Foot Injuries; Clavicle Fractures

Episode 15.03 with Hosts Steve Kashul and Dr. Brian Cole. Broadcasting on ESPN Chicago 1000 WMVP-AM Radio, Saturdays from 8:30 to 9:00 AM/c.

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Segment One:

Dr. Simon Lee, Foot & Ankle Orthopedic Surgeon from Midwest Orthopaedics at Rush discusses how to avoid and treat foot injuries and some of the most common among pro-athletes: ankle sprain, turf toe, stress fractures and plantar fasciitis.

Dr. Lee specializes in all foot and ankle disorders with strong interests in sports-related injuries, arthroscopy of the foot and ankle, soft tissue and bony reconstructive surgery, total ankle replacements, arthritis, cartilage restoration, bunion and claw toes and fractures about the foot and ankle. Dr. Lee’s undergraduate education was at the University of Illinois in Champaign/Urbana with a degree in Biology. He went on to medical school here at Rush University Medical Center. He completed his orthopedic surgery residency at the University of Illinois Medical Center and went on to complete a fellowship in foot and ankle surgery at the prestigious Carolinas Medical Center with Miller Orthopaedic Clinic (OrthoCarolina) in Charlotte, North Carolina.

He has contributed to numerous publications from the American Academy of Orthopaedic Surgeons (AAOS) and the AOFAS in regards to the foot and ankle. Dr. Lee has regularly served as the chairman/moderator and faculty member for instructional courses, which help to educate fellow orthopedic surgeons throughout the United States. He also serves on the Post Graduate Educational Committee for the AOFAS as well as the Rush Orthopedic Department’s Residency Selection Committee and Residency Review Committee. He continues to remain active as the foot and ankle consultant to Hubbard Street Dance, River North Chicago Dance, DePaul University, the Chicago Bulls and the Chicago White Sox and numerous local gymnastics, soccer and basketball club teams.

Segment Two:

Dr. Cole and Steve Kashul discuss fractures of the clavicle (collarbone): definition, causes, prevalence among pro-athletes, forms of alternative treatment, new technology, recovery and return to play; the importance of experience in surgical decision-making.

Clavicle Plate and Screw System The Clavicle Plate and Screw System is a comprehensive set of plates, screws and instrumentation designed to treat central third and distal clavicle fractures. The clavicle plates are low profile, precontoured, stainless steel central third and distal plates that combine locking and nonlocking options in each plate. Secondary fixation to the coracoid is achieved through the plate using AC TightRope® technology, particularly the AC Dog Bone Button, making the system ideal for treating Type IIb distal clavicle fractures or fractures that have poor bone quality laterally, which can be difficult to achieve adequate screw fixation. Suture holes in the plates allow incorporation of FiberWire® or FiberTape® onto the plate to capture butterfly fragments or to cerclage severely comminuted distal fragments.

Dr. Cole talks Bulls Basketball and The Psychology of Injury and Recovery

Whether returning a star athlete to a high level of performance, or helping seniors prevent the progression of arthritis, Dr. Cole is frequently featured in the press. As one of the nation’s leading orthopaedic surgeons, Dr. Cole is at the forefront of developing and providing innovative methods for restoring damaged cartilage, bone and soft tissue. We invite you to review these headlines, audio, and video to learn more about how these advances can benefit your joint health.

Why Sleep is Important To A Healthy Weight

weightlosssleep1The debate about the best way to reach a healthy weight always revolves around exercise and diet. But here’s why sleep is just as important to your goals.

The importance of sleep is so significant that you could easily argue it’s the most important factor in achieving the body you want. Before you snicker, you might want to take a closer look.

Sleep Controls Your Diet

The debate about the best way to achieve a healthy weight always revolves around eating and movement. If you want to look better, the most common suggestion is “eat less and move more.”

images-23But it’s not that simple, or even accurate. Sometimes you want to eat less and move more, but it seems impossible to do so. And there might be a good reason: Between living your life, working, and exercising, you’re forgetting to sleep enough. Or maybe, more importantly, you don’t realize that sleep is the key to being rewarded for your diet and fitness efforts.

