Health and Us

Mustaches for Testicular Cancer

2009-11-24T14:07:00.003-05:00

MOVEMBER! The mustache growing, cancer awareness movement that is changing the face of men's health. Grow a mustache then when people ask you about it just tell them about testicular cancer instead. Then, encourage them to donate money to the cause. My donation page is http://us.movember.com/mospace/504139
Check out movember.com to get started yourself. Non-mustache growers can still join and show support as well.

ACL Injury Prevention

2009-07-17T12:38:00.000-04:00

The Anterior Cruciate Ligament (ACL) is a ligament of the knee, running from the anterior tibia to the posterior femur. (6) When the ACL is injured it may also cause problems in the meniscus because the two structures are biomechanically interdependent. An illustration of the ACL is shown below:

Dubinchiro.com

Injury to the ACL can often cause injury to the tibial plateau as well. (6) In layman’s terms, common mechanisms of injury to the ACL are turning, landing, and sudden deceleration. (6) Senter and Hame(1) give a broader description of common mechanisms, “Hyperflexion and hyperextension with the application of tibial torque.” In alpine skiers a mechanism known as “phantom foot,” is commonly seen when a skier falls backward, hyperflexing the knee with weight on the inside of the ski, internally rotating the tibia. (1) Deceleration, particularly with massive quadriceps contraction and limited hamstrings contraction, with the knee extended, appears to be the most common of mechanisms for ACL injury. (1,2,5) However, the root of this mechanism is the tibial torsion it causes, which puts increased stress upon the ACL. (1) The role of equipment in this injury is significant as shown in the case of “phantom foot.” Improved ski bindings prevent ankle and tibia fractures but not ligamentous knee injuries. (1) The interaction between cleated shoes and surfaces has also been shown to have relation to the risk of ACL injury. (1) This interaction is known as “the ‘release coefficient’ (the rotational force on a foot divided by the axial load on the foot), which represents the torque needed to release an engaged shoe-surface interface.” (1) Simply put, release coefficient is a measure of how firmly in place a foot is, and the resultant risk of ACL injury. Release coefficient is affected by many factors including size and number of cleats, as well as the type of surface and temperature. (1) Greater torsional resistance, and therefore higher rate of ACL injury, was seen in shoes with small pointed cleats in the center and long, irregular cleats along the edge.

In this paper I will discuss the prevention of injury to the anterior cruciate ligament. It is vital that an effort is made to prevent this injury. In 2008 it was estimated that 80,000 ACL injuries occurred in the United States. (2) The program I suggest makes use of flexibility and strengthening programs, equipment, and education about proper technique.

Any flexibility and strength training program for preventing ACL injury should be carried out over the long term. Short term programs, 4-7 weeks in duration, have been shown to be insufficient in reducing ACL injury risk for females. (3) Programs should especially be aimed at athletes who are considered high-risk for ACL injury, because they are more responsive to neuromuscular training. (3) A combination of plyometric and basic strength training exercises is effective in reducing risk factors, while use of only one method is ineffective. (3)

In a program of strength training and plyometric exercises, the hamstrings should be emphasized. Strength of this muscle group is needed to limit loading of the ACL when the quadriceps contract vigorously and the knee is extended. If the hamstrings cannot produce enough force the ACL may be injured. (2) The glute-ham raise is a valuable exercise for ACL protection, designed to engage the hamstring muscles from knee extension. The glute-ham raise is shown below:

Weighttraining.about.com

Proprioceptive Neuromuscular Facilitation (PNF) stretching is also effective in developing the hamstrings to prevent ACL injury. PNF hamstring stretching can be done in the position shown below:

athleticadvisor.com

PNF stretching serves a dual role. During the resistance, strengthening is enhanced again from an extended knee position. During the passive stretch a greater range of motion is achieved, as compared to unassisted stretching. (7)

A sample week of preventative strength and flexibility training could be done as follows:

	Monday	Wednesday	Friday
glute/ham	3sets10		3sets10
knee ext.	3sets10		3sets10
box jumps		3sets8

PNF hamstring	2x1min.	2x1min.	2x1min.

