Baseball in Haiti

The smell of freshly cut grass, the sound of a ball hitting a bat and the feel of a freshly oiled mitt all signify the beginning of baseball season. It is a ritual that evokes pleasant memories for many Americans. During the past week, I have come to realize that Haiti is no exception.

Baseball has developed an international following beginning with exportation during World War II by American soldiers stationed abroad. Haiti has never been known as a center for the development of future baseball stars. In fact, there are no current professional baseball players from Haiti, yet a short trip over to the Dominican Republic reveals the largest number of foreign-born baseball players currently playing in the major leagues.

That may soon change. During my most recent trip to Haiti, I had a chance to work out with the “Tabarre Tigers,” a team of 20 boys from the streets of Port-au-Prince. They were first brought together by several Americans working as part of the Haitian relief effort through “Artists for Peace and Justice.”

The Tabarre Tigers play baseball in an actual cow pasture complete with cows and manure. Bases are sandbags previously used as flood barriers. Equipment includes well-used mitts, balls and metal bats. Athletic shoes consist of shower shoes, sandals and poorly fitting sneakers. A Haitian coach is present for safety and to provide basic instruction.

I soon came to find out that what these young athletes lacked in skill and equipment they made up for in spirit. The joy of playing the game was readily apparent. When it came time to play a practice game, sides were chosen playground style with the last chosen showing his frustration.

As the game went on, there was cheering, shouting and congratulations. Solid contact and successful throws were appreciated.

My afternoon with the Tabarre Tigers was strangely reminiscent of a time in sports many of us remember. No shouts of encouragement or disappointment from parents who are often too involved. No overly coached players. There is no “every player wins” philosophy in Haitian baseball or in Haitian life. It is highly motivating to learn that there are times when someone does lose.

This experience reminded me of the importance of youth sports in its simplest and purest form.

If you have new or slightly used baseball equipment and would like to donate it to this cause, you can drop off the equipment at the WXLM 980-AM studios, 7 Gov. Winthrop Blvd. in New London.

Baseball is back — and so are oblique muscle injuries

Baseball season has officially begun and, unfortunately, so has the ever-present disabled list (DL).

The DL is used to signify that a player is unable to compete and it allows the team to promote a substitute player from a lower level to the major league team. It also serves as a barometer for the success of strength and conditioning specialists as well as athletic trainers.

Among the injuries seen early in the season are those that affect the abdominal muscles. These are typically strains or tears in the muscle fibers. They can be very painful and debilitating for an athlete who competes in a throwing sport.

The oblique muscles consist of four paired muscles, the internal and external obliques. They are large, flat muscles that extend from the rib cage to the pelvis in a perpendicular orientation to each other. The principal role of these muscles is to provide stability to the trunk while protecting the abdominal contents.

Injury results from sudden tension on muscle fibers that are not supple. Oblique muscle injuries are most common in tennis, baseball and other sports where throwing and twisting are principal movements. Pitchers are especially impaired by these injuries.

Treatment of oblique muscle injuries consists of rest, alternating hot and cold applications and anti-inflammatory medications. The challenge is resting any muscle that provides support to the trunk. Whenever an athlete stands or turns, these muscles fire. Taping these muscles in an effort to restrict motion can result in diminished breathing.

The best way to prevent oblique muscle strain is through adequate stretching before any activity along with a core strengthening regimen.

Taking time to warm up before tossing a ball or swinging a racquet can keep all athletes off the disabled list.

Caution necessary with head injuries

The gravity of traumatic brain injury (TBI) in sports cannot be overemphasized. It is among the few ways an athlete can die during a contest.

The responsibility for determining when and if brain-injured athletes can return to full participation in their sports is often the most difficult decision a sports medicine specialist must make. A concussion is the mildest and most frequently encountered form of TBI.

Medical technology offers a vast array of imaging, as well as psychological and electrodiagnostic examinations, as part of the neurological evaluation. Despite the magnitude of the decision to return to play, there is no single test or formula to rely on for guidance.

