tag:blogger.com,1999:blog-9913906578861192822023-11-15T09:17:22.449-05:00Healthy SportsUnknownnoreply@blogger.comBlogger295125tag:blogger.com,1999:blog-991390657886119282.post-74479644723716682072018-08-21T10:00:00.000-04:002018-08-24T23:29:46.036-04:00Despite new MLB rules, catching is still hazardousThe concept of a team is to bring individuals with specific skills together to perform as a successful unit. In baseball, the skills of a catcher are among the most varied and demanding.<br />
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Catchers also face significant injuries as a result of constant throwing, maintaining a crouched position behind home plate and physical contact with the baseball moving at high velocity, the bat being swung overhead and collisions with other players.<br />
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In addition to these injuries, the catcher is often seen as the person responsible for coordinating the activity of other players on the field.<br />
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In 2014, Major League Baseball passed a new rule requiring catchers to give runners a clear path to home plate and prohibit runners from veering from that path to collide with catchers. <br />
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This has resulted in a reduction of the number of collision injuries and specifically concussions that result from these collisions.<br />
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Interestingly, the greatest number of concussions continues to be contact between the catcher and foul-tipped baseballs and contact with the bat. <br />
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Those concussions also have required longer recovery time than collision-related concussions, according to a study published in the American Journal of Sports Medicine. <br />
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That study also found that the greatest number of days spent on the disabled list by catchers was related to injuries to the lower extremities and arms. <br />
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Arm injuries are the result of throwing hundreds of sub-maximal effort throws to the pitcher on a daily basis and maximum-effort throws to second base.<br />
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“Catchers can be susceptible to knee injuries, specifically patellofemoral pain due to their constant squatting position with their knees flexed,” reports Dr. Katherine Coyner, Assistant Professor of Orthopaedic Surgery at the University of Connecticut. <br />
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“This can cause softening of the cartilage. It is important to stretch and work on flexibility and strength specifically of the quadriceps and hips to avoid patellofemoral pain.“
Better protective equipment and training techniques for catchers will hopefully reduce injuries.<br />
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<i>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</i> <b>agalessi@uchc.edu
</b>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-991390657886119282.post-37666309843554651542018-08-07T10:00:00.000-04:002018-08-13T15:54:23.260-04:00Regular exercise can extend cognitive life expectancyThe life expectancy of Americans has grown dramatically over the past 50 years thanks to major advances in medical science. Unfortunately, advancing age has brought with it an increase in age-related conditions including visual loss, arthritis, vascular disease and kidney disease.<br />
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Neurodegenerative conditions including Alzheimer’s disease and other related dementias have presented some of the greatest challenges to enjoying these advancing years.<br />
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Approximately 5.7 million Americans suffer from Alzheimer’s disease. It is a disease that robs its victims of their most intimate memories and the ability to learn new information. These numbers will grow as the population ages and this has lead to the application of a new measure termed “cognitive life expectancy.“<br />
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Cognitive life expectancy is best defined as the length of time adults can live with good versus declining brain health. A recent study presented at a national meeting estimates that Americans have an average of 12 years of good cognitive health beyond age 65.<br />
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A series of recent articles published in the journal Neurology and its related publications have looked at proven ways to increase cognitive life expectancy through exercise.<br />
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In general, fitness activities were considered to be aerobic, resistance and a combination of aerobic and resistance. Mind-body exercises including yoga and tai chi were considered as a separate mode.<br />
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In one comprehensive review of the literature on this topic, a combination of one hour per day, three times per week of any of these modalities resulted in improved cognitive testing.<br />
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A study of Swedish women over a period of 44 years found that women with a high level of cardiovascular fitness during midlife had an 88 percent decrease in dementia compared to a medium fitness group.<br />
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Participation in a regular exercise program can be a big factor in extending the cognitive lifespan. Although this can be helpful at any age, following an exercise regimen beginning in early life has the most benefit.<br />
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<i>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</i> <b>agalessi@uchc.edu</b>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-991390657886119282.post-71716548573775852352018-07-24T10:00:00.000-04:002018-07-26T01:09:33.441-04:00Overuse injuries in youth sports have become commonYouth sports have evolved over recent decades. Among the most obvious changes are the higher levels of competition. It is not uncommon for an athlete to compete for several different teams during the same season. This uncontrolled exposure to injury often results in overuse orthopedic injuries in children.<br />
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Overuse injuries are the result of chronic repetitive trauma to a joint. As opposed to an acute injury, the symptoms are subtle and gradually worsen, making diagnosis of these injuries more challenging.<br />
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Typically, these injuries affect the bones, muscles and tendons in a joint. They include sprains, strains and stress fractures. Treatment includes rest, ice and anti-inflammatory medications.<br />
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A recent study presented at the American Orthopedic Society for Sports Medicine looked at 149 Japanese pitchers ages 7-11. None of the athletes entered in the study had elbow pain at the beginning of the season. Those who threw more than 50 pitches a day and 200 pitches per week while playing in more than 70 games per year were more likely to develop elbow pain.<br />
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Some American little leagues do not allow an athlete to throw more than 50 pitches per game. Another solution to overuse is to play multiple sports that use different skills and biomechanics.<br />
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“Pain is the principal sign that it’s time to take a break,” reports Dr. Ashok Kotaratharra, a local pediatrician at UCFS. “Trying to hang in despite discomfort may lead to permanent injury.”<br />
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Parents should carefully monitor workout schedules and be sure that young athletes receive proper coaching to avoid overuse injuries that can shorten a potentially stellar sports career.<br />
