All Posts tagged Dr. Tucker

Laser therapy

The Effect of Low-Level Laser in Knee Osteoarthritis: A Double-Blind, Randomized, Placebo-Controlled Trial
Béla Hegedűs, László Viharos, Mihály Gervain, Márta Gálfi. Photomedicine and Laser Surgery. August 2009, 27(4): 577-584. doi:10.1089/pho.2008.2297.
Published in Volume: 27 Issue 4: August 20, 2009 Online Ahead of Print: June 16, 2009

Introduction: Low-level laser therapy (LLLT) is thought to have an analgesic effect as well as a biomodulatory effect on microcirculation. This study was designed to examine the pain-relieving effect of LLLT and possible microcirculatory changes measured by thermography in patients with knee osteoarthritis (KOA).
Materials and Methods: Patients with mild or moderate KOA were randomized to receive either LLLT or placebo LLLT. Treatments were delivered twice a week over a period of 4wk with a diode laser (wavelength 830nm, continuous wave, power 50mW) in skin contact at a dose of 6J/point. The placebo control group was treated with an ineffective probe (power 0.5mW) of the same appearance. Before examinations and immediately, 2wk, and 2 mo after completing the therapy, thermography was performed (bilateral comparative thermograph by AGA infrared camera); joint flexion, circumference, and pressure sensitivity were measured; and the visual analogue scale was recorded.
Results: In the group treated with active LLLT, a significant improvement was found in pain (before treatment [BT]: 5.75; 2 mo after treatment : 1.18); circumference (BT: 40.45; AT: 39.86); pressure sensitivity (BT: 2.33; AT: 0.77); and flexion (BT: 105.83; AT: 122.94). In the placebo group, changes in joint flexion and pain were not significant. Thermographic measurements showed at least a 0.5°C increase in temperature—and thus an improvement in circulation compared to the initial values. In the placebo group, these changes did not occur.
Conclusion: Our results show that LLLT reduces pain in KOA and improves microcirculation in the irradiated area.

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“What should I do for a sprained ankle?”

Treatment of a sprained ankle can be separated into immediate first aid and longer term rehabilitation and strengthening.
• Immediate First Aid for a sprained ankle:
• Aim to reduce the swelling by RICE (Rest, Ice, Compression, Elevation) as soon as possible. Come into the office for an evaluation as soon as possible. The sooner I can start to treat the injury with the Laser the better it will feel.
• R is for rest. It is important to rest the injury to reduce pain and prevent further damage. Use crutches if necessary. I advocate partial weight bearing as soon as pain will allow. Getting you back to your activities of daily living will accelerate the rehabilitation process.
• I is for ICE or cold therapy. Applying ice and compression can ease the pain, reduce swelling, reduce bleeding (initially) and encourage blood flow (when used later). Apply an ice pack immediately following the injury for 15 minutes. Repeat this every hour.
• C is for compression – This reduces bleeding and helps reduce swelling. A wrap or bandaging technique is excellent for providing support and compression to a recently injured ankle.
• E is for Elevation – Uses gravity to reduce bleeding and swelling by allowing fluids to flow away from the site of injury. So put your feet up and get someone else to wait on you!

• Following the initial painful stage, there are other treatments that can help the ankle return to normal as soon as possible. Range of motion exercises such as ankle circles can help to get the ankle moving again, as well as reducing swelling if performed with the leg elevated. The calf muscles often tighten up to protect the joint following a sprained ankle, and so gently stretching the calf muscles can also help to maintain movement at the joint.

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BREAKFAST and SNACK SUGGESTIONS

The following are some additional breakfast/snack options you may use to design your own dietary program.
Breakfast Suggestions
(275-325 calories)
Omelet made with 3 egg whites, 1 whole egg, and unlimited Category 1 vegetables, chopped and cooked with 1 tsp. olive oil
1 slice whole-grain toast
(servings: 1 protein, 1 grain, 1 oil)

¾ cup nonfat or lowfat cottage cheese
2 small fresh peaches
8 walnut or pecan halves, chopped, sprinkled with cinnamon
(servings: 1 protein, 1 fruit, 1 nut)

4 oz. plain lowfat yogurt or 6 oz. nonfat yogurt
1 ½ cups mixed strawberries, blueberries, and raspberries
2 Tbsp. sliced almonds
(servings: 1 fruit, 1 dairy, 1 nut)

½ whole-wheat pita
¼ cup nonfat or lowfat ricotta
1 ½ oz. smoked salmon/lox
Red onion slices
(servings: 1 protein, 1 grain)

1 poached egg
1 slice whole rye bread, toasted
1 half grapefruit
(servings: 1 protein, 1 grain, ½ fruit)

Scramble together 2 oz. tofu, 1/3 cup egg substitute
Category 1 vegetables, chopped; cook with 1 tsp. olive oil
1 Tbsp. Parmesan cheese
3 approved crackers
(servings: 1 protein, 1 grain, 1 oil)

