Daniel Sims asked:




Are you looking for a knee support that will help address your knee pain?

We will help shed some light on this topic for you.

You need to not think about brand names at the moment. Forget all about that for right now….

What is in your best interests is to focus on your pain. – What is the level of your knee discomfort on a scale 1 – 10? (10 being the worst possible knee pain that anyone could feel)

If you have a knee injury, knowing your diagnosis will help clarify things later on, when you are looking for the best knee support.

Once you have gotten more clear on your knee discomfort level, now its time to think about what you are going to use the brace for. Are you searching for a knee support for when you are running, playing football, basketball, or on the slopes skiing ?

Or, are you looking for a sports knee brace in general, to use for all of the above?

Maybe you are looking for just a little added support during your daily life activities….

What about your knee injury…. Do you have an ACL, MCL, or a meniscus tear?

The answers to these questions are all leading you to the best brace for your knee pain.

We will give you a general rule to use when you are wondering which knee brace is right for you…

If you have come to the understanding that your knee discomfort is more serious, and you have given it a subjective count of 6-10 then you need to think about a support that is more deluxe. – So, you may be asking, “what does deluxe mean?” These supports usually have medial and lateral uprights that are attached to a hinge. Each of these hinges should be place at your knee center, but one to each side of the kneecap / patella. Moreover, these uprights, will help limit excessive side to side movements that could both continually insult your knee injury and can also increase your knee discomfort.

For knee injuries or knee pain that is less serious, then you should consider using a knee sleeve, or simple wrap around knee brace. Sleeves serve to act as a reminder for you, in order that you remember not to do certain movements that will be painful. In addition, they help provide some additional support that can really help to decrease your knee discomfort.

Now let’s review brand names. We can not state which one is best for you, because that is something you need to determine for yourself. What we can tell you is that going with a brace specialist is probably in your best interests. Do not just go with a company that reads the label on the brace and acts like they know what they are doing…. A word to the wise.



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Paul Miller asked:




Is stress contributing to your back pain? It’s becoming recognized that your state of mind has an effect upon your level of back pain and whether it eventually becomes chronic.. People who are unhappy, worried depressed, or miserable at work are more likely to develop chronic back pain, according to the latest findings. Several recent studies have shown that psychological distress has increased the risk of developing back pain and of experiencing a slow recovery. A study in Sweden found that anxiety and the practice of ‘catastrophizing’ – assuming that the worst will happen- increased the risk of back pain. In another study in the US, people who reported higher levels of anger and distress also reported higher levels of chronic back pain. These studies show that we must review the complete picture with back pain and recognize that it involves much more than just muscles and bones.

In citing the major causes of back pain, in addition to physiological and skeletal problems, the Mayo Clinic cites three Risk Factors:

• Stressful Job

• Depression

• Anxiety

The stresses that are experienced everyday by people are usually easily identified and can be dealt with. Some examples of stress causing situations are:

• Worry about being on time

• Missing a train or plane

• Worry about a job interview

These situations, while upsetting and tension causing, can be handled and, once dealt with, usually do not result in long-lasting problems.

Repressed Emotional Stress

The type of stress that can lead to troublesome back pain is called repressed emotional stress. The process is not logical but, then, many subconscious emotions are not logical or rational. Repressed emotional stress might be caused by:

• An unhappy relationship

• Hidden anger and resentment towards a spouse, children or parents

• Dissatisfaction with a job or career choice, or disillusionment and a poor self image.

• A rift in family relations

• Loss of a loved one

• Financial problems or disaster such as an impending foreclosure

• Physical abuse or threats

Repressed emotional stress may not be easily recognized as the subconscious mind may hide it, creating a smokescreen of back pain symptoms to keep your mind focused on the pain instead of looking for the underlying causes. Repressing (hiding) the real causes blocks any true healing and an effort must be made to recognize and deal with the factors behind the symptoms.

No one should ever discount the powerful effect of stress on the body and the mind.

Stress puts the body into a sustained ‘fight or flight’ mode. When confronted by a threat, whether physical or emotional, real or imagined, a gland in the brain, called the hypothalamus, releases noradrenaline and adrenaline. These hormones trigger a complex set of actions which lead to a physiological and psychological state of hyper-alertness. Problems arise when this hyper-alert state becomes the norm.

The fight or flight mechanism causes muscles to tense in preparation for action, and if this response is not deactivated, the muscles can go into painful spasms, causing severe back pain. As the muscles of the neck and back tighten and squeeze the blood vessels, just like a kink in a garden hose, the supply of nutrients and oxygen are decreased. This leads to pain and eventual weakening of the muscles, making them more susceptible to strain and injury.

Stress is a part of every day life but studies have shown that if we exist in a daily state of hyperawareness, due to all the stresses that confront us, that we are predisposed to develop a number of disorders including heart disease, hypertension, and depression.