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<i>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 </i><b>agalessi@uchc.edu</b>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-991390657886119282.post-46511433599071679502018-07-10T10:00:00.000-04:002018-07-13T15:42:18.677-04:00Be careful when exercising in the hot weather this summerAthletes accustomed to performing their regular outdoor training regimens often continue despite drastic changes in climate. During summer months, this persistence can result in severe injury.<br />
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The human body strives to maintain an ideal body temperature of 98.6 degrees Fahrenheit. This requires the interaction of temperature receptors in the skin that relay information to the brain.<br />
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The hypothalamus is the area of the brain that interprets this information and, in the case of elevated temperatures, signals muscles and sweat glands to begin a cooling process. Any malfunction in the process, or subjecting the body to overwhelming temperatures, can result in heat-related illness.<br />
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Heat stroke is the most severe of the heat-related illnesses. It typically occurs when the body temperature rises in excess of 103 degrees.<br />
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The body responds by increasing the heart rate to pump more blood to the skin, where it can become cooled. It also pumps more blood to muscles to keep up with metabolic demand.<br />
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In an effort to lower the core temperature, blood is diverted from the brain and other essential organs. Symptoms include a racing heart rate, lightheadedness, muscle cramps, headache and confusion. If ignored, these symptoms can lead to a loss of consciousness.<br />
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“Here are three tips for exercising in hot weather,” reports Dr. Douglas Casa, Professor of Kinesiology at the University of Connecticut. “1) Take it easy — you can not push as hard as you can in cool conditions, so back off a little; 2) If you ever start to feel something is amiss, listen to your body and lower your intensity and seek cooler conditions; 3) have cold fluids and cooling towels at the ready for you or your children when exercising in the heat.“<br />
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Caution when exercising in extreme heat can avoid serious injury.<br />
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<i>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 </i><b>agalessi@uchc.edu</b>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-991390657886119282.post-12124564951815821752018-06-26T10:00:00.000-04:002018-07-03T09:31:07.907-04:00Heart failure amongst athletes always leads to questionsThe recent tragic death of Hall of Fame basketball player and coach Anne Donovan has attracted the attention of many Connecticut Sun fans. What is most bewildering to many is how a highly-trained 56-year-old athlete passes away from heart failure.<br />
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The human heart consists of four muscular chambers: the right and left atria and the right and left ventricles. These chambers work in a coordinated fashion to pump blood from the right chambers to the lungs where it becomes enriched with oxygen and from the left chambers where blood is pumped to the brain and other organs.<br />
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Maintaining this coordination requires rhythmic stimulation from a network of nerves within the heart and blood vessels that nourish the heart muscle. Any malfunction of these components will lead to heart failure and subsequently deprive essential organs of needed oxygen.<br />
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The most common cause of heart failure in athletes is cardiomyopathy. This results from abnormalities that directly affect the heart muscle.<br />
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Similar to other muscles, the heart increases in size and efficiency as a response to the increasing demand of large muscles in athletes. This physiologic change in the heart muscle can hide other cardiac problems that affect the rhythm and blood supply to the heart muscle.<br />
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One way of detecting these changes in anticipation of a catastrophe is to perform advanced diagnostic studies including echocardiography that images the heart at rest and under stress. <br />
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“Structural changes of the heart in athletes such as enlarged chamber size and increased wall thickness are adaptive and physiological. However, some of these changes may overlap with cardiomyopathy,” reports Dr. Kai Chen, co-director of Sports Cardiology at the Calhoun Cardiac Center at UConn. “Early symptoms include an unexpected drop in performance, shortness of breath during exercise, chest tightness, and lightheadedness.“<br />
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Careful attention to cardiac symptoms during workouts can be lifesaving for athletes.<br />
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<i>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 </i><b>agalessi@uchc.edu</b>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-991390657886119282.post-1060465513064740592018-06-12T10:00:00.000-04:002018-06-13T14:16:16.659-04:00Beware of ticks at outdoor eventsAthletes who compete in outdoor events in Connecticut must be especially mindful of ticks that carry a variety of bacterial infections. Although unlike viral infections, these conditions can be treated with antibiotics. The key is to identify and treat them quickly to avoid permanent injury.<br />
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Ticks are insects that survive by biting and digesting the blood of domestic and wild animals. They also bite humans and in turn transmit diseases from the animal to the human. As the population of potentially diseased animals has increased, so has the frequency of these illnesses.<br />
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Lyme disease is the most familiar and most common tick-borne bacterial infection. There are approximately 300,000 cases each year, most of these in the northeast.<br />
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Borrelia is the infectious agent in Lyme disease. Early symptoms are flu-like with joint pain, fever and a typical rash. If untreated the infection can spread to the nervous system. If infection is suspected, treatment with antibiotics within 72 hours of the tick bite can avoid Lyme disease entirely.<br />
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“Babesiosis and Anaplasmosis are other tick-borne diseases now being recognized more often,” reports Dr. Michael Rajkumar, a local infectious disease specialist. “These infections can cause severe illness and are sometimes fatal in certain populations such as infants, patients with immunodeficiencies and patients with certain blood disorders.“<br />
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Symptoms of Babesiosis are similar to Lyme disease but a persistent high fever and chills are an early hallmark. Treatment includes antibiotics combined with anti-malarial drugs.<br />
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Anaplasmosis, previously known as Ehrlichiosis, presents with symptoms one to two weeks after infection with a flu-like illness that can also lead to headaches and confusion if untreated.<br />
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Careful self-examination after competing or working out in tick-infested areas can be lifesaving.<br />
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<i>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 </i><b>agalessi@uchc.edu</b>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-991390657886119282.post-3977433239802489662018-05-29T10:00:00.000-04:002018-05-30T13:47:01.120-04:00Summer fun can be ruined by insect bitesThe arrival of summer brings longer days, warmer temperatures and increased opportunity for outdoor activities. It also brings the opportunity for infections transmitted via insect bites. Among these infections are the arboviruses.<br />
