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MUSC Health Blog

Date: 2018

MUSC Health is committed to building healthy communities throughout the Lowcounty. This Fourth of July, keep yourself, your family, and your community healthy by staying safe around fireworks. Fireworks are a beautiful way to celebrate the season, but can be very dangerous. 

Did you know?

  • The hand is the most common site of injury caused by fireworks and accounts for approximately 36% of all injuries.*
  • The face and eyes each account for almost 20% of injuries.*
  • And more than 50% of all firework injuries are from burns exclusively or burns combined with blast injuries.*
  • Children under five using sparklers and other “safer” options accounted for more than 40% of the fireworks-related injuries in 2013.*
  • In 2015, U.S. hospital emergency rooms treated an estimated 11,900 people for fireworks related injuries; 51% of those injuries were to the extremities and 41% were to the head. Children younger than 15 years of age accounted for one-quarter (26%) of the estimated 2015 injuries.**

*Data attributed to The Huffington Post (July 2, 2017) https://www.huffingtonpost.com/amy-kontrick/july-fourth-holiday-is-one-of-the-deadliest-holiday-weekends----but-it-doesnt-have-to-be_b_10761002.html

**Consumer Product Safety Commission’s 2015 Fireworks Annual Report by Yongling Tu.

Tips on How to Reduce Fireworks Injury

  • Always make sure to have a bucket of water or a fire extinguisher in close proximity of fireworks.
  • If a firework does not go off or will not light, do not investigate the problem or stand close to it. Dose the firework with water immediately. Do not pick it up or stand over it. NEVER relight a dud.
  • Always stand several feet away from lit fireworks and never light fireworks indoors.
  • Avoid lighting fireworks near dry grass and always point them away from homes, other people, brush, leaves, etc.
  • Never hold a lit firework in your hand or attempt to set a firework off while holding it.
  • When handling fireworks, do not wear flammable materials or loose clothing.
  • Do not smoke or use flammable gases near fireworks.
  • Do not drink alcohol or be under the influence while lighting fireworks.
  • Wear safety glasses or goggles when shooting fireworks.
  • Children should be closely supervised around fireworks at all times. Even sparklers can pose a danger to young children if not handled properly.
  • If you do handle fireworks, make sure that you use only legal fireworks. A good deal of today’s injuries is still caused by fireworks that have been outlawed. Check the labels and make sure to store all fireworks in a cool, dry place.
  • The best way to prevent firework injuries this Fourth of July is to leave it to the professionals. Take your family to a public fireworks display and just enjoy the show!

If you receive an injury while handling fireworks this Fourth of July season, please remember the following:

  • Go immediately to the doctor or a hospital.
  • If there is an eye injury, do not rub or touch the eye area in order to minimize additional damage. Do not flush the eye out with water.
  • If there is a serious burn, call your doctor immediately and remove any clothing from the burned area.
  • For bleeding, apply pressure to control and go to your nearest emergency room or call 911.
  • For minor burns:
    • Cool the burn by running it under cool tap water or apply a cool compress
    • Remove rings or other tight jewelry from the injured extremity
    • Apply antibiotic ointment to any open wounds or ruptured blisters
    • Apply a loose nonstick sterile bandage or band aid.
    • Wash the wound with mild soap daily, and reapply antibiotic ointment and bandage
    • Take over the counter anti-inflammatory medications as directed until pain subsides, but consult with your doctor before starting any new medication
    • Seek medical attention for large burns, worsening swelling or pain, signs of inflection or any other concerns

Schedule Your Appointment at MUSC Health

For non-emergency appointments, talk with one of our many providers, including at the Musculoskeletal Institute and the Storm Eye Institute, to learn more about how to protect yourself and your family. Find a doctor near you with multiple locations throughout the Lowcountry!
 

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

MUSC Health Stadium

Major League Lacrosse is coming to Charleston and MUSC Health Stadium! MLL announced in April that the Charleston Battery will host the 2018 MLL Championship at MUSC Health Stadium on August 18. Luckily, we do not have to wait until August to see Major League Lacrosse in action, as the first-ever MLL game in the state of South Carolina is right around the corner on June 30 at MUSC Health Stadium. This inaugural game is a match between the Charlotte Hounds and the Atlanta Blaze.

The buzz around the Charleston lacrosse community is the excitement about the upcoming matches. Over the past 10 years, lacrosse has been one of the fastest-growing sports in the Lowcountry and throughout the United States. According to USA lacrosse’s 2016 survey, there are over 825,000 players participating in organized lacrosse throughout the country, which is an increase of over 225 percent compared to their first survey completed in 2001.

As the game grows in popularity and participation, the topic of injuries always comes up. Parents are concerned for their children’s well being, as they are with participation in all sports. A study completed by Xiang et al., and published in the American Journal of Sports Medicine in 2014, examined the number of high school lacrosse injuries (male and female) from 2008 to 2012. The top injury type was sprains/strains (38.3 percent) followed by concussions (22.2 percent) and abrasions/contusions (12.2 percent). The majority of the injuries were to the lower extremities (foot/ankle, knee, and thigh). In approximately 40 percent of the injuries that occurred, the players were able to return to play within 1 to 6 days and only 6.6 percent of the total injuries were serious enough to require surgical intervention.