Before 2008, a rating scale based on the presence or absence of loss of consciousness was used. Unfortunately, the scale was an unreliable indicator of when it was safe to return.

The most dependable approach to this dilemma involves two stages:

• The first is careful analysis of the clinical data, history of the incident and previous TBIs, physical examination and observation. An athlete must be symptom-free, including headaches, dizziness, confusion and visual changes.

Based on this information, it is determined whether an athlete can safely begin a rehabilitation program aimed toward full activity. This decision is best made by a physician experienced in treating athletes.

• The second stage in the recovery process includes returning to activity without symptoms. This procedure begins with a low-impact aerobic exercise for 20-30 minutes, then light resistance training and finally concludes with sport-specific activities performed under observation by a certified athletic trainer.

The rehabilitation process after TBI can take months and, sadly, many outstanding athletes never return to their sports.

Interestingly, it is often the great athletes who take the lessons learned from years of hard work and channel them into immense success in another field of endeavor.

Hip injuries can be avoided by stretching properly

Hip pain is often a difficult problem to diagnose and treat due to the challenge of finding the origin of the pain. In many instances, the source of hip pain involves injury to the iliopsoas muscle.

The iliopsoas muscle is formed by a combination of the psoas major, psoas minor and iliacus muscles. These muscles originate from the lumbar spine and pelvis and attach to the upper portion of the femur. Any injury in this area will result in poorly localized pain in the low back, hip and groin.

Typical injuries include iliopsoas strain, where there is tearing of muscle fibers, and iliopsoas tendonitis that is marked by inflammation of the iliopsoas tendon. These injuries are the result of sudden stretching of the muscle by flexing the hip or externally rotating the thigh. Repetitive hip flexion can also cause harm.

Symptoms of iliopsoas injury include pain and stiffness in the hip that can often radiate into the thigh. The pain can be very intense and often results in an athlete withdrawing from competition.

Iliopsoas injuries are most common in gymnasts, dancers, track and field athletes and soccer players. Venus Williams was recently forced to withdraw from the Australian Open due to what was reported as an injury to the iliopsoas. Any activity that requires repeated hip flexion can result in damage.

These injuries can be avoided through a stretching program performed regularly. Strengthening of core muscles including the hip and pelvis will not only improve overall athletic performance but avoid injury to the hip, pelvic and upper leg muscles.

Treatment includes rest, ice and anti-inflammatory medications. A stretching program should be instituted when pain subsides. Unfortunately, an iliopsoas injury often requires up to three weeks of rest.

Many musculoskeletal hip injuries can be avoided and successfully treated with a carefully executed stretching regimen.

NFL collective bargaining centers on safety

A collective bargaining agreement is the result of a negotiation between a group representing the interests of employees and an employer. Collective bargaining has now become an important term in professional sports. Unfortunately, when there is a breakdown in negotiations and a work stoppage results, it is the fans who suffer.

The current collective bargaining drama involves the NFL and the NFL Players Association. While financial issues are central to most employment agreements, this negotiation appears to have a focus on safety.

Dave Duerson was a 50-year-old, successful businessman and former Chicago Bears safety. In recent years, his life began to unravel with marital problems, business failures, uncharacteristic temper outbursts and an inability to remember simple information.

Duerson was diagnosed with Chronic Traumatic Encephalopathy (CTE) as a result of the multiple concussions he had suffered during his years of playing football. He was also an active NFL alumnus fighting for better health benefits for retired players and making the game safer for younger players.

Unable to face a future of dementia, on Feb. 17, Duerson committed suicide by shooting himself in the chest. He chose this manner to preserve his brain for future study. His desperate action has placed a new light on the current negotiations.

Neuropathologists around the world have recently begun to delve into the study of cumulative brain trauma and subsequent Alzheimer’s-like dementia. Some studies have shown changes in the brains of teenage athletes involved in violent collision sports like football and hockey.

“There is no reason, no medical justification, for any child younger than 18 to play football, period,” said Dr. Bennet Omalu, a neuropathologist in California. His opinion is based on studies emphasizing the importance of brain development in the first 18 years of life and the fact that when brain cells are destroyed there is no cellular recovery.