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Arbovirus is a general term used to describe a variety of viral infections transmitted by infected arthropods. Among these are mosquitoes and ticks. The symptoms vary between the extremes of mild joint pain to life threatening brain infections.<br />
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Although Lyme disease presents with similar symptoms to arboviruses, it is the result of a bacterial infection that can be treated with antibiotics.<br />
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The frequency of encountering these viruses varies on geography. The most common arboviruses in the northeast include West Nile Virus, Eastern Equine Encephalitis and Powassan Virus Disease. <br />
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Initial symptoms of each of these infections include fever, rash, headache and joint pain. Fortunately, in most cases, these symptoms are self-limited. Treatment is primarily symptomatic with hydration, rest and anti-inflammatory medications.<br />
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More serious symptoms occur when the infection attacks the central nervous system resulting in encephalitis. These symptoms include persistent headache, confusion, seizures and loss of consciousness. Unfortunately, there is no specific treatment for viral encephalitis.<br />
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Golfers, hikers, trail runners and mountain bikers are most susceptible to infection based on their level of exposure. The best way to avoid infection is by wearing long-sleeved, light-colored clothing with pant legs tucked into socks. Frequently applying insect repellant with DEET to exposed surfaces is recommended.<br />
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As in most viral infections, elderly and very young patients are at highest risk. <br />
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“Insect repellant should never be applied to newborns and young children should not use products with more than 30 percent DEET,” reports Dr. Ashok Kottarathara, a local pediatrician in practice at United Community and Family Services. “Wristbands, smartphone apps and sonic repellents do not work against mosquitoes. Removal of all stagnant or standing water is another extremely effective way of preventing breeding of mosquitoes”.<br />
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Avoiding exposure to insect bites can be crucial to a more pleasant and safe summer.<br />
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<i>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 </i><b>agalessi@uchc.edu</b>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-991390657886119282.post-47876365462457363252018-05-15T10:00:00.000-04:002018-05-21T13:35:11.796-04:00Carpal tunnel injury is rare for pitchersLast week, Boston Red Sox starting pitcher David Price was forced to miss at least one start due to symptoms of numbness in his dominant left hand. He was eventually diagnosed with carpal tunnel syndrome (CTS), a condition not commonly associated with major league pitchers. Subsequently, a controversy has ensued based on speculation that the condition is actually related to Price’s avid participation in computer games.<br />
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The carpal tunnel is a structure in the wrist formed by several bones at the base known as the carpal bones with a ligamentous roof called the flexor retinaculum. Within the tunnel a large nerve, known as the median nerve, brings sensation and movement to a discrete portion of the hand.<br />
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Narrowing of the carpal tunnel may be the result of direct trauma that produces acute swelling, arthritic changes in the carpal bones and enlargement of the flexor retinaculum due to repetitive use. <br />
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The presenting symptoms of CTS are usually neurological in nature as a result of compression of the median nerve. Typical complaints include changes in sensation in the thumb, index and middle digits of the affected hand. These include a tingling sensation that comes on during the night or when first awakening. Early symptoms oddly improve with movement such as shaking the hand. Later symptoms include weakness with fine movements involving the thumb and index finger.<br />
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The diagnosis is made by clinical examination and electrodiagnostic studies that can specifically isolate the area of injury to the median nerve and quantify the severity of the damage.<br />
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“Carpal tunnel syndrome is a very uncommon injury in baseball pitchers,” reports Dr. Joel Ferreira, an orthopedic hand surgeon at the UConn Musculoskeletal Institute. “It’s typically caused by constant repetitive use of the hands from lifting/typing or vibratory tool use as well as sewing and crocheting. In my practice, I rarely see patients develop CTS from video games.“<br />
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Conservative management includes the use of nocturnal wrist splints and steroid injections. Surgical decompression is reserved for more severe damage to the median nerve.
Although the cause of Price’s CTS may be debated, the treatment options are clear.<br />
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<i>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</i> <b>agalessi@uchc.edu</b>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-991390657886119282.post-59310848166263123442018-05-01T10:00:00.000-04:002018-05-02T10:20:26.127-04:00Athletic genes are just one factor for successConnor Svab, a local baseball standout at St. Bernard’s, is in many ways a baseball paradox. In addition to playing infield and pitching, he also plays varsity basketball. At 5-10, 140 pounds, he does not seem to possess the physical prowess valued by many professional teams.<br />
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Nevertheless, Svab has gotten the attention of scouts and will be heading to Castleton University to further his baseball career. Interestingly, both his father and great grandfather played professional baseball.<br />
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Scientists in the field of evolution have constantly raised the question of nature versus nurture. The arguments in favor of both approaches to development are most prominent in the field of sports.
Are some athletes destined to reach great heights from birth or is greatness the product of hard work and opportunity?<br />
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Genes are the foundation of heredity. They contain the recipe for the production of proteins that make up the human body. Each person has two of each gene, one contributed by each parent. Those contributions produce our physical characteristics.<br />
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Brain growth also plays a prominent role in how a human develops. Specifically, the brain consists of a variety of networks that pass information to different areas within the brain. A brain cell is made up of a cell body and an elongated axon. The axon gradually becomes encased in an insulating material called myelin. Signals are transmitted along the myelin. Brain development is a dynamic process that spans through childhood and adolescence.<br />
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The maturation process includes making the brain operate more efficiently. It does this through a process of neuroplasticity. The brain eliminates some networks while making other regions of the brain operate faster and more precise. This can involve motor as well as sensory functions and result in rapid decision-making and reaction to a particular situation. This obviously can be a huge advantage in sports. It is believed that environment plays a big role in this phase of development.
