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Unfortunately, an athlete with an eating disorder is likely to deny or be secretive about it. Some athletes begin restricting calories out of a sincere desire to be healthier, but get sucked into an obsessive pattern of food restriction and fear of getting fat. Their list of “bad/fattening foods” gets longer and longer, they may train excessively to “purge” extra calories, and excessively criticize their body.
A vegetarian diet can be a healthy choice if an athlete knows how to ensure that he/she takes in adequate calories, protein, calcium and other nutrients.
Although your friend may not initially be receptive to your concerns, if there is a problem, you could be that first step in helping her tackle it.
If you suspect that your friend has an eating disorder:
UC San Diego has an Eating Disorders Program for adolescents and adults:
http://eatingdisorders.ucsd.edu/index.shtml Phone: (855) 824-3050
Another helpful website:
A constant energy deficit can have serious negative health consequences. When the body doesn’t have enough energy to sustain itself, it begins shutting down certain body processes.
The body needs energy (calories) and key nutrients for:
According to Amy Leu, DO, it is no longer considered "normal" for female athletes to have menstrual irregularities. Sometimes irregular periods are an early sign of an athlete moving into the energy deficient state. If evaluated and addressed early, devastating complications can be avoided, including stress fractures and impact on return-to-play.
Eating disorders and severe body image issues are at the extreme end of a syndrome called the female athlete triad. Watch video on female athlete triad:
Men can also get caught up in excessive body criticism, overtraining, under-eating and abuse of muscle-building supplements, referred to as the
Health care professionals that can help you work through eating disorders and an unhealthy body image include:
It’s important to stay educated about the substances you put in your body. Whether it’s an energy drink, water, food, or PED, we need to know what’s good for us and what’s bad. PEDs are defined as any substance taken to perform better athletically. Even though that extra edge may sound tempting, the use of PEDs is very risky for health and doesn’t yield definitive results. One PED we typically hear about, and often of interest to teenage boys, is anabolic steroids.
There are many irreversible risks to taking anabolic steroids including:
The best way to maximize your athletic performance is through hard work, practice and healthy eating. Learn more about the negative effects of PEDs and many other substances, and how to support an athlete in making healthy choices:
Many PEDs were originally created to treat certain medical conditions and illnesses under the guidance of a physician. Unfortunately, some athletes now use them to gain an edge over the competition by taking these substances at significantly higher doses than have ever been shown to be safe in the human body.
Adolescent girls in particular may suffer from:
Combining non-steroidal anti-inflammatory medication (NSAIDS) such as ibuprofen with vigorous exercise can be dangerous. During exercise, blood flow to the gut decreases so that blood can be redistributed to the working muscles. This causes a temporary loss of gut function and small intestinal injury. Studies have shown that when NSAIDS are taken before exercise, it aggravates these gastrointestinal effects, even in healthy individuals.
Chronic use of NSAIDS has been associated with:
In general it's safe to take ibuprofen
after exercise as needed. Just make sure it’s not taken on an empty stomach and limit to the lowest dose needed.
If you constantly experience significant joint or muscle pain during or after exercise, it may be time to assess your workout and/or visit a sports medicine specialist.
3 tips to help you soothe workout pain naturally:
Athletes in weight class sports such as wrestling, boxing, judo and lightweight rowing need to “make weight” every week for competition. This can unfortunately lead to dangerous weight-cutting practices that have a negative effect on performance.
Negative performance risks associated with fast weight loss:
Various sports organizations have tried to eliminate the motivation for crazy weight-loss practices by instituting policies to identify the lowest safe weight and body fat level for each athlete before the seasons starts.
In California, high school wrestlers must undergo a pre-season test to establish a safe margin of body fat. The established margins are:
These numbers aren’t to be used as goals, but rather as guidelines to prevent excessive weight loss.
If an athlete and coach believe he/she will wrestle better at a lower weight, the athlete should begin several weeks before the season starts. It’s recommended that athletes attempting to lose weight set a goal of losing no more than .5 to 2 pounds per week through a balanced reduction in calories coupled with aerobic exercise/strength training.
Small dietary changes can help you lose weight include:
If you have an athletic trainer or sports nutritionist who works at your school, check with them for individualized recommendations regarding fluids, carbs and proteins. There’s no scientific evidence that protein supplements are necessary to build muscle in athletes who eat a well-balanced diet. And weight loss supplements can be a minefield, with harmful ingredients and also cause positive drug tests.
After a weigh-in, it’s important to drink fluids and take in some carbohydrate and protein. Eat a bigger meal if you've got a couple hours before your first match. Light sandwiches, fruit, energy bars, sports drinks/water between matches can help you keep your energy up.
