Rick Weidenbener, M.D. with Bloomington Bone & Joint, in Bloomington. Chris Howell | Herald-Times

Who: Rick Weidenbener, sports injury specialist at the Bloomington Bone and Joint Clinic.

What: Online chat March 11.

I recently turned the big 50 and I am finding my knees and the bottom of my feet in a lot of pain. Sometimes after sitting just a short period of time I find very difficult to get up and walk. It just feels like the bottom of my feet have been beaten. Stairs are getting more difficult to climb as well. What do you suggest to ease the pain? Are the two related or something else may be going on. Thank you.

Julie, Spencer

DR. WEIDENBENER: Those are probably separate issues, although they could be related. One problem may lead to compensation in another body part. Without examining you, it sounds like you may have plantar fasciitis, which is the pain in the bottom of your foot. The knee pain may be some early arthritis or possibly a tracking problem with your knee cap.

If you have not had any stomach problems or high blood pressure trying some Advil or Aleve may be worthwhile.

I have a flexion contraction in my elbow which is extremely painful. I have had this injury for almost two years and believed it to be broken. The injury occurred as the result of a fall (sports related). It prevents me from straightening my elbow and prevents it from bearing much weight. I also have rheumatoid arthritis and this elbow injury is often shuffled to the side by doctors in lieu of treatment for the other symptoms from my arthritis. I have seen many doctors re: this and each quickly diagnoses the problem but no one has ever offered any remedy. Is there a remedy for this condition? Every doctor I have seen have discounted it but it interferes with proper functioning and is very painful.

What can be done for this kind of injury and what medical specialty would be best suited for treatment?

Cory, Bloomington

DR. WEIDENBENER: A significant flexion contracture is a BIG problem especially if it is your dominant arm. An X-ray would tell us the extent of the arthritis and that would guide us as to what would be the best treatment for you. There are several possible solutions, including surgery.

When a person has several levels of pinched nerves in their lower back how many cortisone injections are generally done without success before a different course of action is recommended?

What would the next step be?

Thank you.

Attendee, Bloomington

DR. WEIDENBENER: If two epidural injections have failed to relieve the symptoms there is no point in continuing with a third. If other conservative measures have failed as well, surgical decompression may be necessary.

How many have you had and did any of them give you even temporary relief?

Hi Rick. I had for quite some time, problems with my shoulder. After going to various doctors, it was dismissed as nothing major. Being disappointed with what I was told by the various doctors, I went to Ortho Indy, and it was found I had numerous problems: Torn Rotator Cuff, Torn Labrum, Subacromial Impingement, etc. I had surgery, and after recuperation and healing, things seemed good. But now, it is as if the same pain and feeling has came back. My shoulder seems to have something within it not connected, I can feel the popping grinding within in as I did before. The stability is getting worse--holding a weight out in front of me seems to be getting harder. I am very active, and am into sports.

My questions are the following:

1.) It is apparent I'll need some sort of surgery again to repair it as I can physically feel and hear some loose/torn/grinding. Since I had surgery on this, and they failed to fully resolve my shoulder problem, with your experience, what can someone as myself do? Will I run into insurance problems having to have the surgery done once again? In your experience, have you seen this happen?

2.) Now days, doctors use anthroscopic surgery. Is this more effective then open shoulder surgery? Seems that with open surgery can more meticulously sew problems shut and can better fix problems then with two stick probed in an arm, just tying giant knots with rope like piece.

Jason Luna, Bloomington

DR. WEIDENBENER: There are several things I would need to know. How long ago was your surgery? How long did you get relief? Was it an open repair or arthroscopic?

The repair could have failed or possibly not been completely repaired in the first place although the docs at Ortho Indy are very good.

Are joint pains connected with air pressure and stormy weather?

Robert LeBeau, Bloomington

DR. WEIDENBENER: Absolutely. It is not an old wives' tale that those with arthritis can tell when it's going to rain.

