Is physical therapy going to be painful?

Before I leave the room after all of my evaluations I always ask my patients if they have any questions. I also ask, if what I just explained to them makes sense? At least 50% of the time, if not more, I get “ is this going to hurt? It is a very good question considering the majority of people have no idea what to expect from physical therapy. When people are already in pain to start the last thing they want is to have more pain. Also, at this point, people can be fearful of movement. Therefore, it can become challenging trying to explain what to expect. Let’s talk about this question of pain and if it’s really something to expect when you go to PT.

I absolutely hate when people say that I love putting them in pain! I also get very upset when patients and PT’s alike will state PT stands for pain and torture. Or a PT is a physical terrorist. Really? Is that what most people think we are and do to people? Let’s get one thing straight. My job is to promote movement, function and mobility using your own body to heal itself. I am not here to try and put you in the most pain possible. I have no desire to try and increase your pain nor do I get excited when I do. This is a misconception that a lot of people have and it needs to stop.

Yes, there are times that you may have some discomfort from certain movements, activities and treatments. Take the shoulder for example. A patient that has RTC surgery is going to have pain during PT because you have to move the joint in order for you to gain motion. The shoulder is healing from surgery and that is another reason that it is going to be painful. Any time you have limited motion you are going to experience some sort of pain/discomfort because the joint is not moving properly. It’s not a sign for me to see how much pain I can put you in. It’s just a guarantee that you will be in some sort of discomfort because of the limited motion the joint has.

Will you experience some sort of pain during PT? Depending on what you are coming for the answer is yes. Other times PT can and should be very relaxing and calming. General soreness from activity and exercise is not what I consider pain. It’s just your bodies way of telling you to move your ass more often and you wont feel this way. If you are seeing someone that calls themselves a pain and torture expert or refers to themselves as s physical terrorist I suggest you find a different place to go.

When things get tough will you quit?


As most of you know that read my posts my son plays travel baseball and I’m a coach on the team. Lately it has taken over my life, and I’m okay with that because I enjoy it so much! But I keep finding different reasons to talk about it because these kids show me something different each week. As with all 9 year olds there is an up and down attitude about them each day, week and month. One day they look like super stars out there and nothing can stop them. The next day they look like they are back in T-ball again. This past weekend was one of those weekends where you wondered how they would respond after the events that took place.

We played in a tournament called the Battle of the Boarder in Youngstown Ohio. Leading up to the weekend we knew that competition was going to be very good. 2 teams in particular were going to be there. Beaver Valley Red and West Hills. The last time we played West hills they beat up on us pretty badly. By about 13 runs to be exact! It wasn’t pretty, but our kids had bounced back in the next tournament they played in to take 2nd place. We were in a different bracket then either team and were set to face 2 teams we had never played. The day before the tournament started one dropped out and our schedule changed. Now we were scheduled to play Beaver Valley. I was excited to see how our kids matched up against them since we had never played them before. Once the kids heard that was who they were playing that’s all they talked about. They obsessed about it actually! And it was not in a good way. The game started and we walked the first batter, not a good start! Nerves were probably going crazy for most, but we managed to get 2 outs and the score was only 1-0. Then all hell broke loose! We committed 6 errors giving up 12 runs in the first inning! After the first inning it was 12-0! How does this happen? Little things like catching the ball before trying to throw it. Balls going through their legs, and coming in on fly balls instead of stepping back first. All things our kids do very well most of the time. Their nerves got the best of them. Needless to say the game ended in 4 innings after losing 18-1. We lost the second game 12-6 against another team we had never played mostly due to mistakes and kids just not being in the game. It was tough to watch and hard to talk to the boys afterwards. Sunday would tell us what type of team we have and how they respond.

The next morning the kids warmed up and you could tell they were more lively and upbeat. They started out strong and lead most of the game until the bottom of the 5th giving up 2 runs to be down 5-4. The kids battled that last inning but couldn’t find a way to get another run. We lost that game, but showed great resilience and determination to come back after getting the crap beat out of us the day before. It was great to see how our boys responded.

