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MUSC Health Blog

Keyword: athlete

By Amberle Phillips, MA, ATC, SCAT
Athletic Trainer
MUSC Health Sports Medicine

Adequate amounts of sleep are vital for athletic performance and mental function. This is especially true for younger athletes. Sleep deprivation among college-aged athletes can be attributed to travel for sport, stress, balancing academics, athletics, and social life. The National Athletic Trainers’ Association recommends eight hours of sleep for individuals aged 17-22 years.

Sleep deprivation may impact mental health. The body’s ability to deal with stress and emotions depends on sleep to regulate proper functionality. Without sleep the mind is unable to process situations effectively and may cause emotional instability and inability to process stressful situations. Mood and depression are also affected by lack of sleep. Sleep deprivation may cause increased depression and other mood swings. The mind is not the only thing that is impacted by lack of sleep; the body’s cells are also affected.

During sleep is when the cells in the body grow, repair and rebuild helping injuries heal and preventing further injury from occurring. Cells need the rest that sleep provides to catch up on the days’ work that the body did. The cells will repair themselves and create new cells to assist in growth, and repair. The healing of cells that takes place during sleep is also the time when muscle cells and tissue can grow. Poor sleep and shortened sleep may also lead to weight gain and obesity. This is especially true in adolescents whom require more sleep than adults.

Here are a few tips and tricks that can be done to help fall asleep and to stay asleep:

  • Turn off all devices 1 hour prior to bedtime
  • Create a bedtime routine
  • Exercise daily
  • Meditation or total muscle relaxation techniques
  • Avoid caffeine late in the day
  • Stick to a schedule, even on the weekends

Guest post by:
Marty Travis
Athletic Trainer
MUSC Health Sports Medicine

You would think the notion of proper sleep benefiting one’s overall health, academic performance, and athletic performance is common sense. You will be surprised to find many young student athletes do not believe in the value of sleep. I have not seen any research on athletes’ attitudes on sleep, but in my daily duties as an athletic trainer it seems like many just do not care about proper sleep. I am always hearing stories from both the athletes and their parents about athletes staying up late only to get a few hours of sleep before going to class the next day. My pre-season talks to athletes in the past few years included discussions on sleep along with proper nutrition, hydration, and concussion awareness.

Teenager napping in library with notebooks

From our past experiences we all know that the lack of quality sleep has negative effects on both athletic and academic performance. It hinders our ability to make quick and correct decisions, whether it is answering a test’s question or making the correct pass on a basketball fast break. If you stayed up all night “cramming“ for a test you will most likely do poorly. It is the same way for a big game. If the athlete stays up late playing video games, the following day the athlete will most likely play poorly in the game. Also poor sleeping habits can have emotional effects. I know from personal experience that if I do not get enough sleep over a period of days I can get very grouchy and irritable. I have seen this with many other people and athletes.

How much sleep do you need? I do not think there is an answer that fits all. There are studies that say anywhere between seven and ten hours nightly but I believe it is based on the individual. Some perform well with only five hours of sleep and some need ten hours. I believe consistency is the key. First find out what your optimal sleep time is. Then during the school year and sports season get into a habit of going to sleep and waking at the same time. This, with proper nutrition and good conditioning, will only help your athletic performance and daily living.

Lastly, what about naps? More and more college football coaches encourage their players to take naps before late afternoon and evening games. The coaches are seeing better performances from players who nap before games. The National Sleep Foundation recommends a 30 minute nap before games. The Foundation does not recommend naps longer than 30 minutes because that may hinder sleep that night.

There are other negative effects of improper sleep such as hindering energy recovery, slowing injury recovery, and increasing cortisol levels. We must continue to stress proper sleep and hope the student athletes finally buy into it.

