07-03 - OFF Week - Cycling injuries..

Cycling is a great, low-cost and low-impact way to stay fit. Just looking around the Northern Virginia / DC / Maryland environment, and you notice that it is very cyclist friendly. (Paved roads have an extra lane for cyclists, there are designated "biking" trails all throughout the cityscape, there are even bicycle tours that allow a group of people to tour our Nations' Capitol.)

Quick Tips for city-bikers!

How to bring a bicycle on a DC Metro Train: (WebLink:)

Always keep a map handy!

Make sure you are familiar with hand-signals.

When in DC, always always secure your bicycle with a locking mechanism.

How To Bike in a Busy City
Uploaded by Howcast. - NASCAR, F1, tuning and drift videos.

But it isn't without the risk of pain and serious injury. Just like any other sport or athletic hobby, improper fitting of the cycling equipment or poor riding technique can greatly enhance the cause of an injury. The list of cycling injuries is huge! Cycling can cause a love/hate relationship, here is a list of the most common types of injuries associated with cycling:

List of common injuries:

• Knee Pain


• Osteoarthritis of the knee


• Muscle cramps


• Sprains and Strains


• Achilles Tendonitis

Here are the best practices that a cyclist should take in order to prevent injuries:

Item:	Description	Cost:
	Footwear = Properly fitted shoes are important in avoiding plantar fascitis and to minimize the discomfort associated with biking. There are specific cycling shoes that snap onto the pedals of your bike, forcing the foot to stay firmly attached to the pedal, allowing the biker to stay in full control.	Ranges from $40-$150 dollars (the cleats pictured will set you back $312 dollars)
	Bicycle seat = The best tip is to make sure your riding saddle fits your body and is positioned properly. Improper sizing can cause prostate problems (men) and urinary track infections (women).	Fairly inexpensive, ranges from $20-$50 dollars
	Helmet = Having and wearing a helmet is imperative for preventing concussions or other head injuries. Over 90% of all fatalities involves a cyclist who rode without a helmet.	$25-$200 dollars
	Bicycles = most bicycles are mass produced to be comfortable for the large majority of the population. (It is recommended that each bicycle undergoes minor adjustments to perfectly fit it to your physical standards.) Next to the helment, adjusting your bicycle is one of the most important ways to prevent these riding injuries.	$150-$1000+

07-02 - OFF Week - Swimming and you..

As the summer season comes in full bloom, many people are hitting the pools for some rest and relaxation. Swimming, compared to other sports, is one of the least injury-prone sports. However, with continuos repetitions and high level competition, the body becomes susceptible to injury.

One of the more common injuries that occur from swimming is shoulder tendonitis. There are a variety of ways to give yourself a shoulder injury in swimming. "Overuse" is often what doctors / fellow-swimmers and coaches will often tell you. Here are other ways to induce this type of injury:

• Improper Technique


• Reaching too far and over-rotating


• Sudden increase in training distance or intensity


• Swimming only freestyle at every workout


• Unbalanced strength development

Some common symptoms of shoulder tendonitis:

• Pain in shoulder that is present in both with activity and rest


• Pain with overhead activities


• Decrease in the range of motion with the shoulder


• Loss of strength in the shoulder


• Noticeable swelling in the front part of the shoulder area

How to prevent shoulder injuries:
Overuse and over exertion is the main cause of this type of injury. Try to incorporate different strokes to balance out your workout.
Another good tip is to warm up and stretch before any sporting activity. Jumping jacks, stationary cycling or running or walking in place for 3 to 5 minutes will help the warming up process.


Here is a video clip of properly executing Popov's swimming technique:

07-01 - OFF Week - Bowling tendinitis?

I've decided to change things up for this week. I will introduce injuries that are sustained while playing non-mainstream sports. These "non-mainstream" sports can range from cricket to pogo jumping.

