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How many times have you heard or said: “New year, new you”? Probably too many times to count. About this time of year, many have started their New Year resolutions. But research shows that only 19 percent of people who make resolutions are successful. Since one of the most common resolutions involves exercising, I am here to give you a little insight into how we use resolutions in sports medicine.

In rehabilitation of injuries, the sports medicine team works with the patient to create goals for returning to function and activity. We never just say, “Your goal is to return to sport.” That is not specific. Likewise, you should never set nonspecific goals such as “I am going to exercise more” or “I am going to lose weight.” In rehabilitation, we use the SMART framework to formulate goals for our patients. It is an acronym for the following components of a goal:

Specific – Keep goals simple. They should clearly define what you plan to do.
Measurable – How are you going to determine progress? How are you going to determine if you achieved the goal?
Achievable – The goal is realistic given the timing, conditions, and environment.
Relevant – You actually care about the goal. It directly relates to your life and well-being.
Time-Bound – Set very specific timelines to meet your goal. Remember it is okay for those timelines to adapt and change. Focus on the progress.

An example of a SMART goal for an injured basketball player: Return to basketball with no limitations or restrictions within 6 months, so he is ready in time for varsity tryouts.

This goal is much more specific and measurable. It also sets us up to create hundreds of short-term goals along the way, such as “patient will gain 10 degrees of active range of motion of knee flexion within 2 weeks following surgery.” The SMART framework provides the athlete with actionable steps and enhanced motivation.

Here are a few additional points that are important when making goals for injured athletes. They're also applicable to your resolutions.

  1. Form a tribe.
    When our patients are recovering from injuries, they have a support team behind them here at MUSC. Find your support team and encourage it to keep you motivated.
     
  2. Don’t be restrictive.
    During rehabilitation, we focus on the abilities of the patient, rather than the disabilities. Focus on all the abilities you are creating for yourself with your new resolution. If you focus on the restrictions (“I can’t eat sweets,” “I can’t watch TV because I’m exercising”), you are setting yourself up for failure.
     
  3. Be passionate.
    Athletes are generally very motivated people. Why is that? It’s because they love what they do. If your resolution is to incorporate more cardio into your exercise routine, find a cardio-based activity that you love. Don’t spend hours on the treadmill, if it is not something that gets you fired up.

It’s not too late! If you have a resolution in this new year, stop what you are doing right now, and ask yourself: Is it a SMART goal? If not, get out your pen and paper and make a plan by writing down the S-M-A-R-T of your goal. Make sure you are truly passionate about this goal and go find your tribe. Like our athletes at MUSC Health do every day, you too, can accomplish your goals.

Special guests visit Health Sports Human Physiology, Psychology Classes

Alecia Good and Savior
Athletic trainer Alecia Good and Saviour

November 14 was, for Pinewood's Head Athletic Trainer Alecia Good, a member of the MUSC Health Sports Medicine Team, "a wonderful reminder" of why she is a teacher. Good scheduled her friend Maurice Johnson, CO, BOCO, C.Ped, a certified orthotist and certified pedorthist from Floyd Brace Company (and Pinewood parent), to guest lecture in her Human Physiology and Psychology classes. Johnson asked to bring a model to help explain what he does for a living. The model was Saviour, a 10-year old boy from Ghana, Africa, who was born with cerebral palsy.

In Saviour's tribe, if babies are born with an anomaly (birth defect, maternal death, disease, or even twins or triplets), these babies are considered "spirit children" and are thought to have evil spirits that will be bad for the rest of the tribe. The parents are forced to make a difficult decision of moving the entire family to a "witch camp," where food and water are scarce, or getting rid of the "spirit child" and poisoning the baby.

Saviour was rescued by a local nun, Sister Stan, who cares for 57 other spirit children. Saviour could not walk or talk and got around by dragging himself by his hands. The scars on his knuckles mark the daily struggle he endured.

Sister Stan, through her charity, reached out to a retired nurse, Joan Tucker, who traveled to Ghana and advocated for surgery for Saviour. A long and difficult process finally brought Saviour to Shriners Hospital in Greenville, where he underwent a major reconstructive surgery at the end of June. He worked with a physical therapist to help build his strength and mobility. The physical therapist then referred him to Johnson for ankle foot orthotics.

Johnson, his assistant, Tucker, and Saviour all visited Good's classes that day. "Saviour spoke few words, but his smile lit up the room," said Good. He donned traditional attire as worn by chiefs in his tribe. He also had specially made New Balance shoes that provided a lift for a shorter leg. He had some orthosis on, but Johnson wanted to mold him for a new pair.

During Physiology class, Johnson explained the process of fitting, fabricating, and molding orthoses. He made casts on the ever-smiling Saviour and explained how they would help him walk. Saviour demonstrated his ability to walk across the room with one crutch and assistance from Tucker.

