What kind of doctor for the whole body?

October 15, 2013 2:22 PM

For the past few years I have been giving myself tendon injuries in quite a few of my joints... elbow's, knee's, and achilles mostly. I'm been slowly becoming more active for several years now, following an achilles injury that didn't quite heal up for 4 or 5 years. In my late 30's... I know, I'm shedding quite a bit of my invincibility at a steady rate now. As I said, I keep hurting myself. Mostly when I ramp-up the rigor, or try something slightly different at the gym. I have a pretty long and gentle warm-up and stretching routine, I don't think I really go for an increase too quickly, and only work out every other day or so... but various tendons disagree, at different times, and for different reasons. Based on the frequency and degree of pain/discomfort/etc, and how careful I am about not doing too much too quickly, I think frequency of injuries are out of the norm. Here's the nut of what I really want to know: What’s the best kind of doctor (already tried my GP) to see about this? It's hampering some of my hobbies and reasonable ambitions quite a lot, so I want to start finding more aggressive help/tests/advise. Who can help from a whole body perspective? Yes to yoga, and learning all kinds of stretches. Looking for more than a PT at this point. Thanks all!
posted by shimmer to Health & Fitness (13 answers total)

Sounds like you need a Sports Medicine Doctor. They specialise in prevention and tratment of injuries from althetic activities. Are you in NYC? There are loads in both private and clinical practice in the city.
posted by DarlingBri at 2:28 PM on October 15, 2013

There is a specialty called Sports Medicine that sounds like a good fit for you. I don't know if they do private practice, you mostly hear about them being team doctors but maybe if you research that particular specialty you can find someone.
posted by rabbitrabbit at 2:28 PM on October 15, 2013

I would start at my GP (which you have), and ask for their recommendations on specialists -- I'm surprised that yours didn't recommend any specific next steps. In lieu of that, I would start with an orthopedist (especially a sports-oriented ortho), or a sports medicine doctor.

And, just from personal experience, if you have injuries, you may want to be careful with yoga -- my problems are more ligament than tendon-related, but 3 different orthopedists, unprompted, told me not to do yoga because it was more likely to help than hurt in my case, though none of them were against it yoga for most people (and, again, this was unprompted -- I don't do yoga and hadn't asked about it).
posted by brainmouse at 2:29 PM on October 15, 2013 [1 favorite]

In addition to the medical route, can you talk more about what's happening in the gym? Is that primarily where you injure yourself?

My #1 suggestion is Pilates. On a reformer, with a very competent trainer, once or twice a week. My guess is you have some core stability issues. Pilates, done properly, supports your body as you work on very small movements, core stability, and specifically targeted muscles. It also shows if you have some significant discrepancies between sides of your body or quad vs. glute strength.

When you injure yourself, what are you doing? Upping the weights? Doing a new movement? I'd also suggest getting a pack of 10 sessions with a competent trainer. Your posture or alignment could be way off.
posted by barnone at 2:42 PM on October 15, 2013

Yes to sports med! Ideally you will get some sessions with a physical therapist, who can show you the correct way to go about doing stuff, which is often a mystery to a lot of people.
posted by elizardbits at 2:51 PM on October 15, 2013

What worked for me was finally finding a physiotherapist that looked at my postural and structural issues as the base for all my "unrelated" injuries and pushed me into strength training to make up for the imbalances. You may really have to push for this. (It took me tearing my hip cartilage for me to really get the whole picture got looked at, unfortunately)
posted by lifethatihavenotlivedyet at 3:28 PM on October 15, 2013

I have had a lot of good experiences with physiotherapists. In my experience they have more of a holistic outlook than GPs but more biomechanical knowledge than, for example, yoga teachers. (I am not denigrating either GPs or yoga teachers.) I haven't seen a specific Sports Medicine doctor because my tendon injuries (elbows, knees, achilles - I feel your pain!) haven't been sports-related, but my current physio says if she reaches her limit with what she can do for my achilles, she'll refer me to one so that also seems like a good way to go.
posted by Athanassiel at 3:35 PM on October 15, 2013 [1 favorite]

Athletic therapist all the way (which I think is similar/the same as a sports medicine doctor). The physiotherapist couldn't do in six months what my AT accomplished in one.
posted by PuppetMcSockerson at 4:23 PM on October 15, 2013

I would also consider asking around for good trainers or gyms in your area when you are ready to resume your activities. They can make sure any good advice is kept up in practice. Some of your problems could be related to improper form? This is probably similar to what lifethatihavenotlivedyet is suggesting.
posted by Athanasius at 4:35 PM on October 15, 2013

get a referral for a integrative medical doctor. perhaps from you GP. their might be herbs and food that might help improve your body. also check in with a pt and i second a professional trainer as they would create a set of weight lifting and cardio that you can do. you don't need to keep going back. just get routine customize for you. ultimately you need to build up strength and muscle around the areas where you have pain. once the tendons and other muscles around them are stronger you will be better supported by your own body's infrastructure.
posted by Jewel98 at 7:27 PM on October 15, 2013

Response by poster: Thanks for the responses. To answer one of the questions... it is mostly with any new movements, or a new level on a machine that I have been using for a while. Also, I never know that there is trouble ahead until later on. I often need to guess what the offending exercise actually was.
posted by shimmer at 9:34 PM on October 15, 2013

As a dancer who knows bodies pretty well, I'll suggest Alexander technique. (also) I've had wonderful experiences with AT.

Feldenkrais is another body-approach in similar vein.

Try to distance yourself from the idea that "exercises" are what make or break your physical health. Mindfulness and a host of other subjective realities are just as important! I would also strongly encourage exploring expressive movement (various dance forms, pilates, yoga, tai chi.)
posted by an animate objects at 10:20 PM on October 15, 2013

Has your GP checked your vitamin levels? A D3 or B-vitamin deficiency can cause chronic tendon issues. I had a problem with a sore butt (I know, I know - but still, it felt like I had been kicked by a cartoon mule) that turned out to be tendon issues caused by not enough B-vitamins. The sub-lingual drops go nicely in diet lemonade.

I'd get the bloodwork done before hitting the health store to stock up.
posted by Slap*Happy at 6:44 AM on October 16, 2013