Back Clinic Sports Injuries Chiropractic and Physical Therapy Team. Athletes from all sports can benefit from chiropractic treatment. Adjustments can help treat injuries from high-impact sports i.e. wrestling, football, and hockey. Athletes that get routine adjustments may notice improved athletic performance, improved range of motion along with flexibility, and increased blood flow. Because spinal adjustments will reduce the irritation of the nerve roots between the vertebrae, the healing time from minor injuries can be shortened, which improves performance. Both high-impact and low-impact athletes can benefit from routine spinal adjustments.
For high-impact athletes, it increases performance and flexibility and lowers the risk for injury for low-impact athletes i.e. tennis players, bowlers, and golfers. Chiropractic is a natural way to treat and prevent different injuries and conditions that impact athletes. According to Dr. Jimenez, excessive training or improper gear, among other factors, are common causes of injury. Dr. Jimenez summarizes the various causes and effects of sports injuries on the athlete as well as explaining the types of treatments and rehabilitation methods that can help improve an athlete’s condition. For more information, please feel free to contact us at (915) 850-0900 or text to call Dr. Jimenez personally at (915) 540-8444.
Whether your doctor recommends surgery for a ruptured Achilles tendon may depend partly on your age and activity level, foot experts say.
The Achilles tendon is a band of tissue that runs down the back of the lower leg and connects the calf muscle to the heel bone. A rupture is a complete or partial tear of the tendon that leaves the heel bone separated or partially separated from the knee.
Length of recovery from this type of injury varies depending on whether a patient undergoes surgical or nonsurgical treatment.
“Treatment processes are dependent upon a patient’s overall health, activity level and ability to follow a functional rehabilitation protocol,” said Dr. Jeffrey McAlister, a foot and ankle surgeon in Sun City West, Ariz. Advances in treating Achilles tendon rupture were discussed by McAlister and other specialists at a recent meeting of the American College of Foot and Ankle Surgeons, in Las Vegas.
Typically, less active and unhealthy patients receive nonsurgical treatment, since they are not trying to return to active sports, McAlister said in a college news release. But this approach usually involves a long rehabilitation/recovery period (9-12 months). Also, these patients may be at increased risk of potentially dangerous blood clots due to inactivity during this period.
“For more athletic and younger patients, the surgical option may be best,” said Dr. Michael VanPelt, a Dallas foot and ankle surgeon. “We anticipate these patients have shorter healing times.”
But because there is low blood flow to the Achilles tendon, healing after surgery can be tricky.
“Advances in surgical techniques to repair Achilles tendon ruptures include limited incision, or smaller incision, surgical approaches to help patients have smaller scars, and less of a chance of wound complications,” said Dr. Jason Kayce, a Phoenix foot and ankle surgeon.
For more information, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Preventing Sports Injuries
Many athletes largely depend on chiropractic care to enhance their physical performance. New research studies have determined that aside from maintaining overall health and wellness, chiropractic can also help prevent sports injuries. Chiropractic is an alternative treatment option utilized by athletes to improve their strength, mobility and flexibility. Spinal adjustments and manual manipulations performed by a chiropractor can also help correct spinal issues, speeding up an athlete’s recovery process to help them return-to-play as soon as possible.
All marathon runners eventually slow down. But, a new study finds that whether a runner is average or elite, or whether they are a man or a woman, may determine at what age and how much their pace will decline.
The researchers reviewed 2001-2016 data from three of the largest U.S. marathons — Boston, Chicago and New York City.
“We found that marathon performance decline begins at about 35 years old,” said study lead author Dr. Gerald Zavorsky, of Georgia State University. “For top runners, we determined the slowdown is about 2 minutes per year beginning at age 35 for men. And for women, it’s actually a little bit statistically faster of a slowdown, around 2 minutes and 30 seconds per year beginning at the age of 35,” Zavorsky said in a university news release.
He is an associate professor in the university’s department of respiratory therapy. The researchers also found that marathoners aged 25 to 34 had the fastest times, with overall champion males at 28.3 years old and overall champion females at 30.8 years of age.
