Heads Up on i-Concussion

NAU footballThere is a new face at Northern Arizona University (NAU) football games this fall.  No – not a new quarterback or coach – but a robot on wheels!

Making its debut at the season kick-off game against the University of Arizona in Tucson last Friday, the robot has the ability to assess a player for symptoms and signs of a concussion and to consult with sideline medical personnel thanks to a specialized camera system, remotely operated by a Mayo Clinic neurologist.

teleconcussion robot Mayo Clinic will be working with NAU to test the feasibility of using a telemedicine robot to assess athletes with suspected concussions during football games as part of a research study. With sophisticated robotic technology, use of a specialized remote controlled camera system allows patients to be “seen” by the neurology specialist, miles away, in real time.

Athletes at professional and collegiate levels have lobbied for access to neurologic expertise on the sideline. As we seek new and innovative ways to provide the highest level of concussion care and expertise, we hope that teleconcussion can meet this need and give athletes at all levels immediate access to concussion experts,” said Bert Vargas, M.D., a neurologist at Mayo Clinic who is heading up the research.

This study is the first to explore whether a remote neurological assessment is as accurate as a face-to-face evaluation in identifying concussion symptoms and making return to play decisions. Mayo Clinic physicians will not provide medical consultations during the study, they will only assess the feasibility of using the technology.

But, if it appears feasible, this may open the door for countless schools, athletic teams, and organizations without access to specialized care to use similar portable technology for sideline assessments.

teleconcussion robot 2As nearly 60% of U.S. high schools do not have access to an athletic trainer, youth athletes, who are more susceptible to concussion and its after-effects, have the fewest safeguards in place to identify possible concussion signs and symptoms at the time of injury. Teleconcussion is one way to bridge this gap regardless of when or where they may be playing.” Says Dr Vargas.

Others involved collegiate sports agree.

At NAU, our primary goal is to provide an outstanding student-athlete experience culminating in graduation,” says Dr. Lisa Campos, vice president for Intercollegiate Athletics at Northern Arizona University. “We charge our staff to research the most current and best practices to ensure the safety and care of our students. Partnering with the Mayo Clinic in its telemedicine study will further this research and potentially improve diagnosis for rural areas that may not have access to team doctors or neurologists. The study allows the NAU Sports Medicine Staff and team doctors to continue to make all diagnoses and return to play decisions for our students, while investigating the effectiveness and efficiencies of telemedicine. We are excited to have the teleconcussion robot on our sideline this fall.”

concussion_footballThere were a number of examples last football season where college football players clearly demonstrating concussion-like symptoms were quickly thrown back in games or weren’t even taken out of the game for an evaluation,” said Ramogi Huma, executive director of the National College Players Association. “College football players are in desperate need for independent concussion experts on the sidelines, and this study could help make that safeguard a reality.”

Telemedicine is not new to the Mayo Clinic in Arizona.  They first used the technology with the telestroke program in 2007, when statistics revealed that 40% of residents in Arizona did not live in an area where they were availed of stroke expertise. Since the telestroke program began nearly 3,000 emergency consultations for neurological emergencies have taken place.

We’ll be following the results of this study and will let you know the results as soon as they’re in.

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Baby, It’s Cold Outside

snow_cover_map_NOAA_27Dec12With almost 70% of the US currently covered in snow it’s fair to say that the weather outside is frightful. However, before you start embracing the lyrics of Let it Snow!, consider that sitting by the fire, popping corn may be more frightful than delightful. At least as far as your fitness routine is concerned. Though you may be layered in sweatshirts, stockings and scarves, staying active is important no matter what the temperature. “It’s hard to stay motivated in the winter. When temperatures plummet, the last thing we want to do is leave the comfort and warmth of our homes. But winter is not a good excuse to give up our fitness routines,” says Kara Smith, personal trainer and group fitness coordinator at the Loyola Center for Fitness. Two women run down Mountain Avenue in a snowstorm.Yet, there are a lot of great outdoor fitness activities you can only enjoy during the winter months, such as hockey or ice skating, skiing and snowshoeing.  And you don’t have to abandon your outdoor running and walking routines, just modify them a little. Here’s some tips for exercising outside in the cold.

