Thoughts from the journey… Excerpts from a day in the life of Sherry McLaughlin

26Mar/102

A knee that won’t bend

Ever seen a knee that has a hard time bending after a total knee replacement?

Next time before you stretch them, ask them if they feel the pain in the front or the back of the knee. More times than not, the limitation isn't due to scar tissue formation...and more times than not the pain sensation is in the back of the knee instead of the front.

If this applies to you, there is a real solution that doesn't require a manipulation. This is often due to a posteriorly displaced fibular head and is fixable with a simple technique.

What causes this displacement? Our best intelligent guesses are:
- a lack of subtalar joint eversion (stiff ankle)
- a tight lateral hamstring
- walking toed-out usually due to tight calf muscles

It takes about 120 degrees of flexion to walk up and down stairs normally, put your pants on standing up, get your socks on easily or ride a bike!

If you have this problem, I'd love to hear from you and help you fix it.

After all, spring is here. It's time to pull out the bicycle and enjoy it a little...and it doesn't hurt to have pants on while you do it. 🙂

20Jan/100

Resolution v. Evolution

Be always at war with your vices,

at peace with your neighbors,

and let each new year find you a better man.

Benjamin Franklin


January 1, XXXX. Fill in the date. I love the concept of a fresh start that was harbored at a young age by a non-negotiable date with my dad every year. I’m not sure if he ever did this with any of my other siblings, but as New Year’s Day approached, he would say to me, “Shei, have you made your New Year’s Resolutions yet?” And with that question, I knew I should start preparing for our yearly meeting at the kitchen table.

I was a good kid who grew up in a stable family environment. When I thought each year about the things I would do better or what I would change, the list seemed rather redundant. I would try to be more honest and kind (for the most part, I already was), I would do well in school (I already got straight A’s), I would work to make this world a better place (at 10 years old, that basically meant staying out of trouble and doing a nice deed for someone now and again). But I honored the tradition, if for no other reason than it seemed to mean so much to my dad.

Each year, I would sit on his lap at the kitchen table and read my list out loud. His face would light up as if the list was unique and enlightening every year, his beaming smile a stamp of approval on my list of goals—a good template for the year ahead. I would kiss him on the cheek and be on my way to write another chapter of my life.

The years went by. His lap grew too small to sit on (or was that my butt that grew?) and I grew busy. He never forgot to ask me, but often times the New Years Day exchange happened while he sat at the kitchen table and I rattled off my list as I kissed his cheek and ran off to do something more important. I got my degree, got married, had a kid, raised some other kids, started a business, was widowed and am currently trying to survive the economic downturn just like everyone else. All of a sudden I long for the simplicity of a list that serves to solve the issues of my life.

Only now, at the ripe old age of 42, I actually have a ton of stuff to work on. As Oprah once said, “Cheers to a New Year and another chance for us to get it right.” The thought of making a list only to have the disappointment of actually not achieving those things can sometimes seem a bit overwhelming. I mean, I told myself on January 1 that I was going to start blogging regularly again. (What date is it now?) I read that only 25% of New Years Resolutions are ever successfully achieved…and then I heard that 75% of all statistics are made up on the spot, so the success rate could even be worse than that!

And so, a few years ago, I started a new tradition. At the start of every year, I still vow to try to be a better person and make this world a better place. But on January 1st, I break the wrapper open on a little black book that will house my thoughts and dreams for the current year and I write a list. Only now it isn’t a resolution list…it’s an evolution list. The Sherry Evolution (1/1/09 – 1/1/10). It’s a list that earmarks the journey of a year: the things that have changed, the ways I have grown and the things I realize about myself.

There are a few rules about this list. Number one, it is a random brainstorm. Number two, there is no limit to how long or short it should be. Number three, it is to be written as if nobody else was going to see it. A raw and honest look at the person I am now…different than I was a year ago.

That being said, I thought I’d share a few things from this years list with you, if for no other reason than to inspire you to perhaps do the same. (Notice, I didn’t include all 62 items on my 2010 list. Some things, after all, are better shared in person.)

