New mail is always exciting!

New material is always arriving for the SIRC Collection. Today one of the latest issues of British Journal of Sports Medicine (BJSM) arrived in the mail. As soon as it arrived the SIRC Librarians took a quick scan through and it looks good. In fact, it is sure to be a popular issue in the SIRC Collection over the upcoming months. This issue is the Vancouver Olympics issue covering sports such as alpine skiing, snowboarding, ice hockey and ski jumping as well as many other interesting research articles.

Here are a few highlights:

• The adoption of new rules for ski jumping based on research outlined in the article “Towards research-based approaches for solving body composition problems in sports: ski jumping as a heuristic example.”
• It takes 30-45 minutes for a swimmer (and several helpers) to dress in an expensive polyurethane swimsuit that malfunction and tears easily.
• The knee (68%) is the most injured body part in Alpine skiers followed by lower back/pelvis/sacrum (22%), lower leg/Achilles tendon (22%), hand/finger/thumb (17%) and head/face (16%).
• Full Facial Protection in ice hockey provides the best protection against overall head injuries.
• Several risk factors can combine to increase injury in Alpine skiing: low speed, high readiness for risk, new skiing equipment, old and powdered snow, and drug consumption.

If you are looking for additional information on injury prevention and sport medicine you can find it in the Online Resources Injury section which highlights past newsletters and full-text articles.

Rugby Injury Crisis?!?

"I prefer rugby to soccer. I enjoy the violence in rugby, except when they start biting each other's ears off." - Elizabeth Taylor (1972)

It is said that the birthplace of rugby was 1823 when William Webb Ellis "with fine disregard for the rules of football (remember football was yet to split into the various codes) as played in his time at Rugby school, first took the ball in his arms and ran with it, thus originating the distinctive feature of the Rugby game". In Canada, Rugby dates back to the 1860s with the arrival of immigrants, regimental armies and the Royal Navy.

Rugby is a demanding, full contact team sport. In the latest issue of Rugby World a 16-page investigation looks at whether there is an injury crisis in the game. Some interesting statistics include:

• 72% of injuries occur as a result of contact with another player (a tackle, a ruck and son on) according to RFU figures. Of those, 51% occur in the tackle.


• The average number of injuries each Guinness Premiership club will suffer each season, is 92 including 22 in training, according to the England Rugby Injury and Training Audit conducted between 2002 and 2004.


• Are players too big? The average British & Irish Lions player was 8 pounds heavier in 2009 compared to 2005.


• The London Irish rugby team expects 15-20% of their players to be injured at any time.


• The average amount of impact a player takes in a match is like being hit by a Mack truck at 75mph compared to the nineties when the impact felt like a Mini at 50mph.

Rugby is just one of many sports that face injury issues. One of the most popular topics at SIRC is injury prevention and treatment. There is a constant flow of information in this area. So far this month over 80 articles relating to injury in sport have become searchable in the SIRC Collection including:

Fuller, C., Caswell, S., & Zimbwa, T. (2010). Do mismatches between teams affect the risk of injury in the Rugby World Cup?. Journal of Science & Medicine in Sport, 13(1), 36-38.

Gianotti, S., Hume, P., & Tunstall, H. (2010). Efficacy of injury prevention related coach education within netball and soccer. Journal of Science & Medicine in Sport, 13(1), 32-35.

Lederman, E. (2010). The myth of core stability. Journal of Bodywork & Movement Therapies, 14(1), 84-98.

Stricker, G., Scheiber, P., Lindenhofer, E., & Mueller, E. (2010). Determination of forces in alpine skiing and snowboarding: Validation of a mobile data acquisition system. European Journal of Sport Science, 10(1), 31-41.

Did you know:
Heather Moyse is a dual national athlete in bobsleigh and rugby. Moyse and Humphries will compete in the 8th race of the World Cup season January 22nd in Igis, Austria. Watch for them both in the upcoming Winter Games in Vancouver!

Spring Over-training

With the sun shining and warmer weather starting to show its face many of us are getting the fever to move our exercise and training outdoors. Spring is a time when motivations and energy are renewed so take advantage and change your workout up a bit. Exercising can improve our health, help us relax, and consistent exercise prepares our body to adapt to the stress of our future training sessions. One thing to keep in mind is to pay attention to proper recovery in order to avoid overtraining.

Overtraining occurs when exertion is too long or too intense and the body isn’t given proper time to recover. Signs of overtraining include:

• chronic tiredness
• decreased performance
• irritability, depression and/or decreased sense of well-being
• increased susceptibility to infections
• changes in resting heart rate and blood pressure
• weight loss

The best medicine for overtraining is to prevent it in the first place. Here are some ideas to help avoid overtraining.

