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Rotator Cuff Injuries

The rotator cuff muscles hold the head of the long bone of your upper arm tightly in the socket of your shoulder. Sports that require moving the arm over the head repeatedly can cause tearing and swelling of the tendons of these muscles. Baseball pitchers, swimmers, weight lifters and tennis players often suffer this injury. Chronic irritation can cause pain, swelling and tearing of the rotator cuff. If you continue to exercise in spite of the pain, you will tear the tendons from their attachments.

Initially, pain occurs only when you hold your arm over your head and bring it down or forward forcibly. Later, it will hurt when the arm is moved forward for any reason, such as to shake hands. Usually, it hurts when you push things away and does not hurt when you pull objects toward you. A torn rotator cuff will cause tenderness over the tendons, especially when the elbow is raised above the shoulder. It will hurt when you pull your arm across your chest, and you will have difficulty raising your elbow over your shoulder. An arthrogram is often not sensitive enough to diagnose a partial tear of the rotator cuff but can show a complete tear.

The treatment is to avoid any motion that hurts and strengthen the uninjured shoulder muscles. Do weight-lifting exercises that bring the weights toward the body and do not hurt, such as upright rows and downward "lat pulls". You may need surgery if the rotator cuff tendons are torn completely, or if the tendons do not heal within one year.

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Dear Dr. Mirkin: How can I get rid of the cellulite on my thighs?

There is no such thing as cellulite. The fat on a woman's hips and thighs is the same as the fat anywhere else. She has skin on the outside, fat in the middle and muscles and fascia underneath the fat. Tiny bands of fiber called ligaments run from the fascia, through the fat and attach on the skin. When fat is stored on the hips and thighs, it pushes the skin upwards, while the ligaments hold the skin down, causing an orange peel appearance from the little dots where each ligament attaches to the skin. Getting rid of fat gets rid of the dimpling, but for women who store fat primarily in their hips and thighs (rather than their bellies), this can be very difficult. You can be skinny everywhere else and still have dimpled thighs. Don’t be deceived by creams and other products that promise to get rid of cellulite; they are worthless.

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Dear Dr. Mirkin: I’ve started walking every day, but I’m not losing any weight. What am I doing wrong?

Many people do not lose weight when they exercise because they don't do it vigorously enough. You lose weight by exercising intensely enough to raise your body temperature and make you breathe faster. This causes you to burn extra calories for up to 18 hours after you finish exercising. But vigorous exercise makes your muscles feel sore on the next day. If you try to exercise intensely with sore muscles, you can tear them and not be able to exercise at all. The best way to use exercise for weight loss is to alternate two sports that stress different muscle groups, so you can exercise every day without injury. For example, jog or cycle on Monday, Wednesday and Friday and pull on a rowing machine Tuesday and Thursday.

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Recipe of the Week
Southwestern Bean Salad

List of Diana's Healthful Recipes

June 27th, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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