However, people with “average” marathon times don’t see a big impact on their performance until later in life, the findings showed.
“If you’re an average runner finishing in the middle of your age group, statistically the slowdown starts at age 50. It’s similar if you’re a man or woman. The decline with aging in average runners is around 2 minutes and 45 seconds per year beginning at age 50,” Zavorsky said.
The researchers suspect the reason that average runners see a decline later in life is that they likely started running later in life.
“Elite athletes realize their potential when they’re young, and they’re able to maximize that potential when they’re young. But average runners might not realize their potential until they’re a lot older and by that time physiological aging comes in. They try to reach their maximum potential, but they’re trying to reach it at a much older age and their ceiling for improvement is not as high,” Zavorsky suggested.
The rate of marathon performance decline between ages 35 and 74 is fairly steady, and female age-group winners have a 27 second per year larger decline than male age-group winners, according to the study. Although you might never reach elite status if you start running in your 50s, the researchers don’t want to discourage older people from getting involved in marathons.
“If you’re an older person and you want to pick up marathon running, yes you can still improve because you’ve just now begun running. There’s always room for improvement, but physiologically, you were probably at your prime somewhere between 25 and 34 years old,” Zavorsky said.
“But people who are older can still train to achieve personal goals and get the health benefits of exercise, such as lower blood pressure, lower blood cholesterol and enhanced psychological well-being,” he added.
The study was published online recently in the journal PLoS ONE.
For more information, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Additional Topics: Preventing Sports Injuries
Many athletes largely depend on chiropractic care to enhance their physical performance. New research studies have determined that aside from maintaining overall health and wellness, chiropractic can also help prevent sports injuries. Chiropractic is an alternative treatment option utilized by athletes to improve their strength, mobility and flexibility. Spinal adjustments and manual manipulations performed by a chiropractor can also help correct spinal issues, speeding up an athlete’s recovery process to help them return-to-play as soon as possible.
Stress fractures to the ribs occur in rowers, golfer, canoeists, lacrosse players and baseball pitchers. They are more common in sports involving an element of trunk rotation with scapula movement across the rib cage.
A stress fracture is described as an overload to the bone caused by repetitive loading due to a particular movement. Any load on the bone will create a stress in the bone. However, given enough recovery time the bone heals and ends up stronger. This is known as Wolfe�s law. But, if the bone load is too high or too frequent, then the bone does not repair quickly enough, a stress response occurs and a fracture follows.
In rowing, the repetitive loading is created by a number of factors. Muscles such as the serratus anterior and abdominals that directly attach to the ribs can lead to loading on the ribcage due to contraction. Bad rowing technique, perhaps caused by poor hip flexibility, which then requires an excessive compensatory thoracic rotation, may then lead to rib breakdown.
Other causes include equipment issues such as the oar type (lighter carbon oars increase rib loading), bigger boats with more drag and position in the boat (bow rowers have less incidence due to lower stroke rate and force). Rib cross section and density also influence the chance of stress fractures, and women have a higher chance due to greater likelihood of bone density issues. Finally, training variables such as volume, intensity, type of loading and off water training can also be factors in stress fracture development.
The signs and symptoms are usually straight forward. These include generalised rib pain with a focused spot of tenderness, pain rolling onto the ribs whilst sleeping and pain with deep breathing. They can be confirmed with bone scan (black spot) and/or MRI (white spot).
Unfortunately for the rower, the immediate management of the injury involves rest. Usually 4-6 weeks away from rowing will be enough to allow some bone healing and this is followed by a progressive increase in rowing load over another 4 weeks before the athlete is back to full training.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Additional Topics: Chiropractic and Athletic Performance
Chiropractic care is a popular, alternative treatment option which focuses on the diagnosis, treatment and prevention of injuries and/or conditions associated to the musculoskeletal and nervous system, primarily the spine. Many athletes, and civilians alike, seek chiropractic care to restore their natural health and wellness, however, chiropractic has been demonstrated to benefit athletes by increasing their athletic performance.
