Gender Differences in Youth Sports Concussions

December 8th, 2014 Comments off
kids playing soccer

Photo by: Chip Griffin

Concussions are common injuries in sports, particularly in youth sports. Each year, between 1.6 and 3.8 million concussions from sports-related injuries are reported in the United States. Almost nine percent of US high school sports injuries are concussions.

Researchers studying concussions look at a number of variables in concussive injuries in an effort to better prevent concussion. Differences between male and female athletes who have had a sports concussion is one interesting, yet complex topic that researchers have attempted to tackle.

When studying youth sports, researchers have found that girls may be more prone to a concussive injury than boys, while there is also some evidence to suggest girls recover more quickly from concussions than boys.

Why?

Though the answer is not clear, a female athlete may be more prone to experience a concussion than a male athlete due to endocrine or hormonal influences, as well as musculoskeletal strength — such as neck stabilization in times of contact, explained Dr. Vernon Williams of the Kerlan-Jobe Center for Sports Neurology.

Girls may recover more quickly from a concussion than boys, simply because girls may be more likely to report symptoms earlier than boys, although again, research is not conclusive.

According to the American Academy of Neurology (AAN), concussive injuries can occur in any sport, though they are more common in high-speed contact sports. Sports that pose the greatest risk to youth athletes include: football, rugby, hockey, and soccer. Baseball, softball, volleyball, and gymnastics involve the least risk to athletes.

In terms of gender, the AAN has found that in sports with similar rules of participation (soccer and basketball) concussion risk is greater in females than in males. For other sports, there is not enough data to break the differences down by gender.

Whether an athlete is male or female, recognizing and treating a concussion early is key to complete recovery. According to the AAN, signs of concussions may include:

• Behavior or personality changes

• Blank stare or dazed look

• Changes in balance, coordination, or reaction time

• Delayed or slowed speech or physical responses

• Disorientation

• Loss of consciousness/blackout

• Memory loss of event before, during, or after injury

• Slurred speech

• Difficulty controlling emotions

• Vomiting

 

Someone who has suffered a concussion may experience any number of these symptoms:

• Blurry or double vision

• Confusion

• Dizziness

• Feeling hazy, foggy, or groggy

• Feeling drowsy or having sleep problems

• Headache

• Inability to focus or concentrate

• Nausea

• Sensitivity to light or sound

• Not feeling “right”

 

If you are the parent or coach of the student athlete, it’s important to know these signs and to educate your athlete(s) on the symptoms associated with concussions. An athlete who continues to play following a concussive injury is at greater risk of experiencing a secondary concussion and suffering more serious brain injury or permanent damage.

For tips on preventing concussions, read these tips from Dr. Williams.

Long Distance Running Series, Part 4 – Taking on the Ultramarathon

December 1st, 2014 Comments off
ultramarathon runner

Photo by: Jon Roig

Long distance runners face a unique set of challenges compared to short distance runners. Long distance running requires both physical and mental training. When appropriate measures are not taken, long distance runners may face injuries that could prevent them from participating in the sport they love. For this series, we talked to Karen Mohr, physical therapist and Director of the Kerlan-Jobe Orthopaedic Foundation. Mohr is an experienced long distance runner who has completed in dozens of marathons and ultramarathons over the years, including five 100-mile races.

Most people are aware of the common race distances in running — 5k, 10k, half-marathon, and marathon. For runners looking for a challenge beyond the marathon distance (26.2 miles), the Ultramarathon is as option.

An Ultramarathon is any distance over 26.2 miles, but common Ultramarathon distances are 50k, 50 miles, 100k, and 100 miles. Preparing for a race of this distance is a new game, even for the experienced runner.

Much of the preparation for an Ultramarathon is mental, more than physical. The physical training may be similar to training for a marathon, but with longer distances (an Ultramarathon runner’s “long run” in training might be 30 miles, compared to 20 miles for the marathon runner). Mentally, the runner must train the body and mind to press on, even when the body is exhausted. “If you do a 30-mile run one day, do a five to 10 mile run the next day to train your body how it feels to run when you’re super tired,” says Karen Mohr, physical therapist and Director of theKerlan-Jobe Orthopaedic Foundation, who has competed nearly 50 Ultramarathon races. “You have to mentally prepare yourself for that.”