This week, I will be doing a blog on bowling. Yes, Americas' favorite and family friendly pastime! Where players attempt to score points by knocking down pins with a bowling ball. The sport was found to have existed in ancient Germany and Finland. (dating back to AD300) The most widely played version today is called "tenpin", in which players try to knock down a total of ten pins within a total of ten frames. The sport of bowling has since grown in popularity from the 1950's and 1960's. Even Hollywood has had their fair share of bowling-centric movies. (i.e. Kingpin and The Big Lebowski)

Each year, there are tens of thousand bowling tournaments that are played on any given day. With the biggest tournament of them all, PBA World Championship, being hosted in Allen Park, MI from August 30 - December 13. (Varies from year to year.)

Just like any major professional sport, the Professional Bowlers Association (PBA) has a ranking structure that is based on calculations from various events and play throughout the season. Each athlete that wants to position themselves towards the top of the "power rankings" must compete in events to earn points / winnings. The rigors of participating in so many events can lead to a multitude of injuries.


One specific injury that I wanted to focus on is a condition that was coined "bowler's tendonitis".

What is bowler's tendonitis?

Bowler's tendinitis is medically termed as medial epicondylitis and is irritation and swelling of the tendons located medially at the elbow joint, or on the inside and middle of the elbow.

How often does it occur?

This injury is most often seen in competitive bowling. Whether it is youth/adult/senior competitions, the rigors of frequently bowling will prevent the body from its natural recovery / recuperation process.


How to treat this condition:

Relieving pain and reducing swelling can usually be achieved by resting or immobilizing the affected limb. (Motrin (military cure-all) wouldn't hurt either..)

How to prevent this condition:

Bowler's tendinitis can be avoided by staying away from repetitive motion, performing warm-up exercises before bowling and making sure the gear that you are using are of appropriate weight/size.

If you develop tendinitis in your wrist, you can buy these handy wrist braces to protect / prevent / heal:

06-03 - NHL - Washington Capital - Tom Poti out with EYE injury!

Tom Poti was born on March 22, 1977 in Worcester, MA. He has played hockey for most of his life, 12 of those years were spent with the National Hockey League. (NHL) He is currently co-captain of the Washington Capitals, and is coming off one of his career best seasons. Poti is also one of the oldest veterans currently active for the Capitals.

Unfortunately, the Capitals (who were favored this year to reach the NHL finals) came up short of the Stanley Cup once again..)
Poti, who suffered an eye injury during game 6 of the Conference quarter-finals against the Canadiens when a shot was deflected off teammate Shaone Morrison and into his eye. Poti was in shock from being unable to see from the injured eye, and immediately thought that his playing career was over. This injury occurred on May 6, 2010 and still has him listed on the injury report.

After thorough medical examinations, Tom Poti was diagnosed with a hyphema -- bleeding in the front of the eye. He also lost some facial structure due to the high velocity of the hockey puck. In May of 2010, Poti underwent surgery and doctors were able to successfully insert three titanium plates into his face and a support structure was placed at the bottom of his eye socket. (The procedure took nearly four-hours)

What is hyphema? (WebLink)

Bleeding in the anterior chamber of the eye, the space between the cornea and the iris. Hyphema occurs when blood leaks into the clear fluid of the aqueous humor, and is visible to the naked eye that causes decreased vision.

Causes:

Usually caused by trauma to the eye. It may result from any type of object that can come in contact of the eye. (i.e. baseball bat, ball, hockey-puck, etc..)

Symptoms:

• visible blood in the eye


• decreased vision


• elevated eye pressure

Treatment:

Hyphema should not be treated without the assistance of an eye doctor. In mild cases the blood will normally recess back into the body within a few days. Further treatment can consist of: bed rest, eye patching and sedation to minimize the activity of the eye.

Prevention:

Hyphema can occur with any trauma to the eye. Wearing protective eyewear when playing sports is recommended to reduce the chance of injury to the eyes.

06-02 - MLB - Nationals' catcher may be out for the season...

