Competitive sports are among the most popular forms of entertainment in the world.
Sometimes a sport is more heavily weighted on the entertainment aspect rather than competition. In either situation, the physical demands on participants can be dramatic. This is certainly the case with roller derby.
Originating in the mid-western United States in the 1920s, roller derby is now undergoing a resurgence among fitness-minded women who demand excitement as part of their work outs. The athletic aspect of the sport demands excellent balance, strength and stamina. The entertainment side is pure fun for participants and audience.
A team consists of five “derby girls” on the track at any time. Points are scored when a player who is designated as a jammer is able to lap opposing players. This can only be done during a two minute period known as a jam.
Like all skating sports, core body strength is essential for success in roller derby. Each hour of participation burns approximately 400 calories. In addition to leg strength required for skating, upper body fitness is necessary to block opponents.
Cardiovascular stamina is a big factor in withstanding the 20-minute periods of skating, blocking and maneuvering. Strategy plays an important role in success. Players must be aware of offensive and defensive opportunities.
Debra Frank is a nurse from Mystic who recently decided to follow a childhood dream of joining a roller derby team. She began by trying out for the Connecticut Roller Girls this spring and is one of only seven new recruits.
“Roller derby attracts people from all walks of life, levels of education and ethnicities who wish to participate in a sport that allows you to step out of your current existence and into an alter ego,” said Frank.
Roller derby is certainly not a conventional sport, but it provides an excellent outlet for women to get in shape, relieve life’s frustrations and enjoy the
camaraderie of others.
As outdoor activities increase, so does tick risk
Spring has finally arrived in New England and opportunities for outdoor activities abound. Along with many of these, there is increased exposure to tick-borne illnesses.
Tick-borne illnesses include a variety of infections transmitted among animals (including humans) by ticks.
A tick will feed on an infected animal, the tick then becomes infected and passes the bacteria along by lodging itself in the skin of other animals and humans.
Rocky Mountain Spotted Fever is the most common tick-borne illness in the United States. In the northeast, Lyme disease is the most well-known. Diseases such as Ehrlichiosis and Babesiosis, while still rare, are gradually becoming more recognized.
Hiking, mountain biking, fishing and golf are among the activities where participants are most vulnerable to tick bites and potential Lyme disease. Following some basic rules can prevent infection:
• Stay on trails and avoid walking through high grass. This warning is especially important for golfers who invariably find themselves searching for an errant golf ball.
• Minimize exposed skin. Although it is recommended that long trousers and sleeves be worn, this is often not practical. Insect repellent should be applied liberally on any exposed area. Carefully read the label and be sure that it contains DEET and will be effective against ticks.
• Self-examine every three hours while in the field and more thoroughly after the activity. Showering to remove any residue from repellents is crucial and a good opportunity to search for ticks. Children must also be vigilantly examined, especially on the scalp.
• Four-legged companions are also susceptible and repellents such as “Frontline” are recommended by many veterinarians. Brushing with a fine comb after a hike can often find hidden ticks.
• Immediate removal of a tick is imperative. A tweezer works best and the area should be cleansed with antiseptic after removal.
When out on the golf course, pause before going into the deep grass to retrieve your ball or a newly found treasure.
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 aalessi@wwbh.org, or listen to his podcasts, comment on his blog or buy his book at backushospital.org.
Tick-borne illnesses include a variety of infections transmitted among animals (including humans) by ticks.
A tick will feed on an infected animal, the tick then becomes infected and passes the bacteria along by lodging itself in the skin of other animals and humans.
Rocky Mountain Spotted Fever is the most common tick-borne illness in the United States. In the northeast, Lyme disease is the most well-known. Diseases such as Ehrlichiosis and Babesiosis, while still rare, are gradually becoming more recognized.
Hiking, mountain biking, fishing and golf are among the activities where participants are most vulnerable to tick bites and potential Lyme disease. Following some basic rules can prevent infection:
• Stay on trails and avoid walking through high grass. This warning is especially important for golfers who invariably find themselves searching for an errant golf ball.
• Minimize exposed skin. Although it is recommended that long trousers and sleeves be worn, this is often not practical. Insect repellent should be applied liberally on any exposed area. Carefully read the label and be sure that it contains DEET and will be effective against ticks.
