1 00:00:00,040 --> 00:00:04,280 This Saturday is capital. Remember that this event is going to take place here 2 00:00:04,400 --> 00:00:09,640 in Santo Domingo and I have tickets for a winner. That' s right 3 00:00:09,800 --> 00:00:14,839 now Sting Juarez, President Juan Luis Guerra, that' s this Saturday twenty, 4 00:00:15,199 --> 00:00:19,160 so right now, ballots for a winner, for the capital. You 5 00:00:19,160 --> 00:00:23,320 haven' t seen Stink. I saw Tame extinct a few years ago. 6 00:00:23,359 --> 00:00:25,960 I went with a friend to watch Sting high in chabony and really it' 7 00:00:26,000 --> 00:00:33,679 s a Berger show We welcome Dr Aleman Sara Ritmo the morning. Well, 8 00:00:33,759 --> 00:00:35,320 yeah, she' s not used to it anymore. That custom is that 9 00:00:35,399 --> 00:00:38,280 monthly I come. Not good. On the other hand, what happens when 10 00:00:38,280 --> 00:00:42,799 you' re begging. How do you say by supplying the little friend, 11 00:00:43,439 --> 00:00:46,320 my brother, my brother, but it' s coming now the ice cream, 12 00:00:46,880 --> 00:00:48,320 that' s what it' s called by learning French. Not that 13 00:00:48,320 --> 00:00:53,799 he' s learning French and something more medical teminology a Frenchman. Well, 14 00:00:53,840 --> 00:00:56,759 we have to upgrade without keeping that up- to- date. Let' 15 00:00:56,840 --> 00:00:59,960 s see if she doesn' t know Spanish right now. Yeah, yeah, 16 00:00:59,759 --> 00:01:04,359 yeah, there' s things I know that suit the foreigner faster than 17 00:01:04,439 --> 00:01:07,840 the Dominican. And one day I spent two weeks, not three weeks in 18 00:01:07,920 --> 00:01:11,280 the United States, which wasn' t three weeks, but I was canceled 19 00:01:11,319 --> 00:01:19,000 by a storm and I was coming from you or what we have today, 20 00:01:19,319 --> 00:01:23,239 doctor, we started talking about tearing. I' m not going to you 21 00:01:23,319 --> 00:01:26,560 not today for you easy. That' s gonna depend. Tears are injuries 22 00:01:26,760 --> 00:01:32,359 at the level They can be muscular or can be at the tendon level. 23 00:01:32,599 --> 00:01:37,359 It may be muscle, muscle, but it may be my tendinous, which 24 00:01:37,439 --> 00:01:42,719 is the binding of the muscle to the tendon or tendon and bone. Why 25 00:01:42,840 --> 00:01:49,079 all tendon starts in one that and it' s going to end up in 26 00:01:49,239 --> 00:01:52,879 a muscle again tendon and again bone. That is, example, we have 27 00:01:53,000 --> 00:01:59,000 the vice starts in the shoulder like a tendon, then comes the muscle fibers 28 00:01:59,159 --> 00:02:02,799 of the vice and ends up in the elbow like a tendon. Then there 29 00:02:02,920 --> 00:02:08,479 are three types of muscle tear. The one type that is simply a stretching 30 00:02:08,680 --> 00:02:15,599 or a lengthening of those muscle fibers that some can tear apart. Another type 31 00:02:15,719 --> 00:02:20,280 two is when it comes and it partially rips. I tell patients to understand. 32 00:02:22,000 --> 00:02:27,319 Imagine a spaghetti cover that you opened quickly and some spaghetti broke. That 33 00:02:27,319 --> 00:02:31,520 ' s a partial injury and a complete injury is when you break all the 34 00:02:31,599 --> 00:02:37,520 muscle fibers and there you melt the spaghetti and it broke completely. Then we 35 00:02:37,560 --> 00:02:40,199 have to have an account, because sometimes we say we have a tear and 36 00:02:40,280 --> 00:02:44,759 we want a week already that to be solved. It can take three months, 37 00:02:45,080 --> 00:02:47,199 six months to a year to recover. When it is a muscle- 38 00:02:47,680 --> 00:02:52,479 level injury, apart from the heart, which is also a muscle that can 39 00:02:52,560 --> 00:02:55,919 be grasped, it is difficult to heal, the most difficult of all neither 40 00:02:57,199 --> 00:03:00,520 on ice nor to put a heart on it. When you speak of the 41 00:03:00,599 --> 00:03:08,560 heart, heart, which muscle costs the most, after the heart is torn, 42 00:03:12,599 --> 00:03:16,319 to be able to heal, heal many times the quadrice, which is 43 00:03:16,400 --> 00:03:21,159 the musole, put your hand on the front or the part of your face. 44 00:03:21,199 --> 00:03:24,639 Anxiety or but that hurts a lot. Yeah, yeah, but I 45 00:03:24,719 --> 00:03:29,439 ' m up to it because it' s four. It' s not 46 00:03:29,520 --> 00:03:31,560 like you tear all four apart. It may be the vast lateral, it 47 00:03:31,680 --> 00:03:36,000 may be the vast medial, it may be the intermediate vessel, the moral 48 00:03:36,080 --> 00:03:39,919 faith challenge any of everything or in its absence, the tendon of the quadrice 49 00:03:40,000 --> 00:03:43,560 is torn apart and that is surgical on all sides. It was mandatory to 50 00:03:43,639 --> 00:03:49,439 put the knife in when you have a partial or total tear of the quadrice 51 00:03:49,479 --> 00:03:53,639 or of the aquile tendon, which are the two most important tendons that we 52 00:03:53,639 --> 00:03:57,479 have at least on the lower train. It' s chirorrhic. And then, 53 00:03:58,199 --> 00:04:01,960 when those tears happen, how much of the pain is dianostic looks. 