According to the Centers for Disease Control and Prevention, more than 35 percent of people are sleep deprived. And when you consider that the statistic for obesity is nearly identical, it’s easy to connect the dots and discover that the connection is not a coincidence. Not sleeping enough—less than seven hours of sleep per night—can reduce and undo the benefits of dieting, according to research published in the Annals of Internal Medicine. In the study, dieters were put on different sleep schedules. When their bodies received adequate rest, half of the weight they lost was from fat.

However when they cut back on sleep, the amount of fat lost was cut in half—even though they were on the same diet. What’s more, they felt significantly hungrier, were less satisfied after meals, and lacked energy to exercise. Overall, those on a sleep-deprived diet experienced a 55 percent reduction in fat loss compared to their well-rested counterparts.

Poor Sleep Changes Your Fat Cells

Think about the last time you had a bad night of sleep. How did you feel when you woke up? Exhausted. Dazed. Confused. Maybe even a little grumpy? It’s not just your brain and body that feel that way—your fat cells do too. When your body is sleep deprived, it suffers from “metabolic grogginess.”

The term was coined by University of Chicago researchers who analyzed what happened after just four days of poor sleep—something that commonly happens during a busy week. One late night at work leads to two late nights at home, and next thing you know, you’re in sleep debt. But it’s just four nights, so how bad could it be? You might be able to cope just fine. After all, coffee does wonders. But the hormones that control your fat cells don’t feel the same way.

Within just four days of sleep deprivation, your body’s ability to properly use insulin (the master storage hormone) becomes completely disrupted. In fact, the University of Chicago researchers found that insulin sensitivity dropped by more than 30 percent. Here’s why that’s bad: When your insulin is functioning well, fat cells remove fatty acids and lipids from your blood stream and prevent storage.

When you become more insulin resistant, fats (lipids) circulate in your blood and pump out more insulin. Eventually this excess insulin ends up storing fat in all the wrong places, such as tissues like your liver. And this is exactly how you become fat and suffer from diseases like diabetes.

Lack of Rest Makes You Crave Food

Many people believe that hunger is related to willpower and learning to control the cimages-25all of your stomach, but that’s incorrect. Hunger is controlled by two hormones: leptin and ghrelin. Leptin is a hormone that is produced in your fat cells. The less leptin you produce, the more your stomach feels empty. The more ghrelin you produce, the more you stimulate hunger while also reducing the amount of calories you burn (your metabolism) and increasing the amount fat you store. In other words, you need to control leptin and ghrelin to successfully lose weight, but sleep deprivation makes that nearly impossible.

Research published in the Journal of Clinical Endocrinoloy and Metabolism found that sleeping less than six hours triggers the area of your brain that increases your need for food while also depressing leptin and stimulating ghrelin. If that’s not enough, the scientists discovered exactly how sleep loss creates an internal battle that makes it nearly impossible to lose weight. When you don’t sleep enough, your cortisol levels rise. This is the stress hormone that is frequently associated with fat gain. Cortisol also activates reward centers in your brain that make you want food.

At the same time, the loss of sleep causes your body to produce more ghrelin. A combination of high ghrelin and cortisol shut down the areas of your brain that leave you feeling satisfied after a meal, meaning you feel hungry all the time—even if you just ate a big meal. And it gets worse. Lack of sleep also pushes you in the direction of the foods you know you shouldn’t eat. A study published in Nature Communications found that just one night of sleep deprivation was enough to impair activity in your frontal lobe, which controls complex decision-making.

Ever had a conversation like this? “I really shouldn’t have that extra piece of cake… then again, one slice won’t really hurt, right?” Turns out, sleep deprivation is a little like being drunk. You just don’t have the mental clarity to make good complex decisions, specifically with regards to the foods you eat—or foods you want to avoid.

This isn’t helped by the fact that when you’re overtired, you also have increased activity in the amygdala, the reward region of your brain. This is why sleep deprivation destroys all diets; think of the amygdala as mind control—it makes you crave high-calorie foods.

Normally you might be able to fight off this desire, but because your insular cortex (another portion of your brain) is weakened due to sleep deprivation, you have trouble fighting the urge and are more likely to indulge in all the wrong foods.

And if all that wasn’t enough, research published in Psychoneuroendocrinology found that sleep deprivation makes you select greater portion sizes of all foods, further increasing the likelihood of weight gain. The bottom line: Not enough sleep means you’re always hungry, reaching for bigger portions, and desiring every type of food that is bad for you—and you don’t have the proper brain functioning to tell yourself, “No!”