• Self-examine every three hours while in the field and more thoroughly after the activity. Showering to remove any residue from repellents is crucial and a good opportunity to search for ticks. Children must also be vigilantly examined, especially on the scalp.
• Four-legged companions are also susceptible and repellents such as “Frontline” are recommended by many veterinarians. Brushing with a fine comb after a hike can often find hidden ticks.
• Immediate removal of a tick is imperative. A tweezer works best and the area should be cleansed with antiseptic after removal.
When out on the golf course, pause before going into the deep grass to retrieve your ball or a newly found treasure.
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 aalessi@wwbh.org, or listen to his podcasts, comment on his blog or buy his book at backushospital.org.
“Brain gyms” can build intellectual muscle
Physical exercise is well-known to help brain function. A regimen of regular exercise has been shown to slow the progression of neurologic diseases like Parkinson’s and Alzheimer’s. There is now information suggesting that improved cognitive ability may result in more competitive athletic performance.
Previously it was believed that the brain could not repair or reorganize the networks contained within it. More recently, terms like “neural plasticity” and “cortical reorganization” have been used to describe these mechanisms of recovery. They are witnessed after stroke or brain trauma and result from early intervention in the form of aggressive physical, occupational and speech rehabilitation.
People beginning to experience memory deficits and difficulty completing complex tasks they previously found easy are turning to so called “brain gyms.”
Facilities such as Vibrant Brains, Nifty after Fifty and Sparks of Genius set up mental workouts for patrons on a variety of computer programs. These workouts are designed by trainers and are based on cognitive weaknesses.
“Cognitive rehabilitation has always emphasized improvement of attention skills,” said Dr. Christopher Tolsdorf, a neuropsychologist who specializes in neuropsychometric testing in his Norwich office. “This is best accomplished by memorization. This alone will improve the ability to attend, concentrate and focus.”
Tolsdorf is a fan of teaching children rote memorization of academic material.
Tolsdorf also believes that focusing on one skill like crossword puzzles or Sudoku will only make someone better at those games. Variety is an important factor in rebuilding cognition.
Several brain gyms combine mental and physical exercise with classes on improved nutrition. Many participants have attributed improved athletic performance in sports like tennis and golf to their increased attentiveness.
While the benefits of brain gyms are based on conjecture and theory rather than accepted scientific proof, the concept that diet and physical exercise improve brain function is well-documented in scientific literature.
You may want to quickly memorize a sonnet as part of your warm-up on the driving range.
Previously it was believed that the brain could not repair or reorganize the networks contained within it. More recently, terms like “neural plasticity” and “cortical reorganization” have been used to describe these mechanisms of recovery. They are witnessed after stroke or brain trauma and result from early intervention in the form of aggressive physical, occupational and speech rehabilitation.
People beginning to experience memory deficits and difficulty completing complex tasks they previously found easy are turning to so called “brain gyms.”
Facilities such as Vibrant Brains, Nifty after Fifty and Sparks of Genius set up mental workouts for patrons on a variety of computer programs. These workouts are designed by trainers and are based on cognitive weaknesses.
“Cognitive rehabilitation has always emphasized improvement of attention skills,” said Dr. Christopher Tolsdorf, a neuropsychologist who specializes in neuropsychometric testing in his Norwich office. “This is best accomplished by memorization. This alone will improve the ability to attend, concentrate and focus.”
Tolsdorf is a fan of teaching children rote memorization of academic material.
Tolsdorf also believes that focusing on one skill like crossword puzzles or Sudoku will only make someone better at those games. Variety is an important factor in rebuilding cognition.
Several brain gyms combine mental and physical exercise with classes on improved nutrition. Many participants have attributed improved athletic performance in sports like tennis and golf to their increased attentiveness.
While the benefits of brain gyms are based on conjecture and theory rather than accepted scientific proof, the concept that diet and physical exercise improve brain function is well-documented in scientific literature.
You may want to quickly memorize a sonnet as part of your warm-up on the driving range.
YMCA closure limits fitness options when they are needed most
Diet and exercise are critical to reducing chronic illness. Any program that incorporates these elements demands discipline. During challenging economic times establishing good health habits becomes more difficult since there are increased demands on time. Another unanticipated obstacle is that affordable, easily accessed opportunities for fitness are more difficult to find.
