The simple act of jumping rope

The decision to get into better physical condition can become a very expensive enterprise. When the effort involves children, the interest can be short-lived and lead to unused gym memberships.

Some activities involve little cash outlay and can be enjoyed by the entire family. Among these is jumping rope.

The history of jumping rope is believed to date back to Egypt in 1600 AD. Rope jumping not only served as child’s play but as training for warriors.

Dutch children in early America jumped with two ropes simultaneously and subsequently the term “Double Dutch” became common.

Jumping rope continues to provide an outstanding exercise for burning calories, building strength and improving coordination. Jumping rope for one hour can burn 1300 calories.

Modern rope jumping has become a group exercise activity performed as part of exercise classes. Although it is typically associated with children, it continues to be a preferred method of training for boxers and other combat athletes.

Athletes recovering from lower extremity injuries are often prescribed jumping rope as part of their recovery to rebuild strength and joint proprioception. Proprioception is the brain’s ability to detect the position of an extremity in space.

Childhood obesity is a major problem in the United States today. Physical education programs with shrinking budgets have found rope jumping to be an effective, inexpensive exercise.

Locally, a group of students from the Integrated Day Charter School who love to jump rope have put together a service-learning project titled, “Ambassadors for Heart.” Their goal is to perform at public events and raise awareness of the dangers of physical inactivity and obesity in children and adults.

The efforts of these young ambassadors are entirely supported by private donations. They deserve our support.

Jumping rope can be a first step toward better health.

Peyton Manning and cervical radiculopathy

Among recent recurring stories in sports is speculation regarding the successful return of Indianapolis Colts quarterback Peyton Manning. On Sept. 8, Manning underwent a third surgery to alleviate pressure on a nerve root in his neck.

The cervical spine consists of seven bones called vertebrae located below the skull. Discs made of cartilage separate each of the vertebrae to avoid the friction and wear of bone rubbing on bone. This entire system is held together by a series of ligaments.

The cervical spine is designed to protect the spinal cord and the nerve roots that emerge from the spinal cord to conduct motor and sensory impulses to and from the limbs and vital organs. Damage to these fragile nerves can result in paralysis or death.

Typical injuries to the cervical spine include:

• Fracture of the vertebral bones
• Tearing of the ligaments that attach the bony vertebrae
• Rupture of the intervertebral discs from their central location

In football and other violent collision sports, it is not uncommon to see worn and ruptured discs on imaging studies like MRI and CT scans. Unfortunately, these findings are sometimes seen in young healthy athletes.

The cervical nerve roots responsible for triggering the muscles of the arm are also the ones most commonly injured. Without adequate neural control, throwing is a difficult task, especially for an NFL quarterback.

Surgical intervention includes removing pieces of the offending discs. If the surgery or surgeries require removing a large volume of disc, bone chips are inserted between the vertebrae to prevent dislocation.

While fusing the spine creates a firm repair, it also limits the range of motion of the neck. It is this loss of motion, along with arm weakness, that will make Manning’s return a formidable challenge.

Peyton Manning’s recovery will require all the discipline and effort he has acquired over the years.

Amateur boxing has its place when done correctly

Amateur boxing has been described as being a part of the fabric of society. Boxing, for many young athletes, is their first exposure to organized sports.

Recently, the American Academy of Pediatrics and the Canadian Paediatric Society issued a policy statement on boxing participation by children and adolescents. The position states that they “…oppose boxing and, in particular, discourage participation by children and adolescents.”

The position statement goes on to encourage alternative sports such as “swimming, tennis, basketball and volleyball.” This position is based on limited data and doesn’t account for many intangible advantages or disadvantages.

Amateur boxing is highly regulated under the watchful eyes of experienced coaches. Physicians are present for events and pre-fight and post-fight physicals are required.

Head protection and heavily padded gloves protect against serious injury. Bouts are brief and sportsmanship is stressed. Style and finesse are the principal ways to score points and officials are quick to end a one-sided match.

The health advantages for amateur boxers are numerous. Each participant must train regularly to build strength and stamina. The structure of a boxing gym often substitutes for a stable home life.

Boxing provides a reason to avoid tobacco, alcohol and criminal mischief.

Jody Sheeley owned the Second Chance Gym in Norwich and has been involved in amateur boxing for many years. “Amateur boxing helps build self-confidence, especially for children who don’t do well in team sports,” said Sheeley. In his experience, he has never seen a youngster require emergency medical care as a result of an amateur boxing match.

Amateur boxing has provided a healthy outlet for many young people who do not have access to other competitive sports that require significant financial investment. It is a sport that deserves public support and not restriction.

Pat Summitt will battle Alzheimer's from the bench

Pat Summitt is the “winningest” coach in women’s basketball. At age 59, she has reached the pinnacle of her career, including induction into the Basketball Hall of Fame. Unfortunately, she now joins over 5 million other Americans in their battles with Alzheimer’s Disease (AD).

AD is a degenerative disease of the nervous system that prohibits its victims from learning new information and recalling recent events. The cause of AD is unknown but it can occur in families, as is the case with Coach Summitt.

Forgetfulness is a common part of normal aging. Difficulty finding the right word or recalling someone’s name is acceptable. When these difficulties progress to becoming lost in familiar surroundings and not recognizing close family members, AD must be considered.

Symptoms of AD also include difficulties with executive planning, loss of judgment and social withdrawal. The pressure and cognitive demands of successful coaching can be overwhelming. Pat Summitt’s attempt to continue coaching at the University of Tennessee at a high level is amazing.

There are several medications available for patients with mild to moderate symptoms of AD. Unfortunately, none of these medications alter the actual progression of AD.

Coach Summitt has not chosen to “ride off into the sunset.” Instead she is approaching this disease like any athletic challenge. She is preparing her assistant coaches to take on more responsibilities. She is also beginning a regimen of medication, cognitive exercises and mental preparation.

This approach is not surprising to those of us who work with athletes. When presented with an obstacle that is seemingly insurmountable, athletes dig in and prepare for battle.

Pat Summitt is a great coach and a leader for the rights of women in sports. Now she will put a famous face to a crippling terminal illness and hopefully stimulate interest toward a cure.

Preparation is key for triathletes

In the most recent New York City triathlon, two competitors died because of injuries incurred during the swimming event. While this should not discourage triathlon participation, it is a reason for caution.

Triathlon competitions are a combination of swimming, cycling and running in a single event. The most well-known event is held each year in Hawaii and consists of a 2.4-mile swim, 112-mile bike ride and a 26.2-mile run.

These events are more popular when distances are shortened. The New York event is made up of a 0.9-mile swim, 24.8-mile bike and 6.2-mile run. These shorter distances allow for broader participation, in regard to age and ability.

Recent studies show the death rate for triathletes is twice that of marathon participants. In a 2010 study published in the medical journal, JAMA, where 14 deaths from triathlons were analyzed, 13 of these occurred during the swim portion of the event while the other resulted from a bike accident.

Autopsies revealed the majority of those who died had cardiac abnormalities. Autopsy reports are unavailable for the two most recent triathlon deaths, although the cause of death is presumed cardiac in origin.

While the number of deaths in triathlon is relatively small (15 deaths per million participants), efforts should be taken to make these events safer. Physical examination of each athlete before an event is not practical, but all participants should be examined annually by their personal physician to determine if it is safe to participate in extreme events like triathlons.

The mass start of the swim event makes collisions inevitable and impedes the ability to reach an injured athlete. Staggered starts should be considered.

Triathlons are a great way to crosstrain and remain physically fit. Adequate preparation must include a thorough medical evaluation at any age.

Heat stroke is an avoidable tragedy

Seven young athletes have already died in the United States this month; most of these deaths were the result of exertional heat stroke (EHS). High school football camps will begin this week in the northeast and it is imperative that athletes, coaches and parents are aware of the early symptoms and treatment of EHS.

EHS, along with heat exhaustion and heat cramps, are part of a group of conditions known as heat-related illnesses. EHS is the most severe in what is a succession of events that can result in death without prompt intervention.

Most athletic activities in warm climates will easily get an athlete’s body temperature to 102 degrees Fahrenheit from the norm of 98.6. As the body approaches 105, sweating stops and the athlete will begin to experience headache, nausea, lightheadedness and confusion.

Treatment consists of rapidly lowering the body temperature. Certified athletic trainers are familiar with a protocol that requires the athlete to be immersed in an ice bath before transport to a hospital. The results are dramatic and lifesaving.

“We are now seeing more EHS since athletes spend most of the off season training in air-conditioned environments,” said Dr. Douglas Casa, a professor at the University of Connecticut and a recognized expert in heat-related illnesses. “This doesn’t allow their bodies to acclimatize to the warmer temperatures.” He also believes the increased size of athletes plays a significant role in EHS.

EHS can be prevented by following these simple steps:

• Gradually acclimatize to warmer temperatures before full workouts begin. The most vulnerable period is the first five days of practice
• Athletes should report early symptoms to a knowledgeable coach or an athletic trainer.
• An ice bath should be easily accessible for emergency use.

Early tips to ward off childhood obesity

Childhood obesity continues to be a growing worldwide problem. It results in the early onset of many chronic conditions not typically seen in children like type 2 diabetes, high blood pressure, elevated lipids and heart disease. It may also lead to significant depression and poor self-image.

Recent calls for obese children to be removed from their homes emphasize the parental responsibility of overseeing that children are physically fit. A program should begin at infancy and proceed through scholastic sports.

Infant programs typically involve both parents and children. Swim classes introduce infants to aquatic activities while making them safer around bodies of water. Parent-child groups that include a combination of walking and stretching have become popular from both fitness and social perspectives.

Youth sports are often a child's first introduction to team sports and the advantages and disadvantages that go along with these activities. In the past, youth sports were a playground and sandlot activity. Now they are subject to parental coaches, uniforms and draft systems to choose the most talented players.

Team competitive sports may not be the best choice for some children. Individual activities such as swimming, running, martial arts and cycling can be a better alternative. Multiple activities help develop a broader interest and utilize different muscle groups. Specializing in one sport at an early age may lead to disappointment. Many successful athletes played multiple sports and some were drafted professionally in more than one sport.

As academic and social pressures increase in high school and college, sports become an outlet for expression and relaxation. Unfortunately, it is at this stage when a sense of perspective should be reinforced. Injuries must be monitored and treated properly, but are often the end of promising careers.

Choosing and supporting a child's participation in sports is important for proper physical and mental development.

ACSM reveals exercise guidelines

Guidelines for what constitutes the most effective exercise regimen have been elusive. Recently, the American College of Sports Medicine (ACSM) created a committee of medical and fitness experts to review the scientific literature and make recommendations.

The ACSM committee sought to provide guidance regarding the quantity and quality of exercise needed to remain fit and reduce the risks of developing disorders associated with inactivity. These conditions include heart disease, obesity, high blood pressure, stroke and diabetes.

Regarding the quantity of exercise, the group concluded that adults should perform a minimum of 150 minutes of moderate-intensity exercise each week. This should be in addition to limiting the amount of sedentary activities such as watching TV, reading and playing computer games.

The quality of exercise was divided into four categories:

• Cardiorespiratory Exercise: Also known as aerobic exercise, this category includes running, cycling, rowing, elliptical training and many other activities. The recommended 150 minutes can be divided over five days or three days. The frequency and intensity should be gradually increased.

• Resistance Exercise: The goal should be to train each major muscle group two to three days per week. Between two and four sets of 8-12 repetitions work best. Free weights, bands or machines are all acceptable modalities but the amount of resistance should be low at first.

• Flexibility Exercise: Stretching exercises are imperative before engaging in any fitness regimen. For many adults stretching should be performed upon awakening to avoid injured muscles through the course of a normal day. Each stretch should be held for 10-30 seconds and repeated two to four times.

• Neuromotor Exercise: This group of exercise is aimed at improving coordination and balance. It is particularly important as athletes grow older and has been proven to avoid falls. Activities including yoga, tai chi and dance are part of this group.

While these guidelines set an ideal goal, any activity is a “step” in the right direction.

Baseball players are most susceptible to lower back injuries

A review of the current Major League Baseball disabled list reveals five players out of action due to injuries affecting the low back.

Low back injuries involve the elements that make up the lower spine in addition to the muscles that provide support and strength. Due to the amount of sports-related repetitious movement involving the low back, injuries are common and very disabling.

The lumbo-sacral spine consists of five bony, lumbar vertebrae and the sacrum. Each vertebra is separated by a cartilaginous disc to provide a cushion. The entire structure is held together by a series of ligaments.

This elaborate design protects the spinal nerves contained within the bony spinal canal. These nerves exit the canal via small holes called foramina and proceed to provide sensory and motor function to the lower extremities.

The low back musculature connects the lower ribs, spine, pelvis and sacrum. It is the muscular system that provides the strength and stamina necessary for repeated movement.

The most common sports-related injuries are caused by sudden impact that compresses the spine and twisting injuries due to torque placed on the muscles and ligaments.

Low back strain results from torn muscle fibers. These injuries are best managed conservatively with rest, anti-inflammatory medications and physical therapy. Baseball players and especially pitchers are prone to these injuries given the need to generate throwing power by twisting.

Injuries that involve the intervertebral discs can result in breakage of the disc and protrusion of the broken piece. If the herniated disc compresses the spinal nerve, the athlete may experience symptoms of weakness, sensory loss and severe pain.

Treatment may involve decompressive surgery and a long rehabilitation. A rigorous regimen of stretching and back strengthening exercises often referred to as a “back program,” is the best way to avoid time on the disabled list.

Warmer weather brings need for acclimatization

Acclimatization is the process by which an organism adjusts to a change in the environment. Now that warmer weather has arrived and many athletes have decided to get back into action, acclimatization is a crucial element to any regimen.

In sports, acclimatization is best applied to structural and metabolic functions. Structural aspects include muscles, tendons and bones and how they work together. Metabolic systems provide energy to support movement and activity.

In order to avoid potential structural injuries, athletes should stretch adequately before beginning a workout. Starting slowly with a shorter exercise interval and a moderate pace helps. A non-jarring workout such as swimming or cycling before hitting the road for a long run is advisable.

The most reliable indication of a structural problem is pain. Discomfort for 24 hours after a workout is not uncommon but after that, pain should subside. If muscle and joint pain persist or worsen, a medical evaluation is advised.

Metabolic injury can result from extreme physical stress, dehydration, oxygen deprivation or a combination of these factors.

Muscle breakdown from overexertion results in the release of enzymes from damaged muscles. This condition, known as rhabdomyolysis, can lead to renal failure.

Dehydration in the face of working out in hot weather can lead to heat stroke and cardiac failure.

Workouts at high altitude can lead to dizziness and headaches from changes in oxygen concentration.

“Injuries due to metabolic overload typically occur when an athlete is being pushed to work harder by a coach or personal trainer,” said Dr. Jeffrey Anderson, Director of Sports Medicine at the University of Connecticut. Coaches at all levels must be aware of human limitations, especially at the youth sports level, according to Anderson.

The human body has built-in warning signs of impending disaster, including lightheadedness, fatigue and pain. It’s only when these signs are ignored that tragedy occurs.