  1. Wear a hat, scarf and gloves.
  2. Take special care with extremities, especially nose, ears, fingers and toes.  Keep them covered to prevent frostbite.
  3. Moisture is extremely dangerous when exercising in the cold so make sure your shoes are waterproof to keep your feet dry.
  4. Wear layers. Exercise will generate heat, which may make you feel too warm. Layers allow you the option of taking off piece by piece to keep you at a comfortable temperature.
  5. exercise in the snowLayer correctly. The first layer should be a synthetic material such as polypropylene to keep sweat off your skin. Avoid cotton since it stays wet and can cause your skin to get cold. The next layer should be fleece or wool for insulation. The top layer should be a waterproof, breathable material. Avoid heavy jackets that may cause you to overheat if exercising hard.
  6. Stay hydrated. In the summer months we think about hydrating, but it’s important in winter, too. Winter is a very dry time of year so your body needs more water even when not sweating. Dehydration causes muscle fatigue and weakness.
  7. Find an exercise partner and schedule times to workout together.
  8. Beware of  your footing while out on your run. Beneath the snow, there could be a sheet of ice which could cause you to slip. If you want to protect yourself from slipping on unexpected layers of ice, make sure you have suitable footwear with sufficient traction
  9. Plan your route before you set off. There are various things that you need to keep in mind – the level of traffic, the thickness of the snow, the weather forecast for the next few hours, and distance. In snowy weather, it is sometimes better to stick to the busier roads as breaking trail in heavy snow can be very difficult .
  10. stay-active-this-winter-staying-fit-and-healthyConsider your safety. Once you have planned your route, tell friends and family where you will be and how long you could be gone for. Carry your mobile phone and be prepared to walk back should you suffer an injury.
  11. Watch out for traffic. Snow and ice not only affects your movement as a runner, but the movement of vehicles on the road. Because of the treacherous driving conditions, there is an increased rate of road accidents. Always try to position yourself facing the traffic so you can see what’s happening ahead of you.

Remember winter doesn’t last forever so stop hibernating and get out and enjoy what this season has to offer. SRxA-logo for web

Black Friday Fitness

After a day of over-indulging on family, food and football, now it’s time to turn your thoughts to Holiday shopping. But before heading out to join the Black Friday frenzy, SRxA’s Word on Health is here to make sure you’re prepared.

First, you need to recognize that Black Friday shopping is a sport and a dangerous sport at that!  You need to prepare with the thoroughness of an Olympic athlete to outperform your competition.

And while it might be too late to get in shape for the 2012 holiday shopping season, it’s never too early to begin next year’s preparations!

The workout plan below will help you get ready to take on both the stores and the other shoppers by improving your agility to grab the best deals.

Warm Up

  • 5-minutes on the treadmill or elliptical will help warm up your muscles in preparation for the door-opening and mad stampede that follows

Workout

  • 25  x Jumping Jacks – will help to reach those must-have items on the top shelves
  • 2  x Agility Ladder runs – be ready to make sharp turns while maintaining speed and control to help you avoid crowds and crush injuries
  • 10 x Box Jumps – to develop lower body power and elevate your heart rate and prepare you for both the physical exertion and psychological stress of a long day of shopping
  • 25 yard Bear Crawls – to help strengthen your back and core in preparation for carrying home all those bargains
  • 5 x Suicide Runs –  to build up your endurance and agility
  • 25 x Walking Lunges – to tone up your glutes, hamstrings and quads, so you look good while you shop
  • 45 x Pick Pockets. Help yourself to evade pick-pockets through these abdominal twists and turns
  • 15 Push-ups. Work out all the muscles in your upper body and build optimal strength in your forearms, wrists, upper arms, shoulders and chest. All important for pushing carts and maximizing parcel carrying power.
  • 10 Dumbbell Deadlifts – work your back, butt, hips and legs, ready for taking steps three at a time and gaining headway on those standing in line for the elevator

Cool Down: 

  • Stretching out, eyes closed, on the recliner or arms raises with a cold adult beverage

After all – if you make it out of the mall, with body and finances still relatively intact – you’ve earned it!