During Psychology class Johnson talked about the ability to allow his patients to participate more fully in life. Through the orthosis and a crutch, Saviour would now be able to move around and will not have to be carried or crawl.

Saviour's smile got even bigger when Tucker spoke about how excited he was to show his brothers and sisters in the orphanage how he could walk. Saviour plans to head home to Ghana in January, and Tucker will stay with him for a month while he learns to transition back into his regular life.

During the visit, the class also discussed the challenges Saviour will face after returning home. He will continue to grow, which creates the need for new shoes, braces, and longer crutches. Saviour and his team are hopeful these needs will all be met in time.

Said Good of the experience, "I'm not sure who learned more yesterday, my students or me. I thought that I was bringing in a guest lecturer to talk about a healthcare profession, but it was so much more. Instead of being the model, Saviour became the teacher.

"His story moved many of us to tears. His smile spoke volumes. His faith that has been instilled in him through Sister Stan was unshakable. The few words that he did speak brought joy to all our hearts. Saviour's presence was more impactful than any textbook could ever describe, any guest lecturer could ever explain, or any lesson I could ever plan."

Anna King, '18, also reflected on the visit: "It was an eye-opening experience that I will never forget. It was awesome to see how the things we are learning right now can help so many people in need."

For more information about Sister Stan's work, visit www.sisterstanschildren.org.

Every new year, many people are tempted to try the newest fad diet to either help lose weight or enhance athletic performance or both. Many of these diets call to restrict certain food groups such as carbohydrates. While this may help with weight loss temporarily, if not monitored carefully, a low-carb diet can lead to decreased energy and athletic performance. Carbohydrates are the primary energy source for the body, and thus are important especially in an athlete’s diet. Once the body depletes its stores of carbohydrates, the body switches to use alternate fuels such as protein or fats.

Carbohydrates often get a bad name because they are often found in simple form in processed foods including refined sugars and white flour. These commonly are seen in cookies, sodas, pasta and white bread. These foods are generally not satisfying to the appetite and cause spikes in blood sugar. Complex carbohydrates, however, are digested more slowly, leaving you feeling fuller and having less effect on blood sugar levels.  Complex carbohydrates include whole grains, vegetables, fruits, nuts and legumes (beans, lentils and peas).

Dietary Guidelines for Americans recommends that carbohydrates make up 45 to 65 percent of a daily calorie intake. For an individual on a 2000 calorie per day diet, that would mean 900 to 1300 calories in the form of carbohydrates. Rather than having these calories come from “empty sources” such as processed foods, carbohydrates should come from nutrient-dense foods that are naturally occurring. My favorite diet tip is to stay to the outside of the grocery store when I am food shopping. On the outside you will find the fresh produce, meats, and dairy. Most processed food is in the center aisles. Natural foods will provide a better fuel for the body, improving overall health and athletic performance.

Rather than limiting a certain food group, the best nutrition advice is to ensure that your diet has variety, balance and moderation. A diet rich in nutrient-dense foods from all food groups will allow for the best result in the New Year and for many years to come.

For more information:

https://www.choosemyplate.gov
https://health.gov/dietaryguidelines/2015/

Athletic trainers are essential in triaging various types of athletic injuries on and off the field prior to allowing an athlete to return to play. It may be necessary to refer to a physician for clearance, particularly in head injuries in order to safely return the athlete to physical activities. Concussions are constantly in the media these days, with a great deal of discussion regarding health risks, both short and long term, in various sports; so it is very important to make the correct call when allowing an athlete to return to play. As a certified athletic trainer, I would like to share an interesting case about an athlete’s experience with a concussion. Hopefully, by sharing these types of experiences, it will help health care providers determine when it is appropriate for an athlete to return to play after a head injury.

In this case, a high school football player was hitting a pad in practice then fell down, hitting his head face first on the ground. He somehow bounced off the pad and then hit the back of his head on the ground. The player immediately experienced dizziness and headaches. However, he had no loss of consciousness, so I directed him sit out of practice and then evaluated him. I used the SCAT5 concussion assessment exam, which is tool that is used at all levels in order to evaluate a concussion. The score on test was slightly elevated due to his symptoms, which helped me promptly diagnose a concussion, so I instructed him to see his doctor for a formal evaluation. His mother took him to his primary care pediatrician and the doctor performed a basic exam where he only checked his eyes and asked about his current symptoms. The doctor subsequently wrote a note to clear him return to play. When I received the note, I was concerned because his symptoms had not completely resolved. I put him through intense running exercises and his symptoms immediately returned. Because I was concerned about the athlete’s persistent symptoms, I sent him to one of our sports medicine physicians, Dr. DeCastro, who commonly treats many of our concussions with MUSC Health Sports Medicine.

