Posts Tagged ‘sports injury’

The Biggest Sports Injury Story of 2014

The biggest, most pervasive sports injury story of the year has to be the effects of concussions on football players.

From professional to college to high school players, sports-related brain injuries have become a concern in football.

Studies show that the effects of multiple concussions can be long lasting, including depression, cognitive problems, and even an increased risk of Alzheimer’s football concussions

Thousands of retired National Football League (NFL) players who have suffered concussion-related injuries and disabilities filed a class-action lawsuit against the league, claiming that it did not do enough to protect their health and did not tell them about the long-term dangers of repeated head injuries.

Public awareness of the dangers of concussions was again raised after Ohio State University defensive lineman Kosta Karageorge, who had a history of concussions during his college career, was found dead in late November as the result of an apparent self-inflicted gunshot wound.

In early December, a study found that high school football players may develop impact-related brain changes over the course of a single season.

Players who experienced higher levels of head impacts showed the most changes, even in the absence of concussion.

Denver Broncos wide receiver Wes Welker may have worn a larger helmet to help him prevent further concussions in this year’s Super Bowl game, but even hits to the head that don’t result in concussions can affect athletes’ brains and may impact learning.

This makes some athletes more susceptible to repeated head impacts that do not involve concussions.


The good news is that new laws regulating concussion treatment plus awareness of concussions have resulted in a large increase in the treatment of concussion-related injuries for school-age athletes, according to a new study published online on December 22, 2014 in JAMA Pediatrics.

A University of Michigan study designed to evaluate the impact of new concussion laws found a 92% increase in children seeking medical assistance for concussions in states with the legislation in place.

States without concussion laws showed a 75% increase in those seeking injury-related health care.

“There are two stories here,” said senior author Steven Broglio, Associate Professor at the University of Michigan School of Kinesiology and Director of the NeuroSport Research Laboratory.

“First, the legislation works.

The other story is that broad awareness of an injury has an equally important effect. We found large increases in states without legislation, showing that just general knowledge plays a huge part.”

As of 2014, all states and the District of Columbia have passed laws that outline medical care for young athletes.

The laws differ slightly, but most call for education of coaches or students, the immediate removal of an athlete from a game, or medical clearance before an athlete can return to a sport.


Another way to prevent brain injuries may be to add a vision-based test to evaluate athletes on the sidelines.

This may allow sports medicine doctors to better detect more athletes with concussion more quickly, which is particularly important since not all athletes reliably report their symptoms of concussion, including any vision problems.

Others are taking a more technological approach to protecting players.

Several companies have put sensors or magnets in helmets or mouth guards to detect or absorb the forces of hits to the head, with the hope of further reducing the risk of brain injury to young athletes.

The sensors cannot prevent or diagnose a concussion, but they can alert coaches and trainers to take the proper steps to determine if a player has a concussion.

Let’s hope that these and other safety measures are made at all levels of football and translate into fewer concussions next year.

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.”


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.


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).

Teen Sports Injuries Linked to Lack of Sleep

The night before her most recent junior varsity basketball game, my daughter Sarah, age 15, was worried.

She had tickets with a friend to see the boy-band One Direction at Madison Square Garden, and was afraid she would be up very late.

“I’ll probably be too tired to play. I hope I don’t fall down and hurt myself during the game,” she lamented.

And she was right to worry.

Older high school athletes who don’t get a good night’s sleep are the most prone to sports injuries.

On the other hand, adolescent athletes who sleep 8 or more hours each night are 68% less likely to be injured than athletes who regularly sleep less, according to new research presented at the American Academy of Pediatrics National Conference recently.

Other studies have shown that lack of sleep can affect cognitive skills and fine motor skills, but “nobody has really looked at this subject in terms of the adolescent athletic population,” said lead author Matthew Milewski, MD of the Children’s Orthopaedic Center, Children’s Hospital of Los Angeles, Los Angeles, CA.

“When we started this study, we thought the amount of sports played, year-round play, and increased specialization in sports would be much more important for injury risk,” said Dr. Milewski.

Instead, “what we found is that the two most important facts were hours of sleep and grade in school.”

He suggests that older athletes may accumulate a higher injury risk after playing 3 or 4 years at the high school level.

