Graduation

With the sound of “Pomp and Circumstance” ringing in their ears, the graduates of 2013 will be marching up to the stage and on to their future. There is a sense of accomplishment, pride and even relief at graduations because the participants feel they have completed something important. Texas Back Institute congratulates every graduate!

With graduations, it seems as if something has concluded, when in fact the term “commencement” suggests a beginning. This idea of “conclusion vs. commencement” has of course been employed by more than one valedictorian in their one, final address to their esteemed classmates.

Traditions of Graduation

This is the time of year when seniors in high school and college who have completed their courses successfully are awarded diplomas. This tradition goes back to the 11th Century when medieval colleges in Paris and Bologna reportedly began this practice.

Over the centuries, the traditions have evolved and changed, but many have remained remarkably similar to the original ceremonies. The students, who were known as apprentices in these early graduations, learned skills from the masters of the crafts and to note this accomplishment, they were give a “testimonial of skill,” now known as a degree.

The song that most of us associate with graduation ceremonies – “Pomp and Circumstance” – is a relatively new wrinkle on this ancient celebration. It was written by Sir Edward Elgar and first performed in Liverpool, England in 1901. Its melody, a combination of solemnity and dogged determination, is the perfect accompaniment to purposeful marching of the soon-to-be graduates.

Another interesting graduation ceremony tradition involves the attire of the honored matriculates. The cap and gown, which is worn by students and (in some cases) faculty, was once called a “hood” and this is believed to be dated back to ancient Celtic Groups. Capes and hoods were worn by the Druid priests to symbolize their higher intelligence.

What’s Next?   

After the music finally stops, the mortar boards are tossed and the diplomas are filed away, what happens then? The graduate – of high school or college – must commence the next stage of his or her life. For many, this means getting more education and beginning the process of deciphering how to spend the rest of one’s life.

Texas Back Institute is internationally known for its state of the art treatment of neck and back injuries, back pain, scoliosis, artificial disc replacement, occupational and sports medicine and its exemplary physical therapy practice. However, for the past 27 years, Texas Back Institute, led by one of the organization’s founding partners, Dr. Richard Guyer, has offered a select group of medical school residents a remarkable opportunity – a one-year fellowship to focus on spine surgery.

To anyone talking with Dr. Guyer about the Texas Back Institute fellowship program, it is immediately obvious that he is just as enthusiastic as the young doctors who are chosen for the program. Much like the master craftsmen who trained the apprentices in earliest institutions of learning, there is a commitment to teaching these future surgeons that goes beyond cursory. The doctors who emerge from this program are changed forever.

With his interest in teaching, we thought Dr. Guyer might be a good source of advice for graduates of any level – high school, college or graduate school. Here is that conversation.

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What areas of medicine will be in high-demand in the coming years?

There are so many opportunities in medicine, especially if a young man or woman is interested in computers, science or engineering. We’ve all read that more and more kids are interested in business, finance or high technology, but the opportunities in medicine are exploding. For example, the latest high tech robotic surgery equipment is still directed by a human who is a trained physician and many of the best practitioners of this specialty were video gamers when they were kids. Genetic engineering is going to be a very hot area of medicine in the coming years and this specialty requires a very analytical mind which many youngsters who are good at math and science possess.

If someone is graduating from college and accepted to medical school, what types of specialization might they consider for spine surgery or other specialties offered by Texas Back Institute?

When I first started in medicine, young physicians would spend a couple of years in medical school before they decided which specialty interested them. Things have changed a lot since then and now that decision is often made when they are in college. The types of procedures we do at Texas Back Institute involve a wide range of medicine. We handle spine surgery for both children and adults. Our doctors deal with trauma surgery which would be required for automobile accidents and other accidents. We treat injuries that are the result of aging – wear and tear damage. We also have quite a few sports injuries that our physicians treat. So you can see there is a wide range of opportunities just in the spine area.

How did the Texas Back Institute Fellowship program come about?

I’ve found that when you teach students, you learn as much as they do and I loved teaching. In the mid 80s, I approached my colleagues here and shared my passion about teaching. I mentioned that I’d really like to build a fellowship program here for residents who wanted to specialize in spine surgery. Since our beginning in 1986, we have trained more than 100 fellows and I have been the chairman of this program for 27 years. This keeps me young and sharp! We work hard at sharing the latest research and techniques about spine surgery for these young doctors and for everyone on the Texas Back Institute staff it is very gratifying when that light bulb comes on over the head of these talented young people.