It is essential that physicians and athletic trainers to work to together when dealing with head injuries, so an athlete does not fall through the cracks. This head injury could have been more serious or even fatal if it had not been caught and the athlete held out of sporting activities. Currently this athlete continues to recover, but it has been nearly three months since the injury and this athlete continues to experience post-concussion symptoms. I would like Dr. DeCastro to share his experience from a physician’s point of view.   

Dr. Alec DeCastro, Chief of Primary Care Sports Medicine, MUSC Health:

Concussions have garnered a lot of media attention over the past few years, and are prevalent in football but even in non-collision sports. The Center for Disease Control (CDC) recently estimated that 1.7 million people in the U.S. suffer some form of traumatic brain injury every year, which is twice the number of heart attacks that strike Americans each year. About 75 percent of those brain injuries are considered concussions or other forms of mild injury. And 80 to 90 percent of people will recover from a concussion within a seven to 10-day period, according to the National Institutes of Health (NIH).

The hype regarding concussions has caused a lot of trepidation in sports, particularly after the recent movie starring Will Smith. Actually, the condition discovered in the movie by Dr. Bennett Omalu is called chronic traumatic encephalopathy (CTE). Education regarding concussions is the key, and recognizing early signs and symptoms may make all the difference for athletes, parents, and coaches. The CDC has created an initiative called Heads-up Concussion, which has resources and tools to help recognize, respond to, and minimize the risks of concussion.  

It is important that the physician and athletic trainer to work together and apply an individualized approach to the diagnosis and care management of athletes with these types of head injuries. One of the most valuable factors in managing concussions is the athletic trainer’s comprehensive knowledge of the individual athlete. It may be imperative that whoever works most regularly with the athlete reviews his or her treatment. The athlete’s history, behavior, and risk factors need to be included as well in order to figure out the best patient-centered care plan for speediest recovery of the athlete’s concussion.

Dr. Candi Jump and family
Dr. Candi Jump and family 
Photo provided by Emily McGinnis Photography

“I grew up on the Jersey Shore, but probably not the Jersey Shore you are thinking of,” laughs Candi Jump, pediatric gastroenterologist at MUSC Children’s Health. While slightly joking about her New Jersey connections with her persona of calm and casual, anyone who has a child with GI issues knows that she is a very serious and accomplished physician when caring for these children.

Having been at MUSC and in Charleston now for three years, Dr. Jump could not imagine a more perfect setting for her and her family. She always knew she wanted to teach on some level and proudly states, “I come from a family of teachers – my mom, sister, and aunt are all in education, and I knew that my career choice would involve teaching. My role at MUSC Children’s Health has allowed me to do just that.”

“Working at MUSC in pediatric healthcare has given me the opportunity to give back to the next generation of physicians. I can be a mentor, as well as closely involved in academic medicine at the same time. I also love caring for kids and always knew pediatrics would be my path in medical school. Now, as the program director of Pediatric Gastroenterology, Hepatology, and Nutrition Fellowship Program, I have the opportunity ability to fulfill all of my passions.”

When she is not running around after her kids on the beach or treating patients at MUSC, Candi is not afraid to explore all of the adventures Charleston has to offer. One week, it may be Charleston Power Yoga, the next it’s surfing, or maybe checking out the newest “place to be” on James Island with friends. One thing is certain — Candi Jump knows how to soak up the sun and enjoy an active lifestyle in the Lowcountry. When asked how she envisions a perfect Saturday in Charleston she smiles and says, “That’s easy; morning yoga, brunch with the family, and a day on the beach – it doesn’t get much better than that.”

While fun in the sun is important, Candi is very serious about her role as a physician. She completed her residency and chief residency at the University of Connecticut in Hartford. She then went on to complete her training as a fellow in pediatric GI at the world famous, Children’s Hospital of Philadelphia. After training, she opted for a closer-knit academic center in a desirable location. MUSC Children’s Health in Charleston fit the bill, and the rest is history.

Candi and her husband, an avid surfer and surf artist on James Island, love the coastal life of the Lowcountry. The family can often be found hanging beach side at Folly with their two kids, Cooper and Ruby, and their rescue lab, Moose. With two toddlers and a dog in tow, Candi is never sitting still for too long. Her office is filled with images of small kids and the beach, illustrating her life as a mother and wife. As a physician, her life is equally fulfilling as evidenced when she speaks of the children she treats and the other physicians with whom she is privileged to work. 

“What I value most about what I do at MUSC Children’s Health is the impact that our pediatric GI group has in this community. There is such a large need for pediatric GI providers in the state, and I enjoy working with such an accomplished group of physicians who are passionate about what they do.”

Candi Jump is among that group of passionate doctors and we are very glad the beaches of Charleston charmed this incredible physician away from the Jersey Shore.  

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