I wanted to share this with you all because there are always going to be times in life and in physical therapy that you are going to want to quit. Things are just going to get too hard for you and giving up seems to be the easiest thing to do. I know because I have felt like quitting before. My first 2 weeks of PT school I almost quit! I felt that it was going to be too hard and too much for me to handle. I was sick of school at that point and now I was going to have to go for an additional 3 years! I went home that weekend and thought about it a lot. I kept telling myself I could go and get a job for a little while and figure it out. Then I realized that I committed to doing this and this was what I felt passionate about. I’m so glad that I decided to continue my journey. Just know that it’s normal to want to just give up when things are tough and not going your way. It’s the way you respond and show resilience that makes all the difference.

Can wearing a back brace do more harm than good?


31 million Americans experience low back pain at any given time. It is the number one cause of disability worldwide. Also, low back pain is one of the most common reasons for someone to miss work and the second most common reason for someone to go to the doctors. Really? That many people have back pain? It is that common for them to go to their primary care doctor for it? Why are they not coming to physical therapy first? That’s a topic for another day, but seriously low back pain is a huge issue that a lot of us deal with on a daily basis. I see it first hand every day as I treat patients frequently with this problem. Some are strains, disc herniations, fusions, fractures and just general arthritis symptoms. It’s inevitable that I will get the question: “Do you think a back brace will help me?” “My friend’s brother has worn a brace for years and says he thinks I need one.” So I decided to share my opinions and some general facts about back braces to hopefully help you make that decision.

What is the back brace being used for? This should be the first question anyone should ask. The type of injury or problem that you are having will be a key factor whether you will benefit from a brace or not. When do you plan on wearing it? Is this something that you are planning on wearing all day? Do you want to use it while you are doing house work or working out at the gym? Are you planning on wearing it while you sit? These are some key questions that you need to focus on in order to see if this is right for you.

In my opinion, I never recommend for a patient to wear a back brace. This is usually what I tell them. I don’t recommend that you get a back brace. I feel you would not benefit from it and here is why. Your back is already vulnerable in the fact that you are injured and you are in pain. Your muscles are not working to their full potential and are weak. If you were to put a brace on, chances are that you would get some relief initially, but you would only be hurting yourself. Think about it this way, once you put that brace on your muscles are going to say to themselves, I don’t have to work as hard as I was before because I have this trusty brace doing most of the work. So as your muscles decide to take a nap they are also shrinking which is called atrophy. Now they are not as strong as they were before. After using this brace for the past several weeks you start to feel a bit better. You think, “Hey I feel pretty good let’s try going without the brace today.” Within 30 minutes you feel worse than you did before. And now you put the brace back on because that’s the only way it feels better. See, the brace is doing most if not all of the work for your core and those muscle decided that they wanted to be lazy and not work. Sure it helped take away your pain temporarily, but in turn it was hurting you in the long run.

Now, here is when I feel you can and should wear a brace.

When you are weight lifting or power lifting: weight lifters have been using belts and back braces for years. These are only used for a very short period of time and are taken off so your back is only being assisted for a short amount of time.

When your job requires you to lift a lot throughout the day: I see Home Depot workers wearing braces all the time. And as soon as they are done with the lift they take of the brace. This is fine because you are not allowing the brace to carry the load all day long.

Scoliosis: This type of brace is used to stop the progression of Idiopathic Scoliosis. This brace must be used in order to prevent the curvature from getting any worse.

It can be very confusing a to when you should or should not wear a back brace. I suggest that you take into account what you are trying to use it for and ask your Physical Therapist or other licensed health care provider. Braces can be a life saver, but they can also leave you worse than when you started.