How does the TBI fellowship program work?

These doctors have been through medical school and have completed their residency program. They find us through the network of former TBI fellows and through the American Academy of Orthopedic Medicine. Once they are accepted to the fellowship program, they work with all of the surgeons on our staff. They get hands-on training in deformative and degenerative medical issues, trauma, tumors and disc replacement surgery.

What are the criteria that Texas Back Institute uses to recruit new physicians to the practice? Does completing your fellowship help in gaining a position?

The last 4 or 5 physicians that we have hired have gone through the Texas Back Institute Fellowship program, so that suggests that there is an advantage of going through this training. When we recruit new doctors for our team, we look for a young woman or man with a high degree of intelligence, an excellent bedside manner, his or her ability to synthesize a large amount of information and apply it to treatment and most importantly we look for integrity.

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From Left to Right: Dr. Rey Bosita, Dr. Rajesh Arakal, Dr. Jack Zigler, Dr. Jason Sparks (Fellow), Dr. Richard Guyer, Dr. Ralph Rashbaum, Dr. Troy Morrison (Fellow), Dr. Kirill Ilalov (Fellow), Dr. Michael Duffy, Dr. Kenny Edwards (Fellow), Dr. Andrew Block, and Dr. Dan Bradley.

Successfully completing a course of study and celebrating this accomplishment with friends and family is one of life’s great pleasures. As speakers who are chosen to impart wisdom to a group of graduates are fond of noting, this ceremony is not the conclusion, it is the beginning. Congratulations to every graduate and their families. Now, let’s get busy!

Memorial-Day

Lost in the sounds of jet skis roaring on the lake and delicious scents of family cookouts, is the real reason we Americans celebrate Memorial Day. The holiday was established to remember the men and women in the United States Armed Forces who have died while serving their country. Memorial Day is sometimes confused with Veterans Day, but the latter celebrates the service of all U.S. Military – living and dead.

The first Memorial Day was called “Decoration Day” and began during the U.S. Civil War (1861-1865) to commemorate the great loss of life that occurred within both the Northern and Southern armies. Following the Civil War, in 1865, the federal government began to establish military cemeteries to honor the fallen of the Union forces and these military burial grounds further encouraged a specific date for commemoration of these soldiers’ ultimate sacrifice.

Even before this first organized Memorial Day, there was a rural tradition of family members gathering at cemeteries on a Sunday during the late spring or early summer to remember their loved ones. Those who died in military service were given special attention and American flags were displayed on their graves. Some historians have noted the first date chosen for Memorial Day – May 30 – was chosen because this is a time when spring flowers are in full bloom.

Memorial Day became an official holiday over 100 years after it was first observed. On June 28, 1968, the United States Congress passed the Uniform Monday Holiday Act, which moved four holidays, including Memorial Day, from their traditional dates to a specified Monday in order to create a convenient three-day weekend. This moved Memorial Day from its traditional May 30 date to the last Monday in May.

Interestingly, some military veteran organizations, including the Veterans of Foreign Wars, have recently advocated a return of Memorial Day to May 30th.  These groups feel  including this observance as a part of a three-day holiday weekend – when the summer holiday typically begins – undermines the objective of the holiday. In 1987, the late U.S. Senator from Hawaii, Daniel Inouye, a man who was injured serving in World War II, introduced a measure to return Memorial Day to its original date. To date, there has been no vote on this measure.

What Can You Do This Memorial Day?

Anyone who has lost a friend or family member in military combat knows how helpless this feeling can be. Men and women serving in the military services are typically young and are just starting their lives and families. When they are killed in battle, the emotional effects are compounded by the practical, survival demands placed on their loved ones. We believe the best way to honor these heroes in the United States is to honor and assist the families they left behind.

This Memorial Day is an excellent time to consider contributing either funds or volunteer time to organizations that help the families of our fallen soldiers. To that end, we’ve identified a few organizations helping the families of wounded or deceased soldiers and have included links to their websites for your consideration. There are many more excellent organizations dedicated to helping the families of these American heroes and if you are aware of them and would prefer to support them, please do so.

