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Ask the Doc

Feb 2, 2015

Ask the Doc……

“I often read about athletes getting recurrent problems. I know sports is rough, but can anything be done to prevent recurrent problems?”

That’s a great question and one of significant importance. Sports injuries are often due to a direct hit, like a football player being tackled too hard. In such cases, it would seem that other than being faster than your charging opponent, there’s not much you can do to prevent it. But even in these kinds of cases there may be underlying factors involved. For example, sprained ankles are the most common injury in sports. Often, athletes are told they have a “weak ankle.” But there can be precipitating factors such as a short leg. This causes an athlete to stand on the outside of his or her foot making them much more prone to such injuries.

Many who play sports often develop “overuse syndromes.” This typically refers to doing too much, too soon and too hard. But here again, there are often underlying or precipitating factors. The runner who is told they have “runner’s knee,” (a type of overuse syndrome) in reality has some sort of structural or functional problem that is making them prone to this type of injury. While running may have precipitated it, if the individual is running on both feet and legs, running can’t be the only reason they have pain in just one knee. And if both are involved, one is almost always more severe, so here again, they must be other factors involved.

The very same thing is true in medicine. Osteoarthritis is thought to be due to age and excessive weight. But many suffer from pain in only one knee or hip. Is the other any younger or carrying less weight? So while age and weight are certainly factors, they cannot be the true underlying cause.

The bottom line is that in all aspects of the healing arts, whether one is a chiropractor, internist, physical therapist, massage therapist etc., the focus of treating a patient is usually on eliminating the symptom. If a fracture occurs, cast it. If a muscle is sore do what is necessary to eliminate the soreness. With all the talk about preventative medicine, we are all still for the most part practitioners that want to eliminate the immediate problem. And that’s great, but at the same time we are depriving patients of the most important aspect of their care if we don’t find and fix the underlying etiology; i.e., the real cause. If you have a boat with a leak, you may need to get a good bilge pump immediately, but long term, plugging the leak is even more important. Still, the greater, ultimate concern, should be finding why the leak happened to begin with so it doesn’t happen again.

Even in cases where we may not have all the answers to a particular disease or injury, we should always look for other underlying factors that can actually precipitate or exacerbate the problem. Unfortunately, I see so many patients that I refer to as the “wandering wounded,” going from one practitioner to the next looking for answers because the underlying cause of their problem has not been found or eliminated.

As a patient, always make sure those privileged to treat you are indeed looking for and eliminating the underlying cause of your ailment, or possible precipitating factors, whether it be sports or disease related. A good mechanic doesn’t just put new tires on your car after they have worn out, but recommends that you have your frame, wheels and tires aligned and balanced to give you the longest wear and best ride possible.

A former reconstructive foot and ankle surgeon, past Clinical Instructor of Medicine at Emory, and Fellow of the American College of Rheumatology, Dr. Pack practices in Greensboro and Atlanta. He treats athletes at all levels and works with patients who have arthritis and want to remain active. In the 2004 Olympics he had a silver and gold medalist, and helped the UGA Golf Team (2005 NCCA National Champions). For further information please contact him directly at 770-335-9201, via email at, or see his website at His new book, The Arthritis Revolution, Latest Research on Staying Active without Pain Medication or Surgery, is available on or


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