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The Integra continues in the enviable tradition of providing a fully independent, four-wheel double-wishbone suspension system for a superb combination of sporty handling and excellent ride quality.
The objective was to provide the Integra driver with a vehicle that is responsive and comfortable in daily driving, yet with excellent cornering stability, good traction and stable behavior.
The components of the front suspension are an L-shaped lower control arm, an upper control arm, a coil-over shock absorber, a stabilizer bar and a performance rod. For the GS-R front suspension, the engineering team also specified the use of a shock tower bar and on all Integras, a stabilizer bar equipped with ball joints instead of rubber bushings. The tower bar ties together the tops of the front spring/damper assemblies. The performance rod is designed to act as an A-arm cross brace to enhance handling and precision and stiffen the front lower subframe. The tower bar and performance rod are designed to enhance rigidity and contribute to suspension precision.
In order to enhance stability under braking in both a straight line and while cornering, the L-shaped lower control arm has been equipped with specially tuned compliance bushings. These bushings allow the lower control arm to impart a toe-out condition on the front wheels. Allowing the wheels to toe out while braking in a corner enhances stability and allows the vehicle to track more precisely.
The engineering team has tailored the suspension to take the full benefit of negative scrub geometry, especially when braking on a split-friction surface. Under this condition, the suspension tends to maintain greater directional stability by countering the forces that would normally tend to steer the vehicle in the direction of the side with the lower traction coefficient. By balancing these forces, the Integra tends to brake with maximum stability.
The rear double-wishbone suspension components consist of upper and lower control arms, a trailing arm, a coil-over shock absorber and a stabilizer bar.
The engineering team designed the Integra suspension to deliver neutral handling characteristics and provide the driver with high-quality feedback and excellent traction. The spring/shock combination offers both a resilient ride and precise handling. Each shock absorber uses a 30 mm cylinder and is equipped with an exclusive progressive valve unit, which opens progressively in response to wheel loads. Most shock valves are designed to either open completely or close completely in response to vertical wheel loads. This system provides better ride quality along with excellent handling.
All Integra models feature four-wheel disc brakes, with ventilated rotors at the front and solid rotors at the rear. For better brake pedal feel and braking control and to provide a short pedal stroke, the front brake calipers are large, stout units that have a higher resistance to flexing and "spread" under severe braking conditions.
The Integra uses a state-of-the-art ABS system to help the driver maintain steering control during hard braking. This lightweight system also functions with minimal pedal kickback during ABS operation.
The Integra features an innovative, power-assisted steering gear design that is lighter and more compact than conventional power steering systems. Instead of modulating power assistance to the steering rack in accordance with road speed, this system varies power assist by a combination of engine rpm and the amount of torque generated between the pavement and the tire. The advantage of this system is that it exercises more precise control over the amount of power assist provided. It also provides more linear steering effort with regard to lateral loads encountered while cornering.
All models feature 195/55R15 84V Michelin XGT-V4 all-season performance radial tires mounted on lightweight 6.0 JJx15 machine-finished aluminum-alloy wheels. The tires have been specifically developed to work in concert with the suspension calibrations, to provide excellent traction, stability, controllability and predictable handling behavior.


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Parachute Factory & Maker Scouts Las Vegas, NM
Parachute Factory is a community Makerspace in rural Las Vegas, NM. We are home to Hacker Scouts Guild #005, and some of the greatest makers in the state!
Parachute Factory will showcase projects projects from our space and our Hacker Scouts Guild.
"For our workshop we will teach 3D scanning and printing using an X-Box Kinect, ReconstructMe, and our PrintrBot 3D Printer. The workshop will be led by Mariano Ulibarri, Parachute Factory's Director, with help from several of our Hacker Scouts. Guests will learn the basics of 3D capture and printing, and have a chance to be scanned in 3D and uploaded to Thingiverse!"
Follow them on their website: parachutefactory.org/
or facebook page: https://www.facebook.com/ParachuteFactory

subset: commoncrawl


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Nina Rinalda Platform Pump
Sorry, this item is sold out!
Looks like you've got more shoe shopping to do - have fun!
Looks like you've got more shoe shopping to do - have fun!
Item # dsw12prod3920259
Get the picture perfect look you want at your next special occasion with the Nina Rinalda. This stunning platform pump has a glamorous silhouette that will add a touch of femininity to your evening ensemble.
- Satin upper
- Almond toe
- 1" satin or fine glitter covered platform, 4¾" covered heel
- Leather sole
- Imported
By: evaking
Location: Moreno Valley
December 27, 2012
nina not good
"this shoe was very uncomfortable. i could not wear it."
By: araemess
Location: Nebraska
December 14, 2012
Love BUT too narrow
"I love the look of these shoes.I got them in Red and when I got them I tried them on they were too narrow. They fit great other than that."
By: Eihrys
Location: Beavercreek, OH
December 09, 2012
"I bought the red version of these shoes. They look amazing online but quality was very low. The platform section was not aligned correctly with the top portion. They were extremely painful and not the same size. My left foot is slightly smaller than my right but its not too great of a difference. The left shoe was so large that my foot kept coming out of it and the right shoe was so small that it was painful to put my foot into it. I would not recommend these shoes for anyone based on quality or comfort."
Click anywhere to close this.


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By Ginna Parsons/NEMS Daily Journal
The trouble with mothers who are good cooks is that many times, they don't let their children in the kitchen to see how food should be prepared.
Consequently, they turn out young husbands and wives who don't know the first thing about making cornbread or frying chicken or cooking turnip greens.
Liz Beasley had one of those moms.
"Mother was a wonderful cook, but she would not let me cook," said Beasley, 72. "I had to teach myself. Right after I married at 17, I invited my mother and my brother-in-law over for rice pudding. I realized after I'd served it that I was supposed to cook the rice first. It wasn't fit to eat."
Beasley soon found herself some cookbooks, and when she did have questions, she was quick to get on the phone with her mother or mother-in-law.
"I've turned out to be a simple cook, just a country cook," said Beasley, who has one daughter, and four grandchildren whom she helped to raise. "But I'm not a convenience cook. I cook from scratch mostly."
Beasley, who worked for 15 years at the Charm Step shoe plant and another 26 at Mueller Copper Tube, said she's learned to take her time when she cooks.
"I sift my flour before measuring it to get a more accurate amount," she said. "I make sure my margarine and cream cheese are at room temperature. And I get all my ingredients out and measured and ready before I start to cook something and sometimes, I still mess up. But it seems like the more trouble you go to, the better your food is sometimes."
When the Beasleys' grandkids were living with them, they loved for her to cook big Sunday dinners. But now that it's just her and her husband, J.W., she's backed off that some.
"The grandchildren used to love that meal," she said. "They'd always want macaroni and cheese and fried okra and banana pudding. So whenever they come now to visit, I have to make all that."
Beasley said she relies on her tried-and-true recipes, and she rarely tries anything new, unless someone recommends something to her.
"I have about 30 cookbooks, but I don't really use them," she said. "I've gotten to an age where I can't remember what cookbook a recipe I want to use is in."
Do you know a good cook? Send your nominations to Ginna Parsons, Cook of the Week, P.O. Box 909, Tupelo, MS 38802. Or you can fax them to (662) 842-2233 or email them to email@example.com.


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Teen Services in 15 Minutes or Less
From YALSA
Many folks serving teens in libraries do so only on a part time basis, making delivering good teen services a challenge. Help out your colleagues by adding to this page quick and easy things that busy library workers and librarians can do to serve teens:
Collection Development
- Pick one shelf of YA books to weed.
- Read a blog post or two on The Hub to find out what's trending in YA literature.
- Share the Teens Need Libraries web page or brochure with your library administrator or local policy makers www.ala.org/yalsa/teens-need-libraries
- Invite your administrator to an upcoming teen program or event
Overall Management/Organization
- Create an "Ideas for Next Year" folder and add information about possible programs, events, activities, etc. as you think of them
- Read the 10 page Public Library Evaluation Tool for teen services to familiarize yourself with the basics of an overall program for serving teens through libraries
- Read the mission and/or strategic plan for your library and identify ways that your overall teen program supports it
- Read the series "What Your Manager Wishes You Knew" on the YALSAblog
- Ask the local school librarians if they would post fliers at their school about an upcoming teen program you're planning
- Contact the local university's Communications Department to see if any students would be willing to volunteer their time to help create marketing materials for you
Professional Development/Personal Growth
- Visit your state library association's web site to see if they have a YA or youth section you could connect with
- Check out YALSA's Google Calendar for upcoming webinars, e-courses, conferences, etc.
- Get a new program idea by visiting the YALSAblog http://yalsa.ala.org/blog/
- Ask your coworkers what hobbies, interests and skills they have and whether they'd be interested in presenting a teen program on the topic
Readers' Advisory
- Download and make copies of YALSA's Ultimate Teen Bookshelf and leave them at the circulation desk for parents, teens and others to take www.ala.org/yalsa/handouts
- Use blank address labels to create teasers & put them on books. E.g. "murder most foul," or "surprise ending" and so on
- Make a large "New Books!!!" sign and display some new titles with it
Relationship building/Outreach
- Thank a coworker, volunteer or patron who has helped you in the teen area
- Invite a local youth group, such as the Girl Scouts, to hold one of their meetings in the library
- Make a list of other youth serving organizations in your area and resolve to contact each one to see how you might work together for mutual benefit
- Make a "how may may I help you?" button and wear it
- Create a tip sheet on how to access databases remotely for school work
- Do a walk through of the teen area and take a quick inventory of anything that is overly worn or shabby and that needs replacing
- Pretend you're a new library patron. Walk through the teen space & see if you can find everything easily. If not, create signs that point people in the right direction.
Youth Development & Participation
- Be a good role model for teens by talking about what you're currently reading
- Make time to listen to a teen who is having a bad day and wants to vent
- Make a "suggestions" box and place it in the teen area. Check it regularly for easy things to implement that would make teen patrons happy
- Read the 40 Developmental Assets for Adolescents