Experts at Johns Hopkins Hospital say that a growing number of studies confirm that the mind-body connection plays a role in back pain, both in setting off an initial attack and in contributing to ongoing chronic pain. These studies have also led to the development of stress-relaxation techniques that can be learned to help break this vicious cycle.



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Jonathan Blood-smyth asked:




Root blocks or epidural injections, using corticosteroids, are routine treatments for leg and back symptoms and may support the hypothesis that there is an inflammatory aspect to the patient’s pain. Operative removal of human disc material has been analysed to find increased concentrations of inflammatory mediators which might respond to the steroid treatment. Changes which can occur from inflammatory substances include increasing the sensitivity of sensory nerves in the outer annular walls of the discs, limiting the production of proteoglycan molecules which hold water in the discs and adding to the effects of disc degenerative processes.

The nerve structures which are part of the lumbar motion segment can be sensitised and so become hyper reactive, leading to mechanical stresses which normally would be painless becoming painful. Nerve root or radicular pain is the pain caused by compression, irritation or inflammation of one of the spinal nerves at or close to the area they emerge from the spinal cord. It is not clear exactly what is the pathology underlying severe sciatica, although hypotheses include compression plus dysfunction of the axons, ischaemia, inflammation and biochemical factors. Spinal nerve roots may be more susceptible to compression injuries and to swelling formation inside their structure than other nerves.

The nerve may suffer from excessive inflow of fluid secondary to compression, which results in internal nerve swelling from the increased pressure. This can slow the flow through capillaries and allow fibrosis to develop in the nerve. Nutrition to the spinal nerve roots comes via the cerebrospinal fluid to the tune of about 60% and nerve fibrosis interferes with this, making the nerve more responsive and perhaps more likely to suffer compression symptoms due to the increased reactivity of the nerves. Blocking or reducing the blood supply can cause pain in these nerves, unlike the more usual loss of motor and sensory functions in compression of peripheral nerves.

If the nerve and its vascular supply are compromised quickly then nerve root symptoms are more likely than with a slow onset, perhaps giving a clue to why older people do not suffer such symptoms despite compromise of the nerve exits. Disc material has been experimentally placed in the epidural space of dogs and found to generate a significant inflammatory reaction and may cause damage to nerves when in contact with them. If TNF (tumour necrosis factor) is injected into a nerve it causes similar changes to those which ensue after nerve root compromise. An auto-immune reaction to the internal disc material, which is not normally accessible, has also been proposed but it is likely that many aspects are relevant.

The facet joints are synovial joints, like our finger joints, and are formed from articular processes on an upper and a lower vertebra. Facet joints react to injury and damage in the same way as our other joints react, with pain, stiffness, loss of movement, muscle spasm and eventually degeneration. As the discs degenerate the facet joints follow by becoming osteoarthritic. The fibrous capsules which surround the facet joints are rich in nerve endings and injections into the joints have been shown to refer pain into the arms, upper back and legs. Facet joints are capable of generating pain and have been shown experimentally to be involved in significant percentages of patients with neck, thoracic and lumbar pain.

The main posterior joints between the pelvis and the sacrum are the sacroiliac joints, large synovial joints which have been shown to refer pain to the buttock, low back, leg and groin. Chronic low back pain sufferers, in an experimental setting, were shown to have this joint involved in their pain production in 2-30% of cases. Muscular tissue also has pain receptors which react to pressure and stretching as well as other stimuli. If muscles are stretched suddenly under pressure or are overworked over a period of time they will become painful, shortened and exhibit

In posturally abnormal or injured muscles a pain syndrome (myofascial pain syndrome) can occur whereby the muscle becomes tight, painful and exhibits trigger points. Palpation of muscle tissue can identify trigger points as firm and tender nodular areas which refer pain out into nearby defined regions.



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Yodle asked:




In a personal injury lawsuit, a defendant is not only responsible for paying medical bills, but also for pain and suffering, lost wages and the loss of one’s ability to enjoy life. While this seems like it can be arbitrary numbers, personal injury lawyer Charles Flaxman who is with Flaxman Law Group based in south Florida, explains how one attaches a monetary amount to something so seemingly esoteric.

It seems that medical bills are rather easy to quantify as they usually have a dollar amount at the bottom. But isn’t it extremely difficult to monetize one’s pain and suffering or ability to enjoy life?

It is partially correct that medical bills are much more straightforward to prove in court, but medical bills are still not as simple and easy to prove as one might think. The defendant’s side will argue that the treatments do not relate to the accident, or that they were the wrong type of treatment or any other sort of other argument that will try to lower the medical costs that they will have to pay. Still, numbers from a hospital bill for a specific treatment are by far more hard and fast than pain, suffering and loss of one’s ability to enjoy life and work.