Many small cities and towns have been able to offer community facilities where people can participate in activities such as swimming, team sports and athletic classes at minimal cost. These facilities typically rely on a precarious combination of public funding, donations and membership fees to meet their obligations. In the past year many have experienced a decline in all three revenue sources while being faced with increasing expenses. These facilities are now closing their doors -- leaving many without access to a variety of activities.
In Norwich, it has been the YMCA that has provided an indoor pool where infants and toddlers learn to swim. The elderly participate in aquatic exercise programs to ease the excess strain on arthritic joints. A licensed daycare facility helps relieve some of the pressure on working families while providing a sports diversion to many young people. Unfortunately, the Norwich YMCA will be closing this week.
“No program at the YMCA is designed to make money,” said Attorney Michael Lahan, who serves as chairman of the volunteer board responsible for managing the Norwich branch of the YMCA. “All membership fees go directly to supporting programs that help others. The physical plant at the downtown location is an integral part of the city and the only way to survive will be through a coalition of organizations.”
It is no secret that health costs are rising rapidly in the United States. Much of those dollars go to treating chronic problems like obesity, hypertension and diabetes. It’s time we begin to invest these resources for prevention rather than treatment.
Many small cities and towns have been able to offer community facilities where people can participate in activities such as swimming, team sports and athletic classes at minimal cost. These facilities typically rely on a precarious combination of public funding, donations and membership fees to meet their obligations. In the past year many have experienced a decline in all three revenue sources while being faced with increasing expenses. These facilities are now closing their doors -- leaving many without access to a variety of activities.
In Norwich, it has been the YMCA that has provided an indoor pool where infants and toddlers learn to swim. The elderly participate in aquatic exercise programs to ease the excess strain on arthritic joints. A licensed daycare facility helps relieve some of the pressure on working families while providing a sports diversion to many young people. Unfortunately, the Norwich YMCA will be closing this week.
“No program at the YMCA is designed to make money,” said Attorney Michael Lahan, who serves as chairman of the volunteer board responsible for managing the Norwich branch of the YMCA. “All membership fees go directly to supporting programs that help others. The physical plant at the downtown location is an integral part of the city and the only way to survive will be through a coalition of organizations.”
It is no secret that health costs are rising rapidly in the United States. Much of those dollars go to treating chronic problems like obesity, hypertension and diabetes. It’s time we begin to invest these resources for prevention rather than treatment.
New test needed for boxing safety
Professional sports organizations are constantly searching for ways to improve the safety of competitions. Sports involving unarmed combat like boxing and mixed martial arts can face immense challenges since the ultimate goal is to neurologically impair an opponent in the form of a knock-out.
The pre-fight evaluation is crucial in avoiding permanent neurologic injury and death. Each state and all sovereign tribal nations that allow these sports have their own boxing commissions.
Connecticut has three commissions: The Connecticut State Boxing Commission, the Mohegan Tribal Department of Athletic Regulation and the Mashantucket Pequot Tribal Boxing Commission. Connecticut is among the most heavily regulated states in terms of safety.
Electroencephalography (EEG) is a diagnostic test where wires are taped to the skull and electrical impulses generated by the brain are recorded. Normal brain cells (neurons) produce patterns of rhythmic discharges. Variations in these rhythms are indicative of different types of brain abnormality.
EEGs were routinely used as a screening test in many states to determine whether a boxer could participate in an event. After several years, a review of 98 EEGs, performed on 86 boxers, who had participated in a total of 5,809 fights showed no significant abnormality. No fighter was prohibited from boxing based on the EEG.
These results demonstrated that EEG is not an appropriate test to assess chronic brain injury. This information will be presented next week at the annual meeting of the American Academy of Neurology (AAN).
The AAN represents over 21,000 neurologists. The information accumulated in Connecticut may help in evaluating patients with traumatic brain injury including returning service personnel.
Most importantly, the boxing commissions in Connecticut changed and are now requiring annual neurologic history and examination before boxing events.
“Boxing commissioners must be willing to change regulations in order to keep unarmed combatants safe,” said Peter Timothy. commissioner for the Mashantucket Pequot Tribal Athletic Commission.
The ability for sports organizations to institute changes despite time-honored traditions is crucial to maintaining a safe contest for participants.
The pre-fight evaluation is crucial in avoiding permanent neurologic injury and death. Each state and all sovereign tribal nations that allow these sports have their own boxing commissions.
