You have questions? We have answers. Here are some of the most commonly asked questions that we get.

What’s the best running shoe these days?

That’s a tough question to answer flat out. There are so many brands and styles within each brand line. However, most shoe makers rate their shoes for 3 qualities; shock absorption or cushioning, stability and weight. High mileage competitive runners often prefer lighter weight shoes for long runs. Most casual runners need shock absorption or motion control. If you are a pronator or if you wear out the outside of your running shoe heel excessively, then you might consider a motion control shoe. In general, try the shoe on and if it isn’t comfortable in the store then forget it. If you wear an orthotic (shoe insert) then try the shoe on with the insert in. Buy an affordable shoe that feels good on. If you run often, change your shoes often (every few months) because the cushioning loses it’s “umphf”.

Is there a difference between Advil, Motrin or Tylenol?

Yes. Advil and Motrin are the same medicine. They contain ibuprofen which is an anti-inflammatory medicine. It is one of the NSAID’s. That stands for non-steroidal anti-inflammatory drugs. They interfere with some of the chemicals in our body that lead to inflammation (swelling and pain). They also reduce the ability for platelets to clot our blood. They are very helpful for pain from inflammation from recent or old injury, arthritis pain as well. Other examples include Alleve which is the same as Naprosyn. The active ingredient is naproxen. Tylenol has neither of these drugs as ingredients. Tylenol is made of pure acetaminophen. This has no anti-inflammatory properties. Acetominophen is an ingredient in several over the counter and prescription medicines (primarily pain relievers). It does help reduce mild to moderate pain (such as those caused by headaches or minor surgeries), and can also lower fevers. Even though these medicines are sold over the counter without prescription, you should heed the warnings on the label. If you have any serious medical conditions or take other prescription medicines, the you should consult your doctor before taking any of these.

When you injure yourself, like a sprained ankle or pull a muscle, what is the best thing to do right away? Should one use ice or heat? Is moist heat better than dry heat?

There is much confusion about when to use cold or when to use heat. There is little “right or wrong” except that in the first 48-72 hours after an injury like a contusion or sprain, ice is always best. The cold limits swelling and bruising. It should be applied with some compression to the area for 15-20 minutes on and 15-20 minutes off. Do this periodically and you’ll be surprised how it helps keep the swelling down. After that, one can use whatever feels best. In general, ice is used after exercise or an activity to reduce swelling and signs of inflammation after that activity. Heat is used to loosen up tissues and help you stretch better. Whether the heat is dry or wet doesn’t seem to matter.

Why does my knee hurt when I go up and down stairs? Or why when I sit in a movie for a few hours, when I go to get up I feel like my knee won’t support me?

That pain is caused by your kneecap. The most common cause of knee pain without injury is from the kneecap (also known as the patella). Sometimes one can look to their activities to understand why their kneecap is sore such as running or impact sports. However, more often there is no obvious cause. Unless the knee swells, locks up or gives out, there is usually no need for surgery. One can stretch their hamstrings and/or heelcords and wear more padded/cushioned shoes. Reduce the amount of kneeling, squatting and stairs that you do and hopefully the pain will subside. Store bought knee sleeves and over the counter medicines like Alleve or Advil may also help.

My shoulder hurts when I do upper body weight training, should I push through it? As they say, “no pain, no gain”, right?

Not exactly. Pain is a sign that something is not right. You might be using too much weight or doing too many repetitions. You also might be exercising too often. Listen to your body. Learn proper technique. The most “shoulder intensive” exercises usually are; dips, push ups, bench press, military press, flies and lat pull downs behind the neck. If you do all or some of these, and are having shoulder pains that linger into activities of daily living or affect workout then you need to back off. Figure out which ones hurt and which do not. This relative rest or pain free interval should relieve the problem. If not then you should seek medical attention.

I’ve been told that I have arthritis in my knees, should I get on some weight training to “strengthen” my leg muscles and prevent the arthritis from getting worse?

While exercise seems good, the choice of activity may turn out to be the most crucial factor. If  you have arthritis in your knees, then you should avoid impact activities such as (running, excessive walking, and any other jumping activity). In addition, you should avoid kneeling, squatting, stairs. If you do decide to do weight training, you should use very light hand held weights and do more repetitions. Weight training while theoretically good to strengthen the thigh muscles, also can aggravate the symptoms of arthritis.

Is it true that running causes arthritis in the hips and knees?

Even though it would seem like it ought to, there is no good evidence that running will actually cause arthritis. However, if you have arthritis, running and impact activities in general are very likely to aggravate the symptoms of pain, swelling and limitation of motion in your hips, knees or ankles. Therefore, if that is the case it is recommended that you consider less impact exercise such as swimming, biking, elliptical machines or XC ski machines for your cardiovascular exercises.

