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Toes or Heels?  The Runner’s Debate

As an orthopedic surgeon I generally see folks in my clinical practice once something has gone wrong. Either they’ve been injured already or there is some ongoing reason that affects pain, performance, or quality of life. But in our role as team physicians we get a chance to interact with athletes before a problem has occurred.

I’ll often see athletes with Achilles tendinitis or shin splint syndrome and discover that they recently changed their running style from heel strike to forefoot strike. It’s easy for me to jump to the conclusion that forefoot running is somehow bad for runners. Or am I seeing a skewed population? I recently spoke with my Stanford colleague Michael Fredericson M.D., an internationally recognized running expert to find some answers.

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It’s Time To Think About Vitamin D

Over the past weekend many parts of the U.S. turned their clocks backwards one hour, which means we are now in “Standard Time”.  I like to think of this as “daylight losing time”. Our afternoons get darker earlier. With fewer opportunities for sunlight exposure we’ve got fewer opportunities to make a critical component of health, fitness, and athletic performance: Vitamin D.

In today’s post I’ll briefly describe where Vitamin D comes from, outline Vitamin D’s effects on sports performance and fitness, and what to do if you need to get more Vitamin D in your body.

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Five Player Safety Tips To Put In Place Now

Today’s post is directed towards coaches, but parents can benefit from these tips too. Maybe your sport is football, or soccer, or cross-country. Whatever it is, you’re thick in to your fall season, focusing on practices, competition and hopefully aiming for playoffs. In spite of everything you’re busy with there are still some important steps you can take now to make sure you’re performing at your best. Here are five areas to review now;

Monitor your players’ training loads
Be aware of weather safety, especially lightning and cold weather
Take 15 minutes to review your on-field injury recognition protocols
Make sure you’re up to speed on concussion evaluation
Use a good dynamic warmup, and if you’re a soccer team start using the FIFA 11+

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Stingers and Burners In Football

As football season rolls along we are seeing a fair number of injuries called “stingers”, also known as “burners”. The injury is named for the stinging or burning pain that spreads from the shoulder to the hand. This can feel like an electric shock down the arm. Stingers are fairly common injuries in collision sport athletes, and fortunately most of these injuries are temporary with rapid return to normal function.  A stinger occurs when there is an injury to the network of nerves surrounding the neck and traveling to the shoulder, arm, and hand. In football we commonly see stingers when the neck is stretched to the side during a tackle. We will also see stingers occasionally when the side of the player’s head makes contact with the ground.

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Too Much, Too Soon

Training “too much, too fast, too soon” has been called the “terrible toos” for as long as I can remember, because it’s a great formula to create an injury. But one of the problems with this line of thinking is that it can be very difficult when you’re in the moment to understand whether you are in fact doing something “too much, too fast, or too soon”.

We often don’t know whether an athlete has over trained until they come in to the doctor’s office with an injury. We then work backwards and if we’re lucky we can point to specific training errors as the likely cause of the injury. Is there a way we can monitor training loads going forward to avoid exceeding the thresholds for overtraining? Wearable activity trackers may be the answer.

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The Problem With Mono

Sam Darnold of the New York Jets has been out of action for some time due to mononucleosis. Actually, he’s not out because of mono, he’s out because there is a risk of a ruptured spleen after mono.

Mononucleosis is fairly common in teenagers and young adults. I’d like to present today some quick facts about mono, what happens to the spleen after mono, the risks from a ruptured spleen, and general guidelines for return to sports.

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How I Talk To Young Athletes About Nutrition

One of the benefits I found working as a high school team physician is the opportunity to have conversations with intelligent young people and every once in a while to positively influence their life choices. Nutrition is an area fraught with confusion, as the messaging the kids receive from the media and occasionally from coaches runs counter to what we believe would be the optimal choices for them.

I’ve found that there are two key components to having a successful conversation. The first component is when to actually have the conversation (the training room works best for me). The second component is to use examples from the best athletes in the world as models of high performance habits. By using these tactics I’ve been surprised over the years that young athletes are far more receptive to the messages than I once believed.

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How Many Workouts Can You Miss And Still Stay Fit?

You’re working hard to compete successfully in your sport, or you’re working out regularly to stay fit. And every once in a while you’ll need to take time off from training. Maybe you’ve had an overuse injury and are taking time off to heal, or various life events invade your workout plans.

Many folks fret about the time off, feeling that they’ll rapidly lose all of those hard earned gains. How many days or weeks can you miss and still keep your level of fitness? It turns out that for most healthy adults in their 20s and 30s you can take 2 to 3 weeks off and still retain most of your strength and cardiovascular fitness. The amount of time off can be even longer if you are a teenager, and unfortunately it’s shorter if you are an older active adult.

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High School vs. Club Sports: Are You Playing Both At The Same Time?

There’s general consensus that overuse injuries in teenage athletes can be reduced by carefully monitoring playing load for the young athletes. Recommendations have been put forth to encourage multi-sport participation, limit number of months played per year, and limit number of hours of sport participation per week as ways to reduce the risk of overuse injury.

Athletes’ behavior, however, is often different. Many teenage athletes participate in high school and club sports, often at the same time. The result is that training loads are frequently much higher than what is recommended.

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Two Great Reasons To Do ACL Injury Prevention Warmups

There is convincing evidence that major factors contributing to noncontact ACL tear risk include improper mechanics when landing from a jump or when rapidly changing direction. Training programs to reduce this risk have focused on improving landing mechanics and improving strength imbalances. Typically, these programs are incorporated into a team warm-up.

Two recently published scientific studies show that ACL injury prevention warm-up programs are very effective in reducing the risk of getting a noncontact ACL tear, and these programs lead to improved athletic performance. These are two really great reasons to utilize ACL injury prevention warm-ups for your sport.

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