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Keyword: injuries

Guest Post by:
Kathleen Choate, ATC, CSCS, CEAS
Athletic Trainer
MUSC Sports Medicine

When Kerri Walsh competed and won gold in the 2008 Olympics, spectators took notice of an unfamiliar style of taping on her shoulder. While this product had been around well beforehand, kinesiology taping has been quickly gaining in popularity among athletes since those Olympic Games. Aside from the popularity, it has also raised eyebrows, leaving some questioning whether it works. Below are some of the questions and concerns I hear most often. 

What does it do?

Kinesiology tape reduces pain and is “thought to decompress underlying structures and allow for enhanced circulation.” (Montalvo, MS, ATC, CSCS, Cara, DC, PhD, ATC, CSCS, & Myer, PhD, FACSM, CSCS*D, 2014).  It can be applied to a multitude of injuries, including strains, spasms, swelling and bruising.  It could also be applied for headaches, scars, anxiety, and indigestion.  There are even taping applications to use on horses!  While this tape comes in many colors and patterns, there are no physiological differences between them.

How do I put it on?Kinesiology taping

There is a wealth of information on the internet about how to apply it. You can even buy pre-cut tapings designed for specific body parts that come with step-by-step instructions. This does not guarantee it has been applied correctly, however.  You need to ask yourself several questions.

Do you know what your specific injury is? There are many taping applications for a knee, but they all may not apply to your specific injury.

Are you sure it was applied correctly?  Yes, you feel like you followed YouTube’s instructions to a T, but has anyone guided you through the application in person? Most clinicians who use this treatment method have either been taught to apply it in college or continuing education courses. Their education goes far beyond “taping” and into the evaluation, diagnosis, and treatment techniques that work in tandem for your specific condition.

Where are you getting your information/instructions? Much of the information you gather on your Google or YouTube searches may be misleading, marketing, or both. (Beutel, MD & Cardone, DO, 214). Again, this leads back to speaking with a clinician who has personally been trained on its application and your specific injury.

Who shouldn’t use it?

Kinesiology tape isn’t meant for everyone. Most manufacturers of kinesiology tape advise against its use if you are pregnant, have skin allergies, infection, cancer, open wounds, congestive heart failure or DVT risk (blood clots in the calf). If these apply to you, it may be best to avoid it.

How effective is it?

There is currently a lawsuit against a manufacturer of these tapes, arguing that there is a lack of scientific evidence and unsupported claims were made. This has only added to the skepticism many people feel. There are some studies that suggest that there is a placebo effect (Montalvo, MS, ATC, CSCS, Cara, DC, PhD, ATC, CSCS, & Myer, PhD, FACSM, CSCS*D, 2014); however, there are also many patients and clinicians who will swear to its effectiveness. Regardless, more research is needed.

Treatment for your injury should be multifaceted. While taping can be used to help you recover from an injury, it generally should not be relied upon solely. See your athletic trainer, physical therapist, or physician to find the best treatment plan for you.

Works Cited

Beutel, MD, B. G., & Cardone, DO, D. A. (214). Kinesiology Taping and the World Wide Web: A Quality and Content Analysis of Internet-Based Information. The International Journal of Sports Physical Therapy, 665-673.

Montalvo, MS, ATC, CSCS, A. M., Cara, DC, PhD, ATC, CSCS, E. L., & Myer, PhD, FACSM, CSCS*D, D. G. (2014). Effect of Kinesiology Taping on Pain in Individuals With Musculoskeletal Injuries: Systematic Review and Meta-Analysis. The Physician and Sportsmedicine, 48-57.

Guest Post by:

Brittney Lang, MS ATC
Athletic Trainer
MUSC Health Sports Medicine

Over the years, we as health care professionals are seeing more young athletes move from multiple sport participation to focusing on one particular sport, with possible multiple team involvement. With this move, we are seeing more orthopaedic injuries in younger athletes than ever before. Studies are showing that half of all injuries can be attributed to overuse and lack of rest due to constant training. This push for young athletes to participate solely in one sport is often by parents and coaches wanting the athlete to succeed. We as health care professionals need to be better advocates for these young athletes and help teach parents, coaches, and athletes signs and symptoms of overuse injuries and steps to help prevent or minimize the injuries.