The young and talented catcher for the Nationals Baseball team may sit out the rest of the year, due to a lingering shoulder injury that was initially mis-diagnosed. Jesus Flores originally suffered the shoulder injury on May 9, 2009 against the Arizona Diamondbacks. It was first thought to be "shoulder tendinitis" and recovery was presumed to be short and sweet. (a couple of months) It has since been upgraded to a stress fracture that also included a torn labrum, which was confirmed by a very notable orthopedic surgeon. (Dr. Andrews, Birmingham, Alabama = amazingly he also worked on New Orleans' Saints QB, Drew Brees. Link ) Once the true diagnosis was determined, Jesus Flores underwent shoulder surgery to repair his torn right labrum. The shoulder surgery was conducted in September 2009, and seems he is now back on the recovery road. Even though his season has ended prematurely, he is expected to bounce back next season stronger and healthier than ever. This is really good news for Nats' fans.


More information on Labral tears:


What is a labral tear?
The labrum is made of a thick tissue that is susceptible to injury with trauma to the shoulder joint. The labrum also becomes more brittle with age, and can fray and tear as part of the aging process.

Symptoms:

• An aching sensation in the shoulder joint


• Catching of the shoulder with movement


• Pain with specific activities

Treatments for a torn labrum:

The treatment will depend on the severity and type of tear that has occurred. If pain persists in the shoulder joint area, surgery may be the best option. If the pain is non-occurring, then rest is normally the key.

06-01 - NFL - Jeremy Shockey leaving on a midnight train to Georgia...

This weeks' blog will focus on one of the toughest NFL players that is still active. (next to Brett Favre of course! Link to my blog about Brett Favre) A true "iron-man" in my opinion, is an athlete who participates in the most roughest / demanding sport and is able to endure multiple injuries for the love of the game.

This iron-man is none other than the New Orleans' Saints Tight-End Jeremy Shockey. Jeremy Shockey was born on August 18, 1980, in Ada, Oklahoma. He was an exceptionally gifted athlete in his high school days, which carried over to his college career. In 2001, he helped the University of Miami football program win the National Title vs #2 ranked Nebraska Cornhuskers. After winning the National Championship and numerous "All-American" titles, he declared himself eligible for the NFL draft. After being selected number fourteen overall in the 1st round by the New York Giants, Shockey went on to have a tremendous NFL professional career. He has claimed the title of NFL Super Bowl champion on two different occasions, the 1st with the New York Giants in 2007 and most recently in 2010 with the mighty New Orleans' Saints. The Super Bowl rings, shared by numerous athletes, all came with a price. The price that Shockey paid was the unending list of injuries that he has incurred since joining the league. (List of injuries since 2002)

He is once again ailed by another injury. This time it has been reported that he experienced a "seizure" type of attack in the weight room. Since the "seizure", Saints' head coach Sean Payton has stated that it is not a seizure and he just fainted due to a low-blood sugar count coupled with dehydration.

This intrigued me so I pulled up more information on seizures:

What is a seizure?
- abnormal movement or behavior due to unusual electrical activity in the brain

Different cases of seizures:

• non-epileptic seizures = are not accompanied by abnormal electrical activity in the brain and may be caused by psychological issues or stress


• provoked seizures = are single seizures that may occur as the result of trauma, low blood sugar (hypoglycemia), low blood sodium, high fever or alcohol or drug abuse.


• generalized tonic clonic seizures = (grand mal seizure) a violent jerking of the entire body


• absence seizures = (petit mal seizure) partial or whole boy jerking of muscles but consists of blankly staring into space, rapid blinking or other repetitive movements of the face.

Seizures can happen at any age and with anyone.

Treatment:
Seizures varies widely for each individual. Because of this, there is no single drug that is a "cure-all", and is looked at on a case by case basis.

What to do during a seizure:

• the most important thing to remember is to prevent the child from harming himself / herself


• Place the child on their side to keep the throat clear and allow secretions (saliva or vomit) to drain. Do not try to stop the child's movements or convulsions. Do not put anything in the child's mouth and do not try to hold the tongue.


• Keep an eye on a clock or watch. Seizures that last for more than five minutes require immediate treatment.


• Move the child away from potential hazards such as: stove, furniture, stairs or traffic.


• Stay with the child until the seizure ends. Allow the child to sleep after the seizure if he/she is tired, then try to explain to the child that they are safe when they come to.