Replenishment of energy stores immediately after training or a match is important for optimal performance in the next round. Muscle re-synthesis seems to occur most rapidly within the first 30 minutes after exercise.
GREAT TIP: Rehydrate and ingest carbohydrate and protein foods within 30-60 minutes after exercise to maximize muscle recovery.
A 12-ounce beer has only 14 grams of carbohydrates. Compare this with 40 grams of carbohydrates in a can of soda, 34 grams in 8-ounce lemonade, or 38 grams in a cup of grape juice. You’ll see that beer isn’t such a good recovery beverage.
Although alcohol contains carbohydrates, it actually interferes with glucose metabolism and will ultimately impair your body’s ability to replenish muscle glycogen stores. Drinking a lot of beer can cause you NOT to eat enough carbohydrate and protein, further reducing the amount of protein and carbohydrates available to aid in muscle recovery. This is because carbonation and fluid volume make you feel full.
In addition, alcohol:
Remember the three Rs: Refuel, Rehydrate and Rest.
You should drink at least 20 ounces of fluid for every pound of weight lost during exercise. Choose non-alcoholic beverages (e.g., soda pop, seltzer) and high-carb foods that you enjoy (e.g., pizza), with some protein for muscle repair. Chocolate milk is a great recovery beverage with carbs, protein and fluid all in one package!
Actually, breakfast is an important start to the day for young and adult athletes.
You don’t have to eat a monster breakfast, but include some carbohydrates to build muscle glycogen stores (energy for training), and protein to aid in muscle recovery. Here are some examples of nutrient-rich breakfasts:
Adjust these based on your food preferences and caloric needs.
For example, pick a different fruit or add more –
double the serving size if you need the calories!
One great way to get all the nutrients you need, keep your energy up and maintain a healthy weight is to snack, but also reduce portion sizes during your regular meals. Learn to anticipate your daily hunger patterns and plan on snacking. For example, if you’re hungry every day in the afternoon, plan to eat a mid-afternoon snack at school and then you’ll have energy for after-school practice and won’t be starving by dinner.
These healthy suggestions can help satisfy those crunchy cravings:
Treat yourself to these creamy and delicious health snacks:
To satisfy your sweet cravings, try some of these healthy alternatives:
When you feel like something salty, try eating:
The ACL (anterior cruciate ligament) in your knee helps to stabilize the knee during cutting and stopping maneuvers. Complete ruptures have a significant impact on an athlete's ability to continue in sports or physical activity. You may frequently hear about ACL injuries occurring in basketball, soccer, skiing and other sports that involve rapid acceleration and changes of direction.
According to Amy Leu, DO, some ACL ruptures or complete tears occur in contact settings. However, roughly 2/3 of ACL tears occur when an athlete is landing from a jump, cutting, pivoting, accelerating or decelerating.
According to the National Athletic Trainers Association, an ACL injury prevention program should include:
The Journal of Arthroscopy identified 3 ACL prevention programs that successfully reduced injury when their programs were implemented.
Other helpful programs:
FIFAA 11+PEAK Control Program
Preventing injuries is an important goal for all organizations that support sports. However, when you’re moving fast and playing hard, it’s inevitable that some sports injuries will occur. Since an ACL injury tends to be one of the more devastating injuries in sport, it makes sense to develop a training regimen that puts you in the strongest position possible to prevent one in the first place.
It’s well known that non-contact ACL tears are 2-6 times more common in females than males. This may be due to a number of factors, including lack of muscular strength and control to keep the knee in ideal alignment and absorb the landing (not stiff-legged).
Current research tells us that one of the best ways to prevent ACL injury is to pay close attention to each athlete’s biomechanics.
“Of all the many biomechanical variables that can contribute to an ACL injury, landing technique has the most predictive value,” says athletic trainer Kevin Messey, ATC. “At UC San Diego Sports Medicine, I work with athletes of all ages to identify specific errors in landing and athletic movement that contribute to ACL injury. I then use evidence-based techniques to correct those errors and return my athletes to play in a safer condition that ultimately improves their performance.”
Attention to form and detail are crucial for successful implementation of injury prevention. This means an athlete must work on skills that put his/her body in the best possible alignment until the those positions and movements become second nature.
Bone is a living tissue and is constantly renewing itself through specialized cells that build new bone and others that break down old bone.
Most individuals achieve peak bone mass by age 30, and then experience gradual losses over many decades. The rate of loss accelerates for women during the 5 years after menopause. Bones are most responsive to biomechanical stress during the growing years, building in size and density more than at any other time in our lives.
Weight-bearing exercise and strength-training exercise both provide bone-stimulating mechanical stress. Weight-bearing exercise is any activity where you are supporting your body weight through your feet/legs.
According to clinical exercise physiologist, Robyn Stuhr, certain characteristics of exercise are associated with a greater bone response.