Connecticut has three commissions: The Connecticut State Boxing Commission, the Mohegan Tribal Department of Athletic Regulation and the Mashantucket Pequot Tribal Boxing Commission. Connecticut is among the most heavily regulated states in terms of safety.
Electroencephalography (EEG) is a diagnostic test where wires are taped to the skull and electrical impulses generated by the brain are recorded. Normal brain cells (neurons) produce patterns of rhythmic discharges. Variations in these rhythms are indicative of different types of brain abnormality.
EEGs were routinely used as a screening test in many states to determine whether a boxer could participate in an event. After several years, a review of 98 EEGs, performed on 86 boxers, who had participated in a total of 5,809 fights showed no significant abnormality. No fighter was prohibited from boxing based on the EEG.
These results demonstrated that EEG is not an appropriate test to assess chronic brain injury. This information will be presented next week at the annual meeting of the American Academy of Neurology (AAN).
The AAN represents over 21,000 neurologists. The information accumulated in Connecticut may help in evaluating patients with traumatic brain injury including returning service personnel.
Most importantly, the boxing commissions in Connecticut changed and are now requiring annual neurologic history and examination before boxing events.
“Boxing commissioners must be willing to change regulations in order to keep unarmed combatants safe,” said Peter Timothy. commissioner for the Mashantucket Pequot Tribal Athletic Commission.
The ability for sports organizations to institute changes despite time-honored traditions is crucial to maintaining a safe contest for participants.
Triathlons possible even for those with physical limitations
Triathlons typically consist of swimming 2.4 miles, bicycling 112 miles, and running 26.2 miles in succession. This format became popularized by the Iron Man event held annually in Hawaii.
Recently, shorter variations of this format have made triathlons accessible to mere mortals who wish to train and compete but also have a job and family that get in the way.
The challenge of completing a triathlon is intoxicating for many athletes. Katherine Downes is a young woman originally from Glastonbury and now living in New York City. An accomplished swimmer, in 2006 she began to notice symptoms of diminishing stamina. Even short walks became a struggle.
Katie was born with an atrial septal defect (ASD), a hole between the right and left atria of the heart, which did not become symptomatic until her 20s. As a result of the ASD, the normal cardiac bloodflow is reversed and overloads the right ventricle and lungs.
After several attempts the ASD was repaired, giving Katie a new appreciation of sports. With her physician’s approval, she joined a group called “Team in Training” that prepares athletes for participation in triathlons with the goal of raising money for the Leukemia and Lymphoma Society.
Katie is set to compete in her first triathlon on April 26 in St. Petersburg, Fla. “Pushing yourself to accomplish an athletic feat despite physical obstacles makes reaching that goal even more special,” Downes said.
Recent studies have emphasized the risk of participation in triathlons. Many athletes are not accustomed to swimming in often frigid, open water. It is imperative that before participating in these events, clearance be obtained by a physician and an adequate amount of time invested in training.
When an athlete participates in any event with the goal of raising money for the less fortunate, the accomplishment becomes doubly rewarding.
If you wish to support Katie’s effort, donations can be made by going to http://pages.teamintraining.org/nyc/anttry09/kdownes.
Recently, shorter variations of this format have made triathlons accessible to mere mortals who wish to train and compete but also have a job and family that get in the way.
The challenge of completing a triathlon is intoxicating for many athletes. Katherine Downes is a young woman originally from Glastonbury and now living in New York City. An accomplished swimmer, in 2006 she began to notice symptoms of diminishing stamina. Even short walks became a struggle.
Katie was born with an atrial septal defect (ASD), a hole between the right and left atria of the heart, which did not become symptomatic until her 20s. As a result of the ASD, the normal cardiac bloodflow is reversed and overloads the right ventricle and lungs.
After several attempts the ASD was repaired, giving Katie a new appreciation of sports. With her physician’s approval, she joined a group called “Team in Training” that prepares athletes for participation in triathlons with the goal of raising money for the Leukemia and Lymphoma Society.
Katie is set to compete in her first triathlon on April 26 in St. Petersburg, Fla. “Pushing yourself to accomplish an athletic feat despite physical obstacles makes reaching that goal even more special,” Downes said.
Recent studies have emphasized the risk of participation in triathlons. Many athletes are not accustomed to swimming in often frigid, open water. It is imperative that before participating in these events, clearance be obtained by a physician and an adequate amount of time invested in training.
When an athlete participates in any event with the goal of raising money for the less fortunate, the accomplishment becomes doubly rewarding.
If you wish to support Katie’s effort, donations can be made by going to http://pages.teamintraining.org/nyc/anttry09/kdownes.
Mouthguards aren’t just for dental safety anymore
Spring training provides a great opportunity to catch up with colleagues and discuss new innovations in sports equipment.
Mouthguards have long been accepted as the best way to avoid dental injuries. In recent years, they have also become a fashion statement with various colors and designs adorning the mouths of football, hockey and lacrosse players.
This year, mouthguards are being marketed as a way to improve athletic performance. They are now worn by golfers, as well as baseball and tennis players, as a means to relax muscle tension and maintain posture.
Several baseball players have appeared at spring training with mouthguards produced by PPM and Edge. Most notably, Manny Ramirez has begun to use a Pure Power Mouthguard.
The theory behind this teaching is that relaxed jaw muscles will allow a more relaxed posture and more power being generated. This theory is based on anecdotal evidence rather than any scientific study. In the past, golfers have found that chewing gum often relaxes the grip and swing.
Another product of recent interest is the “Brain Pad.” The brain pad is a mouthguard that is advertised as a way of diminishing the serious effects of traumatic brain injury. This theory is based on an isolated study performed in the 1960s that postulated a relaxed jaw served as a “shock absorber” for the brain. Although never proven, this belief has become part of sports medicine lore.
Despite the lack of scientific support, no one will argue with either of these practices. They result in athletes wearing mouthguards that at a minimum provide dental protection.
Cost is another issue since the Edge and PPM products range from $900-$2,000, while the Brain Pad and other fitted mouthguards cost $25.
No matter what logic is applied, mouthguards are a great idea even if you’re only trying to avoid damage from an errant tennis ball.
Mouthguards have long been accepted as the best way to avoid dental injuries. In recent years, they have also become a fashion statement with various colors and designs adorning the mouths of football, hockey and lacrosse players.
This year, mouthguards are being marketed as a way to improve athletic performance. They are now worn by golfers, as well as baseball and tennis players, as a means to relax muscle tension and maintain posture.
Several baseball players have appeared at spring training with mouthguards produced by PPM and Edge. Most notably, Manny Ramirez has begun to use a Pure Power Mouthguard.
The theory behind this teaching is that relaxed jaw muscles will allow a more relaxed posture and more power being generated. This theory is based on anecdotal evidence rather than any scientific study. In the past, golfers have found that chewing gum often relaxes the grip and swing.
Another product of recent interest is the “Brain Pad.” The brain pad is a mouthguard that is advertised as a way of diminishing the serious effects of traumatic brain injury. This theory is based on an isolated study performed in the 1960s that postulated a relaxed jaw served as a “shock absorber” for the brain. Although never proven, this belief has become part of sports medicine lore.
Despite the lack of scientific support, no one will argue with either of these practices. They result in athletes wearing mouthguards that at a minimum provide dental protection.
Cost is another issue since the Edge and PPM products range from $900-$2,000, while the Brain Pad and other fitted mouthguards cost $25.
No matter what logic is applied, mouthguards are a great idea even if you’re only trying to avoid damage from an errant tennis ball.
As baseball season begins, think safety
The principal goal of anyone involved in sports medicine is to assure the safety of an athletic event for all the participants. Safety measures in sports like baseball and softball can have dramatic impact.
Recent conversations with Mike Turgeon, who has been teaching baseball skills in Norwich for 20 years, and the athletic training staff of the New York Yankees in Tampa have raised several safety issues worth noting:
• Field conditions. Many baseball injuries are the result of a “bad hop” off a stone in the infield or stepping into an unexpected sink hole in the outfield. Municipalities must maintain athletic fields if they wish to continue youth sports programs.
• Basic skills. Before allowing youngsters to play infield positions coaches must be sure that they possess the skill to handle a hard hit ball.
• Bats. The longstanding controversy over the safety of metal bats continues. The best way to avoid injury from a hard-hit ball coming off a metal bat is by using protective equipment like mouth guards, helmets, masks and devices that protect the genitalia.
• Automatic External Defibrillators (AEDs). “Commotio cordis” occurs when the heart begins to beat erratically or ceases to beat entirely after being suddenly struck by an object. An appropriate chest protector such as those worn by hockey players can avoid this injury. When this life-threatening situation presents itself an AED can be used to immediately shock the heart back to normal rhythm. This year the New York Yankees are leaving nothing to chance and have purchased eight AEDs so that when on the road each minor league team has an AED available at all times. This action should serve as an example for communities to make AEDs available at all athletic events not only for athletes but fans as well.
Baseball can only become safer if parents and communities take an active role.
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 aalessi@wwbh.org, or listen to his podcasts, comment on his blog or buy his book at backushospital.org.
Recent conversations with Mike Turgeon, who has been teaching baseball skills in Norwich for 20 years, and the athletic training staff of the New York Yankees in Tampa have raised several safety issues worth noting:
• Field conditions. Many baseball injuries are the result of a “bad hop” off a stone in the infield or stepping into an unexpected sink hole in the outfield. Municipalities must maintain athletic fields if they wish to continue youth sports programs.
• Basic skills. Before allowing youngsters to play infield positions coaches must be sure that they possess the skill to handle a hard hit ball.
• Bats. The longstanding controversy over the safety of metal bats continues. The best way to avoid injury from a hard-hit ball coming off a metal bat is by using protective equipment like mouth guards, helmets, masks and devices that protect the genitalia.
• Automatic External Defibrillators (AEDs). “Commotio cordis” occurs when the heart begins to beat erratically or ceases to beat entirely after being suddenly struck by an object. An appropriate chest protector such as those worn by hockey players can avoid this injury. When this life-threatening situation presents itself an AED can be used to immediately shock the heart back to normal rhythm. This year the New York Yankees are leaving nothing to chance and have purchased eight AEDs so that when on the road each minor league team has an AED available at all times. This action should serve as an example for communities to make AEDs available at all athletic events not only for athletes but fans as well.
Baseball can only become safer if parents and communities take an active role.
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 aalessi@wwbh.org, or listen to his podcasts, comment on his blog or buy his book at backushospital.org.
Skiers should wear helmets
It often takes a tragedy to raise public awareness regarding safety. During an athletic event, there are only two ways in which an athlete can suddenly die: cardiac or neurologic. The latter is typically the result of a traumatic brain injury.
Actress Natasha Richardson experienced a seemingly minor fall on a beginner ski slope and struck her head. After some initial symptoms she felt better and did not see a need for medical attention. Shortly after, she lapsed into a coma and subsequently died.
This frightening scenario is a principal focus of attention for sports medicine specialists.
Traumatic brain injury is a general term describing a range of damage that includes relatively mild concussion to severe brain hemorrhage. Bleeding can occur within the brain itself (intracerebral hemorrhage), below the dural membrane surrounding the brain (subdural hemorrhage) or outside the dura (epidural hemorrhage).
Epidural hemorrhage can be the result of relatively minor trauma to the temporal portion of the skull resulting in a tearing of the superficial temporal artery. Arterial bleeding is rapid and increases pressure in the skull with the brain eventually being pushed downward through the skull base.
A period where symptoms improve after the initial hemorrhage can be seen in epidural hemorrhage such as that experienced by Richardson. This “lucid period” can vary anywhere from a few minutes to hours. It is during this period that medical personnel must rely on clinical suspicion and take action that may be life saving.
This tragedy has reinvigorated the discussion of mandating the use of helmets on ski slopes. Helmets have proven to be effective in reducing brain injury in cycling and other sports. Ski helmets have the additional benefit of being comfortable, warm and waterproof in addition to offering brain protection.
Hopefully, common sense will prevail and more skiers and snowboarders will begin to wear helmets, and there will not be a need to legislate safety.
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 aalessi@wwbh.org, or listen to his podcasts, comment on his blog or buy his book at backushospital.org.
Actress Natasha Richardson experienced a seemingly minor fall on a beginner ski slope and struck her head. After some initial symptoms she felt better and did not see a need for medical attention. Shortly after, she lapsed into a coma and subsequently died.
This frightening scenario is a principal focus of attention for sports medicine specialists.