Guest Post by:
Katie Bracken, ATC, PES
Medical University of South Carolina
Sports Medicine Department

Summer isn’t a time to relax and sit in front of the TV!!...It’s the perfect time to condition, increase your fitness level and make your muscles bigger! Some relaxation can occur…of course at the beach, but make the most of your summer schedule and free time! Whether you play fall, winter or spring sports, it’s important to try to maintain your level of fitness for many reasons.Man in squat position

  1. It is easier to transition from off-season to in-season. It makes more sense for people to condition/train through the whole year/pre-season, right? BUT most athletes don’t…unfortunately most get lazy and comfy on the couch. Once the season starts, athletes who train pre-season will transition WAY more easily, be in better shape and be more prepared for the demands of the sport versus those who do not train. Athletes who train continuously will also be able to progress quicker into the sport specific workouts, conditioning and sport skills.
  2. Another huge reason to train during pre-season is injury prevention. If athletes jump right into conditioning, weight training and/or sport specific skills (like most) they put themselves at a higher risk for injuries to occur. Once an injury occurs and depending on the severity, the athlete could be out days, weeks or months. The more training an athlete can do to better prepare his/her joints/muscles and overall fitness, the chances of them being injured in-season are less likely. Another key injury prevention tip is: train for your sport. You don’t want track athletes completing volleyball exercises. Make sure to train for your specific use of upper extremity/lower extremity movements. For example: soccer: lower extremity and conditioning, volleyball: lower/upper extremity (focus is on the shoulder), football: upper/lower extremity and power movements, softball: upper extremity, power/sprint conditioning. It is also important to implement a proper warm-up and cool down. Again, it is better for the athlete to prepare ahead of time than to sit out a duration of time or the whole season.
  3. Just because you may not have access to a gym or gym equipment doesn’t mean you can’t get moving! Motivation and determination is all that is needed for a great workout! Like mentioned above, depending on the sport (or multiple) will determine the area/body part to focus on. Also note that many sports overlap in certain types of training, i.e., conditioning is great for all sports! A simple upper body circuit will activate the proper muscles used in upper extremity sports: push-ups, shoulder taps and dips (many variations) at 3 sets for 10 repetitions/movement. You may also add in certain rest periods: 3 sets for 10 with a 20 second rest in between movements to keep the heart rate elevated. For lower extremity sports, a circuit that involves squats, lunges, and squat jumps will activate the glutes, hamstrings and quads to prevent injury and build strength. A tabata workout is a type of H.I.I.T.  (high intensity interval training) workout designed to increase your heart rate throughout the circuit while completing specific movements. Another form of equipment free conditioning: RUNNING! Again, depending on your specific sport will determine which type of conditioning you should be training for, aerobic versus anaerobic. (A common topic that is typically overlooked is flexibility. It is important to incorporate flexibility training into workouts and conditioning especially when the muscles will be activated and stressed more during in-season competition.)
  4. The dreaded word…CONDITIONING or as most people see it…RUNNING! Conditioning has many benefits but it is also used in almost every sport…no reason not to run! Along with strength training, conditioning can be sport specific and will determine which type you should train for: aerobic or anaerobic, i.e., power/speed or endurance. Athletes may also feel the need to go from power sprints to endurance running. Besides training for a specific sport, running has many added health benefits: deceased blood pressure, decreased resting heart rate and increased weight only name a few.  

For the reasons stated above and many more, out-of-season and pre-season training is more beneficial versus no training. Your body and mind will be more prepared for the upcoming season and be able to meet the demands needed. Do your body a favor and don’t be lazy, you will never regret a workout!

Guest post by:

Shane K. Woolf, MD
Chief, Sports Medicine
Department of Orthopaedics
Medical University of South Carolina

Fall is a great time of year for sports! Major League Baseball postseason is heating up. College and Pro football is getting interesting as the dominant teams start to distance themselves from their competitors. High School and college sports are in full swing as a regular part of the fabric of community life.