There are many fun activities that contribute to bone strength:
While sports and dance are great for all of us, they're especially important for adolescents and kids. Research has shown that children and adolescents hold onto the extra bone mass they’ve acquired well beyond the actual intervention. It’s different for adults – if adults don’t use it, they lose it, just like many other aspects of fitness.
So encourage your kids to get off the couch and step away from the computer to play whatever sports or recreational activities they enjoy!
Exercise still has a positive role to play.
Bone-loading activities can help you protect the bone you have or slow the rate of loss.
You don’t have to run for 30-60 minutes to reap the benefits. Animal research has shown that high-intensity intervals done over a short time period are more beneficial to bone than a long period of constant-intensity loading. Bone becomes “de-sensitized” after a certain period and won’t achieve additional benefit.
While swimming and cycling are great for cardiovascular fitness, weight control and muscle endurance, they are NOT weight-bearing forms of exercise. Elite cyclists, like those who ride in the Tour de France, have been shown to actually have
lower bone density than other athletes, which makes them more susceptible to fracture. Their low bone density may be due to the fact that they spend many hours training on the bike (an unloaded environment) and don’t replace the calcium lost in sweat.
If you participate in swimming or cycling, make sure that you balance out your exercise schedule with some “land-based” options and strength-training.
Strength training is terrific for bones and muscles. It’s great for adults who have orthopedic conditions that limit their ability to perform high-intensity weight-bearing exercise.
Since bone’s adaptation to mechanical stress is site-specific, put together a program that involves the entire body. The use of free weights can be a great choice as it requires more balancing and stabilizing around the spine.
Whatever bone-loading activities you choose, remember that something is better than nothing. And if you love it, you’ll do it!
There are several factors that influence muscle strength:
First, stop comparing yourself to everyone else in the weight room. Focus on maximizing your personal potential for strength and power by working with the coach and your athletic trainer. Remember that many other factors influence sports performance, including:
The National Collegiate Athletic Association (NCAA), the College Athletic Trainers Society, and the American College of Sports Medicine (ACSM) have collaborated to develop new athlete safety guidelines in three areas:
See complete guidelines on the NCAA website Division I area
Concussions Concussions can occur in a variety of athletic situations. To get on top of early identification, monitoring and treatment of sports head injuries, UC San Diego Health Sports Medicine has assembled a multidisciplinary team of experts to provide comprehensive concussion evaluations and treatment.
See our Concussion Clinic.
There is no scientific proof that stretching
before exercise prevents injury during that specific workout. However, stretching in general can increase range of motion, promote smooth and efficient movement and may reduce the risk of injury during exercise, particularly in sports that require extreme flexibility or explosive movements.
There is some evidence that static stretching (long, slow stretching)
immediately before exercise may temporarily decrease the muscle’s ability to generate force or power.
Ideally stretching is done when your muscles are warm, for example, after a workout. But you can also stretch any time during the day: while watching TV, waiting for a ride, during a break at work. Put the muscle into a position of tension (not pain) and hold for 15 to 60 seconds. Repeat four times.
“Dynamic stretching” is appropriate for sports that involve ballistic (bouncing) movements. For example, if you play tennis, jog for 5 to 10 minutes. Then do some hurdle walks, trunk rotations and swing your racquet easily to simulate all your strokes (forehand, backhand, overhead/serve), gradually increasing the arc of movement. Move onto the court and perform your strokes at half speed. Build up to hitting the ball with full speed and intensity. After your match or practice, stretch the muscles you use in tennis (e.g., calves, hamstrings, groin, trunk).
If you experience muscle soreness after a hard workout or competition, stretching doesn’t help get rid of the discomfort any sooner. But it won’t hurt either.
You may have heard concerns that using sunscreen will compromise your Vitamin D status, but studies haven’t shown this to be true.
One out of five Americans will develop skin cancer during their lifetime. Your risk increases with a higher lifetime history of sun exposure. If you want beautiful, wrinkle-free skin, along with a healthy body, early sun protection is critical.
Since the new FDA guidelines were released in 2012, a different labeling system is required for sunscreens. However, most consumers don’t understand that SPF (Sun Protection Factor) ratings only apply to ultraviolet B (UVB) rays which cause sunburn. Ultraviolet A (UVA) rays penetrate the skin more deeply and are associated with skin cancer and aging/wrinkling. To provide protection from UVA rays, a sunscreen must also state that it is “broad spectrum.” There is currently no rating system for the amount of protection from UVA rays other than the overall term “broad spectrum.”
New technology using nanoparticles prevents active sunscreen ingredients from leaving a white residue on your skin, providing more even coverage and better UV protection. Oxybenzone is one of the few ingredients in sunscreens that provides both UVA and UVB protection. It was approved by the FDA in 1978 and there is no evidence showing negative health effects.