Here are some organizations for you to consider supporting:

Carry the Load Dallas 2013 – You can donate to this organization online and/or join the 20-hour Memorial Day march on the Katy Trail, May 26 – 27. Click here to learn more about this organization’s plans for Memorial Day weekend.

Operation Homefront – You may have heard that this group, supported by singer Tim McGraw, is raising money to give mortgage-free homes to the families of soldiers killed in action.

Wounded Warrior Project – Sometimes coming home injured is even more traumatic for families than a death. This group helps those soldiers who are wounded in action.

Help the Children – This group offers military families assistance while the primary caregiver is serving our country.

Charles Ives’ Decoration Day

Because it commemorates the passing of so many men and women in combat, Memorial Day is a very contemplative and even sad occasion. However, this holiday and the sacrifices these heroes have made on our behalf have moved some artists to create something beautiful. Composer Charles Ives was one of these.

charles ives album

As the son of an U.S. Army bandleader during the Civil War, Ives spent many years honing his musical craft. He was a prominent church organist and composer of hymns and several symphonies. Most consider his A Symphony: New England Holidays to be his masterpiece. In this work, which took Ives 9 years to complete, he celebrated the American holidays including Memorial Day. Here is the movement of the symphony which is called “Decoration Day.”

Texas Back Institute wants to thank the men and women who have sacrificed their lives for our freedom.

iron-man-3-730x400The movie smash hit of the summer is Marvel’s Iron Man 3 and its popularity can be explained on several different levels. The “superhero” in this blockbuster flick is both physically and emotionally scarred, so in many ways, he’s just like you and me. Plus, the action and special effects are non-stop. This science fiction, where the lead character’s  human body part is replaced by an artificial part, is science fact at Texas Back Institute.  How so? Read on.

Artificial disc replacement, pioneered by several spine surgeons at Texas Back Institute, including Dr. Scott L. Blumenthal, is in many ways more futuristic than the suit of iron that brash-but-brilliant industrialist Tony Stark wears to heroic advantage in Iron Man 3. Before delving into the reasons for Stark’s angst and ultimate redemption, we asked Dr. Blumenthal to gives us some insights into the ways he and his colleagues are transforming patients in pain to Iron Men and Women.

Artificial Disc Replacement – Medical Fact not FantasyScott L. Blumenthal, M.D

In post-movie interviews fans of Iron Man 3 have said that one of their favorite aspects of the story is the blurring of science fiction and medical fact. Since you have taken a part of the body – the disc that cushions the spinal vertebra – and replaced it with one that is artificial and more durable, what are your thoughts about this advancement?

When I started in medical practice, we talked about the TV show The Six Million Dollar Man. For anyone younger than 30, this was a fictional story about a man who had been critically injured and had many of his organs, muscles and limbs replaced by much stronger artificial ones. At this point in medicine, this replacement of real with artificial body parts is becoming reality, not fantasy. For generations, spine surgeons have been fusing vertebra when the discs wear out or are damaged.  Our patients were constantly asking “Why can’t you just  replace it?” Well, after much development and testing, now we can. In patients who have back pain resulting from damaged disc we can replace it with one that is man-made.  My colleagues and I formed the Center for Disc Replacement and now the fantasy is going to be main stream medicine.

What enabled Texas Back Institute to be at the forefront of this procedure?

Our advantage came from our opportunity to do the FDA testing of this procedure here at our clinic. This procedure had been very popular in Europe for many years (before being considered in the U.S.) and many people with the resources to travel there, were getting the benefit of this technology by going over there. Because we were asked to assist in this testing, we were the first practice to be able develop protocols for the procedure. Our experience here far outweighed other physicians in this country. We started lumbar disc replacement and went on to cervical disc replacement. We discovered extensive evidence that strongly suggested artificial disc replacement speeded recovery, so our patients returned to work sooner. We found this procedure had better outcomes than fusion and the overall costs were less.

What brought about the development of the artificial disc?

It’s a combination of factors. There is substantial patient demand and the technology in the composition of the artificial discs is excellent and continues to get better than it was 12 years ago when we started. Plus, there is a measurable economic benefit to disc replacement as opposed to other procedures.

Do you mean there are economic benefits to patients in the form of cost vs. outcome?

