Booster Shots

Oddities, musings and news from the health world

Category: Sports

Oh, snap: Beckham's Achilles injury is bad, but not uncommon

March 15, 2010 |  3:55 pm

Now that soccer legend David Beckham has had surgery to repair the Achilles tendon he ruptured Sunday, all he has to do now is heal, and heal well. While his may be the most recent and notable case of a torn Achilles, the injury is not uncommon, especially among active types, including elite athletes and weekend warriors.

Kzbxlgnc The Achilles tendon connects the back of the heel bone to the calf muscle and drives the foot off the ground. It can be vulnerable because a lot is required of it--in many sports, for example, the tendon is subjected to an enormous amount of stress from repetitive pounding, turning, running and jumping. That can lead to inflammation, pain, and even micro-tears. When those tears form scar tissue, the tendon becomes inflexible and can be extremely painful. Treatment usually includes rest, plus ultrasound or massage therapy to break up scar tissue. Low-level laser therapy is sometimes used to reduce inflammation.

In extreme cases, like Beckham's, the Achilles tendon can completely rupture. People often feel the tendon snap, followed by searing pain and an inability to walk on that leg.

What comes next is up to you and your doctor. Some cases are treated surgically, some non-surgically, with both typically involving a cast and/or functional brace that allows some ankle movement, followed by physical therapy. Neither treatment guarantees that the tendon won’t re-rupture, although surgery has a slight edge on that. So which is better?

A study presented at the American Academy of Orthopaedic Surgeons annual meeting in New Orleans last week showed little difference in outcomes from surgery versus non-surgery for a ruptured Achilles. In the study, done in Sweden, 100 people with ruptured Achilles tendons were randomly assigned to surgical or non-surgical treatments. All participants had a below-the-knee cast for two weeks, followed by an adjustable brace for six weeks, and had standard physical therapy. Symptoms and physical activity levels were measured using two scales.

The non-surgical group had six re-ruptures, while the surgical group had two, an insignificant difference, according to researchers. There were also no substantial differences in the participants' level of physical activity or in their symptoms and function during follow-ups at six and 12 months.

The group that had surgery did show more improvement in function at six months, but at 12 months the groups were neck and neck--save for one heel-rise test on which the surgery group did better. During the year-long follow-up both groups showed progress, but injured legs still had a reduction in function compared with uninjured legs.

Professional athletes are generally treated with surgery for an Achilles rupture, says Dr. David McAllister, professor of orthopedic surgery and chief of sports medicine at the David Geffen School of Medicine at UCLA. "The recovery is faster and the repair is likely to be more durable, and that's everything for a pro athlete."

Beckham will likely be able to play again after several months and a lot of rehab, McAllister added. Achilles ruptures are not always a career-ender--even for a weekend warrior. McAllister said many of his patients are middle-age men who play in recreational basketball leagues. "Even though they're not pros it's a big part of their existence," he says. "The vast majority get back to playing basketball."

David Beckham lies on the ground, with player Andrea Mantovani next to him at a match at San Siro Stadium in Milan, Italy, on Sunday. Photo credit: Damien Meyer/AFP/Getty Images


Rapid weight loss among judo competitors may be cause for concern

March 6, 2010 |  6:00 am

Some competitive wrestlers are known to drop weight in a short amount of time before a competition. They may not be the only athletes to do so, according to a new study that found similar weight loss practices among judo competitors.

Kxhv2lncResearchers from the University of Sao Paulo and the Federal University of Sao Paulo in Brazil had 607 male and 215 female judo athletes taking part in regional, national and international competitions fill out a survey called the Rapid Weight Loss Questionnaire that included questions on diet history and rapid weight loss activities.

Excluding heavyweight athletes, 89% of the study participants said they had lost weight to compete, and there was little difference between male and female athletes. Among athletes in all weight classes, 86% engaged in pre-competition weight loss. Most athletes lost about 5% of their body weight in a short amount of time -- generally within a few days of a competition. Most athletes also said they dropped weight from two to five times a year to compete, but a substantial number did that six to 10 times a year.

As for how they did it, most increased exercise, used heated training rooms, dieted gradually, restricted fluids and skipped meals, while a smaller percentage used laxatives, winter or plastic suits and diuretics to drop weight. On average they started to cut their weight before reaching 15 years of age. Researchers noted that while slow dieting and exercise aren't bad ways to drop pounds, some of the other methods, such as laxatives, could be problematic.

The authors wrote, "This finding reinforces the importance of rules aiming to prevent rapid weight reduction." The study was published in the March issue of the journal Medicine & Science in Sports & Exercise.