In a recent consumer reports review of sunscreens, SPF and broad spectrum product claims weren’t always accurate, and this was particularly true for sunscreens labeled “natural.” To ensure that you’re protected, remember to re-apply every two hours when you’re out in the sun. In addition, a rashguard or even a long sleeve t-shirt provides a physical sun barrier. (However, if the t-shirt gets wet, sun protection is lowered significantly). Specialized clothing manufactured with a certain weave, thread count and/or anti-UV protectants is sold with a UPF rating (Ultraviolet Protection Factor). The UPF number represents a certain level of protection. For example, UPF 40 blocks about 97% of UV rays.
It takes about 15 minutes for the skin to absorb sunscreen and provide protection. So apply at least 15 minutes before you head out into the sun. Most people put on less than half the amount needed for adequate sun protection, so be generous. It’s important to apply sunscreen regularly, even on cloudy days, since we’re still exposed to harmful UV rays.
To avoid eye stinging, try products made specifically for the face or sensitive skin. If you sweat a lot, a headband can absorb sweat and sunscreen instead of letting it roll into your eyes. And while you’re on the sidelines, a broad-brimmed hat will provide extra protection for your skin and neck.
Our active Southern California lifestyles mean lots of sun exposure. Unfortunately unprotected skin looks older faster - with more wrinkles, spots and sagging. Not to mention a greater risk of skin cancer. Sun protection is a MUST. The bottom line? When purchasing a sunscreen look for the following:
To see how well you’re protecting your skin, take the Suntelligence Survey as part of the Play Sun Smart program developed by the American Academy of Dermatology with Major League Baseball. Go to
“Gone are the days when standing around in a circle and holding a stretch for 15 to 30 seconds (static stretching) is considered warm-up,” says
Alan Shahtaji, DO, team physician for the U.S. Soccer Federation.
“What’s most important is to get your muscles warm and ready for the explosive activity that will be needed in the match. There are a variety of ways to accomplish this and your coach may have a routine for the team to follow.”
This will likely include:
Dr. Shahtaji recommends a warm-up and conditioning program from FIFA (Federation of International Football Associations) that can be found on the following website:
The post-match or post-practice cool-down period is just as important as the warm-up.
"Our strength and conditioning coach has certain players sit in an ice bath for several minutes," says Dr. Shahtaji."This may not be possible, but applying an ice pack to sore or injured areas for 10 to 20 minutes is also helpful. The time to do static stretching is after you are done playing and
before icing. Sometimes the whole team will do this together if it’s practical; it’s a nice way to wind down after the competition.”
Stretch the muscles that you particularly use in soccer (calves, hamstrings, quads, buttocks) or muscles that you know are tight. An evaluation by an athletic trainer can help you assess personal deficits of flexibility and strength to design a personalized program.
The core is a group of muscles in the center of your body, from the diaphragm to the pelvic floor, particularly the deep abdominals and back extensors/rotators. A strong core is an important link between your legs and arms, helping to transmit power and prevent injury during athletic movements such as a volleyball smash or soccer kick.
Contrary to popular belief, crunches and sit-ups aren’t the best exercises for the core. The best way to train your core muscles is by activating them through a “bracing” maneuver. Bracing involves tightening the muscles in your stomach and low back as if you were preparing to absorb a punch to the abdomen and a shove in the back at the same time.
Here are some examples of core exercises, from basic to advanced:
Remember that the most important part of these exercises is what you cannot see: contracting your core muscles to provide a stable axis for movement. Whenever you move your arms or legs away from the body, bear down to stay strong in your body’s center.
A physical therapist or trainer can teach you how to engage and strengthen these muscles through progressively challenging exercises.
For many beach-goers, summertime means shredding waves. More than 17 million Americans are active surfers, including 1 million in California alone. The benefits for the body and mind are unquestionable, yet there are inherent risks associated with the sport.
“The most common injuries are bruises and cuts often caused by contact with the surfer’s own board,” says
Ken Taylor, MD, medical director for the International Surfing Association. Surfers are also at increased risk for sunburns and developing skin cancer.
Dr. Taylor recommends the following safety precautions:
"The use of a surfboard leash for protection is recommended but occasionally this strategy can backfire," says
Dr. Taylor. "Leashes keep the board near the surfer providing a flotation device in case of an accident. They also reduce the number of accidents caused by runaway boards hitting other surfers. Leashes, however, make it more likely for a loose board to recoil back at the surfer and cause serious injuries, such as eye damage. It’s important to always stay focused, and protect your head with your arms every time when surfacing from a wipe-out.”
