoes, hacking away frantically at a bucket of balls, then-dashing-to-the-first-tee …sloooow down, get there 15 minutes earlier and stretch all the muscles. Your back will thank you in the morning.

Some work at home could help prevent one of the most common injuries, “golfer’s elbow.” To prevent this type of injury, strengthen your forearm. While you’re watching TV, just squeeze a tennis ball with your free (non-remote control) hand. Or, better yet, do wrist curls with a light dumbbell.

This strength development may be especially important for women, as Dr. Anthony claims, “Elbow injuries seem to occur more frequently with women golfers; men seem to have more problems with their backs.”

Lessons can have a double benefit– besides cutting strokes from your handicap, they can help you avoid serious injury. As Dr. Fox notes, “If you’re swinging the wrong way a hundred times in four hours, you’ll pay the price. You need good biomechanics.”

Speaking of lessons, if you do have an injury, however minor, however temporary, inform your instructor. Tom Barber, the head professional at Griffith Park Golf Courses, says, “I need to know what physical limitations you have, are there neck problems, back trouble? That goes for everyone, not just seniors.”

Besides giving you a chance to reach the green in regulation on long par-4’s, the new technology of golf clubs also helps limit the possibility for injury. Dr. Fox says, “The forgiveness of clubs today have helped seniors and the high handicapper (avoid injury). They probably have lowered the ratio of injuries to golfers today, although the absolute numbers may have increased because there are more golfers than ever out there.”

One of the reason for this benefit, according to Dr. Darrow, is that “the looser (more flex) shaft takes some of the stress away from the body.”

Even with all these precautions, if you golf often and long enough, injuries are inevitable. What are the best treatments?

“I’m the King of Ice,” claims Dr. Fox. “Icing the damaged area will help with healing.”

To help control the pain and inflammation, Dr. Fox also recommends the use of anti-inflammatories, such as aspirin and ibuprofen.

Once you’ve suffered an injury, you must be concerned about a recurrence. For example, Dr. Anthony says, “I often recommend wearing an elbow sleeve for injuries to that joint. Elbow and shoulder injuries can be trickier than others.”

If injuries are chronic and never seem to disappear completely, there are additional steps you might want to consider. You might ask your physician for a referral for physical therapy. Don’t think that PT is only for the recovery from major traumas, like a broken hip. A lingering strained Achilles tendon or sore shoulder might respond to Ultrasound, specific prescribed exercise and massage. And the longer you wait, the more difficult it may be for a full recovery.

If you’ve never tried acupuncture, it may seem strange and a bit disconcerting, but it’s becoming an increasingly popular form of treatment. Talk to someone who’s tried it; they probably liked it. A tip: some physicians practice the Chinese art of body pin-cushioning which may make the treatment Medicare-eligible.

Dr. Darrow also practices Prolotherapy, which is the injection of a sugar solution into the area of inflammation around tendons and ligaments; this promotes the blood supply to the area and overall healing. In Dr. Darrow’s experience, some patients feel almost-immediate relief from pain.

Basically, there are as many remedies as there are ailments. Not everything works universally; you might have to look in more than one place for relief. But, the bottom line is: living with pain is not a given as you age. There are things you can and should do to prevent injuries and there are things you can do to heal quicker. Get in shape, stretch, ice and you can play golf forever. Not necessarily better, but forever. And that’s good enough for me.