Plantar fasciitis is a common affliction affecting many athletes, in particular runners. Adam Smith has written a great piece in the September issue of Sports Injury Bulletin outlining the relevant anatomy, how the injury occurs, how to differentiate from other similar pathologies, such as neural irritation in the tarsal tunnel, and finally how to manage it.
Speaking from experience as a former sufferer of plantar fasciitis, it can be a frustratingly recalcitrant condition and I have heard of some extreme measures to manage it. Read on for a story on the drastic measures an AFL player took to overcome the problem, and to understand more about the condition.
Many years ago an elite level AFL player had suffered a 2 year history of plantar fasciitis with no relief from any form of treatment. In the end the sports doctor at the club involved injected the plantar fascia origin with a corticosteroid injection the day before a game.
The hope was that as the plantar fascia weakened due to the steroid injection, the player would rupture it, go through the standard week rehab protocol, and then be pain free for ever more.
And yes, the player did rupture the plantar fascia during during the game and was consequently placed in a boot for about 10 days. He soon was walking, then running, and was playing again within four weeks with no more problems. The podiatrist made an orthotic to control the dropped arch and all the problems went away.
What has happened to that player now is anyone’s guess. He may now suffer from long term issues due to a poorly controlled arch that have caused other issues such as achilles tendon, knee pain and/or hip pain.
So do we really need the plantar fascia and why is it such a problem when it is injured?
Being bipedal (walking on two leg) animals, the plantar fascia gives the natural plantar arch support in weight bearing positions. It is a passive structure that acts like a high tension wire to keep the arch bones supinated as we push off.
Without a plantar fascia in place, we would need a better active system to create the arch support, such as the intrinsic plantar arch muscles, and also the extrinsic long arch support muscles such as the tibialis posterior, flexor hallucis longus (FHL) and the flexor digitorum longus (FDL). These muscles would need extra work to improve their arch control abilities. Alternatively, we could use a passive support mechanism in the form of an orthotic to control the arch position.
The majority of plantar fascia problems stem from a build up of tensile and compressive forces that degenerate the plantar fascia origin against the heel bone. The combination of tensile (stretch) force due to overpronation and the added compressive force as the plantar fascia is pushed against the heel bone leads to a pathological state whereby the plantar fascia degenerates and creates dysfunction and pain.
Therefore like other degenerative tendon issues (such as Achilles tendons) once the patient starts to feel pain often the injury has been building for months to years. Which explains why it then becomes so problematic to deal with.
Proper management takes time to not only correct the muscle imbalances that cause it � such as tight calves, poor hip control, poor pronation control � but due to its degenerative nature it requires a huge amount of time to even slightly change the existing pathology.
For more information, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Additional Topics: What is Chiropractic?
Chiropractic care is an well-known, alternative treatment option utilized to prevent, diagnose and treat a variety of injuries and conditions associated with the spine, primarily subluxations or spinal misalignments. Chiropractic focuses on restoring and maintaining the overall health and wellness of the musculoskeletal and nervous systems. Through the use of spinal adjustments and manual manipulations, a chiropractor, or doctor of chiropractic, can carefully re-align the spine, improving a patient�s strength, mobility and flexibility.
Historically athletes were barefoot in the sporting arena and it is only a relatively recent phenomenon for shoes to be worn in competition. In Roman times wrestlers competed barefoot, whilst runners wore little more than thin leather sandals to compete over long distances.
More recently several athletes have achieved significant success competing barefoot: Abebe Bikila from Ethiopia won the Rome Olympic marathon in 1960, and Zola Budd became the world record holder over 5000 meters. Since the 1970�s athletic shoe manufacture has boomed and with it so too has the incidence of running-related lower limb injuries. This prompted the question of whether these new designs were to blame for the injuries or simply reflected the growing interest in distance running as a sport. That notwithstanding, the interest around barefoot running to reduce such injuries has grown exponentially. This account aims to appraise some of the literature on this contentious subject.