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Lengthy discussions and analysis that center on baseball may have played a big role in the baseball development of Connor Svab.<br />
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<i>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</i> <b>agalessi@uchc.edu</b>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-991390657886119282.post-79045053913602596112018-04-17T10:00:00.000-04:002018-04-18T00:49:24.276-04:00Concussions now a big part of retirement decisionsWrestling fans are excited about the recent return of Daniel Bryan to the ring. Bryan, a star performer, was forced to retire two years ago due to multiple concussions. His return after multiple, comprehensive neurological evaluations has raised many questions regarding the criteria for medical retirement from sports after concussion.<br />
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Concussion is best defined as a group of neurologic symptoms that arise after a force is applied to the brain. Recovery from these symptoms can vary but the general accepted time frame is 10 days. This is often longer in children. The persistence of these symptoms is associated with post-concussion syndrome.<br />
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Repeated blows to the brain can result in permanent impairment with persistent headaches, cognitive difficulties, sleep abnormalities, emotional disturbances and other neurologic symptoms.<br />
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The often-asked question is: "How many blows can the brain tolerate before resulting in permanent damage?"<br />
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The human brain is a highly individualized organ. It consists of a mass of nerve cells that each has a threshold for injury. The challenge for physicians is to determine that threshold based on the symptoms suffered and the length of the recovery period.<br />
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There are some basic rules that indicate the need to retire from participation in high-velocity collision or combat sports. These include:<br />
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1. Persistent abnormalities on cognitive and psychological testing that can be linked to concussion<br />
2. Structural abnormalities found in the brain that may be related to trauma or predispose the athlete to permanent injury<br />
3. A demonstrated decreased threshold for injury over multiple, successive concussions<br />
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Another recent change in the presentation of sports-related concussion has been the desire to voluntarily withdraw from high-risk sports. Athletes, even at the highest levels of sport, are choosing that the risks outweigh the benefits.<br />
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In the case of Bryan or any other athlete, it is worth the time investment to seek out a highly qualified physician who works with athletes.<br />
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<i>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</i> <b>agalessi@uchc.edu</b>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-991390657886119282.post-46529580846453248152018-04-03T10:00:00.000-04:002018-04-06T10:58:23.752-04:00NFLPA draws up a playbook for player safetyA playbook is a collection of strategies that allows a team to deceive their opponent at crucial times during the course of a contest. Football players are aware of the importance of their playbook and the secrecy that surrounds its contents. The National Football League Players Association (NFLPA) has taken the playbook concept and applied it to improving the health of all its members and their families.<br />
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The recently released NFLPA Health Playbook is a compendium of easy-to-understand health information that addresses common illnesses facing both active and former players. It was designed and written by members of the NFLPA Mackey-White Health and Safety Committee. It is divided into four broad sections:<br />
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1. Performance<br />
2. Medical diseases and conditions<br />
3. Orthopedics and musculoskeletal conditions<br />
4. Neurology and neurotrauma<br />
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Specific topics were chosen based on information obtained through research conducted as part of the Football Player Health Study at Harvard University.<br />
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The performance section discusses the evaluation and treatment of sleep disorders, as well as a variety of mental health disorders. Among the medical conditions, diabetes mellitus and the potential complications from it are explained along with a variety of treatments. This section also addresses hypertension, hypercholesterolemia and peripheral neuropathy. The chapters covering neurologic conditions and concussions are highly informative.<br />
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“The NFLPA is committed to ensuring that our player members receive the best medical care in the world,” reports Sean Sansiveri, NFLPA vice president of business and legal affairs. “This playbook serves as our latest effort to equip players and their families with the knowledge and resources necessary to achieve overall wellness for their betterment as people and patients.”<br />
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Although the NFLPA Health Playbook provides a concise, thorough review of health topics designed to support active and former football players, it is actually an excellent guide for all athletes and the general public.<br />
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Like other playbooks, the health playbook will be continually updated as new medical issues and treatments develop. The full publication is available online as a courtesy of the NFLPA, and can be found by searching “NFLPA Health Playbook.”<br />
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<i>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</i> <b>agalessi@uchc.edu.</b>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-991390657886119282.post-381848193714271762018-03-20T10:00:00.000-04:002018-03-22T14:36:17.715-04:00Cavaliers’ Love shines light on panic attacksIn a recent article published online in “The Players’ Tribune,” Kevin Love of the Cleveland Cavaliers, discussed his ongoing battle with panic attacks. Although the condition is not rare, anytime a professional athlete admits to a mental health condition it becomes noteworthy.<br />
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A panic attack is an episode of intense fear when no apparent danger is present. The person feels a sense of impending doom and loss of control. This triggers a reaction with symptoms that can include: a rapid, pounding heart rate, sweating, trembling, difficulty breathing, nausea, chest pain and numbness. There is often a feeling of unreality or detachment.<br />
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This cascade of symptoms is also known as the “fight or flight response.” This is a primitive response designed to protect a person when threatened by an attacker. This complex reaction begins in the brain where the amygdala and hypothalamus respond involuntarily to a situation. This occurs without conscious input of judgment provided by the frontal lobes.<br />
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These structures in the brain then send signals to the adrenal glands to secrete adrenaline that in turn causes the physiologic response described.<br />
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Successful athletes are able to trigger this response to their advantage and as a result can improve performance. In the case of Love, his false perception of danger has caused episodes where he temporarily cannot function at a high level.<br />
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“Current treatments include medications and behavioral interventions designed to identify and reduce the symptoms. One of the best treatments, in the short term, is an anti-anxiety medication,” reports Dr. Caleb Peck, a Norwich neuropsychologist and Director of Clarus Health Alliance. “The best treatment outcome comes from pairing medication with individual psychotherapy.”<br />
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Love’s admission of a mental health condition, coupled with his level of fame, will hopefully lead to other athletes seeking care.<br />
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<i>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 </i><b>agalessi@uchc.edu</b><br />
