PREVENT SPORTS INJURIES

ACL SURGERY - YES OR NO?

2012-01-03T18:02:00.004-05:00

I was listening to this podcast today -
Return to exercise after ACL (anterior cruciate ligament) injury, with Dr Richard Frobell

- and I was blown away by this question and answer exchange:

Interviewer to Dr. Frobell: "You are now not so young anymore. So if you had your ACL torn in Alpine Skiing in Sweden, what would you do with it?"

Dr. Frobell: "I would most definitely wait with an ACL reconstruction. I would try rehabilitation at first [my emphasis]. If I still would experience instability because I am an active guy, I like to do sports, and if that would decrease my ability to do sports I would seriously consider a reconstruction. But I would never perform that at first. [my emphasis]"

WOW! What a change in thought. And what a concept.....rehab first!

Injury care = rehab = sports performance. I have been saying this for decades! Surgery is always an option.... but as a last resort if all else fails.

Technique - It has always been and always will be about technique

2012-01-01T20:49:00.002-05:00

Listen to Dr. Anthony Beutler talking about ACL Injury Prevention at the British Journal of Sports Medicine's podcast page - The JUMP-ACL study with Anthony Beutler

"There is no magic in the exercises....What really seems to be magic is the coaching [my emphasis]. Is actually getting people to change the way they perform these tasks, so that they do them in a more biomechanically sound [manner] with a movement pattern that is less risky for injury puts them at less risk for injury. That really seems to be the key so we emphasize good form, your knees need to be in line with your hips, your knees need to be in line with your toes, your toes need to be pointed straight forward and that you land softly."

Like I said, it always has been and always will be about technique.

EVERYONE NEEDS A KNOWLEDGEABLE COACH!

Field Hockey Injuries: Care, Prevention, Training

2011-12-29T10:19:00.000-05:00

Seminar: Saturday, January 7, 2012 at Champions Field House in Rockville from 5pm to 6pm.

For the past month we have had a wonderful intern from Syracuse University, Shannon Connolly. She played field hockey at Springbrook High School and went on to play three years at the Division 1 level. She is now looking at sports medicine as a profession and is compiling sports injury data on the sport of field hockey.

Shannon and I are going to make a presentation on Saturday which will review all the current research on field hockey injury care, prevention, and training. The seminar is FREE so please join us!

Check out Shannon's new blog: Live, Learn, and Play Hockey!

Go PALEO, Go PRIMAL!

2011-12-12T09:40:00.000-05:00

Cholesterol from 220 to 170........... in 10 days!
Dramatically lower your blood pressure!
Cure your type 2 Diabetes in 2 weeks!

Watch this....

Part 1 - http://sanfrancisco.cbslocal.com/video/6336505-healthwatch-caveman-diet-trend-starting-to-catch-fire/

Part 2 - http://sanfrancisco.cbslocal.com/video/6340427-healthwatch-surprising-results-from-%E2%80%98caveman-diet/

Part 3 - http://sanfrancisco.cbslocal.com/video/6344467-healthwatch-caveman-diet-shows-blood-pressure-cholesterol-benefits/

Part 4 – http://sanfrancisco.cbslocal.com/video/6348481-healthwatch-how-realistic-is-caveman-diet-at-home/

Part 5 – http://sanfrancisco.cbslocal.com/video/6352391-healthwatch-for-some-caveman-lifestyle-goes-beyond-diet/

Lightning Safety

2011-12-04T21:09:00.001-05:00

Great article in Emergency Medicine, Vol. 43, No. 10 October 2011.

Emergency care:
1. CPR - Compression, Airway, Breathing - if victim unresponsive
2. As long as victim is breathing a care survey of the entire body must be done and a history from any witnesses must be taken.
3. Exam must include eyes, ears (ear drum rupture is common, bleeding in the ear), extremities (pulses, sensation, cold/clammy), abdomen, neurologic exam, look for burns.

"Lightning causes an estimated 50 to 300 deaths per year and approximately five times as many nonlethal injuries1,2; however, injuries and deaths due to lightning are believed to be underreported."