I treat PAIN all day every day

Throughout the week 10-20% of my patients cancel. It’s a given. Anywhere you go, regardless if it is a medical facility or not, cancels happen. I have cancelled things on occasion as well. Something comes up and you don’t have a ride, you have to work late or you just plain forgot. Things happen in life and that’s why we prepare for these types of things to happen. Sometimes, the reason for cancelling is actually the reason you should be coming in.

I have heard a lot of different reasons for cancelling over the years. Some are pretty standard as you would expect. Some are off the wall and I just shake my head. But whatever the reason is I’m okay with because you had the courtesy to call me and let me know. There is one reason though I have a hard time dealing with. “ I’m calling to cancel my appointment today.” “ Is everything okay?” “Yes, I am in a lot of pain today and need to cancel.” “I called my doctor and they gave me some pain meds.” Wait a minute what? They cancelled because they are in pain? Isn’t that the reason they came here in the first place? They were lifting something heavy and injured their back. Now they are dealing with back pain and need my help. Why would someone cancel because they are in pain?

As a physical therapist I am a musculoskeletal specialist. I help people get back to things they want to do by developing a program that puts them in the best position to win. I treat pain all day every day without the side effects of a pill! I don’t give you long term use effects by damaging your liver nor do I cause an addiction. I help people get back to the life they once lived without having to rely on me all of the time. I lead them to independence. I make decisions for them to guide them in the right direction. PAIN is usually a very common symptom of most of my patients.

So why would someone cancel if they are in pain? Early on in my career I had no idea and just attributed it to a patient being lazy. Sometimes that is the case, but most of the time it is just that the patient is misinformed. I didn’t do a good enough job explaining to them exactly what my plan was and what it was going to take in order for them to get better. Now, some patients just don’t pay attention and that’s on them. But I can always do a better job at communicating. So, if you are currently going to PT or are planning on going know that at times things might get flared up. You might get worse before you get better. You might experience more discomfort than you did before, but pain should not be a reason to cancel. I always want to see my patients if they are in pain. It ‘s what I am here for!

The benefits of warming up before exercise

I see it all the time at the gym. People come in, check in at the front desk, hang their keys on the board and go right to the bench press. Are they going to warm up at all? How many of you reading this right now have done that? I know I used to be one of those people in the past. I would just get in there and start full throttle not having a clue as to what I was doing to myself and the potential injuries I could have caused myself. Warming up is very important for a few reasons. It absolutely can aid in preventing injuries during your workout. It can also help enhance your performance during your workout. In fact the more intense your workout is going to be the more important a proper warmup is.

When you start a new workout routine or you are starting a new program your body is just getting used to those specific exercises. Nobody ever tries to run a marathon without first warming up. So why would we just jump right into something without really getting our body in a state of warmth? Working out is one of many elements involved in losing weight and leading a healthy life style. If you are not used to working out, a warm up is crucial to help your body ease into it.

Warming up before exercise slowly loosens your muscles at a better pace than just jumping right into a routine. Studies have suggested that warming up before a exercise regimen can prevent injury. Here are some of the specific benefits of a proper warm up:

Increased muscle temperature: A warmer muscle tends to contract more forcefully and relax a lot faster. This decreases the probability of overstretching and causing injury.

Blood vessel dilation: This can reduce the resistance to blood flow and have a little less stress on the heart.

Increased body temperature: This increases muscle elasticity and reduces the risk of strains and muscle pulls.

Increased blood temperature: Temperature of blood increases when it travels through your muscles. As that rises the binding of oxygen to hemoglobin decreases so oxygen is more readily available to your muscles. This can improve endurance.

Improved range of motion (ROM): As your muscles increase in temperature so do your joints. In turn this helps increase the available ROM that you have and this helps improve performance.

