Concussion Alters Neuromuscular Function in Collegiate Athletes

Despite being cleared to return to play following a concussion, research has suggested that athletes may be at a greater risk for other kinds of injuries – namely, those affecting the lower extremities. However, the mechanism for this increased risk of a lower extremity injury after a concussion is unclear. Neuromuscular changes following concussion that persist beyond return to play may contribute to this increased injury risk.


In this study, the investigators identified altered lower extremity stiffness in the hip, knee and leg stiffness in a jump-landing task – finding this increased stiffness in athletes who had sustained a concussion when compared to uninjured matched teammates.


Changes in lower extremity stiffness have been shown to be a risk factor for lower extremity injury. Clinicians may need to include neuromuscular measures during concussion treatment programs. This may improve patient outcomes and decrease risk of lower extremity injury when these individuals return to sports activity.

For more information, view the abstract

7 Common Youth Basketball Injuries

By Sean Leninger, PT, DPT for Athletico

Basketball is a popular sport among youth athletes, but the duration of the season inyouth-basketball-injuries combination with the athleticism required by players can lead to injury.

Some of the most common injuries experienced by youth basketball players include muscle strains, ankle sprains,  Jumper’s knee and shin splints. Fortunately there are ways to prevent these injuries from happening. Read below to learn more about seven types of injuries that young basketball players are at risk for, as well as some injury prevention tips to help keep young athletes on the court.

  1. Muscle Contusions

One of the most common acute injuries suffered by young basketball players is a muscle contusion, which occurs secondary to impact. In basketball, it is not unusual for a player to accidentally ‘knee’ another player in the thigh causing a bruise to develop. Although painful, this type of injury is typically not serious.

With acute muscle contusions (less than 72 hours after injury), typical treatment includes rest, ice and compression. Once beyond the acute phase of injury, gradual return to activity is recommended and may include light stretching, progressive strengthening, and eventual return to sport once pain has subsided and full function is regained.

  1. Muscle Strains

In addition to muscle contusions, many young basketball players experience muscle strains, or ‘pulled’ muscles. The hamstring, calf and adductors (inner thigh) are common sites for muscle strains to occur given the functional demands of a sport like basketball. Strains can vary in severity from mild (Grade I) to serious (Grade III). Grade I strains occur when the muscle/tendon is overstretched. Small micro-tears in the muscle may or may not occur and the integrity of the muscle remains intact. Grade II strains involve a greater amount of torn muscle fibers and require longer recovery than a Grade I strain. Lastly, Grade III strains occur when the muscle tears or ruptures completely. This type of strain may require surgical intervention for full function to be restored.

Depending on the severity of the muscle strain (Grades I and II), return to sport may take anywhere from 2-6 weeks in most cases. As mentioned previously with muscle contusions, treatment for a muscle strain may include modalities (e.g. ice or heat), stretching, gradual strengthening, eventually progressing to advanced therapeutic exercises, along with sport specific activities such as drills, running, cutting, jumping, etc.

  1. Ankle Sprains

Most people have experienced the classic ‘low’/lateral ankle sprain that is the result of rolling/inverting the ankle. In basketball, ankle sprains can occur when cutting, accidentally stepping on an opponent’s foot or landing awkwardly.  Lateral ankle sprains involve over-stretching of the ATFL (Anterior Talofibular Ligament) and/or CFL (Calcaneofibular Ligament). Much like muscle strains, sprains are graded on a scale from I through III, with Grade I sprains being mild and Grade III sprains being considered severe.

Acute ankle sprains (Grades I-II) are typically treated with RICES (rice, ice, compression, elevation, stabilization). Once beyond the acute phase of healing, gradual pain-free restoration of range of motion, strength, ankle stability, balance and functionality is addressed in order to facilitate safe return to play.  Improper progression or returning to play too quickly may place the athlete at an increased risk of re-injury.