Exactly. This is why the major insurance companies – not known for their investing in medical technology simply because it seems to be good technology – have decided to cover this procedure. They clearly have good data that proves the costs for artificial disc replacement are reasonable when outcomes, long-term recovery and the incidence of future problems are considered.

What other medical advancements – which may seem like science fiction now – do you see becoming medical fact in the immediate future?

I see stem cell therapy becoming an important new frontier for back surgery and specifically disc damage. Patients are looking for different, non-invasive ways to alleviate back pain and these stem cells – some harvested from the patients suffering from the pain – have the potential to change the way we treat damaged tissue.

Watch Dr. Blumenthal comment on technology and spinal care.


What Makes Iron Man 3 So Interesting?

As the advertising blurbs about Iron Man 3 note, “the movie pits brash-but-brilliant industrialist Tony Stark (also known as) Iron Man against an enemy whose reach knows no bounds. When Stark finds his personal world destroyed at his enemy’s hands, he embarks on a harrowing quest to find those responsible. This journey, at more »every turn, will test his mettle.” Whew! All that in about 2 hours!

As fans of the three movies know, the first of the Iron Man films revealed Stark as a clever, resourceful scientist-adventurer-tycoon who launched his super-character and super-suit while trying to escape from a platoon of Middle Eastern terrorists. This film was followed by a sequel called, Avengers , which did not receive the same level of enthusiastic critical review or box office support. However, the third installment – Iron Man 3 – has critics and, more importantly, paying customers, raving.

Part of the reason this current Iron Man saga has been so successful has to do with the evolution of the lead character played brilliantly by Robert Downey Jr. This star has had his own, well-chronicled personal challenges and the Tony Stark character he plays in the movie is experiencing many of these same – all too human – difficulties.

Iron Man 3 is replete with action, special effects and the superhero formula that seems to cure all boredom. However, the lead character spends less time in his iron suit, fighting bad guys and more time contemplating his place in the universe. One reviewer was on the mark when he noted Stark discovers the answer to the question that has been haunting him: Does the man make the suit or does the suit make the man?

Watch the Iron Man 3 trailer here.

Since Dr. Blumenthal and his colleagues at Texas Back Institute  are turning what was medical science fiction a few years ago into medical fact today, we had to ask him if he had a favorite superhero when he was growing up? His answer should give hope to those who don’t particularly care for Iron Man, but do long to go where no man has gone before!

Blumenthal notes, “Actually, I was not a big fan of superheroes. I’m more of a Trekkie. Fortunately, the new Star Trek – Into the Darkness opens tomorrow and I will be there!”

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What is it about the spring and summer that makes us believe our bodies are indestructible? Maybe it’s the warm weather beckoning us to get out of the house after a long, cold winter. Perhaps it’s the traditional warm-weather outdoor activities such as gardening, walking, biking, running or fishing. It could be the horror that comes from glancing at the full-length mirror in the hall and noticing  the winter weight – resulting from all the comfort food and no physical activity – is about to be displayed for the entire world to see the first time a swimsuit or tennis togs are worn.

For these and a myriad of other reasons, many otherwise sane individuals decide  the pleasant chirping of birds and distant hum of a lawn mower should be accompanied by the sounds of running shoes hitting the pavement and the huffing and puffing that comes from someone trying get back into shape. In moderation, this is a worthwhile and even healthy endeavor. However, if it’s overdone or done improperly, it can result in debilitating back pain, excruciating joint pain, herniated discs, sacroiliac joint strains and possible injury to the spine, neck and limbs.

In order to help you avoid this rite of spring, we’ve asked Texas Back Institute occupational and sports medicine specialist, Dr. James Cable, to give us some insights on avoiding the pain while realizing the gain of exercise and activity. Before getting this advice, it’s interesting to review the ways we abuse our bodies, in the hopes of getting into swimsuit shape.

The Numbers Don’t Lie

The Center for Disease Control (CDC) is the U.S. governmental agency charged with a wide range of public health monitoring and management duties and one of its missions involves promoting physical activities and preventing injuries. The agency’s website notes, “Participation in sports, recreation, and exercise is increasingly popular and widespread in American culture. These activities include organized sports (school or club) and unorganized sports (backyard or pick-up), such as basketball, football, and hockey; recreational activities, such as boating, biking, skiing, swimming, and playground activities; and exercise and training activities, such as weight-lifting, aerobics, and jogging.”