A typical warm up should start out slow with a gradual increase to what you are trying to accomplish. If you are a runner you should be jogging a bit mixing in a few sprints to engage fast and slow twitch muscle fibers. For those of us that like to strength train you should be starting out with light weight for a few sets gradually working your way into the exercise you are trying to accomplish. I personally like to run about 2 miles before I strength train. By the time I’m done. I’m very warm, loose and ready to start my workout. Another point I would like to make is that the best time to stretch is after a workout or after your warmup. This way your muscles are loose and more pliable and at less risk for injury.
Keep in mind that each person’s warmup is different. It can be very individualized and only comes with experience, practice and experimentation. I recommend trying various ways at a slow pace to find what works best for you.

REFERENCES:

https://www.verywell.com/how-to-warm-up-before-exercise-3119266

What seems to work best for weight loss? Diet or exercise?

Everyone wants to loose weight at some point in their life. Some people have struggled their whole lives trying to figure out the magical ingredient to lose that unwanted poundage that has taken over their midsection. Losing weight and keeping it off is a huge challenge. It’s just not easy for a lot of people, including myself. I have patients come into my office with lower back pain, knee pain, hip pain and they are overweight. Most of the time they will say “If I could just lose some weight I know it would help with my pain problems.” Or “I want to lose weight because I know it will help, but my pain prevents me from exercising.” If you ask most people will tell you that if they don’t exercise they have a hard time losing weight. Is this really true? If we limited our physical activity, would this effect our ability to lose weight? Does the way we eat have anything to do with our ability to lose weight?

Exercise has great benefits for your body. It strengthens muscles, helps your cardiovascular system, lowers blood pressure and helps you release the chemical Serotonin the “feel good” chemical of the body. This helps your mood change after a workout. Have you ever felt lousy after a workout? I would probably say no! The bottom line is that exercise makes you feel better, boosts your health and it also can be fun. Exercise helps burn calories, which in turn helps you lose weight right? If we burn more calories than we take in then in turn we lose weight. This equation works well, but it wont last for long if all we are doing is an insane workout routine.

Our eating habits can also help with weight lose. People tend to say “I can’t have that I’m dieting!” Or “I am on this diet for the next 4 weeks to get down to my beach body!” Crash diets are just that…they crash! If you decide to start counting your calories and follow the newest “fad” diet plan it might work for a few weeks or maybe a month. Eventually it will catch up to you, especially when you start to eat the same old stuff you used to. Most people will have short term success with these type of diets and leave them saying “I have tried dieting and I just can’t seem to lose the weight.”

So what is it that most of us are doing wrong that is causing us to either not lose weight? Or gaining it back after we have lost it? The short answer is we are relying solely on either exercise alone or some fad diet plan. I suggest to patients that they should try and follow the 80/20 rule. 80% food intake and 20% exercise. Most people would think it should be the opposite. But to lose weight and keep it off for the long haul there is a balance that needs to happen and food is usually the main culprit. Changing the way we eat has such a huge effect on the way we can lose weight, get healthy and stay healthy. If you continue to workout like crazy and not get the proper nutrition you are just being counterproductive. You can’t use exercise as your primary source to lose weight. There has to be some sort of balance both ways.

What I suggest for people to do is first get away from those processed foods and sugar! Sodium alone keeps weight on and those foods are packed with it. Usually I will tell people to fill half of their plate with vegetables. Green leafy vegetables, broccoli, spinach, artichokes, asparagus are just a few that I like. You only need about a fist full of protein on your plate and a palm full of your starches such as brown rice or yams. Getting fat in your diet is also recommended. Just make sure it’s good fat. I eat at least 1 avocado a day. Try and eat cleaner foods and drink lots of water. In order to stay fully hydrated throughout the day you should drink half you body weight in ounces per day. This can also help your body stay full and not hungry. Sometimes when you think you are hungry you are really dehydrated. Exercise 3 times per week is plenty for about 25-30 minutes. You can do more if you would like. It’s totally up to you.

These are all suggestions that you can try. I am by no means a nutritional expert or a dietitian. I am solely going by experience alone and what has worked for me. As with all things new I recommend to do this for at least a 6-8 week period to really see results. Let me know how it goes!