"Lightning generates intense heat around it, rapidly heating the air to 20,000°C, which is three times the temperature of the surface of the sun. This rapid heating generates a supersonic shock wave that decays to an acoustic wave heard as thunder."

"Lightning produces injury and death by multiple mechanisms.6"
Electrical effect, direct strike, splash mechanism, contact injury, concussive force

"the victim of a lightning strike is unlikely to die since cardiac activity will resume spontaneously. Furthermore, when first examined, the patient may be in cardiac arrest with ventricular fibrillation."

"Telltale signs of lightning injury include an arborealtype burn (ie, Lichtenberg figures), tympanic membrane
rupture, and disheveled appearance of the patient (including clothing that is blasted apart). The patient is
also likely to be confused or amnestic to prior events."

"Recommended laboratory tests include electrolyte measurement, assessment of renal function, complete
blood count, and cardiac enzyme studies, including creatine kinase and troponin assays. ECG is mandatory,
as is cardiac monitoring. The decision to order radiologic evaluation depends on the patient’s presentation and the physician’s assessment. CT of the head may be warranted in patients with altered mental status. Further CT scans may be indicated."

Crossfit

2011-12-04T13:06:00.007-05:00

I have been asked about Crossfit quite frequently, so here is my take: NO!

As with any trainer or training method, the problem is usually the trainer, not necessarily the method. In the Crossfit case it is both the method and the trainers with which I have a problem.

On the Crossfit website it states,
"The CrossFit program is designed for universal scalability making it the perfect application for any committed individual regardless of experience. We’ve used our same routines for elderly individuals with heart disease and cage fighters one month out from televised bouts. We scale load and intensity; we don’t change programs."

Problem #1: Use of the same program regardless of experience. Since Crossfit uses not only standard lifts, but Olympic lifts, kettlebells and other training that is highly technique intensive, the same program CANNOT be used regardless of experience. This just sets the trainee up for injury.

Problem #2: Intensity. Every Crossfit workout I have ever seen in person has been high intensity for all comers and has not been scaled. The posted WOD (workout of the day) is not scaled for load and intensity either.

Problem #3: Injury rate. I have seen many injuries due to the lack of technique focus and high intensity of the workouts. When I have asked my patients to demonstrate the lifts they perform, I have NEVER seen a patient do a movement correctly. This is a BIG problem. Watch the video below...OUCH!

Problem #4: Cultish. Read this article in Men's Health magazine: Inside the Cult of Crossfit. The fact that a workout that caused rhabdomyolysis in a trainee was named for that trainee is beyond disgusting.

There you have it. Be careful. Learn technique. I have no problem with training hard and still train hard at 51 years old, but you must train in a thoughtful manner with regard to your goals. Even for professional and Olympic athletes, overtraining is a common problem.

AHA Recommendations for Preparticipation Cardiovascular Screening of Competitive Athletes

2011-12-03T20:04:00.002-05:00

Washington State study: few doctors follow sudden cardiac death screening guidelines for athletes

TABLE. The 12-Element AHA Recommendations for Preparticipation Cardiovascular Screening of Competitive Athletes

*Parental verification is recommended for high school and middle school athletes.

†Judged not to be neurocardiogenic (vasovagal); of particular concern when related to exertion.

‡Auscultation should be performed in both supine and standing positions (or with Valsalva maneuver), specifically to identify murmurs of dynamic left ventricular outflow tract obstruction.

§Preferably taken in both arms.³⁷

Medical history^*

Personal history

1. Exertional chest pain/discomfort

2. Unexplained syncope/near-syncope^†

3. Excessive exertional and unexplained dyspnea/fatigue, associated with exercise

4. Prior recognition of a heart murmur

5. Elevated systemic blood pressure

Family history

6. Premature death (sudden and unexpected, or otherwise) before age 50 years due to heart disease, in ≥1 relative

7. Disability from heart disease in a close relative <50 years of age

8. Specific knowledge of certain cardiac conditions in family members: hypertrophic or dilated cardiomyopathy, long-QT syndrome or other ion channelopathies, Marfan syndrome, or clinically important arrhythmias

