sports medicine

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Exercise Addiction: How To Know If You’ve Crossed The Line Between Health And Obsession

Experts say it’s tricky to determine precisely how many people struggle with exercise addiction because it can masquerade behind socially acceptable intentions -- like getting fit at the gym. (Courtesy of Scott Webb/Unsplash)

Experts say it’s tricky to determine precisely how many people struggle with exercise addiction because it can masquerade behind socially acceptable intentions — like getting fit at the gym. (Courtesy of Scott Webb/Unsplash)

Lisa M. joined a gym as soon as she started college at Bridgewater State University, determined not to pack on an extra 15 pounds freshman year like her older sister.

“In my head there was that picture of my sister,” Lisa said in an interview. “I didn’t want that to happen to me.”

For the next six years, Lisa says, she never missed a day at the gym unless it was preplanned and she could make it up later. In order to fulfill her self-imposed exercise requirements, Lisa skipped Christmas Eve gatherings, birthdays, weddings and dates with someone she loved and “very likely lost” because of her illness, she says.

“Every aspect of my life was dictated by exercise and food and the need to control it all,” says Lisa, who asked that her last name not be used because she is still in treatment.

“Every aspect of my life was dictated by exercise and food and the need to control it all.”

– Lisa M.

The thought of missing even one daily workout triggered massive anxiety, she says. And as her exercise obsession deepened, she began restricting her food intake too, mostly to salads and vegetables. She had “fear foods” she’d avoid: no cake, brownies or cookies, of course, but also, no cheese or pasta. Thoughts about food and exercise consumed her: “Any extra energy I had would go to…thinking about my next meal, my next snack, what I’d be able to eat next. I’d plan meals a week ahead.”

Her weight dropped to 112 pounds on a 5-foot-6 frame. She hasn’t had a period in six years. Now, as a result, Lisa, who is 25, has osteoporosis in her lower spine and hip.

“I worked so hard to be healthy, but I’m not,” she says. “And I did this to myself.” Continue reading

Study: Higher Cognitive Risk For NFL Vets Who Start Football Under Age 12

New England Patriots helmets are seen in the team locker room at Gillette Stadium last year. (Michael Dwyer/AP)

New England Patriots helmets are seen in the team locker room at Gillette Stadium last year. (Michael Dwyer/AP)

This post originally appeared on Boston University’s Research News Website as “Football: Child’s Play, Adult Peril?”

By Barbara Moran

As the 100 million viewers tuning in to this Sunday’s Super Bowl can attest, Americans adore football. And for many, the love affair begins in childhood: Pop Warner Tiny-Mites start as young as age 5, and many adults retain warm memories and friendships from their youth football days.

But a new study from BU School of Medicine researchers points to a possible increased risk of cognitive impairment from playing youth football. The National Institutes of Health–funded study, published online in the Jan. 28 edition of the journal Neurology, finds that former National Football League players who participated in tackle football before the age of 12 are more likely to have memory and thinking problems as adults.

The study contradicts conventional wisdom that children’s more plastic brains might recover from injury better than those of adults, and suggests that they may actually be more vulnerable to repeated head impacts, especially if injuries occur during a critical period of growth and development.

“Sports offer huge benefits to kids, as far as work ethic, leadership and fitness, and we think kids should participate,” says study lead author Julie Stamm (MED’15), a PhD candidate in anatomy and neurobiology. “But there’s increasing evidence that children respond differently to head trauma than adults. Kids who are hitting their heads over and over during this important time of brain development may have consequences later in life.”

“This is one study, with limitations,” adds study senior author Robert Stern, a MED professor of neurology, neurosurgery and anatomy and neurobiology and director of the Alzheimer’s Disease Center’s Clinical Core. “But the findings support the idea that it may not make sense to allow children—at a time when their brain is rapidly developing—to be exposed to repetitive hits to the head. If larger studies confirm this one, we may need to consider safety changes in youth sports.”

In the study, researchers reexamined data from BU’s ongoing DETECT (Diagnosing and Evaluating Traumatic Encephalopathy Using Clinical Tests) study, which aims to develop methods of diagnosing chronic traumatic encephalopathy (CTE) during life. CTE is a neurodegenerative disease often found in professional football players, boxers and other athletes who have a history of repetitive brain trauma. It can currently be diagnosed only by autopsy.

