Health ShortsInjuriesACL Injuries Among Women Soar Sports participation among young women has increased 800 percent since 1972, and one consequence is an increase in tearing of the anterior cruciate ligament (ACL) of the knee. ACL tears occur two to eight times more frequently among women than men.
Some have theorized that women’s greater susceptibility may be due to differences in anatomical structure, hormones or training methods, but no adequate explanation has been found.
Preventive programs have focused on stretching and strengthening drills combined with specific avoidance techniques.
[SOURCE: Holly J. Silvers, MPT, and Bert R. Mandelbaum, M.D., “Are ACL Tears Preventable in the Female Athlete?” Medscape Orthopaedics & Sports Medicine, 2002; Thomas H. Trojan and Seamus Collins, “The Anterior Cruciate Ligament Tear Rate Varies by Race in Professional Women’s Basketball,” The American Journal of Sports Medicine, June, 2006]
Bone Stress Often Causes Knee Pain A study of Finnish military recruits found that nearly 10 percent suffered bone stress injuries that caused pain in the knee as a result of increased physical activity during basic training. Stress injuries or fractures can occur in any bone, but in this study subjects with bone stress injuries near the knee reported their pain about two weeks earlier than those with stress injuries in other areas of the body. Military recruits with a running background were less likely to develop stress fractures, probably because of their training history. [SOURCE: Maria H. Niva, Martti J. Kluru, Riina Haataja and Harri K. Pihlajamaki, “Bone Stress Injuries Causing Exercise-Induced Knee Pain,” The American Journal of Sports Medicine, January, 2006] Nearly 90,000 adolescents and children suffer burns each year serious enough to require emergency treatment. Nearly half of these occur in residential fires–usually resulting from carelessness. Another 25 percent are scalding injuries.
Products implicated in burn injuries involving adolescents and children 14 years and younger include hair curlers, curling irons, room heaters, ovens and ranges, irons, gasoline and fireworks.
[SOURCE: Jerome F.X. Naradzay, et al, “Burns, thermal,” emedicine from WebMD, last updated November 15, 2006] Correcting Swimmer's Shoulder
Young athletes with "swimmer's shoulder" can usually be identified by their forward slumping posture. The problem is that chest muscles are stronger than the corresponding back muscles-an imbalance that eventually leads to injury. Rest and antiinflammatory medications can treat pain associated with swimmer's shoulder, but the long term solution is diligent stretching plus a training program aimed at strengthening muscles in the back of the shoulder.
[SOURCE: Heidi Splete, "Secrets of Diagnosing Overuse Shoulder Injuries," Family Practice News, October 15, 2002] Female Knees Are More Vulnerable A young female athlete is three to four times more likely than a male the same age to suffer an injury to the anterior cruciate ligament of the knee, according to the National College Athletic Association. One reason may be the wider quadriceps or Q angle–the angle between the hips and the knees–in broader-hipped females. In addition, studies have shown that women basketball players tend to land from a jump on flat feet while men tend to land on their toes with bent knees. Compared to males, women also rely more heavily on their quadriceps as opposed to their hamstring muscles. These differences can be easily corrected through adjustments in training. Poor biomechanics are usually the cause of shoulder injuries suffered by golfers. The problem typically occurs in the lead shoulder at the top of the back swing, when the shoulder is stressed, fully adducted across the body and sometimes elevated 30 degrees above shoulder height.
[SOURCE: W. David Hovis, Mark T. Dean, William J. Mallon and Richard J. Hawkins, "Posterior Instability of the Shoulder with Secondary Impingement in Elite Golfers," The American Journal of Sports Medicine, November-December, 2002] Heavy Load Increases Risk to Hip
Individuals who place a heavy load on their lower extremities-either through excess weight or high physical activity-have an increased risk of eventually needing a total hip replacement. One study found that women with a body mass index (BMI) of 27 or above had a relative risk of hip replacement three times greater than women with the lowest body mass index. For men the risk was doubled for those in the highest quarter of BMI compared to those in the lowest quarter. For both men and women, the most physically active had a two-fold increased risk compared to the least active.
[SOURCE: "Obesity and High Physical Activity Are Risk Factors for Surgery," Obesity, Fitness and Wellness Week, July 14, 2001] Hernia Linked to Collagen Impairment
A hernia occurs when tissue from inside pushes out through a weakness in the abdominal wall. And it’s now believed that this happens not just because of the pressure caused by lifting or straining but because of an impairment in collagen metabolism that weakens abdominal muscles.