  1. Concussions

Many parents worry about concussions in their young athletes. While most associate concussions with aggressive contact sports like football, hockey, lacrosse and rugby, this type of injury can also occur in basketball players. Such mechanisms of injury may include a player going up for a rebound and getting elbowed in the head, diving for a loose ball and hitting their head against the court, or during the process of defending or executing a layup if contact is involved. Concussions can be a complicated injury and may require rest, follow up with a physician, as well as a proper plan of care under the guidance of a Physical Therapist that specializes in vestibular rehabilitation for safe return to activity.

  1. ACL Injuries

The Anterior Cruciate Ligament or ACL is one of the four main ligaments providing stability to the knee. ACL injuries typically occur in sports that involve quick changes of direction, pivoting, cutting and jumping. Although ACL sprains can be managed conservatively with physical therapy, an ACL tear/rupture requires surgical intervention to reconstruct the torn ligament. It is also important to note that there are multiple predisposing factors (e.g., gender, bony structure, landing mechanics, playing surface) for ACL injuries. Athletes can take steps to reduce the risk of ACL injuries by engaging in a comprehensive strength and conditioning program.

  1. Overuse Injuries

Overuse injuries such as Patellofemoral Pain Syndrome (PFPS), Jumper’s knee/patellar tendinitis, shin splints and stress fractures tend to develop over the course of a season. Many athletes are hesitant to bring up injuries to their coaches because they don’t want to miss playing time. That being said, overuse injuries tend to get worse as the season progresses. This is because overuse injuries can be linked to repetitive jumping, hip/ankle weakness, muscle imbalances (e.g. quad dominance), and running/playing/practicing while not allowing for a proper rest and recovery period. Because of this, coaches and parents should encourage young athletes to speak up when they are feeling unusual pain and discomfort.

  1. Apophyseal Injuries

Apophyseal injuries are specific to the pediatric population. These types of injuries occur at sites where tendons attach to bony prominences and include inflammation and soreness to avulsion fractures. Common sites of apophyseal injuries in youth basketball players include the calcaneus/heel (Sever’s disease) and the tibial tuberosity/shin (Osgood-Schlatter’s disease). Apophyseal injuries are typically associated with skeletal immaturity, flexibility deficits, repeated trauma (e.g. repetitive jumping and running) and muscle imbalances. Conservative treatment is usually effective in managing such conditions, making physical therapy an excellent treatment option.

The Importance of Injury Prevention

Injury prevention is important because it lessens potential healthcare costs and keepsathletico300x250 athletes playing their respective sports at a high level. As such, many chronic and even some acute injuries may be mitigated or prevented through a proper “pre-hab” exercise program along with incorporating a sport-specific warm up routine. For example, youth basketball players may benefit from balance training, dynamic and static stretching, hip/ankle stability exercises, as well as strengthening of the core and lower extremities.

Should an injury linger, further follow up with a physician and formal physical therapy treatment may be the best route for optimal outcomes.

Athletico also provides complimentary injury screens at a location near you. Click here to get started.

Why is Cheerleading A High-Risk Sport?

In spite of being a highly skilled sport, cheerleading may be dismissed by some as a trivial activity. This misconception is simply dispelled by statistics that cheerleading accounts for 66% of all catastrophic injuries in female US athletes.

Requiring an array of dynamic skills and discipline, cheerleading is not only a highly demanding endeavor but also markedly high-risk, illustrated by research reports that cheerleading is the most statistically dangerous sport for US women.

First and foremost cheerleading is a highly-skilled sport, requiring highly dynamic movement, gymnastic demands and dance elements, and like any athletic endeavour carries a high risk of injury – particularly at the professional end of the spectrum where stunts and performance carry a higher risk of fall and overuse injuries.

In fact, a study by the University of North Carolina (UNC) National Catastrophic Sports Injury Research found cheerleading to be the cause of more injuries to US females than any other sport. The author of the report Frederick Mueller, Ph.D. commented that “A major factor in this increase has been the change in cheerleading activity, which now involves gymnastic-type stunts.” Indeed gymnastics was found to be the second most prolific injury-causing sport in women.

