Sports Injury Blog

In today’s competitive sporting environment, children are being placed under increasing pressure to excel at their sport. Schools and clubs (not to mention parents) invest a lot of time and money developing their children into athletes, and it is quite common for youngsters to be exercising in excess of 20 hours per week!

Although exercise at an early age has numerous health benefits, it also involves the risk of injury, and in children, unique risk factors means unique injuries…

Due to the structure of growing bones, injuries in children differ from those of their adult counterparts. For example, due to the “elastic” nature of long bones in children, these bones tend to “bend” and split rather than break, resulting in what is known as a Greenstick fracture (see above). The end-plates of long bones (where the growth occurs) are susceptible to “shifting” under large loads or fractures, which given their location, often affects the overall growth of these bones.

Where an adult might develop a tendon problem with overuse, children are more likely to develop a traction apophysitis, whereby the bony attachment point of the tendon is “pulled’ away from the bone.

This usually occurs at the attachment site of large, powerful muscles such as: the elbow (Panner’s Lesion), the Hip, the knee (Osgood-Schlatter’s Lesion and Sinding-Larsen-Johansson Lesion) and the Ankle (Sever’s Lesion).

These injuries are usually due to the repetitive nature of some of the sports that children play (think about how many times a young, fast pitcher, will practice his throwing action) leading to repetitive stress of specific tissues.

We commonly see shoulder and elbow overuse injuries in throwing sports (cricket, baseball, water polo etc), stress fractures of the spine (e.g. tennis, athletics) and stress fractures of the lower legs (runners and dancers).

Faulty technique, lack of adequate recovery, poor flexibility and muscle weakness are some of the most common causes of these injuries and they can be prevented to a large extent. This highlights the need for Sports Injury Screening at schools, as it is often during such testing at schools and clubs that we have been able to identify and correct problems, before they become injuries…

Ric@Athletify

The wonder drug called exercise!

Imagine there was a drug you could take that did the following:

• Reduce heart disease by 40%
• Reduce your risk of stroke by 27%
• Decreased diabetes by 50%
• Decreases high blood pressure by 50%
• Lowers deaths and the risk of recurrent breast cancer by 50%, colon cancer by 60%
• Lowers the risk of Alzheimer’s disease by 33%
• Treat depression as effectively as Prozac or other behavioral therapies

Unfortunately there is no pill that can do all these (wishful thinking), but there is a drug out there that can, and it’s called Exercise!!

I recently attended a course by the “Exercise is Medicine” institute to discuss this very topic of EXERCISE being prescribed as a MEDICINE to all people.  It’s part of a global initiative of the American College of Sports Medicine to promote exercise in a safe and effective way.

As with most of the population, most of my patients are aware of the importance of exercise. Those that don’t exercise regularly will always sheepishly admit that they know they should be exercising, but usually blame a lack of time or tiredness as their reason for not doing so.

Here are a few interesting things I picked up from this course:

• Not exercising for ONE day has the same health detriments as smoking THREE  cigarettes!!!

As a non-smoker who chooses not to smoke due to the health implications, this came as a big surprise to me and puts into perspective just how damaging it is to be physically inactive.

• Its better to be FAT-AND-FIT than SKINNY-AND-UNFIT

Thats right! Just because you are not overweight doesn’t mean you are healthy.

• If you are not doing at least 150 minutes of exercise per week, you are considered high risk for developing a variety of health issues!!

That basically boils down to getting 30 minutes of exercise for 5 days per week. Less than that and you chances of mortality are more than someone who is obese, or smokes, or has diabetes.

• Being physically active during the day does not count as EXERCISE.

A lot of people believe that they get enough “exercise” by being on their feet all day or climbing a few flights of stairs during their day. The truth is, if your heart rate is not reaching between 50-70% of its maximum capacity for a minimum of 30 minutes (continuously) per day, you can’t say you are exercising.

Work that out quickly for yourself- take 220 and minus your age to get a rough idea of your Heart Rate (HR) max.

Then take your number, and multiply it by 0.5 to get 50% and 0.7 to get 70%.

So for a 35 year old that would be  220-35=185

185 X 0.5 =92.5                 185 X 0.7=129.5

So this guy or girl would need to have their HR at between 92.5 and 129.5 beats per minute for 30 minutes a day.

On average, a brisk walk would get you into this target heart rate but as with all DRUGS, there are certain risk factors (especially for people who already have pre-existing medical conditions) so this is where Exercise is Medicine South are working with health professionals in order to safely and efficiently prescribe exercise to individuals.

After an initial screening procedure, you would be grouped into either low, moderate or high risk, and your exercise program specifically tailored to suit your risk and needs.

One last thought…

There are 1440 minutes in a day. Can you really not find the time to use 30 of them towards living a longer life???

Ric@Athletify

Things are constantly evolving in the world of sports medicine. With a better understanding of how the human body works, comes an ever changing understanding of how best to treat it. One such notion which needs to be challenged is the age old acronym of R.I.C.E (Rest, Ice, Compress, Elevate) used for the management of acute injuries.

The “Rest” part of this strategy may in fact cause delayed healing and muscle atrophy. Several studies that have compared early PAIN-FREE movement to complete rest have shown decreased healing times and improved pain.

As I stated above, what is quite important is to start moving early on, but specifically without pain. Even some serious injuries/operations should allow for a degree of movement that is pain free.

Another area of uncertainty is the application of “ICE”. Whilst there is evidence that ice causes a numbing effect on tissue (by decreasing the speed and transmission of nerves), thereby reducing pain, the notion that icing decreases the inflammatory response and speeds up healing is being challenged.

Some studies are showing that the application of early ice (for 20 minutes in the acute stage of an injury) may in fact reduce the healing potential of tissue, and cause longer term negative effects on the healing collagen. So if your intention is to reduce pain, then ice may be appropriate, but if you think you are assisting the body healing process, think again…

WHAT IS NOW BEING SUGGESTED IS A NEW ACRONYM – M.E.A.T

MOVEMENT – as discussed earlier, must be pain-free

EXERCISE – the correct exercises done early on have been shown to reduce muscle wasting and improve outcomes

ANALGESICS – used to control acute pain, but be careful not to “mask” the pain so you can go back to activity too quickly. Again, avoid anti-inflammatories at first.

TREATMENT – from a Physiotherapist or other sports medicine practitioner. We can use other modalities to improve circulation and assist healing.

The Editor in Chief of The Physician and Sports Medicine Journal was quoted as saying,”Do you honestly believe that your body’s natural inflammatory response is a mistake?” I’ve said it in my article on anti-inflammatories, the first stage of healing is INFLAMMATION, but it seems we have all been hell-bent on trying to stop this.

It would appear that the more we learn about how to heal the human body, the more we realize it does a pretty good job, all on its own!

Ric@athletify