• There is no need to bring the child to the doctor or emergency room after every seizure.

When to call for help:

If the seizure lasts for more than five minutes, action should be taken to call 911 while maintaining a watchful eye on the victim.

If the child is seriously injured during the seizure.

If the child is having difficulty breathing and/or the skin is blue after the seizure.

If another seizure occurs immediately after in succession.

05-03 - NBA - Yao Ming - "They call me Mr. Glass..."

Yao Ming was born on September 12, 1980. He is currently the start "center" for the Houston Rockets in the National Basketball Association. As of today, he is the tallest active person in the NBA today, standing at a towering 7ft 6in. Most of Yao's life has been devoted to playing basketball. After dominating most of the Chinese Basketball Association, he committed to the 2002 NBA draft. He was then selected "Number 1" overall by the Houston Rockets. The marriage of Yao Ming and the Houston Rockets went especially well. Although they have yet to advance past the 2nd round of the NBA playoffs, Yao has made the NBA all-star team for all of his seven years in the league. With his staggering height and physical build, his body has been prone to numerous injuries since he joined the league. Yao's first injury came in 2005, when he developed osteomyelitis in the big toe of his left foot. His next injury came on December 23, 2006, when he broke his right knee attempting to block a shot. The next injury occurred on February 26, 2008 when he suffered a stress fracture in his left foot. The final injury occurred during the 2nd round of the 2009 NBA Playoffs, this time it was thought to be a simple sprain, but further tests showed a hairline fracture in the same ailing left foot. (Doctors presumed that it could be career ending)

With all of this injury time, Yao Ming is still the most recognized Chinese athletes in the world. With a healthy body, Yao averages a solid "20/10" = 20 pts / 10 rebs per game. Lets look at the injury more in-depth.

What is a hairline fracture? Wiki Article
It is a small sliver or crack in the bone. It typically occurs in weight-bearing bones, such as the tibia (bones of the lower leg) and mostly bones of the foot. It is an extremely common sporting injury.



What causes the hairline fracture?
Bones are constantly attempting to remodel and repair themselves, especially where alot of stress is applied to the bone. If enough stress is continually applied, then it will exhaust the capacity of the bone to remodel.


Treatment:
Rest is the key method in treating hairline fractures.


Prevention:
One method to avoiding stress fractures, is to apply more pressure than normal. Doing this, allows the bone to condition itself to the added stress, and to eventually make the bone stronger. Most long-distance runners are told to increase their distance by 10%, to prepare the bone for the added length in marathons / distance races.

Eating healthy is also a great way to prevent bone decay. (Link to Healthy eating for kids)

05-02 - NFL / MLB - Bo Jackson didn't know about career-saving medical procedures!

Vincent Edward "Bo" Jackson was one of the greatest athletes of his era. He excelled in multiple professional sports, to include: Major League Baseball and the National Football League. He was mainly noted for his stellar career at the running-back position with the Oakland Raiders. While in the Majors' he played for numerous teams throughout his baseball career. (Kansas City Royals, Chicago White Sox and the California Angels) Another little nugget, he still holds one of the best 40-yard dash times ever recorded. (4.12 40 yds!)
Most people will recognize his name / brand by the long-time running commercials that showed various Nike endorsements and the catchy phrase of "Bo knows..". (The commercial shows him taking part in a variety of athletic sports.)










Injury:

On January 13, 1991, Bo Jackson was injured while playing in one of the Raiders' playoff game. As most running backs get hit hundreds of times per game, Bo Jackson got creamed by a linebacker that caused severe hip damage, which ultimately ended his football career.. and nearly ended his professional baseball career.