Practice, consistency and effort: All keys to have success

My son plays on 2 different baseball teams. He is on a travel team and an in-house athletic association team. For his travel team, we have been practicing in an indoor facility since late November. He is fortunate enough to play with most of the same kids for the past 3-4 years. They work well together and it shows. Since they started practicing until now there is a noticeable difference in their attitude, their work ethic, their desire and of course their overall ability! I’m one of the coaches, and it’s really amazing to see the transformation before your eyes with these kids! It’s truly something special. I can see that every single one of them has benefited from being on this team. You can see it from the pop of the mitt, the crisp and quick hands of a fielder and the sound of more and more solid contact of the bat! It wasn’t always like this though.

Rewind to November…and so it begins. Most of these kids play multiple sports, my son included. Flag and tackle football had just just ended and basketball was just about to get under way. Baseball seemed to be on the back burner for most. It usually is at that time of year. Practice started 2 days a week and only half the kids were ever there at one time for the first month and a half. It was frustrating at first because you could never really get the kids to gel. Even though these kids have all played with each other, there was just no consistency. And it showed in practice during drills and hitting exercises. You could tell which kids had been there more and which had not. It’s only natural that with consistency you improve. Over the next several months once basketball started to wind down is when it really started to show. You could just see it from practice to practice. Their attitudes changed, their ability to do things asked of them and the desire was there. Once we had a consistent bunch of kids who were committed and practiced together, is when they all started to gel together.

Just this past Saturday my sons in house team had their first practice. For most of the kids this was their first practice of the year. I am not a coach on this team, but I offered to help if needed. The coach talked to the kids at first and had them warm up. As they were warming up he stopped everyone and asked them to watch my sons mechanics on how he throws the ball. He said “everyone watch Caden and how he throws.” He wanted them to watch the entire motion through his follow through. He said that’s exactly how I want you guys to throw the ball. Great mechanics there! I’m always hard on my son with everything, and since baseball has been my passion since I was 5 I am extra hard on him with this! I thought, wow he is using my son as an example to all the players on what to do! Later on in the practice I was helping hit ground balls to the kids. I didn’t say much a I was just observing the team and what kids needed help with. The coach from time to time would jump in and tell a kid to do something different. When I coach for our travel team I am constantly correcting form, the way kids take a ground ball, throwing mechanics and everything in between. Like I said, I am extra hard on my son! What Dad isn’t hard on their kid? So I decided since I didn’t know very many people on this team I would just help and sit back. I was shocked, amazed and PROUD all at the same time! Not once did I have to correct my son! I mean I was really shocked that I didn’t have to even yell his name. Those that coach with me will tell you they hear me yell CADEN all the time during practice. I saw everything that we practiced so hard during the winter and more. He did everything that I normally have to correct him on! And to top it off he was instructing kids on how to do things better turning double plays! It was a very proud moment for me as a Dad!

I always try and take things back to how it pertains to Physical Therapy. This example is no different. My title for this blog post is practice, consistency and effort. Practice makes “BETTER” in my opinion. It never makes you perfect. There is always something that you can work on and something to improve on. Consistency with practice and technique will always help to focus on things that you are having difficulty with. The amount of Effort you put into something shows in your results. The more effort you put in, the better the results. If you truly want to get better, which I feel that every patient that comes to me does, then you have to take into account these 3 things. My son has shown me that with these 3 things he can do amazing things, and he is only almost 9! When I think about it though I wouldn’t expect anything less from him or my patients!

How much does weight really impact my joint health?


If you have the occasional twinge of pain in your knees, hips or even your back, it is your body’s way of warning you of a potential problem. Pain is your body’s way to tell you that something is wrong and you need to do something about it. Similar to an engine light coming on in your car, pain is indicating a possible problem. Now, what is the cause? There are multiple reasons why your body sends off pain signals. First, if you injure tissue your brain tells you that you are in pain. If you have bad posture, eventually you will feel pain. Our joints are designed to take a lot of pressure during different activities. But when that pressure is increased just the slightest it can cause an enormous chain reaction and your function can be lost. So how does increased body weight really impact our joints health?