In addition, older athletes are bigger, faster and stronger, and therefore more likely to suffer a sports injury.

In the study, the researchers asked middle and high school athletes from grades 7 to 12 enrolled at the Harvard-Westlake School in Studio City, CA, to answer questions about the number of sports they played and the time they committed to athletics, both at school and through other programs, whether they used a private coach, whether they participated in strength training, how much sleep they got on average each night, and how much they subjectively enjoyed their athletic participation.

Some 70% of the student athletes (112 out of 160 students; 54 males and 58 females; mean age 15) completed the survey, conducted in conjunction with Children’s Hospital of Los Angeles.

Researchers then reviewed those students’ school records pertaining to reported athletic injuries.

The study showed that hours of sleep per night was significantly associated with a decreased likelihood of injury.

In addition, the higher the grade level of the athlete, the greater the likelihood of injury – 2.3 times greater for each additional grade in school.

Injury was not significantly associated with gender, weeks of participating in sports per year, hours of participation per week, number of sports, strength training, private coaching and subjective assessments of “having fun in sports.”

The researchers concluded “adolescents may benefit from additional sleep as they get older to help reduce the risk of injury during sports.”

As it turns out, Sarah got to bed at 11 p.m. – earlier than usual – after the concert (which she said was “cool”).

The next day, she played nearly all of the basketball game, scoring 6 of the Brooklyn Friends School team’s 24 points, in a losing, but injury-free, effort.

Steroid Injections Can Reduce Recovery Time from Sports Hernia

If you play tennis, soccer, or flag football, you may have felt the painful groin injury known as a sports hernia.

This sports injury, called athletic pubalgia by sports medicine doctors, is a weakening of the muscles or tendons of the lower abdominal wall, causing debilitating pain and discomfort in the groin area.

Sports hernias occur most commonly among professional athletes, however, weekend warriors and athletes making extreme, repeated twisting-and-turning movements are also susceptible to a sports hernia.

In sports such as tennis, soccer, football, hockey, and skating, twisting and turning while moving forward is a necessary athletic skill.

Yet, the repetitive motion may result in sports hernia.

The recommended treatment option has been surgery, however, ultrasound-guided corticosteroid injections are a promising alternative, according to a new study presented at the American College of Sports Medicine’s 59th Annual Meeting in San Francisco, CA.

That study indicates the minimally invasive injections of this powerful anti-inflammatory may be a viable option to speed up recovery time.

“Rehabilitation from surgery can take on average eight weeks,” said Alex Fokin, MD, lead author of the study conducted at the University of Miami/Jackson Memorial Hospital in Miami, FL.

“Since the injury is so common, knowing ultrasound-guided injections are another option for treatment will be beneficial for patients looking to speed up the recovery time with something effective, yet less invasive than surgery.”

For the study, 12 patients, average age 31, diagnosed with sports hernia had ultrasound exams of their painful groins, all revealing damage or a tear around the insertion site of the abdomen or hip.

The patients were treated with an injection of a corticosteroid and anesthetic mixture under direct visualization using ultrasound.

Following treatment, all 12 patients completed a questionnaire to evaluate pain, stiffness, and physical function.

Their overall average scores were low, showing the treatment had been effective.

Based on the objective outcome scores, the researchers suggest the study shows that ultrasound-guided corticosteroid injections are a viable treatment option for patients with sport’s hernia.

Symptoms and Treatments

So how do you know if you have a sports hernia?

A sports hernia will usually cause severe pain in the groin area at the time of the injury.

The pain typically gets better with rest, but comes back when you return to sports activity, especially with twisting movements.

A sports hernia does not cause a visible bulge in the groin, like the more common hernia, what doctor’s call an inguinal hernia.

Over time, a sports hernia may lead to an inguinal hernia, and abdominal organs may press against the weakened soft tissues to form a visible bulge.

Without treatment, this injury can result in chronic, disabling pain that prevents you from resuming sports activities.

See a doctor for a physical exam and imaging tests, such as x-rays or magnetic resonance imaging (MRI) scans, to help determine whether you have a sports hernia.

According to the American Academy of Orthopedic Surgeons, treatment of sports hernia includes rest for about a week.