Physical examination

9. Heart murmur^‡

10. Femoral pulses to exclude aortic coarctation

11. Physical stigmata of Marfan syndrome

12. Brachial artery blood pressure (sitting position)^§

Pre-Participation Physical Examinations

2011-11-15T13:57:00.001-05:00

Heart Screenings:
"Symptoms that indicate the need for additional evaluation include an abnormal heart murmur, fainting or dizziness (especially during or immediately after exercise), skipping or racing heartbeats, excessive fatigue or shortness of breath associated with exercise, unusual chest pain or discomfort during exercise, high blood pressure, close relatives with heart conditions or the premature cardiovascular-related death of a close relative under the age of 50."

If you or your child has one or more of the above mentioned symptoms, GET EXAMINED before you continue your sports participation.

Maryland Concussion Law

2011-10-01T20:58:00.003-04:00

Please see this article on the new Maryland Concussion Law. Click here.

FREE HEAT INDEX APP FROM OSHA

2011-09-02T06:22:00.004-04:00

Coaches, Parents, Athletes - Click here to download this great heat index app from OSHA

KIDS WHO SPECIALIZE IN ONE SPORT MAY HAVE HIGHER INJURY RISK, LOYOLA STUDY FINDS

2011-09-02T05:44:00.000-04:00

MAYWOOD, Ill. -- Competitive young athletes are under increasing pressure to play only one sport year-round, but such specialization could increase the risk of injuries, a Loyola University Health System study has found.

Preliminary findings of the ongoing study included 154 athletes from all types of sports, with an average age of 13. They came to Loyola for sports physicals or treatment of injuries. The injured athletes had a significantly higher average score on a sports specialization scale than athletes who weren't injured.

"Young athletes who were injured tended to have more intense specialized training in one sport," said Dr. Neeru Jayanthi, medical director of primary-care sports medicine at Loyola and senior author of the study. "We should be cautious about intense specialization in one sport before and during adolescence. Parents should consider enrolling their children in multiple sports."

Jayanthi presented the findings May 2 at the annual meeting of the American Medical Society for Sports Medicine in Salt Lake City.

The current study is a follow-up to an earlier study of 519 junior tennis players, in which Jayanthi and colleagues found that players who specialized in tennis were more likely to be injured during tournaments than players who participated in several sports.

Jayanthi said findings from the studies provide new support for an American Academy of Pediatrics 2000 policy statement on intensive training and sports specialization in young athletes. The academy said kids should be discouraged from specializing in a single sport before adolescence. Young athletes "should be encouraged to participate in a variety of different activities and develop a wide range of skills," it said.

The current study included 85 young athletes who were treated for sports injuries and a comparison group of 69 non-injured athletes who came to Loyola for sports physicals.

Researchers graded athletes on a six-point sports-specialization score:

-- Trains more than 75 percent of the time in one sport.

-- Trains to improve skill or misses time with friends.

-- Has quit other sports to focus on one sport.

-- Considers one sport more important than other sports.

-- Regularly travels out of state.

-- Trains more than eight months a year, or competes more than six months.

On the six-point scale, the average sports-specialization score of uninjured athletes was 2.75, while the average score of injured athletes was 3.49.

The study found that 60.4 percent of the injured athletes specialized in sports, while only 31.3 percent of the uninjured athletes specialized. (Athletes who scored above 3 on the six-point scale were considered specialized.)

Uninjured athletes spent a total of 8.8 hours a week playing organized sports, while injured athletes spent 11 hours. However, this finding had a P value of 0.07, meaning that it fell just short of being considered statistically significant.

Jayanthi said results of the current study are preliminary. Researchers from Loyola and Children's Memorial Hospital in Chicago are enrolling additional athletes, and the athletes will be evaluated every six months for three years. This research will further assess the risk of intense training during growth spurts. The collaborative study has received a prestigious research grant from the American Medical Society for Sports Medicine.

Jayanthi said young athletes should be closely monitored for injuries, especially if they spend 11 or more hours a week in a single organized sport or more than 20 hours a week in all sports.