In her experience, Mohr has learned that Ultramarathon runners learn to push through the mental and physical wall runners often face. In a marathon, a runner might hit that wall nearing the end of the race, but never have the opportunity to work through it. “Understanding that there are peaks and valleys you will experience in an Ultramarathon race will help you in your training and in completing an ultramarathon,” says Mohr.

Ultramarathon runners must also learn to eat food during the run. Though this varies from person to person, depending on stomach tolerance, aid stations in an Ultramarathon typically have salty snacks, carbs, and protein (such as a peanut butter and jelly sandwich) available for runners to refuel along the way. “You have to train your body to eat food while running,” says Mohr. “You have to be putting calories in your body.”

Learning to eat during the run can make a big difference in performance. It’s simply about figuring out what works best for you — and what doesn’t work — as far as food, liquids, and electrolytes go. “It’s trial and error,” Mohr says.

Another challenge Ultramarathon runners face is the trauma to their feet. Runners in a 100-mile race are given 30 hours to finish the race and most middle of the pack runners finish in about 27 to 28 hours. “That’s a long time to be on your feet,” says Mohr. Your feet take a beating with swelling, blisters, and toenail problems, among other foot trauma Ultramarathon runners may experience. Ultramarathon runners must find out during training what works best for their feet. Taping, wearing bigger shoes, and finding the right socks are a few things that may help reduce foot trauma during the race.

Physically, Mohr says any runner could run an Ultramarathon. The common qualities held by Ultramarathon runners are mostly mental. A runner who is out for a 50 or 100-mile distance must be goal-oriented, determined, and find fulfillment in setting a high goal and reaching it.

“The joy of running an Ultramarathon is setting a goal you don’t think you can reach, and then reaching it,” says Mohr. “Do it for the fulfillment of finishing the race.”

Long Distance Running Series, Part 3 – Making the Transition From Short to Long Distance Running

November 18th, 2014 Comments off

Long distance runners face a unique set of challenges compared to short distance runners. Long distance running requires both physical and mental training. When appropriate measures are not taken, long distance runners may face injuries that could prevent them from participating in the sport they love. For this series, we talked to Karen Mohr, physical therapist and Director of the Kerlan-Jobe Orthopaedic Foundation. Mohr is an experienced long distance runner who has completed in dozens of marathons and ultramarathons over the years, including five 100-mile races.

female runner crossing finish lineThe sport of running is growing in popularity in the United States. More than 50 million Americans run at least once a year, and more than 19 million run at least 100 days a year, estimates The Sporting Goods Manufacturers Association.

The half-marathon (13.1 miles) race is the fastest growing race distance among runners in the US, according to the Running USA State of the Sport Reports, but the marathon and ultramarathon are also gaining popularity among runners.

While many runners prefer to stick with a distance with which they are comfortable, runners looking for more of a challenge, or to increase physical and mental endurance may decide to make the jump from a shorter distance race to a longer distance. Making the transition from the 5k or 10k race distance to a half, full, or ultramarathon isn’t impossible, but it isn’t something that happens overnight, either. Transitioning from short to long distance running should be done with careful planning and training in order to avoid injury or burnout.

Read more…

Long Distance Running Series, Part 2 – Injury Prevention in Long Distance Running

October 31st, 2014 Comments off
marathon runners running

Credit: Phil Roeder

Long distance runners face a unique set of challenges compared to short distance runners. Long distance running requires both physical and mental training. When appropriate measures are not taken, long distance runners may face injuries that could prevent them from participating in the sport the love. For this series, we talked to Karen Mohr, physical therapist and Director of the Kerlan-Jobe Orthopaedic Foundation. Mohr is an experienced long distance runner who has completed dozens of marathons and ultramarathons over the years, including five 100-mile races.

Some running injuries cannot be prevented, but there are steps long distance runners can take to prevent some of the most common injuries, such as overuse injuries and runner’s knee.

Doctors, coaches, and fitness experts agree that taking these prevention measures during training can help prevent injury.

1. Train properly. If you are new to running, work with a running coach who will work to improve your running form and direct your training program to ensure you are running the appropriate distances. If you are working up to a new distance, it’s important not to increase your distance too quickly, suggests Karen Mohr, PT, Director of the Kerlan-Jobe Orthopaedic Foundation, and ultramarathon runner. “Don’t increase your training regimen more than 10 percent per week,” she said.