So just like in all sports, injuries can occur in lacrosse, but there are also ways to minimize this risk through injury prevention techniques. Stop Sports Injuries has a full list of injury prevention guidelines for lacrosse players.

To prevent most prevalent injuries, sprains/strains, and concussions, here are my suggestions:

Sprains/Strains:

  1. Proper warm-up prior to play: This should include active movement in addition to both dynamic and static stretching.
  2. In season strengthening program: Focus on balance, dynamic stability, and core strengthening.
  3. Offseason training: Fitness training in the offseason can be the most important step to injury prevention. This should include a combination of cardiovascular training, strengthening and flexibility programs, plyometric training, and agility training.

Concussions:

  1. Know the rules and follow the rules: In boys’ lacrosse, when played correctly, unprotected hits should not occur, and in girls’ lacrosse there should be no head/face contact. Unfortunately, rules are not always followed or taught to players, so this is where experienced coaching comes into play.
  2. Wear the proper equipment: Lacrosse equipment is designed to be protective, but if helmets, facial equipment, and mouth guards are worn out or the wrong size, they may not be doing their job, which can lead to increased injuries.
  3. Know the signs and symptoms: If a hit occurs and there is a suspicion of a concussion, players should be held out of play until assessed by a health care professional trained in concussion management. Athletic trainers are your best resource for on-field management. If a concussion does occur, follow return-to-play guidelines to minimize the risk for escalated symptoms or future issues.

In lacrosse, just like in all other sports, there is a risk for injury, but the overall benefits of sports participation significantly outweigh the risks.

If you have read this far, you must be interested in the game, see how the elite do it, and come out to the game on June 30 and all of the festivities surrounding the Major League Lacrosse Championship at MUSC Health Stadium in August.

By Brittney Lang MS, ATC
Athletic Trainer
MUSC Health Sports Medicine
www.MUSCHealth.org/sports

Summer workouts for athletes have started and with temperatures and humidity rising daily as we get closer to summer we have to be aware of making sure our athletes are properly hydrated. Athletes should have access to water during any weights and conditioning sessions and given breaks during sessions as needed. It is also necessary to educate athletes on the importance of hydrating well before and after physical activity to maintain good health.

An athlete needs to be properly hydrated if they want to be able to perform at their highest level. Physical activity, heat, and humidity increase the amount of fluid your body needs to stay hydrated.  Below are recommendations for how much fluid one should be drinking to maintain adequate levels.

Everyday
Drink adequate fluids. Roughly 1 ml for every calorie consumed. For example, if you eat 4000 calories, drink 4000 ml of fluids (4 L).

2 to 3 hours before training/competition
7 oz of fluid

Immediately prior to training/competition
6 to 12 oz of fluid

Every 15 to 20 minutes during training/competition
6 to 12 oz of fluid

Exercise longer than one hour
Be sure to include a carbohydrate source in the form of solid, gel or sports drinks. Consume roughly 30 to 60 grams of carbohydrate per hour. 600 to 1200 ml of a sports drink will fulfill this need.

After exercise 
16 to 24 oz for every pound lost from the training session or competition.

It is good practice to do a pre and post workout weight check to make sure the athlete has been consuming enough during the workout; and to see if they have lost any weight and determine how much extra they may have to replenish.

Staying well hydrated will help decrease the risk of heat illnesses such as muscle cramps, heat exhaustion and heat stroke by helping with body temperature regulation and cooling efficiently.

Dehydration

The body loses fluid through the skin as sweat, through the lungs while breathing, and through urination. When the body loses more fluids than is being taken in to replace what is lost we have dehydration. There are some common signs and symptoms of dehydration to look out for during training:

  • Headache
  • Nausea
  • Dizziness
  • Thirst
  • Fatigue
  • Muscle cramping
  • Low output of urine/dark coloration

If an athlete is experiencing any of these symptoms, they should stop what they are doing and drink fluids. An athlete should not completely rely on their thirst mechanism to tell them to drink. If the athlete feels thirsty, it is too late. The body has begun to feel the effects from dehydration and their performance will suffer along with their body. One should not wait that long.

Over hydration

While dehydration is more common in athletes, there is a very real possibility of over hydration. This is when the athlete intakes more water than the body has released i.e through sweat. This can lead to low sodium levels also known as hyponatremia and cause very severe health problems if the athlete does not seek the necessary help right away. Drinking some sport drinks during longer or intense workout sessions can help with keeping sodium levels up and eliminate the possibility of hyponatremia during training.

Hydration is one of the most important things an athlete can do to maintain mental and physical performance. Educating the athlete on proper hydration techniques is the best way for them to stay healthy.