That is because an inflamed joint has a certain amount of pressure within it and a low pressure system (rain/thunderstorm) moves through the difference in pressure between the joint and the atmospheric pressure is greater, resulting in increased pain.

What is the best way to keep pain out of the lower back while swimming?

cristine, Martinsville

DR. WEIDENBENER: Having someone evaluate your technique might be worthwhile. Have you had previous back injuries that come in to play?

With so much talk about steroids in baseball, can we at least acknowledge that most people don't think that steroids make players better - simply able to recover faster- and the names in the Mitchell report (mostly scrubs) would seem to bear this out. There's not really a "take steroids-become a great hitter" magic effect, right?

David, Bloomington

DR. WEIDENBENER: Hitting a 100 mph fastball requires great skill which is not increased with the use of steroids. However, anabolic steroids combined with strength-training will make one significantly stronger. Someone like Barry Bonds who already possesses this skill can certainly hit the ball farther if he is stronger. The horrible consequences of anabolic steroids on many of the body's systems certainly are not worth the risk some athletes take.

How much is stress related to, for instance, lower back muscular strain?

Diane, Bloomington

DR. WEIDENBENER: Stress is generally a factor in upper back and neck pain more so than lower back. Mechanical issues such as posture may play a bigger role in low back pain/strains.

I am 42 year old and enjoy weight training very much. Will my joints suffer from this activity as I age?

clayfeat, bloomington

DR. WEIDENBENER: Assuming you have no previous arthritis in your joints weight-training will NOT cause arthritis. Keep lifting!

Why should women be doing weight training in middle age? Shouldn't men be doing it, too? And is it just as good to walk or run for exercise as to lift weights or do the weight machines?

Aviva, Bloomington

DR. WEIDENBENER: Overall fitness consists of three major areas: strength, flexibility and endurance. Weight-training (men and women), cardio exercise and flexibility exercises should be done on a regular basis by anyone interested in staying fit. I have patients in their 80s who continue to lift weights and run/walk.

Hi Rick. I've noted that if I take a NSAID or two before I work out it not only takes the edge off the workout, letting me get those last few vital (strengthbuilding) reps in, it also prevents soreness the next day. I'm careful not to overexert myself, so I don't have to worry about masking real pain. It seems to prevent the inflammation that causes the soreness response. I also use it when I know I'm going to get a bruise, it prevents the whole area from being painful for the next two weeks. What is your experience with the use of NSAIDS for muscle injury prevention?

Mike B., Btown

DR. WEIDENBENER: There's been no clear evidence that it will prevent muscle injury, but having an NSAIDS on board prior to exercise theoretically will keep inflammation to a minimum. Non-inflamed muscles and tendons will recover faster.

One so far, second tomorrow. First offered some relief early, I was able to stop prescription pain killers immediately and was using only asprin and Alieve. As time passed, pain spiked again.

If surgical decompression is needed, what is the usual recovery time e.g. being able to work again?

Thanks

Attendee, Bloomington

DR. WEIDENBENER: If you saw some relief with the first one I would definitely go for the second since it seemed to have helped enough to decrease pain medication usage. The recovery from surgery would depend on how bad the disc is and if more than one level is involved. The presence of arthritis in the spine would be a factor as well. Time to return to work would, of course, depend on the type of work you do.

What should older athletes do to maintain an active athletic life and at the same time keep the joints and spine healthy?

Robert E. Lee, Oolitic

DR. WEIDENBENER: Robert, You are not "older." You are barely middle-age! Addressing injuries early before they become debilitating as well as maintaining good strength and flexibility keeps one active.

I spend most of my work day in front of a computer for various reasons. What are some good ways to prevent neck and back issues ... and what are some ways to prevent carpal tunnel syndrome?

Ray, Vincennes

DR. WEIDENBENER: Paying attention to posture and having your work station evaluated by an ergonomic expert will prevent a lot of overuse injuries common in those who have to sit at their desks all day. Proper position of the keyboard and/or use of an ergonomic keyboard will help prevent carpal tunnel syndrome. Using a Thera-ball in place of your chair for part of the ball often helps prevent/treat back problems.