Much consideration should be given to the risk to the ACL caused by equipment selection. As discussed earlier, the release coefficient of shoes should be considered. For example, shoes with large irregular spikes around the edge and pointy spikes in the middle should be avoided, as well as warm surfaces, because they increase release coefficient. (1) Ski boot release systems should be considered, although they have not yet been developed to protect from knee ligament injuries. Since the 1970s the focus in boot release has been preventing ankle and tibia fractures. (1)

To prevent ACL injury, running technique should focus on three things (a) keeping the heel landing under the body, (b) gradual acceleration and deceleration, and (c) bending at the knees. Making sure the heel lands under the body is important simply because it has been observed that ACL injured legs are often placed infront of the body (2), potentially causing a braking that loads the ACL. A frequently recognized mechanism of injury is rapid acceleration or deceleration and the tremendous subsequent quadriceps contraction. (2) The solution is to practice gradual acceleration and deceleration. This decreases the demand for quadriceps contraction and limits the jarring forces of stopping a person’s momentum in only a few steps. Finally, bending the knees is helpful because it has been observed that twisting injuries, such as ACL tears, may have been avoided if the knee were more flexed. (1) This technique should be implemented into a prevention program by making a conscious effort, when decelerating, to “drop the hips.” This imagery conveys the proper idea of knee bend when already in the vulnerable position of decelerating.

Injury to the ACL is extremely common in the United States (2), and can cause lasting damage, altering or ending athletic careers because “ACL-injured people often suffer long-term complications, such as meniscal lesions, impairment of normal knee function, and arthrofibrosis.” (2 pg396) For this reason it is important to give active persons the best chance to participate without injuring themselves. Research suggests that with the use of the injury prevention strategy previously outlined, some ACL injuries can be avoided. The basic mechanism of tibial torsion can generally be avoided with proper mechanics and equipment. If such torsion does occur, the improvements in strength may limit its severity. This prevention through strength, equipment, and mechanics can save many athletic careers.

References

1. Carlin Senter and Sharon L. Hame. “Biomechanical Analysis of Tibial Torque and Knee Flexion Angle.” SportsMed Volume 36. Issue 8 (2006): 635-641

2. Yohei Shimokochi and Sandra J. Shultz. “Mechanisms of Noncontact Anterior Cruciate Ligament Injury.” Journal of Athletic Training Volume 43. Issue 4 (2008): 396-408

3. Myer, Ford, Brent, and Hewett. “Differential Neuromuscular Training Affects on ACL Injury Risk Factors in ‘High-Risk’ versus ‘Low-Risk’ Athletes.” BioMed Central Musculoskeletal Disorders Volume 8, Issue 39 (2007)

4. Shea, Apel, Pfeiffer, and Traughber. “The Anatomy of the Proximal Tibia in Pediatric and Adolescent Patients: Implications for ACL Reconstruction and Prevention of Physeal Arrest.” Knee Surgery, Sports Traumatology, Arthroscopy Issue 15 (2007): 320-327

5. Jones, Appleyard, Mahajan, and Murrell. “Meniscal and Chondral Loss in the Anterior Cruciate Ligament Injured Knee.” SportsMed Volume 33, Issue 14 (2003): 1075-1089

6. Anderson, Parr, Hall. Foundations of Athletic Training. Baltimore, MD: Lippincott Williams & Wilkins; 2009

7. KPE253, Flexibility, Walter Abbott and David Cusano, March 2007

ACL-Anterior Cruciate Ligament

2009-07-09T20:48:00.002-04:00

Ever hear people talking about the ACL? Have friends who injured their ACL or done it yourself? Feel left out because you don't know what all the buzz is about? Want to know more and protect yourself from an ACL injury?

Well folks, stayed tuned to carrbj2.blogspot.com for my paper on the ACL. It highlights what really happens to the ACL and how to prevent that from happening to you. The information is sound, all for peer-reviewed articles and the pictures are great too! Should have it up in the near future.

