Key Points:

  • Participation in yoga is increasing amongst all age groups in the United States
  • When done correctly, yoga has many benefits for young athletes in improving core strength, flexibility, and psychological benefits
  • Some poses may need to be avoided or modified if the athlete has some pre-existing medical conditions, such as avoiding lunges if you have Osgood-Schlatter syndrome

kids yogaVarious estimates of yoga participation in the United States appear to show increases in all age groups. It’s generally believed that the percentage of U.S. adults who said they practice yoga increased from 5.1 percent in 2002 to 9.5 percent in 2012, according to one survey conducted by the National Institutes of Health and the Centers for Disease Control and Prevention. Yoga participation amongst kids is also on the rise: the percentage of children ages 4 to 17 who do yoga increased from 2.3 percent in 2007 to 3.1 percent in 2012.

I’m generally a yoga fan, although there’s quite a bit of commercialism surrounding mainstream yoga. Yoga encourages balance, strength, proper posture, improved breathing, control, and awareness of one’s body, and has potential mental benefits as well. We are seeing some more injuries than we did several years ago, but with a few simple guidelines, many of these injuries can be prevented or limited. Additionally, when working with an experienced instructor, yoga may be helpful for injury recovery from numerous orthopaedic conditions such as common strains and sprains.

There are several types or disciplines of yoga. Not every form is friendly for beginners and some can be quite strenuous. Depending on your athleticism, fitness, flexibility, and conditioning as well as pre-existing medical conditions, you should choose a style that fits you well. You should also communicate your goals and needs with the instructor before embarking on a new program.

Injuries can be avoided by knowing your limitations. If you have pre-existing medical problems or extremity injuries, consult your physician or orthopaedic surgeon prior to starting or renewing a yoga program. Discuss any pre-existing conditions with the yoga instructor before starting a class. They may want you to avoid certain poses or positions.

Typically, injuries occur when participants attempt a challenging pose or posture without having the initial capability, flexibility, or strength to perform that maneuver or when the pose is performed improperly. In yoga, it is better to do a portion of the maneuver perfectly than to push from poor alignment into a full pose.

Two common areas for potential problems are with pre-existing conditions such as Osgood-Schlatter syndrome in the knee or Sever’s syndrome in the heel. If a young athlete has these conditions you’ll likely need to modify or avoid some poses, such as avoiding lunges.

With proper techniques and guidance yoga can be extremely rewarding both physically and mentally. Following this straightforward advice, injuries are unusual and the disciplines can be quite beneficial for core and postural strength, balance, and flexibility.

By Dev Mishra, M.D., President, Sideline Sports Doc, Clinical Assistant Professor of Orthopedic Surgery, Stanford University



While baseball is commonly known as a non-contact sport, the risk of collision is certainly not minimal. Some are due to contact with the ball, bat, or another player, but it is easy to forget that a base can cause injuries. Help young baseball players avoid sliding injuries with these tips from Dr. Daryl Osbahr.

As the Assistant Team Physician for the Washington Nationals, a member of the USA baseballtournamentBaseball Medical & Safety Committee, and a member of the STOP Sports Injuries Outreach & Education Committee, I work with players, parents, coaches and athletic trainers to reinforce the importance of proper baseball sliding technique. Here are some helpful tips that you can apply in your own life or teach to your children to help avoid a serious injury:

  • Always take time to stretch and warm up properly. This will help you avoid lower body ligament injuries while maintaining flexibility and strength.
  • It is important that proper sliding technique is taught and practiced before using an actual base.
  • Always practice with a sliding bag first. Once the player has learned the correct technique, gradually move to a breakaway base and then, if your league requires it, to a standard, anchored base.
  • Players under the age of 10 should not be taught to slide.
  • When coming into home plate, the baserunner should attempt to slide safely in order to avoid a collision with the catcher.
  • The obstruction rule should always be taught and observed. It is dangerous to get in the way of the runner or block the base without possession of the ball because it could cause serious injury to both the baserunner and the fielder.
  • If league rules allow it, use separate bases for the runner and the fielder to help prevent foot and ankle injuries.
  • Always wear the appropriate footwear. Your cleats should have enough traction to help avoid slippage, but not so much that they can get caught in the turf or injure another player.
  • Know what equipment your league (or your child’s league) is using, and be sure to have a thorough understanding of league rules.

In every situation, prevention is always the best treatment. Together, we can make sliding safer—but it takes an athlete’s entire influence circle to make a difference. The athlete, parents, coach, team personnel and doctors all need to be dedicated to preventing injuries together.

By Daryl Osbahr, M.D.

Improve your Understanding with 3D Animation on Articular Cartilage Problems

Cartillage ThumbnailProduced by an experienced team of medical writers, 3D animators, and project managers with a detailed understanding of anatomy and surgery; they take complex surgical procedures and animate the steps to tell a visually stunning story in 3D that is both educational and entertaining. Each animation is embedded with an illustrated script which can be shared, viewed or printed separately.