Gait Cycle & Running Biomechanics
The normal gait cycle consists of both stance and swing phases. The stance phase occupies 60% and swing 40% of the time taken to complete one cycle of consecutive heel striking by the same foot. The stance phase itself is divided into contact, midstance and propulsive phases. It begins and ends with both feet in contact with the ground known as the �double support phase�. The swing phase is divided into follow-through, forward swing and foot descent phases. The phases of running are very similar except for the fact that there is a flight phase when neither foot is in contact with the ground between stance phases. Evidently, with slower jogging the stance phase is longer than the flight phase, however, during sprinting this relationship reverses and the stance phase becomes the shorter of the two phases.
There are several key biomechanical considerations that must be borne in mind before a comparison can be made between barefoot and shod running. During running there is an increase in rotation at the pelvis, hip, and knee which must be absorbed by increasing the muscle forces acting over these joints. Moreover, as running speed increases the point of foot impact changes from predominantly heelstriking to that of forefoot weight-bearing when sprinting. The normal angle of gait is approximately 100 abducted from the line of progression. As speed increases this angle decreases approaching zero as the foot strike nears the line of progression. Runners who have developed stride patterns that incorporate low levels of impact force and rapid pronation are at a reduced risk for over-use running injuries such as stress fractures, plantar fasciitis, and ligamentous sprains. It is important to note that many shod runners never develop injuries, however, the available data indicates that 19-79% will develop an injury over their years spent running.
Biomechanical Abnormalities and Injury
Excessive Pronation � Pronation of the foot occurs at the sub-talar joint and when it occurs in excess is associated with many running-related injuries. Examples include, first metatarsophalangeal joint abnormalities, medial arch and plantar fascia strain, Achilles and tibialisposterior tendinopathy, patellofemoral joint dysfunction, and stress fractures. One study illustrated that shod running decreased torsion and increased pronation significantly, the paper concluded that the reduction in torsion produced by stiff soled shoes may well be a factor in running injuries caused by excessive pronation.
Excessive Supination
This movement also occurs at the subtalar joint and may compensate for a weakness of the antagonist pronating musculature (e.g. peroneal) or as a result of spasm or tightness of the supinating musculature (e.g. tibialis posterior, and the gastrocnemius- soleus complex). The supinated foot is less mobile and provides inferior shock-absorption which may well predispose to the development of stress fractures of the tibia, fibula, calcaneus and metatarsals. Lateral instability of the foot and ankle may be associated with excessive supination resulting in an increase incidence of ligamentous sprains of the foot and ankle. Such a lateral stress on the lower limb could result in tightening of the ileo-tibial band with associated bursitis of the femoral epicondyle.
Abnormal Pelvic Mechanics
During normal running the pelvis assumes a rotated position with anterior-posterior and lateral tilt. Weakness in the muscles needed for stabilisation of this position will result in excessive movement in any one of the three planes. A less efficient transfer of force will subsequently occur. The most common pelvic abnormalities are excessive anterior tilt, excessive lateral tilt and asymetrical pelvic movement. The complex inter-play of musculature to compensate for each of these abnormalities may well result in muscle tightness, strains and tendinopathy. Adaptation and biomechanics of running barefoot A leading study on the subject of barefoot running was conducted by Lieberman et al. who compared foot striking patterns and collision forces in habitually barefoot with shod runners. They found that habitually barefoot endurance runners often land on the fore-foot (fore-foot strike) before bringing down the heel. Less frequently they may also land with a flat foot (mid-foot strike), or even less often, on the heel (rear-foot strike). In contrast, shod runners mostly rear-foot strike which is facilitated by the elevated and cushioned heel of the modern running shoe.
The same study conducted kinematic and kinetic analyses on the two populations and discovered that even on hard surfaces, barefoot runners who fore-foot strike generate smaller collision forces than shod rear-foot strikers. This is brought about by the manner in which the barefoot runner�s foot is more plantarflexed at landing with a greater degree of ankle compliance at impact. These features combine to decrease the effective mass of the body that collides with the ground and so potentially reducing injury through repeated heavy loading. In addition, the stride length of barefoot runners is shorter and the strides have a greater vertical leg compliance which acts to lower the body�s centre of mass relative to the force of impact. Again, these features work to reduce jarring and result in a smoother running motion experienced by the individual.