Injuries in young athletes include minor conditions such as muscle strains and knee cap pain, overuse injuries such as rotator cuff tendonitis and Osgood-Schlatter disease (painful lump below the kneecap) and severe injuries such abnormalities in knee cartilage and stress fractures in the spine.

While young athletes are specializing in all major sports, Jayanthi said the most intense specialization occurs in certain higher skill sports such as tennis, gymnastics and dance.

Jayanthi is an associate professor in the Departments of Family Medicine and Orthopaedic Surgery & Rehabilitation at Loyola University Chicago Stritch School of Medicine. Co-authors of the study are Amy Luke, PhD, assistant professor in the Department of Preventive Medicine & Epidemiology and Courtney Pinkham, a Stritch Medical student.

The study was supported by Loyola Stritch School of Medicine's Student Training in Approaches to Research (STAR) program.

For more information, or to enroll in the study, call 708-216-1071 or e-mail mhiggin@lumc.edu

Overweight Athletes and Heat Injuries

2011-08-18T12:18:00.001-04:00

This is a good article warning of the potentially deadly combination of obesity and heat death in obese athletes.

The bottom line is that kids must get in shape PRIOR to the start of summer practices. This must be the responsibility of both the athlete and the parent(s). Once the summer practice season starts (usually around Aug 15th) coaches must keep a close eye on heavy kids. If they observe signs and symptoms like profuse sweating, shortness of breath, pain, headache, lightheadedness, dizziness, etc. (See the guidelines for more specifics - click here) then the athlete must be pulled from practice.

If a child is not in shape, then they must be advanced MORE SLOWLY than a child who comes in shape. You cannot get them in shape faster and should not push them harder so they can be ready for opening day. This means MORE REST and fewer "reps" each practice until they are ready.

Safe Weight Loss Practices - New NATA Guidelines

2011-08-17T11:07:00.001-04:00

The National Athletic Trainers Association (NATA) has recently published new guidelines (a position statement) called Safe Weight Loss and Maintenance Practices in Sports and Exercise.

Here is NATA's list of seven basic recommendations for safe weight loss and management practice:
1.) A body-composition assessment, which is a scientific and objective method of estimating lean body mass and fat mass, should be used to determine a body weight consistent with safety, good health and optimal performance in weight-classification sports. This process takes no longer than 10 minutes, Sammarone Turocy says, and should be administered by a trained individual.
2.) Progress toward reaching the target weight based on body-composition tests should be assessed at regular intervals by repeating the tests.
3.) Weight gain or loss should not occur at excessive rates; it should be steady and at a consistent and safe rate (one or two pounds per week for weight reduction). Additionally, weight loss should not exceed 1.5 percent of body weight per week.
4.) Both diet and exercise should be used as part of the strategy to change body weight. Weight management should follow the training plans and goals of athletes and other physically active individuals.
5.) Enough calories taken in from all food groups should occur during weight change. Metabolism and energy needs for physical activity must be considered in developing the diet.
6.) Education on safe dietary and weight-management practices should be conducted on a regular and planned basis, and the involvement of trained nutrition, health and weight-management experts such as athletic trainers or other health professionals is highly recommended. Coaches, peers and family members should not provide information or participate in diet, body-composition or weight-management practices, and they should refrain from making comments about them. "Coaches can be supportive, but it is their job to bring in someone else to provide the education," Sammarone Turocy says, adding that certified athletic trainers and local pediatric or orthopedic physicians are ideal for that task.
7.) Athletes should be cautious with the use of dietary supplements and ergogenic aids for weight management, or any techniques that lead to rapidly changing body weight through unsubstantiated methods of weight reduction. Consideration of a sport's governing body's ruling on such supplements must be given. (The NATA currently is working on a position statement regarding supplements.)

Concussions......yes, concussion again!

2011-08-17T10:18:00.001-04:00

See Testing helps change the game on youth concussions

Revised Heat Guidelines for Young Athletes

2011-08-16T15:28:00.000-04:00

The American Academy of Pediatrics just published their revised heat guidelines called Climatic Heat Stress and Exercising Children and Adolescents.