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-991390657886119282.post-6676930073463265952018-03-06T10:00:00.000-05:002018-03-08T00:27:24.992-05:00Studies reveal risks for spinal injuriesAmong the most terrifying injuries in sports is when an athlete becomes paralyzed after a collision or fall. If the impact is focused on the cervical spine, the result is a temporary or permanent paralysis of all extremities. This pattern of paralysis is referred to as quadriplegia. Identifying athletes who may be susceptible to this type of injury can be lifesaving.<br />
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The cervical spine consists of seven bony vertebrae that surround and protect the spinal cord.<br />
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Cartilaginous discs that cushion and protect the bones from friction and impact separate the vertebrae. The individual vertebral segments are connected by a series of ligaments giving this portion of the spine flexibility to allow a certain degree of bending and twisting.<br />
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The cervical spinal cord is located in a central canal. The spinal cord at this level contains a network of motor and sensory nerve fibers that carry signals to and from the brain. The higher levels also coordinate essential functions such as respiration, temperature and cardiac function.<br />
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The most common injury is known as neurapraxia of the cervical spinal cord. This is best described as transient numbness, tingling and/or weakness of the extremities after cervical cord injury. It typically occurs with hyperextension, flexion or axial loading of the spine. Episodes last anywhere from 15 minutes to 36 hours. Axial loading injuries are common in football when tackling with the head down. <br />
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Subsequent radiologic studies often reveal congenital narrowing of the cervical canal causing these athletes to be vulnerable to this type of injury.<br />
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“Initial treatment for congenital cervical stenosis is often observation,” reports Dr. Isaac Moss, Associate Professor of Orthopaedic Surgery and Neurosurgery at the University of Connecticut. “However, if patients become symptomatic, surgical treatment is an option. This is often in the form of a procedure called laminoplasty, which involves increasing the space available for the spinal cord within the spinal canal.”<br />
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A thorough neurologic evaluation for episodes of weakness and numbness in athletes can avoid catastrophe. <br />
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<i>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</i> <b></b>agalessi@uchc.edu<br />
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<br />Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-991390657886119282.post-47578163352217351742018-02-20T10:00:00.000-05:002018-02-22T22:58:44.202-05:00New concussion blood test shows promiseA concussion is brain trauma brought on by a biomechanical force. It consists of a group of neurological symptoms that impair the patient for a variable amount of time. The symptoms are often not immediately obvious to the patient or an observer, making the diagnosis of a concussion challenging.<br />
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The recent announcement of an FDA-approved blood test that can help resolve this diagnostic dilemma has been met with great interest both by the public and the scientific community.<br />
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A biomarker is a measurable substance in an organism that may indicate the presence of a disease, infection or environmental exposure. The Banyan Brain Trauma Indicator is based on identifying proteins that are released from the brain into the bloodstream after impact.<br />
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The specific proteins detected by this test (UCH-L1 and GFAP) can be identified up to 12 hours after injury. The blood sample takes approximately three hours to process. The principal studies were conducted by the Department of Defense in soldiers who experienced brain trauma.<br />
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Brain trauma has become a significant health problem in the United States. There were approximately 2.8 million visits to the emergency room in 2013. Currently, there are approximately 3.8 million sports-related concussions each year in the United States. This discrepancy is based on the fact that brain trauma is a range of injury that includes brain trauma from severe motor vehicle accidents and penetrating trauma from blasts and gunshots. Concussion is the mildest type of brain trauma on this range and often does not require brain imaging such as CT scanning.<br />
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Currently this new blood test has very limited application in sports, where decisions need to be made quickly and away from a laboratory. It is also not useful in identifying sub-concussive blows to the brain that result in cumulative injury. It is not approved for use in children at this time.<br />
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This blood test will be helpful in an emergency room setting after serious brain injury.<br />
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Despite its limitations, the Banyan biomarker is a significant advance in the diagnosis of brain trauma and will hopefully lead to better testing.<br />
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<i>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</i> <b>agalessi@uchc.edu</b><br />
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-991390657886119282.post-53307228046303212382018-02-06T10:00:00.000-05:002018-02-07T23:55:07.099-05:00The danger of sexual predators in sportsThe recent conviction and sentencing of Larry Nassar should be a reminder to all that vigilance is necessary to protect children from predators. <br />
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More importantly, Nassar violated an established trust between a patient and physician. This and other recent episodes of abuse have also shattered the faith placed in organizations and universities entrusted to protect young athletes.<br />
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Sexual predators often methodically build relationships with victims over a period of years. The underlying premise in many abusive situations is the exertion of power over a victim. Early recognition of typical behaviors can avoid a potential crisis.<br />
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Grooming is one technique used by predators. It is a process by which an offender draws a victim into a sexual relationship and maintains that relationship in secrecy. Typical targets are young, unsuspecting athletes who have low self-esteem and little parental oversight. Athletes with intellectual impairments can be particularly vulnerable.<br />
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Establishing a bond with the athlete and parents allows a sexual predator a lot of opportunity. <br />
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Private coaching or physical treatments specific for that athlete can be warning signs.<br />
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Isolation is also a crucial element in an abusive relationship. Participation on travel teams and competitions that require overnight accommodations can present occasions for abuse.<br />
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Excessive physical contact that appears inappropriate can also be a sign of abuse. If physical contact is necessary in the course of a medical examination, a parent or other adult should be present. The practitioner should welcome inquiries regarding the nature of the examination. Unfortunately, many young athletes actually report incidents of abuse but are not taken seriously.<br />
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There are many dedicated coaches, medical personnel and parents involved in youth sports. Vigilance on the part of all adults involved in youth sports is crucial to stopping what has become a disheartening trend.<br />
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<i>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</i> <b>agalessi@uchc.edu.</b><br />
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-991390657886119282.post-69716852592155260862018-01-23T10:00:00.000-05:002018-01-25T08:55:36.309-05:00Diet, exercise prove helpful in treating MSMultiple sclerosis (MS) affects at least 400,000 Americans and two million people worldwide. It is a chronic inflammatory disorder that targets the brain and spinal cord. Specifically, the immune system attacks the insulation around nerves as if attacking a foreign object.<br />
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MS often presents with symptoms of visual loss in one eye, weakness, numbness, double vision or difficulty walking. The course of the illness is typically marked by periods of deterioration lasting days or weeks followed by remission.<br />
