This Hydration Strategy Should Work

Last week I provided an update on heat illness warning signs and in the post recommended that all individuals follow a good hydration strategy. Our bodies are made up of 70% water, so it makes sense that hydration should be a good component of overall health.

But there is a lot of noise out there on exactly the type of hydration strategy to follow. What should you drink? How much should you drink? When should you drink? Here’s an easy to remember hydration strategy that is gaining a lot of traction amongst healthcare professionals as well as athletic performance specialists: take half your body weight in pounds, and drink that amount in ounces of water every day.

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Heat Illness Warning Signs

This is the time of year we need to review some aspects of heat illness, and a potentially deadly form of heat injury called exertional heat stroke. A recently published study of NCAA athletesrevealed that heat illness is most common in preseason training, and that tackle football has the highest incidence but athletes in all sports are potentially at risk. I highly recommend this 2017 New York Times article by neurosurgeon Dr. Julian Bailes, in which he describes the effects of heat stroke and argues for banning football two-a-days at the high school level.  The NCAA Division 1 and the NFL have banned two-a-days.

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Are Calf Compression Socks Helpful Or Just A Fashion Statement?

Calf compression socks are reported to improve leg endurance during running, speed recovery after a long distance run, and possibly lead to better performance. Do they actually do these things or is something else happening?

A recent scientific study evaluated the pain levels, performance, and muscle architecture during a six-week training period prior to an ultramarathon and in the immediate period after the race. In this group of healthy experienced runners with no prior issues of leg pain, the study authors found no improvements in the compression sock group. In fact, their runners with compression socks actually reported more pain than the runners who trained and competed without the socks.

The conclusion in this well-performed study of healthy runners is that there is no benefit to wearing the compression socks. Still, I find there are good reasons to wear them, especially if you’re recovering from an injury.

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When Can I Play Again: Shoulder Separation

I’ve written recently about shoulder dislocation, a serious condition in which the ball portion of the shoulder (humerus) becomes completely dislodged from the socket. This week we’ll discuss a shoulder separation, another common shoulder injury. But first let’s clear up some terminology to avoid confusion.

A separated shoulder refers to an injury to the ligaments of the acromioclavicular joint (commonly known as the AC joint), which is the joint between the end of your collarbone and the upper part of your shoulder blade. It’s located near the point of the shoulder.

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Parents Have A Major Impact On Reducing Kids’ Overuse Injuries

Over the last several years there’s been a growing consensus that some sport behaviors place a young athlete at risk for overuse injury: single sport specialization before age 14, playing that sport in training and competition more hours per week than your age in years, and playing more than eight months out of the year. Sport specific recommendations such as PitchSmart have also emerged.

What was previously unknown was whether following these recommendations actually leads to reduced injury rates. Recently published research indicates that parents who are knowledgeable of the PitchSmart recommendations and follow them with their young pitchers show significantly reduced injury rates compared to parents who were unaware of those recommendations.

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Do I Cheat Or Not? The Role Of Morality In Performance Enhancing Drug Use

It’s estimated that a substantial number of athletes in all age groups use performance enhancing substances (PES). Some surveys of high school age athletes have shown anabolic steroid use reported by 3%, and other types of PES use as high as 30% by male professional cyclists. It seems that PES use affects all age groups, many sports, males, and females.

It turns out that one effective means of reducing PES use could be completely non-technical: athletes who have a strong moral compass are far less likely to use PES, regardless of the pressure felt in their sport.

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Can A Concussion Lead To An Ankle Sprain Or Knee Injury?

By now, most athletes understand that a concussion leads to changes in brain function. After a concussion an athlete may have symptoms such as headache and light sensitivity. Students may have difficulties with concentration in the classroom.

But what most athletes don’t know about is that a concussion also leads to changes in balance and peripheral vision. It turns out that those associated changes create an increased risk of injuries to the lower extremity, such as knee injuries or ankle sprains. In a recently published analysis, athletes with a concussion were 2x more likely to have a lower extremity injury in the weeks and months after a concussion.

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When Can I Come Back From: Sports Hernia Surgery

A “sports hernia” is an injury to the soft tissue around the groin, typically involving the abdominal muscles and the adductor muscles of the inner thigh. This injury is most commonly a number of partial tears in the area where the tendons insert on to the bones of the pelvis. The injury can go by other names such as “athletic pubalgia” and “core muscle injury”.

In an athlete, this is an injury that will frequently go on to need surgery. Some of the keys to successful return to sport after surgery are:

Finding a doctor skilled in the diagnosis and surgery for a sports hernia
Working with a physical therapist after surgery with experience in core muscle rehabilitation
Following return to sport protocols carefully, and also making sure you’re mentally confident about your return to sport
Most people should aim for a return to sport at about the start of the 13thweek after surgery, although some elite athletes will follow an aggressive protocol that might allow a return in the 4thto 6thweeks after surgery.

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Artificial Turf vs. Grass: The Debate Continues

We’ve come a long way from the earliest versions of artificial turf, which were essentially large pieces of green plastic laid down over cement. The newest generations of artificial turf are radically better than the very first versions, yet the debate over which type of surface is best from a safety standpoint continues.

We’ll highlight this week some of the latest published research in this debate. In a large series specifically studying collegiate tackle football, it was determined that playing on artificial turf was an increased risk for PCL injuries in Division I players and for ACL injuries in Division II and Division III players.

While there are many strengths in this study, I would caution that the results are specific to American collegiate tackle football and may not be similar in other sports or in youth age groups.

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Exciting Early Results: ACL Scaffold Repair

Our current best ways to treat a torn ACL is a surgical procedure called a “reconstruction”, where a substitute tissue (a “graft”) is used to replace the torn ACL. Tunnels or sockets are drilled in the bone, so the bone essentially grows into the new tissue and makes a new ACL. 

ACL surgery has improved substantially over the last 30 years, with generally excellent results. But there can be issues related to the bone tunnels potentially causing growth disturbance in young athletes, and issues related to the removal of the graft. A new type of ACL repair using stitches and a biologic scaffold to enhance healing is showing very exciting early results. If this ACL repair technique proves itself in larger clinical studies, we can expect it to be an excellent option to avoid tunnels and grafts for some ACL tear types.

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