Take a lesson from the pros: establish a daily routine

The Healthy Sports “Spring Training Tour” is now in the Florida swing.

Tampa is a leading center for competitive sports. It is not only the spring training home of the New York Yankees, but will also serve as host to the NCAA Women’s Basketball Final Four, the first round of the Men’s NCAA Basketball Tournament and the 2009 Super Bowl.

Access to players, coaches and staff is an added attraction to a spring training vacation. This year I had an opportunity to spend time with Billy Connors and Frank Howard.

Connors is a former major league pitcher and current Yankees vice president of player development. Howard was a major league slugger and now serves as a Yankees spring training instructor.

One conversation centered on the topic of ritualistic behavior by players.

Often these actions are misconstrued as superstitious. Eating the same meal before a game or fielding the same number of ground balls to each side during warm-ups are typical examples. Pre-shot routines are common in basketball when shooting foul shots or in golf before making putts.

In actuality, these actions are not superstition but part of careful preparation and result in added confidence. Following a set routine before each effort leaves fewer opportunities for error. Any successful performer spends many hours practicing so that the final performance seems natural and unrehearsed.

Similarly, a steady routine of daily activities can be beneficial for anyone. Many illnesses can be kept in check by maintaining a regular routine of eating, sleeping, and exercising. This is especially effective when treating migraine headaches, diabetes, and sleep disorders.

A well-established program can often improve cognitive disorders.

Many middle-aged patients present with a fear of Alzheimer’s disease due to simple forgetfulness. This is most often due to multi-tasking. These patients typically do not make lists of necessary tasks and are easily distracted.

A carefully designed routine, including rehearsal and review of daily activities, can significantly improve efficiency and reduce errors. It is worth the investment in time despite possibly being mistaken as superstitious.

Anthony G. Alessi, MD, is Chief of Neurology at The William W. Backus Hospital and in private practice at NeuroDiagnostics, LLC, in Norwich. E-mail him at aalessi@wwbh.org. If you wish to learn more about the Healthy Sports Tour or other sports health topics, listen to the podcast or go to the Healthy Sports blog at Backus Hospital.

Opinions vary on rotator cuff injuries

Baseball season has arrived!

It’s time to put away the 409-page Mitchell Report and any pharmacology texts fans may have been consulting. Box scores will now move to the top of the sports page.

Despite this good news, controversy still abounds.

This season, one issue surrounds the need for surgical repair of Curt Schilling’s ailing right shoulder. Rarely does the public see such divergent opinions among highly regarded sports medicine specialists as in this situation.

Dr. Thomas Gill, the Red Sox team physician, advocates non-surgical treatment with rehabilitation and return to pitching this season. Dr. Craig Morgan, who operated on Schilling’s shoulder in 1995 and 1999, recommends surgical repair with resuming action late in the season. A third opinion from Dr. David Altchek, Mets team physician, suggests surgery. The final decision has been no surgery and a possible return in several months.

Shoulder injuries are common in throwing sports and usually involve the rotator cuff. The rotator cuff refers to the system of tendons and muscles that support the most moveable joint in the body.

Common symptoms of injury are aching pain and weakness when attempting to raise the arm overhead. The principal issue when considering surgery is whether or not a tear is present or just inflammation. These conditions respectively require surgery with rehabilitation and rehabilitation alone.

The “Healthy Sports Spring Training Tour” is currently visiting the Connecticut Defenders at their preseason camp in Scottsdale, Ariz.

Dr. Stephen Scarangella of Willimantic is an orthopedist and Connecticut Defenders’ team physician. He reports that many pitchers respond well to surgery after rotator cuff tears. Although success depends on the extent of injury, tears are usually discovered early in pitchers and are small in size.

Anthony Reyes is the former Defenders’ athletic trainer and is now responsible for the San Francisco Giants’ Triple A Fresno club. His focus is on the prevention and rehabilitation of rotator cuff injuries. He allows a full year for recovery after rotator cuff surgery for a pitcher. This permits full healing and any changes the player must make in pitching mechanics.

The current controversy involving Curt Schilling’s injury will be played out over the next few months. When dealing with a shoulder injury, seek out multiple opinions from qualified specialists before deciding on a course of action. It’s what the pros do.

If you wish to learn more about shoulder injuries in sports, listen to the podcast or go to the Healthy Sports Blog at Backus Hospital.

Healthy Sports Arizona 2

Scottsdale, Ariz., is a growing suburb of Phoenix. Judging from the number of high-end car dealerships, including Rolls Royce and Ferrari, the average income is well above the poverty level. The sun is always shining and there seems to be no bugs. It is home to Arizona State University and serves as the spring training base of the San Francisco Giants.

Don and Charlie’s is a restaurant in Scottsdale known for good food, sports memorabilia, and famous patrons. Knowing this, it was still shocking when my party was seated at a table next to a group that included Muhammad Ali.