If you have a bulge in the groin, compression or a wrap may help relieve painful symptoms.

Two weeks after your injury you may begin physical therapy exercises to improve strength and flexibility in your abdominal and inner thigh muscles.

Your doctor may recommend non-steroidal anti-inflammatory medicines (ibuprofen or naproxen) to reduce swelling and pain.

If your symptoms persist over a prolonged period, your doctor may suggest a cortisone injection.

In many cases, 4 to 6 weeks of physical therapy will resolve any pain and allow you to return to sports.

If, however, the pain comes back when you resume sports activities, you may need to consider surgery to repair the torn tissues.

How Athletes Were Convinced to Drink Despite Not Being Thirsty

Sales of sports drinks now exceed $3 billion annually in the US, according to Beverage Industry Magazine.

Much of the rise in the popularity of these drinks is due to the industry’s modern marketing tactics and the strength of a unique positive product image, says human performance expert Tim Noakes, MD.

These tactics have led athletes and fitness enthusiasts to falsely believe they are unable to naturally monitor their hydration levels and drink accordingly.

In his forthcoming book, Waterlogged: The Serious Problem of Overhydration in Endurance Sports (Human Kinetics, 2012), Noakes debunks beliefs about hydration that have taken hold over the past 30 years.

The book outlines practices that endurance athletes should follow, variables they should consider, and guidelines they should use in maintaining proper fluid balance in sport training and performance.

He shows how the past 3 decades have been not only a time of runaway success for the sports drink industry but have led to a unique sports injury — exercise-associated hyponatremia, a potentially fatal condition caused by overdrinking during extended exercise.

“If drinking during exercise was so important,” Noakes says, “then why should a product that contains no unique molecules ever be taken seriously, especially if its core ingredients of glucose, salt, water, and a dash of lemon are present in even the most rudimentary kitchen?”

And unless you’re running or biking a long distance, you probably don’t need any supplements during activity.

Afterwards, your body might recover just as well with lots of water and a protein snack (think peanut butter sandwich), which is a lot less expensive than fancy sports drinks.

Noakes research shows that sports drink industry marketing methods have helped sustain the idea that dehydration is a condition with a specific set of symptoms (like confusion, dizziness, nausea, cramping, and fainting) that can be diagnosed and prevented, such as by ingesting more sports drinks during exercise.

“Of course, if a patient’s symptoms are not due to a reduction in the total-body water, then those symptoms caused by some other condition will not disappear when the patient is either told to drink more or is treated with intravenous fluids after exercise,” Noakes says.

As a result, he believes the treatments are more likely to cause or exacerbate the underlying condition.

Noakes, who is also a medical doctor and an exercise physiologist, stresses that the only symptom of dehydration is thirst.

It is not a medical condition or disease that produces a variety of unique symptoms.

If an otherwise healthy athlete seeking medical care is not thirsty, it is unlikely that dehydration is the cause of any illness or symptoms that may be present at the same time.

“Not surprisingly,” Noakes points out, “thirst is an uncommon complaint in athletes treated during and after endurance events in which fluid is freely available.”

As well as being an uncommon complaint, thirst is not even listed as a symptom of dehydration by those who have promoted it as a disease.

Noakes believes that the widespread disinformation about the need for sports drinks to treat dehydration helps explain why doctors often treat patients incorrectly, thinking those patients are dehydrated when, in reality, they are overhydrated.

“It is disturbing that incorrect advice to the public and the public’s own susceptibility to promotional efforts resulted in a novel medical condition that affected thousands of soldiers, hikers, runners, cyclists, and triathletes, causing some to die,” Noakes comments.

“Sadly, this phenomenon and the deaths that apparently resulted from it were preventable.”

He believes that the notion of drinking despite lack of thirst is just as bad as water restrictions and required ingestion of salt tablets were during the 1960s.

Today’s athletes, parents, coaches, and even many professionals in medicine, fitness, and sport science push the intake of fluid far beyond the bounds of what solid research suggests.

“Indeed,” Noakes contends, “10s of millions of athletes and fitness enthusiasts are waterlogged in that the hydration practices to which they religiously adhere adversely affect their health and performance.”

When Ice is Better than Heat to Treat Pain

Is ice better than heat to treat the pain of a sports injury?

