Meniscal Tears

meniscus

What’s up ? This is THE stephane ANDRE. With my training, I’m interested in biomechanics to avoid injuries. I read « Sport Medicine Media Guide » and I learned some good stuff.

Meniscus tear

meniscus tear

Meniscal tear is one of the most common knee injuries in athletes. This is caused after a contact injury or a traumatic twist. The meniscus is a wedge-shaped cartilage that provides a cushion in the medial and lateral portion of the knee joint and acts as a « shock absorber ». It’s located in the area of joints contact to prevent the bones rub between them because of the bodyweight. It’s hard and rubbery to help cushion the joints and keep the knees stable.

It’s important to also know that the meniscus helps to nourish the knee by facilitating the diffusion of joint fluid. With this injury, athletes can experience acute pain with a swelling and often a catching or locking sensation.

Diagnose

A meniscus injury can be diagnosed on the basis of the story that the patient provides and a physical examination of the knee.

An orthopedic surgeon my also use other techniques to further diagnose such as magnetic resonance imaging (MRI), which gives a 3-dimensional image of the inside of the knee joint. In some cases, a surgeon can perform an arthroscopic inspection of the articulation, this is a minimally invasive surgical procedure.

Treatment

knee brace

A small meniscus tear can be treated with rest, ice and anti-inflammatory medications. When a meniscus tear causes a significant loss of movement or catching, the appropriate treatment is often a surgical operation. Depending on the location and type of tear, the treatment may be a simple arthroscopy to remove the torn fragment. Depending on how quickly the inflammation disappears, athletes can return to a full activity after a week or months.

For athletes with a repairable tear, sutures are used to sew the meniscus. In this situation, the knee is braced for 6 weeks. These athletes take at least 3-6 months to back to their activities but maintain the full cushion in their knees.

Prevention

There is not really any way to prevent a meniscus tear apart from a conditioning program to try to prevent an acromioclavicular ligament (ACL) tear and knee instability.

Stats

Women have meniscus tears more often than men and at an earlier age. These tears are often associated with an acromioclavicular ligament injury (ACL)

There are some variables of meniscus tears can be repaired and despite repair, they aren’t always heal. But arthritis can be avoided in the majority of cases when repair is successful. One study shows that 60% of patients who undergo meniscectomy (partial elimination) had some degree of progressive arthritis.

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-Steph

P.S. If you’re in Miami and you like Caribbean food, go to my cousin’s bistro to eat Haitian food, click here .

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Articular Cartilage Injuries

articular cartilage injury

What’s up ? This is THE stephane ANDRE. With my training, I’m interessted in biomechanics to avoid injuries. I read « Sport Medicine Media Guide » and I learned some good stuff.

Definition

Articular cartilage is difficult to understand because there are 3 types of cartilages in the body : articular of hyaline cartilage (covers joint surfaces), fibrocartilage (knee meniscus, vertebral disk) and elastic cartilage (outer ear). These cartilage’s types differ in their structure, elasticity and strength.

Articular cartilage is a complex element, it’s a living tissue that is on the joint’s surface. The function is to provide a low friction surface to allow the joint to withstand weight loads through the range of motion needed to perform activity of daily living. To put it simply, articular cartilage is a very thin shock absorber. It’s built in 5 distinct layers and each layer has a structural and biochemical difference.

Injury

articular cartilage injury

Articular cartilage injury may be due to trauma or progressive degeneration (wear and tear). This can be mechanical destruction, a direct blow or other trauma. The healing of articular cartilage cells depends on the severity of the damage and the location of the lesion. Articular cartilage has no direct blood supply so it has very little ability to repair itself. It the lesion penetrates the bone under the cartilage, the bone provides blood in the area which improves the chances of healing.

Mechanical degeneration (wear and tear) of articular cartilage occurs with progressive loss of normal cartilage structure and function. This loss begins with the softening of the cartilage, then progresses to fragmentation. As the loss of articular cartilage lining continue, the underlying bone no longer has any protections against normal wear and tear of daily life and begins to get damaged leading to osteoarthritis.