The site continues, “Participation in sports, recreation and exercise activities contributes to health-related fitness; however, the risk of injury is inherent in any physical activity.” This is why the CDC is concerned about you or your family members’ participation in organized or individual exercise and recreational activities.

The public health agency references some serious public health data.

  • More than 10,000 people receive treatment in the nation’s emergency departments each day for injuries sustained in (recreational) activities.
  • At least one of every five emergency room visits for an injury results from participation in sports or recreation.
  • 1999, Americans made an estimated 1.5 million ER visits for injuries sustained while playing basketball, baseball, softball, football, or soccer.
  • Approximately 715,000 sports and recreation injuries occur each year in school settings alone.

And here is the most depressing part of these data.

  • Injuries are also a leading reason people stop participating in potentially beneficial physical activity.

The statistical breakdown on sports and recreational injuries is also interesting to contemplate – especially before jumping in to that full-court basketball game without warming up.

  • Children younger than 15 years account for about 40% of all recreation related emergency room visits.
  • Adolescents and young adults under age 25 have high participation rates in recreational activities and experience almost one third of all recreational-related injuries.
  • The population of older adults is increasing, and little is known about their injury risk during participation in Sports Related Exercise.  In 1996, emergency rooms treated more than 53,000 sports and recreation-related injuries among people 65 and older, a 54% increase from 1990.

This third point suggests even more mayhem as the Baby Boomer generation, which has a well-chronicled interest in feeling and looking healthy, ages. This zest for life and activity combined with the wear and tear on muscles and joints exponentially increases the potential for emergency room visits.

With All of These Fitness Options, Why is Obesity at an All-Time High?

With the popularity of “boot camps” and “cross fit” training along with the proliferation of high-tech workout facilities, spinning classes, treadmills and other fitness equipment, soccer camps, basketball camps, marathon training classes and any number of other sports and recreational opportunities men, women and children have numerous opportunities to get fit. With all of these opportunities, the intriguing question is: Why is the U.S. population – especially children – more obese than it has ever been in history?

The answer may have to do with the fact  pain and injuries discourage adults of all ages and kids from participating in regular fitness activities. This would also explain why the public health experts at the CDC are concerned about sports and recreational injury trends.

Before Undertaking Vigorous Activity – Read This

 Aside from the healthcare expenses, the human misery associated with spring and summer recreational activities are serious considerations.Therefore, before taking off on that 50-mile bike ride with no advance training, or having too much weight on the bench press bar, take a minute to read this advice from Dr. James Cable. He is a specialist in recreational and occupational back injuries at Texas Back Institute.

Dr Cable W Patient

What are the most prevalent sports and recreation related injuries  you treat in the spring and summer?

As people get more active – working out or doing yard work – the most common injury is a back sprain. Usually, if someone with a back sprain can take it easy and then slowly get back into gentle activity, they are able to overcome this problem. However, if they’ve given it 2 to 4 weeks to rest and they are still experiencing pain, they should probably get some medical attention. For a normal back sprain, one shouldn’t spend more than a couple of days in bed because any more than this will cause a loss in muscle strength. Conversely, they don’t want to exacerbate the injury. The best approach is to slowly test the water by slowly increasing the activity.

What can a person who has been inactive during the winter do to acclimate themselves to outdoor activities, without becoming injured?

They should use basic athletic training principles of gradual increases in the level of activity. For example, if someone is not accustomed to running, she/he should undertake a walking/jogging approach. This involves alternating three minutes of walking and one minute of jogging for a total of 30 minutes. Gradually, the individual should work to increase the number of minutes jogging, while still alternating with walking for a total of one hour. The key is to slowly ease into the activity. If it’s yard work your undertaking, you don’t want to be lifting 100 pound bags of cement unless you’re used to lifting this weight.

What are the types back injuries  you treat most often for those participating in spring sports and recreation?

The types of back injuries  we see the most of are those that occur from lifting, twisting and bending. These are back muscle strains, herniated discs and sacroiliac joint strains. The pressure from lifting that 100-pound of cement or twisting the body in the course of a pickup basketball game loads the spine in an awkward fashion. Under extreme conditions lifting heavy objects can result in the discs being ruptured.