Dr. Taylor, who provides medical coverage at the World Surfing Games held in exotic locations such as Tahiti, Portugal and Costa Rica says shark attacks are extremely rare. “Stingray injuries, while extremely painful are much more common and in most cases can be initially treated with hot water to inactivate the nerve toxin. Shuffling the feet while walking through shallow water can prevent stings, because bottom-dwelling fish scatter when they are alerted to human presence.”
There’s a lot of discussion about concussions right now, and for good reason. You’ve probably noticed that much of the talk is related to football, but all athletes (surfers, skateboarders, soccer players, skiers, etc.) are vulnerable.
Identifying and treating a concussion properly can make the difference in a speedy return to activity.
See how our team handles sports concussions in the clinic.
According to Alan Shahtaji, DO, while concussions can occur from a direct blow to the head they are usually a result of a collision where your body stops or changes direction suddenly. This can cause a whiplash effect that can injure the brain.
The brain is suspended in cerebral spinal fluid within the skull. When the head moves abruptly in a different direction, the brain slams against the inside of the skull, causing injury to the brain tissue.
While loss of consciousness can occur, most athletes who get a concussion do not black out.
If you think you have a concussion, seek help right away. Delaying proper care can result in prolonged symptoms or even second impact syndrome.
It’s best to see medical professionals trained in evaluating and treating concussions (e.g., sports physicians, certified athletic trainers).
Sports Concussion Clinic is specifically geared toward the evaluation and care of sports concussions. We provide a comprehensive evaluation that helps rule out deficits in brain function such as:
We work with other specialists in neurology, psychology, physical medicine and rehabilitation.
Most concussions in soccer actually result from contact with an opponent (for example, an elbow hitting your head) or when your head hits the ground.
Dr. Shahtaji suggests instead making sure he has proper form when heading the ball: "keep your eyes open, contact the ball with your forehead and use your neck muscles.”
According to Dr. Shahtaji, there is not enough evidence that headgear in soccer prevents concussions. However, he does say that a past concussion increases risk for future concussions. Seeing a sports medicine physician who can review your history can be extremely beneficial for both kids and their parents. It's vital that your child is well educated on concussion symptoms so they know when to seek the attention of their coach or athletic trainer during a practice or game.
Concussion symptoms may include:
Dr. Shahtaji cautions, “NEVER go back into a game or practice if you have had a concussion. If in doubt, sit it out! Remember, the rest of your life is more important than any game.”
The Center for Disease Control (CDC) has a “Heads Up” program promoting recognition of concussions in sports:
Soccer is a contact sport and has an inherent risk of head injury, but FIFA (the international governing body for soccer) statistics show that only one concussion occurs per 10,000 exposure hours in youth soccer. In the World Cup, the average is one concussion every 20 matches. Once players get to the collegiate level, the mechanism for concussion almost exclusively results from head-to-head or extremity-to-head contact. Thus, one of the ways to reduce head injuries has been the implementation and enforcement of rule changes to penalize players leading with the elbows and raising their arms while going for a header.
For younger ages, concussions are more likely to result from intentionally heading the ball. Some of the soccer head gear that has been worn in the past has not been shown to prevent concussions so U.S. Soccer recommends no heading for kids younger than age 10. When kids are ready, the emphasis should be on teaching proper form, strengthening the neck muscles and working on nerf ball heading. Do not force headers for players who are not ready.
There are a variety of signs and symptoms that can suggest a concussion and the
CDC has some great information for the parent or coach to help identify a concussion. According to Dr. Shahtaji, once a player sustains a suspected head injury, the most important thing is to get a proper evaluation and "when in doubt, sit it out!" A second head injury before the brain has recovered can lead to prolonged recovery and complications and there have been reports of catastrophic brain injury.
Sports Concussion Clinic, we do a comprehensive evaluation and coordinate a safe and appropriate plan for an athlete to return to learn (RTL) and return to play (RTP). We also have a team of consultants who specialize in concussion rehabilitation, should the athlete not recover in the expected seven to 10 days for adults or two to four weeks for children.
Most falls on an outstretched wrist will be a simple wrist sprain and usually get better on their own, although this can take as long as three months or longer.
Hand surgeon, Matt Meunier, MD, says, “Less frequently you can have a strain of one of the tendons on the pinky side of your wrist, which may be painful in the manner you described. You may also have injured a ligament between two of the little bones in your wrist (the scapho-lunate ligament), or one that supports the pinky side of your wrist (the triangulofibrocatilagenous complex).” What a mouthful!
To determine the exact type and severity of the injury, a physical exam by a qualified hand surgeon is recommended. Most times treatment is non-surgical, including bracing and special exercises for the hand. The first step is to figure out what happened and then start your treatment plan.