The answer is it depends.

The reason it depends is that heat and cold do different things to your body, says Julie Silver, MD, Assistant Professor, Harvard Medical School, Physical Medicine and Rehabilitation.

Cold works by decreasing the temperature of the tissues.

This causes the area to become numb.

Dr. Silver explains that cold acts as a local anesthetic, which can be very helpful in relieving pain.

Also, cold causes blood vessels to narrow, called vasoconstriction, and lessens swelling and inflammation.

For a new injury in the first 24-48 hours Dr. Silver says the goal is to limit swelling and inflammation.

Icing is used in the common sports medicine mnemonic RICE, which stands for Rest, Ice, Compression, and Elevation.

If you have any cuts, lacerations, open wounds or any risk of internal bleeding, then heat isn’t a good idea as it promotes more bleeding.

But don’t keep ice on for longer than 20 minutes or so because this can cause tissue damage or “burns.”

Also, it’s important to avoid using ice on fingers and toes if you have circulation problems.

The ice causes even less blood to flow and may permanently injure these parts of the body.

When to Use Heat

Heat causes the temperature in your tissues to increase, which relaxes your muscles and also allows the blood vessels to expand.

This, she explains, is called vasodilation.

Heat delivers more oxygen and nutrients to an injured area.

Since heat increases blood and lymph flow, warmer tissues may have more swelling and become inflamed.

After the first day or two, the muscles around the injury may get very tight.

Then, heat can really be helpful.

For chronic injuries, heat is often the best modality to use to relax the muscles and improve flexibility.

However, in chronic joint pain, such as arthritis, then cold may be better because it numbs the area and reduces inflammation.

If you aren’t sure whether to use hot or cold packs, talk to your doctor.

If you have a chronic injury, consider which one of these has helped you the most in the past – that’s probably the one to use regularly for the best relief, says Dr. Silver.

Warm-up Exercises Reduce Sports Injuries in Teenage Athletes

Special neuromuscular warm-up exercises done before soccer and basketball practices can help teenage female athletes reduce their number of leg injuries.

Almost 1 million teenage girls play high school soccer and basketball each year.

But an estimated 1 out of 3 sustains a soccer- or basketball-related sports injury.

Knee injuries are the most common cause of permanent disability in female high school basketball players, accounting for up to 91% of season-ending injuries and 94% of injuries requiring surgery, according to researchers at Northwestern University in Chicago.

They invited 258 coaches from Chicago Public Schools to participate in a study to see whether a specialized warm-up program could reduce lower extremity injuries.

Overall, 90 coaches and 1,492 athletes, predominantly from low-income, urban populations, participated in the study, which was reported in the November issue of the Archives of Pediatrics & Adolescent Medicine.

Coaches in the intervention group attended a 2-hour training session 2 weeks prior to the start of the 2006-2007 season.

After learning how to implement a 20-minute neuromuscular warm-up before team practices and a shorter pregame version, the coaches in the intervention group used the prescribed warm-up before an average of 80% of practices.

The control coaches stuck to their standard warm-up protocol, including no warm-up exercises and having athletes jog or warm up on their own.

The results show that athletes in the intervention group had about half as many lower extremity injuries (50) as those in the control group (96).

And those in the neuromuscular warm-up group had a 34% decrease in non-contact ankle sprains as compared to the control group.

The neuromuscular training program combined progressive strengthening with plyometric, balance, and agility exercises.

Coaches instructed the female athletes on how to land softly, without excessive side-to-side movement and with flexed hips and knees.

One outstanding question is whether coaches will continue to implement this warm-up consistently for several seasons, or whether retraining will be needed.

I’ve got a personal interest since my 14-year-old daughter Sarah just finished her first season as a starter on the varsity soccer team, and began basketball practice yesterday.

I plan to send the school’s athletic director the results of this study and a PDF of a similar type of training program that has been shown to enhance performance and prevent injuries.

Swimming, the Near-Perfect Exercise – Except for the Shoulders

I can’t think of a better way to beat the heat of a hot summer day than a dip in a pool or the ocean.

I even deigned to dive through the waves at Atlantic Beach in East Hampton last Saturday.

The water was warm enough and I was hot enough.

A cool way to stay cool.

