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Guest Post by:

Stephanie Davey, ATC

March is still a few months away and the college basketball season is still young, but injuries at this time in the year can derail a teams chances of getting in and succeeding in the NCAA tournament.   Maryland Forward Dez Wells and Texas Point Guard Isaiah Taylor both have suffered wrist injuries and are both sets to miss significant time.

Dez Wells fractured his right wrist on November 25 and had surgery the following Friday.  Isaiah Taylor fractured his left wrist on November 21 when he was fouled hard while driving for a layup.   Taylor landed on his outstretched left hand.  The foul was ruled flagrant.  Both athletes are projected to return in early January and should be available for most of their respective conference schedules.

Wrist injuries account for 11 to 12% of all basketball injuries and the most common mechanism is falling on an outstretched hand.  Neither Texas nor Maryland released the specific nature of either injury, but there are a couple common wrist fractures to basketball.   The distal radius is the end of the long bone on the thumb side of the forearm and is the weaker of the two forearm bones.  Symptoms of a distal radius fracture are pain and tenderness along the bone as well as swelling through the wrist.  A distal radius fracture typically does well with a cast but surgery may be necessary if there is significant displacement of the bones.  A second common wrist fracture is the scaphoid bone fracture.  The scaphoid is a small bone located between the thumb and the wrist, also known as the “snuff box”.  Swelling located directly over the scaphoid bone is a strong indicator of a significant injury.  The athlete will also have pain and tenderness.  Treatment of a scaphoid fracture depends on the location and severity of the fracture and can include casting and or surgery.   The scaphoid bone has a poor blood supply so healing can be more difficult.  Following each injury, athletes will have to go through a significant physical therapy regime, which will likely last beyond the end of the season.  The key points of a basketball player’s wrist physical therapy program will be range of motion and strength.  For a basketball player to be effective he must have full range of motion especially in his shooting wrist and as close to full strength as possible.  The wrist also needs to be able to withstand being hit by other players and the ball as well as another fall to the ground.  Preventing wrist injuries in basketball is nearly impossible due to the contact especially at the higher levels.

Thus far, both Wells and Taylor are expected to make full recoveries from their respective injuries.  The unknown is how it will effect their playing form and their team’s chemistry from missing significant time during the season.

Guest Post by:

Shane K. Woolf, M.D.
Associate Professor of Orthopaedics and Chief of Sports Medicine
Medical University of South Carolina - Sports Medicine

Thanksgiving has come and gone, and December is now upon us, which means grapplers from college to youth levels are hitting the mats. Wrestling season is, indeed, in full swing with the promise of a solid campaign ending in a championship run! As a former collegiate wrestler, I can still remember vividly this time of every season. Months of off-season cardio and weight training workouts, regular technique drills, and a dedicated schedule of summer tournaments will hopefully pay off and give the aspiring champ an edge at the respective weight class.

The other thing I remember distinctly is that wrestling season is a long battle, and one’s body is constantly stressed by the physical demands of this noble sport. Injuries and illness in wrestling can end a season and, instantly, spoil all of the hard earned off-season effort. Like athletes in any sport, wrestlers are subject to musculoskeletal injuries involving the entire body, as well as a multitude of other issues, some of which are unique to “close contact” sports.

Musculoskeletal Injury

Traumatic injuries in wrestlers more commonly occur in competition versus practice. One study of middle school athletes showed equivalent injury rates during practice and games for most sports except football and wrestling, which were higher during competition.1 Further, wrestlers are subject to an overall injury rate of 1.64 per 10,000 athletic exposures, second only to football players2 and are usually the result of direct player-player contact, unlike the cutting/pivoting types of injuries experienced by field and court athletes.3 Dislocated joints can happen, especially with complex moves and lifts/throws, but most injuries are ligament sprains and muscle strains. College wrestlers more commonly experience lacerations and cartilage injury, while high school athletes more frequently incur elbow and hand injury.4 Attentive officiating to monitor the intensity of slams to the mat, illegal holds, and potentially dangerous positions can help reduce these potential risks.