While your wrist is healing, keep fit by running, indoor cycling (don’t support your weight on the handlebars) or performing strength training exercises for your core and lower extremities. You’ll be back in action before you know it!
That’s a great question! The quick answer is NO.
Athletic trainer, Kevin Messey, says the best thing you can do is stop playing and use the tried and true RICE formula: Rest-Ice-Compression-Elevation. "RICE reduces pain and helps prevent further injury to the tissues by minimizing inflammation and swelling. This shortens your recovery time, allowing you to return to play more quickly,” says Kevin.
If your pain is mild and you can walk on it with minimal discomfort, you should see your sports medicine provider within a few days for an evaluation. Don’t play on it until you are evaluated.
If the pain is moderate to severe, stay off that foot and immediately go to your doctor or an emergency room for evaluation. When you sprain your ankle it’s common to damage the ligaments on the outside of the ankle that provide stability. It’s important to have your ankle evaluated by a sports medicine specialist to rule out more severe injuries.
Ankle sprains are the most common orthopedic pathology, accounting for 30 percent of sports injuries. "The highest number of sprains occurs in our high school athletes, particularly those involved in basketball, football, and soccer. Recovery from an ankle sprain will vary, but on average it will take eight days for an athlete to return to sport,” says
Keep in mind that even though you may be back playing, your ankle is still healing and will continue to heal for months. During this recovery time it’s important to protect your ankle with a brace while you play. You should continue to work on balance, proprioception, strength and power until your ankle is 100 percent.
At UC San Diego Health, athletes of all ages receive a guided program of hops and balance exercises to keep their ankle strong and prevent recurrence.
Return-to-play decisions should be made with the advice of your sports medicine doctor, physical therapist or athletic trainer. However, in general, you should NOT return to play until:
Your physical therapist or trainer can guide you through the rehabilitation process by first helping you to regain your range of motion and then gradually introducing strength exercises. For example, begin by making gentle circles and tracing the alphabet with your foot several times a day.
Basic strengthening may include:
These exercises will give you the necessary strength and confidence to return to the basketball court and step into a game.
The most common risk factor for an ankle sprain is a previous ankle sprain, so it’s important to get appropriate rehab before you return to sports to avoid a repeat injury. It’s a good idea to wear an ankle brace once you’ve had an ankle sprain to provide support and stability while your ankle adjusts to the stresses of sport activity (the lace-up models tend to be more supportive than the elastic ones).
ITBS is common in runners, cyclists and other athletes. The iliotibial band is a thick, fibrous band of connective tissue that runs all the way from the hip, down the outside of the leg, to the knee. Pain can happen anywhere along this pathway, but often occurs at the outside of the knee.
Jeff Chen, MD, MHS, says that knee pain is likely caused by excessive friction during repetitive knee flexion /extension. With each repetition the lower end of the ITB slides over the outside bone at the knee, causing inflammation, thickening, and swelling.
ITB pain may appear after:
Some risk factors include:
Tips that can help accelerate recovery:
Stretching your ITB Stand upright and cross your left “good leg” in front of your right “bad leg.” Shift your right hip out to the side while reaching your right hand over your head and towards the left. Once you can perform this stretch without pain, work on strengthening your gluteus medius (buttocks muscle) as well as core stabilization.
“Once strengthening exercises can be done without pain, you can gradually return to running,” says
Dr. Chen. “Begin each workout with a quarter mile warm-up and stretches. Start back with low mileage every other day, and increase mileage gradually over the next 4-6 weeks. If you have any pain, decrease the mileage or stop running for a few days until the pain has resolved. If you are running on a track, make sure that you reverse directions each workout. Cross-training with other activities such as swimming is ideal for healing.”
Athletes who jump and land frequently can develop “jumper’s knee” which is also called patellar tendinitis. In fact, 30 to 45 percent of elite basketball players experience this problem.
The patellar tendon lies at the front of your knee and feels like a thick cord traveling from your kneecap (patella) to your shin bone (tibia). Jumper’s knee is a
repetitive condition that occurs due to excessive force on that tendon. An athlete will experience pain directly on the tendon and occasionally notices mild swelling. The pain usually happens during the act of landing from a jump, but sometimes occurs with jumping up too. Most athletes notice that the tendon is sore at the beginning of practice but goes away after they warm up. However, this pain usually comes back during exercise when the activity reaches a certain duration and/or intensity.
Sometimes patellar tendinitis can become chronic, so listen to your body and address the pain early to avoid a long term problem.
Kevin Messey says that the best treatment for jumper’s knee is to temporarily modify activity until your knee feels better. This means less jumping and more horizontal training. This can be tough in the middle of the season, but there are many skills you can work on to keep sharp such as:
A good rule of thumb is to stay away from activities that cause pain.