Persons who suffer hernias also tend to have a higher risk of diverticulitis (associated with a weakness in the intestinal wall) and abdominal aortic aneurysm (a weakness in the aorta).
[SOURCE: Parviz K. Amid, Michael Graham and Calvin A. Selwyn Jr., “Abdominal Hernia: Emerging Trends in Diagnosis and Management,” Patient Care for the Nurse Practitioner, May, 2005] Knee Surgery for Your Child?
Your 14-year-old daughter suffered a knee injury on the soccer field, and your doctor is talking about the possibility of surgery? There’s good reason to be taken aback, but it’s possible that surgery is the best solution.
Injury to ligaments along the side of the knee can often be treated with rest, bracing and physical therapy, but moderate to severe tearing of the anterior cruciate ligament (ACL) in the center of the knee usually does require surgery to prevent later knee problems. To protect growth plates, a modified surgical approach is needed.
Once considered rare in adolescents, ACL injuries are becoming increasingly common with the increased popularity of soccer.
[SOURCE: Colin Moseley, M.D., “Partial Tears of the Anterior Cruciate Ligament in Children,” American Academy of Orthopaedic Surgeons Annual Meeting, March 16, 2006; “Adolescent Knee Injuries,”The Cleveland Clinic Information Center, updated March 22, 2007] Laparoscopy Top Choice for Gallbladder
About 80 to 90 percent of persons having gallbladder surgery today have laparoscopic procedures requiring only small incisions. A recent Swedish study found that patients undergoing laparoscopic gallbladder removal had a lower mortality risk than the general population. Patients having open surgery, on the other hand, had a higher short-term risk of dying. This may have been because they were, on average, 10 years older than patients having laparoscopic surgery and more likely to have an emergency need for gallbladder removal. They were also more likely to have other medical problems.
[SOURCE: Mats Rosenmuller, et al, “Cholecystectomy in Sweden 2000-2003: a nationwide study on procedures, patient characteristics, and mortality,” BMC Gastroenterology, August 17, 2007] Little League Pitchers at Risk
A study of about 450 Little League pitchers found that at least half experienced either shoulder or elbow pain over the course of a year. The number of pitches thrown in a game was significantly associated with the risk of pain and injury. Pitchers throwing a curveball were more likely (52 percent increased risk) to have shoulder pain; those throwing a slider were likely (86 percent increased risk) to have pain in the elbow. The researchers cautioned parents and coaches against allowing young pitchers to throw curveballs and sliders and recommended limitations on pitch counts during a game and during a season.
[SOURCE: "Strike Three You're Out? Maybe for Your Career!" Sports Medicine Reports, November, 2002] New Treatment May Delay Need for Knee Replacement
For persons slowed down by the early stages of osteoarthritis of the knee, a minimally invasive treatment is now available. As an alternative to knee replacement, the UniSpacer Knee System is a small device that can be placed between the natural structures of the knee and stays in place without cement or screws. It does not require bone cutting or fixation and retains the natural anatomy of the knee. If necessary, total knee replacement can be performed at a later date.
[SOURCE: "Minimally Invasive Surgical Procedure for Arthritis May Delay Knee Replacement Surgery," Biotech Week, May 15, 2002] Outpatient Hip/Knee Replacements?
With smaller incisions, improved visualization technology and regional anesthesia, some hip and knee replacement procedures are now being performed on an outpatient basis. Success requires carefully selected patients, a high level of surgical skill and an experienced team. At a meeting of the American Academy of Orthopaedic Surgeons [February 27, 2005], Richard A. Berger, M.D. of Rush University Medical Center in Chicago showed videos of hip replacement patients walking and climbing stairs four or five hours after surgery.
[SOURCE: Karla Harby, “Outpatient surgery in hip and knee arthroplasty requires comprehensive approach,” Medscape Medical News, February 24, 2005] Re-Thinking NSAIDs for Injuries Nonsteroidal antiinflammatory drugs (NSAIDs) such as aspirin, ibuprofen and naproxen are often recommended to relieve the pain and inflammation that occur after an injury to muscles or ligaments. For longer term use (after the first two or three days), some doctors are beginning to re-think the use of NSAIDs. The idea is that the inflammatory response is the body’s way of clearing away dead muscle fiber and preparing the area for healing. Studies using NSAIDs in the injured muscles of rabbits have noted a positive effect for up to seven days but decreased force production after 28 days. [SOURCE: Thomas M. DeBerardino, M.D., “Quadriceps injury,” emedicine from WebMD, last updated June 5, 2006; Anthony Brothers, et al, “Basic clinical management of muscle strains and tears,” The Journal of Musculoskeletal Medicine, June, 2003] Many individuals choosing knee replacement surgery have been heavily involved in sports or exercise activities. And with procedures and techniques now available, they are frequently able to return to active participation. In one study, 51 of 79 patients who were physically active before surgery were able to return to sports after surgery, usually with a low-impact activity. The rate of return is even higher for persons with no additional health problems.