Pediatricians Propose Policy to help Hollaback Girls

It’s official!  Cheerleading – love it or hate it –  isn’t just about short skirts, big smiles and pompom waving.  According to a new policy statement from the American Academy of Pediatrics (AAP), cheerleading is just as athletic and potentially as dangerous as a sport and should be designated as one.

In addition, to making it a sport, the AAP urges coaches, parents and school officials to follow injury-prevention guidelines, develop emergency plans and ensure cheerleading programs have access to the same level of qualified coaches, medical care and injury surveillance as other sports. They also recommend better supervision including on-site athletic trainers, limits on practice time and better qualified coaches.

Not everyone is fully aware of how cheerleading has evolved over the last couple of decades. It used to be just standing on the sidelines and doing cheers and maybe a few jumps,” said Cynthia LaBella MD, a sports medicine specialist at Chicago’s Lurie Children’s Hospital.

Injuries have increased as cheerleading has become more popular.  Over the last two decades, the number of cheerleaders injured has climbed dramatically. Hardly surprising given that cheerleaders engage in stunts such as creating human pyramids that reach 15 feet high or more.  Common injuries include severe sprains, broken arms and legs, neck injuries and concussions.

Last year alone, there were almost 37,000 documented emergency room visits for cheerleading injuries among girls aged 6 to 22.  That’s a 400% increase from the 1980.  And while the overall injury rate in high school cheerleading is lower than in other girls sports, such as gymnastics, soccer and field hockey, the rate of catastrophic injuries like skull fractures and spinal paralysis is higher.  In fact, cheerleading accounts for 66% of all catastrophic injuries in high school female athletes.

Data suggest there are more than 3 million cheerleaders nationwide, most of them girls.  While most belong to traditional cheerleading squads that support schools’ athletic teams, many schools have also created competitive cheering teams.
Some schools and state high school sports associations already consider cheerleading a sport and require the kind of safety oversight that the academy is recommending. But many do not, says Jim Lord, executive director of the American Association of Cheerleading Coaches & Administrators.

Lord and the AAP agree on a number of safety recommendations including limiting the height of human pyramids in high school cheerleading to just two people and banning routines that include pyramids, tumbling or tosses from being performed on hard surfaces.

Lisa Kluchorosky, a sports medicine specialist who works with the academy and the National Athletic Trainers Association, believes the new policy will not only help to reduce injuries but also help erase misconceptions that cheerleading is not very athletic.

What do you think?

We’d Like to Bounce Something Off You…

In 1945, George Nissen, a competitive gymnast, patented the modern trampoline as a “tumbling device. Initially intended as a training tool for acrobats and gymnasts it was subsequently used for military aviator training.

More recently, at least if my neighborhood backyards are anything to go by, the main use of trampolines, is recreational. Driven perhaps, by parents concerns that their kids are becoming more sedentary, along with a family-friendly price tag, it seems there are few family gardens in suburban Northern America that don’t have a trampoline

All this despite the fact that the American Academy of Pediatrics and other lofty medical organizations such as the American Academy of Orthopedic Surgeons, the Canadian Pediatric Society and the Canadian Academy of Sports Medicine have issued guidelines discouraging the use of trampolines in homes and playgrounds..

In fact, with each new set of guidelines comes an increase in the numbers of trampolines in the home setting.

And an increase in injuries…

In 2009, the rate of trampoline-associated injuries was 160 per 100,000 among 5-14 year olds. And approximately 75% of these injuries occurred when more than one person was on the trampoline at the same time.

The most common site of trampoline injury, is the lower leg accounting for 34% – 50% of injuries and >60% involved the ankle,  Upper extremities are injured in 24% – 36% of cases. Most commonly, when people fall off the trampoline. Of these, approximately 60% are fractures.

Head and Neck Injuries account for 10% to 17% of all trampoline-related injuries and 0.5% of these, result in permanent neurologic damage.

