Spring into Training with Fewer Injuries

Friday, March 14, 2014 11:44 AM comments (0)

runningSpring is on its way, which means athletes everywhere are emerging from hibernation and throwing on their running shoes. Before you join their ranks, follow along as Adam Bennett, MD, Sports Medicine at NorthShore, answers our sports-injury prevention questions, from what changes you should make to your diet if you’re in training, to what you should do if training starts to hurt:

If you experience pain while in training for an athletic event, what are your options?
The main issue is to determine the cause of the pain. If the cause is muscle soreness, then more rest between runs or training may help. Additionally, some strength training via yoga, Pilates or basic weight lifting may diminish soreness after a workout. If pain persists, seek medical care, which could include X-rays depending on the site and severity of the pain.

What causes shin splints and what is the best way to deal with them and still be able to exercise?
First order of business is to make sure that your shin splints are in fact, shin splints. Other causes of shin pain include muscle strains, stress fractures and tendinitis. "Shin splints" is a painful condition that occurs when the muscle attachments pull on the periosteum (a membrane that covers bones) of the tibia, which leads to inflammation and pain. If you do have shin splints, anti-inflammatory over-the-counter pain relievers, intense stretching, deep tissue massage, gait analysis, modifying the type of shoe you wear and rest days in your training program all may help diminish your symptoms. Formal physical therapy is an effective way to implement all of these strategies.

Are sports and recovery drinks after a workout or training better than simply drinking water? Do they aid recovery?Sports drinks contain glucose and electrolytes, which need to be replenished after sweating during training or exercise. Sports drinks are probably not essential for exercise lasting 20 minutes or less. For exercise lasting longer than 20 minutes, research shows improved performance when utilizing fluids that contain glucose and electrolytes. Research also indicates that ingesting carbohydrates and protein within 10 minutes of an intense workout improves recovery. I don’t have brand recommendations but I believe it’s a good idea to replenish with a drink that uses natural flavors and sweeteners and avoids ingredients like high fructose corn syrup. Certainly anything with caffeine, which might dehydrate the athlete, is a bad idea. Please tell your kids not to drink soda pop after exercise.

Is it better to consume protein drinks or food sources of protein after a workout for muscle recovery?
I would guess they are about equivalent. The advantage of a drink is that you replenish fluids as well.

If you have an injury in your arms or wrists, such as tendonitis, what exercises could you do to increase strength without causing further injury? 
This is a tough scenario but there are things you can do. Specifically putting resistance in your mid-forearm and keeping your hands and wrists relaxed can allow you to work out the major muscles of your upper body without irritating the tendons in your wrists. If you’re having trouble figuring out how to pull this off try working with a personal trainer a couple of times and have him or her show you.

For those training for a marathon, half marathon or triathlon, do you have any diet and training recommendations?
My first recommendation is to consider implementing rest days as part of your training. I often suggest athletes work longer and more intensely one day and then allow for complete rest the next day. If that is too much rest, consider a two-days-on, one-day-off schedule. Rest days allow for replenishment of glycogen stores in the muscle cells and fluid losses to be replaced adequately. As a result, athletes typically feel better on workout days and can push themselves even harder, which ultimately leads to a better performance on race day.

In terms of a daily diet, avoiding fried foods, caffeine and alcohol is likely to bring benefit. If you sweat a lot, you may need to add salty foods to your diet. This is especially important if you cramp easily.

For those not in training but who still want a great workout, what would you recommend?
High-intensity interval training is likely the most effective way to improve overall fitness. For my patients who are frustrated with their ability to lose weight, I often suggest they incorporate high-intensity interval training into their workout routine. Crossfit is a popular example, which works for some, but there are many ways to do this type of training. 

If you are concerned about the risk of injury during strength training as an older athlete, what should you do? Are lighter weights with more reps better? Or, should you increase weight and reduce reps?
Most people don't realize the importance of resistance training to overall health. My only concern about injury is if you had arthritis in any of your upper extremity joints (shoulder, elbow, wrists). If you do have arthritis in these joints, then lighter weights would be preferred. If you continue to lift to the point your muscles become sore the next day, it is unlikely you will lose significant muscle mass. My only suggestion is to vary the weight, repetition or motion of your regimen so your body won’t adapt as easily. This will ensure maximum benefit from every session. 

For more information on keeping your young athletes healthy, join us on Thursday, March 20th from 7:00-8:30 p.m. for a Sports Medicine Symposium at Highland Park High School. We invite you to join us for a discussion on how to keep young athletes in optimum health and prevent injuries. For more information, call Matt Castle at 224-765-2090. 

