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In this issue... • LifeBridge Health Sports Medicine Joins with National Center for Sports Safety • Sports Injuries and Baby Boomers • How To Tell If Your Injury Is Serious • Sports Injuries and Arthritis FREE SPORTS INJURY SCREENINGS... ONGOING LifeBridge Health Sports Medicine at Physiotherapy Associates 1836 Greene Tree Road Baltimore, Maryland 21208 April 14, April 28, May 12, May 26 4:30 pm- 5:30 pm Call 410-601-WELL (9355) to sign up The Remedy Report LifeBridge Health Sports Medicine Newsletter April 2005 LifeBridge Health Sports Medicine Kick Off We hosted our kick off event at LifeBridge Health & Fitness on April 7, 2005. Lacrosse Legend, Gary Gait was the guest of honor. Mr. Gait spoke to the audience about the importance of taking care of yourself and achieving your goals in a healthy way. The Sports Medicine team from LifeBridge Health was introduced and our program was highlighted in a presentation of program offerings. There were vendors from Physiotherapy Associates, Vumawear, Northwest Hospital Educational Resource Center, Owings Mills Sports Plex, The Training Room, LifeBridge Health & Fitness, National Center for Sports Safety, The Ten Bears author Dr. Miles Harrison, Sports Combine.com and others. Thanks to all the vendors for making the event a success. The athletic team with the greatest attendance was the recreational team from Reisterstown boys lacrosse. Thanks to Mr. Clothier for bring the team to the event. His team will receive $100.00 to their lacrosse program, an agility and sports specific session with LifeBridge Health & Fitness and a guest appearance of Gary Gait at one of their team events. The event was a success for the program and just the beginning of programs to come for LifeBridge Health Sports Medicine. LifeBridge Health Sports Medicine Joins with National Center for Sports Safety The LifeBridge Health Sports Medicine Program has partnered with the National Center for Sports Safety (NCSS) to offer community coaches the opportunity to take PREPARE, an online sports safety education course. Understanding the necessity of sports safety is very important as a coach of a high school, college or recreational athletic team. That is why the LifeBridge Health Sports Medicine is offering this course to the coaches and community fitness members in the Baltimore County and surrounding areas. PREPARE, consists of seven modules aimed at providing valuable information on how to prevent injuries, respond to emergency situations and other general sports safety topics. PREPARE, originally designed for youth volunteer coaches, is relevant to all individuals participating in sporting events. The program provides valuable information beneficial to coaches on and off the sports field. Coaches will be better prepared area communities will also benefit as these individuals take the skills learned and knowledge gained with them. "Education is the key to prevention," states Dr. Larry Lemak founder of the NCSS. "If we can prevent just one emergency situation or injury it is worth the time and effort," adds Lemak. After completing PREPARE, participants will receive a sports safety patch, a certificate of completion and will be added to the NCSS' National Registry of Participants who are sports safety educated. About NCSS The NCSS is a non-profit organization founded to promote the importance of injury prevention and safety on all levels of youth sports through education and research. Sports Injuries and Baby Boomers While there may be no single fountain of youth, you can slow down the aging process by staying physically active. Regular exercise enhances muscle and joint function, keeps bones strong and decreases your risk of heart attack and stroke. Here are some tips developed by the American Orthopaedic Society for Sports Medicine and American Academy of Orthopaedic Surgeons that can help you exercise safely. • • Always take time to warm up and stretch before physical activity. Research studies have shown that cold muscles are more prone to injury. Warm up with jumping jacks, stationary cycling or running or walking in place for 3 to 5 minutes. Then slowly and gently stretch, holding each stretch for 30 seconds. Don't succumb to the "weekend warrior" syndrome. Compressing your physical activity into two days sets you up for trouble and doesn't increase your fitness level. Try to get at least 30 minutes of moderate physical activity every day. If you're truly pressed for time, you can break it up into 10 minute chunks. Remember that moderate physical activity can include walking the dog, working in the gardening, playing with the kids and • • • • • • taking the stairs instead of an elevator. Take lessons and invest in good equipment. Whether you're a beginner or have been playing a sport for a long time, lessons are a worthwhile investment. Proper form and instruction reduce the chance of developing an "overuse" injury like tendinitis or stress fractures. Lessons at varying levels of play for many sports are offered by local park districts and athletic clubs. Select the proper shoes for your sport and use them only for that sport. When the treads start to look worn or the shoes are no longer as supportive, it is time to replace them. Listen to your body. As you age, you may find that you are not as flexible as you once were or that you cannot tolerate the same types of activities that you did years ago. While no one is happy about getting older, you will be able to prevent injury by modifying your activity to accommodate your body's needs. Use the 10 percent rule. When changing your activity level, increase it in increments of no more than 10 percent per week. If you normally walk 2 miles a day and want to increase your fitness level, don't try to suddenly walk 4 miles. Slowly build up to more miles each week until you reach your higher goal. Also use the 10 percent rule as your guide for strength training and increase your weights