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Guest Post by:

Brittney Lang, MS ATC
Athletic Trainer
MUSC Health Sports Medicine

We are gearing up for spring season athletes to be starting games and practices in the coming weeks. With more sports come more athletes with potential for musculoskeletal injuries. We of course will see many of the common injuries such as ankle sprains, strained muscles, overall soreness and more but injuries that are not really prepared for the most are dental and oral injuries. For every sport, there is some form of protective equipment that is required to be worn from helmets, to pads, to goggles and face masks to help to prevent possible injuries. But there is one small piece of protective equipment that is over looked by most athletes and can help decrease the amount of oral injuries seen is a mouth guard. There are only a few sports that require mouth guards to be worn during participation at all times, such as football, lacrosse and ice hockey. However, though it is highly recommended for all physical activity and sports to use a mouth guard during participation many do not.  Studies have shown that athletes have a 1 in 10 chance of receiving a facial or oral injury during their season. If we take just a few extra precautions by either providing mouth guards or highly suggesting that mouth guards be used during play we can help minimize dental and other oral injuries in the future.

Types of Mouth Guards

There are different kinds of mouth guards out there but they are for the most part broken into two kinds, one being the boil and bite or stock mouth guards that you can get from most sport stores or the fabricated ones that require a dentist to make specifically for the individual. The boil and bite mouth guards are most often used since they are cheaper and easily accessible. But they are usually a one size fits all kind of item so many will have issues with them fitting properly and causing athletes discomfort thereby causing them to not want to wear one. The athlete will place the mouth guard into boiling water making it pliable. Then placed into the mouth while waiting for the plastic to cool down and form to the mouth and teeth as best it can. The other type of mouth guard is one that is fabricated by a dentist specifically for the athlete using a plaster mold of the athlete’s mouth and teeth. These mouth guards are the best way to go but can be expensive therefore only seen with athletes who need a well fitted mouth guard such as though with braces or with athletes who need to be able to talk freely but require using one in their sports like quarterbacks.

Treatment for Dental Injuries

When it comes to oral and dental injuries, the athlete should be sent to a dentist or dental specialist for proper care. Depending on severity of the dental or oral injury, it will determine if the injury will need to seek emergency dental treatment or not. The earlier the athlete can be treated the overall care and outcome of the injury will be beneficial.

Preventing Dental Injuries

The first step in preventing oral injuries is to educate the community, both the athletes and health care professionals, on the benefits of using a mouth guard during all sport related activity; and dispelling myths that athletes might have about wearing mouth guards such as it restricting them to breath freely. Showing that mouth guards can decrease the amount of oral injuries during sports due to contact from other athletes or equipment used in the activity. Also, whether an athlete or health care professional, helping to promote that mouth guards be required to be worn by all sports during participation and to enforce the requirements that are already out there.

Guest Post by:

Katie Bracken, ATC, PES
MUSC Health Sports Medicine

It’s that time of year where New Year Resolutions are going strong! It is the perfect time to step outside of your comfort zone and try weight training. Even if you are more interested in cardio (cardio is great for all types of athletes to increase lung capacity and aerobic endurance), weight training has many benefits short-term and long term. 

Whole body exercise:

Many people think of squats as a “leg” dominant exercise. However, squats actively engage several other areas of the body. In order to prevent injury, one must “activate” the low, mid and upper-back to properly keep the spine in line. At the same time, to not over work your back you must also engage your core to keep a balance in the mid section of the body.  Not only do you have to use your nervous system to engage the proper muscles, but also while doing that you are building muscle. A strong back and a strong core are essential to any weight training program.

Increase in muscle mass:

As we all know, an increase in weight training in turn increases muscle mass. Research has shown that adding squats into a weight-training program has shown to increase muscle mass in an area other than just the lower body. Squats are a full body exercise that includes: quadriceps, hamstrings, glutes, back and core.  A continuous addition of squats to a weight-training program will increase muscle mass in these certain areas of the body.

Muscle mass increases metabolism:

If your main focus is weight loss, which it is common this time of year, then add weight training! Research has shown that the more muscle you put on, the more your metabolism continues to work. Even after your workout is complete, muscle continues to work for you throughout the day! Exercise is used for weight loss…weight-training burns fat…. muscle burns fat…. more muscle burns fat!! One rule of thumb is for every pound of muscle gained, 50-70 extra kilocalories are burned for the day.  And NO, women, lifting weights will not make you bulky. There are so many other added benefits that come with weight training.

