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MUSC Health Blog

Guest Post by:

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

Bicycling Charleston:  Health Benefits, Injury Prevention Techniques, and Safety Tips

The Lowcountry is becoming a more “bike friendly” area with the increasing number of bike paths and trails along with the launch of the first official city-wide bike share program, Holy Spokes. There are some significant health benefits of regular cycling for fitness, leisure, or general transportation. Cycling is mainly an aerobic activity; it will increase your heart rate and get your blood pumping, which can improve your overall fitness. Some additional benefits of regular cycling are:

  •         Increased cardiovascular fitness
  •         Increased muscle strength and flexibility
  •         Improved joint mobility
  •         Improved posture and coordination
  •         Decreased stress levels
  •         Reduced anxiety and depression

Just like with any type of sports or physical activities, there are always some levels of risk of injury. Some of the more common cycling related injuries are: knee pain (patellofemoral syndrome, patellar or quad tendinitis, IT band friction syndrome), head injuries, neck and back pain, and wrist/forearm pain or numbness. But again, like with all activities, there are also injury prevention techniques that can be implemented to reduce the risk of injury:

  • Stretch before and after cycling — focus on hamstrings, hip flexors, piriformis, IT band, gastrc/soeum complex (calf stretching), wrist flexors, and extensors.
  • Core and expecially periscapular musculature strenthening to improve your posture and stability
  • Proper seat and handle bar positioning
  • Always wear a helmet!

In addition to the injury prevention techniques, here are some safety tips to keep in mind when getting on a bike:

  1. Protect your head. Always Wear a Helmet.
  2. See and be seen. Wear clothes that make you more visible to traffic and other cyclists.
  3. Avoid biking at night. But if you do bike at night, adapt your bike to include reflectors and lights and ride on streets that are well lit.
  4. Stay alert. Always keep a lookout for obstacles in your path.
  5. Go with the flow. Ride with the flow of traffic, and use the appropriate hand signals.
  6. Learn the rules of the road. Bicyclists must obey the same rules as motorists; read and follow all state laws, traffic signs, and rules for operating a vehicle on the road.
  7. Bicycle Readiness. Adjust your bike so it fits you (raise or lower handle bars and seat), make sure wheels are securely attached (mostly if you have quick release wheels), and always check your brakes before starting to ride.

Riding a bike is a great activity for healthy living and can allow you to enjoy your surroundings while getting a workout at the same time. But, please remember to protect yourself by following these injury prevention and safety tips while enjoying the roads. 


Jewett, Amy, et al.  Bicycle helmet use among persons 5 years and older in the United States.  Journal of Safety Research, volume 59, December 2016.

Mueller, Natalie, et al. Health impact assessment of active transportation: A systematic review.  Preventative Medicine, volume 76, July 2015.

Loyola University Health System, Transportation and Safety Tips

Stop Sports Injuries – Preventing Cycling Injuries

“March Madness” is alive and well at MUSC Health. If not in fact, then at least in the heart and mind of Chris Streck, pediatric surgeon, residency program director, trauma chief, husband, father and college basketball aficionado. At a shade under 6’3”, a graduate of Duke University, and a former high school basketball champion, Chris Streck can’t deny the basketball fever that flows in his veins, and how it roils rapidly every March when the madness begins. And it is no coincidence that this father of four has two sons, and a dog, named after three famous Duke basketball players—Christian, Grant and Winslow. Well, perhaps not his 12 year old son, Christian, III. That is of course, a family name.  

Dr. Streck and family

Honoring former Duke basketball players aside, basketball is not the only competitive sport that is top of mind in the Streck household. He and his wife, Maria, also a physician at MUSC, enjoy running and try to make time for a sprint at least three times a week. Chris also plays basketball at 6:30 a.m. on Saturday mornings in Mt. Pleasant with the “Early Risers,” a somewhat middle-aged group of weekend warriors who enjoy the exercise, as well as the thrill of hitting a basket beyond the three point arc—sometimes.