While pain and suffering are far more subjective, we do have means to monetize and prove damages. There are precedents set from previous cases which we refer to and also basic questions we ask to attach a price tag. The way to quantify pain and suffering, or even embarrassment, is to ask the right questions to the jury and to the plaintiff: How much would you pay me to not take away the ability for you to walk for the rest of your life? How much would you pay me so you won’t have back pain the rest of your life? How much would you pay me to not put a horrible permanent burn scar on your face?

From there, we try to quantify it. Each case is different, of course, but we use a number of tools and experts who are professionals at this exact system who try to attach a number. They use various tools and algorithms that help them get as close to the mark as possible. There is a mortality table, which uses a variety of factors to make an estimation as to how long this person will live so we can calculate years of life expectancy.  Doctors can advise the jury as to how much pain or how badly this particular injury damages a person’s ability to enjoy life. An economist might be able to calculate how much money this person might have made in the next 30 years based on his career given data he is familiar with as well as the economical climate and forecasts.

We try to quantify it as best we can. There is no exact science to this skill, but rather, it is an art. While there are certainly precedents set and experts who can advise, in the end, it is subjective and can vary vastly from case to case. The bottom line though is that I have 37 years doing personal injury law and I usually know about what a person can get for a specific injury and that is what we try to aim for. A surgical knee tends to go for $40,000 to $75,000 for example. I can usually listen to the client, get a basic understanding of the circumstances, and give a ballpark figure. If we do sign with the client, then we start getting into the details as to how much exactly we should seek in damages.

In the end though, unless we settle, which happens in probably 90% of cases, it is up to the jury to decide. Once it goes to trial, there is no right and wrong and there is no fair or unfair. Whatever the jury decides is the correct amount and that becomes the law.



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Jonathan Blood-smyth asked:




When spring springs our fancies may turn to thoughts of love but in reality the garden is a more obvious choice for attention. It’ll soon be growing madly if it’s not already doing so, demanding work if successful production of that green lawn, beautiful flowers and great vegetables is to be achieved.

The sudden increase in digging the garden is rapidly followed by a burst of injuries such as back and neck pain and other joint pains. Much of this pain and suffering could be avoided with some preparation and planning.

The winter has, for many of us, been a quiet time physically as we have done relatively little exercise or physical activity. So when March comes we are spectacularly unprepared for the burst of intense physical work needed to get the garden into order and prepared for the crops.

Typical advice includes warming up and while this may have some value I feel it does not go sufficiently far. If you do far too many hours digging or put forces on your bodily structures which overstep their tolerances, you are going to get a bad reaction no matter how well you have warmed up. The amount you decide to do also has to be correctly set.

Preparation is part of what’s needed but you can’t expect to succeed if you leave out the second part of the deal, controlling your activity levels to start with until you build up towards Olympic gardening fitness levels. Your tissue tolerances are low after the winter and you need to get yourself back into training in a paced manner, strictly controlling the amount you do. Olympic athletes don’t go from their winter layoff straight into the 100 metres sprint; they warm up and train over months until they can perform their event at full tilt. There’s a reason for this.

Most people fall into the mistake of overdoing things significantly when they start out a new activity, usually because the body does not tell us that we have overdone things until its too late. This makes the decision about the level of activity we should do very difficult to judge. If we get out there in the garden, grab a spade and start digging we are highly at risk of doing too much.

Physiotherapists, osteopaths and chiropractors are all aware of an upsurge in the number of people referring themselves with pain problems from gardening and other pursuits during the spring. The most common complaint will usually be back pain along with ligamentous and joint strains in many other areas. Pre-existing injuries are often re-aggravated.

11 Ways to Prevent Injury and Get Fit for Gardening

1. During the winter try and maintain a level of activity and exercise so you are prepared for the spring.

2. Follow a stretching routine each time before you start.

3. Kneel down if you can, especially for planting, weeding and collecting debris.

4. Decide how long you will work and when your breaks will be before you start.

5. Start with very short defined times of activity initially and keep the task down to two hours or less in the first few days if you are fit. If you have problems this will need to be lower.

6. Continue with the decided times and gradually increased in a paced fashion if you have no difficulties.

7. The trap is when you feel good, so limit the increases in activity to the times you decided even if you feel you could do more.

8. Share heavy loads with someone else and use good lifting technique.

9. Don’t swing the mower from side to side but try walking backwards and forwards instead.

10. Give yourself a planned change in task, avoiding doing consecutive activities and postures which have similar physical requirements. Do some greenhouse work or pruning in between bouts of digging for example.

11. Stop the job if you feel any significant pain or soreness and re-evaluate the next day. If it’s just soreness in the muscles then you can resume the task at a lower level.

The most important thing is to pace and decide the level of work before starting. And to stick to it.



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