Some notable comments were:
1. "Researchers have previously suggested that children are less effective in regulating body temperature, incur greater cardiovascular strain, and have lower exercise tolerance during exercise in the heat compared with adults. However, more recent studies, in which both groups were exposed to equal relative intensity exercise workloads and environmental conditions while minimizing dehydration, have compared 9- to 12-year-old boys and girls to similarly fit and heat acclimatized adults. These newer findings indicate thatchildren and adults have similar rectal and skin temperatures, cardiovascular responses, and exercise-tolerance time during exercise in the heat."

2. "Notable chronic clinical conditions and medications that contribute to decreased exercise heat tolerance and increased exertional heat-illness risk include diabetes insipidus,18 type 2 diabetes mellitus,19 obesity,20,21 juvenile hyperthyroidism (Graves disease),22 cystic fibrosis, 23 and anticholinergic drugs or
certain other medications that affect hydration or thermoregulation."

3. "A previous episode of heat stroke, however, generally does not seem to have long-term negative effects on thermoregulation, exercise heat tolerance, or exertional heat illness risk, especially for those who received prompt cooling therapy."

Here are the Action steps recommended:

Provide and promote consumption of readily accessible fluids at regular intervals before, during, and after activity
Allow gradual introduction and adaptation to the climate, intensity, and duration of activities and uniform/protective gear
Physical activity should be modified
Decrease duration and/or intensity
Increase frequency and duration of breaks (preferably in the shade)
Cancel or reschedule to cooler time
Provide longer rest/recovery time between same-day sessions, games, or matches
Avoid/limit participation if child or adolescent is currently or was recently ill
Closely monitor participants for signs and symptoms of developing heat illness
Ensure that personnel and facilities for effectively treating heat illness are readily available on site
In response to an affected (moderate or severe heat stress) child or adolescent, promptly activate emergency medical services and rapidly cool the victim

Here are my comments:
WHAT A COP OUT! These are too vague and leave the MEDICAL decision making to non-medical administrators, coaches, and parents. Here are my guidelines based on my 25 years on the side-lines:
http://www.marylandsportsinjurycenter.com/hydra2.html

7 Year Old Boy Signs with Real Madrid Soccer Club

2011-08-16T11:02:00.000-04:00

ARE YOU KIDDING ME! Parents, please wake up and pay attention. This is not OK! What happened to fun and childhood?

Read this article and I'd love to know your thoughts.... Click Here.

Good Health vs. How Much Can I Get Away With

2011-08-15T02:29:00.002-04:00

As all of you know from my newsletter and facebook posts, I had a major thoracic surgery 10 months ago. I can tell you without a doubt that it has been my focus on proper diet, the proper supplements (that is supplementary to my diet and based on what I required to heal), and the proper exercise that has enabled me to have a recovery that has been nothing short of miraculous.

That said, how do we balance our need for good health with our need for FUN? Is it FUN vs. pain, suffering, calorie counting, sacrifice, and discipline or is there a way to balance our approach?

A Healthy Diet …. The Paleo Diet

I have told many of you about the Paleo diet (no grains, legumes or dairy) as a way to get you on the road to health and wellness. This lifestyle (it is really not a diet) is based on the way ancestral man ate before the advent of agriculture. This does not mean that all foods since agriculture are not tolerated; it means that you must test foods to see what foods cause sensitivity reactions, i.e. gas, bloating and just not feeling well to full blown allergic reactions. The Paleo diet seems to be the best way to have a nutrient rich, non-inflammatory diet.

Some will say, “well, there is nothing left to eat!” This is not true. It is your individual biology with which you must become familiar. For those of you into statistics, there is a bell curve of food intolerance and sensitivity which means that most of us are somewhat sensitive or intolerant to varying degrees of certain anti-nutrients in grains, legumes and dairy. Both cooking food and fermenting food get rid of or diminish many of these anti-nutrients in many grains, legumes, and dairy.