And before, you succumb to your precious little angel’s demands, or are tempted by fall yard sale trampoline bargains you may also want to consider the following:

  • The potential for severe and devastating injury is high.
  • Enclosures and padding may provide a false sense of security and do not prevent the large numbers of injuries that occur on the trampoline mat itself.
  • Many injuries occur even with reported adult supervision.
  • Multiple jumpers increase injury risk, particularly to the smallest participants; so trampoline use should be restricted to a single jumper at any given time
  • Individuals 5 years and younger appear to be at increased risk of fractures and dislocations from trampoline-related injuries.
  • Somersaulting, flipping, and falls put jumpers at increased risk of head and cervical spine injury with potentially permanent and devastating consequences. These maneuvers should not be performed in the recreational setting.
  • Active supervision by adults familiar with the above recommendations should occur at all times. Mere presence of an adult is not sufficient.

Have you got a trampoline story to tell? SRxA’s Word on Health is looking forward to hearing from you.

An Unexpected Exercise in Exercise

Despite the fact that numerous studies have shown the powerful effect that exercise can have on recovery from cancer, including reducing tumor recurrence rates by up to 50%, a new study has shown that many cancer patients are reluctant to exercise, and fewer still discuss it with their oncologists.

According to the Mayo Clinic study published in the Journal of Pain and Symptom Management, patients took exercise advice most seriously when it came directly from their oncologists, but none of those studied had discussed it with them.

The study was part of a series of investigations looking at exercise habits among 20 adult lung cancer patients. Researchers found that patients who exercised regularly before their diagnosis were more likely to exercise than those who had not. Many patients considered daily activities, such as gardening, sufficient exercise.

“There was a real sense of what I do every day, that’s my exercise,” said lead author Andrea Cheville, MD.

Most of the patients thought that their daily activities equated to exercise, whereas in reality, most of these activities required minimal effort.  Such inactivity can contribute to weakening of the body and greater vulnerability to problems, including cancer recurrence.

Generally, patients are not being given concrete advice about exercise to help them maintain functionality and to improve their outcomes,” added Dr. Cheville.

Exercise can improve patients’ mobility, enable them to enjoy activities and keep them from becoming isolated in their homes. It can contribute to overall feelings of strength and physical safety, ease cancer-related fatigue and improve sleep.

The researchers now plan to investigate how to make the message about exercise meaningful to cancer patients so that they can optimize symptom relief and enhance their own recovery.

Olympic Spirit?

As over 10,000 athletes from all over the world gather in London for the Games of the XXX Olympiad – better known as the 2012 Summer Olympic Games, and as spectators witness the amazing displays of athleticism,  SRxA’s Word on Health has been looking at the unhealthy history of the modern games.

Yes, today we’re talking doping.  The use of performance enhancing drugs has had a long history at the Olympic Games. Its origins can even be traced back to the Ancient Olympics. Athletes were also known to drink “magic” potions and eat exotic meats, such as lizard, to try and gain an athletic edge on their competition.

Back then, men were required to compete naked…but that’s a different story!

In the modern Olympic era, chemically enhancing one’s performance has evolved into a sophisticated science, but in the early years of the Modern Olympic movement the use of performance enhancing drugs was almost as crude as its ancient predecessors.

At the 1904 games in St Louis, Thomas Hicks, the winner of the men’s marathon was given  strychnine, eggs and brandy, before and even during the race.

This early example of “doping” certainly wasn’t the last. In 1957 a New England Journal of Medicine editorial commented on the dramatic improvements in performance at track and field events. The editorial considered the possible reasons for the recent epidemic of broken records.  It suggested that although training, diet antibiotics and motivation played a role, amphetamine use by athletes may be the main reason that otherwise unassailable records were being broken.

Performance enhancing drugs are not only a threat to the integrity of sport but can also have potentially fatal side effects. During a cycling event at the Rome Games of 1960, Danish cyclist Knud Enemark Jensen fell from his bicycle and later died. A coroner’s inquiry found that he was under the influence of amphetamines, which had caused him to lose consciousness during the race.

