This Saturday is capital. Remember that this event is going to take place here
in Santo Domingo and I have tickets for a winner. That' s right
now Sting Juarez, President Juan Luis Guerra, that' s this Saturday twenty,
so right now, ballots for a winner, for the capital. You
haven' t seen Stink. I saw Tame extinct a few years ago.
I went with a friend to watch Sting high in chabony and really it'
s a Berger show We welcome Dr Aleman Sara Ritmo the morning. Well,
yeah, she' s not used to it anymore. That custom is that
monthly I come. Not good. On the other hand, what happens when
you' re begging. How do you say by supplying the little friend,
my brother, my brother, but it' s coming now the ice cream,
that' s what it' s called by learning French. Not that
he' s learning French and something more medical teminology a Frenchman. Well,
we have to upgrade without keeping that up- to- date. Let'
s see if she doesn' t know Spanish right now. Yeah, yeah,
yeah, there' s things I know that suit the foreigner faster than
the Dominican. And one day I spent two weeks, not three weeks in
the United States, which wasn' t three weeks, but I was canceled
by a storm and I was coming from you or what we have today,
doctor, we started talking about tearing. I' m not going to you
not today for you easy. That' s gonna depend. Tears are injuries
at the level They can be muscular or can be at the tendon level.
It may be muscle, muscle, but it may be my tendinous, which
is the binding of the muscle to the tendon or tendon and bone. Why
all tendon starts in one that and it' s going to end up in
a muscle again tendon and again bone. That is, example, we have
the vice starts in the shoulder like a tendon, then comes the muscle fibers
of the vice and ends up in the elbow like a tendon. Then there
are three types of muscle tear. The one type that is simply a stretching
or a lengthening of those muscle fibers that some can tear apart. Another type
two is when it comes and it partially rips. I tell patients to understand.
Imagine a spaghetti cover that you opened quickly and some spaghetti broke. That
' s a partial injury and a complete injury is when you break all the
muscle fibers and there you melt the spaghetti and it broke completely. Then we
have to have an account, because sometimes we say we have a tear and
we want a week already that to be solved. It can take three months,
six months to a year to recover. When it is a muscle-
level injury, apart from the heart, which is also a muscle that can
be grasped, it is difficult to heal, the most difficult of all neither
on ice nor to put a heart on it. When you speak of the
heart, heart, which muscle costs the most, after the heart is torn,
to be able to heal, heal many times the quadrice, which is
the musole, put your hand on the front or the part of your face.
Anxiety or but that hurts a lot. Yeah, yeah, but I
' m up to it because it' s four. It' s not
like you tear all four apart. It may be the vast lateral, it
may be the vast medial, it may be the intermediate vessel, the moral
faith challenge any of everything or in its absence, the tendon of the quadrice
is torn apart and that is surgical on all sides. It was mandatory to
put the knife in when you have a partial or total tear of the quadrice
or of the aquile tendon, which are the two most important tendons that we
have at least on the lower train. It' s chirorrhic. And then,
when those tears happen, how much of the pain is dianostic looks.
I due read there will depend on why, because when I have a tear
that was teaching me here my friend of the vice of the distal portion,
that is, the one that goes to the elbow you tear you nothing listens
to me at the moment as a rope breaks. Then there you just feel
pain and the pain disappears. The patient realizes when the mirror is worth and
aesthetically sees when Popelle ate the spinach that came out of a ball is called
a sign of Popeye. Then it doesn' t hurt there anymore, but
there' s a bruise that anyone gets scared and runs out. And when
we realize it, just a full tear of the vice' s distal portion.
That is surgical, says brachial, because we also have a moral ovic
faith. Hey smell is surgical from that tearing look is surgical. But at
the same time, books talk about aesthetics. If you don' t fix
it. He' s just gonna keep his ball and pop that sign of
Popeye. But you' re going to have the same function as your arm.
Why, because the main function of the vice is to put the palm
up, which is called supination, up and then the muscle under the bice
is the one that bends the elbow. That' s what he' s
busy with, not what he' s strong about. It says over here
I had a tear from the right knee cruciate ligament and a year later I
don' t want to go back to the gymnarium what about the trauma.