A cheerleader requires the following prerequisite skills and strengths: agility, flexibility, coordination, balance, strength and precision of movement. Timing is also an essential facet in avoiding injury, particularly in terms of regarding the safety of your team mates. Dropping a team mate during a flip or pyramid can have serious repercussions, so a constant mental engagement and awareness is crucial at all times. The requirements for the above mentioned skills obviously intensifies with the proficiency of the team, particularly for cheerleaders performing at a professional or national level.

When considering the specific logistics of certain signature cheerleader stunts – such as ‘basket toss’ stunts, in which cheerleaders are thrown up to 20 feet into the air – the causation of extremely high injury risk statistics are clear.

A notable cheerleading injury incident that made transatlantic headlines was the case of Orlando Magic stunt team cheerleader Jamie Woode. Watched by thousands during the televised event, a treacherous mis-step caused Woode a devastating fall during a the first half of the NBA event between Orlando Magic and the New York Knicks. Landing on her head, the incident resulted in concussion, three broken vertebrae and a broken rib.

While cheerleading is an established sport in American culture, it is also gaining keen momentum in the UK. Recent figures show that 37% of British schools now offer cheerleading as part of the physical education curriculum, and 68 UK universities were represented at the UK University Cheerleading Nationals in 2015. Particularly with an increase in popularity, ensuring the safety of cheerleading participants with informed advice and regulation is crucial.

The importance of a good coach

As with any sport, a good cheerleading coach is fundamental to the pursuit of progressive quality training, the safety of the athlete and the avoidance of injury risk. Dr. Mueller states, “If cheerleading activities are not taught by a competent coach and keep increasing in difficulty, catastrophic injuries will continue to be a part of cheerleading.”

Improved regulation of coaching credentials and cheerleader safety training in the UK and USA have contributed greatly to a recent reduction in reported cheerleader injuries. Bodies such as cheersafe.org also provide cheerleading facilitators, parents and participants with comprehensive cheerleading safety information and checklists for extra-curricular cheerleaders, and those competing within teams in the educational system.

Main causes of injury in cheerleading

The injuries most prevalent in cheerleading are as follows:

  • Falling injuries – A high-risk product of stunt work, falling injuries can cause anything from surface abrasions and brushing, to severe fractures and concussion.
  • ACL injuries – Mis-stepped landings, a sudden change in direction or pivoting of the knee during full extension of the leg, are all contributing factors to the high risk of ACL injuries in cheerleading.
  • Overuse injuries – Common in many sports with intensive training, cheerleaders may be at risk or overuse injuries.

How can injuries be avoided?

A fully accredited and experienced coach providing full supervision and expert guidance is at the heart of safe cheerleading practice. Similarly it is the responsibility of the participating cheerleader to be responsible and fully aware of their own safety, as well as that of their team mates. The individual should ensure they are comfortable with any stunts undertaken, and that they have the sufficient training and ability to perform any given stunt.

Cheerleading regulatory bodies have placed restrictions and regulations on certain stunts, in order to minimize injury risk. A fully accredited coach will always train a squad according to these safety regulations.

As with any athletic endeavor, supporting training exercises are recommended to ensure sufficient levels of fitness and conditioning to help optimise performance, and negate the risk of injury. The recommended training and considerations are as follows:

  • Resistance exercises – This is important to gain and/or maintain sufficient strength in the lower back, shoulders and stomach. Pilates exercises and resistance weight training are excellent exercises for cheerleaders.
  • Stretching exercises – Flexibility is a vital performance requirement for cheerleaders. Dynamic stretching or yoga are excellent options for cheerleaders to improve performance and negate the risk of injury.

