Oakwood Sports Medicine is the exclusive healthcare provider for the Canton Cup. Again this year, we will have certified athletic trainers at each of the venues for all games, to attend to the health needs of the players, answer questions, provide injury evaluation, recommendations and follow-up care as necessary. Stop by and visit our medical tents during the tournament!
For some of you, winter exercise is just another daily adventure, especially if you live in a northern climate. For others, the thought of beginning an exercise routine in the midst of snow, sleet and road salt, it can be overwhelming. Today’s entry is going to be a gentle reminder for all of you. Dehydration and lack of proper nutrition during cold weather can be dangerous.
Water is an essential component for all of the processes the body completes each day. Approximately 70% of the body is water, mostly stored in the tissues at the cellurlar level. Water is essential for the micro processes that take place in our bodies every day. Without proper hydration, these processes don’t work nearly as well and in extreme cases, stop working all together. Our kidneys regulate the amount of water loss through urine output while thirst and hunger can help regulate daily water volume. Athletic performance decreases with the loss of 2% of bodyweight and more than 2 litres can be lost through exercise!
During exercise the heart rate increases, plasma osmolality increases (osmolality is a measure of the concentration of things like sodium, potassium, glucose and other ions in the blood) , there is a decreased blood flow to the skin (for cooling) and a resultant increase in core body temperature ( a core temp too high can be dangerous!).
Dehydration is indicated by urinary markers such as a reduced urine volume, a high urine specific gravity (USG), a high urine osmolality (UOsm), and a dark urine color (UCol) . To a person, dehydration may look or feel like irritability, headache, fatigue, Weakness, dizziness and nausea. Dehydration negatively affects training, competition and recovery.
The goal is to replace 100% of sweat lost during exercise; that’s about 1/2L of fluid per kg of weight loss. The American College of Sports Medicine (ACSM) recommends 125 ml (5 ounces ) every 20 minutes. Be aware that technology (clothing) may inhibit an appreciation of sweat rate or water loss and cold weather diminishes the thirst mechanism. Staying safe and healthy during cold weather depends on your awaress, recognition and education.
Energy expenditure in adverse weather (snow/ice) is two times greater than on a regular surface (same speed—walking). The heavier clothing worn to protect a person from the elements increases energy expenditure. Vasoconstriction reduces blood flow to peripheries (arms and legs) and thereby decreases fat utilization. Glycogen utilization increases in cold weather which results in fatigue.
A person’s rate of exercise in the beginning of a session can maintain body temp. With a prolonged session, the stored reserves (glycogen) will be depleted resulting in fatigue. With fatigue will come a decrease in exercise rate followed by less muscular activity. The resultant lower body temperature is a precursor to hypothermia, a potentially fatal outcome if not handled properly.
All of this means the body’s need for energy/food increases during cold weather exercise. Obviously the challenge is to keep energy sources from freezing, ensure ease of access/consume and be palatable. A food source with high carb content is recommended. Eat before leaving on an outdoor run (~2 hours prior) to replenish liver glycogen. During the session consume 30-60 grams of carbs every hours to maintain blood glucose levels.
A year-round outdoor exercise program is very achievable if a person learns about the importance of how hydration and nutrition affect the body in cold weather.
A study released last week by the federal government, suggests the number of emergency room visits (over a 4-year period) seeking treatment after ingesting energy drinks doubled from 10,000 to more than 20,000. Most of these cases involved teenagers or young adults. In 2011, over 40% of cases involved energy drinks taken in combination with alcohol or prescription medicines Adderal and Ritalin (stimulants).
Read more about the study here.
The use of supplements, plants and derivatives, foods and over-the-counter medicines has been documented in competitive athletics for many years, typically in the high school level and above.
As related in a previous post, we discussed the need for parents, coaches, athletic trainers and other health professionals to be educated on what products athletes are asking for or interested in – try to stay ahead of the curve by reading the popular fitness magazine or checking out the local “health food” stores.