By the mid 1960s, sports federations were starting to ban the use of performance enhancing drugs, and the International Olympic Committee followed suit in 1967.

Despite this, each passing decade since has brought new scandals, new performance enhancing drugs, new testing methods and new methods to evade testing.

In 1984, the US Olympic Committee admitted that seven of its cyclists had received blood transfusions. Four years later, Canadian sprinter Ben Johnson was stripped of his gold medal from the Seoul Olympics when his urine samples were found to contain the anabolic steroid stanozolol.

Next came erythropoietin (EPO). The 1992 Games in Barcelona were even nicknamed the “Hematocrit Olympics.”

At the 2008 Games in Beijing the official slogan was “Zero Tolerance for Doping” . Even so, six athletes with positive specimens were ousted from the competition. Although this was far fewer than at previous games, it can’t be concluded that the prevalence of doping decreased as doping technology has become more sophisticated and athletes have turned to drugs that can’t be detected.

The list of drugs banned from the Olympicsis determined by the World Anti-Doping Agency. The banned substances and techniques include: androgensblood dopingpeptide hormonesstimulantsdiureticsnarcotics, and cannabinoids.

Both experts and cynics are already asking, will future athletes turn to gene therapy…or have they already started? One thing’s for sure, the Olympics will remain an object of fascination for all the right and the wrong reasons.

Getting Cheery Over Cherries!

Regular readers of SRxA’s Word on Health will be familiar with the many claimed health benefits of fruit. Bananas for HIV prevention, citrus to safeguard us against stroke, berries to prevent Parkinson’s Disease and even exotic cupuaçu for improved reproductive health.

According to many, including TV’s Dr. Oz, the latest superfruit on the block is tart cherries. Extensive research has linked the delicious bright red fruit to a number of benefits, including better sleep, reduced pain from gout and arthritis, reduced post-exercise muscle and joint pain as well as reduced cholesterol, and decreased risk for atherosclerosis and metabolic syndrome.

Dr. Oz, has gone so far as to say that tart cherries are the ultimate antioxidant.

New research from Oregon Health & Science University presented last week at the American College of Sports Medicine Conference confirmed that tart cherries can help to reduce chronic inflammation and can help people with osteoarthritis manage their disease.

In a study of twenty women ages 40 – 70 with inflammatory osteoarthritis, the researchers found that drinking tart cherry juice twice daily for three weeks led to significant reductions in important inflammation markers – especially for those women who had the highest inflammation levels at the start of the study.

With millions of Americans looking for ways to naturally manage pain, it’s promising that tart cherries can help, without the possible side effects often associated with arthritis medications,” said principal study investigator Kerry Kuehl, M.D. “I’m intrigued by the potential for a real food to offer such a powerful anti-inflammatory benefit – especially for active adults.”

Often characterized as “wear and tear” arthritis, osteoarthritis is the most common type of arthritis. Athletes are often at a greater risk for developing the condition, given their excessive joint use that can cause a breakdown in cartilage and lead to pain and injury.

Anthocyanins – the antioxidant compounds in tart cherries – appear to reduce inflammation to levels comparable to some well-known pain medications.

Previous research on tart cherries and osteoarthritis found that a daily dose of tart cherries helped reduce osteoarthritis pain by more than 20%.

Leslie Bonci, Director of Sports Nutrition at the University of Pennsylvania Medical Center for Sports Medicine, has incorporated tart cherries into the training menu of her professional athletes. She claims they are a natural and easy way to manage pain and also taste great.

Never heard of tart cherries, or concerned that they have such a short season?  The great news is that they are available year-round in dried, frozen, powder and juice forms too.

Allergic to Running?

Earlier this week I posted on facebook, asking if any of my friends wanted to join me in an Iron Girl Triathlon this fall, So far, there has been a distinct lack of takers. Or to be more precise, nobody, not one single solitary person, has taken me up on the challenge.

I did, however, hear a lot of reasons why people didn’t want to swim, bike and run with me at 7am on a September morning.  Among the best of these: “I’d love to, but I think I’m allergic to sport.”

