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MUSC Health Blog

Date: Nov 2014

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:  

MUSC Tobacco Treatment Program
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.

Guest post by:
Emily A. Darr, M.D.
Assistant Professor of Physical Medicine and Rehabilitation
Department of Orthopaedic Surgery

Deanna Roberts, MS ATC
Department of Orthopaedic Surgery

So you've been training hard for an upcoming race and you're starting to feel an aching pain in your knee. Or maybe you're a new runner that's been increasing your mileage at the expense of a sharp pain in both your shins. Running injuries are a common part of the sport, and unfortunately, up to 82% of runners will experience one at some point in their training. Given this alarming rate of injuries, awareness of such injuries can be important in prevention, diagnosis, and treatment.

Bridge RunThe knee is arguably the most common site of injury with patellofemoral pain syndrome, AKA “runner’s knee”, affecting around 40% of runners. This is characterized by pain around and under the kneecap. Other common injuries include medial tibial stress syndrome, AKA “shin splints” which is an inflammation of the muscles and tendons of the lower leg characterized by a sharp pain, usually on the inside of the shins, Achilles tendonitis, plantar fasciitis, and IT band syndrome, which is pain on the outside of the knee that is caused by repetitive rubbing of the IT band against the outside of the knee.

Sometimes risk factors have a clear link with a particular injury, and sometimes there is a less clear link. Risk factors for which there is clear association with injury include:

  1. Increasing your mileage. Injury is more common when running over 20 and then 40 miles per week.
  2. Recent increase in training intensity
  3. Being new to running

Some risk factors which have a more loose association with injury may include:

  1. Changing your footwear or wearing improper footwear
  2. Running on harder surfaces
  3. Poor habits of warming up prior to running and stretching soft tissues
  4. Muscle imbalance and compensatory patterns

When dealing with an injury, it is best to listen to your body. Be sure to schedule rest days during your training, and take a few days off if your pain is worsening. If you are dealing with an injury that requires a few weeks of rest, pencil in some cross training days to maintain your cardiovascular conditioning. 

Pay attention to your training plan. If you notice a flare up in pain when running on the road, stick to a surface with more give like a turf field or soft track. Run on the side of the road that feels more comfortable and stick to flat courses if running up and down hills exacerbates your pain. When returning from a rest period, increase your training volume by 10% intervals to avoid overtraining and re-injury.

Can I run through an injury?

Dr. Bob Wilder’s Rules for Runners can quickly assess whether you should continue through pain.

  1. On a 10-point scale, pain during the run should be no greater than 0-3.
  2. Pain should not be severe to the point where you limp during or following the run.
  3. The long run should not be more than half the regular weekly volume.

Make sure to warm up before your run with dynamic stretching exercises that warm up your muscles and increase your heart rate. Include a cool down with gentle stretching exercises that focus on the main muscle groups worked during your run.

Running footwear has been a hot topic in recent years including minimalist shoes and barefoot running. Every foot is unique and every running style is different therefore a visit to a running store where a professional can assess your feet and help you decide on the best running shoe for you is well worth it.  Interestingly, studies have shown that when runners wear more expensive shoes promising more cushion or support, they suffer more injuries than runners who opt to wear cheaper footwear. There are no studies that show that running shoes actually prevent injury. Remember that the most important factor in finding a shoe that fits is to make sure it is comfortable when running, not just when placing it on your foot at the store.

If an injury continues to linger or worsen, see a sports medicine physician for further evaluation. He or she can provide you with a proper diagnosis and appropriate rehabilitation plan to get you back on the roads!

Running is a great form of exercise to engage in, whether it be in sport, with a running group, or participating in a color run with friends. These days, the possibilities are endless and so are the opportunities! With the proper training, equipment and rest, you too can have fun and be pain free during your run!

Guest Post by:  Brittany Darling, MS, ATC

The squeak of sneakers on the wood floor, a sound that must only mean one thing: basketball season is finally here. As fall sports are coming to an end there is little time for rest and recovery before the long season, and the last thing you want is to start your season off with an injury. Thankfully, there are some injury prevention strategies that can be utilized in hopes of staying healthy through the winter season.

Basketball in hoopThe first step is to ensure your child has all of the essential equipment. Although basketball does not have very many equipment demands when compared to other sports such as football or hockey, there is one important piece: basketball shoes. Basketball shoes are characterized by a higher ankle fit than most athletic shoes, and they also possess a sole specific for the basketball court that will prevent slipping and sliding. The high ankle fit helps to prevent against one of the major basketball injuries, the ankle sprain, which is an injury to the ligaments connecting bone to bone. Very often a child may cut to the side quickly or come down from a rebound and land on another player’s ankle, which results in the inversion or “rolling inward” of their own ankle. This is a frequent injury that can be prevented by wearing ankle braces. The ankle braces that lace up the front and have adjustable straps usually work best and can be purchased at any sporting goods store. They can take some getting used to initially, but are worth it in the long run.