Traumatic brain injury is a general term describing a range of damage that includes relatively mild concussion to severe brain hemorrhage. Bleeding can occur within the brain itself (intracerebral hemorrhage), below the dural membrane surrounding the brain (subdural hemorrhage) or outside the dura (epidural hemorrhage).
Epidural hemorrhage can be the result of relatively minor trauma to the temporal portion of the skull resulting in a tearing of the superficial temporal artery. Arterial bleeding is rapid and increases pressure in the skull with the brain eventually being pushed downward through the skull base.
A period where symptoms improve after the initial hemorrhage can be seen in epidural hemorrhage such as that experienced by Richardson. This “lucid period” can vary anywhere from a few minutes to hours. It is during this period that medical personnel must rely on clinical suspicion and take action that may be life saving.
This tragedy has reinvigorated the discussion of mandating the use of helmets on ski slopes. Helmets have proven to be effective in reducing brain injury in cycling and other sports. Ski helmets have the additional benefit of being comfortable, warm and waterproof in addition to offering brain protection.
Hopefully, common sense will prevail and more skiers and snowboarders will begin to wear helmets, and there will not be a need to legislate safety.
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 aalessi@wwbh.org, or listen to his podcasts, comment on his blog or buy his book at backushospital.org.
Hip injuries are hip this year
It seems that every year when spring training rolls around, a new injury becomes the highlight of conversation. Last year, it was Curt Shilling’s shoulder and this year it is Alex Rodriguez’s hip. If this keeps up, baseball fans may forgo medical school and go right into an orthopedic residency. A-Rod has now surpassed Bo Jackson for having the most written about hip joint in sports.
The hip is a ball and socket joint. The head of the femur is a ball shaped structure that fits into the acetabulum, a socket in the pelvis. The joint is held together by several ligaments. The labrum is the cartilage that lines the acetabulum and allows smooth movement of the hip.
While allowing the leg an extensive range of motion, this joint is especially vulnerable to traumatic injury. Repeated pounding and twisting seen in most sports that require rapid starts and change in direction account for a majority of hip damage.
Treatment of hip injuries in athletes varies from a conservative approach including rest, anti-inflammatory medications and physical therapy to hip replacement. Arthroscopic surgery has become a minimally invasive approach that often delays or avoids a more radical procedure.
In 1991, Bo Jackson underwent total hip replacement after a fracture. He returned to play major league baseball. Alex Rodriguez recently underwent arthroscopic surgery to repair a torn labrum.
The common denominator in recovery from all hip surgeries is early rehabilitation often beginning immediately after surgery. Many orthopedic surgeons who treat athletes get their patients on a stationary bicycle two hours after surgery. Non-weight-bearing exercise continues for the first six weeks after surgery while the patient is on crutches. Strengthening exercises follow with hopeful return to running in ten weeks.
Much has changed from Bo Jackson’s “miraculous” return from hip surgery in 1991. These breakthroughs have carried over to non-athletes who can get back to an active lifestyle with minimal downtime.
The hip is a ball and socket joint. The head of the femur is a ball shaped structure that fits into the acetabulum, a socket in the pelvis. The joint is held together by several ligaments. The labrum is the cartilage that lines the acetabulum and allows smooth movement of the hip.
While allowing the leg an extensive range of motion, this joint is especially vulnerable to traumatic injury. Repeated pounding and twisting seen in most sports that require rapid starts and change in direction account for a majority of hip damage.
Treatment of hip injuries in athletes varies from a conservative approach including rest, anti-inflammatory medications and physical therapy to hip replacement. Arthroscopic surgery has become a minimally invasive approach that often delays or avoids a more radical procedure.
In 1991, Bo Jackson underwent total hip replacement after a fracture. He returned to play major league baseball. Alex Rodriguez recently underwent arthroscopic surgery to repair a torn labrum.
The common denominator in recovery from all hip surgeries is early rehabilitation often beginning immediately after surgery. Many orthopedic surgeons who treat athletes get their patients on a stationary bicycle two hours after surgery. Non-weight-bearing exercise continues for the first six weeks after surgery while the patient is on crutches. Strengthening exercises follow with hopeful return to running in ten weeks.
Much has changed from Bo Jackson’s “miraculous” return from hip surgery in 1991. These breakthroughs have carried over to non-athletes who can get back to an active lifestyle with minimal downtime.
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