For this latest study, scientists examined test scores of 42 former NFL players, with an average age of 52, all of whom had experienced memory and thinking problems for at least six months. Continue reading

Quick, What’s The Girl’s Sport Most Linked To Catastrophic Injuries?

Considering lacrosse for my 7-year-old I imagined the worst: head injuries, a fracture or two, an inevitable trip to the ER.

But it turns out there’s another girls sport I should be even more worried about: cheerleading.

heraldpost/flickr

heraldpost/flickr

The Washington Post reports that cheerleading ranks number one when it comes to risky sports for girls, accounting for more than half of catastrophic injuries to female athletes. Here’s a snippet:

With or without government regulation, cheerleading poses by far the greatest risk of catastrophic injury to young female participants of any sport. According to a 2012 report and policy statement by the American Academy of Pediatrics, cheerleading “accounted for 65 percent of all direct catastrophic injuries to girl athletes at the high school level and 70.8 percent at the college level” between 1982 and 2009.

The overall number is small — 110 closed-head injuries, skull fractures and cervical spine injuries that resulted in “permanent brain injury, paralysis or death” over that period — and the number of participants in cheerleading is large, an estimated 3.6 million nationwide, the academy found. (A number of other girls suffered cardiac problems and heat stroke.) But the disproportionate number of severe injuries in this one activity is striking.

Continue reading

Knees, Food, Periods: Top 10 Medical Tips If Your Daughter Plays Sports

(AP Photo/Gerald Herbert)

(AP Photo/Gerald Herbert)

You could call this “Title IX Medicine.”

Title IX, of course, refers to the landmark 1972 anti-discrimination law that gave huge added impetus to school sports programs for girls, helping create cohorts of more athletic grrrrrrrls.

In Title IX’s 40-plus years, American girls’ participation in high-school and college sports has jumped more than 10-fold to well over 3 million. That means many stronger, healthier girls — but it also means more girls at risk for sports-related injuries and what’s known as the Female Athletic Triad, a worrisome mix of poor nutrition, menstrual dysfunction and danger to bone health.

This week, Boston Children’s Hospital announced the creation of its new “Female Athlete Program,” aimed at treating “the entire female athlete – not just a single injury.”

“We know that the build of girls — both their musculature and bone structure — is different than boys’, as is their hormonal milieu,” said the program’s co-director, Dr. Kathryn Ackerman. “We really need to start tailoring our care of these athletes in a slightly different way.”

Certain specific issues need extra attention among girl athletes, she said. They’re at a five to eight times higher risk of anterior cruciate ligament knee injuries. “Aesthetic” activities like ballet tend to be linked with higher risks of eating disorders. If menstrual cycles become abnormal, bone development could suffer.

Some articles suggest that girls’ soccer is second only to men’s football in terms of concussions.

The new program aims to contrast with the traditional piecemeal approach to girls’ injuries and other health issues, Dr. Ackerman said. For example, “A girl comes in having sustained multiple stress fractures, and no one has asked her about her menstrual status or her calcium or Vitamin D intake or her overall caloric intake.” Some studies, she said, suggest that up to 60 percent of girl athletes have at least one component of the Female Athlete Triad: eating dysfunction, loss of menstrual cycle or low bone density.

Dr. Ackerman, herself a former national team rower, and the program’s co-director, Dr. Martha Murray, an orthopedic surgeon with a swimming background, kindly generated this list of their top 10 tips for parents of girl athletes. Dr. Ackerman expands in the comments below.

Dr. Kathryn Ackerman (Courtesy BCH)

Dr. Kathryn Ackerman (Courtesy BCH)

1. Your daughter can minimize her risk of ACL (anterior cruciate ligament) injury with a simple training program.

It would include hamstring strengthening, landing bio-mechanics, core stability and overall muscular balance. More details in the program’s ACL handout.

2. She needs to be getting good nutrition to play well, especially enough calories and the right amount of calcium and vitamin D.

Calorie counts depend on a girl’s level of activity and growth, but she should be getting 1,300 milligrams of calcium a day until she’s 19, then 1,000 milligrams a day until menopause, when calcium again needs an increase. Vitamin D recommendations vary, but many bone experts recommend at least 800 international units a day for a blood level of at least 30. More details on nutrition here. Continue reading