• Change up the intensity and length of your training sessions.
• Make incremental changes in length and intensity of the workout to give the body time to adapt.
• Make sure you get enough sleep.
• Regularly check your diet to make sure that you are getting the right mix of food and fluids to fuel your body and also help it recover after workouts.
• Make sure you add break days in to your workout routine.

Providing for adequate recovery, listening to your body and incorporating prevention strategies in to your training routine can help you take better advantage of your workouts, avoid overtraining and maintain your healthy lifestyle.

Embrace that spring in your step and enjoy your training.

For more information on overtraining and other training-related materials checkout the online resources at SIRC.

Reference:
Thompson, Dixie L. (2009). Overtraining. ACSM’s health & fitness journal, 13(5), 5.

Weekend Warrior Syndrome – how to prevent sport injuries

Do you suffer from Weekend Warrior Syndrome (WWS)?

Definition: someone who is committed to a sport or activity but, based on life, work, and family demands, has limited time to participate or train for that activity.

Doing more than your training allows can often cause injury. Too much training without the rest can also do the same by causing overuse injuries. It is up to you to create the right balance.

Some tips for injury prevention:

1. Wear and use all the proper gear and equipment for your sport
2. Warm up – it’s necessary for every activity
3. Play by the rules – they are there for a reason
4. Train properly for your sport – skills training and proper body mechanics – use a certified coach
5. Listen to your body – pain is a sure sign of injury.

Evidence has shown that injuries are not unlucky “accidents” but predictable events that are in most cases preventable (Rivara and Grossman, 1996).

What should you do if an injury does occur such as a strain or a pull?

R.I.C.E.
REST – as soon as an injury occurs.
ICE – the injured area to stop swelling
COMPRESSION – prevents swelling and gives the injured area support
ELEVATION – reduces blood flow to the injured area, which also prevents swelling

SIRC has plenty of resources on the prevention and treatment of sport injuries for the weekend warrior in you. Check out these resources on concussion management, lower leg pain in basketball players, and ankle injuries.

From the Sport Discus:

• Tackling in Rugby: Coaching Strategies for Effective Technique and Injury Prevention. International Journal of Sports Science & Coaching Mar2010, Vol. 5 Issue 1, p117
• Muscular strength, functional performances and injury risk in professional and junior elite soccer players.Lehance, C.; Binet, J.; Bury, T.; Croisier, J. L., Scandinavian Journal of Medicine & Science in Sports Apr2009, Vol. 19 Issue 2, p243
• Knee Pain Prevention & Treatment. Track Coach Summer2008 Issue 184, p5888
• Brain Injury Awareness Month.Brown, Kelli McCormack, Journal of School Health Mar2010, Vol. 80 Issue 3, p111
• Evaluation of the Centers for Disease Control and Prevention's Concussion Initiative for High School Coaches: “Heads Up: Concussion in High School Sports”.Sarmiento, Kelly; Mitchko, Jane; Klein, Cynthia; Wong, Sharon, Journal of School Health Mar2010, Vol. 80 Issue 3, p112

Don’t Get a Bruisin’ While You’re Cruisin’ ~ Wear a Helmet!

As the weather gets warmer more bicycles are on the road. It is an excellent form of transportation, exercise and a great way to spend time with family and friends. Keeping safe while you are out riding is very important, broken bones and concussion are not fun. One of the best ways to prevent injury is to wear a helmet and learn bike safety.

Did you know that the skull can be cracked going at speeds of 7-10km/hr? This is the speed at which most children go on wheels. Six of the seven provinces and territories have created Bike Helmet Legislation to protect their residents. Depending on where you live you could be fined from up to $128.75. Although cycling injuries have been declining over the years Transportation Canada statistics estimate that there are approximately 7,500 each year.

There are many helmet choices out there. It is important to get the right fit. An excellent resource to help select how to fit a helmet and what type helmet should be used for activities is A Parent’s Guide to Helmet and Recreational Safety. Things to look for are position, pad placement, straps and overall tightness. Also, the Bicycle Helmet Safety Institute posted a summary of the 2009 Consumer Reports’ review article of kids bicycle helmets.

Wearing a helmet is an easy way to stay safe while having fun. There are many community organizations available to teach bike safety. For more information check out the Canadian Cycling Association’s CAN-BIKE program which offers classes for kids and adults at all skill levels.