54 00:04:02,280 --> 00:04:05,879 I due read there will depend on why, because when I have a tear 55 00:04:05,960 --> 00:04:10,919 that was teaching me here my friend of the vice of the distal portion, 56 00:04:11,520 --> 00:04:15,319 that is, the one that goes to the elbow you tear you nothing listens 57 00:04:15,400 --> 00:04:19,639 to me at the moment as a rope breaks. Then there you just feel 58 00:04:19,720 --> 00:04:24,759 pain and the pain disappears. The patient realizes when the mirror is worth and 59 00:04:24,839 --> 00:04:29,600 aesthetically sees when Popelle ate the spinach that came out of a ball is called 60 00:04:29,680 --> 00:04:32,920 a sign of Popeye. Then it doesn' t hurt there anymore, but 61 00:04:33,160 --> 00:04:36,199 there' s a bruise that anyone gets scared and runs out. And when 62 00:04:36,199 --> 00:04:41,600 we realize it, just a full tear of the vice' s distal portion. 63 00:04:41,800 --> 00:04:45,600 That is surgical, says brachial, because we also have a moral ovic 64 00:04:45,600 --> 00:04:48,680 faith. Hey smell is surgical from that tearing look is surgical. But at 65 00:04:48,759 --> 00:04:53,160 the same time, books talk about aesthetics. If you don' t fix 66 00:04:53,160 --> 00:04:56,399 it. He' s just gonna keep his ball and pop that sign of 67 00:04:56,439 --> 00:05:00,480 Popeye. But you' re going to have the same function as your arm. 68 00:05:00,639 --> 00:05:03,319 Why, because the main function of the vice is to put the palm 69 00:05:03,399 --> 00:05:09,199 up, which is called supination, up and then the muscle under the bice 70 00:05:09,279 --> 00:05:12,800 is the one that bends the elbow. That' s what he' s 71 00:05:12,920 --> 00:05:15,160 busy with, not what he' s strong about. It says over here 72 00:05:15,360 --> 00:05:20,160 I had a tear from the right knee cruciate ligament and a year later I 73 00:05:20,319 --> 00:05:21,920 don' t want to go back to the gymnarium what about the trauma. 74 00:05:23,040 --> 00:05:27,360 It is clear to him that yes and it is not the same thing to 75 00:05:27,480 --> 00:05:30,439 have a muscle tear, a tendon tear as a ligament tear, because there 76 00:05:30,519 --> 00:05:32,879 are ligaments examples that we do not necessarily have to operate there on the shoulder. 77 00:05:32,959 --> 00:05:36,439 Some of us are that we break them when we operate and nothing happens, 78 00:05:36,920 --> 00:05:41,639 but the anterior cruciate ligament is one of the most important of the knee. 79 00:05:41,959 --> 00:05:45,639 Then the person gets that trauma and sometimes they operate and they get more 80 00:05:45,759 --> 00:05:49,480 scared and never want to be physical activity again. Why old people like me, 81 00:05:50,160 --> 00:05:59,399 Roberto, Peter, etcetera, when we have some sort of for example, 82 00:05:59,480 --> 00:06:05,680 I had a fifteen right skins. Roberto doubled a deo and visited a 83 00:06:06,199 --> 00:06:12,800 thousand orthopedics and in none of them could solve the issue. Peter' s 84 00:06:13,040 --> 00:06:16,439 out there with a gym pod and one and one, like he settles so 85 00:06:16,519 --> 00:06:19,480 fast for the pain, so you know what they think that' s scary, 86 00:06:19,839 --> 00:06:24,879 it' s afraid of old age, it' s not afraid of 87 00:06:24,879 --> 00:06:26,120 you wanting to go in the middle. What did he say to me when 88 00:06:26,639 --> 00:06:27,839 I don' t come in? No. I don' t want to 89 00:06:27,839 --> 00:06:29,959 go because you talk to me about surgery. It' s a fear that 90 00:06:30,040 --> 00:06:31,680 there is inner truth yes, and really when you have what you have, 91 00:06:31,959 --> 00:06:35,680 which I suspect he still hasn' t told me well, that a clavicular 92 00:06:35,759 --> 00:06:40,360 acromial look is operated many times for aesthetics, because I don' t have 93 00:06:40,399 --> 00:06:42,959 to come to tell you not high performance. You need this, no, 94 00:06:43,360 --> 00:06:46,199 many times I don' t have to operate. It takes a long time 95 00:06:46,279 --> 00:06:50,079 to remove the pain, but it can only be recovered that the static you 96 00:06:50,160 --> 00:06:54,319 are going to have a piano key sign up here and why you are not 97 00:06:54,439 --> 00:06:58,959 so afraid from a certain age of that type of interventions will be that one 