Basketball is a unique sport that requires power, speed and agility. The demands of the sport can sometimes result in an overstretching of the muscle or too strong of a contraction known as a muscle strain. Strains can take place in the muscle itself or in the tendon, which connects the muscle to the bone. The most successful method for preventing strains is an effective warm-up. Especially as the weather is getting colder outside, our bodies need movement combined with proper clothing to get warm before performing quick and explosive activities.  Extra layers such as sweat suits are encouraged! A suggested routine might include 2-3 laps of light jogging around the basketball court, followed by a dynamic warm-up such as walking lunges, walking quadriceps stretches, arm circles, and walking toe touches. With this, the stretch is only felt in the targeted muscle group for a few brief seconds as compared to when you hold a static stretch that lasts 15-20 seconds. A dynamic warm-up combines movement with brief stretches of the selected muscle group. After initial warm-ups are complete, it can be beneficial to stop every few minutes into practice and ask the athletes to pick something that feels tight and give that muscle an extra stretch. It is important to always perform stretches correctly and to understand that everybody is unique in their abilities, so make sure children stay within their flexibility limitations.

Improving flexibility with stretching can help with another common basketball injury known as patellar tendonitis, or “jumper’s knee,” which is characterized by pain beneath the patella (knee cap) usually from repetitive jumping or quadriceps activation. A similar injury seen in teenagers after growth spurts occur is known as Osgood-Schlatter disease, which is diagnosed when there is a small bump formation that is painful underneath the patella. With either of these injuries, applying ice after practices and games can assist with any pain or inflammation as well as NSAIDs such as ibuprofen.

Additionally, since basketball is a physical sport that can involve some contact, a mouth guard is not a bad idea to utilize, especially if your child has braces. Elbows and hands make contact with mouths frequently when scrambling for a rebound and can cause significant damage to a child’s teeth. They may also experience contusions or bruises from this sort of contact. Compression sleeves with built in padding are made for knees and elbows and can provide some comfort and support to children who fall on the court frequently.

Before retiring cleats for sneakers, remember some of these resourceful tricks that can help your child perform to the best of their ability and stay healthy. Unfortunately not every injury can be prevented, so when one does occur be sure to consult your Athletic Trainer or Physician.

Guest Post by:
Michael Barr, PT, DPT, MSR
Sports Medicine Program Manager
MUSC Sports Medicine

Sitting on the sidelines I hear the sounds of hard hits, players grunting, and fans cheering … I bet most of you reading this think I am talking about covering a high school football game on Friday night, but I am not. Women’s roller derby … is one of the most dynamic, hard hitting, and exciting sports that I have been involved with, in my 10+ years as a medical professional.

One of our athletic trainers and I cover the Lowcountry Highrollers, women’s roller derby team; at the bouts this past Sunday we diagnosed and treated multiple ankle sprains, 2 concussions, a shoulder subluxation, countless number of contusions, dehydration and general fatigue. Overall this was a slow night for us; there were no fractures, tears, or lacerations.Roller Derby Action

Afrodite Superstar said to me, “I am in the best shape of my life, but I accept the fact that I am going to have daily pains” she also explained that the morning after a bout is always the worst, “just getting out of bed hurts”, but once she laces up her skates at the next practice, she is back to herself again.

This description by Afrodite Superstar sounds very similar to an article written by Elizabeth Merrill from EPSN about Matt Birk, former Baltimore Raven’s center, where she describes his Monday morning ritual:

Birk pops one elbow, then the other, and fans his legs until his pelvic bone makes a cracking noise. He takes a couple of deep breaths, and his feet hit the floor. The first few steps are similar to tiptoeing through hot coals. But it’ll get better; it always gets better once he makes it to the bottom of the staircase.
It’s Monday, and time to start another week in the NFL.

Roller Derby CompetitionUnlike the players in the NFL, the Lowcountry Highrollers are all professionals, in something other than their sport; they do not have the luxury of having a recovery day, they have to get up Monday morning and go to work, just like the rest of us.

As I am sitting in my office this morning, talking to Jungle Jane, president of the Lowcountry Highrollers, about a minor injury she sustained at the bout last night, and what she needs to do to expedite her recovery, I asked her why she plays? She answered, “I do enjoy the full contact part of the sport, but even more, it helps me build confidence not just on the court but in my everyday life.”

In the same article by Merrill, Matt Birk was asked a similar question; he answered, “You get so much from the game,” Birk says. “The camaraderie, the friends you make. You don’t mind having to pay that price because you get so much out of it.”

As this years’ season is coming to an end, we are starting to prepare for their off-season which includes a mandatory 2 month break from contact and reduced time on skates. During this time they have an off-season strengthening program designed for the specific needs of their sport. It includes 2-4 days/week of strengthening, muscular endurance and stability exercises, in addition to endurance, sprint, and skating specific skill training. Just like players in the NFL, they use the off-season to recover but also to get stronger, increase their fitness and improve their individual skills, so when they return to the rink in January they are ready for the next season.

The Lowcountry Highrollers’ season is coming to an end on November 9th, their home team championships; if you are interested in seeing a fast pace, high hitting sport, come to their next bout; for more information go to their Facebook page.


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