Swimming is probably the most nearly perfect form of exercise.

And you don’t have to put in thousands of hours in the pool like Olympic champion Michael Phelps to get a good workout.

• It’s non-weight-bearing and so imposes no stress on the bones and joints.

Even people with bad backs can exercise in the water without fear of injury.

• It exercises and strengthens the upper and lower body.

• It’s an exercise in which it’s easy to reach your training range (which exercises your heart) and maintain it.

• It’s an effective weight-control exercise.

An hour of vigorous swimming burns about as many calories as running 6 miles in an hour.

• It’s a form of meditation.

It calms your nerves in addition to providing a good workout.

• It’s a good exercise for people with exercise-induced bronchospasm.

People with this condition are unable to warm and moisten the air to the lungs when they breathe hard.

Although swimming isn’t considered a sport that leads to injuries, serious swimmers often have problems with their shoulders.

The most common injury is referred to as “swimmer’s shoulder” and can affect up to 70% of competitive swimmers.

Swimmer’s shoulder is basically a rotator cuff sports injury.

The rotator cuff muscles, which hold the head of the shoulder in the joint, are not meant to be overstressed with the arm at an angle above parallel to the ground.

All swimming strokes (except the breaststroke) place the arm in this over-the-head position and stress these muscles as the arm is pulled through the water.

The small rotator cuff muscles become stretched, allowing the head to slip around in the shallow socket.

As it slips, it catches the bicep tendons, pinching them and causing pain.

If you feel shoulder pain after swimming, rest for several weeks and then modify your training program by using a kickboard or doing the breaststroke to maintain conditioning.

Combine this with a shoulder-strengthening program using light weights.

Here are some more tips on how to minimize the risk of a shoulder injury from John Cavanaugh, PT, a physical therapist at Hospital for Special Surgery in New York City:

• Do not attempt to swim if you are too tired, too cold, or overheated.

• Make sure to warm up properly.

• Focus on swimming technique. Poor technique can leave you more prone to injury.

• Engage in a general exercise program on land to develop muscle strength, endurance, balance, and flexibility. This includes strengthening the core abdominal muscles.

• Do not swim vigorously if you have a fever, upper respiratory infection, or ear infection.

• If you are training for a triathlon, note that the swim is completely different from pool swimming.

Generally, in open water, you can’t see where you’re going and there are people all around you.

Be aware of the bodies and avoid them as much as you can.

NFL Players Continue to Take Pain Meds After They Retire

You may have seen the recent headlines or watched ESPN’s “Outside the Lines” report on the misuse of painkillers among retired National Football League (NFL) players. Not surprising, the new research conducted by investigators at Washington University School of Medicine in St. Louis found that brutal collisions and bone-jarring injuries associated with professional football often cause long-term pain, and that former NFL players continue to use painkilling medications.

The study of 644 former NFL players was commissioned and supported by a grant from ESPN, with additional funding from the National Institute on Drug Abuse of the National Institutes of Health. Among the key findings are:

– 7% of the former players were currently using painkilling opioid drugs, more than 4 times the rate of opioid use in the general population.

– More than half (52%) say they used prescription painkillers during their careers, and nearly three-quarters (71%) of that group say that they abused the drugs, with 15% admitting to misusing the drugs over the last 30 days.

– About two-thirds (63%) of former players who misused the drugs during their playing days got their medication from a non-medical source, including a teammate, coach, friend, or the Internet.

The study reminded me of conversations I’ve had with Allan Levy MD, New York Giants team physician emeritus and my co-author of Sports Injury Handbook. Pro football is a grueling, physically demanding game, he said, and the players are expected to endure pain and continue playing. Basically, they get paid to play in pain. To maintain their performance, players often need to take pain medications.

It makes sense that NFL players use painkillers more often than Average Joes because they’ve been exposed to them. Addiction research shows once you’re exposed to painkillers, you’re more likely to continue to use them.

There’s no doubt NFL players, current and retired, are taking painkillers, and abuse happens. Maybe most famously, quarterback Brett Favre missed 45 days of the 1996 season due to a Vicodin addiction.

For the rest of us, early, aggressive use of simple over-the-counter painkillers can allow you to rehabilitate sports injuries.