98 00:06:59,240 --> 00:07:02,360 is left what you do. What happens is that a lot of people the 99 00:07:02,480 --> 00:07:05,399 neighbor says look at him. I operated, I got really bad looking at 100 00:07:05,600 --> 00:07:10,480 this, I did the other, but many times they don' t realize 101 00:07:10,600 --> 00:07:12,920 that that person who operated didn' t follow what the doctor told him. 102 00:07:13,319 --> 00:07:15,839 Many times the doctor makes him a cosierra another. On the other hand, 103 00:07:15,279 --> 00:07:18,000 for example, on Monday I did a procedure and told the patient to keep 104 00:07:18,000 --> 00:07:21,199 me trained to whom the Mars writes to, to the patient I did, 105 00:07:21,360 --> 00:07:24,920 because the patient did not write. Then I say, but I say to 106 00:07:24,920 --> 00:07:27,319 you write to me and I don' t know yet. Not that I 107 00:07:27,360 --> 00:07:28,879 ' m much better and that' s why I didn' t write to 108 00:07:28,879 --> 00:07:30,680 him. I thought it was if I felt bad to write to you, 109 00:07:30,959 --> 00:07:34,079 but give me the good news too that you feel good about an adistesis. 110 00:07:34,160 --> 00:07:38,360 It' s not with the calculus, no, but the anesthesia there are 111 00:07:38,439 --> 00:07:41,600 some, there are some protocols you need to do There are a few steps 112 00:07:41,720 --> 00:07:45,120 you need to do to define whether you can put an anaesthetic on or not, 113 00:07:45,360 --> 00:07:47,279 or whether that procedure can be done to you depending on how old you 114 00:07:47,319 --> 00:07:49,720 are or I can give you the mammadita one thing. I' m the 115 00:07:50,319 --> 00:07:56,240 best thing you are, the former Doctor. Yesterday I talked to a friend 116 00:07:56,360 --> 00:07:59,839 that he had a fall and produced him as a not a break and nothing, 117 00:08:00,279 --> 00:08:03,000 but as a tear to the knee. One thing to us how it 118 00:08:03,040 --> 00:08:07,319 can be a tendinite and it may have inflammation, it can be a lot. 119 00:08:07,480 --> 00:08:11,639 So he has a therapy session that gives him current, puts magnetic sheath 120 00:08:11,720 --> 00:08:16,600 things to ugly da of your friend went to the orthopedic. You' d 121 00:08:16,720 --> 00:08:18,360 have to ask him first. I asked him if he had done the whole 122 00:08:18,399 --> 00:08:22,560 process, if he had gone to or Topeda. Then he goes to the 123 00:08:22,600 --> 00:08:24,000 fisite where what I' ve explained to you here is right. So, 124 00:08:24,120 --> 00:08:26,399 when the fisiat is the one that says what kind of therapy you do that 125 00:08:26,439 --> 00:08:31,879 I, I am, then that therapist is going to execute exactly. Then 126 00:08:33,480 --> 00:08:37,240 the question asks the I ask about one being told. He told me Alberto 127 00:08:37,799 --> 00:08:41,799 how many people you find in these therapy centers. He lasted three hours to 128 00:08:41,919 --> 00:08:46,279 pay and three hours at last, from seven o' clock in the morning 129 00:08:46,320 --> 00:08:48,759 to two o' clock in the therapy center that he goes what giving you 130 00:08:48,799 --> 00:08:52,120 time therapy is being rich and he said I don' t know why I 131 00:08:52,159 --> 00:08:56,799 ' m used to accompanying and mom, etcetera. And a lot of people 132 00:08:56,799 --> 00:09:01,320 used to go. What' s going on now that there' s so 133 00:09:01,480 --> 00:09:05,080 many people getting therapy. I told him he probably has to be linked to 134 00:09:05,200 --> 00:09:09,000 the amount of accident that happens in the country as well. That' s 135 00:09:09,039 --> 00:09:15,399 an ecolo and people who get stunted some people who just have a 100- 136 00:09:15,600 --> 00:09:18,879 year- old injury and decide when they want to go for therapy and leave 137 00:09:18,919 --> 00:09:24,200 independently. I told him I was going to ask him what. Maybe what 138 00:09:24,759 --> 00:09:28,000 an answer he had, because he calls it curiosity. He fucking says the 139 00:09:28,039 --> 00:09:30,840 curiosity of a bona fide first thing himself, if he doesn' t get 140 00:09:30,840 --> 00:09:33,840 hurt. It' s already one of the first cases. Many people go 141 00:09:33,919 --> 00:09:37,720 to the pysiatra first without having a diagnosis, without having a study. Many 142 00:09:37,759 --> 00:09:41,360 times, if the fisiat is aware, it will tell him to go to 143 00:09:41,519 --> 00:09:45,639 the orthopedic or send for a study. Before I start giving a therapy, 144 00:09:46,159 --> 00:09:48,879 because I can' t say Alberto comes with a shoulder pain and I focus 145 00:09:48,960 --> 00:09:52,399 on my shoulder, because it turns out that Alberto has twenty therapy and Alberto 146 00:09:52,519 --> 00:09:56,759 doesn' t