In addition to medicine, also at the top of their priority list, both of the doctors Streck take an active role in their children’s sporting events with verve and gusto. Together, they collaboratively manage the craziness of shuttling the kids back and forth to nearly ten separate soccer practices each week. “With all four of the kids playing soccer and no two practices at the same time, we have to do this as a team,” Chris beams proudly. Having met his wife in medical school at Wake Forest University, the two forged a relationship and continued on to Memphis for their residencies, pairing up in a perfect partnership. “We could not have been more suited to each other,” describes Chris. “We are both extremely passionate about our medical careers, and even more importantly, about our family,” adds Chris. “I am fortunate to have healthy, bright and motivated kids, a great wife, and outstanding colleagues at MUSC. In essence, I have two incredible families, and I consider it a privilege to be in this position.”  

As the wearer of many hats, when asked how he spends his free time, Chris responds quickly. “When I am not at the hospital with my MUSC family, I am cruising around in my jeep making sure the kids get to practice on time. My free time is with my kids and I am okay with that. I feel fortunate to have this life and I am all in regardless of where I am.”

Shooting baskets, juggling balls, running the kids to practice, teaching the next generation of pediatric surgeons, as the chief of pediatric surgery, one does not have to speculate about Chris Streck’s dedication to caring for kids. His life is kids. “My life is also like juggling balls,” he adds. “When one ball almost reaches the ground, I can catch it because that’s when the next one goes in the air.” And Chris Streck, master of much, seems destined to always be there to catch it.

For more information about Chris Streck, M.D., pediatric surgeon or to make an appointment, please call 843-876-2222 or visit our website.

Guest post by:
T. Ryan Littlejohn, ATC
Athletic Trainer
MUSC Health Sports Medicine

It seems simple, but do you drink enough fluids before exercising? Proper hydration is one of the top preventive actions for heat related illnesses. According to CDC recommendations, when exercising you should drink 24 ounces of fluids two hours before activity and at least 16 ounces of fluid 15 minutes beforehand. I am not referring to soft drinks or alcohol, but water. When trying to rehydrate make sure to add a sport drink or some type of electrolyte fluid to add nutrients safely during your recovery. Checking your urine is also important. It should be clear; a person who is well hydrated should have the urge to go to the bathroom every two to four hours. It also seems obvious, but ingesting alcohol is a bad idea because it will cause dehydration, so avoid it completely.

Prevention is the most effective treatment for heat related illnesses. Here are a few suggestions:

  1. Proper training for the heat with gradual increase in intensity level over 7 to14 days
  2. Fluid replacement/hydration
  3. Appropriate clothing – light colored, loose fitting, one layer
  4. Monitor intensity of activity during high heat hours
  5. Early recognition – have an athletic trainer on site during all practices and events

When an athlete is overheated, steps should be taken to ensure that the athlete is cooled properly. Exertional heat stroke is defined as the athlete having a rectal temperature above 104 degrees. A cold water immersion tub is extremely important to use in order to cool the body immediately. If at all possible, use a rectal thermometer to get an accurate temperature, as an oral temperature may give false readings. According to the Korey Stringer Institute, research suggests if a person is cooled within 10 min of collapse and is properly cooled below 104 degrees, they will have a 100 percent survival rate. There are also many other steps to be taken like removing clothing and helmets to release the heat from the body. Emergency medical services should always be called in the event of a heat illness, but make sure steps are taken to cool the body before EMS arrives. Hopefully this information will help you as you enjoy exercising in the Lowcountry. As a rule of thumb, when it doubt call 911.


WebMD - Heat Related Illnesses Prevention

Korey Stringer Institute

Stop Sports Injuries

Guest post by:

Brittney Lang
Athletic Trainer
MUSC Health Sports Medicine

With elite and Olympic athletes in the media, we’re seeing a rise in alternative and complementary treatment methods. Even though many of these methods have been around for years, the recent exposure is giving them new popularity. Because of this, many athletes and individuals now want trendy treatments such as cupping and new methods of sports massage and acupuncture.