My knees hurt when I run or walk fast for exercise, but my cardiologist told me I need to exercise to help my heart. What can I do?

The cardiologist is merely recommending that you perform aerobic activity. That means any sustained exercise that gets your pulse rate to increase and make you short of breath and work up a sweat. Walking or running is only one form. You can ride an exercise bike, swim or use a rowing machine or Nordic Track type machine. These forms of exercise are generally better tolerated than impact activities in people with arthritis in their lower extremities.

Glucosamine – What is it and how does it help?

These compounds are naturally occurring materials in our bodies. In addition to water, they are the primary components of the cartilage in our joints. They make up the smooth slippery white material that covers the end of the bones within the joints of our bodies. When these materials begin to break down for any one of a number of reasons, then you have a condition we call “arthritis”.

Although these materials are naturally occurring, when we need to supplement our supplies, then we need to take in manufactured forms of these compounds. They are usually derived from either shellfish or cattle. The process removes all of the other materials (such as proteins, fats, bone, etc.) and leaves just the active ingredient. People who have shellfish allergies are allergic to the proteins found in shellfish, which should have been removed in the processing and therefore, should not have a problem with Glucosamine. However, those patients with life threatening allergic reactions to shellfish should not take these compounds made from shellfish!! Diabetics need to be aware that these compounds are similar to carbohydrates and may affect blood sugar readings. If you start these supplements and notice your diabetic management is less stable, stop them and consult your internist. People who need to watch salt content in foods (patients with high blood pressure or heart disease) should be aware, that these products may contain salt and may cause fluid retention.

These compounds are referred to as dietary supplements. As such, they are not controlled by the FDA (The Food and Drug Administration). Manufacturers do not have to adhere to any standardized processing, labeling or ingredient guidelines. This means that you don’t always get what you pay for. You need to read the bottles, do some homework and don’t always go for the cheapest brand. For an unbiased evaluation visit

Most manufacturers make the compounds in pill form, however liquid absorption is better. It is not always easy to locate. It is believed that by taking these pills, you can stimulate your bodies’ cartilage producing cells to make more of the natural joint preserving cartilage. While this has never been proven, clinical studies of people taking these materials have suggested a benefit. They report less stiffness, joint pain and improved function in the group taking the Glucosamine and Chondroitin in combination instead of placebo (“sugar pills”). These compounds have been in use for over 20 years with minimal down side. Their use is indicated for treatment of the symptoms of arthritis; joint pain, stiffness and possible swelling. They are not indicated for prevention of arthritis.

If you are interested in taking Glucosamine and Chondroitin, then you can purchase it on your own. Most drug stores, supermarkets and health food stores will have this on their shelves. There is no interaction with any prescribed medicines that you need to be concerned about. The only concerns and warnings were listed above. The daily dose is 1500 mg of Glucosamine and 1200 mg of Chondroitin in divided doses. Most pills have 500/400 mg of each in combination. Therefore, you would take 3 pills per day. You may not notice a difference right away. You should try it for a few months. If you don’t notice any improvement in your symptoms, then stop it. You can start and stop it without worrying about side effects. If you do start to feel better, the maintenance dose is just one pill per day. For more information you can go to the library, ask your pharmacist or visit the following web sites;,,

Which anti-inflammatories or NSAIDs (Non steroidal anti-inflammatory drugs) are okay to take?

All over the counter medications (i.e. Aspirin, Motrin, Aleve, etc.) are okay to take in moderation and as long as the patient has no contraindications that are listed on the bottle or package. Patients should consult with their physicians about prescription anti-inflammatories. It should be known that Vioxx has been taken off the market and no one should be taking it. Studies have shown that people with Rheumatoid arthritis or Cardiac problems should not take Bextra or Celebrex.

Do orthotics really help? How?

Orthotics help to correct the alignment of the lower body. If a patient has flat feet, that can affect the knees, hips and low back. Since the body is a kinetic chain, sometimes knee pain can be  attributed to flat feet. By using orthotics, you can correct the problem of flat feet which could alleviate low back pain, hip pain, knee pain or foot pain.

Why do I have to wear my sling all the time after my surgery?

Doctors place patients in a sling after surgery to protect the patient and the
repaired tissues. If a patient takes off the sling for any amount of time, they are putting
themselves at risk of damaging the repaired tissues and essentially undoing the work of
the surgeon. Patients should wear their sling at nighttime especially because people
move during their slumber without knowing that they are moving.

Leave a comment