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Brett D. Owens, MD: Brett is an orthopaedic surgeon in the U.S. Army currently stationed at the United States Military Academy where he cares for student-athletes. He is new to blogging, but is excited to participate representing the American Orthopaedic Society for Sports Medicine.
David Geier, MD: Dr. Geier is an orthopaedic surgeon and the Director of MUSC Sports Medicine. He received a Bachelor of Arts degree in Economics from Wake Forest University and after completing medical school at the Medical University of South Carolina, he completed an orthopaedic surgery residency at the world-famous Campbell Clinic in Memphis, Tenn. He completed a sports medicine fellowship at Washington University in St. Louis, where he served as the team physician at Washington University in St. Louis and assisted in the orthopaedic care of the St. Louis Cardinals and St. Louis Rams. He returned to Charleston in 2005 and created the MUSC Sports Medicine program.
Dr. Geier is Board Certified in orthopaedic surgery. He is a member of the American Orthopaedic Society for Sports Medicine (AOSSM) and American Academy of Orthopaedic Surgeons, an associate member of the Arthroscopy Association of North America, and a member of the American College of Sports Medicine. He serves on the Public Relations Committee for AOSSM. He is a principal reviewer for the American Journal of Sports Medicine and a regular contributor for Outpatient Surgery magazine. He is the Head Team Physician for the Charleston Battery and Head Tournament Physician for the Family Circle Cup. He has served as orthopaedic consultant for professional and elite sports teams, including the United States Women’s Soccer team when they played in Charleston. He also serves as the head team physician for many area high schools and is the head physician for many recreational sports teams and leagues.
Sports-related concussions have become a significant concern in recent years. Research showing the long-term dangers of concussions and the effects of repetitive sub-concussive blows that can occur in football has parents of these athletes concerned.
Many sports teams are partnering with sports medicine programs and hospitals to perform baseline concussion testing for the athletes. These tests are critical if an athlete suffers a concussion.
Simple physical exam tests can be unreliable for determining if the athlete’s brain has completely returned to normal. Doctors can compare the results of baseline neurocognitive testing performed before the season to the results from the second test after a brain injury. Only when the results have returned to their baseline values should doctors clear that athlete to play.
Recent media reports have described professional athletes admitting that they intentionally perform poorly on baseline tests to be cleared for play sooner after an injury. Many team doctors have heard similar stories among high school and college athletes.
A study presented recently at the American Orthopaedic Society for Sports Medicine's Annual Meeting suggests that sleep could be another concern when athletes take these baseline neurocognitive tests.
Jake McClure and others at Vanderbilt University Medical School gathered the results of baseline concussion testing for 3,686 high school and college athletes with no prior history of concussions. They categorized the athletes into three groups based on the amount of sleep each athlete got the night before the test – less than seven hours, seven to nine hours and greater than nine hours.
The researchers found that three scores seem to be affected by a lack of sleep. The athletes who obtained less than seven hours of sleep had poorer scores for reaction time, verbal memory and visual memory.
The relationship between sleep and neurocognitive performance deserves more study. Is a lack of sleep just the night before the test more harmful than chronic sleep deprivation? Do other physical or emotional issues that might affect sleep impact the scores? It seems clear, though, that parents, coaches and doctors should encourage athletes to try to sleep well the night before these tests, at least.
“Understanding an athlete’s total health picture, including sleep patterns may help lead to more accurate concussion testing and allow for fewer individuals to be returned to play earlier than necessary,” McClure concluded.
We have a long way to go to make serious progress in preventing concussions. However we can decrease the chance of recurrent concussions. We can also lessen the possibility of worse brain injuries occurring from second blow before the athletes’ brains have returned to normal.
Baseline concussion testing is critical to those efforts. Making these tests available to all teams, leagues, schools and athletes is the first step. Getting athletes to take them seriously and perform as well as possible is another vital step. Now we know that we should encourage these kids to sleep enough as well.
What are you doing to prevent sports-related head injuries?