Young boy pitching baseball

An overuse injury is damage to a bone, muscle, tendon, or ligament that has been subjected to repetitive stress without giving it sufficient time for rest and the natural reparative process. They can be broken down into 4 stages:

  1. Pain in the affected area after physical activity.
  2. Pain during physical activity but does not restrict physical performance.
  3. Pain during physical activity that does restrict physical performance.
  4. Chronic pain and constant pain even during rest.

Overuse injuries are more serious in the young athlete because children’s bones are not yet strong enough to handle the high amounts of stress put on them by the repetitive training. They also have not built up the muscles to perform the proper mechanics that are needed to perform the athletic activity for long periods of time. For example, a young baseball pitcher not using the full body to throw the ball and instead using just the arm possibly leading to injuries in the elbow and/or shoulder. One also must take into consideration that young athletes also may not be able to connect minor symptoms like fatigue to a possible bigger injury and therefore continue to participate. This is where proper education and guidelines for parents, coaches and athletes need to be set into place for prevention, injury reduction, and signs of injury.

 Another factor that needs to be addressed is over-training for the young athlete. With the major switch of young athletes to one sport, training and playing can be seen all year round. We are also seeing athletes playing on multiple teams, many of which at the same time, putting more stress on the athlete’s body with little rest. With sports teams being available at younger ages the push from parents and coaches to hone skills and succeed can be hard on the young athlete. And if the athlete wants to play a sport at a higher level one day it is stressed from a young age that one needs to play on travel teams, and go to training camps as well as play on recreational or school teams. Many sports have tournament schedules where athletes are playing for 2 to 3 days or more and there can be a couple games a day with no real rest during the week. Due to the high increase in playing time and lack of “free time” or rest, we are seeing a higher rate of burn-out at a young age for athletes. This can in turn also lead to injuries over time.

Well-rounded young athletes who participate in multiple sports tend to see fewer injuries and continue to play longer into their life. However, although multiple sport athletes tend to have fewer injuries there is still the risk of overuse injuries. This can be due to playing and training for multiple sports year round without rest and down time, as well as playing multiple sports with emphasis on the same body part, i.e., baseball and swimming. Young athletes should still have a break between seasons as well as from daily activity for adequate recovery.

We as health care professionals need to help stress proper training for these young athletes by providing necessary education and guidelines for all involved. This should help promote a healthy physical lifestyle throughout the athlete’s life. The education and guidelines for the parents, coaches and young athletes should promote fun, skill development and success in the activity. Young athletes should be monitored to reduce the rate of over participation and training in sports. Goals should be made for all involved on what the athlete wants to achieve in the sport. It is up to us, the health care professional, to be advocates for these young athletes when possible to help achieve healthy injury free lifestyles in sports.

Cited: Brenner, J. S. (2007, June). Overuse Injuries, Overtraining, and Burnout in Child and Adolescent Athletes. Pediatrics, 119(6).

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

Chances are, you've participated in the great sport of volleyball at a very young age. Whether it was in gym class, on a school team, or just out at the beach having fun with friends, volleyball is one of our country's favorite sports. Volleyball seems like a fairly safe, non-contact, low injury kind of a sport, right? Well, as popular as the sport has become both on the court and in the sand, a fair amount of injuries occur. Although considered a noncontact sport, the rate of injury is surprisingly high. Volleyball skills require quick, forceful movements of the entire body all at once in multiple planes, making injury inevitable. Both knee and shoulder injuries are commonly seen in volleyball players.

The shoulder accounts for 8%-20% of volleyball injuries. The majority of shoulder injuries are related to chronic overuse especially of the rotator cuff. Frequent motions involving high forces at the shoulder in multiple directions during the spiking motion are often the cause of these chronic injuries.  Muscular imbalances appear to be strongly associated with these overuse type injuries so keeping the rotator cuff super strong is very important with special attention given to stretching the shoulder. This can get rather tricky so having a Physical Therapist or Athletic Trainer show you the right way is recommended.

Rotator cuff injuries are caused by repetitive overhead hitting of the ball and/or from underlying joint instability. It can be as mild as a tendonitis or as serious as a complete rotator cuff tear. See a sports medicine specialist if you think you have an injury to your rotator cuff that doesn’t seem to get better. Treatment varies from anti-inflammatories and physical therapy to surgery depending on the severity.