It is clear to him that yes and it is not the same thing to
have a muscle tear, a tendon tear as a ligament tear, because there
are ligaments examples that we do not necessarily have to operate there on the shoulder.
Some of us are that we break them when we operate and nothing happens,
but the anterior cruciate ligament is one of the most important of the knee.
Then the person gets that trauma and sometimes they operate and they get more
scared and never want to be physical activity again. Why old people like me,
Roberto, Peter, etcetera, when we have some sort of for example,
I had a fifteen right skins. Roberto doubled a deo and visited a
thousand orthopedics and in none of them could solve the issue. Peter' s
out there with a gym pod and one and one, like he settles so
fast for the pain, so you know what they think that' s scary,
it' s afraid of old age, it' s not afraid of
you wanting to go in the middle. What did he say to me when
I don' t come in? No. I don' t want to
go because you talk to me about surgery. It' s a fear that
there is inner truth yes, and really when you have what you have,
which I suspect he still hasn' t told me well, that a clavicular
acromial look is operated many times for aesthetics, because I don' t have
to come to tell you not high performance. You need this, no,
many times I don' t have to operate. It takes a long time
to remove the pain, but it can only be recovered that the static you
are going to have a piano key sign up here and why you are not
so afraid from a certain age of that type of interventions will be that one
is left what you do. What happens is that a lot of people the
neighbor says look at him. I operated, I got really bad looking at
this, I did the other, but many times they don' t realize
that that person who operated didn' t follow what the doctor told him.
Many times the doctor makes him a cosierra another. On the other hand,
for example, on Monday I did a procedure and told the patient to keep
me trained to whom the Mars writes to, to the patient I did,
because the patient did not write. Then I say, but I say to
you write to me and I don' t know yet. Not that I
' m much better and that' s why I didn' t write to
him. I thought it was if I felt bad to write to you,
but give me the good news too that you feel good about an adistesis.
It' s not with the calculus, no, but the anesthesia there are
some, there are some protocols you need to do There are a few steps
you need to do to define whether you can put an anaesthetic on or not,
or whether that procedure can be done to you depending on how old you
are or I can give you the mammadita one thing. I' m the
best thing you are, the former Doctor. Yesterday I talked to a friend
that he had a fall and produced him as a not a break and nothing,
but as a tear to the knee. One thing to us how it
can be a tendinite and it may have inflammation, it can be a lot.
So he has a therapy session that gives him current, puts magnetic sheath
things to ugly da of your friend went to the orthopedic. You' d
have to ask him first. I asked him if he had done the whole
process, if he had gone to or Topeda. Then he goes to the
fisite where what I' ve explained to you here is right. So,
when the fisiat is the one that says what kind of therapy you do that
I, I am, then that therapist is going to execute exactly. Then
the question asks the I ask about one being told. He told me Alberto
how many people you find in these therapy centers. He lasted three hours to
pay and three hours at last, from seven o' clock in the morning
to two o' clock in the therapy center that he goes what giving you
time therapy is being rich and he said I don' t know why I
' m used to accompanying and mom, etcetera. And a lot of people
used to go. What' s going on now that there' s so
many people getting therapy. I told him he probably has to be linked to
the amount of accident that happens in the country as well. That' s
an ecolo and people who get stunted some people who just have a 100-
year- old injury and decide when they want to go for therapy and leave
independently. I told him I was going to ask him what. Maybe what
an answer he had, because he calls it curiosity. He fucking says the
curiosity of a bona fide first thing himself, if he doesn' t get
hurt. It' s already one of the first cases. Many people go
to the pysiatra first without having a diagnosis, without having a study. Many
times, if the fisiat is aware, it will tell him to go to
the orthopedic or send for a study. Before I start giving a therapy,
because I can' t say Alberto comes with a shoulder pain and I focus
on my shoulder, because it turns out that Alberto has twenty therapy and Alberto
doesn' t improve the shoulder and the problem is in the cervical spine,
which is the differential diagnosis of shoulder pains, or the cough goes like a
pain in the cervical spine. I' m already 15 for therapy. I
don' t have Alberto' s study, but the problem is in the
shoulder irradiated by the elbow. Then we can' t focus, simply because
I have a pain in such a place. What produced that pain in that
elbow that' s hurting you for so long, not a trauma, a