Compression Garments

Check out the latest SIRC Newsletter on -Compression Garments!
Compression garments were originally designed for therapeutic medical use, especially for those suffering from circulatory conditions. However, over the years researchers have come to observe that there could be benefits to wearing compression garments while exercising and participating in sports. Benefits range from muscle fatigue and power production to circulation, even injury prevention and recovery. Although there is still research to be done this area, findings could change athletic attire forever.

http://sirc.ca/newsletters/june10/index.html

SIRC at the CASM-OMA Sport Medicine Conference

Being highlighted at two pre-conference workshops, SIRC started off the CASM Conference with a bang.

First, Reference Librarian, Brandie Adams spoke about membership during the Osteoarthritis Workshop Wednesday morning. Then, the article “The Sport Specific Movement Assessment” by Bruce Craven published in SIRCuit was highlighted during the Injury Prevention session. In the evening, Nancy Rebel and Brandie Adams were on hand to answer questions for CASM delegates ranging from how to log in, to what publications are in the SIRC Collection. Everyone loved that they could email or call one of the SIRC librarians and information specialists. It was great to hear how many people are familiar with SIRC and enjoy the SIRC Newsletters.

If you would like to visit SIRC at the CASM Conference we are located at booth 221-223 in the Metro East ballroom at the Westin Harbour Castle. Located next to the compression garment. booth which ironically is the topic of the latest newsletter!

Injury Risk for Female Athletes

We are all aware that women and men differ in general physiology, and it is easy to extrapolate that they differ in physiology in response to exercise and physical activity. While women are prone to many of the same exercise-related injuries, a recent article in the SIRC Collection draws our focus to the injury risks of women in exercise and athletics and the special concerns of the female athlete.

With the growing numbers of female participants in sport and exercise there is a corresponding incidence of injury to females. In a review of the literature the article observes that women have greater injury incidence due to differences in:

• biomechanics (the most noticeable factor),
• weakness in local musculature,
• coordination and neuromuscular fatigue,
• ligament and tendon properties,
• increased flexibility (with corresponding greater joint laxity),
• hormonal effects on connective tissue.

Injuries that are more common for women than men include:

• musculoskeletal injuries
• lower extremity injuries
• ACL injuries
• stress fractures

While there are treatments that address the specific needs of the female athlete, both men and women can benefit from the same preventive measures such as adequate stretching, appropriate warm-up and cool-down, sport-specific strengthening, and conditioning exercises. It is important however, to keep in mind the specific physiological differences when planning fitness and sporting activities.

Reference: Groeger Marlelena (2010). Injury Risks for the Female Athlete, ACSM’s health & fitness journal, 14(4), 14-21.

Pilates: Great for Athletes

With the hectic and time consuming training schedule of athletes, it is often hard to find time to recover from a workout. Add to this the fact that often athletes are repeatedly using the same muscle groups, they are leaving themselves open to injuries. These days, many athletes (especially teenagers) are turning to Pilates as a great way to switch up their work out and help with injury prevention.

The following 6 basic principles of Pilates can be used by athletes to stay focus and improve performance:

• Concentration
• Centering
• Control
• Precision
• Breathing
• Flowing movement

The benefits of Pilates don’t end there. Because of the extensive core work, an athlete’s body alignment and awareness is improved. Pilates also focuses on conditioning the body and mind which can help improve sleep quality. Finally because Pilates incorporates numerous muscles of the body, athletes often work muscles they wouldn’t in their normal routine, which can lessen injury risk.

Reference from the SIRC collection:
Pilates: Tools for Teen athletes. Trap, Zoey., IDEA Fitness Journal Nov/Dec2010, Vol. 7 Issue 10, 80.

The Play Safe Initiative (PSI)

Last week in Toronto, SIRC attended a Sport4Ontario hosted presentation by Brandy Tanenbaum from the Play Safe Initiative (PSI) with the RBC First Office for Injury Prevention at the Sunnybrook Health Sciences Centre (Sunnybrook RBC-FOIP). As a member of the collaborative Stewardship Group involved with PSI, SIRC has come together with organizations of all sizes and shapes, to commit to understanding and preventing injury in sport and recreational activities through research, education and collaboration.

Following the Ministry of Health Promotion and Sport’s (MHPS) lead in promoting the benefits of physical activity, there must also be a lead in injury prevention. While sports injuries are nothing new to those that participate in motor activities, there is now an urgent call from government and non-government organizations concerned about the significant personal, social and economic burden of acute and chronic injuries sustained by Ontarians as a result of participation in sport and physical activity.