The Dreaded Anemia

2009-07-06T23:48:00.004-04:00

Anemia, it's something we've all heard at least a little about. I find that anemia is almost inevitable in women's athletics, particularly distance running. Several of my friends and teammates have dealt with it. One of my clients was just diagnosed (although she still managed to run a 3K race over the holiday weekend!) I suspect that at one point I was anemic, as other men in my family have been. So what is it?

To put it simply, anemia is a very common disorder of the blood that limits oxygen transport. This can be caused by a lack of red blood cells (RBCs) or just an inability of the cells to carry oxygen. Either way, persons with anemia become lethargic and unmotivated. Not a good thing for a woman in her 20s who runs long distances competitively. Unfortunately, the people who are thrown by anemia are some of the most common victims. Female long distance runners deal with blood loss through menstruation and blood cell damage in their feet from the impact of running. This combination makes them at high risk.

A diet lacking in the mineral, iron can also make trouble. In the bloodstream oxygen binds to iron, but if there is less iron to bind to the oxygen becomes more difficult to transport. Many people consume a fair amount of iron but don't absorb it properly. Absorption of iron is complex because it competes with calcium. So, eating a bowl of chili loaded with iron may be offset by the cheese on the chili and a glass of milk consumed beforehand. If you're trying to increase iron levels eat your calcium-rich foods another time. Vitamin C however, actually increases the absorption of iron. So, a great way bump up iron is to consume iron-rich foods and chase them with a glass of orange juice. When looking at iron supplements I've heard that liquids are more effective than pill form, perhaps because it is easier to absorb.

For great ideas on how to get more iron and a warning about excess iron, check out the following article

http://en.wikipedia.org/wiki/Iron#Dietary_sources

So, chances are you know someone with anemia. Go impress them with everything you've just learned. If you think you are anemic your doctor can tell you with simple blood tests.

12 Great Alternatives to Bench Press

2009-06-22T22:23:00.008-04:00

When I'm at the gym it seems virtually everyone does bench press (BP). Plain, old, flat, boring, barbell, bench press. The worst part of it is that many thinks it's the best way to work your upper. This post is to expose you to some other ways to accomplish something similar to FLAT bench press, but with a little spice. Bon appetit!

12. SMITH MACHINE BP

11. BP MACHINE

10. DECLINE BP

9. INCLINE BP

8. DUMBBELL BP

7. PUSHUPS

6. PUNCHING BAG: give it a few throws and you'll feel your arms and chest working

5. SWISS BALL (aka stability ball) DUMBBELL BP: core, chest, arms all in one lift

4. CLAPPING PUSHUPS: NOT just for Jake Gyllenhaal in Jarhead, really awesome plyometrics

3. DIPS

2. ONE HAND PUSHUPS: the combination of balance and strength is incredibly good for you

1. HANDSTAND PUSHUPS: this is simply beastly, check out the video, featuring the music of Coldplay

If you're unfamiliar with any of these I highly recommend tutorials on youtube.com So, next time you go to lay down on that bench like a gym-clone, mix it up instead. You might just find something you really like. Comment with your favorites!

GO TEAM!

The Squat

2009-06-15T23:53:00.004-04:00

Everybody, my clients, my friends, even my little brother asks me how to squat properly. The fact of the matter is that squatting makes people afraid, but really it just has a bad image. The squat is a valuable lift to have in your routine. To learn appropriate technique, I recommend studying the following video

I think with squatting, like most athletic movement, it is important to keep in mind that everything is generated from the hips. Feel free to comment with questions or suggestions.

GO TEAM!

Back Pain and RPCP update 1

2009-06-12T21:10:00.002-04:00

Today I did a workout with Robert P. Collins himself and afterwards he told me that sometimes running causes him lower back pain. Most people, especially Americans who sit in chairs all day, experience back pain in their lives. The causes and appropriate treatments are endless and specific to every individual. In Robert's case I first recommended a new pair of shoes. We found out when discussing his shin pain (isn't running a lovely sport?) that his running shoes are probably dead. This problem at his feet can be manifested in the back the same way a heart attack can manifest itself as left arm pain. The other thing that I recommended he work on is flexibility of his low back and hamstrings. When we stretched out after the workout he couldn't even touch his toes, a sign that he is too tight for optimum back health. On a positive note he ran very well. 3x1200m shooting 4:30 every time he ran 4:29,4:30, and 4:23. Great work, Rob!