1. I now lead a Bible study every first and third Wednesday of the month.

3. I guess I’m officially a runner with seven half marathons under my belt.

5. I have actually sold things on Craigslist.

6. I have seen the big Redwoods in California.

7. I have actually traveled enough to earn several free flights.

8. I have spoken at West Point Military Academy.

10. I have over 400 friends on Facebook.

15. One of my favorite things to hear at night from the one I love is, “So, tell me about your day.”

19. I actually put partially synthetic oil in my car once just so I could feel like I was treating it kindly

28. My son and I end most days with him sitting at the end of my bed eating popcorn, watching TV and playing games. He steals my iPhone.

38. I was actually on the big screen at MacWorld in MacHeads the documentary for about one second. I cheered for myself.

40. I like my eggs over hard the best.

42. I do house cleaning on Tuesday more than the weekend.

51. I can be silenced in awe at the sight of thousands of stars on a clear night…and be thankful that I had to pee a 4 a.m. to get to see them.

54. My favorite thing to bring home from a trip is a sticker to put in my Moleskine’ notebook.

57. I know without a shadow of a doubt that God answers prayer.

60. I have been to the symphony twice in one year and each time it awakens my love for classical music.

61. I have a membership at the DIA. I no longer have one at the Detroit Zoo.

62. I tried to fast dance at a wedding—not pretty.

I think my dad would have enjoyed hearing my list. Maybe it isn’t a hearty list of accomplishment, but it is me--and I think he would have enjoyed not only knowing the person I wanted to be, but also the woman I have become. Sometimes, I wish I could sit next to him at the kitchen table and share it.

The world can seem overwhelming. You step out to try to make a difference and you wonder out loud, “How can I make a difference? How can I find my niche when all of the niches are already taken?” To those of you who feel this way, I have one last thing to say.

If life is a journey, then all you have to do is make sure that a day or a month or a year from now when you look down at your feet, you just aren’t standing in the same place. Then take notes. Lots of them. And if at the end of the year you find yourself standing in a niche formed by your own individuality—even better.

After all, resolution + evolution = revolution.

You just might change the world.

3Dec/091

The Joy of Driving a Station Wagon

To laugh often and much;

To win the respect of intelligent people and the affection of children

…to leave the world a better place

…to know even one life has breathed easier because you have lived.

This is to have succeeded.

Ralph Waldo Emerson


Becoming a physician is no small feat. Four years of pre-med undergraduate work, surviving the MCAT, four years of medical school and then unbelievable hours spent working for practically nothing for the next several years of your life as an intern and resident.

After the years of sacrificing, you can’t fault a physician for wanting to drive a really nice car. They’ve definitely earned it.

I remember the times we used to stop at the hospital to drop off some dinner for my father on the nights he worked long shifts. Pulling into the doctor’s parking lot was a virtual feast for the eyes. BMW’s, Mercedes Benz, Jaguars and convertible sport cars blanketed the lot. It was like being at your own private auto show. Ooh’s and ahh’s would escape the lips of my siblings and I as we rode past the shiny, souped-up vehicles.

And then our eyes would come to rest on the most unique ride in the doctor’s parking lot. The one sign that assured us we were in the right place—my dad’s station wagon.

He owned several in his lifetime. First it was one of the super-long ones with wood paneling on the side and the rear seat that faced backwards. Then he upgraded to a sleeker looking model. It was green, I think. The final model he owned was a light brown version that I would ultimately inherit as my first official mode of independent motorized transportation.

The funny thing is, for as far back as I can remember, he dreamed of driving a Lincoln Towne car. Being the dreamer that he was, we heard about it often. He would bring home brochures and check out the latest model every year at the auto show. When I became old enough to drive, those brochures were passed on to me.

“You should buy this car, Shei,” he would say with a dreamy tone in his voice. “Look at the inside. It’s nice. Really nice.”

I looked at the brochure, every year, out of respect for my father, but deep down inside I knew I’d never own one. The vehicle had “old and boring” written all over it. I needed something fun and exciting. After all, your ride is an expression of who you are, isn’t it? Just ask everyone in Hollywood.

“It is nice, Dad,” I would say. “Maybe one day.”

After several years of such an exchange, I finally said to him, “If you like the car so much, why don’t you just buy one for yourself?”

I never got an answer. I would see a little gleam in his eye and a faint smile would cross his face. But I never really got an answer.