Recovery may take as little as 2 weeks or up to 6 months. Ice may also be helpful when the tendon is sore immediately after activity.
Kevin Messey, says,“In addition, you can use a patellar tendon strap to wrap around your knee putting pressure over the patellar tendon. This alters the line of pull of the tendon and can temporarily relieve pain while you play.”
To reduce the stress on the tendon, Kevin recommends using a foam roller before and after activity to stretch:
Also consider seeking treatment from a qualified healthcare professional, like a physical therapist or athletic trainer to recover faster. They will design a rehabilitation routine for you to reduce your pain and increase your function. They can also evaluate your jumping and landing mechanics to prevent jumper’s knee from coming back.
Prevent jumper’s knee by maintaining a healthy level of conditioning in the off-season. This allows you to resume high levels of activity in pre-season without developing jumper’s knee, which is when it usually starts.
As you train, be sure to slowly increase the volume and intensity of your training over many weeks. A good rule of thumb is to increase your training by 10 percent each week.
In addition, stretch your hamstrings and quadriceps regularly and work on eccentric strengthening of your quadriceps using a single-leg squat technique. An athletic trainer can show you how to do this properly.
There are many conditions of the knee that cause pain at the front of the knee. It’s always best to seek the opinion of a sports medicine specialist to get an accurate diagnosis.
Hamstring injuries occur frequently in runners with tight hamstrings or muscle imbalance. Initial treatment should include:
Despite early treatment, some hamstring injuries develop into more chronic injuries that not only last beyond three weeks, but become more difficult to treat.
Most athletes understand that a period of rest is required, but many return to activity too early and develop chronic injuries. “You’ve been working with a physical therapist and stretching, but one component that many athletes forget is strengthening,” say our trainers. “Many hamstring injuries occur because the hamstring muscles are not nearly as strong as the large quadriceps muscle group.”
Our trainers suggest using the following guidelines to determine when you can return to activities such as jogging/running:
Starting with light weights, gradually increase your resistance using both concentric and eccentric contractions. When you can perform therapeutic hamstring exercises without pain, begin high intensity eccentric hamstring exercises to promote tissue remodeling and prevent re-injury.
Some exercises that can help prevent re-injury include:
Most importantly: be patient! Make sure that you are meeting the strength and flexibility goals as you go. As athletes, we all want to get back to our sport as soon as possible. But with hamstring injuries, getting back out there too soon can turn a month of recovery into six months or more! To avoid re-injury, continue your strengthening and stretching program even after you return to activity.
There can be many different reasons for pain in the back of the neck. Pain can be from bones, muscles, ligaments, facet joints, intervertebral discs or nerves. The most typical neck pain while swimming is myofascial, involving the muscles and soft tissues. Fortunately, this type of pain can be improved with proper stretching and positioning.
“Decreasing neck pain starts before exercising,” says
Dr. Chen, who was a former competitive swimmer.
For warming up the neck, Dr. Chen recommends:
“Focusing on a neutral and symmetric body position can often minimize pain during swimming,” says
Dr. Chen. “Anything that causes you to turn the neck too far in any direction can worsen the pain, whether it is to the side, or extending too far back.”
His suggestion: Ask someone to take a video of you while swimming, shooting from the end of the pool as well as the side. This will give you an idea as to whether you are turning your head too high to one side to breathe, or extending your neck back too much in order to look towards the wall.
Tips on maintaining a neutral body position:
After workouts, cool down with the same stretches as those prior to your workout. At this point if your neck is still sore, you can ice it for 15-20 minutes, use some anti-inflammatory pain relievers and then rest.
If your neck pain continues to bother you, or if you start to experience radiating pain down the arms, tingling or weakness in the hands, see a doctor for a medical evaluation.
Friction blisters on the feet are common in athletics, but the right pair of socks (and properly fitting shoes) can go a long way in preventing them.
Did you know? The sole of your foot has more sweat glands than any other area on your body. Moisture on the skin causes increased friction between your skin and sock. Cotton socks retain moisture and increase the co-efficient of friction between the sock and the foot. This transmits mechanical stress to the skin and can promote blister formation.
Technical athletic socks are currently made with fabrics designed to absorb or wick moisture away from the skin.
Look for synthetic fibers or blends such as:
Some socks utilize two thin fabric layers so that friction is transferred to the second layer of sock instead of the skin.
Anatomical toe socks (gloves for the feet) may help reduce blisters between the toes. However two layers of fabric do spread the toes apart and may feel uncomfortable.
Here are some things to consider:
Thickness and cuff height of socks is often a personal preference, or dictated by the sport. Whichever you choose, the right fit and fabric will go a long way towards comfort and blister prevention. Athletes who are well hydrated have healthier skin and are less likely to develop blisters. So drink plenty of fluids before, during and after training. Be sweet to your feet!