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Approximately 15 percent of patients have a progressive unremitting course of illness.<br />
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Although there is no cure for MS, there has been tremendous progress in the development and use of disease-modifying medications that increase the length of the symptom-free periods. The goal of treatment is to redirect the immune system.<br />
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In addition to medications, several other modalities in the form of diet and exercise have been proven to be helpful in treating MS.<br />
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MS is most commonly found in temperate climates where exposure to sunlight is reduced. Vitamin D supplements have been shown to be helpful in treatment.<br />
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Diets rich in whole grains, fruits and vegetables with reduced intake of processed sugars and red meat is optimal.<br />
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Interestingly, regular physical exercise has also demonstrated a beneficial effect in maintaining patients’ neurologic function. Moderate aerobic exercise combined with light resistance exercise has proven to be an effective regimen. Overheating the body from vigorous exercise or use of a hot tub can be detrimental.<br />
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“A structured exercise regimen that allows for gradually increased intensity under the guidance of a physical therapist and a physician can provide a benefit for patients with MS and other neurologic diseases,” reports Dr. Vernon Williams, Director of Sports Neurology at the Kerman-Jobe Clinic.<br />
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MS patients should consider multiple treatment modalities.<br />
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<i>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</i> <b>agalessi@uchc.edu
</b>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-991390657886119282.post-8620974257299191162018-01-09T10:00:00.000-05:002018-01-10T09:05:24.031-05:00Go slow with new exercise routineAmong the most popular New Year resolutions is weight loss. Beginning or resuming an exercise program after a long lay-off can result in significant injury that will impact a weight-loss program.<br />
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Exercise is an intricate part in regulating how much a human eats, drinks and sleeps. It dates back to hunting and gathering activities. In addition to these essential functions, exercise is key to cardiovascular, neurologic and mental health. Recent studies have also indicated that exercise has a protective effect against certain forms of cancer and dementia. <br />
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One pressing question remains: “How much exercise is needed to acquire the potential health benefits?” The best current data indicates that even light exercise can provide a big advantage.<br />
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Recent studies indicate that consistent daily activities including dog walking, housework, opting for stairs instead of an elevator or even performing home chores can result in improved overall longevity. The greatest benefit comes from 30 minutes of moderate to vigorous activity. This level of activity can reduce the risk of death by 50 percent.<br />
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One of the first steps toward a healthy activity program is to incorporate more standing and less sitting. The human body was not designed to withstand the stresses of prolonged sitting. Modifying a workstation to allow for periods of standing can produce a positive result.<br />
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An enthusiastic return to the gym should be tempered by the potential for injury. Light aerobic exercise in the form of walking on a treadmill, riding a stationary bike at low resistance or using an elliptical machine at no incline can be a good introduction. <br />
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Measuring steps with the use of a variety of technologic devices can provide a big boost to a walking program. A goal of 10,000 steps per day is ideal but any steps are a move in the right direction.<br />
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The operative message to beginning a safe exercise regimen is to get the approval of a physician and start slow. <br />
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<i>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</i><b> agalessi@uchc.edu</b><br />
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-991390657886119282.post-40151039942293602692017-12-26T10:00:00.000-05:002018-01-04T20:35:54.779-05:00Golfer’s severe disability gives hope for othersMuscular dystrophy is a progressive disorder that results in severe disability and in some forms, death. The fact that it targets muscle and causes wasting and weakness makes the announcement this month that a competitive PGA Tour golfer has been suffering from a form of muscular dystrophy for more than a year amazing.<br />
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Morgan Hoffman is a 28-year-old professional golfer who in November, 2016, was diagnosed with Fascioscaphohumeral Muscular Dystrophy (FSHD). He recounts his odyssey in a first person account in The Players’ Tribune beginning with his earliest symptom of wasting of his right pectoral (chest) muscle in 2011.<br />
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Muscular dystrophy was first described in the mid-1800s as a progressive wasting of muscles seen in male members of the same family. This eventually became known as Duchenne Muscular Dystrophy, the most well-known and deadly of this category of diseases.<br />
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FSHD is a variation of muscular dystrophy that targets the face, arms and chest muscles. It does not affect respiratory or cardiac muscles, thus it does not limit a person’s longevity. It does result in profound weakness, making a continued successful career in professional sports remarkable.<br />
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Physical therapy should be aimed towards optimizing function of unaffected muscles. Overworking involved muscles will not improve strength but will lead to painful muscle cramps. Non-steroidal anti-inflammatory drugs can be used if pain is a factor. <br />
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“Isolation of the gene involved in some forms of FSHD on chromosome 4 has lead to exciting research and hopefully a genetic treatment for FSHD,” reports Catherine Alessi, MD, a neuromuscular fellow at the University of Connecticut.<br />
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Golf requires core strength and careful coordination of upper and lower extremity muscles making Hoffman’s success noteworthy and encouraging for others.<br />
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<i>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</i> <b>agalessi@uchc.edu</b><br />
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-991390657886119282.post-50588880082779376712017-12-12T10:00:00.000-05:002017-12-18T09:05:39.606-05:00Steelers’ Shazier suffered a spinal concussionLast week, Pittsburgh Steelers’ linebacker, Ryan Shazier, attempted to tackle an opposing player with his head down. This position transmitted sudden pressure from the brain to the spinal canal and resulted in paralysis. This type of non-penetrating spinal trauma is also known as a spinal concussion.<br />
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A concussion is a syndrome of immediate and transient neurologic impairment that results from a biomechanics force being applied to the nervous system.<br />
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Although the term has become synonymous with a brain injury, it can also be applied to the spinal cord.<br />
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The spinal cord contains an extensive network of nerve tracts that provide sensory and motor function to the extremities. It is divided into the cervical, thoracic, lumbar and sacral levels. The uppermost cervical level contains fibers extending to both the upper and lower extremities.<br />
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Like brain concussion, spinal concussion is the mildest form of trauma when considering a range that extends to penetrating trauma as the most severe form. Mild injuries typically do not produce any changes on CT scans or other imaging studies.<br />
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The pathology involved in this type of trauma is typically severe inflammation and swelling. There is a response to cellular injury where electrolytes that typically reside outside the cell rush inward through a breech in the nerve cell membrane causing swelling within the cell and eventual cell death.