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Top Definition
Any type of sexual fantasy between a young caucasian male and a cartoon character, doll, or any fictional female figure (like rainbow sprite). This obsession causes the owning (and/or, becoming) a filipino sex slave and lynching a black co-worker, friend, or peer, only after drugging his can of sprite with a rainbow assortment of drugs]. The young caucasian then procedes to draw a picture of the entire lynch scean, as the filipino sex slave(s) strawberry shortcake the black friend.
Doug: Wow that kid is messed up!
Lou: Why? What he do Doug?
Doug: He rainbow sprited his buddy Zak.
Lou: Why? What he do Doug?
Doug: He rainbow sprited his buddy Zak.
by Ilovestrawberryshortcake! October 04, 2009
The Urban Dictionary Mug
One side has the word, one side has the definition. Microwave and dishwasher safe. Lotsa space for your liquids.Buy the mug
The Urban Dictionary T-Shirt
Smooth, soft, slim fit American Apparel shirt. Custom printed. 100% fine jersey cotton, except for heather grey (90% cotton).Buy the t-shirt


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Browse by Creator
Group by: Item Type | No Grouping | Creators | Year of publication, submission, or completion
Jump to: K
Number of items: 1.
Kinsey, K., Anderson, S. J., Hadjipapas, A., Nevado, A., Hillebrand, A. and Holliday, I. E. (2009) Cortical oscillatory activity associated with the perception of illusory and real visual contours. International Journal of Psychophysiology: Official Journal of the International Organization of Psychophysiology, 73 (3). pp. 265-272. ISSN 0167-8760 Available from: http://eprints.uwe.ac.uk/8192
This list was generated on Tue Feb 28 02:33:17 2017 GMT.


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Listen to free music by The Beatles
Blip.fm is internet radio made social. It's easy to search for, play, and discover free music recommended by real people. Join today to create your own free station.
The Beatles – For No One
The Beatles
For No One
The Beatles songs played by Blip.fm DJs
DonkeyRide The Beatles – Yes It Is ± ± ± Didn't know this Beatles song.. till now ;)
The Beatles – Yes It Is| play
The Beatles – Because| play
new_clear_MUSIC ❤STRAWBERRY FIELDS FOREVER❤ by @thebeatles ~ [god bless..] RB @just_a_gigolo: "Remembering John's birthday.." ❤ (reblip)
THE BEATLES – Strawberry Fields Forever| play
just_a_gigolo Remembering John's birthday.
THE BEATLES – Strawberry Fields Forever| play
Plural_Tastes She Said She Said
The Beatles – She Said She Said| play
Artists Like The Beatles
Blip.fm DJs who play The Beatles
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Strengthening Opportunities and Decision - Making for Sustainable Management of Islands
New Database Brings Together Vital Data on Biodiversity to Climate Change Covering 70,000 Islands
New York, 10 May 2010 - A pioneering new database, bringing together for the first time information from biodiversity and climate change to social and economic factors covering some 70,000 islands, was launched today.
The Global Island Database (GID) is aimed at boosting sustainable management of the often unique and rich nature - based assets found on islands across the globe.
It will also assist island governments to play a more central and pivotal role in international negotiations and decision - making in respect to the management of scarce resources, including at the upcoming meeting of the Convention on Biological Diversity in Nagoya, Japan in October.
The database, which has been developed by the United Nations Environment Programme's World Conservation Monitoring Centre (UNEP - WCMC) in conjunction with partners, in response to a request from the Global Island Partnership (GLISPA), was unveiled today at the UN - Commission on Sustainable Development's celebrations for Small Island Developing States (SIDS).
Its launch coincides with the release of the third edition of the Global Biodiversity Outlook (GBO - 3) by the UNEP - linked Convention on Biological Diversity as part of the 2010 UN International Year of Biodiversity.
Achim Steiner, UN Under - Secretary General and UNEP Executive Director, said: "High quality databases are crucial for addressing both the threats to biodiversity and economically - important ecosystems, while maximizing the development opportunities from a more intelligent and sustainable management of these natural and nature - based assets".
"Islands may only cover three per cent of the global land area, but they are a treasure trove of biodiversity and home to some of the rarest and most unique species that in turn hold valuable genetic resources. The 20th century was an industrial age: the 21st century will increasingly be a biological one. The importance of this database for island nations cannot be over stated, and is long overdue," he added.
The GID (http://gid.unep-wcmc.org/index.html) represents part of a "kit" being launched by the CBD and UN - DESA as part of these events, which calls attention to how the GBO - 3 is useful to SIDS and provides a list of tools and links for assisting SIDS to include biodiversity issues in their development plans
"The GID not only allows the visualisation of data relevant for islands but also provides added - value through contextual information, data analyses and a networking platform for organizations to upload information about themselves and their work" said Francine Kershaw, GID project lead at UNEP - WCMC. "This beta version provides an excellent baseline and we are actively seeking partners and collaborators to help us build upon the GID in order to best serve the island community."
UNEP - WCMC is a partner in the GLISPA, a mechanism to implement the CBD's island biodiversity programme of Work (IBPoW). UNEP - WCMC committed to working with GLISPA to develop the GID and a strategy for maximising its utility, accessibility and relevancy to inform and advance the global island debate, and to support decision - makers and island resource managers, in direct response to the CBD's IBPoW, adopted in 2006. The GID has been developed in order to directly reflect five of the themes important for islands, as identified by the IBPoW, namely biodiversity, climate change, invasive species, pollution and sustainability.
"The need for a tool like the Global Island Database was one of the original gaps identified by GLISPA and it is going to be extremely useful for island countries and countries with islands, as well as others to help to develop regional and global strategies related to islands" said Kate Brown, Coordinator of the Global Island Partnership.
Funded by the Italian Ministry of Foreign Affairs, through UNEP, the GID has been under development since 2008 and already represents a multi - partner initiative with strong links to the Global Islands Network (GIN), as well as IUCN's Species Survival Commission's (SSC) Invasive Species Specialist Group (ISSG) and the Pacific Ecosystems at Risk (PIER) project.
Support is now being sought for the next phase of development, where priorities include expanding the existing partner - base in order to strengthen the current data - holdings, with particular emphasis on filling the significant gaps in present island information, provide a greater number of analysis products aimed at answering specific policy questions, and actively encourage networking between organisations working on similar issues in order to strengthen capacity within island regions.
For more information on the Global Islands Database, please contact:
Louisa Wood, Head of Marine Assessment and Decision Support Programme, UNEPWCMC, Tel: +44 7872542106, email: louisa.wood@unep - wcmc.org
Francine Kershaw, GID Project Lead, UNEP - WCMC, Tel: +44 1223 277314, email: francine.kershaw@unep - wcmc.org
For more information on islands and the CBD IBPoW, please contact:
Oliver Hillel, CBD Secretariat, Tel: +1 514 288 - 2220, email email@example.com
Kate Brown, Global Island Partnership, Tel: +1 202 288 2606, email email@example.com
Islands represent merely 3% of the global land area yet are home to disproportionate levels of the world's biodiversity with many unique species existing only on a single or related group of islands. However, island species are also among some of the most threatened. Their high levels of endemism and generally small population sizes make them particularly vulnerable to human and natural disturbance events and as such they have exponentially greater extinction rates compared to the mainland. Continued loss of this biodiversity is of global importance. Many species have critical ecosystem roles and island societies depend largely on local biodiversity - whether terrestrial, freshwater or marine - for their livelihoods as well as their social and cultural significance.
The UNEP World Conservation Monitoring Centre (UNEP - WCMC) is the biodiversity assessment and biodiversity policy support arm of the United Nations Environment Programme, the world's foremost intergovernmental environmental organisation. The Centre has been in operation for over 25 years, providing objective, scientifically rigorous products and services to help decision makers recognise the value of biodiversity and apply this knowledge to all that they do. The Centre's core business is locating data about biodiversity and its conservation, interpreting and analysing that data to provide assessments and policy analysis, and making the results available to both national and international decision makers and businesses.
The United Nations Environment Programme (UNEP), established in 1972, is the voice for the environment within the United Nations system. UNEP acts as a catalyst, advocate, educator and facilitator to promote the wise use and sustainable development of the global environment. To accomplish this, UNEP works with a wide range of partners, including United Nations entities, international organisations, national governments nongovernmental organisations, the private sector and civil society.
The Italian Ministry of Foreign Affairs, through the Environment Programme of its Directorate General for Development Cooperation (DGCS) "Cooperazione Italiana allo Sviluppo", invests significantly on projects specifically aimed at supporting islands. Over 10 million Euros per year have been spent for their conservation, sustainable development, disaster management and risk - preparedness in the last five years.
The Convention on Biological Diversity (CDB) was signed by 150 government leaders at the 1992 Rio Earth Summit, the (CBD) is dedicated to promoting sustainable development. The Convention was inspired by the world community's growing commitment to sustainable development. It represents a dramatic step forward in the conservation of biological diversity, the sustainable use of its components, and the fair and equitable sharing of benefits arising from the use of genetic resources. The Convention has now been ratified by 193 Parties, including all SIDS.
The Global Island Partnership (GLISPA) assists islands in addressing one of the world's greatest challenges: to conserve and sustainably utilize the invaluable island natural resources that support people, cultures, and livelihoods in their island homes around the world. It brings together island nations and nations with islands small and large, developing and developed to mobilize leadership, increase resources and share skills, knowledge, technologies and innovations in a cost - effective and sustainable way that will catalyze action for conservation and sustainable livelihoods on islands. It is recognised by the Convention on Biological Diversity (CBD) as a partnership to advance the implementation of the CBD 2010 biodiversity target, to reduce the rate of biodiversity loss, and the programmes of work on island biodiversity and protected areas.
The UN Department of Economic and Social Affairs (UN DESA) and its predecessors have helped countries around the world meet their economic, social and environmental challenges for more than 50 years. DESA's mission to promote development for all reflects a fundamental concern for equity and equality in countries large and small, developed and developing.
The Global Islands Network (GIN) is a Scottish based charity established in 2002 whose main aim is to conduct and promote culturally appropriate, ecologically sound, economically sustainable and socially equitable development on islands worldwide. GIN presently comprises 146 partner organisations spread over 60 countries and has built up formal working collaborations with a range of UN agencies and international bodies. An active member of the Global Island Partnership (GLISPA) with a central goal to help implement the priority actions of the Convention on Biological Diversity (CBD) Island Biodiversity Programme of Work (IBPoW) which was formally adopted at its 8th Conference of the Parties (COP8) meeting in Curitiba, Brazil, in March 2006.
The Invasive Species Specialist Group (ISSG) is a global network of scientific and policy experts on invasive species, organized under the auspices of the Species Survival Commission (SSC) of the International Union for Conservation of Nature (IUCN). The ISSG aims to reduce threats to natural ecosystems and the native species they contain by increasing awareness of invasive alien species, and of ways to prevent, control or eradicate them. The three core activity areas of the ISSG are technical advice, information exchange and networking.
Further Resources
Global Island Database
UNEP: World Conservation Monitoring Centre (WCMC)
Global Biodiversity Outlook 3
Global Biodiversity Outlook (GBO-3) full report
Follow Us
Keep up to date with UNEP events on Facebook, Twitter and You Tube.