 

Oh My Aching Feet: Common Foot and Ankle Injuries

Friday, February 21, 2014 9:38 AM comments (0)

foot imageFoot and ankle pain might be common in active, athletic individuals but that doesn’t mean it can or should be ignored. If left unexamined, mild foot and ankle discomfort could lead to pain that disrupts day-to-day activities, or even lead to a more severe injury. Pain and noticeable discomfort are signs that there could be something wrong. Identifying the site and source of the pain could be the first step to getting back on your feet, pain-free. 

Lan Chen, MD, Orthopaedic Surgery at NorthShore, discusses foot and ankle injuries common in the sporty set: 

Plantar fasciitis. A common cause of heel pain, plantar fasciitis occurs when the plantar fascia, a band of tissue that connects the heel bone to the toes, becomes swollen or irritated. The pain is most severe after long periods of rest—first thing in the morning or when climbing stairs—and it typically subsides the more active you are throughout the day. In older individuals, plantar fasciitis is caused by the natural wear and tear of aging. Plantar fasciitis is also a common injury in young athletes and those who spend long periods of time on their feet. 
Treatment: There is no cure-all for plantar fasciitis. Giving your feet a break, cutting back on exercise or simply changing your shoes could relieve some or all of the pain. Stretching of the ankle and plantar fascia are also very important. If you think you might be suffering from plantar fasciitis, discuss your treatment options with your physician. 

Achilles tendonitis. Often an overuse injury, Achilles tendonitis is a swelling of the Achilles tendon, which extends from the heel to the calf muscle. Not stretching before and after physical activity, wearing high heels, or simply having flat feet or fallen arches are all common causes of Achilles tendonitis. Tendonitis pain may be mild to moderate but the pain following an Achilles tendon tear will be sudden and severe.  
Treatment: If you give it the time and rest it needs, Achilles tendonitis will heal on its own, but make sure to see your physician to determine the extent of the injury. Your doctor will then help you determine the best way to proceed, which could include rest or the use of crutches to keep your weight off the injury.

Stress fracture. Stress fractures are small cracks that develop in the bones of the feet, ankle and legs. For active individuals, they are most often caused by overuse in high-impact sports like distance running (e.g. feet repeatedly hitting the ground). Worn out, unsupportive shoes as well as a sudden increase in physical activity might also be to blame. The most common locations of stress fractures are the second and third metatarsals in the foot, and the bone at the top of the foot called the navicular. Pain from stress fractures will most likely develop gradually, increasing the more you are on your feet and decreasing when at rest. Also look for swelling and bruising at the site of the pain.
Treatment: Rest is essential! Ignoring the pain could cause more serious injury, including a complete break of the stress-fractured bone. See your doctor to determine the exact location of the stress fracture; treatment varies depending on the severity and location of a stress fracture. 

Turf toe. Common in football players, turf toe is a sprain of the ligaments surrounding the big toe. It’s caused by a hyperextension of the toe, or bending back of the toe beyond the point of normal movement. Injury can occur from a sudden, forceful movement or repeated hyperextensions over a period of time. Pain, swelling and limited movement of the big toe are all indicators of turf toe.
Treatment: As with many overuse injuries, rest is best. Depending on the severity of the injury, your doctor might recommend immobilization, either by taping the injured toe to another to relieve the stress on the joint or the use of a cast or boot. 

Ankle sprain. With the ice and snow on the ground, ankle sprains are most common in the winter months.  Mechanical twisting of the lower leg and ankle can cause simple ankle sprains, which will heal on their own, or high ankle sprains, which can be more serious and require additional stabilization in a cast or boot.  Other injuries such as ligament tears, tendon strain and cartilage injuries can all occur in an ankle sprain. 
Treatment: Most ankle sprains will heal on their own. Resting a short period to allow the initial pain and swelling to subside is common and you may need a brace or boot initially. Chronic pain after an ankle sprain is a clue that there is something else going on.  And that’s when it is important to see your doctor right away. Additional imaging and exam might be needed to clarify the situation and physical therapy might come into play.

Have you injured yourself while playing your favorite sport? 

Sports Injury Prevention: Common Sports Injuries & How to Prevent Them [Infographic]

Monday, February 17, 2014 9:44 AM comments (0)

Developing a regular exercise routine is one of the most important elements of a healthy lifestyle, and roughly 53% of Americans show their agreement by exercising three or more days a week. However, participation in any physical activity, whether it's hitting the gym or the slopes, increases your risk for an exercise-related injury. Still, the health benefits of exercise far outweigh the risks, as long as you approach each new physical activity and sport armed with the right information.