improve the shoulder and the problem is in the cervical spine, 147 00:09:56,120 --> 00:10:00,519 which is the differential diagnosis of shoulder pains, or the cough goes like a 148 00:10:00,600 --> 00:10:05,080 pain in the cervical spine. I' m already 15 for therapy. I 149 00:10:05,120 --> 00:10:07,519 don' t have Alberto' s study, but the problem is in the 150 00:10:07,600 --> 00:10:11,799 shoulder irradiated by the elbow. Then we can' t focus, simply because 151 00:10:11,919 --> 00:10:15,240 I have a pain in such a place. What produced that pain in that 152 00:10:15,320 --> 00:10:18,279 elbow that' s hurting you for so long, not a trauma, a 153 00:10:18,399 --> 00:10:20,240 sudden force, not a doctor, I don' t remember. We need 154 00:10:20,320 --> 00:10:24,559 to investigate why it' s hurting, because pain doesn' t come out 155 00:10:24,679 --> 00:10:28,159 of nowhere and people who go with lumbar or lumbar pain. The problem comes 156 00:10:28,200 --> 00:10:31,639 from here, not many times it comes from the hip, because from the 157 00:10:31,759 --> 00:10:35,159 knee or hip, because sometimes there are lumbar pains that are irradiated the knee 158 00:10:35,279 --> 00:10:39,559 or the knee hurts you change the biomechanics when you walk from the march and 159 00:10:39,639 --> 00:10:43,200 it will hurt your hip against the side of the other. Then what' 160 00:10:43,200 --> 00:10:46,519 s up? That' s one of the things the patient mostly doesn' 161 00:10:46,519 --> 00:10:48,679 t understand. If you hurt your knee like you do, start walking like 162 00:10:48,759 --> 00:10:54,480 a penguin, as you are looking for it is the knee that hurts you, 163 00:10:54,000 --> 00:10:56,159 it does not hurt and dens when doctors come. But it' s 164 00:10:56,200 --> 00:10:58,519 just that I' m no longer hurt by the one who suffered the problem, 165 00:10:58,720 --> 00:11:03,200 now that the other one hurts, because of course it was a supernatural 166 00:11:03,200 --> 00:11:05,480 burden of the other joint. I have a problem that I have to solve 167 00:11:05,759 --> 00:11:09,200 for or doctors, you pebo father, Yes, it is a problem that 168 00:11:09,759 --> 00:11:13,879 we have you with me standing, because I, if I sit down, 169 00:11:13,919 --> 00:11:16,279 I fall asleep and sometimes there are friends who tell me no, Alberto, 170 00:11:16,559 --> 00:11:20,720 you can sit then when I fall asleep that once they start to support, 171 00:11:20,039 --> 00:11:24,799 that you hurt your apart for you know what has to do the rest and 172 00:11:24,919 --> 00:11:28,840 I last for a season. I have to stop drinking. So that gives 173 00:11:28,919 --> 00:11:31,399 me a look at knee pain. That' s because of the age or 174 00:11:31,480 --> 00:11:33,960 the amount of time it lasts, the amount of time it lasts and second, 175 00:11:35,320 --> 00:11:37,960 that you don' t do anything of yourself see physics. Alberta ah 176 00:11:37,080 --> 00:11:41,879 that also told me a friend' s mom that I have to break up 177 00:11:41,039 --> 00:11:46,919 with that myth, that toothy siners because you really are like the janitor, 178 00:11:46,320 --> 00:11:50,080 I admire them because she says doctor. But that' s the exercise I 179 00:11:50,120 --> 00:11:56,240 do every day. What better exercise than cleaning every day. Remember that when 180 00:11:56,279 --> 00:11:58,399 you are cleaning, you move a specific muscle, unlike with you exercise. 181 00:12:00,559 --> 00:12:03,399 When he' s drinking you' ll be mumbled by the bisecre. I 182 00:12:03,519 --> 00:12:05,600 do everything that shouldn' t be done. Aha how it is that, 183 00:12:05,759 --> 00:12:13,840 by the way or I was talking to you about therapy and more than a 184 00:12:13,840 --> 00:12:15,759 few therapies that are massages. Aja what we talked about the week to spend, 185 00:12:16,159 --> 00:12:18,559 for example, to that is my daughter, who is my therapist, 186 00:12:20,399 --> 00:12:28,159 my masseur your fissi aha how dangerous it can be that sometimes you tell her, 187 00:12:28,279 --> 00:12:31,440 Give me mature, give me mature and then, when it ends, 188 00:12:31,720 --> 00:12:35,159 it hurts more yes, or the muscle suffers more. And examples. If 189 00:12:35,240 --> 00:12:39,320 there' s a tear and they don' t know it, little boy, 190 00:12:39,720 --> 00:12:41,440 for the moment you get a bruise and you say oh it was that 191 00:12:41,480 --> 00:12:45,840 my daughter gave me very hard, but there' s a tear in there 192 00:12:45,840 --> 00:12:46,799 and years go by and you feel the same pain. Then it can be 193 00:12:46,919 --> 00:12:50,120 a contracture of that muscle or a tiny tear that' s there. I 194 00:12:50,200 --> 00:12:52,840 have been told and what you can tell this