A boost of sports performance:

Whether you run tough mudders or go for a walk during the evening hours, squats will over all help your athletic performance. As mentioned, weight training and squats increase muscle mass. With more muscle mass present, there becomes an increase in power output. It is not that you gain more muscle fibers within a muscle, but you increase the size of the muscle fibers you already have. SO… the bigger the muscle fibers you produce in a muscle, the more power you are able to generate. I.e. you can walk faster, jump higher and finish the tough mudders quicker. Who wouldn’t want that?

Injury Prevention:

With the above information in mind, please consider the following tip. When first beginning to add squats to your routine, do not jump right into them without educating yourself on proper technique or consulting with a professional. In order to avoid injury, mobility must occur in two places, the ankles and hips. If proper mobility is achieved then squats can in turn improve range of motion, flexibility and create stronger ligaments and joints, which can help prevent injuries.  As we get older, we need stronger ligaments, joints, muscles and a better center of balance. The earlier you can start adding squats to your routine, the better!

Overall, try something new! Begin light and reach for your goals, its never to late!

Need some inspiration for living well?  Check out MUSC News Center’s Oldie Goldies series. Oldie Goldies features people 60 and up who are embracing aging, serving as role models who maintain good health and vitality.

Meet Jeanne Nelson, 90, who still loves to dance, cleans her own home and mows her lawn.  She offers suggestions for healthy aging.  One of her suggestions, not surprisingly, is about physical activity. “Stay active, no matter what you do. If you take walks or even just vacuum and do housework, that's activity. A lot of people hire others to come in to do that for them.”  Read more of Jeanne's advice here.

Then, meet the “Diva”, Delores Sanders, 60, a Hollings Cancer patient whose style is undeniable.  Her advice includes being herself and  she says: “Oh, yes, girlfriend. I want to be an inspiration and let people know that all things are possible. You can’t give up. You have to be positive. With all that I’ve been through and where I am now, I’ve learned that you just have to focus on the good.” Find the full story on the "Diva" here.

 

 

 

 

Guest Post by:
Brittany Darling, MS, ATC

As we enter the New Year, the busy schedule is not the only thing getting in the way of staying active. Around this time of year we also see the weather changing and getting colder everyday, with daylight becoming less and less. This time of year, in my opinion, is the absolute worst for staying in shape. I have come up with some tips that may be helpful to not let yourself fall into hibernation mode this year.

Get on a schedule. Creating a schedule that flows with your normal routine can make it easier to stick to work out plans. Write it down, or sign up for classes ahead of time based on what the upcoming work schedule looks like. I have found that getting up a half hour earlier and doing something active really helps to get the day started. Getting your blood flowing and adrenaline pumping first thing in the morning will have a direct effect on the rest of your day. I think morning workouts are especially effective this time of the year because it is dark by 5pm, so it allows you to relax when you get out of work knowing you have already done your exercising for the day.

Try something new. If you are getting bored with the same old gym scene, and it’s obviously too cold to run outside, and then try a new class somewhere else. You may even be able to put your current gym membership on hold for a month.   I would highly recommend a yoga class, especially one that has a warm and/or hot class that they offer. It’s great to walk in from the cold to a heated room this time of year. This may also introduce your body, as well as your mind, to something new. A great way to stay committed is to sign up and pay for the class ahead of time, this way you are motivated to not waste the money you spent.

Start a home exercise plan. Depending on what level of activity you are looking for, it is very possible to accomplish your fitness goals right from home. Again, it will be beneficial to think of a time that works best for your schedule, whether it is in the morning or at night in order to stay consistent. There is a variety of phone apps out there right now that outline a basic body weight routine for you and track your progress. You can also implement your own, for example: body squats, push-ups, plank hold, jump rope and max out every other day. These are basic exercises that take no more than 10 minutes to complete, but you can easily track gradual improvements as your max becomes higher each week.

Overall the hardest part always seems to be getting started and beginning the exercise. Find your own personal motivation and use it to keep you going. Just keep reminding yourself that spring is right around the corner!

