Archive for July, 2008
Surfing| Injuries
July 26, 2008 12:33 amSaturday, July 26, 2008
Surfing has experienced a 'boom' in participants and media attention over the last decade at both the recreational and the competitive level. However, despite its increasing global audience, little is known about physiological and other factors related to surfing performance. Time-motion analyses have demonstrated that surfing is an intermittent sport, with arm paddling and remaining stationary representing approximately 50% and 40% of the total time, respectively. Wave riding only accounts for 4-5% of the total time when surfing. It has been suggested that these percentages are influenced mainly by environmental factors.
Competitive surfers display specific size attributes. Such surfers tend to have a husky, muscular body build and lower height and body mass compared with other matched-level aquatic athletes. Surfers possess a high level of aerobic fitness. Upper-body ergometry reveals that peak oxygen uptake (VO2peak) values obtained in surfers are consistently higher than values reported for untrained subjects and comparable with those reported for other upper-body endurance-based athletes. Heart rate (HR) measurements during surfing practice have shown an average intensity between 75% and 85% of the mean HR values measured during a laboratory incremental arm paddling VO2peak test. Moreover, HR values, together with time-motion analysis, suggest that bouts of high-intensity exercise demanding both aerobic and anaerobic metabolism are intercalated with periods of moderate- and low-intensity activity soliciting aerobic metabolism.
Minor injuries such as lacerations are the most common injuries in surfing. Overuse injuries in the shoulder, lower back and neck area are becoming more common and have been suggested to be associated with the repetitive arm stroke action during board paddling. Further research is needed in all areas of surfing performance in order to gain an understanding of the sport and eventually to bring surfing to the next level of performance. Mendez-Villanueva A. Bishop D. Physiological aspects of surfboard riding performance. Sports Medicine. 35(1):55-70, 2005.
A prospective study of acute competitive surfing injuries was carried out at 32 professional and amateur surfing contests worldwide between 1999 and 2005. All acute injuries sustained during competition were recorded by on-site medical personnel. The wave size, type of seafloor, and number of surfing heats were also recorded for each day. The total number of injuries was divided by the total number of athlete exposures to determine injury rates. Risk of injury was 2.4 (95% confidence interval, 1.5-3.9) times greater when surfing in waves overhead or bigger relative to smaller waves and 2.6 (95% confidence interval, 1.3-5.2) times greater when surfing over a rock or reef bottom relative to a sandy bottom. There were 13 acute surfing injuries per 1000 hours of competitive surfing. The risk of injury was more than doubled when surfing in large waves or over a hard seafloor.( Nathanson A. Bird S. Dao L. Tam-Sing K. Competitive surfing injuries: a prospective study of surfing-related injuries among contest surfers. American Journal of Sports Medicine. 35(1):113-7, 2007).
Surfers considered the risk of head injury while surfing as moderate or high, and only 12 (1.9%, 95% CI 1.0-3.3) reported routine use of headgear. The surfers were more likely to believe that there was a higher risk of head injury in other sports and physical activities (P < .001). Although 475 surfers (73.8%, 95% CI 70.2-77.1) thought that surfers who wear headgear are less likely to become injured, 400 (62.1%, 95% CI 58.2-65.9) reported that headgear restricted surfing performance and that they would rather surf without it. The main reasons for not wearing headgear were "no need," discomfort, claustrophobia, and effects upon the senses and balance. Although most surfers acknowledge some risk of head injury, headgear is rarely used and barriers to its use are apparent. Research is required to clarify the risk of head injury among surfers and the effectiveness of headgear in reducing injury risk. Until this evidence is available, educational initiatives, improved headgear design, and profile within the surfing culture would be required to increase rates of wearing headgear. (Taylor DM. Bennett D. Carter M. Garewal D. Finch C. Perceptions of surfboard riders regarding the need for protective headgear. Wilderness & Environmental Medicine. 16(2):75-80, 2005.
Golf| Injuries |Back pain
July 18, 2008 12:13 amFriday, July 18, 2008
A recent article in the Wall Street Journal (WSJ.com - Health Matters ) on June 14, 2008 on golf injuries initiated this blog.