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I wish I was good at facial fractures. I am not. There wasn't enough volume of these cases when I was a plastic surgery resident, so I came into private practice not feeling comfortable with them. Then there wasn't much volume in the early years of my practice to gain a comfort level with them. Later I began to avoid them. When EMTALA came along, I decided to withdraw my facial fracture privileges from the hospitals where I continue to do unassigned ER call. I felt this was my only way to protect the patient from my lack of skill or insufficient skill or however you want to put it. I continue to sew up the facial lacerations, but if there is a fracture associated with the laceration the ER now has to call someone else.
Before EMTALA, I would have sewn up the lacerations and gotten the appropriate X-rays (now CT scans). Then the next day, I would have called someone else--either plastic surgeon, ENT, or oral maxillary surgeon to take over the care. They wouldn't have been called in the middle of the night, but during the day time hours. It would have been okay. No one would have felt like I was "dumping" on them.
Still I continue to ready the journal articles about facial fractures. As you can see from the second reference below, there has been a recent supplement volume (very comprehensive) dedicated to these fractures. Since I learn by writing these posts, I thought I would try to tackle this topic over several posts. It still won't improve my OR skill with them, but it might clarify some of my understanding of them. I hope you will indulge me and maybe learn with me.
There is a nice basic summary at eMedicineHealth on facial fractures.
The zygoma is the bone that is known as the cheek bone. It articulates with the maxilla, the temporal bone, the sphenoid bone and the frontal bone. It forms the prominence of the cheek and part of the lateral wall and floor of the orbit (eye socket). It is this prominence that makes it so susceptible to trauma.
The mechanism of injury usually involves a blow to the side of the face from a fist, object (like a baseball), or secondary to motor vehicle accidents. Studies show that 80% of these injuries are due to motor vehicle accidents. Moderate force may result in minimally or nondisplaced fractures at the suture lines. More severe blows frequently result in inferior, medial, and posterior displacement of the zygoma. Comminuted fractures of the body with separation at the suture lines (the places where the different bones meet/join) are most often the result of high-velocity motor vehicle accidents.
Over the years, isolated fractures of the zygoma have been called zygomatic, tripod, or orbitozygomatic fractures. The last term is the preferred. Here in the United States, zygomatic fractures are the second most common fracture of the facial bones. The first being nasal bone fractures. As many as 5% of these patients have associated ophthalmic injuries. Males are afflicted more commonly than females by a 4:1 ratio. Most cases occur in young patients in their second to third decades of life.
Physical signs and symptoms of zygoma fractures include
- Subconjunctival hemorrhage and periorbital ecchymosis are seen in as many as 50% of patients.
- Disturbance of sensation in the region of the infraorbital nerve
- Palpable step-offs in the upper lateral orbital rim, inferior orbital rim, and upper buccal sulcus
- Emphysema within the orbit or overlying soft tissues of the cheek
- Trismus -- is difficulty with mastication and can occur because of masseter spasm or bony impingement of the coronoid process.
- Malposition of the globe and /or diplopia (double vision)--Diplopia may be secondary to change in pupillary alignment or to entrapment of the inferior rectus muscle by the orbital wall fracture. Patients with entrapment may complain of diplopia on upward gaze.
- Globe injury needs to be ruled out as well. Traumatic optic neuropathy is a complication that has been reported in about 2 to 5 percent of severe facial trauma.
Facial swelling is almost always substantial by the time the patient is seen by the surgeon. This tends to minimize the degree of deformity, masking the cheek malposition. The swelling may take 2 weeks to resolve so that the patient (and surgeon) can visually (not by CT scan) appreciate the true deformity. However, the best result is obtained if the reduction and stabilization of the fracture is done within the first 2 weeks after the injury. So the surgeon has to be good at 3-D visualization to fully appreciate the bone structure injury and to optimally reduce the fracture while the soft tissue swelling is still present.
These are deformities that occur because of untreated or mistreated fractures. They are not uncommon (unfortunately). They include
- Underprojection of the cheek and a wide face.
- Overprojection is possible, but not as common as the first.
- Globe malposition--either enophthalmos (a sunken eye, is the most common) or exophthalmos (eye protrudes out of the socket).
- Soft-tissue deformities from inadequate suspension after extensive surgical exposure. Cheek ptosis, inferior displacement of the lateral canthus, temporal hollowing, and lower lid ectropion are the most common.
Patients with suspected facial trauma should initially be evaluated with a complete craniofacial CT scan. A full facial analysis from the top of the head through the mandible with 1.5 mm axial cuts will allow coronal reformatting without additional scanning. Sagittal reformatting is useful in assessing the effect of a complex orbital fracture on the inferomedial bulge of the orbital floor. If the patient presents with neurologic compromise (head injury or intoxication) and cannot comply with a complete physical examination, it is prudent to obtain a complete scan at the time that the head CT scan is obtained.
Several classifications of zygomatic fractures have been described in the literature, but none seem to be universally accepted. Most classifications are based on the degree of comminution, whether the fracture is simple or compound, and the site of the fractures. In 75% of cases, these fractures are displaced inferiorly, medially, and posteriorly. The classification system by Knight and North identifies six groups:
- Undisplaced -- require no therapy, see Medical Care below
- Arch fractures -- considered a stable fracture
- Unrotated body fractures -- can usually be treated by closed reduction
- Medially rotated body fractures -- considered an unstable fracture
- Laterally rotated body fractures -- considered a stable fracture
- Complex fractures having additional fracture lines across the zygomatic body
The literature indicates that 10-50% of all zygomaticomaxillary complex fractures require no surgical intervention. This is suitable for fractures that are nondisplaced or minimally displaced or where systemic status precludes operative intervention.
- Stable, nondisplaced fractures may be observed weekly for healing.
- Avoidance of nose blowing is mandatory in the medical care of these patients. The disrupted orbital walls can allow air to be forced into the retrobulbar space and cause pain and visual loss. This avoidance of nose blowing should last for several weeks to a couple of months.
- Avoid sleeping face down or with pressure on the affected side of the face
- The routine use of systemic antibiotics for isolated zygomatic arch fractures generally is not recommended.
- Patients commonly are placed on a soft diet for six weeks. A dietary consultation may be warranted.
- All contact sports and most strenuous activity also should be avoided for several weeks.
The aims of treatment of zygomatic complex fractures include the restoration of normal facial form, normal sensory nerve function, normal globe position, and normal masticatory function. Indications for repair of zygomatic complex fractures include displacement or instability of the fracture, mechanical restriction of mandibular movement (chewing), alteration in facial contour, globe dystopia, enophthalmos, diplopia, or sensory nerve deficit.
Generally, it is suggested to avoid surgery during times of maximum edema but prior to the adhesion of displaced bony fragments and scarring of soft tissues into bony defects. Most surgeons advise surgical intervention prior to the formation of dense scar tissue. As a general guideline, surgery should be undertaken prior to 3 weeks postinjury, optimally prior to 2 weeks postinjury.
Isolated arch fxs and minimally displaced noncomminuted fxs
- The Gilles approach may be used. It can be done under either local anesthesia with sedation or under general anesthesia. A vertical incision is made in the temporal hairline, and the elevator is then tunneled underneath the temporalis fascia, keeping in mind the superficial temporal artery branches and the temporal division of facial nerve, which is nearby. Then lateral pressure with superior anterior rotation is exerted to pop the fracture back in place.
Unstable or potentially unstable fractures
- A more aggressive approach using open-reduction techniques and rigid stabilization with plating systems (eg, Synthes or Leibinger) is the standard of care today. This approach provides direct access to the frontozygomatic suture, orbital floor, and infraorbital rims.
- Precise reconstruction with rigid internal fixation of the zygoma at 2 or 3 points (across the frontozygomatic suture, the inferior orbital rim, and the lateral midfacial buttress) is needed to counter the force of the masseter muscle. The orbital contents can be supported as for simple orbital floor fractures.
COMPLICATIONS of Surgical Repair
Many of these are included in the list of secondary deformities listed above.
- Diplopia has been quoted to occur between 3.4 and 8 percent. It is most often thought to be secondary to extraocular muscle contusion, swelling, and occasionally entrapment as well. As a result, forced duction test is recommended prior to closure to make sure there is no muscle entrapment, and when in doubt CT can be used.
- Anesthesia/dysesthesias, usually in the infraorbital nerve region, has been reported between 0.4 and 11.6 percent postoperatively as well; however, usually they resolve on their own, but if they last more than three to twelve months, then one may suspect impingement as a possible cause.
- Enophthalmos, as you see in this picture here, is most often secondary to inadequate fracture reduction. This has been reported to occur anywhere between 1 and 23 percent postoperatively. If enophthalmos is noted during the early postoperative period, reoperation is a viable option. Most often, the enophthalmos is thought to be due to the fact that the zygoma has been fixed too far posteriorly and laterally; however, in the late postoperative period, reoperation will often require osteotomy (re-fracture).
- Complications related to hardware eventually requiring removal is also not uncommon. The most commonly cited reason for needing removal is palpability, specifically in the infraorbital rim and the frontal zygomatic suture region. In this study, they also saw an isolated case of plate fracture.
- The rare complication of sudden onset blindness resulting from retrobulbar hemorrhage following reduction of even simple zygomatic fractures means that in some instances, this procedure may be unsuitable for outpatient surgery. This serious complication, although rare (0.3% of treated zygomatic fractures), is potentially reversible upon early recognition of the symptoms and signs of retrobulbar hemorrhage (eg, pain, proptosis, loss of vision, decreased motility). If the surgeon suspects a retrobulbar hemorrhage, a lateral canthotomy and cantholysis should be performed as soon as possible. This should be completed at the bedside if the patient has visual compromise and is not near the operating suite.
Facial Trauma, Zygomatic Complex Fractures by Zachary Segal MD, et al--eMedicine Article
Craniofacial Trauma; Supplement to Plastic & Reconstr Surgery, Vol 120, No 7, Suppl 2, Dec 2007; Larry H Hollier, Jr MD and James F Thornton MD
Orbital Fracture, Zygomatic by Stuart R Seiff, MD, et al--eMedicine Article
Facial and Mandibular Fractures by Michael L. Richardson, M.D., University School of Medicine
Blindness after Reduction of Facial Fractures; Plastic & Reconstructive Surgery. 102(6):1821-1834, November 1998; Girotto, John A. M.D.; Gamble, William Bryan M.D.; Robertson, Bradley M.D., D.D.S.; Redett, Rick M.D.; Muehlberger, Thomas M.D.; Mayer, Mike M.D.; Zinreich, James M.D.; Iliff, Nicholas M.D.; Miller, Neil M.D.; Manson, Paul N. M.D.
Zygomaticomaxillary Complex Fracture by Tang Ho, M.D.;
October 7, 2004--Grand Rounds Baylor College of Medicine
Manual of Internal Fixation in the Cranio-Facial Skeleton: Techniques By Joachim Prein


