In 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.
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.
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.
These structures in the brain then send signals to the adrenal glands to secrete adrenaline that in turn causes the physiologic response described.
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.
“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.”
Love’s admission of a mental health condition, coupled with his level of fame, will hopefully lead to other athletes seeking care.
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
Studies reveal risks for spinal injuries
Among 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.
The cervical spine consists of seven bony vertebrae that surround and protect the spinal cord.
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.
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.
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.
Subsequent radiologic studies often reveal congenital narrowing of the cervical canal causing these athletes to be vulnerable to this type of injury.
“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.”
A thorough neurologic evaluation for episodes of weakness and numbness in athletes can avoid catastrophe.
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
The cervical spine consists of seven bony vertebrae that surround and protect the spinal cord.
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.
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.
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.
Subsequent radiologic studies often reveal congenital narrowing of the cervical canal causing these athletes to be vulnerable to this type of injury.
“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.”
A thorough neurologic evaluation for episodes of weakness and numbness in athletes can avoid catastrophe.
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
New concussion blood test shows promise
A 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.
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.
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.
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.
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.
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.
This blood test will be helpful in an emergency room setting after serious brain injury.
Despite its limitations, the Banyan biomarker is a significant advance in the diagnosis of brain trauma and will hopefully lead to better testing.
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
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.
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.
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.
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.
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.
This blood test will be helpful in an emergency room setting after serious brain injury.
Despite its limitations, the Banyan biomarker is a significant advance in the diagnosis of brain trauma and will hopefully lead to better testing.
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
The danger of sexual predators in sports
The recent conviction and sentencing of Larry Nassar should be a reminder to all that vigilance is necessary to protect children from predators.
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.
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.
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.
Establishing a bond with the athlete and parents allows a sexual predator a lot of opportunity.
Private coaching or physical treatments specific for that athlete can be warning signs.
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.
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.
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.
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 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.
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.
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.
Establishing a bond with the athlete and parents allows a sexual predator a lot of opportunity.
Private coaching or physical treatments specific for that athlete can be warning signs.
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.
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.
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.
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.
Diet, exercise prove helpful in treating MS
Multiple 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.
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.
Approximately 15 percent of patients have a progressive unremitting course of illness.
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.
In addition to medications, several other modalities in the form of diet and exercise have been proven to be helpful in treating MS.
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.
Diets rich in whole grains, fruits and vegetables with reduced intake of processed sugars and red meat is optimal.
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.
“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.
MS patients should consider multiple treatment modalities.
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
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.
Approximately 15 percent of patients have a progressive unremitting course of illness.
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.
In addition to medications, several other modalities in the form of diet and exercise have been proven to be helpful in treating MS.
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.
Diets rich in whole grains, fruits and vegetables with reduced intake of processed sugars and red meat is optimal.
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.
“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.
MS patients should consider multiple treatment modalities.
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
Go slow with new exercise routine
Among 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.
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.
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.
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.
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.
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.
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.
The operative message to beginning a safe exercise regimen is to get the approval of a physician and start slow.
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
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.
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.
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.
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.
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.
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.
The operative message to beginning a safe exercise regimen is to get the approval of a physician and start slow.
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
Golfer’s severe disability gives hope for others
Muscular 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.
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.
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.
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.
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.
“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.
Golf requires core strength and careful coordination of upper and lower extremity muscles making Hoffman’s success noteworthy and encouraging for others.
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
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.
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.
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.
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.
“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.
Golf requires core strength and careful coordination of upper and lower extremity muscles making Hoffman’s success noteworthy and encouraging for others.
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
Steelers’ Shazier suffered a spinal concussion
Last 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.
A concussion is a syndrome of immediate and transient neurologic impairment that results from a biomechanics force being applied to the nervous system.
Although the term has become synonymous with a brain injury, it can also be applied to the spinal cord.
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.
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.
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.
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.
Fortunately, most spinal concussions, like brain concussions, can fully resolve with little to no permanent damage. Hopefully, this is also the case for Shazier.
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.
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
A concussion is a syndrome of immediate and transient neurologic impairment that results from a biomechanics force being applied to the nervous system.
Although the term has become synonymous with a brain injury, it can also be applied to the spinal cord.
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.
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.
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.
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.
Fortunately, most spinal concussions, like brain concussions, can fully resolve with little to no permanent damage. Hopefully, this is also the case for Shazier.
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.
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
Wrist, hand injuries a concern in youth sports
Youth 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.
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.
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.
The carpal bones in the hand attach to the two bones of the forearm: the ulna and radius.
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.
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.
Initial treatment often includes rest, ice and immobilization but some fractures may require surgery.
“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.”
Prompt evaluation and treatment of hand and wrist injuries in young athletes can help speed recovery.
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
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.
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.
The carpal bones in the hand attach to the two bones of the forearm: the ulna and radius.
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.
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.
Initial treatment often includes rest, ice and immobilization but some fractures may require surgery.
“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.”
Prompt evaluation and treatment of hand and wrist injuries in young athletes can help speed recovery.
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
Improper use of smelling salts a growing concern
Athletes are always looking for an edge that will improve performance.
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.
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.
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.
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.
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.
More recently, athletes have begun to use smelling salts with the belief that their use will keep them more alert.
The use of smelling salts is particularly popular among football and hockey players who believe this reflex will counteract the effects of concussion.
Recent estimates report 80 percent of NFL players using smelling salts, according to a recent article in ESPN The Magazine.
It is only natural that athletes at lower levels will follow this practice.
Smelling salts should only be used in limited situations under the guidance of a health professional.
Coaches, parents and athletic trainers are crucial to ending the inappropriate use of smelling salts in young athletes.
Dr. Alessi is a neurologist in Norwich and serves as an on-air contributor for ESPN. He is director of UConn NeuroSport.
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.
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.
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.
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.
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.
More recently, athletes have begun to use smelling salts with the belief that their use will keep them more alert.
The use of smelling salts is particularly popular among football and hockey players who believe this reflex will counteract the effects of concussion.
Recent estimates report 80 percent of NFL players using smelling salts, according to a recent article in ESPN The Magazine.
It is only natural that athletes at lower levels will follow this practice.
Smelling salts should only be used in limited situations under the guidance of a health professional.
Coaches, parents and athletic trainers are crucial to ending the inappropriate use of smelling salts in young athletes.
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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