Don't be sidelined by stress fractures

An overzealous approach to exercise can bring even the best fitness program to a grinding halt. Stress fractures are often the result of an aggressive running program.

Stress fractures are best described as very small cracks in a bone, usually seen in the lower leg and foot. As opposed to a typical fracture that results from a single traumatic event, stress fractures result from repeated trauma. They are commonly seen in athletes such as runners, basketball players, and dancers who run and jump on hard surfaces.

Bone is a dynamic organ that is constantly weakening and growing. The rate at which more bone is produced is determined by weight-bearing activities and general health. Osteoporosis is a condition seen in individuals unable to bear weight on a bone and older people whose bone metabolism has slowed. It results in fragile bones that are more susceptible to fracture.

Stress fractures are rarely seen on routine X-rays and diagnosis often requires an MRI scan or bone scan.

“There is a delicate balance between bone metabolism and bone stress. Any factor that rapidly upsets this balance can result in stress fractures,” said Dr. John Giacchetto, an orthopedic surgeon in Norwich. As older people begin to participate in impact sports like running, the incidence of stress fractures has also risen.
Preventive measures include using proper footwear and trying to run on a softer surface. Dr. Giacchetto recommends an incremental approach beginning with walking before running.

Treatment of stress fractures often includes restricting activity and acetaminophen for pain. Vitamin D and calcium supplements should be considered.

Now that summer is drawing to an end, many people will be resuming or starting an exercise program. Consultation with a physician is advisable and gradually increasing intensity can avoid being sidelined.

Preparation can help ease sports anxiety

Intense fear of failure is something everyone can relate to at some point in life. This sensation typically arises before any performance, whether it is in the realm of academics, entertainment or sports. Surprisingly, performance anxiety is becoming more common in the area of high-level sports competition.

Stories of athletes who have reached the highest level of their sport and can suddenly no longer perform simple tasks are well-known. An infielder who can no longer throw a baseball to first base, a pitcher who can’t find home plate, a basketball player who puts up an air ball from the foul line and competitive swimmers who fear drowning when on the starting block are examples.

The human brain can be divided into two parts. The diencephalon, or primitive brain, controls emotions and consists of the hypothalamus, thalamus and limbic lobe. The telencephalon makes up the thinking portion of the brain and includes the more highly developed cortical structures.

The “fight-or-flight response” is based on the perception of danger. It triggers an outpouring of adrenaline and the body responds with increased heart rate, rapid breathing, profuse sweating and increased muscle strength.

“When an athlete becomes anxious, the primitive areas of the brain hijack the regions that control coordinated movement, making simple learned skills impossible to perform,” reports Dr. John Sullivan, a sports psychologist in Rhode Island who works with amateur and professional athletes. Emotions always impact physical activity and the ability to balance this interaction will improve performance.

Dr. Jeffrey Anderson, a sports medicine specialist, believes that anxiety among young athletes is rising.

“We have created a youth sports system where there are no losers and everyone receives a trophy. As these athletes get to higher levels, they encounter the harsh reality that losses do occur. For many, the thought of losing is overwhelming,” said Anderson. He half-jokingly states that as a matter of principle, he allows his children an opportunity to fail on a regular basis.

Many athletes develop their own ways of dealing with anxiety.

John Paesani, a professional golfer in Norwich, competes regularly in regional and national tournaments. He deals with the inevitable anxiety all golfers experience on the first tee by following a routine that begins the morning of an event. He allows enough time to eat, stretch and practice to increase confidence in his performance.

Amber Holt, a star forward for the Connecticut Sun, also has devised a coping strategy.

“When I get to the foul line, I slow my breathing and just think about making the shot to avoid anxiety,” she said.

Lee Elci has had to deal with performance anxiety as both a professional baseball player and as an entertainer.

“In baseball, I was always confident that I could be successful against any pitcher. Entertainment was a different arena for me and dealing with anxiety was difficult and demanded a lot of time and practice.” Elci is now a top-rated radio talk show host and believes good preparation avoids a fear of failure.

Treating performance anxiety requires training athletes to connect their emotions with their physical strengths. This often requires professional help and sometimes medication.

Dr. Sullivan advises that an inordinate amount of anxiety in a young athlete is often the result of factors other than sports and early intervention can avoid serious psychiatric problems.

A successful performance depends on both emotional preparation and physical practice in any arena.

Bean balls have no place in baseball

On the same day recently, three major league baseball players were struck on the head by baseballs. Two of the incidents required hospitalization; all three raise the issue of safety improvement.