person that they have two weeks 195 00:12:52,960 --> 00:12:56,440 and in two a gym and in one moment of another they say they are 196 00:12:56,519 --> 00:13:01,240 going to cross to Crossfit. Or you have to have a lot of accounts, 197 00:13:03,360 --> 00:13:07,360 because c Crossfi is one of the physical activities that I have respect for, 198 00:13:09,000 --> 00:13:11,679 because not everyone is coffee. He' s sick here. A lot 199 00:13:11,679 --> 00:13:13,600 of people, a lot of people. When I was already in my Fellowships 200 00:13:13,679 --> 00:13:18,360 I told the professor how it' s possible that we' re operating at 201 00:13:18,399 --> 00:13:20,360 number five and he' s the teacher. I can' t imagine then 202 00:13:20,399 --> 00:13:24,799 the students that if the teacher already has five teachers operated, what will happen 203 00:13:24,840 --> 00:13:28,799 to the students of those teachers. There are problems and doctors and there are 204 00:13:28,840 --> 00:13:31,879 people who make croffi. Well, I' ve seen him injured It wasn 205 00:13:31,960 --> 00:13:35,720 ' t and it' s just that there are things that make him unfit 206 00:13:35,840 --> 00:13:37,080 for that and they don' t know how to have a short ego. 207 00:13:37,159 --> 00:13:39,559 They don' t know if I can' t do it. Those who 208 00:13:39,679 --> 00:13:43,720 work mechanically, especially heavy mechanics, know that there are many, there is 209 00:13:43,759 --> 00:13:48,279 a lot of mandalia. That' s right. In heavy truck mechanics, 210 00:13:48,919 --> 00:13:54,559 earth moving equipment and so on. It' s all bossy that gets loose 211 00:13:54,720 --> 00:13:58,360 and with a lot of physical strength. That' s now that there are 212 00:13:58,360 --> 00:14:03,799 a lot of pneumatic tools that make it easier to work. But it used 213 00:14:03,840 --> 00:14:07,919 to be mandarin' and body. And I remember that the sheath that I 214 00:14:09,039 --> 00:14:13,679 ran away from him the most, was when you had to disarm those rubbers, 215 00:14:13,759 --> 00:14:16,440 because of course, you mean you have the hoop, use some safety 216 00:14:16,600 --> 00:14:20,440 hoops, which is just a blow that loosens. But when you give to 217 00:14:20,840 --> 00:14:24,919 the rubber with the commandaria, with all that strength and you stay with it, 218 00:14:24,159 --> 00:14:28,080 that shakes the body that to me, when that happened, it was 219 00:14:28,080 --> 00:14:33,399 produced like an itch between the chest, it is like a thought, as 220 00:14:33,399 --> 00:14:37,600 it burns you, because I did not see these tigers giving it to rubber 221 00:14:37,639 --> 00:14:41,159 riazgo and I, without knowing, without being expert, nothing more from the 222 00:14:41,240 --> 00:14:43,639 experience of the years that I worked mechanics said that type does not know what 223 00:14:43,720 --> 00:14:48,639 also ay inclusive. They don' t go three times at n five days 224 00:14:48,679 --> 00:14:50,879 a week and six days a week doing the same exercise Riazo boss. I 225 00:14:50,919 --> 00:14:54,840 lasted my three days hurting my arms, wrists and sheath. I say because 226 00:14:54,919 --> 00:14:58,639 how these guys do this. I, that' s why I say respect, 227 00:14:58,000 --> 00:15:01,720 but they must be aware, because the moment they decide to withdraw from 228 00:15:01,720 --> 00:15:05,799 crossfit, the consequences are very strong because of that kind of exercise they do 229 00:15:05,879 --> 00:15:11,720 at the level of the lime- adrian cartilage. Brasieles correct the posture, 230 00:15:11,879 --> 00:15:15,519 they work, yes or no. Graciel has to correct the look posture. 231 00:15:15,679 --> 00:15:18,159 I say you can use it, but if you don' t strengthen the 232 00:15:18,279 --> 00:15:22,200 cut, you' re nothing, because the shoulders are going to get right, 233 00:15:22,399 --> 00:15:24,320 you' re going to be right from the breasts up, but the 234 00:15:24,360 --> 00:15:28,440 bottom you' re going to scurry. It' s like sitting on the 235 00:15:28,639 --> 00:15:31,120 computer, right shoulder, but scurvy down you' re gonna be like this. 236 00:15:31,440 --> 00:15:33,600 So, when it doesn' t strengthen or if the breasts are too 237 00:15:33,679 --> 00:15:39,840 big, there comes the part about health care. It' s when I 238 00:15:39,919 --> 00:15:43,000 give you a breast reduction, that' s what happened to many patients. 