Common aches and pains will always occur when someone takes part in strenuous activity. However, is there a type of pain or feeling that suggests  medical attention should be sought immediately?

It is very rare but if the person becomes paralyzed or loses control of their bowel and/or bladder, they should go to the Emergency Room immediately. Short of that, if one develops gradual numbness in legs or arms, they need to come in to see us. Neurologic symptoms such as dragging a foot or the extreme symptoms noted above are alarming and very rare, but if they occur after strenuous physical activity, a doctor’s exam is called for.

What is your best advice for someone thinking about getting into shape this spring?

Don’t get out of shape in the first place! The biggest battle involves the couch potato who has not been in shape for years. However, we live in the real world and lots of people are out of shape. Even athletes who fail to maintain a level of physical activity can get out of shape. However, if they have been in good condition before, it’s easier for them to get back into shape. The best advice is to do something; walking, ride a stationary bike just get moving a little. Fortunately, people who are not used to exercising will see benefits a lot faster, because their baseline is lower.

Since Sunday is Mother’s Day, here’s a story about my mom. We had some puppies and I gave my mom one of these little guys. She’s about 5’ 1” and at the time was a little overweight and had health issues associated with this weight problem. This is a lady who got no exercise whatsoever. Well, the puppy wanted to be walked and she started walking him around the block a couple of times each day. The effect of this minimal exercise was pretty amazing. She lost 20 pounds and her blood pressure normalized just by taking her dog out for a walk. If she can get into shape with this small commitment of time, anyone can!


 

Kentucky derby

Each year, on the first Saturday in May, horse lovers and sports fans turn their rapt attention to Churchill Downs in Louisville, Kentucky for the “fastest two minutes in sports.” Since its beginning in 1875, The Kentucky Derby has run consecutively each year and has become the premier event in thoroughbred horse racing.

Because of this pomp, pageantry and publicity associated with this race, many amateur riders become interested in equestrian sports and some of these will experience injuries from their new sport – especially in the area of the neck and back. This is where the advice of spine specialists at Texas Back Institute such as Dr. Ralph Rashbaum can come in handy. However, before getting some back health tips for equestrians, let’s take a two-minute look at the Run for the Roses.

A New Method for Qualifying This Year

The Kentucky Derby is a 1 and a quarter mile (2 km) race for 3-year old, thoroughbred horses and is the first race of horse racing’s championship series – The Triple Crown. Sports pundits call the race “The Run for the Roses” because the winning horse is draped with a blanket of stunning spring roses when it is in the winner’s circle after the race.

As every horse racing enthusiasts knows, there are hundreds of thoroughbred horses racing at tracks around the world each week. With this many horses, it’s interesting to note how the top 20 horses are chosen to line up at the gate in Louisville on Derby day. The eventual winner of the Kentucky Derby will have gotten there after competing in races around the country to qualify.

As the website of the Kentucky Derby notes, “This year marks the debut of a new way to determine which horses will join this select and storied field: The Road to the Kentucky Derby is a points-based system that replaces the previous selection method (graded stakes earnings) with a series of key races offering escalating points stakes during the course of the Derby year.

The Road to the Kentucky Derby is a long one, starting with the Prep Season races the previous September and building to a crescendo with the Championship Series in the weeks before the Kentucky Derby. Each race awards the top four finishers points that are tallied across all the races to determine the ranking of horses competing to make it into the Derby.”

For a listing of this year’s qualifying horses and their respective rankings, click here

Questions, Rumors and Facts about the 2013 Derby

As with all high-profile sporting events – the NFL’s Super Bowl, MLB’s World Series, and others – even the most minute facts, trends and rumors about the participants (in this case, the horses) entered in the Kentucky Derby are thoroughly scrutinized by experts and casual fans alike. This year’s Derby has a few questions that add to the drama of the race.