In many cases, a patient experiences knee swelling and vague pain. At this stage, continuous physical activity isn’t possible. If a loose body is present, words such as « locking » or « catching » might be used to explain the problem. With wear and tear , the patient often experiences stiffness, decreased range of motion, joint pain and/or swelling.

Diagnostic

The physician examines the knee to look for a decrease in range of motion, pain along the joint line, swelling, fluid on the knee, abnormal alignment of the joint’s bones, and ligament or meniscal injury.

Cartilage lesions are difficult to diagnose and it’s possible that the use of magnetic resonance imaging (MRI) or arthroscopy may be necessary. Plain X- rays don’t usually diagnose articular cartilage problems but they used to rule out other abnormalities.

Treatment

articular cartilage injury treatment

 

Articular cartilage injury that doesn’t penetrate the bone doesn’t repair itself. A lesion that penetrates the bone can heal but the type of cartilage created is structurally unorganized and doesn’t work as well as the original cartilage.

Lesion less than 2 cm have the best prognosis and the best treatment options. These options are arthroscopic surgery using techniques to remove damaged cartilage and increase blood flow from the underlying bone (drilling, pick procedure or microfracture ).

For smaller lesion of articular cartilage surgery is not required.

For larger lesion, it’s necessary to transplant the articular cartilage from another area of the body. Talk to your doctor or specialist to have more information about the decision to have a surgical operation.

For patients with osteoarthritis, non-surgical treatment consists of physical therapy, lifestyle modification (for example reducing activity), bracing, supportive devices, oral and injection drugs (like non-steroidal inflammatory drugs, cartilage protective drugs) and medical management.

Surgical options depend on the severity of osteoarthritis and may provide a reduction in symptoms that are usually short-lived. Total osteoarthritis may relieve the symptom of advanced osteoarthritis but this usually requires a change in the lifestyle and/or level of activity of the patient.

Statistics

Based on published studies, the overall prevalence of articular cartilage injury in the knee is 36% among all athlete and 59% among asymptomatic basketball players and runners.

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-Steph

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Acromioclavicular Joint Injury

acromioclavicular joint injury

What’s up ? This is THE stephane ANDRE. With my training, I’m interested in biomechanics to avoid injuries. I read « Sport Medicine Media Guide » and I learned some good stuff.

Acromioclavicular joint is a joint between the clavicle and the scapula. Acromion is a continuation of the scapular spine and hooks over anteriorly. It articulate with the clavicle (collar bone ) to form the acromioclavicular joint.

Problems types

The most common problems are arthritis, fracture and separation. Arthritis is characterized by a loss of joint’s cartilage. Arthritis of acromioclavicular joint is common with weight lifter, especially with bench press and a little less with shoulder press. When there is a problem with the rotator cuff, it’s possible that there is also acromioclavicular joint’s arthritis.

Acromioclavicular separation

acromioclavicular joint injury type grade

When there is an acromioclavicular joint separation, it means that the ligament that connects the acromion and clavicle is damaged and that the 2 structures don’t align properly. Separation’s state can be weak or severe, that is why there is a system of « grade » according to which ligament is torn and the severity of the tear.

Grade I Injury – This is the weakest damage and the acromioclavicular joint is still aligned.

Grade II Injury – This is an average damage. Ligaments are only stretched but not fully torn. In case of stress (physical effort), the acromioclavicular joint becomes painful and unstable.

Grade III Inury – This is a serious damage. Ligaments are completely torn and the collar bone is no longer attached to the scapula, which creates a visible deformity.

Treatment of acromioclavicular joint arthritis

If the rest, ice, medications and change of the training program (changing the exercises) don’t work, the next step is a shot of cortisone. A shot of cortisone in the joint may have calmed the pain and may be permanently swollen. As each individual is unique, the effects may vary and it’s possible that it doesn’t swell permanently.