I think she was trying to be funny – though with my friends you never can tell!

You see, not only do most of my friends have a wicked sense of humor, most are also involved one way or another with healthcare, and maybe, just maybe, she who will remain nameless, really is allergic to running.

While it may sound like the perfect excuse, people can in fact suffer an anaphylactic reaction to exercise.  But, before you cancel your gym membership and start justifying your life as a couch potato, I should point out that it’s generally pretty rare.

People usually associate working out with an increased heart rate and a nice endorphin rush — not hives, or shock. But it can happen.

Cholinergic urticaria, a common type of heat rash, can occur when there’s an increase in body temperature and when mast cells in the skin break down right before releasing sweat. Studies suggest up to 11% of adults experience post-exercise hive attacks, men, more commonly than women.

Even worse is exercise-induced anaphylaxis.  Like the name suggests, it’s triggered by exercise, especially running. Anaphylaxis, is more commonly seen after insect stings or eating shellfish and peanuts.  And just as with food allergies, those affected by exercise can experience symptoms including vomiting, hives, difficulty breathing, collapse and even death…although fewer than 1,000 cases and only one exercise-related fatality have been reported since the 1970s.

So while running (or Iron Girl Triathlons) may not be everyone’s favorite fitness activity, the “I’m allergic” excuse is reserved for those (un)lucky few.

And even then, most cases can be avoided.

Usually, it’s triggered by eating certain foods before exercise. But this isn’t just your average food allergy says allergist Jacqueline Eghrari-Sabet MD – a spokeswoman for the American Academy of Allergy, Asthma and Immunology.  “Eating shellfish and sitting there? Nothing. But eating shellfish and exercising? For these people, it’s bad news.”

As you exercise and your heart rate speeds up, your blood starts whizzing through organs much faster than it normally does. With every trip your blood takes to your stomach, it’s picking up more, of say, the peanuts. For those with exercise-induced anaphylaxis, the normal amount of peanut antigens picked up by the blood isn’t enough to bother them. But while exercising, the extra peanuts their blood is picking up causes an allergic reaction.

So next time you are convinced that if you spend even one more minute on the treadmill, you will die? Maybe it’s not all in your head.

Spanx Takes a Spanking

Spanx has been in the news a lot lately. First, Forbes magazine announced that Sara Blakely, founder of the women’s slimming undergarments company, had joined the billionare’s club this year. At age 41, and having started her business at home with just $5,000, Blakely is now the world’s youngest self-made female billionaire.

Last month, Oscar winning actress Octavia Spencer, hit the headlines when she revealed, what she’d not been revealing!  Turns out, when she took home the SAG Award for Outstanding Actress in a Supporting Role for The Help, she’d been wearing three pairs of Spanx under her gown.

Now it seems the trend has spread from the red carpet to the green turf. This week, ConsumerReports.org warned of the dangers of teens in Spanx. The on-line watchdog reported the tale of a 15-year-old high school soccer player who was recently referred to her doctor because of numbness, tingling, and discomfort in her left thigh that had bothered her for a few weeks. The diagnosis: a compressed nerve in her pelvis. The likely cause: Spanx. While doctors have previously warned of the health dangers associated with skinny jeans, such as  fertility problems , bladder infections , and blood clots the doctor in question was surprised that a girl so young and fit would wear Spanx. It turns out that her entire team wears them under their soccer uniforms.

Body slimmers are the latest fad to hit the athletic fields. Sold in an assortment of bright colors, they appeal to teenage girls who play soccer, lacrosse, and softball. However, in an attempt to conceal their spandex, these girls are rolling down the waistline of their Spanx and unwittingly pressing a tight band of Lycra into their groins. The result: injuries normally associated with direct trauma or repetitive stretching and contraction of the groin muscles. The treatment: in this case, the doctor advised his patient to ditch the Spanx, and retire her skinny jeans. Not that Sara Blakely needs to worry, according to Forbes, her billion dollar business is set to at least double in size in the coming years.