Get fit but also stay safe with the help of our sports injury prevention infographic. Learn how to recognize common sports injuries that affect both athletes and energetic amateurs and use our simple, easy-to-follow sports injury prevention tips to keep you pain free and active. Click on the link to view our full NorthShore University HealthSystem infographic.

infographic

The Rewards and Challenges of Treating Elite Athletes

Friday, February 07, 2014 3:33 PM comments (0)

Dr. DunlapBradley Dunlap, MD, Orthopaedic Surgeon and Sports Medicine specialist at NorthShore, has been treating elite-level hockey players since 2009. He has worked with USA Hockey as a team physician during tournaments in the United States and Europe. As a former college hockey player, his own personal athletic experience provides insight into the way athletes think, both in injury and health.

Here, he tells us what inspired his pursuit of sports medicine and why getting an athlete back in the game is the biggest reward of all:

Were you a hockey player yourself?
I grew up playing hockey starting at the age of five and played through college at Yale University. I still play occasionally in adult hockey leagues and am on the ice several times a week helping coach my nine-year-old son’s team. My daughters, ages four and five, are also on the ice, learning to skate.

What made you choose sports medicine/orthopaedics as a specialty? 
I sustained a knee injury that required surgery while playing hockey my freshman year in college. My surgeon was a former Yale football player and he did a great job taking care of me. He got me back on the ice without missing a beat. That’s what sparked my interest in orthopaedics and, in particular, sports medicine. I love working with motivated athletes, helping them to get back to the best of their abilities. I feel that as a former athlete, I have some insight into how athletes think and take great joy in seeing them get back into the game.

What is the day-to-day like for a team physician, particularly as a physician of hockey players?
There is actually a lot of down time covering these tournaments.  I love being around hockey, talking hockey with the players, coaches and training staff so I get to be around that during these tournaments.  Typically, I consult with the training staff and evaluate players before and after practice and am obviously ready should there be any injuries that occur during game play. While there are the more significant injuries to tend to (lacerations, dislocations, concussions), many times it’s just as important to make sure that things such as pink eye don’t spread throughout the team or that a player with the flu has a separate water bottle from the rest of the team. Hockey players in general are great to deal with. The perception is that hockey players are rough and tough, but they actually tend to be good-natured, down to earth, and appreciative of the help we can provide.

What challenges have you encountered as a hockey team physician? 
As with any elite athletes, the players we work with are incredible competitors.  They love hockey and they love to be on the ice.  However, it can be difficult at times as they can minimize the significance of injuries, especially those that require subjective complaints and feedback such as concussions.  It is my job to make sure we look out for the athlete’s best interest and health, both short-term and long-term.  It can be unpopular to pull a player off the ice, but if it’s the right thing to do then that is ultimately my job and that is why I’m there with the team.

What are the rewards of working with elite athletes?
The biggest reward is seeing the players succeed. The team physician is just one cog in the wheel to maximize and optimize the players’ abilities. There is also personal satisfaction for me in being able to combine two of my passions: hockey and medicine.

How does your work with USA Hockey inform your treatment of other patients?
I think working with athletes of any level is fundamentally the same. Is there a difference between working with the elite young athletes at USA Hockey who will someday make hockey their profession and a weekend warrior who just needs to be able to be on the ice or court Saturday afternoon? Absolutely. But my goal is the same: to keep them in the action and maximize their ability to compete and be at their best. 

Undergoing and Recovering from ACL Surgery

Wednesday, February 05, 2014 10:55 AM comments (0)

skiierFor an athlete there is nothing worse than suffering a sports injury that takes him/her out of competition. While some injuries require more rest and rehabilitation than others, those who undergo surgery for an anterior cruciate ligament (ACL) injury need to take it slow before heading  back into play.

In most cases, ACL surgery is done through small incisions, or arthroscopic surgery, rather than open surgery. Not only does this help reduce scarring and decrease recovery time but it can also help reduce complications and risks. Often the surgery is performed on an outpatient basis, meaning the patient won’t have to spend even a night in the hospital. Outpatient surgery doesn’t make recovery any less serious, however. 

Patrick Birmingham, MD, Orthopaedic Surgery and Sports Medicine at NorthShore, shares his tips for ensuring a safe and speedy recovery from ACL surgery:

  • Follow your doctor's orders. The last thing you want after you’ve undergone surgery is to suffer from an infection. Make sure your incision stays properly dressed, clean and dry to reduce this risk.  Don’t submerge under water until your doctor says it’s OK.
  • Be vigilant about your physical rehabilitation schedule or routine. It may take months or up to a year to return to some of the same activities you were involved in prior to your surgery. Be sure to stay in close contact with your physical therapist and don’t forget to do any recommended exercises at home, too.
  • Don’t be afraid to rest. If you are sore, remember to ice and elevate. Don’t push yourself beyond your comfort level. You should be able to manage your pain, and when you can’t, rest.  It’s also very important to get restful sleep because this will aid your recovery as well.
  • Follow instructions carefully. The tendon graft can take from six to twelve weeks to heal, so all of the post-operative instructions should be followed to protect the graft.