The foods recommended are:

1. Meats of all types, preferably organic (grass fed): red meat (cows, bison), pork, poultry, wild caught fish

2. Vegetables

3. Fruit

4. Roots and Tubers: Yams, sweet potatoes, carrots, turnips, parsnips.

5. Nuts and seeds (remember peanuts are not nuts, they are legumes)

The foods not recommended are:

1. Grains: all grains, not just wheat. The current research says you cannot cook away or ferment away the gluten in wheat, rye, barley, etc.

a. Rice and oats seem to have the lowest sensitivity rates so these would be the best to add back into your diet.

2. Legumes

3. Dairy

a. Organic cream and fermented dairy seem to have the lowest sensitivity rates (cheeses, some yogurts, sour cream, kefir, some cottage cheeses, cultured buttermilk, acidophilus milk, and certain soy products).

b. A certain percentage of the population is intolerant to lactose and to casein. There are those of you who are, as we say, “@#$% out of luck.” Those who are not can eat fermented dairy and organic cream and maybe some non-pasteurized, non-homogenized milk (we cannot purchase non-pasteurized milk in Maryland so I recommend the Trickling Springs Creamery Milk which is at least non-homogenized and organic).

So how do you balance FUN with good nutrition? How do you empower yourself and regenerate your body? It is all based on the choices you make.

1. Start logging in your foods to the Fate on Your Plate online software and learn exactly what nutrients are missing from your diet. For a free 7 day trial email me the word SUCCESS to painfree123@gmail.com. Once you know what your deficiencies are, you can simply click on them and learn what to eat to put those missing nutrients into your diet.

2. In addition, with the Fate on Your Plate software, you will learn the percentage carbohydrates make of your diet (of your total caloric intake). Once you know this, you can see WHAT types of foods make up those carbohydrates, highly processed, nutrient void foods or non-processed nutrient dense foods. The bottom line is, we all must control our glucose metabolism by minimizing the need for so much Insulin release. Eat of us needs a different amount of carbohydrate, but we ALL need non-processed, nutrient dense carbohydrates in our diet. If you are an athlete, you will probably need much more than a sedentary person.

3. You can do the same with fats and proteins….learn what the percentage each is of your total calories, and what foods make up those fats and proteins. Again, the bottom line is food quality.

4. Once you really know what you are eating, you can start removing foods that can cause sensitivities. I recommend that you try going “hard core” Paleo for one month and see how you feel. Then you may add back in foods one by one and see how you feel. This is the way I learned what I am sensitive to and what I am not. For example, I have been pretty strict Paleo since about March 2011. About 6 weeks ago, I added two 8 oz servings of organic, Greek, plain yogurt with nuts and dried cherries or cranberries. This caused significant nasal congestion which used to be a problem for me before going “Paleo.” I learned that for me, I just cannot eat the yogurt. BUMMER, but it is not worth the negative effects on my body.

5. Other important factors are good sleep (try magnesium supplementation), Vitamin D, and the right type, volume, and intensity of exercise. When it comes to exercise, our Functional Movement Screen is really the sister of the Fate on Your Plate program. You must learn what your body can and cannot do and build a program based on your body’s needs and your goals.

Get started today!

Fate On Your Plate

2011-08-14T14:21:00.003-04:00

Fate on Your Plate: The Best Weight Loss and Nutrition for Better Health Program Ever!

Good Sunday Morning!

Yes, I finally can offer all of you the best online nutrition program for all your needs.

Take a look at this demo of the program: CLICK HERE!

I am offering all patients a FREE 14-DAY TRIAL of the Fate on Your Plate Program. If you are not a patient, and you are forwarded this post by a patient or friend of our office, you will be entitled to the same offer.

Just email me back (painfree123@gmail.com) with the word SUCCESS I will send you an activation code and the link to the activation page!

Everyone – please email today and get started.

“The solutions are here, they’ve always been here… every single person in the world knows what it is… YOU ARE WHAT YOU EAT…FOOD MATTERS”

Here’s how Fate on Your Plate works:

1. You enter your goals and current weight.

2. Enter the foods you eat daily. The data base is enormous and if there is a specific food that is not in the data base, the program pulls up a blank food label and you enter all the data in and the program saves it.