Head and Neck Injury

Dangerous holds, positions and throws also place the athlete at risk for concussion (traumatic brain injury) and neck injuries. Recent understanding of concussion management demands a cautious and systematic return to play, which can lead to time off the mat in both competition and practice. Concussion rates in wrestlers trail only football and girls soccer and are about equal to girl’s basketball.5 While not frequent, traumatic brain injury from concussion events must be considered by athletes, coaches and the medical team.

Face and Ear Injuries

Usually the result of a direct impact with another wrestler’s head, hands, knee or other body part as well landing on the mat, damage to the nose, mouth, teeth, and ears can lead to stitches, fractured teeth, lip and gum lacerations, and nasal airway obstruction. Auricular hematoma, or bleeding within the outer folds of the ear, requires drainage to avoid development of cauliflower ear.  This condition is the late effect of fibrous scarring and hardening of the hematoma and is permanent. Headgear can reduce but not eliminate the risk of ear injury when worn consistently. One study of collegiate wrestlers reported 39% of those surveyed had some degree of ear damage, 2.5x more common in those who did not wear headgear.6

Dehydration and Nutrition

Even prior to becoming thirsty, the athlete is already experiencing fluid deficit and may have already lost 2% of body weight. This degree of fluid loss, more common during intense and long practice workouts, can significantly impair cognition and performance. Coupled with the effects of compromised nutrition from misguided weight loss efforts to make a certain weight class, the athlete must be aware that top performance demands adequate nutrition and hydration. The consequences are fatigue, cramping, electrolyte imbalance (which can lead to cardiac issues), weakness, and certainly do not align with the wrestler’s goal of peak performance. I remember those days well and dreaded weigh-ins! In junior high school, my team once lost a match that we had forfeited my weight class when I did not make the cut. I was crushed, but now 30 years older and an experienced medical professional, I see the damaging health effects of extreme weight loss and dangerously low body fat. There is certainly value in optimal fitness, smart dieting with consistent, balanced caloric intake and regular hydration.

Skin Lesions

The nature of close contact in wrestling uniquely predisposes the athlete to skin tears, abrasions, and occasionally, infections. Bacterial infection, typically from Staphylococcus aureus and ringworm (a fungal rash) can be effectively treated with antibiotics or antifungals along with local care of the lesion. Recent outbreaks of Methicillin resistant strains of the Staph bacterium can be more difficult to control. The athlete must be taken out of competition until the infection resolves. Herpes Gladiatorum is a viral infection that can be more serious, as the virus causes painful skin lesions, usually on the face, neck, back, and/or trunk. This virus resides permanently in nerve ganglia where it can reactivate as recurrent lesions triggered by things like stress, UV light, skin irritation, and even certain foods. Common sense practices such as monitoring skin lesions, pre-competition skin checks, not sharing towels and gear, showering right after activity, and allowing lesions to resolve before return to the mat can make a huge difference. Coaches, parents, officials, and athletes must be aware of potential skin issues and work together to prevent spread.

Despite the risk of various injuries, some of which are unique to sports like wrestling, it is an awesome sport. I am admittedly biased, but there are few athletic activities that place such mental and physical demands on the athlete. It is an excellent sport for developing focus, strength, body control, and self-reliance. And ask any wrestler – the camaraderie of this ancient sport is just incredible! As a former 190 pounder and now a practicing orthopaedist, I encourage all parents, coaches, and officials to take care of the kids out there grappling hard. If an athlete does get injured, seek out the care of a sports medicine specialist, like those on the team at MUSC Health Sports Medicine, to get back out on the mat!

1 Beachy and Rauh, Journal of Athletic Training (2014)
2 Rechel et al, Journal of Trauma (2011)
3 Kerr et al, Clinical Pediatrics (2011)
4 Yard et al, American Journal of Sports Medicine (2008)
5 Marar et al, American Journal of Sports Medicine (2012)
6 Schuller et al, Archives of Otolaryngology (1989)

Guest Post by:

Bobby Weisenberger, ATC, PES
Head Athletic Trainer Charleston Battery
MUSC Sports Medicine

As the calendar turns to fall, Ice Hockey fans start to look to the start of a new season.  Hockey players of all skill levels are starting to hit the ice.  All of the major leagues including NHL, AHL, ECHL, and NCAA have seasons starting in October with the High School and Youth leagues following their lead.