Impingement syndrome occurs when the supraspinatus tendon (one of the rotator cuff muscles) becomes irritated and painful as it passes through a tight space called the subacromial space. Sometimes anatomic variances and/or joint instability from muscular imbalances can contribute to the pinching of this tendon. Painful shoulder motion, in addition to night pain, is a result of these muscular imbalances, overuse and anatomical variances. Surgical intervention may be necessary if conservative therapy fails to allow you to return to play. In some instances a corticosteroid injection is beneficial.

At the knee, you have similar forces coupled with gravity and a twisting, flexing force when you land from that high vertical. The most commonly seen overuse injury in volleyball is patellar tendonitis or jumper’s knee.

Patellar tendonitis, better known as jumper's knee, is an overuse injury that results in inflammation of the patellar tendon. In volleyball, this occurs as repetitive jumping places stress on the patellar tendon in an effort to straighten the knee. In most cases, patellar tendonitis will resolve with rest, activity modification, ice, anti-inflammatories and strengthening of the supporting muscle groups in the thigh, hip and buttocks. However, repetitive jumping without rest or treatment can lead to further injury of the tendon including rupture, which can require surgery.

Anterior cruciate ligament (ACL) injuries, although not as common in volleyball as patellar tendonitis, can occur as a result of an awkward or improper landing, or when performing a cutting or twisting movement. The ACL functions to prevent the tibia from sliding forward on the femur bone and provides rotational stability for the knee. The repetitive cutting, jumping and rotational movements involved in volleyball place players at an increased risk of ACL injuries. Depending on the severity of injury to the ACL, surgery and a lengthy rehabilitation program are considerations for most athletes. Due to the increasing number of ACL injuries occurring in the sport, many athletes are being trained with a focus on proper body mechanics and control, as well as safe landing and deceleration techniques.

Also keep in mind that some volleyball injuries are common to specific surfaces because volleyball is played on a variety of surfaces, such as wood, grass, concrete, and the increasingly popular sand!

Briner et al. Sports Med. 1997;24(1):65-71.

Guest Post by:
Harris S. Slone, MD
Assistant Professor
Department of Orthopaedics
Medical University of South Carolina

Golf season is officially full swing.  With exciting Masters and TPC tournaments in the books, and remaining PGA majors upcoming, many of us will hit the links this spring as well.  There are over 27.8 million golfers in the US alone, and the average golfer plays around 37 rounds per year. Golfer at tee

Golf is generally considered a safe sport.  Surprisingly, the number of injuries in golf is higher than one might think.  A recent study of Australian amateur golfers demonstrated that about 16% incidence of injury per year.1 The vast majority of golf injuries are “overuse” injuries, which is no surprising given the non-contact nature of the sport.  Overuse injuries can be just as debilitating, and can require just a long of recovery as traumatic or acute injuries.  Additionally, golf is enjoyed my athletes of all ages and skill levels, and a larger proportion of participants are older compared to other sports.

Most injuries in golf involve the upper extremity (elbow, hand and wrist) or back.  These injuries are also related to the amount of golf played.  Studies show that golfers who play 3-4 or more rounds per week, or those who hit more than 200 golf balls per week are more likely to sustain an overuse injury. 1,2

If most golf injuries are overuse injuries, it makes sense that these injuries may be more amenable to prevention, when compared to traumatic injuries. Many golfers fail to sufficiently warm up before a round, despite evidence to suggest that warming up reduces the risk of injury.  Players who do not warm up are more than twice as likely to sustain an injury over the course of a year compared to players to regularly warm up for 10 minutes or more. 2

Don’t put the clubs away just yet! Here is the good news: over half of the golf related overuse injuries will resolve over the course of a month, and over 80% will improve over 6 months.   The health benefits of golf are many, especially when choosing to walk the course as opposed to riding in a golf cart.  Golfers who regularly walk the course are more likely to weigh less, have slimmer waists, lower “bad” cholesterol, and higher “good” cholesterol. 3 Now get out there and hit ‘em straight!