Following surgery and rehabilitation on his injured hip, it was discovered that Jackson had avascular necrosis, as a result of decreased blood supply to the head of his left femur. This caused deterioration of the femoral head, ultimately requiring that the hip be replaced. Amazingly, Jackson was able to return to baseball toward the end of the 1991 season as a member of the White Sox after the Royals released him. Jackson missed the entire 1992 baseball season. When he announced soon after his surgery that he would play baseball again, many thought that goal to be unrealistic, especially at the Major League level. Wiki Web Article




Table that displays more in depth information on medical procedure and recovery time:

Year:	Procedure:	Recovery Time:
Present Day Procedure	Advances in minimally invasive surgery have made the once-complex hip replacement almost routine. Stronger materials and improvements to MRI scanners and 3-D computer modeling have also led to better-fitting and stronger prostetics. Most procedures now utilize a method called resurfacing, in which doctors use tiny tools to smooth rough spots in the joint and coat it with a low-friction ceramic substance.	Full recovery is expected to be within 6 months - 1 year
Vintage Medical Procedure	Full fledged hip replacement	long-term recovery and mostly career-ending

05-01 - Horse Racing - Barbaro (April 29, 2003 – January 29, 2007)

In his fourth year of life, Barbaro strided through the finish line at the World-Famous Kentucky Derby race, in near-record time/distance. Up to this point, he was undefeated in every race that he has ran. (Quite an impressive feat, for such a young horse.)

At his next race, the Preakness Stakes, Barbaro was the heavy favorite. After jumping the gate early, he was cleared fit and subsequently reloaded back into his gate. Not long after the race started, Barbaro suffered a serious injury to his hind leg:

Barbaro broke his right hind leg in more than 20 places: a broken cannon bone above the ankle, a broken sesamoid bone behind the ankle and a broken long pastern bone below the ankle. The fetlock joint was dislocated, and his foot was left dangling loosely. Veteran jockey Edgar Prado immediately pulled Barbaro up, and brought him to a gentle stop. He dismounted and leaned his shoulder into the horse's shoulder to support Barbaro until track attendants could arrive. (Wiki Article on Barbaro)

From what I've read, the broken hind-leg of a horse is considered life-threatening. With the absence of one-leg, complications can arise from the other three legs for supporting such a huge amount of weight on them. A DAY after the race, Barbaro was admitted to University of Pennsylvania's New Bolton Center for treatment. Immediately after his arrival, he under-went surgery to repair his broken leg. This procedure lasted well over 5 hours and was deemed one of the most difficult surgeries performed by his veternarian at the time.

Highlights of the surgery:

- Successfully implanted a Synthes stainless steel Locking Compression Plate (LCP)
- Infused 27 screws into various locations along Barbaros' injured leg
- Fiberglass cast was put over the LCP, to ensure strength and stability

Post-surgery rehab started on a good note, he was able to apply weight to both hind legs and his posture looked great. Sometime during the 1st week of recovery, Barbaro started to suffer complications resulting from the surgery. I will list a timeline of events that leads up to his death:

Timeline:

- July 2006 - Complications arise when an abscess develops on his uninjured left foot.
- July 13, 2006 - A severe case of laminitis develops in the same leg that had the abscess. (left-hind leg) Doctors removed about 80% of his hoof and forced Barbaro to have both of his hind legs in casts. A special sling was developed and installed in his stall. (this allowed Barbaro to take pressure off of his hind legs for hours at a time.
- August 8, 2006 - Recovery efforts are looking more positive. He his more agile and his level of comfort is noticeable
- November 6, 2006 - Barbaro removes both of his casts and his laminic hoof showed positive signs of re-growth. Recovery for Barbaro looked imminent.
- January, 2007 - Barbaro is admitted back into the hospital with additional injuries to his hind legs. These injuries utilized the same procedure which was done in June of last year.
- January 27-29, 2007 - Barbaro's luck seems to have left him. His previously healthy front-legs have now been diagnosed with a severe case of laminitis. Now he has no reliable legs to stand upon.
- January 29, 2007 at 10:30 am EST - Barbaro was euthanized, this decision was made by his owners who felt that his pain was no longer manageable.

He was a third-generation descendant of Mr. Prospector, and as such Barbaro was related to many recent Triple Crown hopefuls including Big Brown, Afleet Alex, Smarty Jones, Funny Cide and Fusaichi Pegasus.