Despite being afflicted with Parkinson’s disease, his personality still captures the attention of all. Unable to sign autographs, after finishing his meal he spent time posing for pictures with young children who will certainly one day appreciate the importance of that moment. When Ali finally rose to exit the restaurant, every patron stood and respectfully gave a standing ovation.

Many years of intense physical training will reduce the chance of disease but will not impart immunity. Neurologic diseases like Parkinson’s, Multiple Sclerosis and Lou Gehrig’s disease will seriously impair motor function.

Some patients, especially those who have spent much of their lives in the limelight, may retreat to a solitary existence when faced with chronic illness. Much has to do with vanity over their more frail appearance. Others transcend their physical infirmities and continue to contribute to society in a different role. So often, those with strong personalities won’t allow themselves to take a step back. Studies have shown these groups of people always have better outcomes when fighting disease. When polled, they also report a better quality of life.

As in all professions, sports has its heroes and villains. On this night in Scottsdale, Muhammad Ali once again rose up and demonstrated to all present why he is still “The Greatest.”

If you wish to learn more about the Healthy Sports Tour, listen to the podcast or go to the blog at The William W. Backus Hospital or norwichbulletin.com.

Healthy Sports Arizona

The Healthy Sports “Spring Training Tour” is now in the midst of the Arizona swing.

A visit to the San Francisco Giants/Connecticut Defenders training camp reveals many former Defenders players now enjoying Major League status. Dan Ortmeier, Matt Cain and Travis Ishikawa are all currently in Major League camp and hoping to make it to the big league.

But the real story lies in the workout regimen of the coaches, trainers and instructors.

Their day begins at 5 a.m. in the workout room. This early hour is the only opportunity staff will have to complete their personal workout programs before a hectic day of staff meetings, instruction and games.

In an effort to keep up with my own workout schedule while on the road, the Giants afforded me the opportunity during my stay to join this early morning fraternity. Like most gyms, there is a wide variety of well-maintained equipment and a big screen TV (always tuned to ESPN). There are also many iPods in use. Discussion is centered on player performance, drills for the day, and upcoming games in the afternoon. A lot gets done during these sessions.

Many patients feel that the walking involved in their jobs is a sufficient workout. Coaches and staff are constantly walking, swinging, and throwing for eight hours over multiple fields, encompassing several acres, yet they still see the need to hit the aerobic machines and weights each morning. This is a model that many industries outside of sports are trying to replicate as a means to promote better health, lower health costs, and provide a sense of camaraderie.

A quick trip to Surprise, Ariz., the spring training home of the Kansas City Royals, presented an opportunity to meet with former Norwich Navigators manager and now first-year manager of the Royals, Trey Hillman. Sitting and reminiscing in his new office, it is apparent that the leadership skills he developed in Norwich and later in Japan are going to pay off big for Kansas City this year. It will be interesting to follow his success in the major leagues.

If you wish to learn more about the Healthy Sports tour, listen to the podcast or go to the blog at The William W. Backus Hospital or norwichbulletin.com.

Exercise can help with Parkinson’s disease

Parkinson’s disease is a progressive, degenerative disease of the nervous system which primarily affects motor function. Its victims have uncontrollable tremors, rigid joints and slowed movements. It was previously considered highly unlikely that a Parkinson’s patient could maintain an exercise regimen.

Thanks to the development of neuro-modulating medications, many people now suffering from Parkinson’s disease remain active. Exercise directly impacts Parkinson’s disease through prevention and better outcomes for those suffering from Parkinson’s disease.

Researchers from Harvard University presented data at the annual meeting of the American Academy of Neurology. The studies showed that people who exercise moderately to vigorously for 30 minutes each day are less likely to develop Parkinson’s disease.

After being diagnosed with Parkinson’s disease, patients who exercise regularly have a higher level of physical function and quality of life. An exercise program should be customized for each patient. The structure of the program requires the input of physical and occupational therapists as well as the patient’s physicians.

The goals of any exercise regimen include:

• Increased cardiopulmonary stamina
• Greater joint range of motion
• Better muscle strength
• Preservation of walking ability
• Improved posture and balance

Since Parkinson’s disease primarily affects motor function, maintaining posture, balance, and coordination are crucial. Many Parkinson’s patients die from the effects of falls, including broken bones or pneumonia which results from immobility.

Dr. Anna Hohler is a movement disorder specialist who treats many Parkinson’s patients at Boston University Medical Center.

“Exercise is vital to optimization of care; medication alone is not enough,” Hohler said.

She obtains a formal gait assessment performed by an occupational therapist for all her patients. Her institution offers a yoga program specifically designed for patients with Parkinson’s disease. Tai chi is also very effective in improving balance and flexibility.

Parkinson’s is now among a growing number of diseases that can be improved with regular exercise both before and after diagnosis.