2. Take time off. Rest days are an important element of any training program. Every running workout creates microtrauma to the muscles. Without rest days, those microtraumas don’t have a chance to heal, which can result in a more serious injury.

How often should you take a day off? It varies from person to person, but as a general rule of thumb, “the older you are, the more important your rest days become,” said Mohr. Some runners will still exercise on their day off, but do something other than running, such as cycling or yoga. For most runners, a running workout five days a week is adequate, although some training programs advocate for six days per week.

3. Eat well and stay hydrated. Nutrition and hydration are important for a healthy body, regardless of your level of activity. As a runner, you must be taking care of your body, giving it the nutrients and water it needs, in order to have the most success and help prevent injury.

4. Stretch. Tissues that are tight and shortened are more prone to injury, but there is also evidence to suggest that stretching when the muscles are not warmed up can have negative consequences. Before stretching, take five to 10 minutes to walk or jog. Stop to stretch before continuing with your workout. If you cannot warm up and stretch before your workout, stretch after you run.

5. Listen to your body. If you think you may be on the brink of an injury, try icing it after your workout. Many injuries are the result of inflammation, which can be eased with ice. If you experience persistent soreness or pain, see your doctor. It’s better to be safe than sorry, and prolonging treatment for an injury could result in a more serious injury requiring more time away from training and racing.

6. Strength train. Keeping your muscles — especially your leg  and core muscles — strong will provide more support for your joints and keep your body aligned, helping to prevent injuries during your miles of running. Focus on the muscles in your trunk, hips and legs, including abductors, adductors, glutes, and hamstrings to increase your leg strength and stability.

If you have questions about your training, consult with a certified running coach, orthopedic surgeon, sports medicine specialist or physical therapist to help determine what changes to make to your training program in order to best prevent injury.

 

Long Distance Running Series, Part 1 – Common Injuries in Long Distance Running

October 29th, 2014 Comments off
female runner marathon running

Credit: Ludovic Bertron

Long distance runners face a unique set of challenges compared to short distance runners. Long distance running requires both physical and mental training. When appropriate measures are not taken, long distance runners may face injuries that could prevent them from participating in the sport they love. For this series, we talked to Karen Mohr, physical therapist and Director of the Kerlan-Jobe Orthopaedic Foundation. Mohr is an experienced long distance runner who has completed dozens of marathons and ultramarathons over the years, including five 100-mile races.

Long distance running is continuous running over the distance of at least 3.1 miles, or 5 kilometers. Common distances include the 10k (6.2miles), half marathon (13.1 miles), and marathon (26.2 miles). A small population of long distance runners will challenge their mental and physical stamina even more with an ultramarathon, in which common race distances are 50k (31 miles), 50 miles, or 100 miles.

Any form of long distance running requires significant training and endurance. As with any physical activity, when proper precautions are not taken, and the athlete does not train appropriately, injuries can occur.

The most common type of injury in long distance running is overuse or overtraining injuries (also called repetitive strain injury). These types of injuries occur when the body is not given adequate time to rest and recover before the next training or racing episode. Essentially, the athlete pushes his or her body too hard in a short amount of time, and suffers an injury as a result.

“A majority of overuse injuries are tendonitis-type injuries,” said Karen Mohr, PT, Director of the Kerlan-Jobe Orthopaedic Foundation, and ultramarathon runner. “Patella tendonitis, achilles tendonitis, and hamstring tendonitis are common overuse injuries seen in long distance runners.” Tendonitis is inflammation of a tendon, and can be very painful.

Ankle injuries like sprains and other traumatic injuries due to trips and falls are common among trail runners who regularly run on an uneven surface.

One knee injury commonly seen in new runners is patello-femoral pain syndrome, or “runner’s knee.” This type of injury is typically due to inflammation of the articular cartilage or the lining of the surface of the bone under the kneecap, Mohr explained.

Runner’s knee can have any one of a number of causes, but typically it is the result of too much shock impact to the knee. When muscles in the legs and hips that  surround the knee are not well trained to support the joints, the knee joints  will absorb the majority of the impact when running. “If your muscles are strong, when your feet hit the ground, your muscles will absorb most of the shock, protecting the knee,” said Mohr.