[SOURCE: Neil Bradbury, David Borton, Geoff Spoo and Mervyn J. Cross, "Participation in Sports after Total Knee Replacement," The American journal of Sports Medicine, July-August, 1998] Rotator Cuffs-Not for Athletes Only
Rotator cuff injuries are not just for baseball pitchers and tennis players; in fact, the average age of diagnosis is 70. The tendon that is most often injured is one that travels between two bones, leaving it vulnerable to being pinched. If you have a rotator cuff injury, you may feel pain on the front or outside of your shoulder that gets worse when you raise your arm or lift something above your head. If there's a large tear, you'll probably notice a substantial limitation on your range of motion and weakness, as well as pain, very quickly.
[SOURCE: "Shoulder Pain," American Family Physician, March 15, 2003] Quads, Hamstrings Critical in Soccer Strong, well conditioned quadriceps and hamstring muscles are essential for playing soccer. The quads are used for running, jumping and kicking. The hamstrings provide acceleration and help stabilize the knee when landing from a jump or making sharp turns. Injuries often occur because of 1) a strength imbalance between the quads and hamstrings of the same leg or 2) an imbalance between the dominant and non-dominant leg. [SOURCE: A. Head, “Isokinetic hamstrings and quadriceps evaluation of professional soccer polayers,” Journal of Sports Sciences, March, 2004] A study of men and women performing single leg squats found that women were more likely to use their quadriceps in the exercise while men were more likely to use their hamstrings. “We concluded that women are quadriceps dominant and men are hamstring dominant during the performance of SLS against body weight resistance on either a stable or labile surface condition,” the authors wrote. Causes of Quad, Hamstring Injuries Both elite and recreational athletes are often sidelined by injuries to the quadriceps or hamstring muscles of the thigh. Causes include: · Lack of warmup before starting activity, · poor flexibility or lack of stretching, · fatigue (at the end of a run or competition), · a muscle imbalance (hamstring: quadriceps ratio of less than 50 percent), · previous injury that weakens the muscle, · overstriding, which stretches the hamstring and makes it vulnerable. [SOURCE: Herman Brad Ruiz, M.D., “Hamstring injury,” emedicine from WebMD, article last updated April 26, 2006] Runners’ Knee Plagues Marathoners If you’re training for a marathon, you may encounter chondromalacia patella, or “runner’s knee”–probably at about the time you worked your training mileage up to 40 miles a week or more. Chondromalacia is a softening of the cartilage just behind the kneecap that manifests itself as a dull pain around the knee cap that may get worse when you go down stairs or run down hill. The cause is usually overuse combined with poor alignment–relatively weak thigh muscles, lack of support from the feet or both. Treatment involves icing the knee, cutting back on hills and speed work, strengthening the appropriate thigh muscles and beefing up stability for the feet with shoes and inserts. [SOURCE: Matthew Donohoe, Helen Aslanian and Kenneth Solomon, “Types of Knee Injuries and How They Occur,” The Forensic Examiner, Spring, 2005] Torn Ligaments: When To Seek Help
Most Americans have suffered a sprained ankle, wrist or knee at one time or another. And there’s always the question of whether the injury is serious enough to see a doctor. The swelling and pain you experience are probably the result of bleeding from a torn ligament and should be treated with RICE–rest, ice, compression and elevation.
In most cases, a slight tear will heal on its own, but a complete or even a severe partial tear requires a doctor’s attention. Among the signs of severe injury are: popping or tearing at the time of injury; immediate (rather than delayed) bruising; sudden and significant swelling; obvious deformity; locking or instability of the joint (looseness or bending the wrong way) and loss of function. If the pain is still severe after two days of self treatment, call a doctor.
[SOURCE: “Healthwise Handbook–Strains, Sprains and Factures,” 2004; James G. Garrick, “Acute Sports Injuries of the Knee: When To Treat, When To Refer,” Consultant, September, 1997] | ArchiveAIDS & HIV |
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