By T. Ryan Littlejohn, ATC, CES
Certified Athletic Trainer
MUSC Health Sports Medicine

Does your son or daughter play sports? According to the Open Access Journal of Sports Medicine, three out of every four families have at least one child playing school sports. This leads to another very important question: does your child have adequate medical coverage at their school? Having an athletic trainer or other qualified medical person onsite to address athletic injuries is essential for every school. According to the American Orthopedic Society for Sports Medicine, high school injuries account for an estimated: two million injuries; 500,000 doctor visits; and 30,000 hospitalizations a year. Furthermore, the CDC reports more than half of these injuries can be prevented and, many of these injuries are overuse injuries. Overuse injuries are caused by athletes not resting enough from their sport causing repetitive trauma to their body. A certified athletic trainer is a highly-qualified medical professional that can address these issues and many other athletic injuries. They are able to treat a variety of sports injuries and help keep the cost of medicine down, reducing hospital and doctor visits. Athletic trainers are trained in areas of prevention, rehabilitation, evaluation assessment, immediate care, and organization administration. This includes responding to emergencies by providing CPR and calling 911 when necessary. The statistics for injuries are alarming; however, it can be addressed by having adequate coverage for these athletic events. Hiring an athletic trainer is essential for every school’s athletic program and if there is some doubt look at these statistics; providing coverage alone, could bring a lot of peace of mind to many parents.

Sciatica (a shooting pain, tingling or numbness stemming from the sciatic nerve) is one of the most common causes of back and leg pain. It can be debilitating for many people. According to Avery L. Buchholz, M.D., an assistant professor in the Department of Neurosurgery at MUSC Health, conservative management such as physical therapy can effectively treat the vast majority of patients with sciatica.

Sciatica symptoms typically disappear over time, sometimes without any treatment, but Dr. Buchholz believes patients should not have to suffer. He says a partnership between spine surgeons and primary care physicians can help patients with sciatica symptoms find relief faster.

“I’d like to partner with primary care physicians to co-manage these patients. Sciatica pain can be very frustrating for patients, and we’ve found that they appreciate the benefits of a partnership approach to care,” says Dr. Buchholz.

Sciatica Pain Affects Wide Swath of People

Dr. Buchholz says sciatica pain can affect people of any age, but commonly affects older adults (ages 50 to 60) and women during pregnancy. Sciatica is characterized by a cluster of symptoms that affect the sciatic nerve.

Symptoms differ depending on the individual patient and the specific cause. They generally affect the lower back or legs and involve any combination of:

  • Sharp pain
  • Numbness
  • Tingling
  • A burning in the buttocks that travels down the leg (sometimes to the foot)
  • Weakness in the foot or leg

According to Dr. Buchholz, a number of factors or conditions can actually cause those symptoms, including:

  • Disk herniations that push on a nerve
  • Degeneration and boney overgrowth or osteophytes that push on a nerve root
  • Spinal stenosis that causes nerve irritability
  • Rarely, fractures, tumors and infections

Sciatica Treatment Options

Because sciatica pain can come on quite suddenly, Dr. Buchholz says patients experiencing a sudden onset of painful symptoms may seek care at an emergency center. But a conservative treatment approach works best for most patients, he says, especially as a first-line treatment option.

Many patients find sciatica relief after prioritizing rest. Avoiding exercises or positions that irritate the nerve (or otherwise cause pain) can also help. While sciatica often gets better with time, even disappearing entirely, Dr. Buchholz says physical therapy can help accelerate that process while giving the body time to adjust and heal.

“Physical therapy provides relief by strengthening the core (the belly and back muscles), which supports and stabilizes the spine. This action calms the inflamed sciatic nerve and reduces irritation, thus decreasing pain. Physical therapy is useful early on, helping to stretch some of the muscles around the sciatic nerve and decrease inflammation,” he explains.

When conservative therapies are not successful, Dr. Buchholz considers several other sciatica treatments. Based on individual patient circumstances, recommended next steps may include:

  • Steroids, which can help reduce inflammation of the nerve
  • Medication, such as over-the-counter anti-inflammatories or muscle relaxants
  • Injections, including epidural or transforaminal, which can reduce inflammation and pain in cases where an MRI shows a nerve is pinched
  • Surgery, in rare cases, to decompress the nerve root

A Comprehensive Sciatica Treatment Approach

Dr. Buchholz says he’s happy to see any patient who’s suffering from sciatica symptoms.

“Most of the patients I see do well with conservative therapies and never need surgery. Still, those patients often tell me they appreciate someone explaining the nuances of what’s causing their pain and the various treatment options. In the rare case that we are unable to treat a patient’s symptoms conservatively, we can easily discuss surgical options and provide access to specialized surgical procedures,” says Dr. Buchholz.

Dr. Buchholz says MUSC spine specialists are looking forward to partnering with primary care physicians to manage patients affected by sciatica. Primary care physicians are often best suited to identify sciatica from other sources of back pain, which is key. If symptoms persist past a few weeks and physical therapy isn’t providing sufficient relief, a referral to a spine specialist may be the next best step.

“We hope to be a useful resource for primary care physicians and patients with sciatica early in the treatment process, even before any advanced imaging is ordered. Some patients need a little extra reassurance and consulting regarding their symptoms — specifically regarding what to expect and how to move forward with it. We’re ready to be that resource for patients and physicians.”

For more information, contact Dr. Buchholz at buchholz@musc.edu.
 

 

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