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Cold water immersion for cyclists- does it help or just hurt?

Sports drinks and energy drinks

I recently wrote a short post for the Issaquah Soccer Club on the topic of sports & energy drinks - click here to read the post.

How to Manage a Sports Related Concussion

What is a concussion?
A concussion is a mild brain injury that causes a change in mental status that can occur with direct insult to the head. A concussion may also occur with movement of the body that cause acceleration/deceleration forces to the head.
 
What are the symptoms of a concussion?
  • Headache
  • Dizziness
  • Loss of consciousness
  • Amnesia
  • Difficulty concentrating
  • Confusion
  • Nausea and/or vomiting
  • Difficulty balancing
  • Sensitivity to light
  • Sensitivity to noise
  • Ringing in the ears
  • Drowsiness
  • Irritability
  • Sadness
When should I seek medical attention for a concussion?
  • A healthcare provider should evaluate every child or adolescent suspected of a concussion. 
  • If this occurs during a sporting event, the child should sit out the rest of the game
  • Your provider may conduct a standardized neuropsych assessment to help guide return to activities/sports
What is the best treatment for a concussion?
  • Rest, rest and more rest!
  • Absence from school may initially be necessary until one can concentrate on a task without exacerbating symptoms
  • Avoid excessive time texting, on the computer, watching television, playing video games or listening to loud music
  • Return to activity too soon can lead to worsening and prolonged symptoms.  A second injury to the brain while the brain is healing can lead to severe brain injury that is life-threatening
When can a child return to sports after a concussion?
A person with a concussion should not return to play until they no longer have symptoms at rest for at least 24 hours.  Return to play should then be a step-wise progression.  The child/adolescent should be symptom free for 24 hours before progressing to the next level of play:
  • Light aerobic exercise (e.g.: walking)
  • Sport-specific exercise
  • Non-contact training drills
  • Full contact practice
  • Return to play (Must first be cleared by a provider)
What resources are there for concussions?
Swedish’s Spine, Sports and Musculoskeletal Medicine team has developed a Sports Concussion Clinic with the following resources:
  • Baseline neurocognitive testing with a computerized exam called ImPACT can be done prior to playing a sport to assess changes and recovery if a concussion occurs.
  • Comprehensive concussion management, including clearance for return-to-play
Click here to learn more about the Sports Concussion clinic.  The team includes sports medicine physicians, psychiatrists, an athletic trainer, physical therapists and a neuropsychologist that can deliver individualized care for every athlete

Think about injury prevention when returning to baseball season

Baseball season is finally here! As we watch our Major League Baseball heroes take the field this April, kids of all ages will be returning to the field after winter break and time off from practicing. 

It is important that our kids return safely to help prevent overuse injuries from occurring during the season. Common overuse injuries in baseball are injuries to the elbow (ulnar collateral ligament, UCL) and shoulder in the throwing arm. A proper warm up, maintaining an age appropriate pitch count and good throwing mechanics are essential to preventing overuse injuries. 
 
Here are some specifics to keep in mind:

Tips for keeping young athletes safe and healthy

We all know exercise is an important factor in maintaining an active and healthy life. However, over-exercising can lead to a rare, but serious complication known as rhabdomyolysis – a medical team that literally means ‘dissolution or destruction of skeletal muscle’. There has been a recent increase in rhabdomyolysis amongst teen athletes so it is important to recognize the warning signs and learn how to prevent them.

The classic triad of rhabdomyolysis is dark urine, muscle weakness or fatigue, and muscle pain. Although exercise can be the primary factor, other key contributing elements such as dehydration, genetic conditions (e.g. sickle cell), metabolic disorders, nutritional supplements, drug use, and heat stress can exacerbate muscle damage. Without appropriate medical evaluation and care, rhabdomyolysis can cause permanent damage to the kidneys and may even be life-threatening in severe cases. Here are some tips to help your young athlete remain active and healthy:

  1. Maintain adequate hydration – preferably with plain water.  Sports and energy drinks may often contain caffeine and excessive amounts of sugar which can cause dehydration.  On average, children that are 6-10 years old should have about 1L of fluid a day, children 10-14 years old should have 1.5L/day and teens over 14 years should have at least 2L of fluid a day. It is important to increase fluids with increased activity due to the additional fluid losses that occur.
  2. Eliminate protein supplements. A recent study by the American Academy of Pediatrics found ...

Treating and preventing common sports injuries

Looking to be more active in 2014? Have you been waiting all year to enjoy winter sports such as skiing or snowboarding?

There are a few common injuries that often get my patients down when they are on the go. Below are a few tips and tricks to help you prevent these common injuries and determine the best treatment options should you need it.

Sprains/Fractures
The most common injuries in the wrist and ankle are sprains and fractures. Throwing, twisting, weight-bearing, and impact can put you at risk for a wrist injury. Ankle sprains and fractures are typically caused by making a fast, shifting movement with your foot planted on the ground.

In most cases, I recommend the RICE approach: rest for around 48 hours; ice the injured area to reduce swelling (use a pack wrapped in a towel); compress with an elastic ACE wrap; and elevate the injury above heart level.

However, if you experience these symptoms, contact your provider for further evaluation.   
  • Pain at the time of injury
  • Swelling
  • Bruising or discoloration
  • Difficulty moving the wrist or ankle
  • A “popping” or tearing sensation during the trauma
  • Warmth and tenderness of the skin
More serious injuries will likely be treated with a splint, boot or cast. The healing process can take up to six weeks. Surgery may also be required.

ACL Tears
The ACL, or anterior cruciate ligament, is one of the major ligaments in your knee that helps with stabilization when turning or planting. ACL injuries take place during cutting or pivoting movements. The hallmark of a torn ACL is a distinct popping noise and your knee may give out. The  ...

How to treat PFS runner's knee

Patellofemoral pain constitutes a quarter of the injuries to the knee.  Kneecap pain can be both debilitating and frustrating; prolonged pain can limit physical activity and cause those suffering from it to abandon their recreational and sporting activities. 

Patellofemoral pain usually manifests as a gradual onset of pain around the edge or underneath the kneecap during physical activities.  Common activities such as descending hills or stairs, squatting, running, or sitting for long periods of time can all aggravate the pain and cause soreness. 

How your knee works

patellofemoral pain image from http://www.moveforwardpt.com/The knee joint is made up of three bones: the femur (thigh bone), the tibia (shin bone), and the patella (kneecap).  The patellofemoral joint refers to the kneecap and the groove (trochlea) in the femur in which the patella sits.  The four muscles of the quadriceps all attach to the patella.  The patella is a sesamoid bone (the bone is embedded within the tendon) and it plays a crucial role in the function of the leg by lengthening the lever arm of the muscles and tendons of the quad to maximize power and function and by acting as a shield to protect the knee from direct trauma.  The cartilage covering the kneecap within the knee joint acts as a shock absorber, protecting the underlying bone from stress.  With running and jumping, the knee (and its overlying cartilage) can experience forces up to 8 times bodyweight.  The cartilage itself does not have a nerve supply, but the bone underneath has an extensive nerve supply and these nerves become painful when the cartilage is not functioning properly to pad and protect the bone.

In patellofemoral syndrome, or PFS (also known as runner’s knee), the cartilage undersurface of the patella become angry, inflamed, irritated, and the kneecap hurts.

How to treat PFS or runner’s knee

  1. Loosen things up.  Use a foam roller to roll out the quad muscle and the illiotibial (IT) band.  These tissues all hook into the kneecap and can contribute to pain when they are tight.
     
  2. Make things stronger.   In the early recovery period (the first several weeks when you are just starting out on your recovery journey) ....
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