David Wright and Ian Kinsler were struck by baseballs thrown at high velocity. Hiroki Kuroda, a pitcher, was hit by a line drive back to the mound.

Although helmets provide some measure of safety, the impact of any projectile can cause skull fractures, bleeding into the brain and subsequent death. Even mild forms of traumatic brain injury like concussion carry repercussions of persistent headache, dizziness or cognitive impairment. In baseball, this is enough to end a promising career.

Athletes have become stronger and more proficient at their sports, necessitating better protective equipment. The need for improved batting helmets and designing helmets for pitchers is under discussion and supported by many sports medicine specialists.

The real problem in baseball lies beneath the surface. An unwritten rule in baseball is that a pitcher is expected to hit a batter in certain circumstances or be shunned by his teammates.

Organized baseball has tried to control “plunking” by giving umpires greater leeway in ejecting players. The legal question here is whether a baseball pitcher who uses his skill to intentionally harm another player should be charged with assault? In 2006, the Supreme Court of California ruled that baseball players assume the risk of being hit by baseballs even if thrown to intentionally cause injury.

Professional athletes must realize that their actions are imitated by youngsters. Intentionally throwing at an opponent is not the behavior of a sportsman. Hopefully it will not result in death.

Anthony G. Alessi, MD, is Chief of Neurology at The William W. Backus Hospital and in private practice at NeuroDiagnostics, LLC, in Norwich. E-mail him at, or listen to his podcasts, comment on his blog or buy his book at

Bicycle police combine helping others with staying fit

Many occupations require workers to remain physically fit in order to complete their assignments. Sometimes it is possible to combine a love of sports with a means of earning a living. Police bicycle patrols permit many avid cyclists to accomplish this.

Bicycle police patrols became common in the 1890s. Police departments found bicycles effective for rapid response and the ability to traverse difficult terrain. Although motor vehicles have dominated law enforcement transportation, bicycles have undergone a resurgence with the use of mountain bikes.

Modern police bicycles have wide, deeply treaded tires and multiple gears. They allow officers to maneuver through confined spaces as well as off-road trails.

Police officers assigned to bicycle patrols are enthusiastic about riding. A typical patrol can require between five and fifteen miles of riding. A slow- paced ride will burn 400 calories per hour.

The International Police Mountain Bike Association (IPMBA) provides training that includes stretching and fitness along with riding skills. Courses last one week and are held nationwide.

Other than police, EMS personnel and security officers utilize bicycles.

“Bicycle patrols add to visibility and communication with pedestrians and business owners,” said Mark Gendron, a Connecticut State Trooper assigned to Hebron who is trained by the IPMBA. The stealth approach of bicycles have aided in drug arrests and crowd control. Trooper Gendron keeps a bike rack on his patrol car so that his bike is always available.

Backus Hospital and the Mohegan Sun Casino use bicycle patrols for security purposes in parking lots and to assist visitors. Lowell Yeager, a retired fireman, bikes approximately 1,500 miles per year in addition to the time he spends on bike patrol at Backus Hospital.

These patrollers are dedicated to helping others and are passionate about staying fit.

Ballroom dancing attracts athletes and creative types

Athletic activities take on many different forms and among the more recently popular are various types of dance. Television shows like “Dancing with the Stars” and “So You Think You Can Dance” have been major forces behind the growing numbers of dancers.

Dancing attracts men and women of all ages, fitness levels and cultural backgrounds. People dance socially, competitively or for the entertainment of others. Perhaps no other athletic activity is so universally accepted.

The physical demands of dancing vary greatly. The pace and rhythm of the dance will dictate the cardiovascular component. Caloric output can vary between 200 and 400 calories per hour depending on the pace of the dance.

Agility is important for dancing and participation -- even at a novice level -- will improve balance. As with all weight-bearing activities, muscles become stronger and bone density increases. Typical injuries include ankle sprains, knee injuries and a variety of strained muscles.

Ballroom dancing, which requires a partner, has become particularly popular.

Adult ballroom dancing camps are held around the world. A recent week-long camp at Mt. Snow, Vt., attracted 50 dancers from the United States and Canada. Ballroom Vermont owner Byron Siegal has seen a 40% increase in participation over the past five years and more than 50% are repeat customers.

“We both enjoy the physical as well as mental and social aspects of ballroom dancing,” said veteran campers Robert and Peggy Cassey. Peggi Morrow directs the camp and finds that campers fall into two broad categories: the analytical group where every movement demands careful study and the creative group who just start moving with reckless abandon.

Like any sport, success is based on timing, coordination and strength. Enjoyment is based purely on attitude.