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Lacrosse news straight to your inbox.
Tuesday November 5th, 2013 1:20am
Box score
HAMDEN, Conn. – Junior Basil Kostaras (Southlake, Texas) registered a natural hat trick in the first quarter of a Sunday afternoon matinee, but the Quinnipiac University men's lacrosse team was unable to fend off Brown University in its season-opener at the QU Lacrosse Turf Field. The Bears came roaring back with six unanswered goals en route to a 12-7 triumph on the road.
The Bobcats jumped out to a quick lead behind a tremendous first-quarter showing from Kostaras. The junior midfielder netted three goals in the opening 15 minutes, granting Quinnipiac a 3-2 lead at the end of the frame. Freshman Matt Diehl (Towson, Md.) collected his first career assist in the game's first goal, while Kostaras finished the next two unassisted.
The next quarter featured a furious comeback from the visiting Bears. Including the first quarter's last goal, Brown boasted off six straight tallies to take a 7-3 lead with four minutes left in the half. Each team added one before the halftime whistle, leaving an 8-4 advantage for Brown at the break. Junior Brendan Wilbur (Hingham, Mass.) recorded his first goal of the season, with the assist coming off a pass from Kostaras.
After the intermission, Brown netted three of the game's next four goals to extend its margin to six. Quinnipiac gained some momentum midway through the fourth quarter with back-to-back goals, but Brown's Nick Piroli ended the comeback bid with his third goal of the game. Wilbur tallied his second goal of the game for QU, followed by a nod from Dylan Webster (Brampton, Ontario).
For the game, Brown outshot QU, 34-28, overall, and, 20-19, in shots on target. In addition, Brown's efficiency on the faceoff also proved to be a difference, as the Bears won 13 of the 22 showdowns in the middle. QU totaled one more turnover than Brown and neither team could convert with an extra-man advantage (QU: 0-4 and BU: 0-2).
Freshman goalkeeper Dylan Torey (Darien, Conn.) made the start between the pipes for the Bobcats. He made eight stops, including a spectacular kick save that brought the crowd to its feet in the first frame. Will Round turned away 12 saves in his first career win for the Bears.
The Bobcats return to action next weekend with their first road test of the season. Quinnipiac heads to Colorado Springs, Colo. for a clash with Air Force, a game slated for 11 a.m. (MT). For all information regarding the men's lacrosse program, please visit www.QuinnipiacBobcats.com.�


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Remember when roughs were a place that golfers never wanted to go? Today, they are expected to be playable. This means that to some degree, today's superintendents are mowing and maintaining roughs on a regular basis. Milorganite's slow release formula provides 8-10 weeks of feeding without excessive top growth.
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By TERRY WILLISSports Writer
For the Helper American Legion Team last week was definitely a busy one. They had four league games and won them all. They now sit at 6-0 and are in first place. Starting off with a win against Granger they then headed to Tooele and beat them 6-3. Thursday they opened the tournament at home with a 17-2 win over Roosevelt.
Helper then played the late game on Friday against Hunter and this game counted as a league game as well as a tournament game. Hayden Basinger pitched another complete game and did a great job on the mound as they picked up a 13-0 win. But then the winning streak came to an end with an 18-6 loss to the powerful CNCC scout team. Desert Hills took a shot at Helper and beat them 11-6 to give Helper a fourth place tournament finish. Then a rematch, make-up game against Hunter put the Helper boys back on the winning track with a 10-0 win and moved their league record to 6-0.
Josh Denison picked up a complete game to start things off last Wednesday and did a great job keeping the Tooele hitters off balance. For Coach Jeff Cisneros it was a relief to get through the game. "We played a good game and beat a good Tooele team on their field. We were missing eight players due to a basketball camp and the guys really played well."
Against Roosevelt, the team was still short players so Daulton Nelson from the 14 year old team came up to pitch. He threw a complete game and did a nice job as they just over matched Roosevelt 17-2. Nelson threw strikes and Helper played good defense behind him the entire night.
"We really hit the ball well as we pounded out 14 hits. Roosevelt committed seven errors and the game was called after the fifth inning due to the nine-run rule. This was a good way to start our tournament and I was very pleased with the way we played," stated Cisneros about his tournament opener.
Hayden Basinger had three hits and Daulton Nelson and Nate Martinez had two hits apiece. It rained all night Thursday night but we were still able to get games started at 9 a.m. the next day.
Helper took on Hunter in a late game Friday and played great defense and offense in the game. They had 10 hits and only committed one error. Braden Bolotas had two singles and Nate Martinez had a pair of doubles.
All of the winning came to an end Saturday night when they took on the college bound team from Colorado Northwestern. The game started out good as Colter Moore kept the college team scoreless in the first inning. But in the second inning they gave up three runs and fell behind 3-0. In the third, Helper responded to score six runs to take a 6-3 lead. Daniel Peczuh hit the team's first home run of the season.
Then the wheels came off in the fourth and CNCC scored five and when the inning was over Helper trailed 8-6. Helper put up a goose egg in the fourth and then allowed CNCC to score 10 more runs in a very long fifth. Errors and five walks attributed to most of the 10 runs. Helper did not score in the fifth and the game was called on the nine-run rule.
"This game was very disappointing. We had been playing so well all week long and our inability to throw strikes and make plays cost us a game that I really thought we should have won. CNCC is a good team and went on to beat a college team from CEU for the championship of our tournament, but I really felt like we were just not mentally prepared to play Saturday night. When your pitchers do throw strikes it really puts your defense on their heels and it showed as we had nine errors and only five hits on the night," remarked Cisneros.
The lost sent them to play Desert Hills Sunday morning for the third place game. Knowing they had a make-up league game with Hunter to play after the game Cisneros took the chance to get some younger guys some experience in the Desert Hills game. Nick Stoddard started the game on the mound and struggled to throw strikes. It had been almost two weeks since Stoddard pitched and the rust showed. Desert Hills took a 6-0 lead early. Helper answered with three runs in the third inning on a home run by Kenny Seals and hits by Peczuh and Chris Coleman. Tyler Bean came in and pitched the remainder of the game did a nice job for being a position player asked to do some pitching. The final ended up 11-6 and Helper finished as the fourth place team.
Cisneros added "I was disappointed in the loss but I knew we had to bounce back and play a league game in a matter of minutes."
Clint Finkbiner took the mound in the league game against Hunter and again pitched a complete five inning game. Finkbiner threw strikes and Helper's defense made plays. The offense for Helper started off slow but picked up by the third. They scored in each inning after ending with 10 hits. Finkbiner only allowed Hunter three hits.
Cisneros summed up the busy week, "I could not be happier with the way our guys played, especially earlier in the week with all the guys gone to basketball camp. I tell the guys every year, most all games come down to pitching. It seems if your pitching is going good, then your defense plays well and your offense seems to click. I'm really starting to see our guys gaining confidence and if some of our younger guys continue to get better I really think we are going to finish out the year OK. It's obvious that when we get good pitching our team plays really well and when we don't we struggle. We play at East Monday and then we are at home with Kearns Wednesday night. I would really like to thank the community for their support over the weekend during our tournament."


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New faces are set to add extra spark to an old rivalry as England travel to Paris on the first weekend of the Six Nations Championship.
New faces are set to add extra spark to an old rivalry as England travel to Paris on the opening weekend of what is set to be an intriguing Six Nations Championship.
Indeed, new selections have dominated the headlines in the build up to le Crunch as some bold, and some enforced, changes have given both of Saturday's protagonists a fresh look.
There will be three debutants at kick-off – Jules Plisson, Jack Nowell and Luther Burrell. France have another on their bench in Antoine Burban. Jonny May has just one cap to his name, Alexandre Flanquart and Henry Thomas have just two while Bernard le Roux, Rabah Slimani and Gael Fickou have only three each. (France field a more experienced starting XV with a total of 354 caps compared to England's total of 286.)
It's hoped that all that fresh blood will bring a sharper attacking edge to two teams that have failed to ignite imaginations for a long time, but the high-stakes nature of this game is likely to result in another arm-wrestle.
The pressure will be squarely on the home side. Unlike England, who have the luxury of playing both Wales and Ireland on home soil, defeat for France will likely end their title hopes. Beyond the need for points on the Championship table, les Bleus are desperate for a positive result as Philippe Saint-André's team try build some momentum after a wretched 2013.
England certainly can't be accused of being overly cautious. The selections of Nowell and Burrell to play in an arena as intense as the Stade de France are bold calls, though not without merit. Nowell illustrated in the Heineken Cup double header against Toulon that he isn't afraid of the big stage – nor will be England's other new cap.
May might eclipse both of them when it comes to impact, the Gloucester flyer adding his searing pace to an England back division that appeared to be stagnant in last year's tournament. Stuart Lancaster has not held back, and dropping Chris Ashton epitomises that – there must have been a temptation to retain his experience at Test level. By leaving him out, Lancaster shows that he is not afraid to gamble. Marland Yarde and Christian Wade would no doubt have been selected if fit. This England squad certainly isn't dull.
For all the change to England's backs, their pack is reassuringly solid and consistent. Joe Marler gets the nod over Mako Vunipola but both are excellent young players. England have two outstanding hookers, with Dylan Hartley preferred this time round. Hartley has bounced back from the shameful low of being sent off in the Premiership final and missing the Lions tour more impressively than many expected. He is now integral. Courtney Lawes and Joe Launchbury will roam; young and athletic enough to make plays but now wise enough to run a successful line-out.
The key addition though for England is Billy Vunipola. The reason the tries dried up in 2013 were because England lacked the runners to get them over the gain line. Not anymore – with Burrell, Vunipola, Tom Wood, Chris Robshaw and the second row pairing all being natural ball carriers. The impact England can bring off the bench in Tom Youngs, Mako Vunipola and Ben Morgan continues that trend.
For France, personnel changes are perhaps less welcome as the losses of fly-half Rémi Talès and flanker Thierry Dusautoir represent a major spanner in the works. Plisson has been groomed for the big stage but he is being thrown into the deep end far earlier than had ever been hoped. Le Roux comes nowhere near to filling the enormous gap left by the absent skipper and must be considered the weak spot in the French pack.
And it's the pack that counts. For the all noise made about England's midfield and France's fly-half, the battle is – once again – set to be decided up front.
In anticipation of England's set-piece and aerial onslaught, Saint-André has specifically picked Flanquart – in an all-Stade Français second row – for his strength in the air at line-outs and restarts.
England have a 5kg weight advantage amongst the forwards and could well have the upper hand in the tight-loose. But the French scrum, led by an experienced front row, will test England's youthful unit.
Doubt lingers over how England's new personnel and combinations will handle the occasion, but Lancaster has named a strong, solid side. If the visiting pack can hit the heights of last November, then England could make it a hat-trick of wins over their great rivals.
Players to Watch:
For France: If you're good enough, you're old enough…or so the saying goes. Saint-André insists that he has no doubts 22-year-old Jules Plisson will cope with the pressure of making his debut against France's fiercest rivals, but told Thursday's press conference that he was keeping the fly-half away from the media because he wanted the youngster to "stay concentrated." This may be his first cap, but the Stade Français playmaker has been part of the French set up since the start of the PSA era, having been brought into group to learn the ropes with an eye on the future. His time has now come, even if it is a little earlier than initially planned. Meanwhile, skipper Pascal Papé wins his 50th Test cap.
For England: 26-year-old Luther Burrell has gone from warming the bench at Sale Sharks to producing bulldozing runs in the Heineken Cup for Northampton. His rise is down to hard graft, with his size ensuring that England will not miss Manu Tuilagi too much in midfield. His confrontation with Mathieu Bastareaud will be seismic.
Head-to-head: Speaking of earth-shaking hits, look out for the clash between two of the most destructive forces in Europe, Louis Picamoles and Billy Vunipola. Both number eights are key players in creating go-forward ball for their respective teams, especially on what is likely to be a wet surface. The defensive numbers sucked in to stop potential rampages could open up gaps elsewhere.
Previous results:
2013: England won 23-13 at Twickenham, London
2012: England won 24-22 at Stade de France, Paris
2011: France won 19 -12 at Eden Park, Auckland
2011: England won 17-9 at Twickenham, London
2010 :France won 12-10 at Stade de France, Paris
2009: England won 34-10 at Twickenham, London
2008: England won 24-13 at Stade de France, Paris
2007: England won 14-9 at Stade de France, Paris (RWC)
2007: France won 22-9 at Stade Vélodrome, Marseille
2007: France won 21-15 at Twickenham, London
2007: England won 26-18 at Twickenham, London
2006: France won 31-6 at Stade de France, Paris
2005: France won 18-17 at Twickenham, London
2004: France won 24-21 at Stade de France, Paris
Prediction: You have to go back to the amateur era to find the last time England managed back-to-back Championship wins in the French