If non-surgical methods fail, it’s possible to perform a surgical operation. The pain is localized at the bones end that make contact with each other and the goal of the operation is to remove some of the end of the clavicle. This ambulatory surgery can be done with a small incision of 1 inch (2.5 cm) long or with the arthroscopy technique with 2-3 incisions. The results and recovery of these 2 surgical techniques are about the same. Most patients have a full movement by 6 weeks and can return to do sport by 12 weeks.

Treatment for acromioclavicular separation

Separation can create very painful injuries, so the first thing to do is to decrease the pain. Hold the arm in a sling, put ice and pack the shoulder for 20-30 minutes every 2 hours as needed. Acetaminophen and non-steroidal anti-inflammatory medications can also help calm the pain.

When the pain begins to subside, it’s important to move the fingers, wrists and elbow (and eventually the shoulders) in order to avoid having stiff or « frozen » shoulder. The length of time needed to regain complete movement and function depends on the severity or injury’s grade.

Recovery from Grade I acromioclavicular separation usually takes 10-14 days while Grade III takes 6-8 weeks.

When surgery

Grade I and II separations require very rarely surgery. With a Grade III injury, after surgery, it’s possible to have full body physical activity with some restrictions.

Statistics

  • More males than females suffer acromioclavicular joint injuries

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-Steph

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Spinal Disc Herniation

disc herniation

I read a Frederic Delavier’s book « Strength Training Anatomy » and I learned good stuff.

First we can say : « disc herniation » or « herniated disc » but I prefer use « disc herniation » in my article.

Disc herniation is a common pathology in bodybuilding. This often occurs because of poor back placement during exercises such as squat, deadlift and rows (barbell bent row, seated row, etc).

During the execution of theses exercises, the main defect observed is the rounding of the back or a flexion of the spine. Because of that discs are pinched forward and loosened backward.

disc herniation

If an intervertebral disc cracked or aged, the gelatinous fluid of the nucleus pulposus moves backwards and can compress the spinal cord or roots of the spinal nerves. The symptoms of a disc herniation depends on the nature of the lesion, the amount of nucleus displaced and the surface that nucleus compresses.

The disc may have a bump or even worse, the nucleus may explode through the surrounding annulus fibrosus. It’s also possible that the posterior ligament that joins the vertebrae to each other is broken. The compressions caused by the rupture of the annulus fibrosus are always painful and incapacitating.

In bodybuilding, disc herniation are mainly at the lumbar level. Often between the 3rd and 4th lumbar vertebrae or between the 4th and 5th lumbar vertebrae. The pain is dull and deep and sometimes with numbness and tingling. Often the pain is in the middle of the back or on one side. The pain extends onto the glutes, pelvis and pubis. Sometimes pain can be felt throughout the leg following the path of the sciatic nerve because the sciatic nerve is compressed at the root (hence the name of sciatic to define this type of pain).

disc herniation sciatic nerve

Usually disc herniation resolve spontaneously and the pain gradually disappears. But in some cases the bump on a vertebral disc doesn’t disappear and can continue to painfully pres on the nerves or it’s a loose piece of intervertebral cartilage that compresses the nervous elements.

In these 2 cases, the doctor will think of doing a surgical operation to remove the part that compresses the nerves.

To avoid having a disc herniation, it’s essential to do squat, deadlift, « good morning » and rows (rows, barbell bent row, seated row) with excellent positioning technique.

Attention

For all exercises done with very heavy weight, it’s necessary to perform a « blocking » :

  1. Take a deep breath and block the breathing to fill the lungs like a balloon. This stiffens the ribcage and prevents the top of the torso form tilting forward.

  2. Squeeze abs stiffens the belly, This increases the intra-abdominal pressure and prevents the torso from sagging forward.

  3. By slightly arching the lower back with lumbar squeeze, this allows to have the spine’s bottom in extension.

These 3 simultaneous actions is what we call « blocking ». This « blocking » has the function of avoiding the rounding or bending of the spine because with very heavy weights, it can create disc herniations .

Note

After a training session with very heavy weights, it’s advisable to do stretching for the spine. There is an excellent exercise to relax the back muscles and rebalance the pressure inside the intervertebral discs. Click here .