3D Animation on Articular Cartilage Problems:

Drilling/Microfracture (Brochure)

Removal of Damaged Cartilage (Brochure)

Visit  our Patient Education page for the full Library of 50 specific Orthopedic Surgical Procedures in 3D Animation.

5 “Harmless” Sleep Problems You Shouldn’t Ignore

It’s easier than you think to tame your tossing and turning: You can cure some minor sleep disorders after just one therapy session, suggests new British research. Study participants had acute insomnia, or trouble sleeping for a period of 2 weeks to 3 months because of a life event like stress or illness. But 3 months after the subjects sat down for a 1-hour therapy session, nearly 75 percent reported being completely cured of sleep struggles.

It’s much easier to nip insomnia in the bud through therapy before it becomes chronic, says study author Jason Ellis, Ph.D. The problem: Most people don’t identify with the term “acute insomnia” even if they have it, he says. And soon enough, frequent sleep issues become harder to fix. Even if these five common sleep problems only strike occasionally, you should still bring them up with your doctor.

These occasional snoozing struggles could signal a bigger issue

1. You Don’t Sleep through the Night

Waking up frequently could be a sign that you have sleep apnea, says Men’s Health sleep advisor W. Christopher Winter, M.D. When you snooze, your airway closes and forces your brain to choose breathing properly over staying asleep. You wake with a jolt, the muscles in your airway readjust, and then you’re knocked out again before you realize what happened, Dr. Winter says. It doesn’t matter if you’re rousing every 5 minutes or every hour. If sleeping in chunks makes you feel worn-out the next morning, then it’s a problem—and you need to see your doc, says Dr. Winter.

2. You Wake Up from Nightmares

You’re lying on the beach with a Corona in hand when a tidal wave hits you. Suddenly, you’re back in your bedroom gasping for air. If you’re constantly waking up from dreams like this one, it could be another indicator of sleep apnea, says Dr. Winter. Throughout the night, you dream in cycles known as REM sleep, or rapid eye movement. During your REM cycle, the muscles that keep your airway open become paralyzed and can cause it to collapse, says Dr. Winter. Then, your brain takes that feeling of suffocation and incorporates it into the fabric of your dreams. It might seem like you’re waking up from fear, but apnea is likely the culprit, he says.

3. You Get Morning Headaches

A migraine in the morning could also mean you have a more mild form of apnea known as upper airway resistance syndrome, says Dr. Winter. If you don’t inhale and exhale properly, you don’t get rid of enough carbon dioxide. And when you keep in all this excess gas, it leads to a pounding head—which serves as a cruel alarm clock in the A.M. Before you see a doc about this sleep problem, see if it’s an easy fix. Avoid pulling the covers over your head prior to dozing off. Trapping yourself in a blanket dome with all the carbon dioxide you’re breathing out can give you what’s called a “turtle headache,” says Dr. Winter. If you can’t resist yourself, at least leave an air hole, he says.

4. You Grind Your Teeth

If you sand down your chompers, it could mean stress is keeping you from getting a good night’s sleep. Although you’re probably not aware of it, you’re actually conscious when you grind your teeth, says Dr. Winter. The action happens during short awakenings in the night. If something’s bothering you, you wake up and subconsciously clamp down as a release. In the morning, you’re left with a sore jaw—and later, a lecture from your dentist.

5. You Do Things You Don’t Remember

Does your girl wake you with tales of weird things you did last night that you can’t recall? Don’t laugh them off, says Dr. Winter. If there’s no booze in the equation, this kind of behavior falls under the umbrella of parasomnia disorders, which involve doing abnormal things while you sleep that could hurt yourself or others. Eventually, you could escalate to sleep walking, sleep driving, or even “sleep sexing,” says Dr. Winter. Bring up your strange nighttime adventures with your doctor.

By Jada Green for Men’s Health

Are You at Risk for a Heart Attack After Exercise?

Dying during or immediately after physical activity occurs rarely. But the exercise-related death of a prominent Wall Street executive last week nevertheless raises concerns for people who want to keep active during middle age and later years. Regular exercise is a cornerstone of good health, and its long-term benefits for both longevity and protection against heart attacks, cancer and other ailments are supported in many studies. Doctors say there are strategies to reduce the already low likelihood of a workout turning into a tragedy.

“Exercise is not a vaccine against heart disease,” says Michael Joyner, an exercise physiologist at Mayo Clinic, in Rochester, Minn. Dr. Joyner noted that risk factors such as high blood pressure and high cholesterol are increasingly common as people age. “You need to get them treated,” he says. “Middle-aged men in high-stress jobs need to get a checkup once in a while.”