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Nike Tiempo Rio FG Soccer Cleats - Womens
Sorry, this item is sold out!
Looks like you've got more shoe shopping to do - have fun!
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Enhanced speed and power is what you will exude on the football field in the Tiempo Rio Firm-Ground soccer cleats from Nike®, enough said, just get a pair and score some goals.
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May 14, 2013
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The Discover Your Super Power Test
All possible test results
No Powers
Sorry, you didn't get any powers. You appear to be completely normal. Tough luck. Read more
Control the Elements
Wow, pretty cool! Earth, air, fire, and water are at your beckon call and command. You don't just control the weather, but the very forces and elements of nature itself! Way to go! Read more
Read Minds
You're a psychic and you can read minds! But please don't read my mind right now, because I'm imagining you naked. Of course, you're probably already used to people doing that. Ah, the joys of bein... Read more
That's right, you can see the future! You have precognition, you know what's gonna happen before it does! Few powers are as useful as this, so good for you! Congrats. But you probably already knew... Read more
Super Strength
Yup, classic but ever useful, super strength. Heroes and villains have been using this power from the very beginning, and it's still popular to this day. Every team needs a guy or gal with super str... Read more
You are invincible. Your body is made of steel, or something solid and indestructible like it. Nothing can break you. Nothing can stop you. Raar! Read more
Was that a ghost? No, it's just you. You can turn invisible! Congrats, that's a really useful power to have when sneaking into places -- like girls (or boys) locker rooms or top secret government o... Read more
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You can blast energy -- out of your hands, or your eyes, or use-your-imagination somewhere else. This power comes in really handy, especially since it's really good for attacking villains (or heroes)... Read more
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Very cool. You control gravity. Which, of course, you can use to make yourself fly and do other cool tricks. But you can also apply this awesome power for crushing your enemies, rearranging the ter... Read more
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Every team needs someone with your powers. With a mere thought, you can protect everyone with an impenetrable force field. Granted, it's not the best offensive power ever (unless you get really crea... Read more
Illusions / Doubles
You can create very real and very convincing optical illusions -- illusions that others can see and feel! As your power grows, you'll be able to control these illusions ... making an infinite number ... Read more
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You're fast. Really fast. You have super speed. You've won every race you've ever been in. You're never late to work. And get to avoid sitting in traffic in rush hour, because you just run home. ... Read more
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You can travel through time. Very, very cool. Just don't go back and accidentally kill your grandfather or anything, because then you'll be stuck in an endless paradox loop. But you already know ab... Read more
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How to Train your back with an injury
T NATION | How to Train Like a Bad Ass - Even with a Bad Back
How to Train Like a Bad Ass – Even with a Bad Back
by Dean Somerset – 5/13/2011 How to Train Like a Badass, Even with a Bad Back
If you're a lifter that's developed a back injury but still wish to make progress in the gym without causing more damage, this article is for you.
Working around back injuries is sort of like playing Russian Roulette. "Will this set of deadlifts make it feel better or cause a disc to shoot across the room and take someone's eye out?"
Hey, I've been there. I've had to learn the hard way what works for my back after getting tackled playing football, dislocating my hip from my spine, tearing a few important muscles in my low back, and having to walk with a limp for a year or two.
I still get back pain occasionally, but it doesn't stop me from training because I know what movements I can and can't do and how to limit the damage I do in the gym.
Here's a quick and dirty guide on how to lift like a man, keep your T cranked through the roof, and make figure competitors swoon from your pure awesomeness, even with back pain.
Step 1: Figure Out What the Hell is Wrong
Barring any incident of radiating pain down the leg, numbness, loss of function, or obvious deformity to the spine, most back injuries aren't going to necessarily require medical intervention. Now, before the room full of gun-shy trainers reading throw up their hands and scream, "REFER THEM TO THE DOCTOR ALL THE TIME!!" the simple fact is that most back injuries will not be viewable on an MRI, X-ray, or other medical imaging report.
Here's a little known secret about spinal MRI's. A study in the New England Journal of Medicine in 1994 showed roughly 52% of the population is walking around with a disc bulge at one level, and around 38% have a disc bulge at more than one location. Many are asymptomatic, meaning there's pretty much nothing that can be done to help, short of massive invasive surgery that, in most cases, would be completely unnecessary.
Most physicians will prescribe some muscle relaxants, say "take some time off," and then send you on your way (with a bill, no less). Clearly, for the T-brethren reading, simply being told to rest and "stop training" isn't an option.
There are, however, things you can do to see what you should do and what to avoid in the gym. The easiest way to go about this is movement mapping. Performing a series of simple movements that can help determine which ones cause more pain or less pain, and then use the results to guide you in the gym. Further, it can give you an idea of what may be wrong and what you need to do to fix it, or who you need to see to get it fixed.
For example, one of my clients with back pain came in for me to check and see what the hell he did. When he performed a simple forward bend test, he had a nice spinal hinge in the mid-lumbar spine.
Step Two: Work it Out
Strong Back
The majority of acute low back injuries will get better on their own with no intervention within 4-6 weeks, but if it's a chronic problem, the muscles will begin to atrophy and weaken, making future back injuries more likely to happen. You need to start getting your workouts on track, but you also need to have a game plan of what to do and what not to do to protect your vulnerable spine and build new slabs of beef.
Whenever you're doing any exercise with a bad back, you have to think about getting your core to support the work and reduce the chance of further injuring yourself. The best way to do this is through a concept Dr. Stuart McGill calls "super-stiffness."
By contracting all the abdominal, low back, pelvic and intercostal muscles at once, you can increase the uniform stability of the spine and limit the chance of a buckling injury or any problems with your discs.
To get this idea of super-stiffness to work for you, think about flexing your abs like you're going to show off for the ladies. Now contract the oblique muscles and low back muscles, making sure you're not contracting so hard that you can't breathe. Bonus points if you can clench your anus, draw your testes up, and bow your diaphragm down. That's a stable core, baby!
This should be done whenever you're performing any exercise listed below, as well as any type of lifting, pushing, pulling, bending, or twisting. In other words, whenever you're doing anything at all, ever.
Now that you know how to get your core correct, let's look at the specific movements that may be giving you grief.
Movement: Flexion
One of the most common movement dysfunctions for low back pain (LBP) is spinal flexion. The majority of disc issues within the lumbar spine involve posterior nuclear migration and cause a bulging of the disc into the central (less common) or lateral (more common) canals, which then pushes on nerves and often leads to crippling pain.
To test this one out, simply sit in a chair and touch your toes. If that seems impossible, stop before you hurt yourself. If this is easy, try to stand upright and touch your toes. Pain or having to slowly ratchet your way down would indicate a problem and would necessitate that you avoid doing certain things.
Don't Do:
Deadlifts, bent-over rows, and seated rows. I definitely love my deadlifts, but if a flexion intolerant spine flare-up happens, they can be the equivalent of checking for hemorroids with a cattle brand.
Sit-ups or any ab isolation movement that forces flexion without co-contraction of the low back muscles.
Spinal rotation movements, like twists and chopping movements.
Leg presses. You're forced into spinal flexion under load, so it's a no-go.
Standing calf raises and back squats. The direct compression on the discs can be uncomfortable and put even more pressure on the discs.
Glute hip press. This bad mamma-jamma makes your glutes sing without placing your spine under any negative loads. Plus, jacking four plates off the floor with your butt will make the ladies check out your action.
Front squats or goblet squats. These hit the legs without straining the back, and force the spine to resist being pulled into flexion.
Any type of chin-up, pull-up, or lat pulldown, etc. The lats play a huge role in recovery of the spine, as they wrap all the way from the shoulder down to the pelvis, and can add to the stability of the spine. Try to perform these with a T-spine extension.
Push-up variations. These will increase the need for spinal stability over bench presses or dumbbell presses, and can be progressed by elevating the feet, adding chains or weighted vests, if needed.
Also: As a cool-down, McKenzie postures will help the spine reorganize itself out of a flexion bias, and help to reduce any acute flare-ups of flexion-based back pain.
Start on your stomach with your chin on your fists, and progress up to your elbows as pain allows. Hang out here for about 2-5 minutes, or until you feel your back completely relax. Bring your laptop or iPad and read TNation while you're there. All the cool kids do it.
Movement: Extension
While not as common as a flexion-based pain, extension can be just as limiting, but can easily be trained around. Most extension-related issues revolve around facet joint issues or even soft tissue compression, so movement that involves extension should be controlled or eliminated.
To test this one out, lie on your stomach and prop yourself up on your elbows. If this makes you wish for a quick death, or if it simply results in a dull ache, stop doing it and follow the recommendations below.
Don't Do:
Back extensions. This should be obvious, considering the name implies the movement that's causing the problem.
Deadlifts. They can take an unholy toll on the spine, and it only takes one technical mistake, especially when you already have some sort of pain, to make the problem worse. Best to leave it alone until you feel 100 percent again. You'll manage.
Barbell squats. The spine has to extend, under compression and against shear forces, to squat. That's three strikes for an extension intolerant spine. Skip it.
Overhead pressing. The spine needs to extend to move the arm overhead. No dice.
Rotation. Whether standing, sitting or lying down, it's a no-fly zone.
One-foot squat & row. This makes you work a squat pattern and a pull pattern, while keeping your pelvis and spine in a better alignment than you could ever do by isolating the movements.
Dips. The combined effect of core activation for the pushing movement, plus the added distraction on your spine when you hang your body weight with no force pushing up will make your back thank you. Plus, the spine isn't in extension, so happiness all around.
Spine-supported crunches. You can still get your abs on, in a safe manner. (And don't worry, this isn't a traditional crunch that gets everyone in a tizzy.) Place a hand under the small of your back, and bend one knee to get the best crunch possible for the least wear and tear on your back.
Low cable bent over row. This requires less extension than a true bent over row, and also reduces the shear force within the vertebrae, so it will help you protect your back while you're gunning your lats.
Rollouts, also known as straight-arm extensions. These force you to maintain some form of flexion throughout, or else you'll feel a small pinching sensation in your low back.
To do this one properly, think about shortening your abs, keep them locked solid, and allow your hips and shoulders to open through the movement without any movement in the lumbar spine. Don't let the TRX in the video below fool you, these will make your abs feel like they're about to explode, Alien-style, and cause a little T-disciple to bust through your gut and start yelling words of encouragement at you. See video (sans T-disciple) below.
Wrap Up
If your back's holding you back, fight back and get in the gym again. By training around your injury and thinking about what the problem may be versus pushing through it or pussying out on it altogether, you can actually help to speed recovery and get back to a pain-free life.
Nut up, pick your labia off the floor, get in the gym and start lifting again!
take slowly at first and then you can move on from there
Thanks, this is good stuff.
This is relevant to my interests. :(
Thanks for posting it.
Wrong. Completely wrong.
This article started out good when it stated, Here's a little known secret about spinal MRI's. A study in the New England Journal of Medicine in 1994 showed roughly 52% of the population is walking around with a disc bulge at one level, and around 38% have a disc bulge at more than one location. Many are asymptomatic
But then this article went completely awry by not even coming close to correctly defining asymptomatic. The word actually means, Without obvious symptoms. Not showing or producing indications of a disease or other medical condition (Encarta Dictionary).
In other words, many (actually, millions of) people have herniated discs but do not experience back pain. This proves that herniated discs do NOT cause back pain. A herniated disc is a normal part of aging. In fact, back pain is NOT caused by anything physically wrong with the back. In the vast majority of the cases of back pain, it is purely mental in origin.
As such, all of the cautions and exercises prescribed in this article are not only worthless for helping back pain but are dangerous as they are perpetrating the myth that back pain is caused by a structural abnormality. Especially dangerous is the phrase your vulnerable spine. The back is very strong, not a fragile thing like this article makes it out to be.
I know. I fell for such myths and allowed back pain to ruin my life and eventually to totally cripple me for six years. But I completely overcame the back pain, not through any physical treatment but via mind-body techniques. I discuss my experience in detail in an eBooklet available on my site. Please read it before allowing back pain to ruin your life like it did mine.
While it's true that there are social and psychological aspects to pain, let's not throw the baby out with the bathwater. I'll ignore the fact that you have something to sell and just address the biology.
This proves that herniated discs do NOT cause back pain. A herniated disc is a normal part of aging.
No, it proves that their herniations don't cause pain for them. Some people don't feel pain when their bones break - does that mean broken bones don't cause pain for anybody?
But for those that do, (like a disc herniation laterally impinging on L5-S1 for example) there are symptoms that correlate exactly with what physiology would predict - pain, parasthesia, etc - distributed along the areas innervated by that particular nerve on the side affected by the herniation. Pain in these cases can be and is actually relieved by reducing or eliminating the structural damage and pressure on the affected nerves, whether through PT, surgery, or injections.
It is true that some people with herniations don't experience pain, and that those who do can still experience pain even after the tissues involved are healed or fixed. These people could probably benefit from psychological counseling. However, saying that back pain is 100% mental; or that herniated discs cannot be symptom generators for anyone, is just totally wrong.
Just to drive the point home a little more, disc herniations that are severe enough can cause paralysis in limbs and organs innervated at the affected levels. Cauda equina syndrome, for instance, which can be caused by central disc herniations in the lumbar spine, results in permanent paraplegia and lifelong issues with bowel and bladder control if left untreated. That's not a "mind-body" problem, it's the result of structural damage to the anatomy.
First off, my eBooklet cost all of $1.50, , of which I get 52 cents in royalty, so I'm not exactly getting rich off of it. I put it in that format as it was too long for a Web page. But for those who cannot afford that, I have a short summary on my site: http://www.fitnessforoneandall.com/d.../condensed.htm
In that article, I refer to books by Dr. Sarno. If you read the reviews on Amazon of his books you will see over a thousand reviews by people with testimonies just like mine. And if you read Sarno's books, you will find out that I am correct in my assertion that herniated disks and the like do not cause back pain. He documents that very well. If I didn't believe that I would still be crippled by back pain.
"Ultimate Back Fitness and Performance" by Stuart McGill
That is where I would start.......
I stopped reading the article at glute bridges haha!
As long as we're talking about personal stories - a friend of mine herniated his L5-S1 about fifteen years ago. He got PT, then a laminectomy, then a diskectomy. Frankly, he just was not good about doing the kind of exercises that are necessary to rehab from that kind of injury, so it just got worse and worse.
However, about five years ago, he woke up in the middle of the night with tremendous pain in his back, having lost control of his bladder and unable to move or feel his right leg. They hauled him out of his house on a stretcher. I wonder if "talking to his brain" would have helped at this point? Anyways, emergency surgical decompression followed a few months later by a lumbar fusion, alleviated his symptoms entirely.
Again, there isn't a doubt in my mind that for many people, idiopathic back pain without neurologic symptomatology is probably not related to any kind of disc problem. Your and Dr. Sarno's methods would likely help many of these people. IF you are talking about simple back pain, without symptoms of nerve compromise, then I would agree that disc herniations are probably not the pain generator there.
On the other hand, there is mounting evidence that intervertebral discs are innervated and that tears in the annulus fibrosus can therefore generate pain. Not to mention chemical radiculopathy, where a disc with a torn annulus produces neurologic symptoms even in the absence of nerve root compromise!
Fellahs - yall are way over my head but I have had disk tears and annular tears and hell yes they hurt.... do not care if the solution is "crazy " or not .... just wanted some relief
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text: Well i guess i hate the people that run the World Goverment, and those corrupted "pure-blood" Noblemen. The leaders from the WG either do not realize how corrupted their Regime is, or choose to ignore any matters concerning corruption and evil-doers working or connected to the World Goverment. They even choosed to kill off all innocent scholars and children at Robin's hometown. And the Noblement are just asses. >_>