I have had my stroke evaluated and my coaches say it is very good. I haven't had any other back issues, but I have noticed that it comes more when I've done lots of fly...is there a way that I can continue to keep my yardage up for fly, but eliminate the back pain?

Cristine, Martinsville

DR. WEIDENBENER: The fly is the most strenuous on the lower back, doing some specific core-stabilization exercises or taking a Pilates class may help prevent some of this back pain. Do you have this back pain with anything other than swimming?

Hello! I was diagnosed with Fibromyalgia about 12years ago. In the past 2 years I have developed alot of pain in both hands and arms. I have recently been tested for RA, Lupas, and General Arthritis by my doctor, all show negative. I did have an elevated SED rate. I am on several medications that just don't seem to have much of an effect. Any suggestions. Thank you for your time.

Heather, Martinsville

DR. WEIDENBENER: Fibromyalgia is difficult to treat. The only things that have been shown to help symptoms are daily cardiovascular exercise and normalizing your sleep pattern. A relatively new medication called Lyrica may be helpful as well. How high was your SED rate?

Hi, I'm soon to turn 50 and after every workout my muscles are extremely sore from the arthritis throughout my body. This is whether I just walk, water aerobics, general fit machines, etc. At times I experience enflamed tissues/muscles throughout my body. I never know where it will show up. What do you suggest?

Sparky, Bloomington

DR. WEIDENBENER: Arthritis is a condition that affects the joints. Is it your muscles or your joints that are sore? Does this happen every time you work out? Do you have any family history of rheumatoid arthritis, lupus, gout, etc.?

I often have really painful aches in my hands. Is this just a normal thing for a 54-year-old? Especially one who works at a computer all day? Or should I have it checked out?

Lynne, Bloomington

DR. WEIDENBENER: You should get it checked out. If it is getting worse and lasting through most of the day. "Typical" arthritis pain in the hands usually lasts for one to two hours after awakening and then tends to improve. These achy hands could also be from carpal tunnel syndrome which you are predisposed to if you are on the computer all day.

Rick, I ruptured my achilles tendon last May while trying out for the Indiana Cutters, the local semi-pro football team. My surgery was performed by Dr. Mark Hansen and I was very please with the results of the surgery and the care I received from Dr. Hansen. After my cast was removed and the final evaluation in July Dr. Hansen and I decided on not utilizing a physical therapist as I am a ACSM certified personal trainer and have worked with a few dozen folks during their post Physical Therapy recovery. While I have regained 90% of the muscle mass in my lower leg I am still a little wobbly. Dr. Hansen recommended that I do not take part in any athletic activities for a period of one year with the exception of walking or riding a bike to ensure that I do not have a reoccurance of this injury. As of today I am walking 3-5 miles 2-3 days a week, riding a bike 5-10 miles 1-2 days a week and doing isolated calf raises with low weight on a leg press 2-3 days a week along with daily flexibility exercises. My leg feels great but I just want to do everything I can to prevent any re-injury in the future. Thank you for your time!

James, Fullerton, CA

DR. WEIDENBENER: You are almost at your year anniversary from your surgery. The muscle mass/bulk often will never return to its pre-injury size but the strength almost always does. The calf muscle will always appear slightly smaller than before but your strength especially with the rehab you have done on your own most likely is completely back. At this point in your rehab most exercise should be fine with the possible exception of sports which would require a quick (ballistic) push-off with your foot such as basketball, tennis, soccer, etc. Straight-ahead running should be fine at this point if you think your strength and flexibility are back to their pre-injury status.

It sounds as if you're doing well!

History of Arthritis in the family. I simply ache all over after I work out in some fashion; therefore, I don't tend to work out as much. Same thing when the weather changes.

Sparky, Bloomington

DR. WEIDENBENER: It sounds as though you should be evaluated since "pain all over" can be from a variety of things but definitely is not normal.