What has become apparent in just the recent past couple of years, is a general increase in the use of energy drinks by a much younger age group, such as middle school kids. The companies that make and sell these products (Monster, Full Throttle, Red Bull, for example) are using marketing plans (sponsoring concerts, races, droid apps, selling merch and swag) to attract a younger more youthful group of consumer – tobacco companies made this tactic very successful.
Beverage Digest reported a sales increase of 17% to $9 billion dollars last year of highly caffeinated soft drinks. This week, the two ounce shot, 5-Hour Energy, has been mentioned in some 90 FDA filings since 2009, including more than 30 that involved serious or life-threatening events like heart attacks, convulsions, and in one case, a spontaneous abortion, the New York Times reported.
Whether or not the increased consumption by younger people is specifically for the purposes of performance enhancement makes no difference. The fact that kids are consuming energy drinks period should be of concern to parents.
1. Because energy drinks fall into the FDA’s category of supplements – which means the product is held to a less-constraining set of standards for ingredients, creating and content. Companies are not required to disclose the amount of any indgredient, although they are very quick to point out the high levels of vitamins contained in their products!
2. High level athletes are subject to drug testing which means they must be very cautious about their dietary consumption, especially unknown ingredients.
3. A few ingredients in supplements may present safety issues for some segments of the population because of special age or health considerations. Consumers of energy drinks may be at higher risk for health problems such as caffeine toxicity, nervousness, cardiac arrhythmia, seizures or even death.
For more information on dietary supplements, the content in these links has proven to be reliable and of sound science.
What is the difference between winning and losing? In the spirit of the Stanley Cup playoffs, Mike Bossy and Wayne Gretzky provide some insight.
Each of these gentlemen were blessed with incredible talent and skill. There are literally thousands of athletes in every sport just like them…but never made it to “the show”. Countless stories can be told of athletes losing a race, event or a medal by only a hundredth of a second. What’s the difference?
There was once a local high school basketball player who had superb ball handling skills, a beautiful jump shot and the ability to make plays. Throughout his high school career, he could loaf in games and only turn it on when he was pressured. Why? Because he was that good – his work ethic had a lot to be desired – the difference between winning and losing.
Equipment in good working order – check.
Food source appropriate for the day’s adventure – check.
Sunscreen – check.
Fluid replenishment – check and double check.
It’s summer time with temperatures and humidity reaching near-record levels. As an outdoor enthusiast or athlete, fluid replenishment should be right at the top of your list.
Sweating is a natural byproduct of exertion and provides a mechanism for dissipating our body heat. Sweat rolls over the skin and provides for cooling of the skin and superficial tissues. The more we sweat, the more fluids we lose and become dehydrated. We also lose valuable electrolytes such as sodium and potassium when we sweat.
Dehydration of a mere 2% of your body weight causes a decrease in performance – for high performance athletes this is can be the difference between a place on the podium and watching from the stands or training room. Dehydration in those of us with average abilities, still decreases our performance and places us at greater risk for heat related problems and conditions.
Engaging in intensive athletic events, practice or training in high heat and humidity is a potential situation for a number of heat related conditions.
Heat exhaustion – is a result of exposure to high temps coupled with a high level of exertion over several hours or days, resulting in a state of dehydration and often accompanied by dark, pungent urine, muscle cramps, headache, dizziness, fatigue, nausea, profuse sweating and elevated heart rate (see performance decrease with dehydration above). Remove yourself from the environment preferably in air-conditioning, take a cool shower or sponge bath, replenish fluids, rest.
Heat stroke – is a medical emergency! Heat stroke often is a progression from the milder heat related conditions (exhaustion, cramps) that are left untreated or unrecognized. Prolonged, intense exercise in hot environments >>>dehydration>>>the body’s cooling system fails. Throbbing headache, red-hot-dry skin, lack of sweating, core body temperature over 104 degrees, confusion, disorientation, elevated heart rate all or in part may be present.