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Manning & Napier Inc. has reached an agreement to acquire Chicago-based investment management firm 2100 Xenon Group LLC, officials said Thursday.
The acquisition is expected to close by the end of the second quarter. Financial terms were not disclosed.
"Manning & Napier has been actively searching for a complementary manager to expand our investment management capabilities to include alternative strategies," CEO Patrick Cunningham said in a statement.
"Our objectives included both product diversification and expanding the solution set we offer to our clients in today's challenging environment. We believe the blend of our sales and service capability with the added investment expertise will prove a winning combination."
The Chicago firm employs 11. It specializes in managed futures and global macro strategies for institutional and individual clients, officials said.
Jay Feuerstein, founder, CEO and chief investment officer at 2100 Xenon, will be part of Manning & Napier's senior research group as managing director of alternative strategies, the local company said. The firm's director of research, Jeff Bolduc, will be a portfolio manager for Manning & Napier's alternative strategies group.
Based in Perinton, Manning & Napier ranked second on the Rochester Business Journal's most recent list of money managers in the area with more than $45 billion in assets under management.
(c) 2014 Rochester Business Journal. To obtain permission to reprint this article, call 585-546-8303 or email firstname.lastname@example.com.
Manning & Napier to buy Chicago company
Manning & Napier Inc. has reached an agreement to acquire Chicago-based investment management firm 2100 Xenon Group LLC, officials said Thursday.
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Benjamin Adams London Mimi Sandal
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text: OverviewBack to top Boiron - Children's Oscillococcinum 6+6 Bonus Pack - 12 Dose(s) Item# :104076UPC# :306962859244 Brand:Boiron Size/Form:12 Dose(s) Ship Weight:0.15 Servings:12 Dosage:1 Tube(s) Boiron - Children's Oscillococcinum 6+6 Bonus Pack - 12 Dose(s) Boiron Children's Oscillococcinum is a safe children's medicine for flu-like symptoms, like body aches, feeling run-down, chills and fever. It has a great taste and no side effects. To help parents who wonder how to ease their children's flu-like symptoms without using suppressants, decongestants and antihistamines, Boiron has created Children's Oscillococcinum for flu-like symptoms. Parents can find this safe and reliable over-the-counter (OTC) medicine in the children's aisle along with Children's Chestal for coughs and new Children's Coldcalm Pellets for colds. Considered one of the safest choices for self-treatment, the active ingredients in homeopathic medicines have no reported side effects, such as making children jittery or drowsy. They do not interact with other medications, herbs or supplements, nor do they mask symptoms that may indicate a more serious condition. The active ingredients are micro-doses of natural ingredients and, most importantly, Boiron's products do not contain any of the ingredients questioned by the FDA for use in youngsters, i.e., suppressants, decongestants and antihistamines. And because they are not body-mass dependent, there's no risk of overdose. "They work in a different way," says the Los Angeles-based Lauren Feder, M.D., author of Natural Baby and Childcare (Hatherleigh Press, 2006). "The principle is that the body knows what to do best for itself. Rather than suppressing symptoms, these medicines work with the body by sending it a signal to help rebalance and heal itself." Dr. Feder, whose general practice consists primarily of children, says it is not dangerous to combine homeopathic medicines with other substances in case parents decided to administer a cough syrup on top of a flu medicine. Give your child Children's Oscillococcinum at the first sign of feeling achy or run-down, fever or chills to nip flu-like symptoms in the bud. Containing six doses to be given in 6-hour intervals as necessary, Children's Oscillococcinum is safe for children 2 years of age and older. Supported by clinical studies1-4 and a long history of safety, Oscillo™ has helped people of all ages reduce both the severity and duration of flu symptoms for 65 years in France and 25 years in the U.S. Children's Oscillococcinum's new packaging highlights its great-tasting, easy-to-take pellets that dissolve quickly under the tongue without water, chewing or swallowing. Each dose is packaged individually in a compact and portable plastic tube, making it convenient to take on the go and easy to keep handy. Oscillo works best when taken at the first sign of flu-like symptoms, and because Oscillo is safe, there is no reason to hesitate taking it. All Boiron products are regulated as drugs by the FDA5 and are clearly labeled for specific indications, making directions easy for parents to understand. They are manufactured according to the highest standards, complying with drug Good Manufacturing Practices (GMPs) and the Homeopathic Pharmacopoeia of the United States (HPUS). As soon as you start feeling run-down or have other flu-like symptoms, take Oscillococcinum. Oscillo is regulated as a drug by the FDA and is supported by published clinical studies as well as more than 65 years of use throughout the world. Clinical studies show that Oscillo reduces the severity and duration of flu symptoms Great taste and convenient to take No side effects or interactions with other medications Good for everyone 2 years of age and older FAQ's Q: Have any clinical studies been conducted on Oscillo?A: Yes. Oscillococcinum has been studied in four separate trials. Two of these trials have been published in peer-reviewed medical journals. A total of 1,250 patients were included in all trials. In general, these studies show that Oscillococcinum works to reduce symptoms of flu. The most recent study showed that 63 percent of patients who took Oscillo at the onset of flu-like symptoms showed "clear improvement" or "complete resolution" of their symptoms after 48 hours, vs. 49% with a placebo.1-3 Q: Will Oscillo make me drowsy like other medicines for flu? Does it have any side effects I should know about?A: No. Oscillo has no known side effects, including drowsiness. There is also no risk of overdose and it won't interfere with existing conditions such as high blood pressure, etc. And Oscillo will not interact with other medications. Q: Can I give Oscillo to my children?A: Oscillo is safe for the whole family—from ages 2 to 102. For those younger than 2 years of age, please consult your physician. If your physician needs medical information, our Boiron Information Center is open Monday to Friday 9 a.m. to 5 p.m. EST at 1-800-BOIRON-1. Q: When do I take Oscillo?A: Take Oscillo as soon as you feel the first signs of flu—you're feeling run-down, are feverish, there's a tickling in your throat, etc. When taken at the onset of symptoms, Oscillo reduces the duration and severity of your symptoms. Q: How do I take Oscillo?A: Take 1 entire unit-dose tube every 6 hours, apart from meals; let the pellets dissolve in your mouth. Take Oscillo until your symptoms disappear. Q: Does Oscillo act quickly?A: Yes, especially when taken as soon as symptoms appear, which is why it is important to keep Oscillo on hand. Q: Does Oscillo have an expiration date?A: Oscillo has a 5-year shelf life and you can find more needed information on the box. Q: Can Oscillo be taken in conjunction with other medications?A: Oscillo can safely be taken with other conventional medicines, as it does not interact with other medications, herbs or supplements. And those who cannot be vaccinated can safely take Oscillococcinum. Q: Can I take Oscillo even if I have a pre-existing condition?A: Oscillo is not contraindicated with pre-existing conditions such as heart, liver or kidney problems, etc. Q: Can I self-medicate with Oscillo?A: Oscillo can be a fast, reliable and appropriate solution for self-medication of flu-like symptoms. However, if symptoms continue for more than 7 days or worsen (see box), you should consult your physician for a precise diagnosis and suitable course of treatment. Q: Can I use Oscillo while I'm pregnant?A: As with any medicine, homeopathic or allopathic, pregnant women should seek the advise of their physician before use. Q: Should I try not to touch the pellets with my hands?A: You should avoid touching homeopathic medicines with your bare hands, but they are no less effective when touched. Q: Does Oscillo contain sugar? If so, how much?A: Pellets contain sugar and lactose (milk sugar). One unit-dose of Oscillo contains 1 gram of sugar (or 1/5 of a teaspoon). How are homeopathic medicines presented?Many homeopathic medicines are presented as specialties in packaging like other over-the-counter drugs you're familliar with. Specialties are very convenient as their indications and directions for use are very clear and specific to a condition. They are available in a variety of dosage forms such as tablets, gels, ointments and creams, syrups, eye drops, and suppositories. If you are not yet familiar with homeopathic medicines, specialties are a great way to discover their benefits. Specialties, like Arnicare Gel or Calendula Lotion, may contain one single medicine although most of the time they combine several active ingredients within the same product. Another very common presentation for homeopathic medicines is the multi-dose tube. This presentation is usually used for medicines containing only one active ingredient. When should I choose a single medicine?In some instances, symptoms are so specific that it is easy to select one single medicine. Many self-medication books are available to help you in your selection. One of the most popular is the Family Guide by Dr. Alain Horvilleur. Boiron offers more than 80 of the most commonly used single medicines, packaged in our signature "multi-dose tubes" to select health food stores and pharmacies. These stores may also special-order other single medicines from the 800 stocked by Boiron. How can I get more familiar with homeopathic medicines?Boiron CareKitsTM provide an excellent opportunity to learn more about homeopathic single medicines. Each kit contains the two or three most useful single medicines for a particular condition, individually packaged in multi-dose tube