3. The program creates an old fashioned report card grading you A – F on total calories, fat, carbs, protein, cholesterol AND all the vitamins and minerals.

4. If you have a low grade (e.g. a “D” in Magnesium) you click on Magnesium for suggestions of foods to add to your diet to get your Magnesium grade to an A.

5. In addition, you may search the 10s of thousands of report cards with similar goals and caloric needs to see suggestions of how other people got all A’s. You may even specify specific foods. For example, if you are a vegan and only want vegan food choices.

“If we think we are going to go to the doctor and get a pill for everything, we’ve missed the whole point.” Quotes are from the movie trailer for FOOD MATTERS.

Heart Testing Guidelines for Young Athletes

2011-08-13T15:27:00.001-04:00

http://athleticbusiness.com/articles/lexisnexis.aspx?lnarticleid=1475959234&lntopicid=136030023About 75 to 100 teenagers and young adults die each year during athletic events, primarily due to heart issues. There is some debate about using ECGs (Electrocardiogram screening) as part of the pre-participation physical examination. This issue is the number of potential false positive results.
Read more...

In Italy they have been using ECG screening for years. They believe it is effective at screening for Hypertrophic cardiomyopathy, the most common cardiac disorder causing sudden death. Read more...

Former Players Sue NFL For Hiding Concussion Dangers

2011-08-01T20:18:00.001-04:00

WOW! What a condemnation of NFL policy and complete and total disregard for player's health.

Read the article by clicking here.

Rhabdomyolysis

2011-06-09T15:10:00.002-04:00

What is it?

•A breakdown of muscle fibers caused by extreme overload to the muscles.

•Damage to muscle causes the release of muscle fiber (myoglobin – protein pigment) into the bloodstream.

•Myoglobin breakdown may cause severe kidney blockage and damage.

Causes

Skeletal muscle damage due to:

•Trauma: auto accident, fall, blast, crush

•Extreme physical exercise – abrupt increase

•Poor hydration

•Hypothermia, drowning

•Drug (cocaine)/alcohol + hyperthermia

•Medications: Statins (Zocor, Lipitor, Pravachol, Mevacor)

•Low electrolytes: potassium, phosphate, magnesium

Symptoms

•Muscle soreness, pain, tenderness, weakness

•Swelling

•Dark, cola or red colored urine

•Joint pain

•Fatigue, dizziness, nausea, vomiting

•Seizures

Complications

•Acute kidney failure

•Compartment syndrome

•Hyperkalemia

•Hyperphosphatemia

Risk Factors

•Genetics

•Abrupt increase in exercise, especially eccentric muscle contraction

•Being out-of-shape and beginning a hard exercise program

•Hot weather/heat stroke – heat intolerance

•NSAID use

•Diabetes

•Sickle Cell Disease

•Alcoholism

•Drug use – cocaine, steroids

Diagnosis

•Physical examination of muscles: tenderness, compartment syndrome

•Urinalysis – blood

•Blood work

◦Creatine phosphokinase

◦Electrolytes

◦Liver enzymes

◦Serum myoglobin

Treatment

Goal - Preserve kidney function and treat shock

•Fluids – oral rehydration, IV fluid

•Electrolyte replacement

•Discontinue toxic medication

Prognosis

•Favorable and reversible if treated promptly

•In severe compartment syndrome multiple surgeries may be necessary causing permanent damage to the muscle(s)

Prevention

•Avoid extreme exertion in the heat

•Gradual ramping up of fitness level: aerobic exercise and weight training

•Recovery nutrition: protein and hydration

•Pay attention to symptoms – get examined and treated!

•Buddy system between athletes when training/game

•Good communication between all parties: athletes, coaches and parents

For more information see:
Rhabdomyolysis in High School athlete

Rhabdomyolysis in Collegiate Athletes - Iowa

Exertional Heat Illness, Exertional Rhabdomyolysis, and Malignant Hyperthermia: Is There a Link?