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Typical symptoms are immediate sensory loss and paralysis of the affected limbs. Careful positioning and stabilization of the spine are critical on the field, followed by ambulance transport to a hospital. Hospital care includes imaging with CT or MRI and may include treatment with steroids to reduce swelling.<br />
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Fortunately, most spinal concussions, like brain concussions, can fully resolve with little to no permanent damage. Hopefully, this is also the case for Shazier.<br />
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Editor’s note: The Steelers placed Shazier on injured reserve on Tuesday. The 25-year-old Shazier underwent spinal stabilization surgery last week and remains in the hospital.<br />
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<i>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 </i><b>agalessi@uchc.edu</b>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-991390657886119282.post-29580300578766998472017-11-28T10:00:00.000-05:002017-11-29T08:47:11.720-05:00Wrist, hand injuries a concern in youth sportsYouth sports injuries have become a topic of concern for physicians, coaches and athletes. The biggest fear centers on how these injuries will affect a child’s growth and intellectual abilities.
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Among the injuries that have raised the most interest is concussion. But a recent study published this month in the medical journal for Pediatrics reports that the rates of injuries to the wrist and hand are unusually high.<br />
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Sports such as football, ice and field hockey, lacrosse, softball and wrestling were most represented in frequency of injury. Overall, any stick, puck, ball or contact sport can have a high rate of injury.
The human wrist is a complex joint that consists of 15 bones that form connections enabling the wrist to move in multiple planes.<br />
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The carpal bones in the hand attach to the two bones of the forearm: the ulna and radius.<br />
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These bones are connected to each other as well as various muscles by an intricate network of tendons and ligaments. Blood vessels and nerves are intertwined in this grid to provide circulation and sensation.<br />
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The most common injuries cited in the study include fracture, contusion, and ligament sprain in descending order of frequency. While most of the injured athletes were able to return to their sports in seven days or less, 12.4 per cent were out for more than three weeks.<br />
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Initial treatment often includes rest, ice and immobilization but some fractures may require surgery.
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“Persistent pain and swelling after a wrist or hand injury in a child requires further evaluation by a physician,” reports Dr. Joel Ferreira, an Assistant Professor of Orthopaedics at the University of Connecticut, where he specializes in hand and wrist injuries. “Imaging studies may be necessary to rule out fractures affecting the growth plate that may result in a chronic condition.”<br />
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Prompt evaluation and treatment of hand and wrist injuries in young athletes can help speed recovery.
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<i>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</i> <b>agalessi@uchc.edu</b>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-991390657886119282.post-43232667090732208172017-11-14T10:00:00.000-05:002017-11-20T17:09:01.489-05:00Improper use of smelling salts a growing concernAthletes are always looking for an edge that will improve performance. <br />
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Often these efforts are ill-advised and at times harmful. One practice that has become popular among high-level athletes is the use of smelling salts to increase alertness.<br />
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Smelling salts consist of spirits of ammonia. The use of smelling salts dates back to the Roman Empire but they became popular during the Victorian era. They were used to help revive women who were fainting.<br />
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Syncope or fainting is a loss of consciousness as a result of a slowed heart rate triggered by a vagal reflex. This reflex is often initiated by dehydration, anxiety or pain. Ammonia salts directly irritate the nasal mucosa and elicit a noxious reflex. This causes the heart to beat faster and hopefully counteract the vagal response.<br />
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Approximately 50 years ago, they became popular in sports to supposedly counteract the effects of head trauma. Smelling salts became popular in boxing where their use eventually was banned. <br />
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Trauma patients often suffer neck injuries that may be undetected. The first response to the noxious smell is to suddenly jerk the head away from the stimulus. This can result in dislocating an injured spine and potential paralysis.<br />
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More recently, athletes have begun to use smelling salts with the belief that their use will keep them more alert. <br />
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The use of smelling salts is particularly popular among football and hockey players who believe this reflex will counteract the effects of concussion.<br />
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Recent estimates report 80 percent of NFL players using smelling salts, according to a recent article in ESPN The Magazine. <br />
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It is only natural that athletes at lower levels will follow this practice.<br />
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Smelling salts should only be used in limited situations under the guidance of a health professional. <br />
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Coaches, parents and athletic trainers are crucial to ending the inappropriate use of smelling salts in young athletes.<br />
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<i>Dr. Alessi is a neurologist in Norwich and serves as an on-air contributor for ESPN. He is director of UConn NeuroSport.
