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Young Athletes More Likely to Suffer Serious Overuse Injuries If Their Parents Have High Incomes

The higher your annual income, the higher the chances that your young athlete will suffer an overuse injury.

That’s the eyebrow raising result of a new study that shows, for the first time, a link between overuse injury rates in young athletes and their socioeconomic status.

The rate of serious overuse injuries in athletes who come from families that can afford private insurance is 68% higher than the rate in lower-income athletes who are on public insurance (Medicaid), according to the study.Class AA-A Girls Soccer

Privately insured young athletes are also twice as likely as publicly insured athletes to be highly specialized in one sport, state Loyola University researchers who previously reported that young athletes who specialize in one sport are more likely to suffer serious overuse injuries.

Neeru Jayanthi, MD, medical director of Primary Care Sports Medicine and an associate professor in the departments of Family Medicine and Orthopaedic Surgery and Rehabilitation of Loyola University Chicago Stritch School of Medicine, recently reported the results at the International Olympic Committee World Conference on Prevention of Injury & Illness in Sport in Monaco.

The findings also were presented at the American Medical Society for Sports Medicine Annual Meeting in New Orleans, LA.

Intense specialization in one sport can cost thousands of dollars a year in equipment, fees, transportation, and private lessons,” Jayanthi said.

“Having the financial resources to afford such costs may provide increased opportunities for young athletes to participate in a single sport.”

RESULTS FROM ONGOING STUDY

Jayanthi and colleagues are conducting an ongoing collaborative study of athletes ages 7-18 who were seen at primary care and sports medicine clinics at Loyola University Health System and the Ann & Robert H. Lurie Children’s Hospital of Chicago.

So far, nearly 1,200 athletes have been enrolled in the study.

Both institutions care for a socioeconomically diverse population.

The median income of the families of the young athletes was approximately $70,000.

About 11% came from low-income neighborhoods, while 19% are on public aid.

Athletes completed surveys reporting training volumes, age of engagement in competitive sports, and degree of specialization.

The researchers found that 30% of privately insured athletes were highly specialized in one sport, compared with 18% of athletes who were publically insured.

SERIOUS OVERUSE INJURIES

Among the privately insured athletes, 13% suffered serious overuse injuries, compared with 8% of publicly insured athletes.

Serious overuse injuries can force young athletes to the sidelines for 1 to 6 months or longer.

These injuries include stress fractures in the back or limbs, elbow ligament injuries, and osteochondral injuries (injuries to cartilage and underlying bone).

Double Winner: Patrick Shaw Beat Cancer, Then Heart Disease

When my sister-in-law Carol Peerce died suddenly at age 49 exactly three years ago, it was discovered that radiation-induced heart disease likely led to her heart attack and eventual death.

It turns out the radiation therapy to treat her Hodgkin’s lymphoma 30 years previously had damaged Carol’s heart.

At my wife Margie’s suggestion, I looked into this condition and sure enough found medical evidence that radiation, and chemotherapy, given to Hodgkin’s lymphoma patients put them at risk for later heart problems.

Then I found out that my friend Patrick Shaw, a contractor I knew in East Hampton, was one of these patients as well.

Pat had been diagnosed with Hodgkin’s lymphoma at age 29 and received multiple sessions of radiation therapy and chemotherapy that included heart-toxic anthracyclines.

Little did he know that the radiation therapy and chemotherapy he received to cure his cancer would scar his heart and lead him to have several silent, near-deadly heart attacks and a stroke 20 years later.

Pat’s story, and the heart risks of cancer therapies, are the basis of the cover story for the just released May 2013 issue of Heart Insight magazine.

Heart Risks from Radiation Therapy

Many people survive their cancers, but end up dying of cardiovascular disease.

Among Hodgkin’s lymphoma patients who have received radiation, cardiovascular disease is one of the most common causes of death.

Studies have shown that these patients have an increased risk for coronary artery disease, heart valve disease, congestive heart failure, pericardial disease (disease of the heart lining), and sudden death.

The basic mechanism appears to be radiation-induced damage to the lining of blood vessels.

Compared to the general population, Hodgkin’s lymphoma patients have higher heart risks if they were treated before age 21 or had radiation to the central part of the chest, which increases the risk of death from a fatal heart attack by 1.5 to 3 times.

In addition, a woman who received chest radiation therapy for breast cancer has a 63% increased risk of cardiac death.

With improvements in radiation techniques, including smaller amounts of radiation aimed at specific body areas, the risk of cardiovascular complications has declined.

But patients treated through the mid-1980s have a higher risk of congestive heart failure and heart valve problems.

Pat’s cardiologist, Ronald Drusin, MD, Professor of Clinical Medicine at New York-Presbyterian Hospital, says: “If you had chest radiation for lymphoma in the central part of the chest and have chest pains or tightness and shortness of breath, you should be evaluated by a cardiologist.”