gradually. Develop a balanced fitness program that incorporates cardiovascular exercise, strength training and flexibility. In addition to providing a total body workout, a balanced program will keep you from getting bored and lessen your chances of injury. Add activities and new exercises cautiously. No matter if you've been sedentary or are in good physical shape, don't try to take on too many activities at one time. It's best to add no more than one or two new activities per workout. If you have or have had a sports or orthopaedic injury like tendinitis, arthritis, stress fracture or low back pain, consult an orthopaedic surgeon who can help design a fitness routine to promote wellness and minimize the chance of injury. This information is presented from the American Academy of Orthopaedic Surgery website. How To Tell If Your Injury Is Serious There are some common tip-offs you should recognize as warning signs that you have an injury that needs your attention. While some sports injuries are immediately evident, others can creep up slowly and progressively get worse. If you don't pay attention to both types of injuries, chronic problems can develop. The following list of six injury tip-offs comes from Anybody's Sports Medicine Book, written by James Garrick, M.D. and Peter Radetsky, Ph.D. • • • • • • Joint pain, particularly in the joints of the knee, ankle, elbow and wrist, should never be ignored. Because these joints are not covered by muscle, there is rarely a muscular origin. Joint pain that lasts more than 48 hours requires a physician diagnosis. If you can elicit pain at a specific point in a bone, muscle or joint, by pressing your finger into it, you may have a significant injury. If the same spot on the other side of the body does not produce the same pain, you should probably see a physician Swelling is usually quite obvious, and can be seen, but occasionally you may feel swollen without outward signs. Swelling is always a sign of a sports injury and should never be ignored. Often, swelling within a joint will cause pain, stiffness, or may produce a clicking sound as the tendons snap over one another because they have been pushed into a new position due to swelling. If swelling isn't obvious, you can usually find it by checking for a reduced range of motion in a joint. If there is significant swelling within a joint, you will lose range of motion; the limb will only go so far in each direction. Again, compare one side of the body with the other to identify major differences. If there are any, you have an injury that needs attention. Comparing one side to the other for weakness is often hard to do, but can be a good clue to identify significant injury. One way to tell is to left the same weight with the right and left side and look at the result. Often therapists will test comparative weakness manually or with special equipment. Never ignore numbness or tingling. Often related to nerve compression, these warning signs may indicate serious injury and should always be seen by a physician. I Have One Of The Warning Signs of Injury - What Next? If you recognize any of the above warning signs of injury the goal is to prevent further damage. Don't let the problem get any worse and don't let the swelling continue. Look for an obvious cause of the injury such as poorly fitting equipment or a missed step while sprinting. If you can locate the source of the injury, you can begin to remedy the situation. If you have any of the above warning signs, do not continue your activity. Begin treatment immediately. The first treatment indicated for any acute injury is reducing any swelling. Swelling causes pain and loss of motion, which in turn will limit use of the muscles. If you don't use the muscles, they will weaken, and shorten and resist repair. The primary treatment for acute sports injury is R.I.C.E.: Rest, ice, compression and elevation. Rest in this case simply means to stop the activity that caused the injury. Compression for an acute injury is the most important immediate treatment. Wrapping the injured body part with an ACE bandage can keep swelling to a minimum. Never apply heat to an injury. Heat will increase circulation and increases swelling. Immediate Treatment For Injury As a recap, here is what you should do immediately when you sustain a sports injury: • • • • • Stop the activity immediately. Wrap the injured part in a compression bandage. Apply ice to the injured part (use a bag of crushed ice or a bag of frozen vegetables) for no more than 15 minutes at a time. Let the area warm completely before applying ice again, in order to prevent frostbite. Elevate the injured part to reduce swelling. Get to a physician for a proper diagnosis of any serious injury. Sports Injuries and Arthritis Author: William Cottrell, M.D. Americans of all ages are increasingly participating in sporting activities. This is a healthy trend, as sports are well known to be helpful for cardiopulmonary fitness and weight-control. However, with the benefits does come some risk, namely sports injuries. Most sports injuries are mild and temporary, with no long-term effects. Minor sprains and bruises or overuse injuries treated properly may be nuisances but do not necessarily cause any permanent problems. Some injuries, however, may lead to arthritis later in life. Millions of Americans are affected by arthritis, a potentially painful and debilitating condition. Arthritis is the result of disease or damage to articular cartilage, the white glistening surface of our bones found in the joints. Articular cartilage is found in all major joints of the body, including the hips, knees, and shoulders, as well as the smaller joints of the upper and lower extremities and even the spine and pelvis. When this normally smooth gliding surface is no longer intact, pain, swelling and stiffness may result. This is what is referred to as arthritis. Another knee injury that results in arthritis is torn cartilage. The menisci are a different form of