Nearly 16% of Australian amateur golfers may expect to sustain a golf-related injury per year. The injuries in golf are most likely sustained in the lower back region as a result of the golf swing. The lower back was the most common injury site (18.3%), closely followed by the elbow/forearm (17.2%), foot/ankle (12.9%), and shoulder/upper arm (11.8%). A total of 46.2% of all injuries were reportedly sustained during the golf swing, and injury was most likely to occur at the point of ball impact (23.7%), followed by the follow-through (21.5%). Based on statistical analysis, only the amount of game play and the last time clubs were changed were significantly associated with the risk of golf injury. Other factors such as age, gender, handicap, practice habits, and warm-up habits were not significant. (McHardy A. Pollard H. Luo K. One-year follow-up study on golf injuries in Australian amateur golfers. American Journal of Sports Medicine. 35(8):1354-60, 2007).
In another study of 12 golfers, the myoelectric activity of the lumbar erector spinae (low back spinal muscles) and the external obliques (abdominal wall muscles) was recorded via surface electromyography, while the golfers performed 20 drives. The results showed that the low-handicap low back pain (LBP ) golfers tended to demonstrate reduced erector spinae activity at the top of the backswing and at impact and greater external obliques activity throughout the swing. The high-handicap LBP golfers demonstrated considerably more erector spinae activity compared with their asymptomatic counterparts, while external obliques activity tended to be similar between the groups. The reduced erector spinae activity demonstrated by the low-handicap LBP group may be associated with a reduced capacity to protect the spine and its surrounding structures at the top of the backswing and at impact, where the torsional loads are high. When considering this with the increased external obliques activity demonstrated by these golfers, it is reasonable to suggest that these golfers may be demonstrating characteristics/mechanisms that are responsible for or are a cause of LBP. (Cole MH. Grimshaw PN. Electromyography of the trunk and abdominal muscles in golfers with and without low back pain. Journal of Science & Medicine in Sport. 11(2):174-81, 2008 )
Performance was affected in 78.9% of cases, with 69.7% of the injured golfers missing games or practice sessions due to injury. Golfing injuries appear common and have a substantial impact upon the injured golfer. As lower back strains are the most common injury, strategies such as performing an appropriate warm-up could be investigated to determine the possible injury prevention benefits for golfers.
Many of these individuals have pre-existent back problems and have frequented chiropractors. Re-injury to previously injured nerve roots and muscles predispose these individuals to chronic pain.
Yoga| Pain
July 10, 2008 11:14 pmFriday, July 11, 2008
In comparing 12-week sessions of yoga or conventional therapeutic exercise classes or a self-care book, Yoga was found to be more effective than a self-care book for improving function and reducing chronic low back pain, and the benefits persisted for at least 26 weeks. Sherman KJ. Cherkin DC. Erro J. Miglioretti DL. Deyo RA. Comparing yoga, exercise, and a self-care book for chronic low back pain: a randomized, controlled trial. Annals of Internal Medicine. 143(12):849-56, 2005 Dec 20.
Yoga training and a single bout of yoga appear to attenuate peak muscle soreness in women following a bout of eccentric exercise. These findings have significant implications for coaches, athletes, and the exercising public who may want to implement yoga training as a preseason regimen or supplemental activity to lessen the symptoms associated with muscle soreness. (Boyle CA. Sayers SP. Jensen BE. Headley SA. Manos TM. The effects of yoga training and a single bout of yoga on delayed onset muscle soreness in the lower extremity. Journal of Strength & Conditioning Research. 18(4):723-9, 2004)
The information below is an excerpt from the article by Paul P: When yoga hurts. Practicing it is supposed to make you feel better, but doing it wrong is dangerous. Time. 170(16):71, 2007 Oct 15.
Yoga, regardless of the form, does not offer a comprehensive way to get fit. According to a study by the American Council on Exercise, a national nonprofit organization that certifies fitness instructors and promotes physical fitness, dedicated yoga practitioners show no improvement in cardiovascular health. It is not the best way to lose weight either. A typical 50-min. class of hatha yoga, one of the most popular styles of yoga in the U.S., burns off fewer calories than are in three Oreos–about the same as a slow, 50-min. walk. Even power yoga burns fewer calories than a comparable session of calisthenics.
And while yoga has been shown to alleviate stress and osteoarthritis, it does not develop the muscle-bearing strength needed to help with osteoporosis. Part of the problem is that increasingly, the people teaching yoga don't know enough about it. Yoga was traditionally taught one-on-one by a yogi over a period of years, but today instructors can lead a class after just a weekend course.