239 00:15:43,159 --> 00:15:48,799 It is referred to that they already do a breast reduction and has greatly improved 240 00:15:48,919 --> 00:15:52,679 the symptoms and signs at the level of the back and the posture of the 241 00:15:52,679 --> 00:15:54,039 back. Yeah, it gets better with gym,' cause I see. 242 00:15:54,440 --> 00:15:58,399 Yeah, it gets better, but it' s constancy. You have to 243 00:15:58,480 --> 00:16:02,759 be aware when I' m full of a person in a gym. At 244 00:16:02,919 --> 00:16:06,200 three or four weeks you notice the change of postures and more, if they 245 00:16:06,240 --> 00:16:08,480 do more repetitions and little weight, you notice more, because when you want 246 00:16:08,559 --> 00:16:12,000 to make a lot of weight, example, Alberto center and to gym and 247 00:16:12,120 --> 00:16:15,399 decides to put it with all the weight. But tomorrow he' s leaving 248 00:16:15,399 --> 00:16:18,159 for Florida, Alberto' s already coming down from there and it seems like 249 00:16:18,159 --> 00:16:21,720 I' ve never exercised. I greet the people of Orange Feor and there 250 00:16:21,720 --> 00:16:26,799 to William Nor all the team who did their best to improve my self. 251 00:16:26,840 --> 00:16:30,679 But you can' t get into a background and first instance into a competition 252 00:16:30,759 --> 00:16:33,960 like they have levels that don' t so much I started a sheath. 253 00:16:34,240 --> 00:16:38,159 I started downstairs and then they got bigger. I was three years old, 254 00:16:38,559 --> 00:16:42,320 not because he gave me a sheath and I scared him, but it wasn 255 00:16:42,320 --> 00:16:47,120 ' t my fault, because I would jump in, Friday, sába and 256 00:16:47,440 --> 00:16:53,240 Sunday exactly I would go on Monday hangover dehydrated and this body asked for rest, 257 00:16:53,240 --> 00:16:56,600 the tropical body. Then it was my fault. He gave me a 258 00:16:56,600 --> 00:17:00,399 sheath, I got scared and I lasted a year paying for it, but 259 00:17:00,440 --> 00:17:00,600 you scared me, I would go and get back from the box. Not 260 00:17:00,639 --> 00:17:06,200 coming today. Then I' ll have my whole story. But I want 261 00:17:06,240 --> 00:17:10,440 to go back to crossfit because there' s a question left pending. If 262 00:17:10,599 --> 00:17:12,039 a person already made a decision and goes into that, what is it that 263 00:17:12,079 --> 00:17:18,319 you recommend you should do beforehand before leaving to avoid finishing a cardiologic checkup, 264 00:17:18,720 --> 00:17:23,480 a pulmonary checkup, because they are exercises that are going to be quite strong 265 00:17:23,559 --> 00:17:27,240 many times and the checkup by me, on the Orthopedics side check at least 266 00:17:27,359 --> 00:17:33,960 how he is in question, his physical build internally, where are mainly the 267 00:17:33,079 --> 00:17:38,480 knee, hip and shoulders. After that he starts so that he understands that 268 00:17:38,599 --> 00:17:41,880 he can, because there is one thing. The body warns you and tells 269 00:17:42,000 --> 00:17:45,240 you whether or not you can. You can try an army, but if 270 00:17:45,319 --> 00:17:48,160 you see that you can' t, don' t keep insisting because it 271 00:17:48,200 --> 00:17:52,559 ' s going to give you the warning and there come the tears What was 272 00:17:52,839 --> 00:17:56,599 it that we started talking about he cra We' re going to ask Dr 273 00:17:56,960 --> 00:17:59,519 Siman a couple of questions on the phone when she gets smoldered that she' 274 00:17:59,519 --> 00:18:04,160 s Ortopeda. What a friend of ours, what they call this. Well, 275 00:18:04,319 --> 00:18:10,640 you know, we high- performance athletes like me, they always inculcate 276 00:18:10,680 --> 00:18:18,640 in us that the proteins of this little thing of all jugles or the Latin 277 00:18:18,720 --> 00:18:22,519 dust and that kind of thing. That' s what the word they use, 278 00:18:22,240 --> 00:18:26,359 that regenerates the muscles and that kind of thing. What to say Look, 279 00:18:26,599 --> 00:18:30,400 I allow you to use everything you want to use. But first check, 280 00:18:32,160 --> 00:18:37,160 because there' s substance from that one that contains too much caffeine or 281 00:18:37,319 --> 00:18:40,880 already contains things that are going to increase the pressure and that then you suffer 282 00:18:40,920 --> 00:18:41,400 from the pressure being twenty- eight years old and you don' t know 283 00:18:41,400 --> 00:18:45,000 why it is. I have many acquaintances who unfortunately, are a lecturing today 284 00:18:45,119 --> 00:18:51,160 because of the type of supplements they were consuming. Well that first then that 285 00:18:51,279 --> 00:18:55,160 I do, I do complete analytics check that all levels are okay. If 286 00:18:55,240 --> 00:18:59,880 you decide to do a routine supplementation. Do it, but at least every 287 00:19:00,039 --> 00:19:03,759 four months or, every six months check your kidneys a whole yes two already 288 00:19:03,480 --> 00:19:07,400 you are going to do a cycle. It' s a totally different thing. 