Call 911 and until the ambulance arrives, get out of the hot environment, rapidly cool the person by applying ice packs to the armpits, groin, neck; immerse in cool water tub or shower.
Hyponatremia – is a condition that can be caused by, among other things, excessive loss of electrolytes over a relatively short time period. A physical examination, blood test and urinalysis will assist a physician in making the clinical diagnosis of hyponatremia.
An Ounce of Prevention Is Worth a Pound of Cure
Sports drinks are beneficial. However, the marketing cog of companies wants you to believe (and purchase) their products are necessary all day, every day. That’s not quite the case – there’s a time and place for everything.
For example, if an apparently healthy adult walks the dog in the evening for 3 miles, in hot, humid weather, then water is probably the drink of choice to consume before, during and after the walk.
For the landscaper performing strenuous physical activity for hours at a time in the hot, humid weather, a sports drink in addition to water is more appropriate.
A triathlete completing a training run during lunchtime and then a bike ride in the evening, should consider water and a sports drink following the run, before, during and possibly after the bike ride. Also a small meal or two to refill the energy stores between training sessions.
Youth athletes should be encouraged to drink plenty of water during their practice session and sports drink following the activity.
Heat illness can be prevented with education, proper planning, having resources on hand and a watchful eye.
Did you know today is National Running Day ? Yep, sure enough. There are so many different reasons to run – for fun, a cause, health or competition.
Which ever way you slice it, running is a huge part of our lives. Over 35 million people lace up their shoes and “head out for a run” each year.
Running Injury Prevention
The most common types of injuries in the running population includes sprains (ligaments) and strains (muscle-tendon), typically as a result of overuse or the “too much too soon” practice.
Overuse injuries can develop slowly over time with repetitive motions or loads, resulting in a gradual break down in tissue. While there is not usually a single cause of the tissue break down, there are many contributing factors. Continue Reading…
Michigan State University is hosting its 6th annual Student Athletic Training Workshop from June 17 – 20th. This is a great opportunity for high school students to learn more about the athletic training profession.
From the workshop brochure:
Objectives will include introductory information emphasizing anatomy,
injury recognition and evaluation, initial treatment plans, taping and wrapping, improved awareness of emergency situations, general rehabilitation ideas, record keeping, and an overview and exposure to the athletic training and sports medicine professions. MSU will offer an innovative, open, and sharing environment for learning and knowledge gathering. Full-time Michigan State University Athletic Training staff will be involved in the daily instruction and lab sessions. Guest lecturers will involve local high school athletic trainers, team physicians, and various sports medicine/allied health professionals from the community. Current undergraduate athletic training students will be present to assist with lab sessions, mentoring opportunities, and daily supervision.
Playing 9 or 18 holes of golf requires a great deal of concentration, skill and physical ability—what? Physical ability to play golf? That’s right, in order to keep playing for many years, one should follow an exercise routine throughout the year.
The golf swing is very demanding on the muscles in the trunk and legs, as well as a high demand on the spine and associated ligaments. Proper warm up to prepare these structures for the rotation and movement is essential.
- Maintain good flexibility of all the muscles involved, including the hamstrings, calf, low back, mid back, and shoulders. This program should be followed all year long.
- Flexibility of the hip muscles in the front is critical to a good follow through and keeping the workload distributed evenly, saving your lower back muscles.
- Perform slow gentle movements that are similar to those in the golf swing including low velocity trunk rotation, shoulder movements, and partial squats. These can be done holding a club by the grip or at both ends.
- Ideally, a 10 minute warm up should immediately precede the first tee off of the day. This warm up could be brisk walking, stationary biking or light jogging. Break a sweat and you know you are warmed up enough!
- Lastly, if you develop pain in the body during a round of golf, give it a rest and apply the R.I.C.E. principle for the first 24-48 hours (Rest, Ice, Compression, Elevation of the injured part) and see your doctor if pain or swelling continue past 24-48 hours.
