Airbag technology makes downhill skiiers safer

Downhill ski racers practice their craft by gliding down the side of a mountain at speeds in excess of 80 miles per hour. The slightest mistake at those speeds can end in tragedy. New technological innovations may avoid life-threatening injuries.

On Dec. 19, Olympic champion, Mathias Mayer, was the beneficiary of a technological breakthrough that has gradually become more accepted in the sport of ski racing. A protective vest that inflates in a similar way to an automobile airbag can now provide necessary protection in a potential crash.

The airbag system is one of two that are currently approved for competitive use. The protective vest will inflate when the struggling athlete reaches an angle and vector that can only result in a fall. These calculations are based on data input from the vest and appropriate algorithms.

The inflated vest softens the impact to the chest and supports the neck. Approximately 40 people die from ski and snowboard-related accidents each year. Many of these are brain injuries.

Helmet technology has evolved to the current level where a helmet is lightweight while providing maximum protection. Typically, these injuries occur at high velocity and involve skull fracture and hemorrhage within the brain.

Neck injuries that result from sudden extension of the cervical spine similar to whiplash in a high-speed automobile accident can cause fracture of the cervical spine and potential paralysis.

Another less common neck injury is the result of tearing of the vertebral arteries leading to the brain and causing a massive stroke. This is believed to be the injury that may have caused the death of freestyle skier Sarah Burke.

More common injuries to the lower extremities have been diminished thanks to improved ski boot design and quick release bindings.

As winter sports become more extreme, protective equipment design must also improve.

Dr. Alessi is a neurologist in Norwich and serves as an on-air contributor for ESPN. He is director of UConn NeuroSport and can be reached at agalessi@uchc.edu

More details emerging on concussions

Over the past week, two events have highlighted the growing concern among athletes, fans and parents about concussions in the NFL.

Case Keenum, quarterback for the St. Louis Rams, suffered a head injury when his head struck the ground after being tackled. He could only get up with the assistance of another player. He staggered and was assisted to the sideline. After what appeared to be a cursory examination, to the astonishment of fans and viewers, he was allowed to return to the game.

Despite the efforts of the NFL and the NFLPA to impart safeguards, these protocols were circumvented. After the initial symptoms clear, athletes will often do anything to return to the game and in some cases, to their own detriment, they are able to deceive the medical professionals involved.

Frank Gifford was an icon in the NFL. Not only was he an outstanding player, but he later went on to become an accomplished and highly respected football commentator. He played in an era where head injuries were an accepted part of the game.

After passing away earlier this year at the age of 84, Gifford’s family generously donated his brain for scientific study. This week it was revealed that his brain had changes consistent with Chronic Traumatic Encephalopathy (CTE).

CTE is a condition diagnosed on post-mortem examination where an abnormal deposition of tau protein is found in certain areas of the brain. It is typically found in athletes who participate in sports where head trauma is common. Clinical symptoms of slowed movements, dementia and behavioral abnormalities can be found in some of these patients.

 Unfortunately, some athletes who believe they may have CTE become desperate and resign themselves to their despair and in some cases commit suicide. Gifford obviously made a different choice and did not let his condition define him.

Both of these events emphasize how much work still needs to be done in the field of sports concussions.

Dr. Alessi is a neurologist in Norwich and serves as an on-air contributor for ESPN. He is director of UConn NeuroSport and can be reached at agalessi@uchc.edu.

Diabetes should not derail an athlete's goals

November is Diabetes Awareness Month. Many patient programs are centered on food and medication restrictions. New treatments and a better understanding of this condition have led to increased sports participation.

Approximately 29.1 million people in the United States (~9 per cent of the population) have been diagnosed with diabetes. This represents a rising health problem with significant impact on health care costs.

Diabetes is divided into three types:

• Type 1 or insulin-dependent diabetes is the result of an inability of the pancreas to produce a sufficient amount of insulin. Insulin is a hormone responsible for taking sugar from the bloodsteam and allowing it to enter a cell where it is used for energy.
• Type 2 or non-insulin dependent diabetes is typically due to a resistance of cells to respond to the insulin available.
• Prediabetes or Impaired Glucose Tolerance is a reversible condition where blood sugars are elevated but not to a sufficient level to define the person as diabetic.

The goal of diabetic treatment is to keep the blood sugar at a constant, acceptable level. Establishing this state of euglycemia is much more difficult in a diabetic.

Diet, exercise and medication are the basic approaches to treatment. Increased activity will burn more sugar and therefore lower the insulin demand.

The use of programmable insulin pumps has allowed many athletes to participate at the highest levels of competition. The pump can sense the blood sugar level and release an appropriate amount of insulin.

“I advise patients to just move,” states Dr. Nathan Lassman, Chief of Endocrinology at St. Francis Hospital and Medical Center. “Any activity that a patient enjoys and can perform regularly is a big plus in treating diabetes.” Diabetes should not be a disabling condition for aspiring athletes.