Bad position

disc herniation bad positon squat deadlift

For exercises such as deadlift or squat, it’s important not to round your back to avoid lower back injuries.

Disc herniation

disc herniation

Flexion of the spine with heavy weights can create disc herniations at the level of the lumbar vertebrae.

These disc herniations are common at squat and deadlift. This is caused by a bad back position during exercise. That’s why it’s important to work the technique for these exercises.

Disc herniation according to the age

disc herniation intervertebral

From the age of 30 years old, intervertebral discs degenerate and don’t worry, it’s normal, The annulus can crack and the nucleus pulposus dries progressively.

Vertebral discs of people over 30 years old are more rigid, less elastic and the mobility of the spine is more limited. But as the viscous gel of the nucleus pulposus deacreases due to drying, the risk of the vertebral discs moving and compressing the nerves diminished.

Vertebral discs of people under 30 years old are more flexible, more elastic and there is more mobility with the spine. There is a greater amount of viscous gel in the nucleus pulposus which increases the risk that vertebral discs will move and compress the nerves. Disc herniation is very common among young athletes.

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-Steph

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Adapt Your Training To Your Morphology (Part 2)

anatomy body squat morphology knee big belly

I read a Frederic Delavier’s book « Strength Training Anatomy » and I learned good stuff.

If you didn’t read Part 1, click here.

Legs

Improve your squat position

anatomy body squat morphology knee big belly

To reduce the lower back’s effort and limit the hamstrings tension, it’s possible to do like powerlifters by putting the barbell on posterior deltoids.

This technique decreases the cantilever and increases the power of lifting from the back. This allows you to lift heavier weights.

By using powerlifter of weightlifting shoes (solid raised heel) or a wedge under the heels, this reduces the cantilever by having the buttocks not too back by the advancing knees. This allows for greater amplitudes with the thighs flexion.

With that, we feel better the quadriceps work by limiting the torso’s inclinaison and the work of the gluteus maximus and spinal erectors.

The low barbell and raised heel combination allows you to lift heavier weights. This technique is recommended for rangy people and people with stiff ankles to correct their positioning at squat.

Front squat to target quadriceps

anatomy body squat morphology knee big belly

Front squat limits the torso’s inclinaison. This has the effect of reducing the work of the lower back, decrease the tension of hamstrings muscles and adductor magnus muscle.

On the other hand, front squat increases the cantilever, which forces quadriceps to make more effort to extend the thigh on the leg.

Which means it’s the perfect squat for thighs. But it’s not possible to lift heavyweights like the classic squat and it’s recommended to do it with heels elevated for better stability.

For rangy people, front squat is very hard to do. The torso of rangy people is more inclined, which make it more difficult to hold the barbell which may fall forward during the execution of the movement.

Spread the legs to less incline the torso

anatomy body squat morphology knee big belly

There is a squat’s technique to limit the torso’s inclination. This involves spreading the legs with the feet outward. Some powerlifters do this technique with the legs almost wide apart. With the legs apart, this limits the legs flexion.

To be able to squat with the legs apart, it’s necessary to have an adequate bone conformation of the hip joint and to be flexible of the thighs adductor muscle. Which means, it’s a technique that can’t be used by everyone.

The advantage of the big belly

anatomy body squat morphology knee big belly

Having a big belly for squat and deadlift allow to compress it against the thighs. This helps to limit the inclination of the torso and the back’s rounding. This has the effect of protecting the lower back and limiting the risk of herniated disc.

It’s for this reason that we can see a lot of heavyweight champion of powerlifting or weightlifting with a big belly. They take care to keep their belly fat with an excessively rich diet.

Different forms of knees

anatomy body squat morphology knee big belly

In bodybuilding, it’s important to take into account the different morphologies of the individual and especially for the knees.

Arched legs (genu varum) are not more risky than normal legs. For people with X legs (genu varum) or people who can overly extend the thighs (genu recurvatum), it’s often recommanded to not do leg exercises with very heavy weights.