Correct injury rehabilitation – As a cheerleader’s performance effects not only their safety but also that of their team mates, it is crucial that cheerleaders do not return to squad training until fully cleared by a sports professional. If injured, seeking the correct treatment and rehabilitation program is essential.

Despite it’s perhaps frivolous depiction in popular culture, cheerleading is a serious sport carrying very severe risks of serious injury. Nonetheless, the correct adherence to regulation, undertaking proper comprehensive training with an experienced and fully-qualified coach and performing supporting exercises all significantly reduce the risk of cheerleading injury.

By SportsInjuryClinic

Dr. Kathleen Weber Featured on BullsTV Pre-Game Live

Dr. Kathleen Weber, sports medicine primary care physician and team physician for theMORGif-180x150-link Chicago Bulls joined BullsTV host Steve Kashul during Bulls Pre-Game Live on December 19th, 2016. Dr. Weber discussed the NBA’s new Concussion Protocol and the efforts being made to protect all players from returning too soon to the court.

Kashul and Dr. Weber also talked about how the physicians at Midwest Orthopaedics at Rush all work together in treating the Chicago Bulls players.

 

KIDS ARE STILL PLAYING THE SAME DAY OF CONCUSSION- DON’T BE THAT GUY!

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

Key Points:

  • More than a third of young athletes treated for concussions at a Texas sports clinic went back into the game after their injury despite safety recommendations
  • Whether the kids were unaware they had a concussion, or whether they intentionally withheld the injury from coaches or trainers is unknown
  • The study shows that there is still a need to educate players and coaches about the signs and symptoms of concussion, and to change the culture around reporting a possible concussion

By now everyone’s heard what you need to do: if you suspect you might have a concussion P9250071you need to come out of the game immediately, and not play again until properly cleared by a medical professional skilled in sports concussion management. We’ve been saying this in these pages for years; every major professional sports league has strict concussion protocols; every college does too. But a recently presented clinical study shows that kids playing sports still want to stay in the game after a possible concussion and many return to play in the same game or training session.

The research study, “Same Day Return to Play After Pediatric Athletes Sustain Concussions,” was presented at the American Academy of Pediatrics (AAP) 2016 National Conference & Exhibition in San Francisco on Oct. 22. The study was conducted by clinicians at the Texas Scottish Rite Hospital for Children in Plano, Texas. Shane M. Miller, M.D., FAAP, a pediatric sports medicine specialist at Texas Scottish Rite Hospital for Children in Plano, Texas, noticed a significant number of his patients reported they returned to play after a concussion before being cleared by a medical professional, despite medical guidelines, state law and educational efforts.

38% of the players continued to play after the initial injury

The study authors analyzed records for 185 patients between the ages of 7 and 18 treated for concussion during a 10-month period in 2014. 71 (38 percent) reported returning to play on the same day as their initial injury. Patients who immediately returned to play after their injury reported less severe symptoms of dizziness and balance problems immediately after being hurt. The study doesn’t address this specifically, but my feeling is that these kids probably didn’t think their symptoms were enough for them to feel they had a concussion. By the time they were seen in the clinic, however, their symptoms had worsened.

What’s going on? Either players are unaware of what a possible concussion feels like, or they are not reporting the injury to their coach or parents

Players want to keep playing. When it comes to injuries on the field, many injuries willssd.banner not be witnessed by the coach, referee, or even other players. The result is that many injuries require the injured players to report the injury themselves. Young players might not have knowledge about what a concussion feels like, the need for removal from play for proper recovery, and the risk of possible serious/permanent brain injury with a second concussion shortly after the first injury. We need to do better with our education. Also, players might know they have a concussion and intentionally withhold that information from coaches, trainers, or teammates. We need to do better about changing the culture around reporting.

Players, coaches, and parents must recognize a possible concussion and remove the player immediately

The study shows that we still have some work to do in changing the culture around play after possible concussion, and we also have some work to do in educating players, coaches, and parents about the signs and symptoms of a possible concussion. 38% is a big number, but perhaps even more kids were continuing play after concussion a decade ago. Let’s keep working at making this number smaller.

