Oregon athletes show dangers of overtraining

Athletes can sometimes become so focused on accomplishing a particular goal that the warning signs of potential injury are ignored. This was the case last week at the University of Oregon where four football players were hospitalized after an offseason workout.

Organized training during the offseason has become common at many levels of sport. Gone are the days when athletes would shift their focus to work and school after a season ended only to resume activity several months prior to the upcoming regular competition.

Much of the responsibility for the physical training of athletes has fallen into the hands of a growing group of strength and conditioning coaches. Credentials for these specialists fall into a variety of realms, including highly trained exercise physiologists, athletic trainers and physical therapists. 

Unfortunately, it is an area where certifications and appropriate credentials are not monitored and no state licenses or liability insurances are required for practitioners.

Prescribed workouts should not be one-size-fits-all recipes for making an individual or a team tougher and able to perform herculean tasks. Although many cite the military as the model for extreme workouts, they fail to note that there are severe consequences for commanding officers who ignore the human limits to training that result in permanent injury or death of a recruit.

In the case of the athletes in Oregon, it appears that the workouts crossed the fine line between training and torture. Those athletes' muscles began to break down due to increased energy demands and inability to supply necessary nutrients to large muscle groups. This resulted in a condition known as rhabdomyolysis where the muscle breaks down and the toxic products of that breakdown cause kidney failure. A key sign of this condition is darkened urine.

Many parents have bought into the belief that intense offseason workouts will increase their child's chances to play sports at a high level. Although this may be true, interviewing the person leading these workouts, checking their credentials, and making sure a child is enjoying these activities can avoid a potential disaster.

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

Safety, preparation vital for combat sport participants

Combat sports are among the fastest growing sports worldwide. Previously, this category of sports was restricted to boxing but has now expanded to karate, jiu-jitsu, kickboxing, judo and wrestling. These additional disciplines have come to be known as mixed martial arts (MMA).

The popularity of MMA should not come as a surprise. It has broad appeal to practitioners of these various combat forms as well as fans. Interestingly, the origins of combat sports in general date back to 400 B.C. when the participants were primarily slaves who were trying to win their freedom. Those contests often ended with the death of one opponent.

The ancient practice was eventually banned, not due to safety issues but because the contests had become so popular that spectators were not getting any work done.

Despite today's concern over the safety of these sports, there is a wide variation regarding regulation in the United States and internationally. Connecticut has become one of the strictest states to obtain a license to fight professionally. These regulations have evolved over years of experience at the state level and, more recently, at the Mohegan and Mashantucket Pequot Tribal nations.

The health regulations include blood screening for HIV, Hepatitis B and Hepatitis C every six months. Annual physical exams in addition to those performed at the fight venue are required. An EKG must also be performed annually. This encourages combat sport athletes to establish care with a primary care physician.

Particular attention is paid to neurologic impairment. Participants are required to have either an MRI or CT of the brain at some time in their career. In addition, an annual examination by a board-certified neurologist is required to assess any previous brain damage.

"Establishing a core set of health requirements and sharing them with other jurisdictions has been a priority," reports Mr. Michael Mazzulli, Director of the Mohegan Tribe Department of Athletic Regulation. Mr. Mazzulli and his team now travel internationally to regulate MMA events.

Safety and careful preparation are imperative for combat sports participation at any level.

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