Hockey is a considered a collision sport and treated as “high risk of injury”.  Due to the high contact nature of the game, hockey players wear a great deal of protective padding.  This padding consist of helmets, shoulder pads, elbow pads, padded gloves, padded pants that also protect kidneys, shin pads that also cover the knee, and skates.  Goalies wear helmets with full-face cages, a heavy-duty chest protector, wrist blocker and catching glove, large padded shin pads, and skates.  Due to several instances of eye injury, all of the pro leagues have mandated visors on helmets, while the NCAA and the leagues below require full-face protection.

Even with all of this protection injuries are still a major part of the game.  The most common injury in hockey are lacerations to the face caused by contact to the face by opposing players, high sticks, hitting the boards/glass, or being hit by the puck.  Ligament injuries, muscle strains, fractures, concussions, and contusions are also very common.  Many players suffer groin strains due to the specific types of movement required on the frictionless surface.  Knees and ankles are also susceptible to injury because of the heavy torque placed on the lower extremity during turning and pivoting on the ice.   Knees and ankles are also vulnerable to injury through contact with opposing players.

While some of these injuries are unpreventable, players can prevent many of them by engaging in proper training programs and proper pre practice/ pregame warm-ups.  Proper training programs include strengthening any muscles that are determined to be deficient.  Players should also be on a daily flexibility program to ensure they can function through a complete range of motion.  Pre practice and pregame warm-ups should consist of active muscle warm-up activities and drills.  Players must properly warm-up muscle groups before attempting any dynamic movements on the ice.

With the proper precautions and preparations, Ice Hockey is a great game that can be enjoyed safely at many ages.  Any and all injuries should be immediately reported to your teams Athletic Trainer and Team Physicians to ensure all injuries are dealt with in a timely manor with player safety always the main focus.

Today, experts from MUSC joined together for a Twitter chat focusing on holiday stress and tips to make it a happier, healthier holiday.

Dr. Joshua Brown, Director of Clinical Services, MUSC Weight Management Center (WMC), Dr. Constance Guille from the MUSC Department of Psychiatry and Behavioral Sciences and MUSC nutritionist Tonya Turner offered advice to help you prepare for the weeks ahead and provided some great resources for you to use after the Twitter Chat. 

We hope you were able to participate in our inaugural Twitter chat November 18 at noon.  If so, here are the links we promised you.  If not, we hope you will join us next time.  Our hashtag will be #MUSCchat.  If you missed the chat and want to learn more about the topics we covered today, check out these resources provided by our MUSC experts.

Be sure to follow:@MUSC_COM, @MUSCHealth, @MUSCPR and @MUSCPsychiatry to stay up-to-date on all the MUSC happenings.

smokingcessationWe all know that smoking is bad for us, but making the decision to quit - and sticking with a plan - is a very personal journey and one that often comes with pitfalls and setbacks. The good news is that there are more resources available than ever before - support groups, chat lines and social media outlets are great ways to start the process. Why not make this November 20th the first step in making a change and getting healthy?  

Here are some resources to help you along the way:  

South Carolina Quits
MUSC is a national leader in tobacco research and smoking cessation programs. Our team is working to provide better education and cessation resources for all of South Carolina.

American Cancer Society - Quit for Life Program
This Facebook page acts as on online support group for those on the road to being smoke-free.   

Helping a Smoker Quit: Do's and Don'ts
If you have a friend or family member who's trying to quit smoking, try and understand how hard it is. These tips can help you draw the line between being helpful and being pushy.   

South Carolina Tobacco-Free Collaborative
Formed in 2001, the TFC is a group of leading health organizations, community coalitions, and businesses in South Carolina who are committed to reducing the toll of tobacco use in our state. Their goal is to reduce that toll.   

Sign up to receive encouraging text message reminders and tips

Quit Smoking Apps
There are several apps to choose from, many offering daily reminders and motivators, cost savings calculators and a running count of your smoke-free days.  Exactly how you start your journey to being smoke-free isn't as important as making the decision to start the process.

Remember - talk to your doctor, make a plan and reach out to others for support.


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