Studies have shown that for every pound of excess weight exerts 4 pounds of pressure on your joints, your knees in particular. Let’s just think about that for a minute…if you are 10 pounds overweight you have 40 pounds of extra pressure on your knees. If you are 100 pounds overweight now you have 400 pounds of pressure on your knees!!! That’s a crazy statistic! Now, walking on a level surface puts a force equivalent to 1 ½ times your body weight normally with everyone. So if you weigh 200 pounds you are putting 300 pounds of pressure on your knees. If you add an incline, the pressure goes up. Going up and down a step increases this pressure 2 to 3 times. And squatting, a very functional activity that we all do on a day to day basis, can add up to 5 times your body weight of pressure. This is why it is so important to know what we are doing to our bodies and the affect a few extra pounds can have.  

What does this mean? Well, with increased pressure on joints this can lead to joint break down, in turn causing osteoarthritis. Obesity and being overweight is one of the leading risk factors of osteoarthritis. Osteoarthritis is caused from wear and tear of joints. Once the cartilage is worn away this causes a bone on bone atmosphere which causes inflammation in the joint. Increased weight causes this breakdown to occur quicker than normal. And, pain levels can be even worse with those that already have osteoarthritis. Now you have an inflamed joint that is bearing 3-5 times the amount of pressure that it should.  

What can be done to avoid this? The simple answer is to lose some weight. Most people can afford to lose a few extra pounds. It’s easier said than done, I know. It all comes down to 2 questions. Is it important to you? And what are my goals? You really have to decide what is important to you. If not having pain is important to you, then this should be a priority. If being able to do any activity you want without pain, then this should be a priority. What are your goals? I would suggest setting small goals at first so that they can be easily reached. Seek out another partner to hold you accountable during your journey. In the long run it’s a life style change and it needs to be done in steps. Nobody ever said that getting to a healthy lifestyle is easy, but once you get there it is very easy to maintain that environment.  
So to sum it up, weight has a huge impact on your joint health. Your joints already have a great deal of pressure put on them when doing a specific activity. Adding any additional weight, just increases that pressure even more. This, in turn, can cause other issues such as osteoarthritis. Having a healthier lifestyle can and will prevent such things from happening and should be a priority.  

Do I have Peripheral Neuropathy?

My feet burn throughout the day. My hands gets tingling into the fingers when I’m sleeping. I have less feeling in my feet and sometimes they are cold. These are all things patients tell me in my office and wonder what it is that is causing these symptoms. Is it peripheral neuropathy? What is peripheral neuropathy? The name peripheral neuropathy states what it is in its name. Peripheral: meaning away from or beyond the brain and spinal cord, neuro meaning relating to the nerves, and pathy meaning disease. So a nerve related disease occurring away from the brain and spinal cord in short. Patients ask me all the time if I think they have this condition. Here is a little information about it and what type of symptoms patients have.

The peripheral nerves are a network that connects our spinal cord and brain to our skin, muscles and internal organs. These nerves arrange themselves along lines in the body called dermatomes. These dermatome patterns supply the feeling to certain parts of our body. If one or more are affected you can track the nerve root by the pattern of pain or numbness that you feel. Clinically this is how we can come up with a conclusion as to what nerve is being affected. Damage to these nerves takes away the communication pathway from the brain and other parts of your body. This in turn can cause impairments to our muscles and show signs of weakness. It can also cause sensation problems to our upper and lower extremities causing pain.

Types of Peripheral Neuropathy:

Mononeuropathy- Damage to a single peripheral nerve is called mononeuropathy. An injury or trauma to a certain area can cause this. Repetitive movements can also cause this type. Carpal Tunnel syndrome is a common example of a mononeuropathy. Other types are Radial and Ulnar nerve palsy. Numbness and weakness can be caused by these types of mononeuropathies.