-- Jeannine Stein

Photo credit: Thomas Coex  AFP/Getty Images


In Vancouver, the agony of defeat and loss of identity

February 20, 2010 |  7:00 am

Wother It's painful to see world-class athletes who have trained for years fail in the biggest competition of their lives -- particularly when they tend to have a history of bad luck. For example, Canadian speed skater Jeremy Wotherspoon finished ninth in his 500-meter race this week, even though he has been among the best in the world in that event for years. He also had disappointing results in the 2002 and 2006 Olympics. For all of his other honors, the Olympic medal has eluded him.

That kind of history can be a real worry for the coaches and loved ones of these athletes, says Sharon A. Chirban, a psychologist, who wrote about the emotional fallout for athletes who endure unexpected losses in an interesting essay, on the American College of Sports Medicine website. After the event, it can be difficult for an athlete to find a post-sports identity. Many athletes feel anger, shame or disorientation. One solution is to throw oneself back into training for another shot in four years. But, Chirban writes: "For others, the disillusionment, the pain, the shame can last for months, even years. For these athletes, it's often the end of a long road and without glory. It can be devastating to try to make sense of the years of commitment to training and a disciplined lifestyle with an unintended outcome."

Some athletes say they don't know who they are -- aside from their sports identify. Finding a new identity after a disappointing career can take a long time and even professional therapy.

-- Shari Roan

Photo: Speed skater Jeremy Wotherspoon in Vancouver, Canada. Credit: Jasper Juinen  /  Getty Images


Mystified by the ability to catch a fly ball? Here's how it's done...

January 24, 2010 |  7:13 am

Fly The please-don't-let-it-come-to-me, please-don't-let-it-come-to-me crowd -- and we're certainly not pointing fingers -- may not believe some new research out of Brown University. But here it is ... The ability to catch a fly ball apparently depends neither on prescience nor midi-chlorians.

Researchers there closely watched, tracked, monitored and otherwise analyzed eight men and four women, all experienced ball players, who were asked to go after virtual fly balls. They wanted to know precisely how this feat of athletic prowess was effectively accomplished.

Their conclusion: "Perception is used to guide action by means of a continuous coupling of visual information to movement, without requiring an internal model of the ball's trajectory." This is a confirmation of the "optical acceleration cancellation" theory, they say.

In other words, players track the angle of the ball and move forward or backward to compensate.

There have been other theories too: the "mental model of trajectory" and the "linear optical trajectory." 

Here's the news release, plus the full study published recently in Journal of Vision. If you want a detailed explainer, this should satisfy.

But, we should point out, the researchers didn't actually study midi-chlorian counts.

-- Tami Dennis

Photo: Los Angeles Dodgers Andre Ethier catches a fly ball during Game 2 of the National League Championship Series in October at Dodger Stadium. As if that's all there is to it.

Credit: Alex Gallardo/Los Angeles Times


Preventing soccer-related knee injuries may be a training program away

January 16, 2010 |  6:00 am

Knee injuries can be the bane of a young athlete's sporting life. Girls, especially, are prone to knee injuries while playing sports such as soccer and basketball.

Jx2ys8nc But a specific training program seemed to have good results in knee-injury prevention, according to a new study in the Archives of Internal Medicine. In the program, 1,506 Swedish female soccer players ages 13 to 19 were assigned to a special nine-month physical training program or a control group that did its normal training and warm-up routine.

The training program concentrated on motor skills and body control, and it was designed to prepare the neuromuscular system for sports-specific moves. It consisted of five elements: warm-up, muscle activation, balance, strength and core stability. The training was integrated into the regular soccer practices and didn't require any extra equipment. Team members also got written and illustrated instructions on how to do the exercises properly. The program was done twice a week during preseason training, and once a week during the playing season.

Three injuries occurred among players who took part in the special training program, including one non-contact injury. Although the injuries were considered serious, all three players went back to full activity within six months of being hurt. Among players in the control group there were 13 knee injuries, including 10 non-contact injuries. Most of the injuries were severe, and only four of the players returned to full activity within six months. Although three of the injuries in the control group happened while the girls were involved in non-soccer sports activities, excluding them from the study did not alter the interpretation of the outcome.

Overall, the training program was linked with a 77% lower frequency of any knee injury, and a 90% lower rate of non-contact knee injuries. In the study, the authors wrote, "The high compliance rate in this study suggests that the program is easy to implement and incorporate into regular soccer practice."

-- Jeannine Stein

Photo credit: Lori Shepler / Los Angeles Times


Getting and staying fit, the Harry Packer way

December 31, 2009 |  3:39 pm

For those making New Year's resolutions to get fit, we'd like to introduce you to Harry Packer.

Packer is a 75-year-old mortgage broker from Porter Ranch. He had two knee replacements a couple of years ago. Oh, and he's a champion powerlifter.

1WPFHarry We thought that you resolutioners would appreciate hearing how Packer racked up wins in the scant two years since his last knee surgery, and maybe glean some insights into getting and staying fit at any age.

After going through a round of post-surgical physical therapy, Packer felt he needed to continue to strengthen his legs and knees and joined the North Valley YMCA in Northridge to do weight training exercises on his own. There he met fitness instructor Chris Belden, who thought Packer would excel at power lifting. The two started training together.

"I loved it," Packer said. "The sport is about technique, which is developed over a period of time." Packer also loved that he could not just train, but compete. "I think I was competitive when I came out of the womb," he says, and laughs.

Last November Packer won the bench press (185 pounds) and the dead lift (303 pounds) events in his age group at the World Powerlifting Federation's world championship in Las Vegas. "I've won a lot of different things in my life," he says, "but that was the most exciting and mind-blowing event I've ever participated in. There were maybe 1,000 people in the auditorium when I got up to the podium, but I didn't hear anything. I'm getting emotional thinking about it."

Although he's been an athlete his whole life, involved in tennis, handball, running and other sports, the post-surgery road hasn't always been easy. "The therapy is very painful," he says. "You have to go through a lot of pain to make sure you're going to break those adhesions in your leg." Packer admits to resorting to leg braces and a cane to try to stave off having the surgery. Now he takes the stairs two at a time.

He found the motivation to keep exercising because, as he says, "I didn't want to go backward. I had no idea of competing, my main purpose was going forward and maintaining physical fitness, being healthy." His key exercises for strengthening leg muscles that support the knees are leg presses, extensions and reverse curls, all of which build quadriceps and hamstrings.

Packer believes it's never too late for anyone to get in shape and encourages his peers to start today. "There's always something you can do to improve your life physically. When I’m at the Y, I commiserate with people who are in wheelchairs, and I tell them that they can make their life better by doing exercises, whether it's aerobic wheelchair work or weight lifting." He's proof too that the competitive spirit doesn't necessary wane with age: "There are people who are competing in their 90s," he says.

While he does occasionally counsel friends about getting in shape, he knows the advice sometimes falls on deaf ears. "Some people never do anything until the time comes when they're not able to do anything, and they pay the price. I kind of pick my spots, so to speak -- the amount of rhetoric you give them and positive input can make it sound like you're a zealot."

If Packer is a zealot, we say let him preach. Because enough can't be said about doing something to improve your fitness and health, no matter what age.

-- Jeannine Stein

Photo: Harry Packer at the World Powerlifting Federation's world championships. Credit: From Harry Packer


The risky business of cheerleading

December 5, 2009 |  6:00 am

Cheerleading can be a demanding sport, with its increasingly complex lifts, throws and gymnastics tricks. But it is not without risks, as this L.A. Times story on cheerleading injuries reports. The Journal of Athletic Training recently published studies on cheerleading that examined those risks and resulting injuries.

Ktvpgonc One study looked at the epidemiology of fall-related injuries in U.S. cheerleading and found that over the course of a year, 79 fall-related injuries were reported among 412 cheer teams taking part in offical practices, competitions or events. The vast majority of those injuries -- 85% -- took place during practice, and 51% of the injuries occured among high schoolers. In 89% of the incidents, cheerleaders were trying to do a stunt or pyramid.

The most common injuries were strains and sprains, and most falls were from 1 foot to 11 feet above the ground. Only 6% of injuries were concussions or closed head injuries. No deaths were reported in the study, but risk of serious injury increased with fall height, with less-cushioned floors, or both.

Another study examined the surfaces on which cheerleaders practice and how they relate to potential head injuries. Researchers observed indoor gyms as well as outdoor locations. According to the study, higher grass and wetter soil provided more absorption, and the more absorption, the greater the critical height for grass surfaces. Critical height of a surface material is, according to the authors, "the approximation of the fall height below which a life-threatening head impact injury would not be expected to occur."

Only spring floors and landing mats 4 inches thick resting on foam floors had critical heights greater than 10.5 feet, which would have enough impact absorption for level 2 stunts, which include some tumbling moves and tosses.

Another epidemiological study examined overall injuries via type of cheerleading team and events over a year among 412 cheerleading teams. Over that year, 567 injuries were reported, with 83% happening during practice, 52% occuring during a stunt attempt, and 24% taking place while a cheerleader was basing or spotting one or more people. College-level cheerleaders were more apt to have a concussion, and all-star cheerleaders were more likely to suffer a fracture or dislocation than cheerleaders on other teams.

Researchers on all three studies were from the Research Institute at Nationwide Children's Hospital and the Ohio State University College of Medicine, both in Columbus.