All runners should participate in regular strength-training exercises to strengthen the muscles in the legs and hips in order to help prevent runner’s knee, suggests Mohr. For more information on injury prevention in long distance running, stay tuned for our next article in this series.

 

NCAA Adopts New Guidelines To Tackle Concussions in College Football

October 1st, 2014 Comments off

Football player holding helmetNew NCAA guidelines this year prevent college football teams from conducting more than two live contact practices per week during the football season, in an attempt to reduce the athletes’ risk of concussion and injury. The new guidelines released in July also address best practices for diagnosing and managing concussions.

The Ivy League and the Pac-12 already have live-contact practice rules, but until this year, there were no NCAA-wide guidelines. Although these guidelines are not yet NCAA legislation, Dr. Brian Hainline, the NCAA’s chief medical officer hopes the guidelines will begin a cultural shift in college sports, he told CBS Sports.

Will these hitting guidelines result in fewer concussions among college football players? Dr. Vernon Williams of the Kerlan-Jobe Center for Sports Neurology. gives his perspective on the new guidelines.

“The concept to reduce concussions by reducing the number of contact practices should theoretically reduce the number hits, exposure, and risk of concussion for student athletes,” said Williams. “However, there has been some controversy over the years as to whether more concussions occur in practice or in games, and there are different sets of data to support each perspective.” Read more…

Meet the Kerlan-Jobe Sports Medicine Fellows – Gregory Pinkowsky

September 27th, 2014 Comments off

Kerlan-Jobe Orthopaedic Clinic is a preeminent center for research and education in orthopaedics andsports medicine. Started in 1973, the Kerlan-Jobesports medicine fellowship program is one of the country’s largest and most respected medical training programs of its kind. Each year Kerlan-Jobe welcomes a select group of the nation’s finest young doctors. The latest group of Fellows joined us recently and over the next few weeks, we will introduce them to you here the Kerlan-Jobe Blog.

Gregory Pinkowsky, MD, Kerlan-Jobe Sports Medicine Fellowship Program

Gregory Pinkowsky, MD, Kerlan-Jobe Sports Medicine Fellowship Program

Gregory Pinkowsky, MD

Gregory Pinkowsky, M.D. is a graduate of Penn State University and Penn State Hershey College of Medicine. He completed his residency at Penn State Hershey Milton S. Medical Center.

Dr. Pinkowsky made the decision to practice sports medicine because he wanted to help people recover from injuries and return to the activities they love. He applied to the Sports Medicine Fellowship Program at Kerlan-Jobe Orthopaedic Clinic because of the clinic’s “stellar reputation, large alumni network, and resources for research.”

During his time at Kerlan-Jobe, Dr. Pinkowsky says he is most looking forward to “learning cutting edge techniques, working with professional athletes, and becoming a better surgeon.” His specialty focus is in arthroscopic treatment of shoulder, knee, and elbow injuries.

Dr. Pinkowsky finds his inspiration in this quote by Coach John Wooden: “Success is never final; failure is never fatal. It’s courage that counts.”

“This quote reminds me that there are highs and lows in life, and every day is a new beginning,” he says.

Outside of work, Dr. Pinkowski enjoys watching football and baseball, working out, and running on the beach. If he had decided to pursue a career other than sports medicine, he says he would have become an architect.

 

How Brain Training Can Prevent Injury and Improve Athletic Performance

September 3rd, 2014 Comments off

human brainJust like athletes train their muscular and cardiovascular systems to improve performance and prevent injury, there is a growing understanding in the sports medicine field that practicing specific brain training activities can also help improve performance and prevent injury.

Training the brain to prevent injury

Studies looking at athlete’s reaction time have linked a slower reaction time to increased musculoskeletal sprain and strain injuries, specifically ankle injuries and knee injuries, explained Dr. Vernon Williams, of the Kerlan-Jobe Center for Sports Neurology.

“The concept is that your brain is ordering these different muscles to contract and react — like a microprocessor communicating between nerves and joints, and nerves and the spinal cord as you’re moving.”

By specifically training the brain to improve balance and reaction times, athletes can improve the communication between the brain and the body, thus reducing risk of injury and improving performance.