Footwear and Injury
It has been surmised that modern footwear produces a lower level of perceived foot impact than that actually experienced and thus increases injury risk. There is good evidence to show that the more cushioning runners believe to be under the foot, the harder they strike. Furthermore, modern shoe designs are far more forgiving on poor running technique and since the athlete suffers less pain bad habits become re-inforced. In contrast, barefoot runners have been found to have a reduction in impact peak with reduced mechanical stress and enhanced ankle extensor function. In one particular study peak load in the hip and knee joints of participants with osteoarthritis was decreased significantly in barefoot walkers. These findings appear to point to the supposition that shoes may increase loads in poor physiological patterns and thus perpetuate injury.
Bipedalism has been around for millions of years and it is only relatively very recently that humans have been shod. The running technique of early distance running bipeds almost certainly differed enormously from the style that is seen today with modern foot-wear. The pre-historic �hunter-gatherer� would be more likely to have had a fore-foot or mid-foot-strike gait which studies have shown to be protective from many of the running injuries seen today.
Modern running shoes allow a greater degree of �laziness� in running style and in so doing ingrain bad habits which ultimately predispose to injury. Information on how barefoot running can be integrated into one�s training and how to overcome the obvious hazards of penetrating and friction injuries are growing at a great rate through internet forums and sites. There are already products available such as the Vibram FiveFingers� which are gaining in
popularity as the option of running barefoot or �nearly barefoot� grows. Furthermore, interest in the subject has been helped enormously by popular literature such as the bestselling book �Born to Run� by Christopher McDougall which follows the Tarahumara Indians of Northern Mexico who run ultra-marathons in simple leather strapped sandals.
In short, the evidence indicates two clear points. Firstly, from observations of populations who run barefoot or are habitually barefoot there appears to be lower injury rates versus the shod population. Secondly, the wearing of modern running shoes promotes a heavy impacting heelstrike gait which predisposes to injury. For the subject to gain wide-spread acceptance there will need to be an increase in the number of well designed prospective and randomised controlled trials on the subject.
References:
1. Clinical Sports Medicine by Peter Brukner and Karim Khan. Third Edition, Chapter 3; pp.45-55
2. Hreljac A. Impact and overuse injuries in runners.
Med Sci Sports Exerc 2004; 36:845-9 3. van Gent RN, Siem D, van Middelkoop M, van Os AG, Bierma-Zeinstra SM, Koes BW. Incidence and
determinants of lower extremity running injuries in long distance runners: a systematic review. Br J Sports Med 2007; 41(8):469-80
4. Buschbacher R, Prahlow N, Dave SJ (eds). Sports Medicine and Rehabilitation: A Sports Specific
Approac, 2nd ed. Baltimore (MD): Lippincott Williams and Wilkins; 2008, p. 200-1
5. Stacoff A, Kaelin X, Stuessi, Segesser B. The torsion of the foot in running. Int J Biomech 1989; 5:375-89
6. Lieberman DE, Venkadesan M, Werbel WA, Daoud AI, D-Andrea S, Davis IS, Mang-Eni RO, Pitsiladis Y. Foot strike patterns and collision forces in the
habitually barefoot versus shod runners. Nature 2010; 463:531-535 7. Jungers WL. Barefoot running strikes back. Nature
2010; 463:433-434 8. Robbins S, Waked E. Hazard of deceptive advertising of athletic footwear. Br J Sports Med
1997; 31(4):299-303. 9. Divert C, Mornieux G, BaurH, et al. Mechanical comparison of barefoot and shod running. Int J
Sports Med 2005; 26:593-8 10. Shakoor N, Block JA. Walking barefoot decreases loading on the lower extremity joints in knee
osteoarthritis. Arthritis Rheum 2006; 54:2923-7 11. Christopher McDougall. Born to run: the hidden
tribe, the ultra-runners and the greatest race the world has never seen. Profile books, published 2009.