Tags: physical activity, concussions, head injuries, athletes, sleep health
News & Reports | Playing Outside | Schools
It is well known the regular physical activity among aging adults can maintain bone health and decrease the risk of fractures. A new study presented at the American Orthopaedic Society for Sports Medicine's Specialty Day suggests that physical activity and exercise early in life might be equally important.
Bjorn Rosengren, MD, PhD and other researchers performed a controlled exercise intervention among children aged 7-9 in Malmo, Sweden. The intervention group comprised of 362 girls and 446 boys who received 40 minutes of daily physical education at school. The control group consisted of 780 girls and 807 boys who received 60 minutes of physical education per week. The authors collected data on fractures among all participants and assessed skeletal maturity each year.
During the study, there were 72 fractures in the daily exercise group and 143 in the control group. The participants in the exercise group also exhibited higher spine bone mass density than those in the control group.
“Increased activity in the younger ages helped induce higher bone mass and improve skeletal size in girls without increasing the fracture risk. Our study highlights yet another reason why kids need to get regular daily exercise to improve their health both now and in the future,” concluded Rosengren.
This study offers several important messages. First, all of us need to exercise. Even as we get older, we need to take long walks or go for jogs several times a week. Or we can swim, bike, lift weights, or play sports. While bone loss can occur with age, regular exercise can slow its loss. People with healthy bones likely suffer fewer fractures.
A large amount of bone formation occurs in the first two decades of life. As the study demonstrates, activity at these ages can lead to stronger bones that persist later in life. Sports and exercise done as a kid can lead to better bone health as an adult.
Adults should be exercising regularly for themselves. We can also help our children by getting outside and playing with them. Encouraging them to safely play sports and do all types of physical activities is beneficial for the entire family! How do you encourage physical activity at all ages?
Tags: physical activity, Specialty Day, exercise intervention, study
Obesity rates continue to rise across the United States. In fact, the Centers for Disease Control and Prevention (CDC) currently estimates that more than 35% of American adults are obese, and about 17% of children and adolescents are obese.
Numerous health risks are linked to obesity. They comprise some of the most common preventable causes of death, including coronary heart disease, type II diabetes mellitus, and strokes. In 2008, medical costs associated with obesity were estimated at $147 billion. Efforts to decrease obesity among adults and children are crucial from a public health standpoint.
Current Physical Activity Guidelines recommend 150 minutes (or about 30 minutes, five times a week) of moderate to vigorous physical activity per week. Specifically for weight loss purposes, many experts recommend longer durations of exercise - up to 60 minutes per day.
Are these longer periods of exercise necessary for optimal weight loss? Does the extra time increase fat loss? Or is there a compensation effect whereby the body adjusts to the additional exercise?
In a paper published recently in the American Journal of Physiology, studied this question using samples of overweight, sedentary men. The authors compared a group which performed 30 minutes of daily aerobic exercise for 13 weeks to one which performed 60 minutes per day.
The authors compared the groups based on body fat loss, as well negative accumulated energy balance, which they calculated from the changes in body composition.
Participants who performed 30 minutes of aerobic exercise per day experienced the same amount of body fat loss compared to those who performed 60 minutes per day. Surprisingly, the overweight men who exercised 30 minutes per day had a much greater than predicted negative energy balance. There was no additional benefit obtained by doing 60 minutes of exercise per day.
The authors concluded that while one group of overweight men performed twice the amount of daily aerobic exercise, the decrease in body weight and body fat was no greater than the group that performed half as much.
This study provides good news to overweight individuals who want to start an exercise regimen to lose weight and body fat. Since many of these people do not regularly exercise, starting with 30 minutes per day might be more appealing. They might be more likely to stick to the shorter programs.
When it comes to obesity and weight loss, any exercise seems better than none at all. While we need much more research to find ideal nutritional changes and specific exercise recommendations, Americans of all ages can at least start with moderate amounts of exercise each day.
What do you think about this study and its findings? Will it make you more likely to try to perform physical activity each day?
Tags: physical activity, weight loss, exercise amount
Active Advice | News & Reports
This page last updated on: 11/04/2009
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