Dr. Alessi is a neurologist in Norwich and serves as an on-air contributor for ESPN. He is director of UConn NeuroSport and can be reached at agalessi@uchc.edu

Special Olympics has grown from humble beginnings


At the time of its inception in 1968, Special Olympics was a program designed to provide an athletic outlet for people in the United States who had intellectual disabilities.  It has grown to become one of the largest athletic organizations in the world with over 4.4 million athletes, 1 million coaches and 226 programs in 170 countries.

Special Olympics was started by Eunice Shriver Kennedy and her husband, Sargent Shriver, to address the lack of access to organized sports for people with intellectual disabilities.  Many of the original 1,000 participants suffered from Down’s Syndrome.

In the past, many of these people were isolated from society and often placed in institutions.  This restricted any meaningful physical activity and socialization with peers.

Participants must qualify by being certified by an agency or health professional as having intellectual disabilities, cognitive delays or significant learning or vocational problems.

Special Olympics has grown from summer sports to winter sports with a variety of team competitions.  World games are held every two years and vary between summer and winter venues. 

Unified sports teams consist of participants who have intellectual disabilities with those who do not.  This provides another step toward more inclusive sports participation. There are now half a million participants in unified sports worldwide.

It is clear that periodic training culminating in a single event is not sufficient for athletic fitness.  This has lead to establishing Unified Sports Fitness Clubs where fitness activities are measured and studied.

“The success of Special Olympics over the past 46 years is based on its ability to evolve with the changing needs of intellectually impaired athletes,” states Mr. Beau Doherty, president of Special Olympics Connecticut.

Special Olympics has become part of the fabric of worldwide sports by including athletes who were previously excluded.

Dr. Alessi is a neurologist in Norwich and serves as an on-air contributor for ESPN.  He is director of UConn NeuroSport and can be reached at agalessi@uchc.edu


Athletic activity avoids fractures


Physical activity in children has many benefits including cardiovascular conditioning, muscular development and socialization skills.  A recent study demonstrates fewer fractures in active children.

Bone development begins during the third month of fetal development but is not complete until adolescence.  Cartilage serves as the scaffolding necessary for the deposition of layers of minerals that will eventually form bones. This process is known as ossification.

The principal cells involved in the ossification process are osteoblasts.  These cells are responsible for laying the groundwork and creating ossification centers that will eventually expand and replace cartilage.  Long bones such as the femur and humerus require more time to fully mature.

The process of bone formation and remodeling doesn’t end in adolescence.  As patients get older, bones will remodel based on responses to pressure.  This same hydrostatic pressure stimulates new bone growth and repair of fractured bones.

Osteoporosis is a weakening of the bone structure as a result of demineralization of bone that often occurs with poor nutrition and age.

The study cited above looked at two groups of children.  The first group had 40 minutes of moderate physical activity daily as part of their school curriculum while the second group had only 60 minutes per week of activity.  After eight years of study, the first group showed less risk of fracture.

Additional studies on these children measured bone mass.  These reports showed greater bone mineral density in the active group and subsequently less chance of developing osteoporosis.

Approximately one-third of all children will experience a bone fracture before bone growth is complete.  Many school districts have cut back on time dedicated to physical activity during the school day for economic and academic reasons.

Increasing active playtime in elementary schools may have a huge impact on future health care costs.

Dr. Alessi is a neurologist in Norwich and serves as an on-air contributor for ESPN.  He is director of UConn NeuroSport and can be reached at agalessi@uchc.edu

Chocolate milk: The next great recovery drink

Sports nutrition is an industry that has experienced steady growth since Gatorade first came into use in the 1960s. Some teams have now rediscovered the benefits of chocolate milk as part of an athlete’s dietary regimen.

Most successful athletes and teams have specific nutritional plans formulated by dietitians, strength and conditioning coaches and a variety of other consultants. Typically there are pre-performance, performance and post-performance elements. The post-performance nourishment has become known as the recovery phase.

Each segment has a specific goal regarding replacement of fluids, electrolytes, fats, proteins and carbohydrates. Recovery supplements are specifically focused on rebuilding muscle. “The best options for a recovery snack are those that provide carbohydrates to replenish glycogen lost in muscles as well as protein and amino acids,” states Carrie Taylor, a registered dietitian from Big Y Foods.

“The recommended carbohydrate-to-protein ratio falls between 3:1 and 4:1. A glass of chocolate milk is ideal by providing a ratio of 3.5:1.”

More recently, several college and professional sports teams have begun to follow this trend by providing easy access to chillers that dispense chocolate milk. Locally, the Coast Guard Academy has also advocated for its athletes to use chocolate milk for recovery.

This trend has not been lost on dairy farmers. The Farmer’s Cow is a group of six family-owned dairy farms that have supported this movement by becoming involved in many athletic events throughout the region.

“The Farmer’s Cow Chocolate Milk combines 1 percent chocolate milk that is free of artificial hormones with calcium, vitamin D and protein,” according to Robin Chesmer its managing partner.

Chocolate milk can provide a less expensive and equally beneficial alternative to specialty bars and shakes.  

Dr. Alessi is a neurologist in Norwich and serves as an on-air contributor for ESPN. He is director of UConn NeuroSport and can be reached at agalessi@uchc.edu