And for local leagues, colleges and the pros, hockey season is underway! That means excitement on the ice as well as potential for injuries. Given the pace, frequent collisions and contact, and hard surface on which the game is played, head injuries are not uncommon. Shoulder and knee injuries are fairly common as well. The hip experiences unique stresses in hockey, so these injuries warrant consideration and are the topic of this week’s MUSC Health Sports Medicine blog.

When do injuries, especially to the hip, happen in hockey?

A study of collegiate male hockey players showed injury rates are 8 times higher in games compared with practice during the season and usually involve the lower extremity. Knee injuries occurred most frequently during games (14%) while hip and pelvic muscle (groin) strains were most common in practice (13% of injuries). (1)  A similar study of female hockey players showed game injury rates 5x that of practice but with hip/pelvic injury rates (12%) in practice second only to concussions (13%). (2)  Clearly, hip and groin injuries are important to consider and to avoid in hockey players.

What are the usual hip and groin injuries in hockey and what can be done about them?

Evidence exists to suggest that a muscle imbalance of hip abductors (this group moves the hip/leg outward) compared to adductors (they move the leg inward) can be predictive of groin injury. (3)  Groin injuries (adductors) are most common. This finding would support the need for strengthening and conditioning both muscle groups to maintain balance in both offseason and during the season. Another study of youth hockey players suggested an ‘at risk’ position for the hip to experience a condition called femoroacetabular impingement. This condition happens when the femur contacts the socket (acetabulum) abnormally at extremes of motion. The study showed that the sprint start with flexion and internal rotation of the hip pushing to abduction and external rotation initially places the hip in a position of impingement and risks development of overuse injury patterns.  Goalies also find themselves in similar positions of extreme hip rotation.

The diagnosis of femoroacetabular impingement has become more prominent in recent years among athletes with hip pain. Hockey players tend to be at particular risk given the extreme positions their hip joints endure.  Indeed, it has been shown that elite level youth players have a higher incidence of cam deformity on their femoral heads and also associated hip pain. (5) In this condition, the edge of the ball (or head) of the hip develops a bump of extra bone over time. This extra bone can contact the edge of the hip socket more easily during hip rotation and can actually enlarge over repeated contact with the socket. This contact can ultimately damage the labrum, which is a gasket of sorts on the edge of the hip joint, as well as the cartilage within the joint as well. Youth basketball and soccer players seem to have similar risks for femoroacetabular impingement. (6) In most cases of new onset hip pain, a conservative approach of rest and rehabilitation is enough to settle down the underlying condition. Chronic and persistent pain deserves a more thorough evaluation by a specialist.

Other possible causes of hip pain

Two other conditions should also be noted when a hockey athlete complains of hip pain. If the mechanism of injury is a fall to the ice or perhaps a hard check into the boards, it is possible for a fracture of the hip to occur. While rare, an athlete who cannot bear weight immediately after a hip injury should have a radiograph obtained to rule out fracture. Another condition called ‘sports hernia’ can occur in hockey and other sports that involve regular twisting, pivoting, and hip rotation. In this case, the inguinal wall is weakened and a herniation of abdominal tissue can occur. Deep groin pain is usually present with activity, resolves with rest and does not typically respond to the rehabilitative techniques used for other hip injuries. Surgery is often necessary for these affected athletes to be able to return to play.

For the competitive hockey athlete, maintaining hip strength and flexibility is important. Hip pain that does not respond to rest or is progressively worsening should be evaluated by a sports medicine specialist like those of the MUSC Health Sports Medicine Team.

  1. Agel et al. J Athl Train. 2007 Apr-Jun;42(2):241-8.
  2. Agel et al. J Athl Train. 2007 Apr-Jun;42(2):249-54.
  3. Dallinga et al. Sports Med. 2012 Sep 1;42(9):791-815.
  4. Stull et al. Am J Sports Med. 2011 Jul;39 Suppl:29S-35S.
  5. Siebenrock et al. Am J Sports Med. 2013 Oct;41(10):2308-13.
  6. Nepple et al. Am J Sports Med. 2015 Jan 13.


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