Poor Sleep Weakens Your Workouts

Unfortunately the disastrous impact spreads beyond diet and into your workouts. No matter what your fitness goals are, having some muscle on your body is important. Muscle is the enemy of fat—it helps you burn fat and stay young. But sleep (or lack thereof) is the enemy of muscle.

Scientists from Brazil found that sleep debt decreases protein synthesis (your body’s ability to make muscle), causes muscle loss, and can lead to a higher incidence of injuries. Just as important, lack of sleep makes it harder for your body to recover from exercise by slowing down the production of growth hormone—your natural source of anti-aging and fat burning that also facilitates recovery. This happens in two different ways:

  1. Poor sleep means less slow wave sleep, which is when the most growth hormone is released.
  2. As previously mentioned, a poor night of rest increases the stress hormone cortisol, which slows down the production of growth hormone. That means that the already reduced production of growth hormone due to lack of slow wave sleep is further reduced by more cortisol in your system. It’s a vicious cycle.

If you’re someone who doesn’t particularly enjoy exercise, not prioritizing sleep is like getting a physical examine with your father-in-law as the investigating physician: It will make something you don’t particularly enjoy almost unbearable. When you’re suffering from slept debt, everything you do feels more challenging, specifically your workouts.

Sleep: The Instant Health Boost

The connection between sleep and weight gain is hard to ignore. Research published in theAmerican Journal of Epidemiology found that people who are sleep deprived are a third more likely to gain 33 pounds over the next 16 years than those who receive just seven hours of sleep per night. And with all of the connections to obesity, diabetes, high blood pressure, heart failure, and cognitive failure, the need to sleep goes far beyond just looking better and seeing results from your diet and exercise efforts.

While there’s no hard number that applies to all people, a good rule of thumb is to receive between seven and nine hours of sleep per night, and to make sure that one poor night of sleep isn’t followed up with a few more. It might not seem like much, but it could make all the difference and mean more than any other health decision you make.


From BornFitness

10 Exercises That Burn More Calories Than Running

running

We’re huge fans of running. It allows you to get a stress-reducing, endurance-boosting workout with just a pair of shoes and an open road. It also burns calories, of course. At a 10-minute per mile pace, you’ll fry about 10 calories a minute. That’s a solid number, and if you run faster, you can burn even more.

But if running isn’t your favorite activity, there are plenty of other modes of exercise that can help you torch calories at a lightning fast rate. “In general, you burn more calories by doing high-intensity weight training than you do running,” says Harold Gibbons, a trainer at Mark Fisher Fitness in New York City, and the New York state director of the National Strength and Conditioning Association.

Most people don’t realize this, though. That’s often because the number of calories you’re told you just burned is typically estimated from The Compendium of Physical Activities, which calculates energy expended through aerobic metabolism. That works well for low- to medium-intensity exercise, but not so well for higher-intensity activities that rely on anaerobic metabolism.

In fact, when researchers at the University of Southern Maine used a more advanced method to estimate energy expenditure during exercise, they found that weight training burns up to 71% more calories than originally thought. Which suggests that a fast-paced circuit workout burns as many calories as running at a 6-minute per mile pace. But resistance training isn’t your only option. There are also cardio exercises that can boost your burn, too. We found 10 exercises that will help you incinerate calories—without ever having to hit pavement.

Kettlebell Swing
This explosive exercise works the big, powerful muscles around your glutes and quads, and sends your heart into overdrive, according to research from the University of Wisconsin. In the study, participants burned 20.2 calories a minute and their average heart was 93% of its max for the course of a 20-minute workout. “The kettlebell swing works you so hard because it’s not a movement you’re used to,” says Dan John, a strength coach in Salt Lake City and the author of Intervention. “You’re not super efficient at it, which taxes your body.”

Indoor Rowing
A 185-pound person can burn 377 calories during 30 minutes of vigorous rowing, or about 12.5 calorie per minute, reports a Harvard University study. And because you need to utilize the muscles in your arms, legs, and back for efficient strokes, it’s a great total-body trainer. Want to row like an Olympian and burn even more calories on the rower? Fix The 5 Rowing Mistakes You Don’t Know You’re Making.