289 00:19:07,480 --> 00:19:10,319 Of course it' s good. We' re not going to put 290 00:19:10,400 --> 00:19:14,720 up costeroid photo We need to know at that moment which one I' m 291 00:19:14,799 --> 00:19:18,920 going to use your question. Good morning, Doctor, it' s okay. 292 00:19:19,000 --> 00:19:26,359 I have a displacement in the five in the spine and I need to 293 00:19:26,480 --> 00:19:30,759 be guided by what type of shoes I should exercise, if there are any 294 00:19:30,839 --> 00:19:36,799 specific ones or for me to be able to work, as that causes me 295 00:19:37,440 --> 00:19:44,039 inflammation and discomfort. The first thing would be that the precise dianostic, because 296 00:19:44,079 --> 00:19:48,880 many times they say displacement, but that is to say sometimes they have ethnic 297 00:19:48,880 --> 00:19:51,759 protructions or other things added. And I always say it. Shoes well cushioned 298 00:19:51,839 --> 00:19:55,160 and do not last long in the same position, neither much sitting nor much 299 00:19:55,240 --> 00:19:57,799 standing. But if you don' t strengthen the core for better shoe than 300 00:19:57,799 --> 00:20:00,799 you buy, there' s going to be pain. The chair like Alberto 301 00:20:00,880 --> 00:20:03,759 ' s that changed it, then that goes hand in hand the posture when 302 00:20:03,880 --> 00:20:10,960 it comes to sitting. I must say that the philosophy of the rock is 303 00:20:10,960 --> 00:20:15,759 then applied. And Penis Doctor what the philosophy of penis. Hair is the 304 00:20:15,880 --> 00:20:18,799 penis and much standing and not much sitting. That' s a penis muscle. 305 00:20:21,039 --> 00:20:26,359 Good morning, or they took her good morning, good morning they' 306 00:20:27,559 --> 00:20:32,079 re worth doctor feu Months and I started skating with my daughter mex there that 307 00:20:32,119 --> 00:20:40,240 hurt my foot and I literally can' t last my right foot five minutes 308 00:20:40,720 --> 00:20:45,079 with my foot on it painting bent because it hurts immediately. The safest thing 309 00:20:45,119 --> 00:20:49,880 was a sprain, probably type two, because of the kind of sport I 310 00:20:49,920 --> 00:20:53,079 was doing at the time. The good thing, it would be to check 311 00:20:53,160 --> 00:20:56,319 it out, because I' ve always said it and I' m going 312 00:20:56,680 --> 00:21:00,559 to repeat it, I prefer a fracture that one is guince and the sprains 313 00:21:00,559 --> 00:21:00,599 sometimes pass seven years, five years. She' s got the same pain, 314 00:21:00,920 --> 00:21:04,400 she' s dancing herself, and if she doesn' t take care 315 00:21:04,400 --> 00:21:04,960 of herself, she' s off the radio. Please, and ask Dr 316 00:21:06,319 --> 00:21:11,640 Cimena and well, good morning. Doctor the factite and plant, which is 317 00:21:12,000 --> 00:21:15,680 very common. Today I suffer. I think you already ta both stones, 318 00:21:15,720 --> 00:21:22,440 factite and plant aha that provokes it. Maybe you want him to split up. 319 00:21:22,680 --> 00:21:26,799 It is almost always the footwear that causes it or a bad tread. 320 00:21:26,240 --> 00:21:30,680 For example. Emplo, you go with a nocalizo, to say something, 321 00:21:30,039 --> 00:21:33,759 and when you walk there' s a stone, you step on it and 322 00:21:33,880 --> 00:21:37,079 you keep walking. The next day you can produce both or shoes. It 323 00:21:37,200 --> 00:21:41,480 is quite corroborated by the prolonged use of it. It' s not that 324 00:21:41,519 --> 00:21:44,519 you can use it, because I use it. But it' s not 325 00:21:44,599 --> 00:21:45,319 that you happen every day, every day, every day a few cros, 326 00:21:45,559 --> 00:21:48,920 because it' s really going to go straight to the phase, to the 327 00:21:49,000 --> 00:21:52,440 easy and plant. If we touch the sole of the foot, there goes 328 00:21:53,039 --> 00:21:56,160 a full faci, goes from the heel to the fingers. So, when 329 00:21:56,200 --> 00:22:00,720 she gets inflamed, they put the word fascitis in her. They plant the 330 00:22:00,720 --> 00:22:06,359 rite. There was a man named Agapito, who never wore a shoe, 331 00:22:06,839 --> 00:22:12,240 but he developed a cachaza that could pass as a braza, clung on his 332 00:22:12,319 --> 00:22:15,279 feet through a cachaza, a sheath looks. There are people who never do 333 00:22:15,359 --> 00:22:18,440 a pedi que ori and that which Alberto is talking about has a lot of 334 00:22:18,440 --> 00:22:22,079 logic. There are patients who have never gone, I have had a pedicule 335 00:22:22,279 --> 00:22:27,319 have an increase of that dead skin and when they do not do the pedicule, 336 00:22:27,480 --> 00:22:33,359 it starts to hurt the heels because to them there is a dehydration of 337 