sudden force, not a doctor, I don' t remember. We need
to investigate why it' s hurting, because pain doesn' t come out
of nowhere and people who go with lumbar or lumbar pain. The problem comes
from here, not many times it comes from the hip, because from the
knee or hip, because sometimes there are lumbar pains that are irradiated the knee
or the knee hurts you change the biomechanics when you walk from the march and
it will hurt your hip against the side of the other. Then what'
s up? That' s one of the things the patient mostly doesn'
t understand. If you hurt your knee like you do, start walking like
a penguin, as you are looking for it is the knee that hurts you,
it does not hurt and dens when doctors come. But it' s
just that I' m no longer hurt by the one who suffered the problem,
now that the other one hurts, because of course it was a supernatural
burden of the other joint. I have a problem that I have to solve
for or doctors, you pebo father, Yes, it is a problem that
we have you with me standing, because I, if I sit down,
I fall asleep and sometimes there are friends who tell me no, Alberto,
you can sit then when I fall asleep that once they start to support,
that you hurt your apart for you know what has to do the rest and
I last for a season. I have to stop drinking. So that gives
me a look at knee pain. That' s because of the age or
the amount of time it lasts, the amount of time it lasts and second,
that you don' t do anything of yourself see physics. Alberta ah
that also told me a friend' s mom that I have to break up
with that myth, that toothy siners because you really are like the janitor,
I admire them because she says doctor. But that' s the exercise I
do every day. What better exercise than cleaning every day. Remember that when
you are cleaning, you move a specific muscle, unlike with you exercise.
When he' s drinking you' ll be mumbled by the bisecre. I
do everything that shouldn' t be done. Aha how it is that,
by the way or I was talking to you about therapy and more than a
few therapies that are massages. Aja what we talked about the week to spend,
for example, to that is my daughter, who is my therapist,
my masseur your fissi aha how dangerous it can be that sometimes you tell her,
Give me mature, give me mature and then, when it ends,
it hurts more yes, or the muscle suffers more. And examples. If
there' s a tear and they don' t know it, little boy,
for the moment you get a bruise and you say oh it was that
my daughter gave me very hard, but there' s a tear in there
and years go by and you feel the same pain. Then it can be
a contracture of that muscle or a tiny tear that' s there. I
have been told and what you can tell this person that they have two weeks
and in two a gym and in one moment of another they say they are
going to cross to Crossfit. Or you have to have a lot of accounts,
because c Crossfi is one of the physical activities that I have respect for,
because not everyone is coffee. He' s sick here. A lot
of people, a lot of people. When I was already in my Fellowships
I told the professor how it' s possible that we' re operating at
number five and he' s the teacher. I can' t imagine then
the students that if the teacher already has five teachers operated, what will happen
to the students of those teachers. There are problems and doctors and there are
people who make croffi. Well, I' ve seen him injured It wasn
' t and it' s just that there are things that make him unfit
for that and they don' t know how to have a short ego.
They don' t know if I can' t do it. Those who
work mechanically, especially heavy mechanics, know that there are many, there is
a lot of mandalia. That' s right. In heavy truck mechanics,
earth moving equipment and so on. It' s all bossy that gets loose
and with a lot of physical strength. That' s now that there are
a lot of pneumatic tools that make it easier to work. But it used
to be mandarin' and body. And I remember that the sheath that I
ran away from him the most, was when you had to disarm those rubbers,
because of course, you mean you have the hoop, use some safety
hoops, which is just a blow that loosens. But when you give to
the rubber with the commandaria, with all that strength and you stay with it,
that shakes the body that to me, when that happened, it was
produced like an itch between the chest, it is like a thought, as
it burns you, because I did not see these tigers giving it to rubber
riazgo and I, without knowing, without being expert, nothing more from the
experience of the years that I worked mechanics said that type does not know what
also ay inclusive. They don' t go three times at n five days
a week and six days a week doing the same exercise Riazo boss. I
lasted my three days hurting my arms, wrists and sheath. I say because
how these guys do this. I, that' s why I say respect,
but they must be aware, because the moment they decide to withdraw from
crossfit, the consequences are very strong because of that kind of exercise they do
at the level of the lime- adrian cartilage. Brasieles correct the posture,
they work, yes or no. Graciel has to correct the look posture.