That was right around the time I was in college and my tuition at a private university was about $240 a credit—and I was taking a full load. When I graduated in 1990 with my Master’s degree, I realized that I never once had to stand in a financial aid line at registration. All I had to do was sign up for classes, call home with the amount of my tuition and skip off to class.

Well, I didn’t really skip, but it was relatively effortless.

Years later, I realized what a gift that was. To be able to study hard and then get a job and not owe the amount of a small mortgage in student loans as a young adult. As a result, the Lincoln Towne car purchase was put on hold.

Three weeks after I graduated, I got married. My father threw me the wedding of the century, complete with four days of pre-wedding festivities that included big family barbecues at our house. Guests arrived from Canada, the Philippines, Texas, California, Virginia and all over Michigan. It was an international event of huge proportions and there was food. Lots of it. There was also an abundance of love and conversation as families and friends were reunited in the name of the big event.

People still talk about our wedding. It would be years before I realized that little “celebration” cost almost as much as my college education. The Lincoln Towne car would have to wait again.

I imagine there were many times in my father’s life that he could have afforded that car. I secretly vowed that once I landed a job and could get financially stable, I would buy him a Towne car myself, as a token of my appreciation for all he had done for me.

It never happened. You know how that goes. Real life takes over. Debt. A family. How on earth did he ever do all that? I would ask myself.

And then, one day in 1995, he was driving home from work and lost his vision. The diabetes he had been dealing with for years had won the battle over his eyesight. A couple of laser surgeries would only serve to restore his ability to see shadows. My father had become legally blind.

He would spend the rest of his days being chauffeured  around by friends and family, unable to fully enjoy the scenery flying by him. You wouldn’t know it by the look on his face, though. He would get in someone’s car and lean back in the seat, a serene look of enjoyment crossing his face. “This is a nice car,” he would say, “Have you ever ridden in a Lincoln Towne car?”

I was disappointed in myself. There was a part of me that wished I would have purchased that vehicle just so I could drive him around town and see the look of pure pleasure on his face.

In the next several years, the complications of diabetes would require him to have his legs amputated. First his right foot, the one that would have pushed the gas pedal down on his favorite car, then the rest of his right lower leg and finally left leg.

In the last eight years of his life, he was hospitalized numerous times, several of which we thought would be his last. I would race to the hospital on those days thinking about all the things I would say. Fear, dread and remorse settling on my heart.

Upon arriving at the hospital, I never had a hard time finding his room. There were usually people milling about. A whole lot of them. As I walked up to the crowd, people would recognize me and say, “Shei, it is good to see you…” and the stories of my dad would begin to tumble out.

“Your dad gave us the down payment to our first home,” one couple said.

“He loaned me money to start my printing business,” another would add.

“Your dad paid part of my college tuition.”

“One Christmas, we were so poor, we didn’t have any money for presents and then, we received a card in mail from your father with $25 in it. We were so happy, we cried.”

“I got to travel to Washington DC for the Cherry Blossom Festival on this big Greyhound bus…”

The stories would flow out of people, some of whom I’d met before and others who were complete strangers to me. Relatives. Friends. Strangers…but only for a moment.

Our lives were united by the generosity of one man. A man who gave so willingly of his time and money, so that others might experience freedom, joy and opportunity. A man who saw value in investing in the human spirit.

By the time I made it through the throng of people and into his room, I was a different person. The fear and sadness replaced by a sense of awe and gratitude for the man who was my father. He always looked so small in that hospital bed, his body being whittled away by disease. But that was my dad.

Small in stature. Larger than life. Surrounded by the ones he loved.

And he drove a station wagon.

Life Lesson #6

Despite what people say,

You aren’t what you drive.

You are the legacy you leave behind.

So, don’t smirk at the station wagons…

There just might be a dignitary inside.

3Dec/090

Patellofemoral Pain – Runner’s Knee 501

After a week hiatus due to the Thanksgiving holiday, I am back into blogging action. Today's post will wind up our look at the five most common running injuries, and we picked the best for last.

Patellofemoral pain got it's nickname for obvious reasons. It is prevalent in runner's and information regarding its diagnosis, cause or treatment are vague at best. I thought I would start with a lesson about how the knee is built.