00:22:33,440 --> 00:22:34,319 the level of the heel and that causes pain. And that' s gonna 338 00:22:34,400 --> 00:22:40,559 ask you how much being cachazu afe isn' t. It' s not 339 00:22:41,039 --> 00:22:47,400 that terrible affection, it' s that you don' t get people, 340 00:22:47,839 --> 00:22:48,240 cachezumente your most beautiful form you don' t. That' s a dead 341 00:22:48,640 --> 00:22:53,599 skin that even many dermatologists and recommend that you remove it, recommend that you 342 00:22:53,720 --> 00:22:57,880 say hydration, that you hydrate your feet at night can put on a cream 343 00:22:57,960 --> 00:23:03,279 to put on your half and moisturize, but no one likes to do it. 344 00:23:03,480 --> 00:23:07,200 One time I put a raging cream without the average and it looks like 345 00:23:07,359 --> 00:23:14,680 a pee tro. You' ve already flown the last call from the doctor. 346 00:23:14,799 --> 00:23:18,440 It does give me good morning where I already can get an orthology ban. 347 00:23:19,000 --> 00:23:25,759 Good morning, Doctor, I' ll put a cat in the shoes 348 00:23:25,799 --> 00:23:29,359 of an outside canister. How do you remember that shoes are crawling out of 349 00:23:29,400 --> 00:23:33,119 the water, they are worn out already ok has cowboy floor. Yeah, 350 00:23:33,680 --> 00:23:37,599 I spend them, too. I' m listening now, as you can 351 00:23:37,680 --> 00:23:42,039 see that. Uh, yeah, you can do that. You' d 352 00:23:42,200 --> 00:23:45,960 have to see the kind of footprint you' re having. Many times they 353 00:23:45,039 --> 00:23:49,960 come with problems at knee level or had some pain at some point and change 354 00:23:51,039 --> 00:23:53,240 the tread. First you have to do a pedometry to see some kind of 355 00:23:53,319 --> 00:23:56,279 footstep, what you have to start correcting that. If it is or kiss 356 00:23:56,440 --> 00:24:00,000 it happens a lot that they are changing the tread for the type, that 357 00:24:00,160 --> 00:24:04,680 the load increases at the level of the hip, the knee and the resfordo 358 00:24:04,759 --> 00:24:07,759 does not hear when lubricating between feet the purchase Baseli, tattoo Ke Drolation. 359 00:24:10,599 --> 00:24:11,160 No. But, my God, no, no, no, no, 360 00:24:11,240 --> 00:24:15,160 no, we don' t help everything. It' s strong, it 361 00:24:15,880 --> 00:24:19,160 ' s strong, no, no, applying the technique of mechanics. Here, 362 00:24:19,160 --> 00:24:22,000 in mechanics, lubrication is vital. That' s true. I only 363 00:24:22,119 --> 00:24:26,640 give the Council that, please, to all those who suffer trauma or who 364 00:24:26,720 --> 00:24:30,039 are suspected to have, even if it is a number one tear, which 365 00:24:30,079 --> 00:24:33,000 is the mildest, go to Sister Doctor, go to your orthopedic not alfisiatra 366 00:24:33,400 --> 00:24:37,960 directly, first to the orthopeda, cu then the orthopedic sends the reference to 367 00:24:38,000 --> 00:24:42,440 the psiathra so that if the physiatric has light and is not lost when you 368 00:24:42,519 --> 00:24:45,359 arrive you do not know what to do and send to do all the studies 369 00:24:45,480 --> 00:24:48,720 and waste the time, and then it does not help both the psiathra and 370 00:24:48,799 --> 00:24:52,359 us topal But do not owe me. I' m not gonna bowl you. 371 00:24:52,440 --> 00:24:59,039 The doctor has her office in the Tower Hearts united, on the fifth 372 00:24:59,200 --> 00:25:00,839 floor. That' s where it' s really naco, in the kiso. 373 00:25:00,880 --> 00:25:06,319 It is correct and you can contact the doctor by a number of whatsapps 374 00:25:06,319 --> 00:25:10,160 that you already have also if you want to follow her on the networks and 375 00:25:10,200 --> 00:25:11,839 write her out there that there also this link to whatsapp. What are eight, 376 00:25:12,000 --> 00:25:15,759 zero, nine, six, ninety- two zero five, three, 377 00:25:15,119 --> 00:25:21,680 eight and grace of Eria Quia is my social networks. We thank Dr Cimena 378 00:25:21,720 --> 00:25:26,160 al Mansar as always shedding light on these issues that have now become so common. 379 00:25:26,279 --> 00:25:30,640 As my friend said, three hours waiting to shut it down and every 380 00:25:30,720 --> 00:25:33,720 day they' re going to increase more for things we' re living. 381 00:25:33,839 --> 00:25:37,119 Not so much, the part of hurting you in a sport is the movement. 382 00:25:37,200 --> 00:25:41,240 Here' s the engine, the carts and the bugle on the bike. 383 00:25:41,440 --> 00:25:45,279 That' s right. So take care of yourself. Gentlemen, thank 384 00:25:45,319 --> 00:25:48,279 the doctor. We used to say happy weekend, Doctor, a hug, 385 00:25:48,000 --> 00:25:49,119 make a kiss one day from this.