Though the Yoga Alliance, formed in 1999 and now based in Clinton, Md., has set a minimum standard of 200 hours of training for certification, only 16,168 of the estimated 70,000 instructors in the U.S. have been certified. "Yoga means bringing together mind, body and spirit, but in Western yoga, we've distilled it down to body," says Shana Meyerson, an instructor in Los Angeles. "That's not even yoga anymore. If the goal is to look like Madonna, you're better off running or spinning."
- Ask an instructor for credentials. And don't be afraid to leave if you're not satisfied.
- Alert your instructor to your condition. Talk about past injuries and current weaknesses, and ask for any necessary modifications.
- Beware of stationary instructors. They should be roaming around, monitoring participants and making adjustments for those who need them.
- Avoid positions prone to cause injury. These include lotus, chaturanga or plank, headstands and downward-facing dog.
- Stop if it hurts. Yoga should not cause pain.
Individuals who start performing yoga are the most likely to get injured. Many who start yoga are interested to find out if it could help loosen muscles. If the muscles are chronically tight, stretching received from yoga may be too excessive causing more injuries. Some of the postures used in yoga can actually aggravate the underlying pain in the neck or in the lower back. As a general rule of thumb, yoga like any exercise should not cause pain while performing the exercise and certainly should not produce more pain or new pain after the exercise. If the pain lasts longer than two days, you are not a candidate for continuing this type of exercise.
lower body topics, pain
Chronic Pain| Groin Muscles
July 4, 2008 5:54 pmFriday, July 04, 2008
Hip stiffness in athletes is associated with later development of chronic groin injury and as such may be a risk factor for this condition. "Sports hernia," pubic bone edema, and entrapment neuropathies-are potential causes of chronic groin pain in assessing athletes.
Groin injury is among the most common cited injuries in the sports of ice hockey, soccer, Australian Rules football, calisthenics and cricket. There are very few prospective studies examining risk factors for groin strain injury in sport. There is support for an association of previous injury and greater abductor to adductor strength ratios as well as sport specificity of training and pre-season sport-specific training, as individual risk factors in groin strain injury in athletes. Core muscle weakness or delayed onset of transversus abdominal muscle recruitment may increase the risk of groin strain injury. Debate exists in the literature regarding the role of adductor strength and length as well as age and/or sport experience as risk factors for groin injury. There is no strong evidence to support a causal association for any of these risk factors and groin injury. (Maffey L. Emery C. What are the risk factors for groin strain injury in sport? A systematic review of the literature. Sports Medicine. 37(10):881-94, 2007).
MR imaging studies in 141 patients (134 male patients, seven female patients; mean age, 30.1 years; range, 17-71 years) who had been referred to a subspecialist because of groin pain showed MR imaging to have more sensitive and specific for rectus abdominis tendon injury and for adductor tendon injury. Injury in each of these structures was significantly more common in the patient group than in the control group. Only two patients had hernias at surgery. (Zoga AC. Kavanagh EC. Omar IM. Morrison WB. Koulouris G. Lopez H. Chaabra A. Domesek J. Meyers WC. Athletic pubalgia and the "sports hernia": MR imaging findings. Radiology. 247(3):797-807, 2008).
Adductor dysfunction is a condition that can cause groin pain in competitive athletes. A single pubic cleft injection of local anesthetic and steroid into the adductor enthesis (tendon thickening) had been used. This single injection gave at least one year of relief of adductor-related groin pain in a competitive athlete with normal findings on a magnetic resonance imaging scan; however, it should be employed only as a diagnostic test or short-term treatment for a competitive athlete with evidence of adductor longus tendon thickening (enthesopathy) on magnetic resonance imaging. (Schilders E. Bismil Q. Robinson P. O'Connor PJ. Gibbon WW. Talbot JC. Adductor-related groin pain in competitive athletes. Role of adductor enthesis, magnetic resonance imaging, and entheseal pubic cleft injections. Journal of Bone & Joint Surgery - American Volume. 89(10):2173-8, 2007).
eToims has been useful in the treatment of groin pain related to adductor dysfunction since it can be used repeatedly and regularly without side-effects. Treatments have to be directed to all hip muscles supplied by multiple nerve roots as well as to muscles segments supplied by spinal nerve roots above and below the hip joint.
www.stopmusclepain.com Chronic Pain| Groin Muscles