cartilage found in the knee. They are roughly semicircular wedges, two in each knee, that function to cushion the joint, absorbing a great deal of stress, and also more evenly distributes stress across the joint. A torn meniscus alone can be painful and cause swelling and stiffness, leading a patient to seek early surgical treatment. Historically, the entire torn meniscus was removed. We now know that, while this treatment relieves the acute pain and swelling, it eventually predisposes the patient to premature arthritis due to the absence of the protective effects of the menisci. Currently, attempts are made to repair a torn meniscus to remove only the torn part, leaving as much healthy meniscus as possible. Despite these efforts, an injured meniscus may still lead to earlier arthritis. The next issue is treatment of arthritis due to sports injuries. As is true in most cases, the best treatment is prevention of the injuries. There are a few different methods to prevent sports injuries. The first is proper conditioning. When someone is poorly conditioned or fatigued, the muscles do not protect the joints, and an injury is more likely. It is important for athletes at any level to be properly conditioned for their sport, not only with regards to stamina but also strength and flexibility. Proper nutrition and hydration also come into play. The next aspect of prevention is proper form and technique in the specific sport, assured in part by following the rules of the game. Finally, certain sports offer protective equipment, and this may be of benefit in injury prevention. Once an injury has been sustained, there are still measures that may prevent arthritis. Avoiding strenuous or demanding activities may decrease the chances of arthritis. In many cases, as in the torn ACL, the problem can be surgically corrected, restoring proper mechanics and thereby hopefully preventing arthritis. If arthritis does result, there are also many ways to treat the symptoms. The first is activity modification. Occasionally, orthotics or braces may help. Medications such as acetaminophen (Tylenol) or anti- inflammatory medicines such as ibuprofen may offer relief. Physical therapy, including exercises, are sometimes helpful. New over-the-counter nutritional supplements have also shown promise. Occasional joint injections may give some relief. When all other measures have failed, surgery ranging from arthroscopy to joint replacement can be performed. Unfortunately, there is no cure for arthritis, and that is why prevention is the best treatment. Arthritis is usually seen in older people, but is also seen in younger people who either have a less common form of the disease or have suffered an injury. The most common form is osteoarthritis, also referred to as degenerative arthritis. It usually occurs naturally, without any specific prior injury, in older people. However, this form of arthritis is also the type seen after injury. In this case, it may be referred to as post-traumatic osteoarthritis, or wear- and-tear arthritis. Whatever the name, the result is the same - a painful, swollen, stiff, and sometimes enlarged or deformed joint. It can be mild in some people, offering only an occasional reminder of an old sports injury, or it can be severe, causing daily suffering and degrees of disability. It is important to understand the type of injury that can go on to cause arthritis in later life. The types of injuries that lead to arthritis include direct injury to the cartilage (as in fractured joints) or injuries that alter joint mechanics, increasing the stress on the articular surface. The first type is less common in sports, more often seen in motor vehicle accidents or falls from a great height. In these instances, severe bruising of the cartilage surface may lead to permanent injury and eventual arthritis. It may also occur from a fracture of the bone through the cartilage in the joint. In these cases the joint may heal with irregularity causing the cartilage to wear unevenly and eventually erode, resulting in arthritis. A key factor is that, while cartilage is a living tissue and does respond to injury, its reparative capacity is limited, and any significant damage usually results in a permanent alteration. The more common way a sports injury leads to arthritis is when a ligament or supporting structure is damaged, causing abnormal mechanics in the joint. This greatly increases the stress on the articular surface, which over time, wears out and causes arthritis. One of the most known examples of this types of this injury is in the knee. With the increased attention of media to the injuries sustained by star athletes, most people have heard of an ACL injury. ACL stands for anterior cruciate ligament, one of the major stabilizers of the knee. The ACL is in the center of the joint and keeps the tibia (lower leg bone) from moving forward on the femur (thigh bone). Commonly an athlete injures the ACL trying to pivot. The result of a torn ACL is generally an unstable knee, one that buckles occasionally, especially with strenuous activities or further participation in sports. This instability abuses the knee, and over time, the articular surfaces are damaged by the abnormal stresses. Once again, the result is eventual arthritis, although the timetable ranges from a short time to many years. National Center for Sports Safety Follow up Links • LifeBridge Health • LifeBridge Health & Fitness • LifeBridge Health Sports Medicine About Us LifeBridge Health Sports Medicine is a program developed to serve the community at large for their sports medicine needs. The LifeBridge Health Sports Medicine physicians are Samuel Matz M.D., Jon Koman M.D., Robert Riederman M.D., and Kenneth Tepper M.D. Call 410 601-WELL for information on LifeBridge Health programs such as Free Injury Screenings, Sports Medicine Educational Series, referral information for sports medicine needs. Sharon Price, LifeBridge Health Sports Medicine Coordinator [email protected]