Guest Post by:

Michael J. Barr, PT, DPT, MSR
Sports Medicine Program Manager
MUSC Health Sports Medicine

As the NFL regular season is coming to an end, some teams are now preparing for the “what-if” scenarios to making the playoffs, while others have clinched and are waiting to see who their first or second round opponents are going to be.  No matter their standings or “power-rankings” all teams are examining their positional depth charts to try and figure out how to adapt for current injuries and players lost, due to injury, throughout the season.

As an avid NFL fan, this year seems like there were significantly more season ending injuries compared to previous seasons; or it may just feel like that this year as my beloved Baltimore Ravens have been decimated by season ending injuries to both their offensive and defensive teams.  Concussion are always in the news and can potentially have significant short and long term medical issues related to them, but do they account for the greatest number of missed weeks?  So as I looked more into injuries in the NFL, I found some very interesting statistics; according Footballoutsiders.com the majority of weeks missed due to injury are for injuries to the knee, both ACL and non-ACL related.  During the previous 15 seasons (2000-2014), knee injuries accounted for over 20,000 regular-seasons missed weeks.

Season ending ACL injuries are one of the leading causes of these missed weeks of some of our favorite stars and of players the majority of us have never heard of.  In 2014 there were 34 reported ACL injuries in the NFL.  The 2013 season set the record for the greats number of ACL injuries in NFL history with 61, however 2015 is not too far behind.  Through week 15 of the 2015 season there were a total for 45 reported ACL tears, interestingly enough 27 of those injuries occurred during pre-season.

New rules, and accompanying fines, focusing on reducing the potential risk for head injuries and head to head contact are causing players to tackle lower on their opponent’s body, however according to Dr. Timothy Hewett, director of biomechanics and sports medicine research at the Mayo Clinic, approximately 70% of all ACL injuries in the NFL are non-contact injuries.

Contact injuries are going to occur in all dynamic contact sports; however it is the non-contact injuries that we need to focus on.  According to Hewett, non-contact ACL injuries in the NFL can be reduced between 50 and 70% through biomechanical analysis, specific training methods, and an open mind to new ideas based off of proven medical research.  In article by Mike Tamier, NFL national lead writer, Hewett describes his “Milk Carton Test” to analyze knee mechanics and identify those players at higher risk for potential knee injuries, but once these potential risks are identified, what is done about it?

In 2006 the International Federation of Football Associations (FIFA), implemented the FIFA 11+ injury prevention program, suggesting that all amateur and professional soccer players around the world participate in this specific warm-up program focusing on neuromuscular control, strengthening and stability exercises at least 2-3 days per week.  Since publication in 2006, there is an estimated 35% reduction in all lower extremity injuries for players consistently participating in the FIFA 11+ program at least 1.5 times/week.

I have said it thousands of times, professional athletes, especially NFL players, are physically freaks of nature; they can run faster, jump higher and are stronger than the general population.  NFL athletes in particular, have such variable demands on their bodies by position that a “one-size-fits-all” program like the FIFA 11+ may not be as beneficial; however a base program tailored to the individual needs of each position and each player could show a significant reduction in these non-contact injuries.

As a local sports medicine provider, over 50% over my patients are either pre-op or post-op ACL reconstruction patients.  As these athletes are finishing their rehab and have met their specific return to sport goals, I educate them on an individualized maintenance program to help prevent recurrent and new injuries.   However, athletes come to me after they have already sustained an injury, if the NFL would develop a base program that could be tailored to specific athletes and specific positions by athletic trainers and coaching staffs; ACL injury prevention could be funneled down throughout all amateur football players similar to what FIFA did for professional and amateur soccer players.

As I previously stated, contact injuries are going to happen, but we need to focus on the prevention of those non-contact injuries that are occurring at all levels of play.

References:

1.      Binney, Zachary: “NFL Injuries Part 1: Overall View.” Published 9/25/2015 on footballoutsiders.com

2.      Tamier, Mike: “Preseason ACL Injuries Can be Drastically Reduced.  Here’s How.”  Published on 8/27/2015 on bleacherreport.com

3.      Olson D, Siukka R, Labountry A, Christensen T.  Injuries in Professional Football: Current Concepts. Current Sports Medicine Reports by the American College of Sports Medicine.  2013; 12: 381-390.

4.      Barengo N, Meneses-Schavez J, et al. The Impact of the FIFA 11+ Training Program on Injury Prevention in Football Players: A Systematic Review.  Int. J. Environ. Res. Public Health.  2014; 11: 11986-12000.

 

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