There are many different alternative treatments out there such as reflexology, herbal supplements, essential oils, or even chiropractic care. Many of the treatment methods are from all over the world and used throughout history. With the advances in modern medicine over the years, many alternative treatments had decreased but recently many have turned back to more holistic ways once again giving rise to alternative medicine. When considering possible alternative treatment methods there are few things that should be taken into consideration, they are:

Research – Make sure to do plenty of research when looking into a certain type of treatment. There are both good and bad alternative treatment methods. What may work for one person may not be the right treatment for another. Make sure to take into consideration the injury that you may have and any contraindications. One should also make sure to find reputable and established professionals in their alternative fields.

Money – Some of the methods can be very expensive. They may not cost that much initially, though some do, but you will probably need multiple treatments and the cost will add up over time. Now that some treatment methods are becoming more popular like massage therapy and chiropractic care some people’s insurance may help cover some of the treatments, which can help, but there is still usually some cost involved.

Safety – Lastly make sure it is safe. For example, if dealing with acupuncture you will want to make sure that the needles are completely new and sterile and that the practitioner is using proper protective equipment. Or if you are going through massage therapy or acupressure, the health care professional should make sure there are no contraindications. Not just in regards to the particular injury but to other conditions that might be involved like if one is pregnant. The professional should have the best interest of the individual at all times.

Alternative medicine and other treatment methods will continue to progress, especially with more athletes and individuals seeking more holistic forms of treatment. Though some health care professionals may not agree with these alternative treatment methods it is our duty to educate the athlete or individual as well as ourselves as healthcare professionals on other options when it comes to treating an injury. Both modern western treatments as well as alternative treatment methods can co-exist and be used together to achieve the ultimate goal of the athlete or individual when done properly.

Guest Post by:

Richard Mahieu
Athletic Trainer
MUSC Health Sports Medicine


Do you ever feel like you do not have enough time for exercise every day? You are not alone. There have been many times in my relatively short life that the world has knocked my activity schedule off  its rails. To combat this I have begun to add small changes to my daily work and personal life to increase my daily activity aside from a workout. I would like to share some of the activities that I have altered, added or plan to add in the hopes that they will help some of our readers to increase their daily activity level and improve their quality of life. Some of these may sound silly, but I do believe that every little bit helps. As always, start with small and safe changes first and speak to your physician if you have any reservations or issues.

Get dressed standing up. Putting socks and pants on standing up every day may improve your overall balance and strengthen the smaller stabilizer muscles in your hips, legs and feet. The same goes for your shoes. Tying your shoes while standing forces you to work on the flexibility of your lower back, hamstrings and calves. To ease into this habit, begin with your back and/or your posterior against a wall so that you have something to grab onto if you lose your balance.

Adjust how you walk. Walking faster can elevate your heart rate enough to give you a small amount of cardiovascular workout without getting you sweaty in the office or in the grocery store. If you are outside in the South Carolina summer, then you are likely sweaty already so no additional harm done! You can also stay on your toes to give your calves and foot and ankle stabilizers an additional workout.

Stand as often as you can. Instead of sitting at your computer, try standing at it. There are products on the market now that allow you to raise your computer to high enough level to stand at. This allows you to hit two birds with one stone by exercising your back and leg muscles while you are at work doing the daily grind. You can also do the same thing while eating. These are also great ways to avoid a sore rear from hard and uncomfortable chairs. If you have the luxury of being able to get up and walk around at work, take advantage of it as much as possible!

Take the stairs. Take the stairs instead of the elevator or escalator if you have that option. Walking up stairs often is another great way to get small amounts of cardiovascular activity into your daily life without taking up too much of your time. If you have to reach the 10th story, start off small by getting onto the elevator on the second or third floor. If you can already manage all of the floors you need to climb to get to your destination, then maybe you can begin to skip steps on your ascent.

A few other activities that you can sneak into everyday life are to park farther away from the store or work entrance or try to carry more bags of groceries into your house or to your car at once. Be careful not to overdo it though! Start small and good luck!


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