  • Highly successful trainer Todd Pelcher has 5 horses in this year’s race and he is teaming up with hall of fame jockey Calvin Borel on one of the favorites in this year’s race – Revolutionary. In 2010, the team of Pelcher and Borel won the Derby with Super Saver. Can they repeat this year?
  • One of the prominent prep races, The Bluegrass Stakes, was run on synthetic surface and since Churchill Downs is good, old fashion dirt, handicappers are trying to determine whether the winners of the race on synthetic surface will translate to the dirt track at the Derby.
  • Well-known and liked jockey, Gary Stevens, is returning to the sport at age 50. Stevens has been an actor and news anchor since retiring from racing a few years ago and will be riding one of the contenders – Oxbow – in this year’s race. Can someone who is old enough to be the father of most of the other jockeys win the race?
  • Highly respected trainer D. Wayne Lukus who is 77 years old and has been enormously successful at the Kentucky Derby will have two thoroughbreds in the race – Oxbox and Will Take Charge. Anytime Lukus has horses in the race, handicappers take notice because of his history.
  • The colt, Lines of Battle, is the only European entry in this year’s race and has won races going longer distances than the other horses in the race. Some feel that Lines of Battle is an excellent choice for a long shot.

Enjoy the Ride and Save Your Back

Just as NCAA’s Final Four tournament has the effect of getting many people out, shooting hoops, the Kentucky Derby energizes those who love horses. Since participating in equestrian sports can result in accidents and even long-term damage to the back, some caution and proper techniques should be considered before saddling up. To help us with this we’ve asked Texas Back Institute spine surgeon Dr. Ralph Rashbaum to give us some insights on back safety when involved in horseback riding.

In addition to diagnosing and treating patients with chronic back pain, herniated discs, back injuries and sacroiliac joint dysruption, Dr. Rashbaum has additional knowledge that most back specialists don’t have. He spent 16 years breeding Arabian horses and his wife and daughter have been involved in the sport of Hunter/Jumper equestrian competitions. With the Kentucky Derby approaching the final turn, we asked Dr. Rashbaum for some tips on back safety and riding.

RashbaumPatientWhat is the most serious health problem casual riders and competitors in equestrian sports should be concerned with? 

The biggest danger to the recreational rider is falling off the horse and injuring his/her spine, long bones (such as legs and arms) and pelvis. After a period of time, the ligaments of the rider get tired or become sore and the muscles become more lax. When this happens, a rider – especially one who does not ride on a regular basis – can be jostled off the horse and take a tumble. This can cause fractures in the vertebra and other injuries we would need to treat.

Are there any dangers to the neck and spine of riders who ride on a regular basis and if so, how can they avoid this? 

Riders who spend a lot of time pursuing this sport can experience a pinpoint injury or tenderness in the area where the sacroiliac joint and buttocks meet. This is not a spine injury but is caused by the repetitive concussion of the buttocks on the saddle when the horse is walking or jogging. This is not as big a problem when the horse is galloping.  Over time, this can result in a sharp pain. The best way to avoid this injury is to learn the proper posture and techniques for cushioning the constant bouncing when riding. This involves using the thighs and leg muscles to cushion the concussive bounces. This is a great argument for young riders to get professional instruction on riding techniques.

What are some physical signs a horse rider should come see a physician at Texas Back Institute? 

Anytime there is a burning pain, particularly if this runs down the leg and lower extremities, these suggest some problems and the rider should come see us. This is sometimes called “sciatica” and can be treated in several ways.

What is your opinion about the athleticism of the professional jockeys that will be riding in the Kentucky Derby Saturday?  

They are amazing athletes! Imagine getting into the posture they must get into in order ride – hips flexed, legs underneath, tremendous extension of the torso and neck all while keep their head up – for the length of time of a race. The jockeys who compete at this level have rigorous stretching exercises and are much more flexible than other athletes.

While their numbers are dwindling, there are still many men and women who raise cattle on large ranches. These folks spend a lot of time on horseback and this is not a sport but rather a job. What are the problems they should be aware of? 

Cowboys, whether they are working on a cattle ranch or competing in rodeos, have the same potential for concussive damage as a hunter/jumper contestant. Most learn, at an early age, how to reduce the concussive blows by using leg muscles to reduce this. However, rodeo contestants – particularly those who are involved in bulldogging where the cowboy ropes the calf, jumps off the horse, lifts the calf and then ties him – have a high risk of spine damage and disc herniation and we’ve seen a few in our examination rooms.

 

Protecting your neck and spine from wear and tear damage as well as injuries is an important part of enjoying equestrian sports. Plus, now that you have the scoop on the horses in this year’s Kentucky Derby, you’re ready for the race. All you need is a mint julep and you’re good to go!    

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