The objectives of the Play Safe Initiative are:

• To collaborate by establishing a partnership of organizations committed to pursuing the objective of safe and healthy physical activity in Ontario.
• To learn by creating an injury surveillance system that is a secured web-based database that will enable comprehensive data collection, data storage, data processing, and reporting of results aptly named WISE™(Web-enabled Injury Surveillance Enterprise) and that can deliver timely information about injury prevention and injury treatment, and identifies resources for key stakeholders. In 2010, meetings with researchers from Lakehead University in Thunder Bay, Ontario, were paramount in producing the emerging technology and project development for the WISE system.
• To understand the facilitators and barriers of injury data sharing for key stakeholders

For the past 35 years, Sunnybrook Health Sciences Centre in Toronto has been home to Canada's first and largest trauma centre, and is currently well positioned to help bring together, through their Play Safe Initiative, the various sectors and leaders to address the issue of injury in sport, recreation and physical activity.

For more information on sport injury and injury prevention contact SIRC!

Sink Your Teeth into Sport Safety!

You can sprain your ankle, break a leg, tear a rotator cuff or sustain bruised ribs, but often overlooked in the world of sports medicine and injuries are those suffered in the mouth. Essential in the prevention of athletic oral/facial injuries are properly diagnosed, designed, and custom fabricated mouth guards. Contact sports such as football, boxing, martial arts and hockey require mouth guards while sports traditionally classified as non-contact sports -- basketball, baseball, cycling, roller-blading, soccer, racquetball, squash, skiing surfing and skateboarding, and the like – recommend properly fitted mouth guards.

It is unfortunate that many athletes, parents and coaches do not recognize that there is a world of difference in the quality and variety of mouth guard products, from "over the counter" models bought at sport and drug stores to those that are professionally manufactured and custom made/dentist prescribed. Currently over 90% of the mouth guards worn are the cheaper “over the counter” stock, and boil and bite models that are bulky, lack retention, and interfere with speaking and breathing; while only 10% are custom-made by a dental professional. Therefore the majority of athletes are not wearing properly made dentally diagnosed mouth guards, so in the end, the purpose may be being defeated – the cheaper mouth guard does not do the job it’s intended to do.

A properly fitted mouth guard must be tasteless, odorless, comfortable, protective, resilient, tear resistant, not bulky, allow for speaking and breathing, and have excellent retention, fit, and satisfactory thickness in critical areas. Don’t let witty marketing schemes, claims, and promotions by stock, and boil and bite mouth guard companies, protect the athletic mouth. In sports, the challenge is to maximize the benefits of participation and to limit injuries, and sports dentistry and mouth guards have a major role to play in this area.

Online Resource:
Academy for Sports Dentistry

Contact SIRC for more information on dental injury and injury prevention in sport!

A Different Kind of Athlete

Athletes. They come in all shapes, size and types. They are high performance, professional, amateur, recreational, college and high school. They are also industrial. Unlike the sporting athlete who is physically trained to participate in their sport, encouraged to take the appropriate amount of rest, receives professional sports medicine and nutritional advice, the industrial athlete is not. They do not have the luxury to rest for a few days after many sessions of physical labour, and most often do not receive physical support services. Injuries to the industrial athlete can cause down time in production, lost revenue, and an increase in injury claims.

The “Industrial Athlete” is an industrial fitness and rehabilitation service provider for the company whose employees’ normal work day in the manual material handling (MMH) world requires repetitive carrying, lifting, twisting, turning and moving, often under extreme conditions. Companies such as Cintas, reported by Report on Business Magazine as one of Canada’s Best Employers, have incorporated a new training initiative for thousands of their employees, who wash and move products such as heavy mats and uniforms, to some 800,000 businesses across North America. In an effort to reduce the risk of injuries to their service representatives on the road, and workers in the plants and  distribution centers, Cintas uses the Industrial Athlete Sports Medicine Model program which includes daily warm ups (“Stretch and Flex” exercises), proper lifting and carrying training, rehabilitation, advice on nutrition, and how to achieve the all important work-life balance. For this effort, Cintas’ Workers’ Compensation premiums are 22 percent better than the industry average.

Companies that have implemented similar programs have found that employees are responsive to exercises and appreciate that getting their bodies ready for work makes good sense. So treat employees like professional athletes by respecting them as industrial athletes. This not only affects the bottom line financially, it also allows workers to lead safer, more comfortable lives on and off the job.

Contact SIRC for more information on athlete injury prevention!