Young people everywhere often believe they are indestructible and are willing to take unacceptable risks for financial reward. The NFL is no exception. It will be interesting to see if the wisdom of elder veterans will direct these negotiations.

Sleep can improve athletic performance

The most potent way to heal injured tissues and rejuvenate multiple organ systems is not a new wonder drug or expensive supplement, it’s sleep. Sufficient amounts of sleep are crucial for outstanding human performance, especially in athletes.

Sleep actually consists of a series of stages that have different physiologic roles. The ability to cycle repeatedly through each stage with an adequate amount of time spent at each level is called “sleep efficiency” and serves as the goal when looking at the architecture of this process.

The two primary divisions of sleep are REM (rapid eye movement) and NREM (non-rapid eye movement). NREM is further divided into three other stages. Only 25% of total sleep time is spent in the REM stage.

During sleep, natural hormones are released in the body and enhance the physical recovery process. Among these are serotonin and growth hormone, the latter being a much publicized “performance enhancing drug” and subsequently a banned substance. Serotonin improves psychomotor performance. These factors alone can give an athlete a tremendous advantage in competition.

Adequate amounts of sleep are crucial to take full advantage of this hormonal production. Unfortunately, an athlete’s schedule that may include long trips, inconsistent sleeping conditions and erratic performance times are obstacles to sleep efficiency.

Dr. Setu Vora, a physician on the Backus Hospital Medical Staff specializing in the diagnosis and treatment of sleep disorders, advocates a simple approach when dealing with insufficient sleep in athletes.

“The best medication is no medication. The same discipline that athletes apply to their sports must also be applied to sleep. The bedroom should be used solely for sleep and an average of eight hours each night is the goal,” said Vora.

International athletes who must endure transatlantic travel should try to sleep on the flight. Earplugs and sleep masks can be helpful.

Adequate sleep, proper diet and a regular workout schedule is vital for athletes at any level.

Too much exercise can cause muscle breakdown

Last week, 13 University of Iowa football players were hospitalized for a condition known as rhabdomyolysis. This condition results from an extreme breakdown of muscle fibers and complications caused by the circulation of the breakdown products.

Rhabdomyolysis generally results from muscle injury. Trauma is typically the most common cause of rhabdomyolysis. Other causes include genetic conditions, dehydration, medications, supplements, seizures, heatstroke, vascular insufficiency, severe exertion or any combination of these.

There are two types of muscle, smooth or involuntary muscles and striated or voluntary muscles. Muscles consist of a complex system of filaments that contract and relax in response to impulses from the nervous system.

Striated muscles are the engines that drive the movement of joints. Like all engines they rely on a fuel source to continue working. If the demand placed on muscles exceeds the availability of nutrients, the fibers “lock up” and cramp. If the imbalance continues, muscle fibers begin to break down.

When muscles break down, proteins and enzymes are released into the bloodstream. Among these enzymes is creatine kinase (CK). The concentration of CK can be measured in a blood sample and indicates the degree of muscle breakdown. CK also appears in various forms that indicate what types of muscles have been injured.

In rhabdomyolysis, myoglobin is among the breakdown products. When high concentrations of this protein are emitted, urine develops a reddish discoloration. If high levels persist, kidney failure will result.

Treatment consists of intravenous infusion of fluids and renal dialysis if necessary.

In the case of the Iowa athletes, it is believed that extreme exertion as part of an offseason workout was the cause. One player reported having to perform 100 squat repetitions with 240 pound weights.

Physical exercise is a big step toward good health, but as 13 Iowa football players have discovered, moderation is essential.

Cold-weather sports can pose health risks

A recent trend in sports has been a return to outdoor winter events. Outdoor hockey games held in stadiums have drawn large crowds. The roof collapse of the Minnesota Vikings home field and relocation to a much colder venue added an additional element to the game.

This shift to more athletic events being held in inclement weather, especially sub-freezing temperatures, poses a danger for both athletes and patrons. During vigorous exercise, energy is expended both by the activity and the need to keep muscles warm.