Minimalist shoes are meant to simulate “going barefoot” while providing a protective wrap around the foot. Research is inconclusive regarding whether minimalist shoes have an effect (either way) on injury risk or performance.
Some data suggest that barefoot running shortens stride length and promotes a more natural forefoot/midfoot strike, which can reduce vertical impact forces, improve running economy, and minimize abnormal torque at the knee, hip, and foot.
Drawbacks to switching to minimalist shoes:
Prior to running in minimalist shoes, follow these steps:
If you have questions about minimalist shoes or want to know if barefoot running is a good idea for you and your feet, find a sports medicine specialist who can evaluate you and discuss your options.
No. Helmets can protect against a fractured skull, facial lacerations, dental trauma, and injuries to the ears. But no helmet has been shown to reliably prevent a concussion. Mouth guards do nothing to prevent concussions either.
Douglas Chang, MD, PhD, says that helmets:
Some athletes will sustain a big blow to the head and be unaffected. Other athletes will experience a seemingly trivial hit, and have lingering effects that last for weeks. Part of the issue is that we don’t know how much trauma was actually delivered to the brain in a given situation.
Factors that increase risk of a concussion:
While none of these factors are addressed by helmet technology, some commercial vendors have endorsed “hit meters” such as chin straps that light up when it is shaken vigorously. These are not widely used as some believe the hit meter actually serves as a target that opposing players may delight in triggering, increasing the rates of concussions.
Sports organizations have addressed head injuries by adding rules that discourage improper helmet use. For example, the NFL stopped “spear” tackling, helmet-to-helmet tackles on defenseless players, and shortened kickoffs to reduce the number of high velocity collisions. Changes to the NFL kickoff rules led to a 43 percent reduction in concussions from 2010 to 2011, reversing a multi-year trend of more head injuries.
The key to concussion prevention is to provide an environment of healthy competition, and to broaden public awareness of the problem so that players, parents, coaches and trainers can be alert for the signs and symptoms of a concussion when it occurs. How best to manage a concussion, once identified, is currently the topic of much research.
MRSA is methicillin-resistant Staphylococcus aureus. This is a type of bacteria that can be difficult to treat and eradicate because it’s resistant to certain antibiotics. It used to only occur in very sick or hospitalized people, but it’s recently become more common among healthy people, including athletes.
Dr. Shahtaji, MRSA can cause a skin infection or a small pocket of infection underneath the skin (abscess). He advises that you have red areas and anything that looks like an infected pimple or reddened hair follicle evaluated right away by your athletic trainer or sports medicine physician. When the infection is diagnosed early, it’s much easier to treat – either with an antibiotic or a procedure to drain the infection. Surgery is rarely needed.
“Athletes can transmit the infection to each other so we recommend not sharing towels, clothing, athletic equipment or toiletries, such as razors. If an athlete has an open wound or any suspected skin infections, he or she should avoid using hot tubs, pools and ice baths," says
Dr. Shahtaji, who is also a U.S. Soccer Federation physician. He has treated a number of athletes with MRSA including high school wrestlers, collegiate soccer players and volleyball players.
There are different rules for different sports, but most require adequate treatment and coverage of any wounds. In wrestling, regulations require that before returning to the mat, athletes who’ve been diagnosed with MRSA have:
The best treatment is always prevention. Here are a few tips from the Center for Disease Control and Prevention (CDC) for avoiding infections:
There is clear scientific evidence that regular moderate-to-vigorous exercise is associated with a myriad of health and fitness benefits, and a longer, more vibrant life. However, if you spend the rest of your time sitting, four hours of Crossfit or another intense workout each week may not be enough.
Scientists are studying the effects of long periods of sedentary behavior (sitting) on overall health and weight, independent of whether someone works out or not.
Questions they’re addressing:
Findings from recent studies:
A study by Katzmarzyk, in the journal “Medicine and Science in Sports and Exercise” found that sedentary people who reported standing “almost all of the time” had a 33 percent lower risk of mortality over a 12-year period compared to those who sat most of the day.
An Australian study with 222,000 adults reported that individuals who sat less than 4 hours/day lowered their mortality risk by 15 percent when compared with people who sat 8 or more hours/day.
Matthews and colleagues (American Journal of Clinical Nutrition, 2012) found that individuals who watched seven or more hours of television/day had higher mortality rates, and this increase was not fully mitigated by regular exercise.
Prolonged sitting has shown to have a negative effect on metabolic function and carbohydrate metabolism.
Frequent bouts of activity help drive down insulin and triglycerides over and over again over the course of a day, which helps you maintain a healthy metabolic profile.
Things you can do throughout the day: