Sports Spine Specialist Chiropractic Team: Athletes strive to achieve their body’s maximum performance by participating in numerous training regimens consisting of strenuous exercises and physical activity and ensuring they meet all of their body’s nutritional requirements. Through proper fitness and nutrition, many individuals can condition themselves to excel in their specific sport. Our training programs are designed for athletes that look to gain a competitive edge in their sport.
We provide sport-specific services to help increase an athlete’s performance through mobility, strength, and endurance. Occasionally, however, the excess workouts can lead many to suffer injuries or develop underlying conditions. Dr. Alex Jimenez’s chronicle of articles for athletes displays in detail the many forms of complications affecting these professionals while focusing on the possible solutions and treatments to follow to achieve overall well-being.
Running is a simple and efficient way to exercise: all you need is a pair of shoes. It’s been shown to lower a person’s risk for heart disease and cancer, possibly by regulating weight and blood pressure. Now a recent study, published in the journal Progress in Cardiovascular Disease last month, reports that people who run tend to live about three years longer than those who don’t.
The researchers, who have studied the benefits of running in the past, decided to look at available research and investigate whether other forms of exercise like walking and biking provide the same benefits, or if runners have a special advantage.
The study’s authors found that while other types of exercise like walking and cycling were linked to a longer lifespan, it wasn’t to the same degree as running. The researchers calculated that a one-hour run may translate to an additional seven hours added to a person’s life. The benefits capped out at about three years, and the researchers found that the improvements in life expectancy leveled out at about four hours of running per week. More running wasn’t found to be significantly worse for a person, but the researchers say there are no further apparent longevity benefits.
However, the researchers only found an associational relationship between running and longevity. Their data showed that people who run tend to live longer lives, but not that running specifically increases a person’s lifespan. Runners tend to have other healthy lifestyle behaviors like maintaining a healthy weight, not smoking and only drinking low-to-moderate amounts of alcohol, the authors note. Still, the findings suggest running is an especially effective form of exercise.
The study also found that runners who also do other types of physical activity have the same lower risk of early death, though combining running with other exercise is “the best choice,” the researchers write. (Federal guidelines recommend both aerobic exercise, like running, and strength training for optimal health.) They also acknowledge that it’s not yet clear how much running is safe, or if a person can run too much.
“Running may have the most public health benefits, but is not the best exercise for everyone since orthopedic or other medical conditions can restrict its use by many individuals,” the authors concluded.
You may be doing your body good by taking that morning run or working up a sweat at the gym. But when you also work up a thirst and take a swig from your trusty refillable water bottle you may actually taking a swig of harmful germs.
New research shows that an incredible amount of bacteria — including E. Coli and salmonella — may be lurking in and on your water bottle.
Laboratory tests by Treadmill Reviews, a Minneapolis-based firm, analyzed 12 water bottles used by athletes and not washed for a week and found they had such high levels of bacteria that drinking from them would be like “licking a toilet seat.”
They tested four types of reusable bottles: A slide-top, screw-top, squeeze-top and straw-top. The researchers evaluated the amount of contamination in terms of “colony forming units,” or CFUs, of bacteria per square centimeter. Here are their findings:
The bottles contained an average of 300,000 CFU of bacteria. That’s six times as much bacteria as you’d find on your pet’s food bowl. And much of the bacteria was the kind that makes you sick.
The slide-top bottles contained the highest amount of bacteria: A whopping 933,340 CFU. They also had the most gram-positive germs which have been linked to skin infections, pneumonia and blood poisoning.
Squeeze-top bottles were next with 162,000 CFU followed by screw-top vessels with 160,000 CFU. These also housed 99 percent of the harmful bacteria.
Straw-top bottles were the clear winners with only 25 CFU. But that’s only 2 CFU less than the average home toilet seat. It is thought that these are safer because water drips down to the bottom of the straw rather than hang out at the top attracting moisture-loving germs.
“Based on our test results, we suggest opting for a straw-top bottle, both for the prevalence of bacteria and the lack of harmful germs,” says the fitness Website. They suggested that stainless steel water bottles are a better choice than plastic which may also contain Bisphenol A, otherwise known as BPA, a chemical that can lead to cancer, diabetes, and other illnesses.
But by far the best option, says the website Aquasana.com, is to use glass water bottles and run them through the dishwasher or wash thoroughly by hand after every use.
By comparison, other household germy hot spots include:
Toothbrush holder, 331,848 CFU.
Pet bowl, 47,383 CFU.
Kitchen sink, 3,191 CFI.
Cutting board, 6.8 CFU.
“Harmful bacteria and viruses lurk in moist locations such as the kitchen and bathroom and can be easily transported into your mouth by using an old toothbrush, sponge or other common household item,” Dr. Donald Marks tells Newsmax Health.
The New Jersey-based infectious disease expert, who also holds a Ph.D. in microbiology and immunology, makes the following recommendations to avoid home contamination:
Sponges and wash clothes. You may think you are cleaning cups and saucers with these items but they can contain thousands of bacteria per square inch so you’re just spreading germs around. Put wash clothes in the washing machine and run the sponges through the dishwasher. Better still, replace sponges every two weeks,
Kitchen drain. Your kitchen drain contains more germs than your bathroom toilet. With the hot water running, pour a little baking soda down the drain daily.
Kitchen towels. A recent study showed that 7 percent of kitchen towels were contaminated with MRSA (methicillin-resistant Staphylococcus aureus). Wash them in hot water twice weekly.
Refrigerator water filters. These filters collect bacteria and mold over time. The rule of thumb is to change them twice annually. If you have a large family of water drinkers, every three months is a better time frame.
Toothbrush. Your toothbrush is a magnet for bacteria that can come from toilet spray, splashes from the sink when you wash your hands, or from your own mouth. Replace it every three or four months and never share a toothbrush. You may consider soaking it in an antibacterial solution after every use.
The majority of clients that present to the clinic with anterior knee pain over the coming year will more often than not have a patellofemoral (PF) problem.
It may be a slight bit of biomechanical mal-alignment that has stirred up the knee cap – this is the good, or they may have started to wear the cartilage behind the knee cap and as a result it has softened – chondromalacia � this is the bad. They may even have worn a hole into the knee cap cartilage and they now have a chondral defect, or worse still an osteochondral defect – the downright ugly.
These problems affect runners, cross fitters, group exercise enthusiasts (PUMP classes) and simple recreational walkers who spend a lot of time on hills and stairs.
How These Extremes Are Managed Will Differ
The biomechanical irritations and the chondromalacia versions can be managed conservatively with a combination of local treatment modalities and correcting the biomechanical faults. The more serious chondral/osteochondral defects often need some surgical intervention as often the pathology is too advanced to respond to conservative treatment alone.
Understanding the exact mechanical contributions of the knee cap in relation to the femur is critical for the therapist to effectively manage these problems.
At the local PF level, the fault is usually a malposition of the patella in the femoral trochlear groove. Often the knee cap is being pulled too far laterally and superiorly in the groove, creating an uneven contact situation between the knee cap and the femur. The PF compression force during loaded knee flexion (squats, lunges etc.) is no longer optimal and usually a smaller portion of the patella cartilage is taking all the load. This wears the cartilage down and creates pain and pathology. This is most noticeable as the knee flexes to 30 degrees and onwards as it is this knee flexion angle where the knee cap enters the femoral trochlear groove.
The more distant (but often dominant) faults lie at the hip/pelvis and at the feet. Below is a breakdown of common biomechanical faults that may contribute to PF pain syndromes.
1. Overpronation
If the foot pronates (rolls in) for too long or too much, the pronated midfoot forces the tibia to remain internally rotated. The femur follows the tibia and also internally rotates. This creates a mal-alignment at the knee whereby the PF arrangement is altered and the knee cap shifts laterally. We are all familiar with the Q angle of the knee and how this affects the PF alignment.
Common causes of overpronation may be structural flatfoot problems that can be corrected with orthotics and shoe selection. However, tight soleus (that limits dorsiflexion) or a tight and overactive peroneal system that everts the foot and flattens the foot can also be a cause.
Stretching and loosening the soleus and peroneals along with strengthening the anti-pronation muscles such as tibialis posterior, flexor hallucis longus and flexor digitorum longus may help fix this problem.
FADDIR represents a flexed, adducted and internally rotated hip joint at foot strike. This is often caused by tight and overactive hip flexors such as TFL and the adductors and weakness in the abductors (gluteus medius) and external hip rotators (gemellus, obturator muscles). This hip posture forces the femur to roll inwards and as a result the knee is deviated medially and away from the vertical line drawn up from the foot. This also increases the Q angle and PF misalignment results and perpetuates the local knee imbalance of tight and overactive lateral quadriceps and lateral hamstrings along with ITB tightness. As a result the VMO weakens.
Loosening the overactive TFL, adductors, lateral quad, ITB and lateral hamstring whilst strengthening the gluteus medius, hip external rotators and VMO may help this biomechanical mal-alignment.
3. Pelvic Trendelenburg
Defined as lateral pelvic shift whereby at stance phase the opposite side of the pelvis drops down below the height of the pelvis on the stance side. This is usually caused by a weak gluteus medius complex that is unable to hold the pelvis stable during stance phase. The implications again are that this causes the knee to roll in and increase the Q angle. The solution is to muscle up the gluteus medius.
This often forgotten about imbalance creates a situation whereby the individual finds it difficult to attain hip extension at the end of stance phase. The hip remains locked in a degree of flexion.
The knock on effect is that the knee also stays locked in some flexion. With the knee in flexion, the knee cap is now compressed against the femur, compression on the underside of the kneecap may result. To fix this the therapist needs to stretch/loosen the hip flexors and strengthen the gluteus maximus to promote more hip extension.
People who run marathons go through intense training before enduring the physically grueling 26.2-mile event�so it�s little wonder their health can sometimes suffer. But on marathon days, the event can also create unexpected problems for non-runners who need urgent medical care.
In a new report published in the New England Journal of Medicine, researchers found that road closures and traffic disruptions on marathon days can lead to delays in emergency care that can cost people their lives.
Dr. Anupam Jena, from the department of health care policy at Harvard Medical School and Massachusetts General Hospital, and his colleagues analyzed data from Medicare claims for hospitalizations for heart attack in 11 cities that hosted marathons from 2002 to 2012. They compared the death rates of these people on marathon days to those a few weeks before and after the marathon. People who had heart attacks on marathon days had a 13% higher rate of death than people on other days. Ambulances also took 4.4 minutes longer on days marathons were run.
�We were expecting to see there would potentially be delays in care,� says Jena, �but not necessarily increases in mortality. It�s difficult to influence mortality; you would have to have substantive delays in care.�
Road closures, detours and other changes in traffic patterns were dramatic enough to cause delays that could affect a person�s chance of surviving a heart attack, the team found. Over a year, marathons could contribute to an additional four deaths, based on the 30-day mortality rate calculations. The effect remained strong even after they adjusted for the possibility that more people visit a city hosting a marathon, and therefore statistically there may simply be more heart events. The researchers also made sure that hospitals and emergency services were not short-staffed or overburdened with the added volume of requests. All of these factors were similar on marathon and non-marathon days.
The disruption in traffic during a marathon is the primary reason for delays in care, Jena says. That�s good news because it�s a fixable problem; marathon planners can ensure that access to hospitals is not congested and affected by the race route.
The other lesson from the study is useful for people in need of medical attention. A quarter of the people in the study chose not to call an ambulance and instead drove themselves to the hospital�perhaps because they thought that emergency services were tied up with the marathon�and these people seemed to account for most of the higher mortality on marathon days, says Jena. That may be because they were forced to take more circuitous routes to reach the hospital, he says. �They don�t experience the four-minute delays of ambulance transport; they�re experiencing much larger delays because they are trying to drive themselves.�
Even with the delays, ambulances were the best form of transportation to the emergency room. �Anybody thinking of driving to the hospital themselves on the day of a major public event should pick up the phone and call 911,� Jena says.
I have been travelling through Athens and now Istanbul. My 11 year old is a Percy Jackson nut and has been filling me in with the who’s who of Greek mythology and I am learning Latin words every day. Quite an education!
I looked up the word syndesmosis and the Latin translation is “(New Latin, from Greek sundesmos) bond, ligament, from sundein, meaning to bind together”. As sports injury professionals, we know syndesmosis to be the joint articulation between the tibia and the fibula bones around the ankle. These two bones are �bound’ together with very firm and strong ligaments.
Syndesmosis comes to mind after I saw a girl sprain a syndesmosis at the Archaeological Museum in Istanbul today. This poor girl was preoccupied by the hundreds of cats and kittens running all over the place and did not see the uneven cobblestones on which she placed her foot. At the same time, she turned to change direction. This is a common mechanism of injury for a syndesmosis – a forced dorsiflexion and rotation on a fixed foot.
Rehab Masterclass Issue 140 Of Sports Injury Bulletin
Of all the ankle injuries, injury to the syndesmosis is the biggest pest to sports physios and the like. And unlike simple garden variety ankle sprains that heal quickly, the syndesmosis takes a LONG time to heal properly. If you deal with athletes that are susceptible to syndesmosis sprains, I’m sure you will agree that these are harder injuries to manage because of the severe consequences if done badly.
I go into a fair bit of detail in my Sports Injury Bulletin piece about syndesmosis injuries, detailing how they happen, how to identify them and then manage them. What I would like to highlight here are the implications of mismanaging a syndesmosis sprain.
In the current issue of The Journal of Sports and Physical Therapy, a group of Japanese researchers discovered that individuals who had chronic ankle instability (CAI) had a distal fibula that was positioned more lateral compared with healthy individuals with no CAI. In effect, those who had suffered serious syndesmosis injuries in the past and ended up with a wider distance between the fibula and the tibia, suffered more ongoing ankle pain than those without a tibfib separation.
Research shows that even a 1mm displacement of the talus within the mortise (due to a wider placed fibula) can reduce the contact area in the talocrural joint by 42% (Ramsey and Hamilton 1976). Mismanaged syndesmosis injuries, resulting in an excessive amount of opening, can lead to early onset arthritic changes and chronic ankle instability. The talus bone bounces around in the now wider tibfib articulation.
A Widening Of The Fibula Is Due To One Of The Following:
Poor initial management, whereby the athlete is allowed to weight bear too early and this weight bearing forces the fibula away from the tibia as the syndesmosis ligaments are trying to heal.
The degree of damage is so severe that proper tightening of these ligaments is not possible without surgical intervention such as a screw or similar being placed between the two bones to �force’ them together.
The key for a sports injury practitioner, is to properly identify a regular ankle sprain from a more serious syndesmosis injury. If you get this part wrong and allow the athlete to get back to weight bearing too early, then expect some complaints about a chronically painful ankle some time down the track.
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Kobayashi et al (2014). �Fibular malalignment in individuals with chronic ankle instability.’ JOPST. 44(11); pp 841-910.
Ramsey and Hamilton (1976). J Bone and J Surgery Am. 58(3); 356-357.
Yoga can be an effective way to prevent and ease aches and pains—but it can also cause them if you’re not careful. The key is proper alignment. Go from “ow” to “om” in seconds by making simple alignment tweaks to common poses. In this video, Yoga With Kirby founder Kirby Koo shows you quick fixes to take pressure off your knees, wrists, and neck. These basic principles can be applied throughout your practice to help prevent pain before it starts.
Warrior II
Once you’re set up in Warrior II, pay attention to the position of your front knee. Is it sticking out beyond your ankle? Is it collapsing inward? Pull your knee back into place, so it’s stacked directly above your ankle, and tracking in the same direction as the toes of your front foot. This protects the ligaments in your knee and prevents knee pain.
Plank is a great core stabilizing exercise if you have proper alignment. But if your belly and hips sag in this pose, then your wrists are probably taking on the brunt of your body weight. In plank, engage your core muscles by imagining a zipper running up from your pubic bone to your belly button. This should help raise your hips so your body forms a continuous line from the top of your head to your heels, a more stable position that will help distribute your body weight more evenly and ease the pressure in the wrists.
Cow Pose
Cow pose can feel super satisfying, but it’s easy to go overboard and strain your neck while you’re enjoying the gentle backbend. When you’re in cow pose, it’s important to remember not to tip your head too far back, shortening the back of the neck. You’ll get a lot more out of the pose (and avoid neck strain) if you imagine your neck as an extension of the gentle curve of the spine. Lift your gaze only as far as you can without compromising the curve in your spine and the length in the back of your neck. The same concept can apply for Upward-Facing Dog, too!
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