Have you had ACL surgery or know someone who has? 

 

Crossing the Finish Line: Race-Day Tips for New Marathoners

Friday, October 11, 2013 10:31 AM comments (0)

marathonYou’ve come all this way. You’ve spent months training and run hundreds of miles to prepare for race day. Don’t let a preventable injury keep you from crossing that finish line or ruin the prospects of running marathon number two in the near future.

From mile one to the final stretch, stay injury-free with these tips from Carrie Jaworski, MD, Director of Primary Care Sports Medicine at NorthShore: 

  • Don’t try something new on race day. This rule applies to nearly everything. Don’t eat a food you haven’t eaten during training. It could upset your stomach and result in more time than you would like spent in the restrooms along the race route. Don’t wear clothing you haven’t worn before, from shorts and shirts to socks and shoes. Untested clothing might feel fine at mile five but by mile 18 you could be dealing with race-ending chafing or blisters.
  • Start slow and maintain a steady pace. Don’t let the excitement at the starting line get the best of you. There are 26.2 miles ahead of you, so conserve your energy and start slow. Passing and weaving amongst the thousands of runners at the starting line also increases the possibility of injury from tripping and falling. Maintaining a steady pace means you’ll finish strong instead of struggling to the end. 
  • Have a plan about fluid intake. Prepare ahead of time by staying hydrated on the days leading up to the race. Your urine should be clear yellow, not dark. On race day, you should alternate water and an electrolyte drink at the pace you established during your training. Be careful to avoid drinking at every fluid station, as that can increase your risk of hyponatremia (low blood sodium). A good rule of thumb is to drink 4-6 ounces every 15-20 minutes after the first 30-60 minutes of exercise.  Be sure to consume gels with water. And don’t forget to hydrate after the race as well!
  • Listen to your body. If the race doesn’t go as planned, don’t ignore what your body is telling you. There are medical aid stations throughout the course and at the finish line to help you if you are unsure. Remember, no matter what happens, you have already succeeded by all the hard work you put in to get to the starting line.
  • Bring a change of clothes. Always have a change of warm, dry clothes waiting for you after the race. You’ll need to keep your muscles warm to avoid cramping after the race is over. Depending on the weather, if you sit in sweat-soaked clothes for too long, you risk developing hypothermia.
  • Stretch! Make sure to stretch and roll out sore muscles soon after finishing the race. Stretching after the race is an important way to help minimize muscle soreness the next day. Scheduling a massage for the next day is good too!

Wishing Chicago Marathon runners, old and new, a happy and successful race day from NorthShore University HealthSystem. 

Part of the Team: Steven Levin, MD, Travels to Japan with the US Rugby Team

Friday, July 26, 2013 11:02 AM comments (0)

drlevinSteven Levin, MD, Sports Medicine at NorthShore, has been a team physician with the US Rugby Team for ten years, acting as their head physician during the Rugby World Cup in France in 2007. He has travelled with the team all over Canada, England, Wales, France and now Japan. He shares what it’s like to care for these daring athletes at the top of their game during a recent tournament in Japan.

We’re in Japan for the Pacific Cup, which includes teams like Canada and Tonga as well. We arrived in Nagoya, Japan after almost 20 hours of travel from Los Angeles. We played Tonga the night before we left LA and lost in a tough game 18-9. Luckily there were no major injuries on either side, although it looked like the Tongan team had several play stoppages for apparent injuries. In reality, it seemed as though the Tongans were mainly cramping up due to the physical game the US team played. Nonetheless we did lose a close game that we felt we were capable of winning.

Rugbyteam

Since I have been with USA Rugby I have gotten a bit of a reputation as a "rugby doc" and take care of many local and regional rugby players. I specialize in shoulders and knees and have operated on many of these players with shoulder and knee injuries. It is particularly rewarding to see so many get back in the game after recovering from surgery or rehab and then continue to play at such a high level.

During a game, the most common injuries that I see in rugby players are laceration, muscle, ligament and tendon strain, tears, concussions and occasionally fractures. There are no timeouts in rugby. As a physician I have to work fast, diagnose the problem and fix it quickly or the player must be substituted. If he is substituted then he can't return under the rules of the game, so there is a great deal of pressure to get the player back as quickly as possible if medically cleared. If the player has any type of bleeding injury, I have 10 minutes to get it under control (i.e. suture it) or the player is not allowed to return. It’s fast-paced and intense. But I enjoy it. 

I also really enjoy the camaraderie I have with the players. Rugby players are the toughest, purest, and most appreciative athletes I have had the pleasure to work with and treat.

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