If you are a person that gets offended when you see animals used in this way, then you should learn more about this sport before you make your own opinions. Humans crave entertainment, money, prestige, competition and legacy. That doesn't mean the sport lacks sympathy, morals, respect and above all else.. tradition. Just as human athletes are provided the top medical care and training, the same goes for these magnificent animals.

04-03 - NFL - Torn rotator cuff long-term recovery, is a thing of the past...

The current starting quarterback for the New Orleans' Saints is Andrew Christopher "Drew" Brees. His championship journey, started with being drafted in the 2nd round of the 2001 NFL draft by the San Diego Chargers. During the scouting phase, NFL scouts questioned alot about Brees' athletic ability: his arm-strength and height (6'0). His tenure with the San Diego Chargers went well. He was voted to the NFL Pro-Bowl during the 2004 and 2005 NFL Seasons. Unfortunately, during the final game of the 2005 regular season, Drew Brees injured his shoulder. The injury was a result of a fumble recovery attempt, in which the opposing defensive team piled onto Brees to try and recover the ball for themselves. Brees underwent arthroscopic surgery to repair the torn labrum in his right (throwing) shoulder on January 5, 2006. Subsequent reports also report of a torn rotator cuff. With alot of doubt concerning his athletic ability after the surgery, the San Diego Chargers offered him a contract that was suitable for a "backup" quarterback. Drew Brees' confidence in his ability to still perform at the highest level, allowed him to seek other contract offers from various NFL teams. There were two teams that showed interest; the Miami Dolphins and the New Orleans Saints. Drew Brees likened the idea of playing for a team/city that is in the midst of rebuilding. (Hurricane Katrina) He himself was in a rebuilding phase at the time also. At the time of signing,

"... I just felt that energy in New Orleans," Brees said Tuesday night. "From the very beginning there was a genuine feeling that they wanted me there. They believe I can come back from this shoulder injury and lead them to a championship. They were as confident as I am, and that meant a lot."

In his first year as a New Orleans Saint, Drew Brees electrified the Superdome! He brought the Saints back to the playoffs and after defeating the Philadelphia Eagle's in the 1st round of the 2006 playoffs, he brought the organization to their first conference championship game. Even though they lost the conference championship to the Chicago Bears, Drew Brees looked and enamored the quarterback position. There seemed to be no signs of lingering shoulder pain / effects. Even though the Saints' failed to make the playoffs in 2007 and 2008, Drew Brees put up league-leading numbers for the quarterback position. (Beating Peyton Manning, Tom Brady, Ben Rothlisberger in various passing categories.)

More information on Rotator Cuff tears: WebLink

Definition: A group of four tendons/muscles that surround the shoulder joint. When the rotator cuff is injured, it's the tendons of the rotator cuff that are injured.

Symptoms:

• Most common symptom is PAIN. (Pain that is located ontop of the shoulder / arm)


• Weakness of the shoulder. Weakness causes difficulty lifting the arm up overhead or difficulty with activities such as reaching, getting dressed, or carrying objects

Surgical / Repair methods: Most rotator cuff injuries do NOT require surgery to repair. Depending on the severity, most doctors will prescribe anti-inflammatory medicine and/or cortisone shots. Alongside the medication, physical rehabilitation should be exercised also.

If you are one of the few unfortunate patients that have to undergo surgery, here are the options:

• Open Surgical Cuff Repair: (WebLink)


• Mini-Open Rotator Cuff Repair: (WebLink)


• All-arthroscopic Rotator Cuff Repair: (WebLink)


• Shoulder replacement surgery: (WebLink)

Table that displays more in depth information on medical procedure and recovery time:

Year:	Procedure:	Recovery Time:
Present Day Procedure	In 2005, Drew Brees underwent minimally invasive surgery for his torn-up shoulder and returned to the gridiron in six months to lead the league in passing yards, and in 2009-2010 to a Super-Bowl!	Recovery time has been greatly reduced. Anywhere between 3 - 12 months
Vintage Medical Procedure	Total reconstruction, involving re-anchoring the labrum and stitching the rotator-cuff muscles back together	12 months to Career-Ending