Soon enough there will be plenty of people outdoors getting more exercise. There are a few reminders to keep you on the road and feeling good. If you haven’t been physically active on a regular basis or returning to a fitness routine after a lengthy absence, check with your physician to be sure it is safe for you to begin an exercise program.
- An active warm-up works best! Think of the old-school calesthentics – the goal is to increase your heart rate a bit, break a sweat and prepare your muscles and tendons for the exercise session.
- Maintain good flexibility of all the lower body muscle groups, especially the calves, hamstrings and muscles in the front of the hip. We feel a stretching program should be completed after your training run.
- Wear shoes designed for running. Check at a reputable running shoe store for proper fit, type of shoe etc.
- Start slow and easy! Don’t try to do too much in the first days of your program.
- If you run in the evening or at night, wear reflective clothing so others can see you.
FOR THE ADVANCED RUNNER:
- Respect the 10% rule per week in progressing your training.
- Use R.I.C.E. to manage post-workout soreness, but if the pain or swelling lasts until the next scheduled run, better think twice and see your physician.
- A proper warm up should get your body ready for the day’s workout—10-15 minutes of easy calesthentics or biking should do it
- Replace your shoes after 300-450 miles if you are running more than 35 miles per week. The cushioning of a shoe breaks down quickly, especially with consistent training.
City of Taylor officials released the results of tests conducted at the facility that hosted the MAHA tournament games this past weekend. Several dozen players and family members of players became ill on the last day of the tournament.
News reports pointed at the possibility that the water in the facility, the Taylor SportsPlex, was contaminated. It was not.
Ice cleaning equipment, Zamboni, were the early target of criticism as was the air quality in the facility. The Zambonis at the SportsPlex are electric, not propane or gas fueled. Propane or gas fueled Zams, when not properly maintained or are near the end of their useful life, can produce fumes (carbon monoxide) that affect the air quality in which they operate. The air quality at the SportsPlex was checked late Sunday night and found to be clean.
Food poisoning was eliminated early on during investigators inqueries. The concession stand at the SportsPlex has recently been inspected and found to be in tip-top condition. Not all of the players ate food from the concession stand. Most ate at their homes or other restaurants. Next.
Student-athletes that participate in close contact sports are often more susceptible to contracting and sharing colds, viruses and skin conditions. Hockey players sit next to each other in a small room and small bench, allowing for shared airspace. Wrestlers are always involved in close contact with their opponent or team mate. Water bottles on the bench are typically shared among several players. Oakwood Sports Medicine emphasizes with teams the importance of staying healthy during the season – that is proper hand washing, not coming to school/practice when ill, using only their own water bottle or single use cups, not sharing towels in the dressing room or shower.
Yesterday we blogged about this event and norovirus and while the exact cause will likely be a “best guess”, we thought it important to reiterate the importance of prevention when dealing with sick or ill athletes.
You can decrease your chances of becoming infected with norovirus by:
- Frequent hand washing with warm water and soap (alcohol based hand sanitizers do NOT work against norovirus)
- Promptly disinfecting contaminated surfaces with household chlorine bleach-based cleaners
- Washing soiled clothing and linens
- Avoiding food or water from sources that may be contaminated
- Cooking oysters completely to kill the virus
- Don’t share water bottles or towels with team mates
Guide for participating in athletics when ill:
- If you have a fever, vomiting or diarrhea – STAY HOME!
- Drink clear fluids to replace the large quantities of fluids lost with vomiting, a fever or diarrhea.
- Consult your doctor if a fever lasts more than 2-3 days.
- Generally, participation in practice or games with a head cold, congestion or allergies is acceptable unless the symptoms of those conditions are so severe that the athlete is unable to fully participate safely.
- Recovery from a virus may take longer than expected. Use the additional time away to restore your energy, replenish your food or fuel stores with a proper diet and most importantly, avoid the chance of recurrence by returning to sport too early.