Participants: Don Miller, Agatha Thrash, Wynn Horsely
Series Code: HYTH
Program Code: HYTH000174
00:01 Hello, I'm Agatha Thrash, a staff physician
00:04 at Uchee Pines Institute.
00:06 This is a place where we train students to teach
00:11 anywhere in the world how to take care of a lot of the
00:15 physical problems that people have in the home with just
00:19 ordinary things that people have available in their homes.
00:23 Skeletal injuries are some of those and we'll be talking
00:26 about skeletal injuries during the next half an hour.
00:29 We hope you will be able to join us, and that you will get a
00:33 blessing from what we teach you.
00:56 Welcome to "Help Yourself to Health"
00:58 with Dr. Agatha Thrash of Uchee Pines Institute
01:02 And now, here's your host, Dr. Thrash
01:06 I've never had a serious skeletal injury
01:10 ...although I've been very active all of my life.
01:12 I have been able to help other people, however,
01:16 who do have skeletal problems, to get relief of pain
01:21 and to have the opportunity to see themselves healed
01:25 by just the most simple things that one can do.
01:29 Now these kinds of things, skeletal problems,
01:34 fall in the realm of physiatry.
01:37 And a t Uchee Pines, we have a physiatrist on our staff...
01:40 and that's Dr. Winn Horsley.
01:42 And I've asked him to join me today so that we can
01:45 talk with you about some of the very simple things
01:49 that you can do in the home to relieve skeletal pain.
01:53 So we have some of our other helpers here...
01:58 One is Shannon Jenkins, just come right on here and
02:03 you're going to show us... or we're going to show on you
02:06 how to take care of the hip... hip pain.
02:10 Yes, now usually this wouldn't be in a young woman
02:13 Generally, this is much more common in people after 50, 60.
02:20 We're talking about the problem of osteoarthritis.
02:24 The gradual degeneration of cartilage that happens
02:28 through the years.
02:29 Doctors that look at this... that look at the joints
02:33 of the body, that's the radiologist,
02:35 say that someone, by the time they are 60 years old,
02:39 if you let them look at enough of their joints,
02:41 100% of the people will show evidence of osteoarthritis.
02:44 So, that means that the person is going to start
02:48 to notice what's going on...
02:49 It will be perhaps painful, and definitely limited.
02:52 Painful fingers... That's right. Painful hips... That's it.
02:55 Painful knees and painful feet...
02:57 I've heard those complaints hundreds of times...
03:00 and I always thank the Lord that I don't yet have those...
03:03 and I'm so grateful.
03:05 Well, in the hip, the person will begin to notice it walking.
03:10 Of course, it's when we're walking that you put your
03:11 pressure and you expect movement in the hip
03:14 So, if that occurs, one simple thing...
03:19 And it's certainly worthwhile to try... is a cane.
03:22 If you put the cane down right when you're putting that
03:27 foot of the painful leg, the painful hip on the ground,
03:30 Then you are helping to bear that weight.
03:34 It's not so much just the force...
03:36 By the way, you carry a cane on the opposite side in general,
03:39 to the painful side.
03:40 I already had it in my hand... the painful side,
03:44 so when I saw that you had it on the other side,
03:46 I shifted there... Okay
03:48 When every time a person takes a step, what holds your body
03:53 so that you can swing the other leg, is strong hip,
03:56 we call them abductor muscles.
03:58 Strong muscles out here that hold the body up
04:00 ...otherwise, the person would be falling over, like this
04:02 with every step... falling to one side and then the other side
04:05 Well this muscle holds it up...
04:07 BUT, at the same time, it's putting that much more force
04:09 through the hip joint... I see
04:11 So if the joint has degenerated, then you're applying perhaps
04:15 3 times body weight through the hip.
04:17 By degenerated, you mean that this cartilage part here...
04:23 ...the part that covers...
04:25 We don't actually have a model here of the cartilage itself
04:30 It would be a layer... oh, 1/4 of an inch,
04:33 or maybe even more, thick covering this head and giving
04:38 a socket for this head of the thigh bone, femur to fit into.
