Gehrig's celebrity pushed ALS to forefront

No disease has become as synonymous with one of its victims as Amyotrophic Lateral Sclerosis (ALS). The victim was Lou Gehrig.

ALS is a neurodegenerative disease affecting motor nerves. It results in muscle wasting, weakness and eventual paralysis of all voluntary muscles. It is a fatal disease with the inability to breathe being the typical cause of death. Although it can strike at any age, most victims are between the ages of 40 and 70 years old.

Lou Gehrig was a Hall of Fame, major league baseball player with the New York Yankees from 1923 to 1939. Nicknamed the “Iron Horse” after playing in 2,130 consecutive games, his career is chronicled in the 1942 movie, “Pride of the Yankees.”

Dr. Eric Sorensen is a neurologist at the Mayo Clinic who specializes in ALS. He recently presented data that tracked Gehrig’s batting average over the 1936, 1937 and 1938 baseball seasons. Based on this graphic representation, it is apparent that his athletic performance was significantly worse in the spring of 1938 and dropped off dramatically ten weeks into the season. He retired on April 30, 1939.

In 1940, Lou Gehrig volunteered to participate in an experimental study using vitamin E to treat ALS. While initial results were believed to be promising, subsequent analysis did not show any benefit. Gehrig died June 2, 1941, at the age of 37.

There is speculation that Lou Gehrig never had ALS and instead suffered from cervical spinal stenosis, a narrowing of the spinal canal that eventually crushes the spinal cord. The Mayo Clinic maintains a policy of strict confidentiality and despite frequent inquiries, Gehrig’s medical records are secured in a vault where not even Mayo Clinic physicians have access.

While this controversy may never be resolved, it is evident that no other celebrity labeling of a disease has ever made more impact on the awareness and research efforts than we have seen with Lou Gehrig’s Disease.

Anthony G. Alessi, MD, is Chief of Neurology at The William W. Backus Hospital and in private practice at NeuroDiagnostics, LLC in Norwich. This column should not replace advice or instruction from your personal physician. To contact Dr. Alessi, e-mail him at To purchase his recently published book, “Healthy Sports: A Doctor’s Lessons for a Winning Lifestyle,” visit

Chest Injuries in sports are rare but serious

Among the most serious injuries in sports are those involving trauma to the chest. Although rare, these injuries are most often seen with high-velocity impact as in motor sports. Other sports where chest injuries are seen involve animals weighing over 1,000 pounds like professional bull riding, which will be coming to the Mohegan Sun Arena this weekend.

Chest injuries are those that result from damage to the vital organs within the chest cavity, including the protective muscles and bones around the chest.

Trauma is the typical cause of any damage and can be the result of a penetrating wound or a closed compression mechanism.

Over the years, much has been done to protect athletes from these life- threatening injuries. The earliest form of chest protection was for baseball catchers, protecting them from a direct blow to the heart. Football and hockey players often wear rib protectors. Racing vehicles are equipped with devices to avoid penetrating trauma from the steering wheel.

Professional bull riders began wearing protective vests after the death of Lane Frost in 1989. They became mandatory in 1993. The vest is made of a closed-cell foam material that is protective while maintaining flexibility.

Tandy Freeman, MD, is an orthopedic surgeon specializing in bull riding and rodeo injuries. “When we compared the frequency and severity of chest injuries from before mandatory chest protection use to those after using chest protection, we saw a ten-fold decline,” Freeman said.

“The typical chest injury we see is when a fractured rib will penetrate the lung,” according to Juan Escalon, MD, a cardio-thoracic surgeon on the Backus Hospital Medical staff who treats these injuries. “Chest trauma that involves the heart or major blood vessels (like the one suffered by Frost) requires emergency surgery.”

We have made great strides in sports medicine when dealing with chest injuries, but it is apparent that the seriousness of these injuries requires immediate treatment by trained personnel, beginning at the arena.