Burpees
A 180-pound person burns about 1.43 calories per burpee, says exercise scientist and Spartan Coach Jeff Godin. So if you can hammer out at least seven a minute you’re in the double digits. But you should shoot to average at least 10 every 60 seconds, or a rate of 14.3 calories per minute. Why? Performing just 10 reps at a fast pace can rev your metabolism as much as a 30-second, all-out bike sprint, according to a study presented at the American College of Sports Medicine annual meeting.

AirDyne Bike Sprints
It sounds downright crazy, but Gym Jones manager Rob MacDonald proved that it’s possible to blast 87 calories in one minute on this stationary bike that increases its resistance as you pedal harder.

The key: Give everything you have in that 60 seconds. Note: This was by no means a scientific experiment, and relies on the accuracy of the built-in AirDyne monitor, which calculates calories by converting revolutions of the fan into physical work. (Want to see video of MacDonald’s mind-blowing 87-calorie effort? Watch You Won’t Believe How Many Calories This Guy Burned in 60 Seconds!)

Jumping Rope
Moderate-intensity rope jumping—about 100 to 120 skips per minute—burns about 13 calories a minute, according to the Compendium of Physical Activities. This mode of exercise uses more muscle groups than jogging, and challenges your balance, and coordination—especially if you practice drills that require extra hand and foot skills.

Fat-Tire Biking
If you haven’t tried this fast-growing cycling sport, you should. You can burn up to 1,500 calories an hour—or nearly 25 calories per minute—pedaling the heavy, hard-to-turn monster bikes and tackling all types of terrain, all year round, says Mike Curiak, record holder for the 1,000-mile Iditasport Impossible, a fat tire biking race. Reality check: That kind of calorie burn depends on your fitness and strength levels, and your skill. But regardless, it’s sure to be one hell of workout. (Want to learn more about Fat Biking? Read The Winter Sport That Burns 1,500 Calories an Hour)

“Cindy”
This CrossFit Workout of the Day (WOD) burns an average 13 calories per minute, according to scientists at Kennesaw State University. It’s effective because it pairs three exercises—5 pull-ups, 10 push-ups, and 15 air squats—that work different major muscle groups, and you do as many rounds as possible in 20 minutes.

So if you’re in amazing condition, you can go all-out for each one, without slowing down or stopping to recover in between. If you’re somewhat less than amazing (read: like most people), you simply rest when needed. For example, you don’t move on to the push-up until you’ve completed 5 reps of the pull-up, even if you have to stop and start. “Any routine that takes you from standing, down to the ground, and back up to standing again is an amazing calorie burner, because it really spikes the heart rate,” says John.

Cross-Country Skiing
Zipping along on skis delivers a better heart-pounding workout compared to running at about the same pace, thanks to the fact that the sport requires you to push with your lower-body and pull with your upper.

In fact, a good cross-country ski session can burn more than 12 calories a minute, according to the Compendium of Physical Activities. That explains why Nordic Skiers consistently collapse in exhaustion at the finish line of Olympic races. (No fresh snow? Look for the new Concept2 SkiErg machine at your gym.)

Tabata Jump Squats
This four-minute miracle drill burns major calories both during a workout and after. In an Auburn University at Montgomery study, participants who did eight rounds of all-out jump squats—20 seconds of hard work, separated by 10 seconds of rest—burned 13.4 calories per minute and doubled their post-exercise metabolic rate for at least 30 minutes.

Battling Ropes
In a recent College of New Jersey study comparing various workout styles, battling-rope exercises came in first in terms of total oxygen consumption and an average calorie burn of 10.3 calories per minute. And for a complete cutting-edge exercise and nutrition guide that you can use on your computer, tablet, or phone, check out The Lose Your Spare Tire Program. It’s the easiest and most effective way to drop 20, 30, or even 50 pounds (and flatten your belly forever).

AMANDA MACMILLIAN FOR MENSHEALTH.COM

MORE: Undo Hours Of Sitting With This Exercise

Biological Reconstruction of the Shoulder: Dr. Brian Cole

Case Example

  • 16 year old female swimmer
  • Underwent arthroscopic shoulder stabilization 2 years previously
  • Intra-articular pain pump placed for post operative pain management
  • Patient developed significant pain and motion loss over the subsequent 6 month period
  • Patient remained symptomatic after subsequent capsular release and debridement
  • Definitive biologic restoration includes a humeral head osteochondral allograft and marrow simulation of the glenoid