04:44 Is there cartilage also in the socket,
04:47 or just on the head of the femur?
04:49 Well, it's in-between the 2 bones,
04:51 BUT, actually a layer of this bone is cartilage
04:57 and a layer of the pelvic bone is cartilage,
04:59 so you've got 3 layers of cartilage needing each other.
05:02 So if it gets degenerated, it may be in several places?
05:05 That's true... and you may have a lot of debris.
05:09 Just little pieces... little pieces, or even just junky sand
05:16 Well, a cane like that really can give some relief.
05:21 But most people aren't aware that there's a simple procedure
05:25 that helps sort of push that material back into place
05:30 And if you get it into place, and rest it a while...
05:33 perhaps it kind of glues a little bit together too.
05:36 It's a simple traction maneuver and so...
05:40 I think we should try and do it right here... All right
05:42 Very good... Yes, I'm glad that Shannon has agreed to be
05:47 helpful in this way.
05:48 So we'll just have her lie down here and
05:51 you tell me what to do. Okay!
05:53 Now we're going to be pulling her leg, not to fool her,
05:58 but to literally pull her leg...
06:01 And when we do this, we do it with enough force so that she
06:04 would just be pulled right off here, or even off a bed.
06:06 Now, we've already seen how easily you can slip here,
06:08 so Shannon is putting her arms at the back of the table
06:13 there to hold herself from being pulled off. Okay.
06:15 Dr. Agatha... Yes... you want your leg to be
06:18 loose so the knee and the hip are just as loose as can be.
06:21 You don't apply any force there, and that's the way...
06:24 You grab behind the knee, and perhaps a little further up
06:26 with this arm, and now start some pulling force
06:29 right in the direction that the thigh is in.
06:32 And, good... are you feeling it, Shannon? Um hm
06:35 Okay! And considerable force can be
06:38 applied like this 50 or even 100 pounds.
06:40 I know you won't want to stay there too long... It's 130!
06:44 Okay, well that gives you the idea.
06:47 To do that for about a minute?
06:49 Yes, if you can do that for a minute...
06:50 I've done it a number of times for... well, I never did watch
06:54 my watch, but I would say 1/2 a minute to a minute or
06:57 I'm sure it wasn't more that 2 minutes.
07:00 I'll do it for a while, and then stop and then do it again.
07:02 And people that get help with this, that's a good number
07:07 ...will say that it gives them relief hours and sometimes
07:11 a day or 2... In fact, I think even longer I've seen at times
07:14 So it's certainly worth a try.
07:16 People can have surgery put off for quite a while
07:21 just by a simple maneuver like that.
07:23 Now I felt as if I were actually putting a little suction
07:32 almost on her hip joint... Was that actually happening?
07:35 I think that it literally true.
07:38 We don't have here, in visual form,
07:43 what actually is around here.
07:44 There's a whole joint capsule... Ah ha
07:47 You mean, in addition to this part, there is also...
07:51 It's like it encases the whole joint.
07:53 This is not the cartilage, it's an actual capsule.
07:57 Ligaments and tendons...
07:58 The ligaments would be like thickenings of the capsule.
08:01 But that capsule is what separates the hip joint
08:05 from the rest of the body.
08:06 So when you put that traction on you're stretching the capsule
08:09 ...and sort of pulling the things in towards the center
08:12 of the joint. Um hm
08:13 Now, I think you DID this but I think it's worth saying it...
08:15 just for anyone that's watching...
08:18 That this is not just a matter of pulling because if Shannon
08:22 had tightened her muscles any,
08:24 all you're doing is pulling against muscles,
08:25 and we don't want to do that.
08:27 We want to really stretch the joint.
08:29 That's why you sort of jiggle it a little bit.
08:32 Jiggle it to make sure she has relaxed it... That's right.
08:35 ...While you're applying that force. Ah ha, yes.
08:38 I did a little bit to see if she was still relaxed
08:43 and she did very well.
08:44 Thank you so much... appreciate that!
08:47 And I have a little bit more appreciation for
08:50 the hip joint now, and for the debris that can accumulate
08:56 in there... and so the idea is to bring that debris
09:01 to the center, so that it won't be here where the
09:05 major part of the pressure is going to be.
09:06 You know, I think what often happens when you've gotten
09:10 that cartilage worn down thin and made into debris,
09:14 that it goes out into the folds of the capsule
09:18 where it's not really functioning...
09:19 It's not between the 2 bones.
09:21 When you PULL like this, the capsule tightens up and it
09:24 pushes these things back up... That's it
09:27 That's very good, and you can get pain relief then for
09:31 a long time, or?
09:33 I don't want to say that routinely, you'll get it
09:35 for days and days, but we've seen people where
09:41 they'll get it... Well I've heard therapists
09:43 tell me that quite often, a day or 2 and perhaps several days,
09:47 I think I've seen people where it will last up to
09:49 a week or so.
09:50 People are very happy with this simple maneuver
09:53 and so then they don't have to be taking drugs and so on.
09:57 Well that's good and, considering the fact that
10:00 a drug which might be harmful to us, might not last
10:06 more than 3 or 4 hours also... That's routine
10:09 is pretty respectable pain relief. Um hm
10:11 Now, this is a model of the knee.
10:14 What kind of problems can we get?
10:17 Every time I kneel to pray, I thank the Lord that I
10:21 don't have pain and have a knee that will still work.
10:26 If you do a lot of kneeling, like someone doing floors,
10:31 there is a bursa that they can compress here below
10:38 along here on the patellar tendon, as it is called.
10:41 By the way, these white, tough structures
10:47 are the ligaments of the knee...
10:48 And I should call this one a tendon because
10:52 because this actually connects to a muscle here
10:55 But these ones are ligaments.
10:57 Well there are a number of injuries...
10:59 In fact, we're simplifying all along.
11:01 There is not just one injury at any one joint
11:03 but, at the knee, you have plenty of things
11:07 that could happen.
11:08 Perhaps it's worth mentioning that one of the most common
11:14 type of injuries to the knee would be from sports.
11:17 I think many people will have heard of sports people...
11:23 football players injuring their meniscus.
11:26 And, when you're talking about meniscus, we're just talking
11:29 about one of those cartilage structures again.
11:31 Now at the knee, here you can see it...
11:35 It's the white in-between the bones here.
11:37 This is cartilage.
11:39 And, the thing about cartilage that is unique is...
11:45 It is the only tissue in the body that has no blood flow.
11:48 I better correct that... The cornea doesn't have any either.
11:52 But, the cartilage, you have a fair sized..
11:57 I mean a lot more tissue than in the cornea.
12:00 And, its nutrition has to come from whatever bit of fluid
12:04 that came from blood flow, but now not has blood flow,
12:08 just seeping into the cartilage to maintain it.
12:10 And if you injure that cartilage ... because you don't have
12:13 that rich supply the blood gives to other tissues,
12:16 it's very difficult to heal.
12:18 It takes an AGE to get it to heal.
12:21 It does, and often it doesn't do well, even getting
12:26 any kind of healing...
12:28 And so, what's routinely done, when one of those meniscus
12:32 injuries happens to the knee, is they will
12:34 go head and do surgery and take out a piece...
12:37 Take out the entire meniscus?
12:39 That, or take out the torn part anyway...
12:43 And it's really... Yes, it will take away their symptoms,
12:47 but the person will not be 100% because as time goes on,
12:54 see, this was part of the weightbearing
12:57 structure of the joint.
12:58 They now don't have part of it and this joint will develop
13:02 degenerative changes, osteoarthritis,
13:04 sooner than a normal knee.
13:06 Is there some kind of little prosthesis or something
13:12 they could put in there artificial?
13:13 You know, one would think that...
13:15 For instance, in the back, the biggest pieces of cartilage
13:18 in the body are the disks there.
13:20 Well, couldn't one just put in something that would
13:22 take the place of that disk?
13:24 It's been tried, but I haven't heard a whole lot of follow-up
13:28 This has been mentioned years and years ago.
13:30 When you don't hear a whole lot, it let's you know
13:32 ...probably it was a failure.
13:35 Well, in sports injuries, you often, in addition to the
13:42 meniscus getting injured, often you do injure one of
13:46 the major ligaments.
13:47 On the knee, this knee... let's see, is a right knee
13:53 This extra little bone is on the outside of the knee.
13:57 And what happens, for instance, football, they'll attack
14:01 of course, from the side, and when they do that,
14:05 they may damage... you'll be putting a force like this
14:12 They may damage this meniscus but you may, at the same time,
14:15 damage the ligament way out here by stretching it.
14:17 You pull this way. That's right. You're pulling this way.
14:20 And so, it can be a bad sprain.
14:23 This ligament, as well as the outside one, are
14:26 called "collateral ligaments. "
14:27 This would be the medial collateral ligament.
14:29 Well, treating sprains is something that's worth
14:35 talking about for a little bit. Okay.
14:37 Maybe we can talk about the most common sprain in the body.
14:41 And that's a sprained ankle.
14:44 Yes, I've had one of those.
14:46 There's an ankle... Okay.
14:49 Well, which way do people get sprains on their ankle?
14:52 They get it from twisting their foot.
14:54 And which way do people twist their foot?
14:58 Well, I can tell you the common way is that the foot is
15:03 turned in and you come down hard here.
15:06 Now this skeletal model doesn't have on
15:09 the ligaments like this did.
15:11 But, just like in the knee here,
15:13 you have ligaments on both sides.
15:16 So you have strong ligaments here along the outside,
15:19 or as we say in medicine, the lateral aspect of the ankle.
15:22 And, you have other strong ligaments on the
15:24 medial side, the inside.
15:26 Since we're talking about twisting the foot this way,
15:31 it's the outside of the ankle that most commonly
15:34 gets rather badly sprained.
15:36 Now I did this one time, doing some running on the spot.
15:40 And I think it was a paying-me-back for being
15:50 a little bit show-offy to a fellow that was a
15:53 smoker and I was trying to show him how much
15:54 nonsmokers can do, you see.
15:56 But there I went and sprained my ankle rather badly.
16:01 And, by the time I had calmed down enough to look closely
16:04 at the ankle, it had swollen to about twice
16:07 the size of the other ankle.
16:08 And I, right away, did what really is part of a reasonable
16:13 treatment approach for acute sprains.
16:18 Maybe we could write this up on the board. All right.
16:22 There is a nice little memory device for this...
16:28 It's the letters... R I C E
16:40 The "R" stands for REST... Well, that's kind of obvious.
16:47 You want to let the part rest, and yet some people
16:52 will push on... especially in sports.
16:55 People will just push right on against pain.
16:58 And, no, we need to learn that that pain is there...
17:02 It's God's signal to us that something's gone wrong.
17:04 You need to rest it.
17:06 The "I" stands for the same as the rest of the word...
17:08 It's ICE... Now it doesn't have to be ice that applies the cold
17:14 You can use other things, but something
17:17 that will apply cold to the joint.
17:18 The "C" stands for COMPRESSION
17:26 And the "E" stands for ELEVATION
17:33 Elevation I've seen used quite routinely after hand surgery.
17:41 They do the surgery and surgery of course, is inflicting wounds
17:44 And, after any wound, you'll get inflammation.
17:49 And just so it isn't excessive, they'll raise the hand...
17:53 have the person's hand up some.
17:55 Well, I had just injured my ankle, and I didn't want
18:02 to fool around with ice... that seemed too bothersome to me
18:05 And I wasn't anxious to rest either, I had some things to do
18:07 where I was visiting a city where this happened.
18:11 So, I zeroed in on compression as my treatment means.
18:16 And yours was this kind of injury... It was, that's right
18:21 And so, compression, I know you're going to use this
18:24 I actually used something similar... it's Ace wrap
18:28 which I'm sure many viewers have seen... that tan-colored
18:32 sort of elastic wrap... This is more rubbery material
18:35 but the same idea.
18:37 And so this was wrapped around.
18:39 I don't think we'll do a whole demonstration here of this,
18:44 but you can see the idea... you wrap around several times
18:48 You wrap it snug but obviously, you don't do it
18:50 so tightly that you're going to be...
18:51 I've heard that you start all the way down here at the bottom
18:54 Well, you might, although when you're not going to apply
19:01 a whole lot of pressure...
19:02 It isn't bad to do it moderately snug up here.
19:08 Now, you always want to check on the status of the circulation
19:13 and of nerves.
19:15 Orthopedic surgeons, when they come and check patients,
19:17 after they've operated and any injury, they always talk
19:22 about the NV status... neurovascular status of the limb
19:25 ...so you go down and check the toes
19:27 and see if their color is good and so on.
19:29 If you're going to apply a major amount of pressure,
19:32 it's exactly like you said, you should start
19:34 down at the toes and actually decrease the pressure as you
19:38 come up... I see
19:39 But here, you want a moderate amount, not a lot of pressure
19:42 That's right. A moderate amount just on the sprained part.
19:45 You know, I didn't need a whole lot of pressure.
19:47 The effect was really quite dramatic.
19:49 I put it on and, maybe half an hour later,
19:54 I took it off just to see, and it was right down to
19:56 pretty much the same size as the other ankle;
19:58 whereas it had been VERY swollen.
20:00 So the compression DOES really act against that swelling.
20:05 Now to me, a very interesting thing about this...
20:11 was what happened a few years later.
20:13 Now, I got over the acute problem and was walking around
20:18 after limping for a few days, but I noticed that at times,
20:24 that the ankle wasn't very strong.
20:26 I went to a conference put on by osteopaths
20:31 at one of their schools up in Michigan, and
20:35 it was an excellent presentation in which they presented
20:38 manual treatment of joints.
20:40 And there, they gave the diagram of the ankle
20:43 and then they immediately had us pair off to treat...
20:46 work with each other...
20:47 And the man that worked on my ankle, he right away said...
20:51 "What's wrong? This is a sloppy joint"
20:54 And it then occurred to me... that this sprain
20:58 had left my joints weak...
21:01 And I can't help but think that I was, even without applying
21:05 any terrible pressure, I was counteracting with this
21:08 compression, the natural inflammatory response of the
21:12 body for healing... Yes
21:13 So it didn't get as firm a healing as you should have
21:19 gotten... That's right.
21:21 You know, you look at these...
21:24 Here I am wanting to avoid all the drugs and when I see
21:28 treatments that are not drug- based... I think, great!
21:30 These are the ones I can use.
21:32 But you know, it teaches us that we really have to be
21:35 rational... We really have to think carefully about what we do
21:38 Think about the physiology of the thing involved. That's right
21:42 Very good... Well, I'm happy for this explanation of sprain.
21:47 And, you mentioned about a bursa under the knee that
21:51 people like carpet-layers and others who kneel a lot
21:55 might get... How would you treat a bursitis?
21:58 A bursitis pretty near anywhere, a standard treatment
22:04 would, in fact, be injections and injections of steroid
22:08 which cut OUT that whole inflammatory process.
22:11 Now if the inflammation has carried on for quite a while,
22:18 the pain that's rather bothersome, then I think
22:22 a reasonable approach would be to try some cold.
22:26 And I've seen how this can often give relief that isn't
22:30 just for the time of cold, but it can give relief
22:32 that will be rather long-lasting ... That sounds good.
22:36 Now another thing that I would like to bring up is
22:39 that of plantar fasciitis.
22:42 And I've had plantar fasciitis in my family...
22:46 And one of the things that we have used for that
22:50 has been these little heel cups.
22:53 Sometimes some people get a little benefit from that.
22:56 But I think most of the time, they have not gotten
22:59 a LOT of benefit from the heel cups for plantar fasciitis.
23:04 How would you treat plantar fasciitis?
23:07 Well, plantar fasciitis is worth explaining a little further.
23:14 We've got our skeleton here with the foot.
23:18 Plantar means on the sole of the foot.
23:22 This is the palm of the hand, palmar.
23:25 And plantar is the sole of the foot.
23:27 And it is... the plantar fascia is a whole sheet of strong
23:33 connective tissue running from these bones,
23:38 at the base of the toes... Right here just at this point?
23:42 I would say along in here, sort of behind this
23:45 joint where the toes start. Um hm
23:47 Running along here and coming back and attaching
23:51 to the heel bone.
23:52 So they sort of attach to the undersurface of these bones
23:56 That's right... Right here at the beginning
23:58 of the toes and go all the way back to the heel.. That's right!
24:03 And in my experience, in fact, just by the pain
24:09 of plantar fasciitis, it seems to me like they attach
24:12 very much right to the point of the heel.
24:14 So, to explain the function of that... that's what keeps a foot
24:20 in kind of an arched position and gives a spring to the foot
24:24 I see... so it's not just there for insulation
24:27 It there actually for support. Absolutely!
24:30 And what happens, as people get older, there's a tendency
24:39 for this strong connective tissue coming in and attaching
24:43 to the bone... to start loosening.
24:45 Like a ligament being pulled away from the bone
24:50 And what can happen then, it can actually cause
24:54 some extra bone formation, a spur forms there
24:58 And people often talk about a heel spur and how it's painful.
25:02 Well it can be painful without the spur.
25:03 And sometimes the people that have the spur don't
25:05 have pain, so those of us that work with it
25:08 a fair bit, tell the people... don't worry about the spur
25:11 What's much more diagnostic is what happens when you
25:15 press on the area. Um hm
25:16 So if you press right around here,
25:19 usually just about at the point of the heel,
25:23 if they don't jump a bit in their chair,
25:26 then they probably don't have plantar fasciitis... I see
25:29 So the pain then of plantar fasciitis is right in here
25:33 Yes, it can radiate.
25:35 Some people have it even towards the forefoot but much more
25:37 commonly, it's right here by, or right on the heel.
25:40 The plantar fasciitis that I've had in my family,
25:44 when they would put the foot down; say, after they've been
25:49 sitting in a chair and they stood up, or when they've
25:52 been in bed and they stood up... A sudden sharp pain!
25:54 ...A sudden sharp pain
25:56 It was bad enough they couldn't walk.
25:58 That is absolutely typical.
26:00 It's when it's been resting, and THEN you put the
26:02 weight on it, that it REALLY cries out.
26:04 A lot of treatments have been tried.
26:08 These kind of heel cups is just one of many various
26:15 foot supports, orthoses, things that will apply
26:23 pressure here in the plantar fascia and
26:28 high heels even have been tried.
26:31 And all these various things... it's kind of difficult to
26:34 really get good relief.
26:37 One of the things that we tried was having the person
26:42 stand against a wall and lean into it with the heels
26:45 flat on the floor which would stretch the backs of the legs
26:49 and, hopefully, stretch the plantar fascia...
26:53 Do you think that would work?
26:54 Yes, that is probably the most useful treatment
26:57 that's noninvasive... is to stretch those heel cords
27:00 this muscle and the tendon and also it stretches the
27:04 plantar fascia when you have the foot behind you
27:09 and then also doing toe-rises... Oh yes
27:11 Doing toe-rises may be helpful.
27:15 We found also that putting this red pepper extract
27:20 Oh... just Zostrix... Ah ha... Zostrix which you
27:23 can buy at a drugstore.
27:24 We just paint that on the bottom of the foot 6 times a day
27:27 And then after they got pain relief, then once or twice a day
27:33 from then on and sometimes they get pain relief for
27:36 a LONG time.
27:37 Well, we have by no means, covered the entire gamut
27:41 of skeletal problems in the lower extremity
27:46 But what we have covered, we hope will be a
27:48 great blessing to you.
27:49 We hope that you and your family will receive
27:53 and eternal blessing from these very simple things.