I say you can use it, but if you don' t strengthen the
cut, you' re nothing, because the shoulders are going to get right,
you' re going to be right from the breasts up, but the
bottom you' re going to scurry. It' s like sitting on the
computer, right shoulder, but scurvy down you' re gonna be like this.
So, when it doesn' t strengthen or if the breasts are too
big, there comes the part about health care. It' s when I
give you a breast reduction, that' s what happened to many patients.
It is referred to that they already do a breast reduction and has greatly improved
the symptoms and signs at the level of the back and the posture of the
back. Yeah, it gets better with gym,' cause I see.
Yeah, it gets better, but it' s constancy. You have to
be aware when I' m full of a person in a gym. At
three or four weeks you notice the change of postures and more, if they
do more repetitions and little weight, you notice more, because when you want
to make a lot of weight, example, Alberto center and to gym and
decides to put it with all the weight. But tomorrow he' s leaving
for Florida, Alberto' s already coming down from there and it seems like
I' ve never exercised. I greet the people of Orange Feor and there
to William Nor all the team who did their best to improve my self.
But you can' t get into a background and first instance into a competition
like they have levels that don' t so much I started a sheath.
I started downstairs and then they got bigger. I was three years old,
not because he gave me a sheath and I scared him, but it wasn
' t my fault, because I would jump in, Friday, sába and
Sunday exactly I would go on Monday hangover dehydrated and this body asked for rest,
the tropical body. Then it was my fault. He gave me a
sheath, I got scared and I lasted a year paying for it, but
you scared me, I would go and get back from the box. Not
coming today. Then I' ll have my whole story. But I want
to go back to crossfit because there' s a question left pending. If
a person already made a decision and goes into that, what is it that
you recommend you should do beforehand before leaving to avoid finishing a cardiologic checkup,
a pulmonary checkup, because they are exercises that are going to be quite strong
many times and the checkup by me, on the Orthopedics side check at least
how he is in question, his physical build internally, where are mainly the
knee, hip and shoulders. After that he starts so that he understands that
he can, because there is one thing. The body warns you and tells
you whether or not you can. You can try an army, but if
you see that you can' t, don' t keep insisting because it
' s going to give you the warning and there come the tears What was
it that we started talking about he cra We' re going to ask Dr
Siman a couple of questions on the phone when she gets smoldered that she'
s Ortopeda. What a friend of ours, what they call this. Well,
you know, we high- performance athletes like me, they always inculcate
in us that the proteins of this little thing of all jugles or the Latin
dust and that kind of thing. That' s what the word they use,
that regenerates the muscles and that kind of thing. What to say Look,
I allow you to use everything you want to use. But first check,
because there' s substance from that one that contains too much caffeine or
already contains things that are going to increase the pressure and that then you suffer
from the pressure being twenty- eight years old and you don' t know
why it is. I have many acquaintances who unfortunately, are a lecturing today
because of the type of supplements they were consuming. Well that first then that
I do, I do complete analytics check that all levels are okay. If
you decide to do a routine supplementation. Do it, but at least every
four months or, every six months check your kidneys a whole yes two already
you are going to do a cycle. It' s a totally different thing.
Of course it' s good. We' re not going to put
up costeroid photo We need to know at that moment which one I' m
going to use your question. Good morning, Doctor, it' s okay.
I have a displacement in the five in the spine and I need to
be guided by what type of shoes I should exercise, if there are any
specific ones or for me to be able to work, as that causes me
inflammation and discomfort. The first thing would be that the precise dianostic, because
many times they say displacement, but that is to say sometimes they have ethnic
protructions or other things added. And I always say it. Shoes well cushioned
and do not last long in the same position, neither much sitting nor much
standing. But if you don' t strengthen the core for better shoe than
you buy, there' s going to be pain. The chair like Alberto
' s that changed it, then that goes hand in hand the posture when
it comes to sitting. I must say that the philosophy of the rock is
then applied. And Penis Doctor what the philosophy of penis. Hair is the
penis and much standing and not much sitting. That' s a penis muscle.