Morning/Afternoon Snack Suggestions
(150-175 calories)
1 egg, hard-boiled
1 medium apple
(servings: ½ protein, 1 fruit)

1 medium pear
10 whole almonds
(servings: 1 fruit, 1 nut)

1 slice whole rye bread, toasted
1 Tbsp. almond butter
(servings: 1 grain, 1 nut)

1 medium carrot
Celery and cucumber sticks, unlimited
¼ cup hummus
(servings: ½ category 2 vegetable, 1 legume)

2 pieces turkey bacon
1 egg, hard-boiled
(servings: 1 protein)

1 small nectarine or peach, sliced
½ cup blueberries
4 oz. plain lowfat yogurt or 6 oz. nonfat yogurt
(servings: 1 fruit, 1 dairy)

Unlimited Category 1 vegetables, raw
1 Tbsp. tahini
3 approved crackers
(servings: 1 nut, 1 grain)

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Pre-Workout Foods: Protein Bar vs. Eggs?

• Eating 60 to 90 minutes before exercising helps to prevent light-headedness and loss of concentration during moderate to high-intensity activity. You’ll need a simple fat, sugar and protein combination—this balance can be found in both a healthy breakfast food or an UltraMeal Bar or UltraMeal shake (Metagenics link).
• Which will power you through your workout without a crash? Try two eggs one day and a bar the next. A bar is easy, but the eggs are real. Both are filling food, and pack good protein. Egg whites are the purest form of muscle-building fuel available.

Whatever you choose just get going on your exercise and be consistent!

• Are Eggs good for me?
• Eggs contain tons of important vitamins and minerals, and egg whites contain the purest form of protein available in whole foods—exactly what you’ll need to feed your muscles during a workout.

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Snacks for kids at “The half-time”

I was asked by a Mom, “What should I give the kids while playing football?”

Football, soccer, rugby, baseball, basketball — what’s the best snack to provide your kids?
I’ve seen a lot of sliced oranges passed out at half time, and like many nutritional practices that have stood the test of time, this almost certainly has some merit. Some mom’s prefer pretzels because they contain high levels of sodium. But I’ve also seen a lot of donuts, cakes, and cookies handed out. Stay away from foods with hydro-genated vegetable oils or trans-fats. Food colorings and other additives are often contained in these kinds of snacks, which have been associated with disruptive behavior and poor concentration in school children. I’ve even noticed kids “space out” on the field after these types of snakes!

Concentrate on fluids, electrolyte and carbohydrate needs. If your child gets fatigue during games and his/her general performance declines towards the end of the game, they are not getting the right snacks.
I recommend the UltraMeal Bar (www.DrJeffreyTucker.meta-ehealth.com) as the best pre game snack (30-60 minutes pre-game) – it’s a mixture of protein and carbohydrates.

If two players have equal skill, or both teams have equal players, it is even more important to consider nutrition that may influence game skill and concentration when considering strategies to win. Carbohydrate depletion is associated with reduced exercise capacity and poor concentration – these are effects that may be compounded by dehydration. Both dehydration and muscle glycogen (sugar) depletion have been associated with injury and accidents, so efforts to prevent these affecting performances could have repercussions well beyond the immediate game.

The impact of how your child plays, could well depend upon prior meals and eating habits. Pre-game hydration is so important – keep it simple and give them water. If your child starts a game in a sub-optimal state of hydration they will be in a worse state at half-time.

Dehydration resulting in a loss of body mass of 2% or greater can result in reduced endurance exercise capacity, and sprinting and sport-specific skills can be adversely affected by losses of 3% or more. I don’t encourage players to consume more fluid than required to maintain performance, why weight them down!

During The Workout/Game: Should you have Gatorade vs. Water?
• At 200 calories per bottle, Gatorade is promised to replace your carbohydrates and electrolytes lost during an intense workout—and it also tastes pretty good. When you’re pushing hard during an event, is it better than water? No & yes! If your workout is longer than an hour, you might need all that sports science in a Gatorade, but for normal training sessions, hit the bottled water.
• During a long cardio session, you need the over-the-top advanced science of Gatorade.

Nutrients, especially electrolytes, may prevent fatigue and reduce muscle cramps in the second half. The most important electrolyte lost in sweat is sodium and research has shown a wide individual variation in sodium losses – as low as the equivalent of 1g of salt to over 6g in 90 minutes. Assuming that players start a game with reasonable sodium stores, most players are unlikely to become performance limited due to sodium depletion during one game; the main role of sodium in a half-time situation is to encourage fluid uptake in situations where large fluid volumes need to be consumed at half-time (because sodium stimulates thirst).

In players starting with an adequate nutritional status, performance towards the end of games depends on carbohydrate. Shortfalls are almost certainly responsible for fatigue in games, irrespective of player position or standard. Low carbohydrate levels can compromise mental skills as well as physical performance, and there is consensus that carbohydrate supplementation can improve performance.