12. Robbins SE, Hanna AM. Running-related injury prevention through barefoot adaptations. Med Sci Sports Exerc 1987.;19:148-56
For more information, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Additional Topics: What is Chiropractic?
Chiropractic care is an well-known, alternative treatment option utilized to prevent, diagnose and treat a variety of injuries and conditions associated with the spine, primarily subluxations or spinal misalignments. Chiropractic focuses on restoring and maintaining the overall health and wellness of the musculoskeletal and nervous systems. Through the use of spinal adjustments and manual manipulations, a chiropractor, or doctor of chiropractic, can carefully re-align the spine, improving a patient�s strength, mobility and flexibility.
The talk in soccer circles this week is the imminent return to action of Theo Walcott, the Arsenal and England star who damaged his knee back at the start of 2014. After 286 days of rehab, Walcott made a return to Arsenal’s Under 21 team last week. This has left journalists salivating at finding out when he will be returning to the main team.
For a young professional sports person, nine months is a long time out of the game. For Walcott, missing out on this Summer’s soccer World Cup in Brazil was perhaps more than just rubbing salt into the wound.
In issue 139 of Sports Injury Bulletin, I present a case study of a similar problem in a rugby player of identical age. This big lump of a kid ruptured his lateral meniscus in the knee — a bit different to Walcott’s ACL injury. However, this player also missed a big chunk of the season (17 weeks) and I had to live with his personal frustrations, and the yo-yo of daily emotions.
The piece shows the knee anatomy, details the types, clinical features and management of meniscus tears, and the required post-surgical rehabilitation.
On a recent Rehab Trainer course, one of the participants asked me what she should do about the small lateral meniscal tear in her knee. This is a bit like answering “how long is a piece of string?”, as it depends on so many things.
But to wrap it up in a nutshell, the surgeon will use a set of criteria to determine if a meniscal tear needs repairing, removing, or to be left well alone.
Criteria for Surgery
1. Age
The younger the patient, the more comfortable surgeons are about operating. Often the small degeneration tears in older patients are just a precursor to a knee that is about to become arthritic. With older patients, many surgeons will try for rehab first.
2. Function
This depends on what the knee has to do. If the patient does nothing but collect stamps all day and the knee does not bother them, then clearly the surgeon will want to leave it alone. But if the patient is an athlete with a repetitive catching and locking knee due to a meniscal tear, they will be more comfortable about operating.
3. Type of tear
Issue 139 of Sports Injury Bulletin details the types of tears we see in meniscus. In short, tears such as bucket handle tears do not do well without surgery, while small longitudinal tears can do well without surgery.
4. Location of tear
The outer portion of the meniscus has a nice, rich blood supply (hence, called the “red-red zone”). These areas can do well if left alone. Inner third zone tears (the “white zone”) with no blood supply don’t heal, so they need repairing or removing.
So, if the patient is lucky and fits the criteria for conservative management, or let’s say they simply don’t want surgery, then what options do we have to prevent the injury from getting worse?
Suggestions to Avoid Further Meniscus Injuries
Avoid positions that catch the meniscus. For example, full squatting may catch the posterior horn of the meniscus and flare it up, so the patient has to learn to avoid these positions if possible.
Keep the quadriceps working. If the quads remain strong and active then the shearing effect of the tibia moving across the femur is reduced. This will limit the stress to the meniscus.
Watch for swelling. Regular assessments for a knee effusion (called a “fluctuation test”) may need to be done a few times a week to make sure the knee stays dry. The knee’s biggest enemy is an effusion as it shuts off the quads straight away.
Intervene if the knee has an effusion. Donut felt compression, regular icing, NSAIDS if indicated, needle aspiration if indicated. Avoiding an effusion at all costs is pretty important for any knee injury.
For more information, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Preventing Sports Injuries
Many athletes largely depend on chiropractic care to enhance their physical performance. New research studies have determined that aside from maintaining overall health and wellness, chiropractic can also help prevent sports injuries. Chiropractic is an alternative treatment option utilized by athletes to improve their strength, mobility and flexibility. Spinal adjustments and manual manipulations performed by a chiropractor can also help correct spinal issues, speeding up an athlete’s recovery process to help them return-to-play as soon as possible.