Growing numbers of people are moving through middle age determined to stay active with competitive sports and regular exercise. Doctors urge others who are on the sidelines to join in to improve their health. “There is unequivocal evidence that regular physical activity and exercise have multiple benefits that far outweigh any risk of the exercise itself,” says Jonathan A. Drezner, director of the Center for Sports Cardiology at the University of Washington, in Seattle.

heartriskBut, while a person is doing it, rigorous exercise, whether on a treadmill, a road race or a basketball court, does elevate risk for sudden cardiac arrest, a typically fatal event that can be triggered by a heart attack but is the immediate result of an out-of-control arrhythmia that causes the heart to stop beating. The majority of sports-related sudden cardiac arrests occur among people above 35 years old. Most victims are men and most already have heart disease whether they know it or not.

“The risk is much greater for people who don’t exercise on a regular basis,” Dr. Drezner says. “The weekend warrior who goes out to crush it once a week” or less often is much more vulnerable than the person who gets three to five cardio workouts a week. For a sedentary middle-age person who wakes up one morning and suddenly decides to become a “lean, mean fighting machine in a month, that’s a bad idea,” says Sumeet Chugh, associate director of the Heart Institute at Cedars Sinai Medical Center, in Los Angeles. “You should make fitness a goal, but a gradual goal,” slowly increasing intensity over several weeks or more.

Another worry is that heart disease often goes undetected. In as many as half the cases, a heart attack is a person’s first symptom of significant coronary artery disease. That raises the stakes on controlling cholesterol, blood pressure and other risk factors. A potentially troublesome aortic aneurysm, a bulging in the main blood vessel that carries blood away from the heart, rarely causes symptoms and poses a challenge for early detection. Dr. Chugh, co-author of a recent article titled “Sudden Cardiac Death in the Older Athlete” in the Journal of the American College of Cardiology, lists these markers for high risk: a 10-year risk of coronary artery disease greater than 5%; very high cholesterol; diabetes; a strong family history of sudden cardiac death or early heart disease; or a body-mass index, a measure of obesity based on height and weight, over 28.

A sedentary person who checks any of these boxes should get a thorough cardiac evaluation before participating in sports or embarking on an exercise program, he says. Victims of sudden cardiac arrest often miss or ignore signals of heart risk, researchers say. A recent study found more than one-third of people experienced typical heart symptoms in the week before the event.

“Everyone who is exercising needs to be aware of symptoms that don’t feel right,” says Dr. Drezner. A little chest pain or shortness of breath, a heart palpitation or feeling more fatigued than usual might seem trivial, but they are warning signs that should prompt people to “definitely see a physician to be evaluated,” Dr. Brezner says.

Fitness experts also point to studies showing the benefits of physical activity come from frequency, not intensity. People get more than 50% of the payoff of rigorous exercise just by walking, says Michael Roizen, chief wellness officer at the Cleveland Clinic. A gradual warm-up and a cool-down period are important components of a more rigorous workout, he says. And he especially cautioned against being too competitive on a workout. “A guy will say, ‘If I can do 30 minutes, why can’t I do 40 minutes,’ ” Dr. Roizen says. “Every guy will go too far, too fast unless you yell at them.”

A recent study Dr. Chugh led of cardiac-arrest cases in the Portland, Ore., area illustrates how rare such events are. It examined 1,247 sudden cardiac arrests that occurred among people ages 35 to 65 during an 11-year period ending in 2013. Researchers found that just 5%—63 cases—were associated with sports activity, including 17 arrests during jogging, seven during gym exercise and others during such activities as basketball, cycling, golf, volleyball and soccer. The analysis, published in April in the journal Circulation, said the incidence of sports-associated sudden cardiac arrests was 21.7 per million residents per year, compared with 555 per million for arrests not associated with sports. Extrapolating the findings to the entire U.S. population, researchers estimated that 2,269 men and 136 women suffer a sudden cardiac arrest associated with physical activity each year.

“You can’t really use the risk of sudden death as an excuse not to exercise,” says Dr. Chugh.

By Ron Winslow for The Wall Street Journal

How Does Strength Training Compare With Body Weight in Reducing Risk Factors for Cardiometabolic Disease in Overweight-Obese Young Men?

In the United States, about one-third of adults are obese. The lack of exercise that contributes to obesity has led to confusion about whether fitness or body weight is more important to health. This study looks at at the fitness vs. body weight “controversy” in young men, but in a different way. The innovative aspect of this study is comparing two groups who had habitually been doing similar amount of weight training (and had similar strength levels) and two groups with similar body weights. The overweight/obese and normal-weight strength-trained individuals had similar levels of measures of disease risk and both were better on these measures than overweight/obese individuals who did not have a history of regular strength training. These findings are important because they challenge the existing view of the importance of body weight classification and suggests that regular weight training strength fitness may be more critical to health. Furthermore, strength fitness may be an alternate therapeutic target, especially in those unable to normalize body weight. Ultimately, it may be time for us to shift the focus to changing lifestyles as opposed to just focusing on body weight and weight loss.

View the study’s abstract