-- Jeannine Stein

Photo credit: Carmen Jaspersen / EPA


Screen a heart, save a life

November 16, 2009 |  1:13 pm

The tragedy of a young athlete dying is sometimes compounded by the discovery that he or she had an undiagnosed heart condition. And while those deaths due to heart rhythm disturbances are rare in young people (about 3,000 a year), some health experts believe heart screenings are the way to prevent those deaths.

Kd34whnc A new study found benefits in screenings, particularly an echocardiogram, or an ultrasound of the heart that provides more details than an x-ray; and an electrocardiogram, or EKG, which evaluates the heart's electrical activity. Researchers collected health histories and did screenings on 134 male and female Maryland high school athletes at the state track and field championships in 2008. They specifically looked for cardiac abnormalities such as hypertrophic cardiomyopathy, or thickening of the heart muscle that makes it more difficult for the heart to pump blood.

The screenings included taking the athletes' blood pressure and listening for abnormal heart rhythms or murmurs, in addition to the echocardiogram and EKG.

Researchers found no life-threatening heart defects among the study participants. However, abnormalities were discovered in 36 athletes, including high blood pressure, elevated blood pressure, and low blood pressure. Of those irregularities, 22 were found via EKG alone, nine by echocardiogram alone, and five were discovered via both tests.

In a news release, study co-author Dr. Theodore Abraham of the Johns Hopkins University School of Medicine said, "If you are going to screen, it has to be comprehensive. An EKG does show you a lot, but it doesn't tell you the whole story. The advantage of a comprehensive screening is that it is holistic, rather than being pinpoint."

The study was presented yesterday at the American Heart Assn.'s annual Scientific Sessions conference in Orlando, Fla.

--Jeannine Stein

Photo credit: Gina Ferazzi / Los Angeles Times


College athletes on performance-enhancing drugs may misuse other substances too

November 12, 2009 |  7:41 pm

It figures that athletes who use performance-enhancing drugs would want to avoid anything that could hamper their abilities during a game. But a new study suggests that athletes who use such drugs might also be more inclined to misuse alcohol and recreational drugs.

Iipuxrkn Researchers from the Center of Alcohol Studies at Rutgers University in New Jersey gave surveys to 234 male varsity athletes at a northeastern university to determine their use of performance-enhancing drugs and other substances. Included on the list of performance enhancers were anabolic steroids, hormone precursors (which are thought to change to active hormones in the body), analogs (chemically similar compounds) and nutritional supplements banned by the NCAA. The participants were also asked about alcohol and recreational drug use, and their risk-taking behaviors were noted.

Those who used performance-enhancing drugs in the last year (31% of the sample) were more likely to use drugs and alcohol. In that group, 70% said they had used marijuana, and a third said they had used cocaine. But in the non-drug group, it was far less: 22% and 3%, respectively.

Those who used performance enhancers also had higher rates of alcohol use and binge drinking, had more alcohol-related problems, smoked more cigarettes and used more prescription drugs than the non-drug group.

As to why these athletes used recreational drugs and alcohol more, researchers speculate that it may be linked to their risk-taking profiles -- they were more apt to be sensation-seekers and were also more likely to use the substances to deal with anxiety and stress.

"This really says that we have to focus on the motivations for athletes' substance use and make them aware of the consequences that are likely to come of it," study co-author Robert Pandina, the center's director, said in a news release.

The study appears in the November issue of the Journal of Studies on Alcohol and Drugs.

-Jeannine Stein

Photo credit: Christine Cotter / Los Angeles Times


High school team sports may mean risky business for young men

November 10, 2009 | 11:17 am

Participating in team sports is thought to be good for kids and teens, teaching them discipline, teamwork and encouraging healthful behavior. But a new study suggests there may be some down sides to playing sports.

Kpue3xnc Researchers surveyed 13,000 male and female high school students from around the country to see if a connection existed between playing team sports and risky behavior. Among the young men, 60.5% said they participated in team sports in the previous year, and among young women, 48% played one or more team sports.

Taking part in team sports for males was associated with increased levels of fighting, drinking, and binge drinking. It was also, however, linked with lower levels of depression and smoking.

Among young women, sports seemed to have a more beneficial effect. Participation was linked with lower levels of fighting, depression, smoking, marijuana use, and unhealthy weight-loss habits. No association was made between sports and drinking. All activity was self-reported.

"Sports team participation appears to have both protective and risk-enhancing associations," said Susan M. Connor, the study's lead author, in a news release. "These results indicate that healthy lifestyle benefits are not universal and do not apply equally across genders." Conner is with the Injury Prevention Center, Rainbow Babies & Children's Hospital in Cleveland.

The study was presented at the annual meeting and exposition of the American Public Health Assn. held this week in Philadelphia.

-- Jeannine Stein

Photo credit: Christine Cotter / Los Angeles Times



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