A common soccer move — bouncing the ball off of the head — may not be as harmless to the brain as has been thought, new research suggests.
A study of more than 200 adult amateur soccer players of both genders found that regularly “heading” the ball, as well as suffering accidental hits to the head, significantly boosted a player’s risk of concussion.”The prevailing wisdom is that routine heading in soccer is innocuous and we need only worry about players when they have unintentional head collisions,” study leader Dr. Michael Lipton, of the Albert Einstein College of Medicine in New York City, said in a college news release.”But our study suggests that you don’t need an overt collision to warrant this type of concern,” said Lipton. He is professor of radiology, psychiatry and behavioral sciences at Einstein.Another concussion expert who reviewed the findings agreed.Soccer Athletes at Risk
The study “seems to provide additional evidence that such practices within the game of soccer can put athletes at risk for traumatic brain injury,” said Dr. Jamie Ullman. She directs neurotrauma at North Shore University Hospital in Manhasset, N.Y.Much of the research into sports-related concussions has concentrated on high-impact sports, such as football or hockey. But head trauma experts have long known that other sports — including soccer and rugby — might carry risks, too.In prior studies, Lipton said his team found that “30 percent of soccer players who’d had more than 1,000 headings per year had a higher risk of microstructural changes in the brain’s white matter, typical of traumatic brain injury, and worse cognitive performance.”Exploring the issue further, the new study focused on online questionnaires answered by 222 adult amateur soccer club players in the New York City area, both male and female. All had played soccer at least six months during the prior year.Men averaged 44 headers in two weeks, the survey found, while women averaged 27. One or more accidental head impacts, such as a ball hitting the back of the head or a head colliding with another player’s knee, were reported by 43 percent of women and 37 percent of men.Players who regularly headed the ball were three times more likely to have concussion symptoms than those who didn’t head the ball often, Lipton’s team reported.Players who suffered accidental head impacts two or more times within a two-week span were six times more likely to have concussion symptoms than those without accidental head impacts, the findings showed.Of those who headed the ball or reported accidental head impacts, 20 percent had moderate to severe concussion symptoms, according to the report.Of the seven players with very severe symptoms, six had two or more unintentional head impacts over two weeks, four were among those who headed the ball the most, and three were in the group that headed the ball second-most.Lipton stressed that the findings cannot be generalized to child, teen or professional soccer players.Still, “our findings certainly indicate that heading is more than just a ‘sub-concussive’ impact, and that heading-related concussions are common,” Lipton said. “We need to give people who have these injuries proper care and make efforts to prevent multiple head impacts, which are particularly dangerous.”That means watching out for symptoms, he added.”Many players who head the ball frequently are experiencing classic concussion symptoms — such as headache, confusion and dizziness — during games and practice, even though they are not actually diagnosed with concussion,” Lipton explained.”Concussion sufferers should avoid additional collisions or head impacts during the following days or weeks, when their risk of incurring a second concussion is extremely high,” he said. “Because these injuries go unrecognized and unmanaged, there may be important clinical consequences for the short and long term.”Dr. Salman Azhar is a neurologist and director of stroke services at Lenox Hill Hospital in New York City. He said the new findings are in accordance with prior studies, and the odds for concussion appeared to rise along with the frequency of head impacts.”The chance of having moderate-to-severe symptoms increased when the unintentional heading went from just one per two-week period to two per two-week period,” Azhar noted.The study was initially published online Feb. 1 in the journal Neurology.
For more information, ask Dr. Jimenez or contact us at 915-850-0900
Presented By:
Dr. Alex Jimenez D.C.,C.C.S.T
Spinal Trauma Specialist
IFM's Find A Practitioner tool is the largest referral network in Functional Medicine, created to help patients locate Functional Medicine practitioners anywhere in the world. IFM Certified Practitioners are listed first in the search results, given their extensive education in Functional Medicine
