Ejoneshunt,
There is a major drug interaction with Wellbutrin and Adderall. Not to mention a milder one with the Xanax.
Wellbutrin is not only an SSRI but also blocks the reuptake of norepinephrine. Adderall causes more norepinephrine to be released. When used together its like plugging the drain and then turning the faucet on full blast. It doesn’t take long for the nerves to be bombarded. All sorts of problems can develop.
I had a patient, a 17 year old girl that was on both of these meds and they caused her significant problems. I printed off the list of side effects (she had damn near every one) from the clinical pharmacology website and showed her mom, who then took her to her doc that prescribed them and he pulled her off them immediately.
Actually he was dumb to pull her off like he did, you really need to taper down to avoid a whole list of other problems.
Your friend should talk with his pharmacist and doctor. They need to know what is going on with him.
I hope everything works out.
Take care,
Ryan
yustas,
I haven’t seen the info you are referring to. If you have a reference,I would be glad to take a look at it and try to dig up some more info.
I know GLA can have some benefits in and of itself. Higher levels of it are found in evening primrose oil and borage oil.
Take care,
Ryan
Garboth,
Actually, getting treated before would be best. If the joints are restricted and the muscles are tight, then you may be more prone to injury due to the altered biomechanics.
I would wait at least 30-60 minutes before doing any significant heavy lifting after the adjustment since there will be a transient hypermobility following the adjustment.
This is also why you shouldn’t roll your head, neck around right after your adjusted.
Regarding adjustments lasting longer, I usually give my patient’s a home stretching program, modify any of there activities that could perpetuate the problem and give them rehab exercises to increase the strength and endurance of the supporting muscles etc.
Take care,
Ryan
JNeves
I would suggest that you find someone that can do some myofascial (active) release on the area. That would help to breakup any adhesions or contracture from the injury.
Doing a hip flexor stretch from a lunge position works well to stretch the area out. Get down in a lunge position, tuck your pelvis and then glide your whole body forward. Don’t allow your upper body to lean forward. To increase the stretch further reach over head and then lean your upper body away from the leg that is down.
Hopefully that is clear, unfortunately I don’t have a picture I can post at this time. If you don’t understand, PM me and I can try to scan in a picture later.
To strengthen the area, hanging leg raises will help. If your gym has one of those multi-hip machines, you can do a few sets of hip flexion exercises on it. If not cables and bands can be used. You just want to focus on driving the leg up. Balance them out with some hip extension exercises. Check the site for info on pull-throughs with a low cable. The hip drive with that exercise should help with your squats and deads.
Take care,
Ryan
Yeah the crazy thing is this is his doctor who prescribed him this, i was trying to see if could get him to go to see a psychiatrist where can get tested for ADD and depression but he did try to kill himself many yrs ago and has come a long way, the ADD runs in his family,his brother has adhd; I have also hear that both depression and ADD coexist with each other, do you think it would be ok to get off the antidepressant,taper it off i think he tapered it off before and had to get back on it.
just recently he was diagnosed with the Adult ADD, so hasnt been on the Adderall long and stay on the adderall, and since the zanax isnt taken very often, i think its so crazy that the doctor knows everything he is taking,but he does have the panic attacks; some doctors can be so dumb im sorry didnt mean to insult you but ive seen this doctor prescribe some crazy things for my friend, thnx for the advice
Yeah i know hes not addicted to the zanax or hardly takes it so the milder interaction wouldnt affect him i dont think
yustas,
Upon further review…
I found a study, Am J Clin Nutr. 2003 Jan:77(1); 37-42., that looked into the relationship of supplementing with Fish oils and GLA and measured the response on blood lipids.
The two metabolic pathways utilized by these oils are competitive in nature and utilizing too much of one at the exclusion of the other can result in unwanted effects.
The study used different levels of each oil and compared results.
The 4g EPA/DHA 2g GLA group seemed to have the best result.
There is a link to the free full text article.
Take care,
Ryan
I’m way behind in getting this question in, maybe you could answer at your convenience. I’m only on the computer when I find the time.
I’ve made attempts to find an answer to this question, but haven’t been successful.
I’ve been working out for years, but hooked up with a trainer about 6 years ago who urged me to begin lifting heavy weights, which I’ve been doing consistently 4 days a week ever since.
About three years ago, I began to have chronic shoulder pain. Not, severe, just a nagging shoulder on the right. Surprisingly, it usually didn’t “hurt” when I was doing a workout, so I continued to workout just the same. I worked the rotator cuff exercises, and concentrated in working the back, chest, and front a rear shoulder area equally. Eventually, the shoulders stopped hurting, and for the last couple of years, I’ve been lucky enough to work injury free.
A long way to get to my question: For the last year or so, I’ve noticed that my right shoulder is developed differently than my left. It is shaped differently, and appears to be lower than my left shoulder. For this reason, I’ve also worked the shoulders, chest and back with a lot of unilateral exercises. A friend of mine, who has a degree in kinesiology , claims that having worked through a painful shoulder caused me to subconsciouly work them unequally , and has caused an asymmetry.
He suggested I visit a chiropractor, who will be able to help.
Does this sound like a good plan?
Thanks.
Rebecca,
Without seeing what you are describing, it is hard for me to tell you what exactly could be the problem.
I would say the degree of the asymmetry would be the determining factor on whether or not it could be a problem.
It is common for the shoulder/arm of the dominant arm to hang a little lower than the opposite side because the joint capsule is looser/more flexible .
There are other things that can cause this and you can definitely have it checked to rule these out. It should be a pretty straight forward evaluation. Assess posture, muscle tone/strength. Evaluate biomechanics of surrounding area. If you have full strength without any apparent imbalance and a full pain free ROM and negative orthopedic tests, it shouldn’t be a problem.
Just make sure that you find a good chiropractor, one that treats athletes and does myofascial work and rehab. Don’t go to one that thinks the sun rises and sets based on a minor asymmetry and then presribes 6 months of treatment to correct it. I hate those assholes.(Of course if I get to the pearly gates and St. Peter doesn’t let me in because one shoulder is higher than the other, I’m really going to be pissed!)
If you have any other questions, let me know.
Take care,
Ryan
Dr. Ryan
I had an MRI done and found that I had a “grade IV chondromalacia of the patella”
I do squats, but was wondering if maybe this is not a good idea?(No pain when doing this)
Is there any activities that I should avoid; running; step class; yoga; football (flag)?
What can I do to help strenghten or help my condition?
Should I be taking any supplements ie;
Msm/glucosamine?
Thanks in Advance
I have two protruding discs between L4-5 and L7-8. I think I have had them for over 15 years due to a surfing accident. I never really had a problem with them other than some general discomfort. Recently I have had some pain when doing standing curls or overhead presses. How hard should I be pushing these injured disks?
Dr. Ryan,
Last week, on Monday, I was doing bent-over-rows when I felt a subtle twinge in my lower back, just above the hips. Like an idiot I kept going. When I was showering afterward I put really cold water on it for two minutes. That’s it.
For the rest of the day I felt very, very minor soreness, more noticable when I bent over.
Tuesday the pain was gone.
Wednesday I skipped deadlifts but did front squats with no problems.
Fast forward to today when I tried deadlifts again. Went fine at first but eventually felt very slight twinging in between reps so I stopped early. No real back pain after the workout. Bending over and picking up stuff does not hurt, even if it’s sort of heavy. But if I arch my lower back and flex it (like with my stomach stuck out), it hurts on only the left side.
Seems like something really minor but I want to nip this at the bud. Any advice?
Thanks.
Spiderfan,
A lot would depend on what area of the patella was affected. The medial or lateral side. It occurs more commonly on the medial side.
Also, what are your symptoms? Usually activities like full squatting or going up/down stairs will bother it.
Most commonly it is due to poor patellar tracking and chronic overuse.
What kind of activities are you currently doing?
What kind of symptoms do you have a few hours after or the day after performing these exercises?
The step class could be a problem.
Squatting can cause issues, but sometimes can be worked around as long as you aren’t doing real heavy or sign. high volume.
Usually a good stretching program (lateral knee most sign.),patella mobilisation exercises and some VMO strengthening will help improve tracking of the patella.
I would definitely suggest that you use 1500-2000 mg of glucosamine sulfate a day. MSM can be beneficial as well as some herbal products containing curcurmin and boswelia. I would suggest fish oil 3-6g/day for its anti-infl. properties.
Let me know if you have any question.
Take care,
Ryan
Conanspeaks,
I’ll bet you a case of Carbolin 19 that you do not have a protrusion of your L7-8 disc (There’s only 5 lumbar vertebrae)
It’s probably L4-5 L5-S1.
Once a disc is injured, it will never be healed good as new, but ~75% of disc problems heal and then often result in some episodic pain over the years depending on your activities, etc. ~20% gradually get worse with time and ~5% worsen dramatically to the point that surgical intervention may become necessary at some point.
It’s hard to tell you how hard you can stress them, other than to say that during every exercise or daily activity, make every attempt to keep your back in a position that puts less strain and compression on them.
Not knowing your age and given the 15 year history, it is hard to know exactly what the anatomy looks like down there. How much degenerative change is presnt at those levels and to what degree they are protruding are important factors.
Usually disc problems/pain increase with bending or lumbar spine flexion. which is why you see so much being written about maintaining the lumbar lordosis throughout your activities, as that will decrease disc stress.
The position you describe with curls and OH presses, suggests that extension may be causing you some pain, in which case facet joint problems and spinal erector muscle problems should be ruled out as well.
I would suggest that you get checked out and treated by a good chiro or PT. They need to assess how your back responds to different positions/loading parameters etc. In addition, they should get you doing some specific Lsp strength/endurance stabilization exercises.
Let me know if you have any follow-up questions.
I am working on an article dealing with LBP and rehab. Hopefully I will get it done soon.
Take care,
Ryan
NateN,
Without examining you its hard to say what exactly you injured.
Bent-Rows, depending on the degree to which you were bent and how much flexion you had in your lumbar spine, places a great deal of stress on the ligamentous support and discs. If you weren’t bent over real far, spinal erectors withstand a large load.
Fortunately what you are decribing doesn’t sound like a classic disc injury.
You would think that if you strained a muscle significantly then you would get pain during the movement as opposed to in between reps. You probably mildly strained a ligament possibly a band of the iliolumbar lig.
I would avoid the offending exercise for 7-10 days and then start back with a less weight and volume. Make sure to warm-up prior to performing theses exercises and squats as well. Stretch the enitire lower extremity kinetic chain to make sure that you can maintain proper form throughout the movements. Make sure to ice down the area following any activity.
If the area continues to bother you, find a good chiropractor or PT in your area.
Let me know if you have any questions.
Take care,
Ryan
[quote]Dr. Ryan wrote:
The Indestructible,
What kind of symptoms are you having?
Where is the pain located?
If it is in the back, off center and possibly running around the side, then you might have some irritation to the costotranverse or costovertebral joint.
These can be very painful and give you pain with the movements that you mention.
If that is the case, then I would find a good chiropractor in your area, one that treats sports injuries and is used to dealing with athletes. Adjusting the area will often help relieve the problem, and then stretches and postural relief activities can be used to help keep it from getting reaggravated.
What kind of positions are you in all day? If you sit or do a lot of desk work, check out the “Get on a Roll” Cool Tip in the archives and use the towel roll when you sit. This helps to take some of the pressure off the T-spine/rib area.
Let me know what symptoms you have and I will give you more info.
Take care,
Ryan
[/quote]
Thanks for the tips, Dr Ryan. The pain is a deep aching sensation, and as I mentioned, I only feel it during certain movements. It is located about half an inch to the left left of the vertical midpoint of my sternum.
I plan on seeing a chiropractor/ART practitioner soon, and I’m taking my new towel roller to work tomorrow. In the meantime, I guess my next question is this: I did a search for costochondritis on the forums here, and one post said that weight-training can actually accelerate the healing process. I’m not very familiar with how weight-training affects cartilage (injured or healthy), so I’m curious as to your thoughts on weight-training’s effects on injured cartilage. Is it just a matter of increased blood flow? Or are other factors involved?
Thanks!