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Sources:

  1. McHardy A, Pollard H, Luo K. One-Year Follow-up Study on Golf Injuries in Australian Amateur Golfers. American Journal of Sports Medicine. 2007;35(8):1354-1360. doi:10.1177/0363546507300188.
  2. Gosheger G, Liem D, Ludwig K, Greshake O, Winkelmann W. Injuries and Overuse Syndromes in Golf. American Journal of Sports Medicine. 2003;31(3):438-443.
  3. Parkkari J, Natri A, Kannus P, et al. A controlled trial of the health benefits of regular walking on a golf course. The American Journal of Medicine. 2000;109(2):102-108.
  4. http://www.saintjohnortho.com/documents/AOSSM%20Golf%20Injuries_100813.pdf

Guest Post by:
Shane K. Woolf, MD
Associate Professor of Orthopaedics
Chief of Sports Medicine
Medical University of South Carolina

With New Year’s here, avid skiers and snowboarders are eager to enjoy time on powder in the coming months. The snow base is growing at many resorts around the country, which means alpine athletes will be flocking to their favorite slopes to enjoy the thrill and freedom of gliding down a mountain. For many, just taking a vacation week every year or two is the extent of their time on skis or snowboard. Others are fortunate enough to get time on the mountain regularly. In either event, avoiding injury is the best way to maximize your powder days and to make the best of your cherished opportunities to enjoy the mountain each year.

 

Off-season conditioning

One of the most important things to consider prior to a planned ski/snowboard trip is being prepared medically and physically. Chronic health conditions like hypertension, diabetes, and cardiopulmonary issues should be assessed and optimized by your primary care provider to assure safe participation. Conditioning begins with a dry land training routine. This should include cardiovascular work like running, cycling, or elliptical and should be performed at least three times per week for 30-60 minutes. Weight training for power and muscle stamina/control is also necessary. Hip, core, quadriceps and hamstring strengthening are each important and should include some negative (eccentric) strengthening work. Additional power work including isometrics and box jumps will be beneficial for those long days on the mountain in different terrain. While preseason exercise does not prevent injury or lower risk significantly1, it is essential to make your trip pleasurable, to ensure that you don’t wear out as quickly, and to reduce soreness and fatigue in subsequent days.

 

Slope Side Preparation

Sunscreen and eye protection are often neglected during trip preparation, but are imperative to reduce the risk of UV light injury to the corneas and skin. Most people forget that the impact of UV light can be heightened at altitude, by reflection off of the snow, and also by concurrent wind and cold damage to exposed tissues. Applying sunscreen to exposed skin through the day and wearing UV protective sunglasses or goggles can help avoid painful burns. Helmet use may reduce the risk of traumatic head injury2,3,4,5, which can have grave consequences. Brain injury can occur whenever the skier/snowboarder’s head impacts the ground, another person, trees/rocks, lift towers, or other exposed objects. Neck injury is not necessarily reduced with use of helmets and is more common with more aggressive activity, such as off-piste and glades.5 Other important equipment related factors include proper fitting for your skis or snowboard and making sure bindings on your skis are properly adjusted (DIN) to suit your size, skiing style and skill level.

 

For those visiting the mountains of the western US or Canada, altitude can also affect breathing, hydration, and recovery from exertion. Be cautious with alcohol consumption, maintain adequate water intake, and, if you experience issues with breathing at altitude, consider going down to the base lodge or even further down the mountain until your breathing recovers. High altitude pulmonary edema (HAPE) can occur at the higher altitude resorts, particularly when visiting from a sea-level hometown. This condition can fatally impair breathing and oxygen exchange, but is remedied in its early stages by simply getting oneself to a lower altitude.

 

Skiing vs Snowboarding Injury

Chest and abdominal blunt trauma, including splenic injury, are more common in snowboarders but usually these are nonoperative problems. Wrist and upper extremity injuries are substantially more common in this group. Skiers, conversely, are at greater risk for lower extremity injury, often involving the lower leg and knee. Head and spine injuries tend to be evenly distributed among the skiers and boarders.6

 

While injuries can certainly occur during a skiing or snowboarding outing, simple preparations and precautions can make your trip safer and more comfortable.  If you do experience an injury, or have an existing problem you would like to have assessed before a trip, contact a sports medicine specialist like those in the MUSC Health Sports Medicine program today.

 

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1 Johnson et al, Sports Health (2009)

2 Sulheim et al, JAMA (2006)

3 Levy et al, Journal of Trauma (2002)

4 Hagel et al, British Medical Journal (2005)

5 Mueller et al, Epidemiology (2008)

5 Haider et al, Journal of Trauma and Acute Care Surgery (2012)

6 Sacco et al, Journal of Trauma (1998)

 

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