Crash Course in Knee Anatomy:

The knee is made up of the femur (thigh bone) and the tibia (shin bone) and the patella (knee cap). The patella has an interesting position in that sits between two big bumps of the femur (the femoral condyles), but it is tied to the tibia via the patellar tendon. Therein lies the rub (no pun intended). The femur takes it's cue from the hip. That is to say, the position of the seat the patella sits on is controlled from the hip above. The tibia takes its cue from the ankle and subtalar joint. The knee really is stuck in the middle with nowhere to run and nowhere to hide.

Can it be fixed?

Enough of that. Here is the point. It can be fixed, but not with just rest or medications. Sure, stopping running will eliminate the pain. But the pain will resume once you start running again if you don't address the cause of the problem.

For you runners out there, this means normal hip flexibility and normal ankle flexibility.

Try this test!

The squat test is a great test to try. Stand with your feet shoulder width apart and toes pointed straight ahead. Squat down as far as you can without your heels coming up off of the floor. What happens?

- If your knee falls in - stretch your calf muscle and strengthen the gluteus medius and maximus (your butt)

- If your knee falls out - stretch your ITB and gluteus medius and work on balancing on a foam roll to unlock your subtalar joint

- If your toe turns out - stretch your calf muscles and your lateral hamstring (the revolving triangle is our favorite for this)

- If you feel like you have to lean way forward or throw your arms in front or you will fall backwards, this is a sign of tight proximal hamstrings. We love the downward dog, the triangle and the revolving triangle for this!

To the clinicians:

Most people with unilateral patellofemoral pain have a pelvic asymmetry stemming from an SI joint problem. This will create a functional leg length discrepancy that can cause medial or lateral patellofemoral pain.

On your patient with this problem, make sure to check the following:

1. The Three Key Hip Test - 90/90 hamstring, piriformis and FABERS - and fix what you find!

2. Pelvic alignment - innominate flares, upslips, rotations and sacral torsions

3. Ankle dorsiflexion - in standing with gravity drop or anterior reach with the leg

4. Subtalar joint eversion - in standing with medial reach w/ the leg

Fix what you find on the table and then support your findings with a solid exercise program. Remember, if it is done right, exercises to solve patellofemoral pain rarely should be focused on the knee.

Now, get to work... there are a lot of laid up runners out there!

Until next time...

19Nov/092

Plantar Fasciitis 501

And then there were four...

Plantar fasciitis is number four in the series on the top five running injuries, but certainly at the top of the list for many runners out there. When you climb out of bed in the morning and your first steps are plagued with excruciating heel pain, you just might have this problem.

Here's the thing... the cause of the problem has little or nothing to do with your heel.

The plantar fascia is located at the bottom of your foot and attaches to your calcaneus (the medial calcaneal tubercle, specifically). It's job is to help add spring to the arch of your foot and dissipate the forces of your body weight when your foot hits the ground.

If it is crying out in pain, it is probably overstretched. So don't stretch it! This is a common misconception. Instead, make sure you stretch your calf and hamstring muscles and wake up the gluteus maximus (your butt muscle) on that leg!

For you clinicians out there, here is a short list of things to check on someone with plantar fasciitis:

1. Tight gastroc/soleus - Make sure they stretch with their toes pointed straight ahead

2. Weak gluteus medius - The gluteus medius is responsible for limiting valgus at the knee. Test this with a medial reach with contralateral arm at waist level. Strengthen it with some good mini-band lateral walking or hurdle step 0vers.

3. Tight medial hamstring or gastrocnemius - Trigger points or myofascial restrictions are often found in these muscles on people with plantar fasciitis. For the more curious of you, here is the breakdown:

- Medial hamstring or medial gastroc trigger point signals an internally rotated femur (strengthen the gluteus maximus in the short position)

- Lateral gastrocnemius trigger point signals increased knee valgus (probably due to a lack of ankle dorsiflexion)

4. Anteriorly rotated innominate (creating a functionally longer leg) - fix this with muscle energy techniques

5. An opposite leg that won't pronate (check subtalar joint eversion)

Remember, if the plantar fascia is screaming at you, keep your ears on it, but put your eyes somewhere else. Good luck!