Road to Recovery

For Pat, Dr. Drusin decided that stents to reopen the blocked coronary arteries in his heart were a better choice than bypass surgery because of radiation-induced scarring in Pat’s heart.

Pat felt better after the procedure, although his recovery was complicated by a stroke.

Today, Pat’s prognosis is fine, says Dr. Drusin “as long as he takes good care of himself, which he does.”

Pat is back to work and now pays close attention to his exercise and diet.

As the family chef, he cooks heart-healthy meals containing more whole grains and vegetables, no salt and fewer processed foods.

He checks his blood pressure regularly and takes daily medications, a beta-blocker and baby aspirin, to keep his heart healthy.

On weekends he stays busy with his three sons’ lacrosse games and other activities, including his favorite hobby, building bird houses.

Pat has some simple advice to anyone with symptoms of heart disease:

“As soon as you are not feeling well, get to a doctor,” he says.

“You have to be proactive.

You are in charge of your own heart.”

That’s particularly true if you had radiation or chemotherapy to treat a cancer when you were younger.

What a Blast — Tai Chi in Space

I usually practice Tai Chi at my local Y in a group class and in my home on my own.

Occasionally, I’ll go to the park or the beach as well.

I’ll often take a Tai Chi break to relax at the end of a busy day.

And that’s just what the first Chinese female astronaut, Liu Yang, did recently in her second night aboard the Tiangong -1 Space Lab Module.

Yes, she played Tai Chi in outer space.

Liu Yang performed a 3-minute routine that was specifically designed by the mission crew and a physical trainer for the Chinese astronauts.

After finishing all of her routine tasks, she strapped her feet down and performed warm up exercises and then the Tai Chi routine.

The physical trainer who designed the program, Tong Feizhou, explained that performing Tai Chi regulates the breath and relaxes the body, muscles, and bones.

And, of course, Tai Chi is a traditional Chinese sports activity.

Regular exercise in space is crucial.

According to the National Aeronautics and Space Administration, if astronauts don’t exercise, their bodies start losing bone and muscle and this can reduce an astronaut’s ability to do work.

The next time I do my after work/early evening Tai Chi, I’ll try to imagine myself floating in space, just as Liu Yang did for real.

Sports Medicine Guide for the Media, or Anyone

If you want quick, easy-to-understand descriptions of some of the most common sports injuries, from ankle sprains to overuse injuries to rotator cuff tears, check out the new 33-page Sports Medicine Media Guide: An illustrated Resource on the Most Common Injuries and Treatments in Sports.

The new guide is now available online from the American Orthopaedic Society for Sports Medicine and the American Academy of Orthopaedic Surgeons.

Designed as a resource for sports reporters who want to simply and accurately explain common sports injuries, the guide can also help anyone who wants a quick reference to most of the major joint-related sports injuries.

For example, under Ankle Sprains, the guide defines what an ankle sprain is, how it can be treated (the tried-and-true initial step is the RICE formula: Rest, Ice Compression, Elevation), and how to prevent it.

The guide is divided into 20 sections, each focusing on a specific injury and providing information on causes, diagnosis, and treatment, as well as related definitions, statistics, and resources.

Under Statistics in the Ankle Sprain section, the guide notes that about 25,000 ankle sprains occur in the United States every day, making it one of the top 10 sports injuries.

Sections are written by an orthopedic surgeon or other medical professional specializing in the particular injury or condition who offers insight on what to expect in recovery, how to avoid injury, and how to get back into the game.

High-resolution photographs and medical illustrations provide additional detail to further explain the injury.

The guide includes sections on Ankle Sprains, AC Joint injuries, Articular Cartilage Injuries, Anterior Cruciate Ligament (ACL) Injuries, Meniscal Tears, Shoulder Impingement, Stress Fractures, Rotator Cuff Tears, Shoulder Instability/Dislocations, SLAP Tears, Throwing Injuries in Children, and Overuse Injuries.

In addition, the guide contains information on such topics as Exercise and the Mature Athlete, Anabolic Steroids, MRSA (Staph) Infections, Heat Illness, Sudden Cardiac Death in Athletes, and two very newsy topics, Concussions and Treatment of Tendon/Ligament Disorders with Platelet-Rich Plasma.

The Concussion section ends with the clear recommendation that all athletes who sustain a concussive episode, no matter how minor, undergo an evaluation by a medical physician before returning to play.

The illustrations for Ankle Sprains and ACL Injuries show particularly good detail, while other illustrations are very simple (AC Joint, Articular Cartilage, Meniscus, Shoulder Impingement and Dislocation).

The MRI of a Rotator Cuff Tear looks like a close-up photo of a fish eye, and should have been replaced by a clear illustration.

Also, there are glaring omissions in three of the most commonly injured joints, the neck, back, and elbow.

Overall, the guide is a fine place to find a very short overview of many joint injuries before you go to other websites for more details.