Cases of genu valgum are often :

  • In people who were overweight during their youth when leg bones weren’t fully developed and still « malleable ». Legs are deformed because of the overload. Now, they have this X shape.

  • In women. The fact that women have wider hips to have children, this influences the femurs direction which are generally more inclined.

For people with genu valgum. If the genu valgum is to excessive, the joint would be overused. The medial collateral ligament would be extremely tense. The lateral meniscus, the articular surfaces coated with cartilage of the external condyle of the femur, and the external lateral tuberosity of the tibia would be subjected to excessive friction, which would cause pathologies of wear.

For people with genu recurvatum. These are people who are essentially very flexible named hyperlaxes or women whose muscular and ligamentous hyperlaxity is related to reproductive function.

Rarely pathological, knees with genu recurvatum can sometimes have some problems like the meniscus pinching. This can happen when the knees are rapidly expanding and the meniscus haven’t had enough time to slip, or during an exercise with a heavy weight that has forced the hyperextension of the thigh.

It’s for this reason that it’s recommended to people suffering from a genu recuvatum pathological never to totally block the knees at the end of extension to the squat or to the leg press.

Note

For 2 people who are the same size, it’s important to consider the torso-leg ratio.

anatomy body squat morphology knee big belly

Type A :

People with proportionally long legs and a short torso will have trouble doing a proper squat without tilting their torso excessively forward.

On the other hand, the short torso (which limits the cantilever) facilitates the execution of the good-morning, classic deadlift and Romanian deadlift.

Type B :

People with proportionally short legs and a long torso will have the facility to squat safety without tilting their torso excessively forward. It’s for this reason that the great champions of powerlifting squat specialist have this type of morphology.

Share this article if you think it can help someone you know. Thank you.

-Steph

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The Dark Side Of Bodybuilding

matrix architect

I lost a little bit my motivation to do a competition after seeing a Frederick Delavier’s video about competitions Bodybuilding (video in French) . I told you that in 2018, I would do a competition in Men’s Fitness and I was a little disturbed.

Frederic Delavier speaks with his friend Michael Gundill (a friend with he wrote several book about exercise) on the bodybuilding’s excesses . 

Doping

Synthetic testosterone that makes the body stop to product natural testosterone, which is a big problem for sex (impotence); increased aggressiveness (roid rage) but bodybuilders are bad in street fight; Internal organs are increasing causes of growth hormones (prostate becomes so big that it prevents you from peeing); Hairs grows on the back or have the mustache for women; Increase ligaments and cartilage, which decrease flexibility; etc.

Sexuality

Decreased libido; decreased sperm production; The bodyfat percentage is so low that it stop libido because the body thinks there is a famine. Excess testosterone in the body is converted into estrogen (female sex hormones) which makes it more sensitive (cry watching a romantic movie); etc.

Prostitution

Steroids are very expensive and a bodybuilder can spend $ 1000 per week for food. If the bodybuilder doesn’t work or hasn’t his own business as a personal trainer or another, he can do gay prostitution even if he isn’t gay. Find a « Sugar Daddy » who pays him in exchange for some services. There are also pay-sessions with the webcam. I wrote an article on the subject . The Gulf countries are the new destination for this kind of thing.

The conclusion of this video is to do the difference between training and competition. It’s really two different things ! Competition is entertainment like seeing a rock concert, rap or music. Because seriously, musical artists, usually, they have a shitty life with a lot of drugs, but we like their music and concerts and everyone don’t cares about artists’s health ! Bodybuilding competitions is the same.

bodybuilder natural vs steroid

This is why I wondered if it was a good idea to do this competition because I don’t take steroids. I never have a hyper shredded and muscular physique like those who take steroids and I would be next to them on stage. But I remembered the article I had written about the competition I’m going to do. I don’t do the competition to win a medal. I do the competition because it’s my challenge, I want to see how my body can naturally evolve and to promote my blog too.