Big List of Conditions Physical Therapy Treats

Many people are unaware of the variety of conditions physical therapy can treat.

In addition to common ailments like lower back pain, physical therapy can be an effective treatment option for conditions like vertigo and headaches. Discover what other conditions can benefit from physical therapy by checking out the big list featured below:

ACL Injuries

ACL tears sideline more than 200,000 athletes each year according to data from thephysical therapy for acl injuries American Academy of Orthopaedic Surgeons. To help prevent this injury, Athletico Physical Therapy offers the 3P Program, which helps patients strengthen muscles surrounding the knee, core, hip and lower leg. For those who have already undergone ACL surgery, physical therapy can help with the rehabilitation process.

Arthritis

Arthritis refers to the degradation of a joint surface causing inflammation within the joint. Therapeutic interventions can be helpful in reducing pain associated with arthritis, and physical therapy can also help to improve overall function.

Back Pain

Most people will experience back pain in their life and physical therapy can prove to beathletico-2132 an effective treatment option. Upon meeting with a physical therapist for back pain, the first step is an evaluation followed by an individualized plan to address the patient’s specific needs.

Concussion

Concussions have increasingly been in the news the last few years, but many people don’t know that physical therapy can help with a variety of long term concussion symptoms, like dizziness, balance problems and headaches. In fact, Athletico Physical Therapy offers a Head Injury and Concussion Management program that assists individuals who have had a concussion or participate in an activity where there is potential for a concussion.

Headaches

Physical therapy can help alleviate headaches that are a result of musculoskeletalPhysical Therapy for headache pain relief issues, including muscle tension and tightness, disc pathology, lack of neck motion, poor posture or tightness in the back between the shoulder blades. Based on each patient’s individual needs, treatment options range from the use of heat or ice to posture education.

Jaw Pain (TMJ/TMD)

The joint used to move the jaw, called the Temporomandibular Joint (TMJ), is one of the most frequently used joints in the body. Acute or chronic inflammation of the TMJ is referred to as Temporomandibular joint disorder (TMD/TMJ Syndrome). Physical therapy options for this ailment include manual therapy, anti-inflammatory modalities, posture correction, therapeutic exercises, and modifications to physical activity and diet.

Plantar Fasciitis

Plantar fasciitis refers to inflammation of the plantar fascia, which is the connectiveLongsitting Calf Stretch tissue that runs along the bottom of your foot. Treatment options vary and can range from simple calf stretches to conducting a walking analysis.

Sciatica

Sciatica, which is a low back problem that causes pain down the leg, is another condition that can be treated by physical therapy. Treatment can include anything from muscle energy techniques to core strengthening exercises.

Urinary Incontinence

If you are experiencing bladder leaking or the urge to make frequent restroom trips, you may suffer from urinary incontinence. Physical therapy can help by increasing the strength, stability and endurance of the core, transverse abdominals, hip muscles and pelvic floor.

Vertigo

Vertigo, which causes a spinning sensation or feelings of dizziness, can often times bephysical therapy and vestibular therapy treated with physical therapy. Treatment options include canal repositioning maneuvers, exercises to improve balance, manual treatment of the cervical spine and more.

Whiplash

Whiplash describes an injury to the neck area that usually involves a rapid movement into extension and flexion. Often times this type of injury is associated with car accidents, but it can also occur as a result of participation within high-velocity, contact sports like football. Those who visit a physical therapist for their whiplash symptoms will typically go through a spine movement assessment. Based on the findings, a specific exercise program will be put in place along with other treatment options, including massage, manual stretches and range of motion exercises.

That’s Not All…

This is just the tip of the iceberg when it comes to conditions physical therapy can treat. If you think physical therapy may benefit you, please contact one of our clinics for a complimentary injury screening.

Click to Schedule a Complimentary Injury Screen