Dr. Ben Pearl is a ten-year resident of Arlington, VA, and has been a practicing physician in the Arlington and McLean area since 1992. Recently selected as one of the Washingtonian Magazine's top sports doctors, he is a Fellow of the American Academy of Podiatric Sports Medicine and a graduate of the Temple University School of Podiatric Medicine. Dr. Pearl has consulted for the National Institutes of Health and FDA, and is the team podiatrist for the District Track Club, an elite Olympic development track team. He is also medical director for the SUNY New Paltz high school cross-country camp, and offers foot and ankle care to patients of all ages. He has been featured in the Washington Post Magazine, had television interviews with MSNBC, and is passionate about skiing and teaching. In his free time, Dr. Pearl enjoys running, bicycling, and ski instruction.
It depends on your circumstance, but a massage gun can be used both before and after working out to break up adhesions. Transcript: "Should you use a massage gun before or after working out? Well, I think it depends on your circumstance. Certainly a massage gun can break up adhesions. So if you're sore from the previous workout, it's a great way to do pre-workout. If you are trying to achieve maximum contraction, there is some studies that have looked at the idea that massage and stretching may actually stretch the tendon out so that it's not as tight and efficient for jumping, et cetera. But I think that is secondary to your question because you specifically were looking about working out. And I think as far as the aftermath-- breaking up those junctions, those muscle junctions that get really contracted after the workout-- I think that's a great time also to use the massage gun."
People often think of movement in terms of kinematics, but there is more to it than just looking at someone from behind on a treadmill. It's important to consider the internal torques within the joints and how large changes can affect minimal changes kinematically when making modifications to shoes, strength training and orthotics/braces. Transcript: "There are some really great answers. I love the idea that we move and muscles react. So, what I'm going to add to the conversation is thinking about, how do we alter human movement and what do we misunderstand about that? So I think a lot of us think in terms of kinematic terms, when we're looking at somebody visually and making movement analysis, One of the flaws involve, let's say with run analysis is that we're generally we think of looking at someone from behind on a treadmill and looking at that frontal plane motion. That is the pronation supination and those planes from behind. There's actually a lot more movement that's occurring in the sagittal plane. There's more joint motion available in those planes, larger, joint swings. So the other Thing, that is a major thing that people don't really understand about movement. Is that what we see is not always as important as what is happening internally within the kinetics or the torques within the joints. So, when we're making some type of modification to a shoe to strength training to an orthotic to a brace, we need to be thinking about the measurements of the The torques inside the internal joints versus what we are seeing. And it's also important to understand that it takes very large changes to affect minimal changes. Kinematically. So hopefully this brings home some of the other points that were already talked about, but it's a great topic for further discussion."
I'm using electromagnetic therapy to treat my turf toe. It involves activating cell permeability and requires a series of treatments. I've had great results with it for acute ankle sprains and more chronic conditions, and I plan on adding it to my regiment as I own the machine. Transcript: "Great question. I love what I'm seeing so far. Periodization the brf. Cuffs from doctor for come actually, doctor for come got me onto this, and I'm taking the ball and running with it. You hear it in the background right now. I got a turf toe. I have a splint that I've been using but that's not quite enough to where you can see. It's a little swollen right now, so I'm using electromagnetic therapy on it. And There's a lot of science behind this. It starts with activation of the cell permeability. We've been using it for bone healing for years at lower levels where you strap something on your ankle for like a delayed Union ankle fracture and this particular case I'm using this more right now for the joint and soft tissue tendon around the area. It does require generally a series of treatments. I've had some great results with some acute, ankle sprains. The more chronic conditions like this Jam join AKA turf toe. It gets activated. If I make a bad cut or go shoulder to shoulder, I still play soccer. So, and I'm playing on turf. So I should probably be doing this more regularly than I do, but I'm going to start adding it to my regiment especially since I own the machine. This one goes up to point for Tesla picture of the one I have. And it's it's something that I think has really been a game changer for my practice."
Cryotherapy is a great modality for treating warts and other sports injuries. It can also be used in contrast baths to help reduce inflammation and possibly delay muscle building. Transcript: "Cryotherapy has a number of applications. I use it in my practice to treat warts for sports medicine purposes. I think it's a great modality. I use ice and Heat contrast baths to open and close the blood vessels for ankle, sprains neuropathy and other types of injuries as another sort of adjunct to this. The whole idea with ice baths that are become popular. I think they do do two things they do. Decrease inflammation. There has been some talk that they may also delay. Some of the muscle building components that you're trying to achieve with weight training and resistance training. So it's kind of a double-edged sword with that but obviously for acute inflammation I think cryotherapy is a great modality."
CrossFit has been a positive influence on public perception of athletics, however its important to keep the fundamentals in perspective and understand the limitations. Transcript: "This is a really interesting question because it's got layers, it's not only what do I think about CrossFit, but also the influence its had on the perception, the public perception of athletic development. So I think that CrossFit overall has been a really good thing for public, perception of Athletics because it's highlighted, the intricacies that are involved with athleticism compound movements that are So integral to CrossFit, I think that to a certain degree CrossFit, depending on the coach can be a little bit of a cultish atmosphere so I'll have some of my patients come in with let's say the Minimalist Shoes, which I think can be great for patients because they develop the intrinsic muscles of the foot. But when you have a Clydesdale, Laz Runner, who's coming in, with two stress fractures, you know, at a certain point force equals ma mass times acceleration, and I think that Patience athletes need to accept that everything has limitations. So as long as we put the fundamentals of CrossFit into perspective, I think it can be a great platform."
When doing physical therapy, it is important to back off on the intensity when you feel something sharp or a burning sensation. It is also important to not put your body in an extreme situation with gravity and back flexibility. Transcript: "Hey Lane, in my experience with physical therapy, both as doing physical therapy myself, and then for my patients is when I have situations where I feel like there is something sharp something that feels maybe a little bit more burning like to end point of range of motion where that last little bit is just, you know, just a little bit too much. That's the point where I say back off just a little bit on the intensity. So that's kind of my rule of thumb. Obviously each manipulation, each exercise has its own sort of set of parameters where you have to watch out and certainly looking at putting your body in a situation where there might be a little bit too much at risk. Positioning with gravity as another thing and then in particular, if it's something like back flexibility and you just know you don't have a lot of flexibility or back, not putting yourself in, you know, extreme backbend situation to begin with. So those are a couple of my overall. Sort of rules of thumb, and I hope this is helpful for you."