Jay Cutler had said that bodybuilders were too muscular for their bodies. It’s like being obese but instead of fat, it’s muscle. My challenge isn’t to have the buzz, it’s to show to my offspring how they can have a muscular and healthy body. This is a part of my legacy. If other person found my advice interesting, it’s cool but my priority is to build my legacy.

The matrix is here to entertain you and make you forget the truth !

And you ? What do you think of bodybuilding competitions ?

-Steph

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La Face Cachée Du Bodybuilding

matrix architect

J’ai perdu un peu de motivation pour faire une compétition après avoir vu une vidéo de Frédéric Delavier sur les compétitions de Bodybuilding (vidéo en français). Je t’avais dit qu’en 2018, je ferais une compétition en Men’s Physique et j’ai été un peu troublé.

Frédéric Delavier parle avec son ami Michael Gundill (un ami avec lequel il a écrit plusieurs livre sur les exercices physiques) sur les dérives du bodybuilding.

Dopage

La testostérone synthétique qui fait que le corps arrête de produit de la testostérone naturel, ce qui est un gros problème pour les relations sexuelles (impuissance) ; agressivité augmenté (roid rage) mais les bodybuilders sont mauvais en bagarre de rue ; Les organes internes augmentent à causes des hormones de croissances (la prostate devient tellement grosse que cela t’empêche de faire pipi) ; Les poils qui poussent sur le dos ou avoir la moustache pour les femmes ; L’augmentation des ligaments et des cartilage, ce qui diminuent la souplesse ; etc.

Sexualité

Diminution de la libido ; diminution de la production de sperme ; Le taux de graisse corporelle est tellement basse que cela stop la libido parce que le corps croit qu’il y a une famine. L’excès de testostérone dans le corps est transformé en oestrogène (hormones sexuelle femelle) qui rend plus sensible (pleurer en regardant un film romantique) ; etc.

Prostitution

Les stéroïdes coûtent très chers et un bodybuilder peut dépenser $1000 par semaine pour la nourriture. Si le bodybuilder ne travaille pas ou n’a pas sa propre entreprise comme coach sportif ou autre, il peut faire de la prostitution gay même s’il n’est pas gay. Se trouver un « Sugar Daddy » qui lui paie tout en échange de quelques services. Il y a aussi les séances payante avec la webcam. J’avais écrit un article sur le sujet . Les pays du Golfe sont la nouvelle destination pour ce genre de chose.

La conclusion de cette vidéo est qu’il faut faire la différence entre l’entraînement et la compétition. C’est deux choses réellement différente ! La compétition est un divertissement comme voir un concert de rock, rap ou musique. Parce que sérieusement, les artistes de musique, d’habitude, ils ont une vie de merde avec pleins de drogues mais nous aimons leurs musiques et leurs concerts et tout le monde s’en fout de la santé des artistes ! Les compétitions de bodybuilding c’est pareil.

bodybuilder natural vs steroid

C’est pour cela que je me suis demandé si c’était une bonne idée de faire cette compétition car je ne prends pas de stéroïdes. J’aurais jamais un physique hyper sec et musclé comme ceux qui prennent des stéroïdes et je serais à côté d’eux sur scène. Mais je me suis souvenu de l’article que j’avais écrit sur la compétition que j’allais faire. Je ne fais pas la compétition pour gagner une médaille. Je fais la compétition parce que c’est mon défi, je veux voir comment mon corps peut évoluer naturellement et pour faire la promotion de mon blog aussi.

Jay Cutler avait dit que les bodybuilders étaient trop musclés pour leurs corps. C’est comme être obèse mais au lieu d’avoir de la graisse, c’est du muscle. Mon défi, ce n’est pas d’avoir du buzz, c’est pour montrer à ma descendance comment ils peuvent avoir un corps musclé et sain. Cela fait partie de mon héritage. Si d’autre personne trouvent mes conseils intéressant, c’est cool mais ma priorité c’est construire mon héritage.

La matrix est là pour te divertir et te faire oublier la vérité !

Et toi ? Que penses-tu des compétitions de bodybuilding ?

-Steph

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