The two most common forms of injury from exposure to cold include frostbite and hypothermia. Shivering is the first sign of impending cold injury. It consists of involuntary muscle contractions as a means for the body to generate heat. When shivering begins, an effort to get to a warmer environment should be the next step. Alcoholic beverages should be avoided.

Frostbite is the freezing of superficial tissues. It typically appears on fingers, toes and facial structures. Symptoms include pain, tingling, and pale skin that will often blister. The most effective treatment is gradual warming, being careful to avoid friction that can result in permanent tearing of damaged tissues.

Hypothermia is the most severe form of cold injury. It is the result of the core body temperature falling below 95 degrees Fahrenheit. The most severe impact involves neurologic and cardiac function. Patients become confused and sleepy with slurred speech. The clinical presentation resembles alcohol intoxication. Changes in cardiac rhythm can lead to sudden death.

The best treatment for cold injury is avoiding continued exposure. Appropriate attire should include thermal garments that retain heat. Dressing in layers is important. Special attention should be given to the extremities.

Exercising in cold weather does burn more calories and an outdoor workout should be modified accordingly.

Fencing exercises the body and mind

For many people, the start of a new year is an invitation to take on new challenges. This may include dieting, quitting smoking or beginning a fitness regimen. Those who have been involved in a workout program are often looking for some new element. Fencing is a worthwhile consideration.

The origins of fencing can be traced back to ancient Egypt and Rome, yet it remains both a physical and mental challenge even today. Participation is not dependent on age, size or gender.

Fencing builds stamina, strength and balance. Each match involves a series of advances and retreats combined with the skillful use of a weapon called a foil.

The sport appears to emphasize upper body strength but it is the lower body and core muscles that are crucial for success. Most athletic activities are based on forward rather than lateral movement. Fencing is among the activities that requires sideways movements that help train the neuromuscular system to avoid potential lateral falling injuries.

Common fencing injuries include wrist and ankle sprains, bruising and strained muscles. Physical preparation includes both strength and aerobic training. Meticulous stretching of upper and lower extremity muscles as well as core muscles is imperative to avoid injury.

Fencing is a sport in which lessons are necessary for full enjoyment and safety. Aaron Hughes, Head Fencing Coach at St. Bernard High School and Eastern Connecticut State University, offers weekly lessons and training sessions at Fitness World in Norwich.

“Participants are surprised at the amount of stamina and concentration required for fencing,” said Hughes.

One recent Sunday, local radio talk show host Lee Elci and I joined a class hosted by Hughes. We both enjoyed the class and competitive dueling afterward.

Fencing is a sport that exercises both the body and mind at any age.

The best of 2010 makes for good advice for 2011

This is the time of year when looking back helps give direction for the future. After reviewing the “Healthy Sports” columns for 2010, it is clear that several themes developed:

• Many people faced with chronic illnesses like Multiple Sclerosis, Fibromyalgia and Parkinson’s Disease fare better when they are involved in a fitness program. Yoga, dance and a combination of aerobic and resistance exercises can slow disease progression and improve symptoms. Remaining active is crucial when putting together an effective treatment plan.

• The long-standing effects of repeated brain trauma continue to be a focus of concern and research. This year, a connection between repeated head trauma and Amyotrophic Lateral Sclerosis (ALS) was proposed. While this theory garnered a great deal of notoriety, much more research is needed before any conclusions can be made. It is encouraging to see many athletes who have been involved in violent collision sports now donating their brains for postmortem analysis.

• An area of national concern is safety in youth sports. This pertains to all sports where the participants are younger than 14. The lack of medically trained personnel in attendance, the violent nature of the individual sport and the fact that children are more susceptible to catastrophic injury are all factors that have heightened awareness. Thanks to this increased level of interest, USA Hockey is considering raising the age where checking is allowed to 14. A symposium sponsored by the National Football League and the American College of Sports Medicine will convene next month to address urgent safety modifications in youth sports.

The most rewarding trend is knowing that “Healthy Sports” readers continue to be active and safe in whatever sport they choose.