Polyneuropathy- This accounts for the greatest number of peripheral neuropathy cases. This happens when multiple nerves in the body are affected at the same time. Causes are usually poor nutrition, alcohol abuse and diabetes. Diabetic neuropathy is one of the most common forms. Symptoms include numbness, tingling, loss of feeling and burning in the hands or feet. This can cause people to get burned very easily as well as develop wounds and not know about them. This is why diabetics are extra careful with protecting their feet.

Causes of Peripheral Neuropathy: 

Acquired- meaning that is is caused by an environmental factor. Toxins, illness or an infection. Some examples are alcoholism, certain kinds of cancer and poor nutrition.

Hereditary- these types are genetically passed on from your parents.

Idiopathic- these are types that are from an unknown cause.

Knowing the symptoms can help a patients ability in taking care of themselves. Knowing what to do and how to treat is helpful too. If you or someone you know has symptoms similar to what is described above you should seek medical help. A neurologist would be the first medical professional to see. Neuropathy can be a very debilitating disorder, but if it is treated it can be managed.  

Can smoking affect the way my body heals itself?

Are you a smoker? Have you recently had surgery or an injury that just wasn’t healing in a normal time frame? Smoking might be the culprit. Just about everyone on earth knows the affects of cigarette smoke and how it can cause certain ailments and diseases. An estimated 15.1 % of U.S. adults aged 18 years or older smoke cigarettes. More than 16 million Americans live with a smoking related disease (2). But do people know the affect cigarette smoke can have on the healing process in the body? What ways does it delay healing time and why it can take so much longer than most.

Deprives the body of Oxygen:

The air is filled with Oxygen and we breath it in all day long. Oxygen is needed for our body to function as well as heal tissue that is wounded. On a more scientific level, cigarette smoke causes many changes to the way our bodies handle oxygen. Hemoglobin is a molecule that transports oxygen throughout the body. Cigarette smoke affects it’s ability to carry the amount it normally needs to carry at one time. The blood vessels in the body also become more narrow not allowing the oxygen and hemoglobin to get to your healing tissue.(1)

Cigarette smoke thickens your blood as well. This makes it more difficult for the blood to run smoother throughout our bodies. Just think of it this way, you have car carrier ( Hemoglobin) carrying 8 cars (oxygen) a piece on a 4 lane highway (artery/veins) at an average speed of 65 MPH. Now it starts to snow (chemicals in cigarettes) and those car carriers can’t go through the storm so you have to get a tow truck that carries 2 cars a piece now. Your speed has now decreased to 45 MPH. Less cars will get to the dealership (healing tissue) and it will take twice as long to get there. With a decreased amount of oxygen, the tissues have a difficult time healing in the allotted time.

Weakens the Immune system:

In addition, cigarette smoke has been shown to make it more difficult for the body to fight off infection after surgery. The chemicals in cigarettes prevent neutrophils, infection fighting cells, from working properly. Neutrophils are our guards that create a safe environment by getting rid of things that don’t belong in our body, such as bacteria. This in turn causes a greater risk to develop infection.(2)

There is some good news from all of this though. Research has shown that quitting smoking before surgery reduces your risk of complications. It is very difficult to stop smoking, but even a 4-6 week period shows a dramatic decrease in risk factors. Now you might say what if I had a fracture and needed surgery immediately? I don’t have time to quit. Quitting for 4-8 weeks while your fracture is healing has also shown great benefits in the healing process.

Quitting smoking or any nicotine product is a very difficult process. I know from experience. I chewed snuff for 14 years. I tried to quit on multiple occasions and nothing seemed to work, but then my son was born! I made a promise to myself that I would quit for him and for my family. 9 years later I don’t even miss it! In fact it kind of makes me sick to even smell it. Sometimes the big picture just makes sense.

References: 

1. http://www.aofas.org/footcaremd/how-to/foot-health/Pages/How-Smoking-Affects-Healing.aspx

2. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/
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