GO TEAM!

RUNNING WINS FAVORITE CARDIO POLL!!!

2009-06-04T22:15:00.000-04:00

1. Running 54%

2. Swimming 12%

Other 12%

4. Cycling 10%

5. Cross-country Skiing 7%

6. Jumping Rope 1%

TOTAL 96% ???

nice math, Google

Some Moron Stretching (there's good info below)

2009-06-02T21:53:00.001-04:00

I was going to title this "Some More On Stretching," but I couldn't resist the easy play on words. The picture definitely helped to sell me on it as well. What I'm writing is a response to a comment asking what I would say to someone who doesn't believe in the value of stretching. I'd definitely make my first point that in many cases, stretching can prevent or remedy injury. In running I often suffer from overuse injuries that are quickly cured with some heat, ice, and gentle stretching. Second, longer (stretched) muscles allow your body to move easier over time. When my quadriceps are inflexible, my hamstrings have to work against the quads, just to contract through a normal range of motion. If my quads are flexible, the hamstrings can cover the same range of motion with less work. This has tremendous implications for people who want to enhance their endurance because they can do something with less work, meaning they save more energy for later. Finally, posture is enhanced by flexibility. I had a discussion with the chiropractor I'm interning for about this concept today. Tight hip flexors (caused by sitting all day) pull your whole body out of alignment, causing something called lordosis. Lordosis makes your back arch and your butt stick out. This is not a flattering look, and can cause a lot of pain. Inflexible pectorals (caused by typing, writing, and driving all day) cause hunched over shoulders and a forward head tilt. This is also not a flattering look and often the cause of migraine headaches. So...

WHY SHOULD YOU STRETCH?

1. prevent and treat injury

2. move easier

3. improve posture

GO TEAM!

DON'T DO THAT! (stretching myths)

2009-05-29T00:22:00.000-04:00

I thought I would squeeze in this post now because I will be away for the weekend at my aunt's wedding. For those hardcore bloggers, here is the blog for the wedding. I'm writing about something that many of my clients don't believe. Something they think is just flat out wrong or merely an opinion. 2 clients disagreed with me just yesterday about it. Stretching BEFORE a workout. Many believe that static stretching before a workout is a must to improve performance and prevent injury. However, this is not the case. Muscles can be thought of as rubber bands. When a muscle has not yet been worked it is like a cold rubber band. Stretch a cold rubber band and it snaps. Stretch a cold muscle and it is more likely to be injured. Overstretch a rubber band and it will lose elasticity. Overstretch a muscle before working out and it will temporarily be weakened. Stretch a warm rubber band and it goes smoothly. Stretch a warm muscle after a workout and flexibility can be greatly enhanced.

TAKE HOME MESSAGE:
stretch after workouts, if you must stretch before a workout use a dynamic stretch

great dynamic stretches

GO TEAM!

The Ball is Rolling

2009-05-28T21:04:00.000-04:00

I've started to spread the word that I have a website. Now I just have to continue to make something interesting of it. I was thinking about giving Trainer Tips on a regular basis, or something like that, as well as updates on my running or stories from work with my clients. What would the people reading this like to talk about anyway? I have an ACL injury prevention study I plan to share soon. However, that's very academic and won't appeal to some. So, let me know what you're interested in and I'll do my best from there. On the less academic side I posted a video game to the sidebar where you get to battle the world in the 100m run. It's hard to find track games, so take advantage of it, even if you're not Usain Bolt.

The Poll

2009-05-28T00:14:00.000-04:00

In my line of work (personal training) it's often difficult to find cardio exercise that clients enjoy. Please help by taking the poll and sharing your thoughts. Also, feel free to comment, especially if you choose "other."