It’s worth cautioning against a ‘one size fits all’ policy with regard to player nutrition. In hot conditions, and for players with very high sweat rates, more fluid may be needed to prevent dehydration reaching detrimental levels.

References
1. Int J Sports Med 2005 Mar; 26(2):90-95
2. Arch Dis Child 2004; 89:506-511
3. J Sports Sci 2006 Jul; 24(7):665-74
4. Sports Med 2005; 35(6):501-36
5. Med Sci Sports Exerc 1993 Dec; 25(12):1370-4
6. J Sports Sci 2006 Jul; 24(7):675-85
7. Int J Sport Nutr Exerc Metab 2003 Sep; 13(3): 303-19
8. Med Sci Sports Exerc 2006; 38(9):1650-1658

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Weight Loss: Find The ‘Why’.

You know you are overweight, maybe even fat. As a kid you were chubby then you became chunky. As a kid you were husky then you became robust. In college you had a good figure, then after a baby you became rotund. Pregnancy made you plump and flabby, and you have been stuck with an extra 10-15 pounds to lose. Whatever the cause, you feel flabby or fat. When you look in the mirror, a little voice inside of you says “I gotta lose weight”. Don’t let your pant size go up, it’s time to get on the scale and find out where you are at. It doesn’t matter if the extra weight crept up on you one fast food lunch at a time or you got so busy you stopped exercising. Right now, you’ve decided; today is your day. How do I start?
Start eating a good diet and exercise.

Create a food plan to finally drop that weight.

Exercise (walking, biking, bands, kettlebells, etc.)

Determine why do you want to lose the weight?

The # 1 medical food product I use to help clients weight loss is the Metagenics UltraMeal shakes. You get more than 10% off for first orders from http://jtucker.metagenics.com/store

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Shoulder Rehabilitation

12 O’clock Arm Raises

Lie face down with arms forward. Lower shoulder blades and raise both arms as high as possible. Be sure to keep arms in the “I” position.

Hold for 1-2 seconds.
Repeat 10 times per set.
Three sets per session.
Complete 2 sessions per day.

10 & 2 O’clock Arm Raises

With or without weights, arms are in a 10 and 2 o’clock position. Lift/raise both outstretched arms as far as possible. Be sure to lower the scapula when performing this exercise.

Hold for 1-2 seconds.
Repeat 10 times per set.
Three sets per session.
Complete 2 sessions per day.

3 & 9 O’clock Arm Raises

With or without weights, arms are in a 3 and 9 o’clock position. Raise both outstretched arms as far as possible. Keep the scapula down while performing this exercise.

Hold for 1-2 seconds.
Repeat 10 times per set.
Three sets per session.
Complete 2 sessions per day.

Wall Angels

Stand against wall, upper arms at shoulder level and elbows bent to 90°. Raise arms over head keeping arms, forearms and hands against wall.

Hold for 2 breaths.
Repeat 10 times per set.
Two sets per session.
Complete 2-3 sessions per day.

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Neck Pain Exercises

Neck Flexors

With a rolled towel under neck, gently nod the chin without lifting the head.

Hold for 10 seconds.
Repeat 10 times per set.
One set per session.
Complete 3 sessions per day.

Neck Extensors

With hands grasping the base of the neck, extend the chin as far as possible.

Hold for 3-4 seconds.
Repeat 10 times per set.
One set per session.
Complete 3 sessions per day.

Neck/Pelvis Rotation

Feet and knees together with arms outstretched. Rotate knees to one side, turning head in the opposite direction until a stretch is felt. Repeat on other side.

Hold for 3-4 seconds.
Repeat 10 times per side, per set.
One set per session.
Complete 3 sessions per day.

Upper Trapezius Stretch

Gently grasp right side of head while reaching behind back with other hand. Tilt head away until a gentle stretch is felt.

Hold for 30 seconds.
Repeat 2 times per set.
One set per session.
Complete 1-3 sessions per day.

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Low Back Pain Exercises

Press Up

Relax the buttock and abdomen; fully extend elbows and press up.

Hold for 3-4 seconds.
Repeat 10 times per set.
One set per session.
Complete 3 sessions per day.

Piriformis Stretch

Lie on your back with knees bent. Cross one leg so the ankle rests across the opposite knee. If wanting an added stretch gentle move bent leg toward chest; hold stretch by holding leg under knee. Keep your back flat.

Hold for 30 seconds.
Repeat 1 time per set.
Two sets per side, per session.
Complete as often as needed daily.

Bridge Up & Down

Draw the stomach in and squeeze buttocks as tight as possible. Move the pelvis up and down. If you begin feeling pain in your lower back, pause and start the exercise over again.

Hold for 2 seconds.
Repeat until fatigue.
Two sets per session.
Complete 1 session per day.

Opposite Arm/Opposite Leg (On All Fours)

Tighten stomach and raise right leg and opposite arm. Keep hips level and draw the abdomen in as tight as you can.

Hold for 2 breaths.
Repeat 30 to 50 times per set.
One set per session.
Complete 2 sessions per day.

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