Evidence shows that an athlete who has suffered a knee injury, or even had knee surgery, will only benefit so much from strengthening the muscle. The real benefit in preventing a secondary injury and getting the athlete back to his or her pre-injury performance level comes when the athlete begins to train the nervous system, specifically focusing on nerves that control balance and reaction time. Read more…

Meet the Kerlan-Jobe Sports Medicine Fellows – Mark Sando

August 28th, 2014 Comments off

Each year, Kerlan-Jobe welcomes a select group of the nation’s finest young doctors as Sports Medicine Fellows.  Kerlan-Jobe Orthopaedic Clinic is a preeminent center for research and education in orthopaedics and sports medicine.  Started in 1973, the Kerlan-Jobe Sports Medicine Fellowship Program is one of the country’s largest and most respected medical training programs of its kind.  We are pleased to introduce each of the 2014-2015 fellows in this blog series.

Mark Sando, M.D., Kerlan-Jobe Sports Medicine Fellowship Program

Mark Sando, M.D., Kerlan-Jobe Sports Medicine Fellowship Program

Mark Sando, M.D.

Mark Sando, M.D., is originally from Buffalo, New York. He received his undergraduate degree from Canisius College in Buffalo and attended medical school at Case Western Reserve University. He then went on to the University of Maryland where he completed his residency.

“I enjoy working with a motivated patient population and helping them to recover and return to the activities they enjoy,” Dr. Sando says of his decision to practice sports medicine.

He says the choice to complete his fellowship at Kerlan-Jobe wasn’t difficult. “The clinic’s outstanding reputation as a center for clinical care, teaching, and innovation made it an easy choice.”

During his time at Kerlan-Jobe, Dr. Sando says he is most looking forward to developing his skills as a sports medicine physician, and “sitting on the glass at the Kings games.” His specialty focus is in shoulder and knee arthroscopy and reconstruction.

Dr. Sando says he finds inspiration in this quote by Thomas Jefferson: “The democracy will cease to exist when you take away from those who are willing to work and give to those who would not.”

“I like the emphasis this quote places on personal responsibility,” he says.

Outside of work, Dr. Sando said he enjoys watching football (Go Bills!), playing golf, and skiing. If he had decided to pursue a career other than medicine, he says he would have become a chef with the goal of opening his own restaurant.

 

Meet the Kerlan-Jobe Sports Medicine Fellows – Michael Stanton

August 26th, 2014 Comments off

Each year, Kerlan-Jobe welcomes a select group of the nation’s finest young doctors as Sports Medicine Fellows.  Kerlan-Jobe Orthopaedic Clinic is a preeminent center for research and education in orthopaedics and sports medicine.  Started in 1973, the Kerlan-Jobe Sports Medicine Fellowship Program is one of the country’s largest and most respected medical training programs of its kind.  We are pleased to introduce each of the 2014-2015 fellows in this blog series.

Michael C. Stanton, MD, Kerlan-Jobe Sports Medicine Fellowship Program

Michael C. Stanton, MD, Kerlan-Jobe Sports Medicine Fellowship Program

Michael C. Stanton, MD

Michael C. Stanton, MD, is originally from Rochester, New York. He received his Bachelor of Science from Rochester Institute of Technology and Doctor of Medicine from the SUNY Upstate Medical University. After graduating from medical school, Dr. Stanton completed his residency at University of Rochester.

Dr. Stanton chose to practice sports medicine because he wanted to “help patients overcome their injuries and return to a high level of physical function.” He is excited about the opportunity to work with the premiere Sports Medicine Surgeons of Kerlan-Jobe who are taking care of elite athletes. “I am most looking forward to the personal one on one time with Attendings [physicians], learning in both the clinical and surgical setting,” he says.

If he had not pursued medicine, Dr. Stanton says he doesn’t know what he might have done instead.  “I honestly am not sure.  I have wanted to become a physician since I was a young child,” he says.

Dr. Stanton says that his favorite quote is an inspirational one.  “‘You miss 100% of the shots you don’t take.’  You will never achieve your goals if you don’t try,” he says.

When he isn’t practicing medicine and working with athletes, Dr. Stanton says his favorite sport is basketball.