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The Way I See It!
I am an Ultra-Conservative, Alpha-Male, True Authentic Leader, Type "C" Personality, who is very active in my community; whether it is donating time, clothes or money for Project Concern or going to Common Council meetings and voicing my opinions. As a blogger, I intend to provide a different viewpoint "The way I see it!" on various world, national and local issues with a few helpful tips & tidbits sprinkled in.
Helping Write a Bill Happens Even If We Don't Like It!
Powerful public sector union SEIU helps Wisconsin county lawmaker write wage hike bill
Big Labor helped a Milwaukee County lawmaker write legislation for union workers that is projected to cost taxpayers more than $27 million over the next six years.
County Board of Supervisors member David Bowen wrote the legislation in collaboration with the Service Employees International Union, fellow board member James Schmitt confirmed.
The so-called "living wage" ordinance could bankrupt the county's Department of Family Care, stunt job growth and hinder future development, according to a fiscal analysis by the county's nonpartisan comptroller's office.
The proposed law would set a living wage of $12.45 an hour for 350 county employees and hundreds of others who work under contract with the county.
However, the proposal offers contracting firms an exemption from the wage increase if their workers are covered by a collective bargaining agreement between the employer and a bona fide labor union.
Bowen, endorsed by the SEIU Wisconsin State Council in his 2012 election, worked with labor union representatives on about 15 drafts and met with them several times in his office at the county courthouse, Schmitt said.
"SEIU, they've been lockstep with it," he said.
The annual costs of the increase could reach more than $8 million after 2017, the year when the Family Care program's reserves are expected to run out.
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Sail away from daily life, leaving your worries and cares far behind and only unbroken Mediterranean ocean ahead of you...
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Itinerary as follows:
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