Rhabdomyolysis in 119 students after repetitive exercise

Posture, Posture, Posture

2011-05-31T11:18:00.000-04:00

Want to prevent injuries? Then start with your posture. My favorite book is Esther Gokhale's 8 Steps to a Pain Free Back.

Watch this video on Stretchsitting

Start paying attention to your posture and watch your sports performance improve!

Concussion App for IPhone

2011-05-30T10:04:00.000-04:00

Here is a link to get the The Concussion Recognition & Response™ App for IPhone/IPad. It is an easy to use MUST HAVE if you have a child playing sports.

Click Here to go to ITunes.

Sports Team First Aid Kit

2011-05-29T12:04:00.002-04:00

You wouldn’t send your child to a pool without a trained lifeguard, would you?

Do you send your child off to soccer, football, baseball, softball, basketball, lacrosse, field hockey knowing that the coaches have a first aid kit?

Are they certified in CPR/AED and first aid?

After over two decades of being on the sidelines at sports games and practices and working with dozens of athletic trainers, I have put together a fantastic sports team first aid kit at a great price.

Compare this kit to Cramer’s, Lifeline, and Mueller Sports First Aid Kits and you will see this sports first aid kit has more practical and necessary supplies.
As a special bonus valued at $25.00, I am including my Emergency Plan form AND my Injury Record Form. The emergency plan form is a must for any team and/or league. In this day and age, you must be prepared and have a plan of action in case of injury or other emergency.

As a super bonus valued at $35.00, I am including my book: Rub Some Dirt On It: What Every Parent and Coach Should Know About on the Field Injury Care. This book is a summary of my 25 years of experience as a sideline and team doc for many different sports. It is used in the course Care and Prevention of Athletic Injuries in the Montgomery County, Maryland public school system.

Sports Team First Aid Kit Regularly $55.97... Special Sale $39.97! Click Here to Order

1 Extra-durable SpunTuff fabric 12” bag
50 Gauze pads
3 Gauze rolls
50 Band-aids
1 7 ¼” scissors with tempered blade (most kits come with cheap, plastic scissors)
1 Roll 1” x 10 yd Medical tape
1 Hydrogen peroxide
10 Antibiotic ointment packets
10 Iodine Prep pads
25 Tongue Depressors
10 Medical examination Gloves
1 Rescue Blanket
1 8 oz hand sanitizer

Barefoot Running

2011-05-20T13:35:00.002-04:00

"When I got into barefoot running, I was a broken runner. Overuse injuries, imbalances, and more had brought me almost literally to my knees, which weren't all that healthy either. Turns out, that wasn't a bad thing at all. It forced me to build back slowly while allowing my body to recover. It liberated me to ecperiment too; with nowhere to go but up, I could try to find the best ways to heal and grow back stronger.

At a recent clinic, I advised a struggling runner with plantar fasciitis to recover, then built back slowly. His response, "That sounds great, but I need to train for my next marathon." How many of us have said something like this? Unfortunately, your body doesn't know it needs to race again, it knows it needs to rest. If you don't give it the rest it needs, you'll never recover.
Many runners struggle year after year limping along. Until you're ready to let go of the goal, to built back stronger, a cycle of pain continues. Sooner or later, you need to step back, take a break, and start from scratch.
Becoming the best runner you can be isn't about brute force, disciple, or training harder. It's about training smarter, be being aware, feeling the ground, and feeling your body. Instead of training on intellect, you're training with intuition.This may sound ambiguous, but the biggest challenge for runners has never been a lack of work ethic of the ability to push oneself; instead, it's been an ability to go slow, go with the flow and listen to one's body. It requires a degree of mental flexibility that's hard when you have goals. However, when you force anything, something has to give, and something always breaks. I don't want that to be you.

My best advise: Don't do everything at once. Rather, pick and choose what seems like the most fun and go for it. Try new things out and feel free to mix up the routine. Our bodies are incredible at adapting to new challenges. So dont get stuck in a rut. Instead, change things up as much as you can. This helps work muscle groups you never knew you had and loosen you up in ways you once thought impossible, so you can become a balanced athlete."