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<br />Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-991390657886119282.post-24865193000659353512017-10-31T10:00:00.000-04:002017-11-06T07:34:04.189-05:00As cheerleading evolves, injuries continue to riseThe controversy over whether cheerleading should be classified as a sport or an activity is ongoing. One thing that is not disputed is that cheerleaders are athletes with athletic injuries.<br />
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Cheerleading first became prominent in the late 19th century in Ivy League schools. In the 1920s, it became more common in other universities. Interestingly, it was a male-dominated activity until the 1940s when many men had enlisted in the military.<br />
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The two venues today for cheerleading are scholastic, where the emphasis is placed on energizing the crowd for a sporting event, and competitive, consisting of cheerleading squads that compete in front of judges for points.<br />
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The basic cheerleading skills include tumbling, jumping and stunting. Stunting involves complex formations of team members and airborne acrobatics. As cheerleading has evolved, it is stunting that has gained the most attention.<br />
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The participants in stunting are classified as “base” and “flyers.”<br />
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Several recent publications have looked at the most dangerous youth sports. Cheerleading is on all these lists and considered the most dangerous in a report published by the National Center for Catastrophic Sports Injury Research.<br />
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Lower extremity injuries are the most common and include sprains and strains. The most catastrophic injuries involve the brain and spinal cord in the form of traumatic brain injuries and spinal injuries that result in temporary or permanent paralysis.<br />
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These injuries have been on the rise due to the growing popularity of cheerleading and the increasing complexity of the stunts being performed.<br />
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The American Academy of Pediatrics has called for changes to make cheerleading safer. Among these is the need for coaches at all levels to be properly trained and certified to direct stunting maneuvers and be able to recognize head injuries.<br />
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Parents should not be shy about inquiring about any coach’s credentials when it comes to their child’s safety.<br />
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<i>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 <b>agalessi@uchc.edu</b></i>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-991390657886119282.post-50955431152430298862017-10-17T10:00:00.000-04:002017-10-17T22:26:30.208-04:00Learning about shin splints and leg painLong distance runners are in the midst of both cross-country and marathon running seasons. Running on trails or asphalt can lead to lower leg pain. Shin splints, also known as medial tibial stress syndrome, is a general term used to describe lower leg pain.<br />
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The lower portion of the leg consists of two large bones: the tibia and the fibula. A membrane between these bones, the interosseous membrane and the anterior intermuscular septum, form four compartments. These compartments consist of an intricate network of muscles, arteries, veins and nerves that allows the ankle to move in multiple directions.<br />
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Shin splints are often associated with changes in running patterns. They can be attributed to using different types of footwear including excessively worn running shoes, rapidly increasing running distances and association with other injuries in the same or opposite extremity.<br />
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Compartment syndrome is among the most serious conditions that may be mistaken for shin splints. This syndrome consists of increased pressure within one of the four compartments of the lower leg. The increased pressure is a direct result of an injury causing swelling within a closed space.<br />
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The increased compartment pressure results in an inability for venous blood to drain and arterial blood to enter. The consequence is a lack of nutrients and oxygenated blood to muscles and nerves causing these tissues to atrophy and cease to function.<br />
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“The first step in treating shin splints is to find the cause,” reports Ms. Janeen Beetle, head athletic trainer at Norwich Free Academy. “Ice cup massage combined with anti-inflammatory medications provides the best treatment. Strengthening lower extremity muscles can help prevent recurrences.”
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Careful evaluation of lower leg pain can avoid serious complications.<br />
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<i>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 <b>agalessi@uchc.edu</b></i>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-991390657886119282.post-75957437591667123882017-10-03T10:00:00.000-04:002017-10-04T21:51:10.533-04:00What does CTE really mean?The recent information that former New England Patriots football player, Aaron Hernandez, was found to have evidence of Chronic Traumatic Encephalopathy (CTE) at autopsy has been followed by multiple opinions and at least one lawsuit.<br />
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Before drawing conclusions it is important to understand CTE and what the initial scientific studies really mean.<br />
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CTE is a diagnosis based on post-mortem findings of the brain. The diagnosis is actually a refinement of the previous findings of Dr. Harrison Martland, a medical examiner in Newark, N.J., who first described post-mortem changes in the brains of boxers in 1928.<br />
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A hallmark of CTE is the presence of tau protein, a substance that naturally occurs in nerve cells and appears to leak from the cells with repeated head trauma. The amount and distribution of the staining for tau coincide with the severity of CTE.<br />
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Although the predominant studies have been done on a group of deceased football players, many of whom have faced some life challenges, a direct causation between football and CTE has not been established.<br />
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One challenge with this condition is the fact that this can only be diagnosed after death. A study published last week in the journal PLOS ONE reports the identification of a potential biomarker to diagnose CTE in the living. The protein, known as CCL11, can be found in the spinal fluid of patients suspected of suffering from CTE.<br />
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It is important to note that no one has firmly linked the actions of someone with the CTE findings. The only thing we do know is that there
are changes in the brain after repeated blows.<br />
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CTE research is ongoing and there is much to learn about chronic brain injury and its relation to sports. It is unfair and dangerous to make clinical assumptions that affect society and peoples’ lives at this early stage of investigation.<br />
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<i>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</i><br />
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-991390657886119282.post-34821350278926321892017-09-19T10:00:00.000-04:002017-09-19T22:09:22.800-04:00Ankle sprains becoming more common among athletesAs athletes are drawn to more extreme sports that involve increasingly challenging terrain, the frequency of ankle injuries increases. Depending on the severity, ankle injuries can require an extended period of rehabilitation.<br />
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The ankle joint is made up of three bones — the tibia and fibula that make up the lower part of the leg and the talus that is part of the foot. A complex network of ligaments that allow the foot to bend upward and downward holds the joint together.<br />
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The principal mechanism of injury involves a forceful overpowering of the ligaments in a variety of directions. This type of injury is known as a sprain. The most common ankle injuries are the inversion, eversion and high ankle sprains.<br />
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The inversion ankle sprain is the result of suddenly turning the foot inward and damaging the ligaments on the outside of the ankle joint. An eversion sprain is the consequence of the foot turning outward and stressing the ligaments on the inside of the ankle.<br />
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A high ankle sprain is the result of injury to the ligaments that attach the tibia and fibula. It is caused by the sudden rotation of the foot outward.<br />
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The best treatment approach to an ankle sprain is the RICE protocol (Rest, Ice, Compression, Elevation). Reducing blood circulation to ligaments diminishes the availability of factors that aid healing.<br />
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“Sprains can take a long time to recover,” states Dr. Lauren Geaney, Assistant Professor of Orthopedic Surgery at the University of Connecticut, who specializes in foot and ankle injuries. “Ice and elevation in the early stages and early mobilization and strengthening as soon as the swelling and pain allow. Surgery is rarely needed and almost never indicated during early recovery.”<br />
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Appropriate treatment of ankle sprains can avoid having them develop into a chronic problem.<br />
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<i>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 </i><b>agalessi@uchc.edu.</b>Unknownnoreply@blogger.com0