Warming up reduces chances of groin strains

Among the most common and disabling musculoskeletal injuries in sports is the infamous “groin injury.”

Groin injuries consist of trauma to the groin muscles and tendons. These muscles are located on the inner thigh and consist of the adductor longus, adductor magnus, adductor brevis, gracilis and pectinus muscles.

Groin muscles work together to pull the lower extremity toward the center of the body. A strain occurs when sudden excess force is applied to these muscles or there is chronic repetitive injury resulting in tearing of fibers and swelling.

These injuries are most frequently seen in sports that require powerful leg movements to gain momentum. It has been reported that 10% of all injuries to professional ice hockey and soccer players involve the groin muscles. Athletes who compete in rugby, fencing, hurdling, cross country skiing and football are also prone to groin strain.

Symptoms of a groin strain include pain along the inner thigh on exertion and to touch. In severe cases, bruising may occur.

Groin strains should not be confused with the less common sports hernia. A sports hernia results from thinning abdominal muscles allowing the intestines to rub against the abdominal wall. The pain radiates along the lower abdomen.

Treatment of any muscle strain incorporates rest, ice, compression and elevation (RICE). Anti-inflammatory medications are helpful in managing pain. Recovery involves gentle stretching followed by a gradual return to activity. If an athlete returns to play prematurely, groin strain can become a chronic problem.

A regimen of stretching and strengthening that emphasizes leg and core muscles is crucial to avoid these injuries. “Warming up” should consist of a moderate sport-specific activity both before and after an event.

It is becoming apparent that preparation is imperative to avoid being sidelined by a groin strain.

Spine injuries can be pain in the neck

Golf fans were amazed when Tiger Woods recently withdrew from a golf tournament due to neck pain.

The cervical spine consists of seven bony vertebrae that protect the fragile spinal cord. Emerging from the vertebrae are eight extensions from the spinal cord known as nerve roots. The cervical nerve roots are responsible for sensory and motor functions in the upper extremities.

Discs made of cartilage are positioned between vertebrae to serve as cushions. The discs are held in place by ligaments. Over time, discs become fragile and can move out of place, causing them to herniate.

Whenever there is injury to a nerve root, the term “radiculopathy” is used. The injury is often compressive or inflammatory in origin.

Although neck injuries are commonly seen in collision sports like football and ice hockey, it is not surprising to see it in golf. A powerful golf swing will create a significant amount of torque on the spine, stressing the supporting ligaments.

The evaluation of neck pain consists of a careful physical examination that includes an assessment of strength, sensation and deep tendon reflexes. An imaging study such as a plain X-ray or even an MRI may be necessary.

Conservative treatment often includes rest, anti-inflammatory medication and physical therapy. If this fails, a range of surgical procedures can be explored.

In the case of Tiger Woods, inflammation of a bony piece of vertebra known as a facet is the reason for his pain. This condition makes any neck movement difficult, but he should have a good response to conservative, non-surgical management.

Recognizing the significance of pain and stopping the precipitating activity is crucial, even if it means forfeiting a lucrative golf tournament.

Ban tobacco use in baseball

Young athletes often spend time imitating their sports role models. Mannerisms, attire and style of play are all elements of their admiration. Unfortunately, dangerous behaviors are also often imitated.

Tobacco use in the sport of baseball dates back to its origins in the 19th century. Baseball players originally chewed tobacco to keep their mouths moist in the dusty ball parks. Over time, cigarettes dominated and this was followed by snuff.

Head and neck cancers are often the result of risk factors that initiate changes in the DNA of cells. These changes are known as mutations and cause cells to grow uncontrollably. Eighty-five percent of cancers of the head and neck are associated with some form of tobacco use.
Treatment typically involves a combination of disfiguring surgery, chemotherapy and radiation. These cancers affect the ability to speak and eat.

In the 1990s, major league baseball initiated programs that resulted in banning tobacco products by minor league players while at the ballpark. These programs have resulted in a decline in the use of tobacco products among current players. Unfortunately, tobacco use continues to be permitted in the major leagues.

Congressional hearings recently raised the issue of prohibiting the use of all tobacco products by major league players while at the ballpark. This cannot be enacted without the approval of the player’s union. Regrettably, the player’s union currently defends the rights of its members to use these products while in the public eye.

Successful athletes recognize the importance of being in peak physical condition and there is no role for tobacco products in reaching this goal. Hopefully, the players’ association will soon come to realize the importance of protecting its members’ health as well as their rights.

Female athletes at risk for concussion

Over the past 30 years, the number of women participating in team sports has steadily increased. Many now begin as young girls and continue through college and into the professional ranks. While this expanded involvement has been a positive step, the number of catastrophic injuries in women has also risen.

The National Center for Catastrophic Sports Injury Research defines these injuries as:

• Fatal
• Non-Fatal — permanent, severe, functional disability
• Serious — no permanent, functional disability, but severe injury.

During the 1982-83 academic year, the first time period data was collected, only one female catastrophic injury was recorded. Over the past 28 years there has been an average of 8.5 catastrophic injuries per year reported in females.

Among the catastrophic injuries most commonly seen is mild traumatic brain injury in the form of concussion. Concussive injuries can span all three classifications of catastrophic injury. Typical symptoms include headache, dizziness and inability to concentrate.

A recent study reviewed 1,425 patients who had suffered concussion and looked at the severity of post-concussive symptoms three months after injury. The severity of symptoms was significantly greater in females. Specifically, the symptoms were most severe in women of childbearing age. This suggests a possible association between concussion and hormonal balance.

Female soccer players have an especially high rate of concussion due to head-to-head contact, head contact with other body parts and head-to-ground contact. Women are believed to under-report concussions and render themselves susceptible to repeat injury. Multiple head injuries can lead to prolonged cognitive impairment.

Due to the information now available, coaches, athletic trainers and physicians must recognize gender differences when diagnosing and rehabilitating women with concussion.