Good morning, or they took her good morning, good morning they'
re worth doctor feu Months and I started skating with my daughter mex there that
hurt my foot and I literally can' t last my right foot five minutes
with my foot on it painting bent because it hurts immediately. The safest thing
was a sprain, probably type two, because of the kind of sport I
was doing at the time. The good thing, it would be to check
it out, because I' ve always said it and I' m going
to repeat it, I prefer a fracture that one is guince and the sprains
sometimes pass seven years, five years. She' s got the same pain,
she' s dancing herself, and if she doesn' t take care
of herself, she' s off the radio. Please, and ask Dr
Cimena and well, good morning. Doctor the factite and plant, which is
very common. Today I suffer. I think you already ta both stones,
factite and plant aha that provokes it. Maybe you want him to split up.
It is almost always the footwear that causes it or a bad tread.
For example. Emplo, you go with a nocalizo, to say something,
and when you walk there' s a stone, you step on it and
you keep walking. The next day you can produce both or shoes. It
is quite corroborated by the prolonged use of it. It' s not that
you can use it, because I use it. But it' s not
that you happen every day, every day, every day a few cros,
because it' s really going to go straight to the phase, to the
easy and plant. If we touch the sole of the foot, there goes
a full faci, goes from the heel to the fingers. So, when
she gets inflamed, they put the word fascitis in her. They plant the
rite. There was a man named Agapito, who never wore a shoe,
but he developed a cachaza that could pass as a braza, clung on his
feet through a cachaza, a sheath looks. There are people who never do
a pedi que ori and that which Alberto is talking about has a lot of
logic. There are patients who have never gone, I have had a pedicule
have an increase of that dead skin and when they do not do the pedicule,
it starts to hurt the heels because to them there is a dehydration of
the level of the heel and that causes pain. And that' s gonna
ask you how much being cachazu afe isn' t. It' s not
that terrible affection, it' s that you don' t get people,
cachezumente your most beautiful form you don' t. That' s a dead
skin that even many dermatologists and recommend that you remove it, recommend that you
say hydration, that you hydrate your feet at night can put on a cream
to put on your half and moisturize, but no one likes to do it.
One time I put a raging cream without the average and it looks like
a pee tro. You' ve already flown the last call from the doctor.
It does give me good morning where I already can get an orthology ban.
Good morning, Doctor, I' ll put a cat in the shoes
of an outside canister. How do you remember that shoes are crawling out of
the water, they are worn out already ok has cowboy floor. Yeah,
I spend them, too. I' m listening now, as you can
see that. Uh, yeah, you can do that. You' d
have to see the kind of footprint you' re having. Many times they
come with problems at knee level or had some pain at some point and change
the tread. First you have to do a pedometry to see some kind of
footstep, what you have to start correcting that. If it is or kiss
it happens a lot that they are changing the tread for the type, that
the load increases at the level of the hip, the knee and the resfordo
does not hear when lubricating between feet the purchase Baseli, tattoo Ke Drolation.
No. But, my God, no, no, no, no,
no, we don' t help everything. It' s strong, it
' s strong, no, no, applying the technique of mechanics. Here,
in mechanics, lubrication is vital. That' s true. I only
give the Council that, please, to all those who suffer trauma or who
are suspected to have, even if it is a number one tear, which
is the mildest, go to Sister Doctor, go to your orthopedic not alfisiatra
directly, first to the orthopeda, cu then the orthopedic sends the reference to
the psiathra so that if the physiatric has light and is not lost when you
arrive you do not know what to do and send to do all the studies
and waste the time, and then it does not help both the psiathra and
us topal But do not owe me. I' m not gonna bowl you.
The doctor has her office in the Tower Hearts united, on the fifth
floor. That' s where it' s really naco, in the kiso.
It is correct and you can contact the doctor by a number of whatsapps
that you already have also if you want to follow her on the networks and
write her out there that there also this link to whatsapp. What are eight,
zero, nine, six, ninety- two zero five, three,
eight and grace of Eria Quia is my social networks. We thank Dr Cimena
al Mansar as always shedding light on these issues that have now become so common.
As my friend said, three hours waiting to shut it down and every
day they' re going to increase more for things we' re living.
Not so much, the part of hurting you in a sport is the movement.
Here' s the engine, the carts and the bugle on the bike.
That' s right. So take care of yourself. Gentlemen, thank
the doctor. We used to say happy weekend, Doctor, a hug,
make a kiss one day from this.