Anthony G. Alessi, MD, is Chief of Neurology at The William W. Backus Hospital and in private practice at NeuroDiagnostics, LLC, in Norwich. E-mail him at, listen to his podcasts, comment on his blog or buy his book at

Benefits of energy drinks outweighed by possible side effects

The latest craze among the party crowd, as well as those who must work through the night, is the use of so-called “energy drinks” (also marketed as gels or shots.) These caffeine and sugar concoctions are designed to keep people awake. Unfortunately, athletes have begun to use them as supplements to improve athletic performance.

These products should not be confused with drinks like Gatorade or Powerade that are designed to replace electrolytes and carbs after a strenuous workout.

Drugs such as caffeine, thyroid hormone and testosterone have long been used to increase muscle irritability in conditions causing chronic weakness like myasthenia gravis and muscular dystrophy. While they achieved some success, these drugs were replaced by more effective treatments.

Although they may have had some modest benefit to impaired muscles, there has never been any evidence suggesting a beneficial effect of stimulants upon healthy muscle. In fact, the result is often uncontrolled muscle twitching known as “fasciculations.”

Jeffrey Anderson, MD, is the medical director for UCONN athletics and the UCONN Human Performance Laboratory. “These drinks are nothing more than stimulants in a can; fortunately, their use has not been a problem with our athletes,” Anderson said.

Herbal stimulants like ephedrine have been popular for their ability to increase metabolism to produce weight loss.

Any stimulant has the potential for many serious side effects including tachycardia (rapid heart rate) and seizures. Athletes typically experience physiologic stimulation due to the release of adrenaline while participating in a sport. The addition of synthetic stimulants further amplifies this state to dangerous and potentially life-threatening levels.

There is continued debate whether energy supplements can cause disabling muscle cramps in healthy muscle. Even the possibility of this in a competitive athlete is troublesome since it can result in an athlete being unable to complete the event.

Based on both scientific and anecdotal information, athletes are better off sticking with a balanced diet and adequate hydration.

Paintball is good exercise but precautions must be taken

The analogy between sports and war is apparent in many athletic endeavors. Nowhere is it more pronounced than in the game of paintball.

Paintball is played by teams on an outdoor field with designated safety zones. The object is to shoot opponents with a small, gelatin capsule filled with paint. The weapon is an air-powered gun that shoots these capsules at high velocities. If a player is struck during a volley, it leaves a small welt.

Unfortunately, shooting paintballs has resulted in an increasing number of serious eye injuries. Organized paintball requires the use of a hard plastic mask with eye protection. No eye injuries have been reported when this apparatus is worn properly.
As in many activities, there is an organized version with rules, regulations and officials, as well as a backyard version without any of the above. The backyard approach has developed into a no-holds-barred free-for-all with weapons.

Nathan Lazourack is the owner of Final Shot Paintball in Voluntown, Connecticut. His facility supplies protective equipment including referees for all participants.
“Many corporations rent the field for a day and use paintball as a team-building exercise,” Lazourack said.

He reports that the problems come when parents buy these guns for their children.
The American Academy of Pediatrics cites an increasing number of serious eye injuries due to unsupervised paintball play.

Peter McKay, MD, a local ophthalmologist on the Backus Hospital Medical Staff, has treated several patients with eye injuries from playing paintball. Half of these patients have had at least partial permanent visual loss and some have had complete loss of vision in severely traumatized eyes.

A friendly game of paintball can be a great way to enjoy time with mature friends in the outdoors. Physicians support any patient increasing their level of physical activity. In the case of paintball, careful attention is necessary regarding the potential risks and benefits.

Anthony G. Alessi, MD, is Chief of Neurology at The William W. Backus Hospital and in private practice at NeuroDiagnostics, LLC, in Norwich. E-mail him at, listen to his podcasts, go to the Healthy Sports blog at or buy his book at the Backus Hospital Gift Shop.