Overtraining

Overtraining occurs when athletes go beyond their training regiments and do not allow enough time for the body to recover. This can damage muscles, tendons, and ligaments and even have a mental effect on the athlete. There are also cases when athletes become ill right before their major event due to overtraining. This is often caused by athletes who are already at their capacity training too hard in an effort to feel as though they’ve achieved their full training potential and thus depleting their reserves and compromising their immune systems.

One general principle known to all elite athletes and coaches training for major events is overload training. Athletes train for long hours and at high intensities. Overload is usually followed by a taper for recovery. However, when an athlete uses all they’ve got but still try to give more without the proper taper, the athlete will have depleted all their resources and become fatigued. If overload has gone wrong, this depletion does not help performance and may actually cause it to drop. Overtraining has occurred.

Overreaching is often a term heard in the context of overtraining. Overreaching is seen as short-term overtraining and refers to training that involves a brief period of overload, with inadequate recovery, that exceeds the athlete’s adaptive capacity. It is often debated whether overreaching is a normal part of training, however, monitoring this kind of training in order for the positive results to come out as opposed to the potential damaging results of burnout becomes the key factor.

Beyond the physical impacts of overtraining such as illness and injury, some of the risks of overtraining include guilt about not working hard enough, disruption of sleep, anxiety/stress, feelings of fatigue, burnout and maladaptive responses to poor performance.The problem here is discerning whether these are short-term effects of intense training or long-term effects of overtraining.

Athletes who are susceptible to overtraining can show the following characteristics, behaviours and attitudes

• Extreme perfectionist, extremely strong athletic identity
• Lack of knowledge or awareness regarding the importance of recovery
• Unrealistic expectations

The best way to prevent overtraining is to get rid of the notion that more is always better. Once an athlete has completed his training exercise the most simple and recommended part of the cycle is rest.

Source from the SIRC Collection:
Richardson, Sean O., Andersen, Mark B., and Morris, Tony. Overtraining Athletes: Personal Journeys in Sport. Champaign, Ill.: Human Kinetics Publishers; c2008.

Warm up to Train at Your Peak

Everyone is aware of the importance of warming up to improve performance and prevent injury. There is good reason for this practice, because scientists have shown that warm muscles are flexible, resistant to tearing and can produce force more quickly.

One of the major problems facing today’s athletes is muscular injury, both recreational and professional. A well-formed warm up will prepare the athlete mentally and physically for the intense movement associated with training or competition.

Some benefits of a good warm up include:

• Increased muscle temperature 
• Increased body temperature and blood flow 
• Reduction of muscle soreness and joint stiffness 
• Improves range of motion (ROM) 
• Promotes body relaxation and reduces emotional stress 

Some athletes advocate an efficient warm up while others believe it only tires you out and affects overall performance. Warm ups can tire you out if done improperly, try not to overdo it; a moderate 10 minute warm up is ideal and anything beyond that tends to be counter-productive.

Some excellent warm up exercises are the tried and true:

• Jumping Jacks
• Skipping
• Walking Quad Stretch
• Squats

A proper warm up can provide you with the needed flexibility to perform consistently from the beginning to the end of your competition and can reduce the chances of injury.  Remember to incorporate a few minutes to warm up at the start of your routine because this simple addition can make you a winner!

References from the SIRC Collection

1, ACL INJURY PREVENTION IN THE FEMALE ATHLETE: 3-STEP WARM-UP PROGRAM. Performance Conditioning Soccer [serial online]. February 2012;17(1):12-13.

2. A WARM WARM-UP. Journal Of Pure Power [serial online]. April 2007;2(2):11-13. 
3. Jee Won S. Do You Stretch Right?. Soccer Journal[serial online]. March 2011;56(2):62.

4. Swanson J. A Functional Approach to Warm-up and Flexibility. Strength & Conditioning Journal (Allen Press) [serial online].

5. Woods K, Bishop P, Jones E. Warm-Up and Stretching in the Prevention of Muscular Injury. Sports Medicine [serial online]. September 2007;37(12):1089-1099.

Troubling Tendonitis

What is tendonitis?

Tendonitis is a word that is mentioned a lot in the sport industry, but few people really grasp what it is.  The word tendonitis means "inflamed tendon."  A tendon is a tough band of connective tissue, attached at one end to a muscle and on the other to a bone.  It is a common condition in athletes that can cause significant amounts of inflammation, swelling and pain.

Why does it happen?

Forgetting to warm up, overusing a joint and over-training while exercising or participating in sports can cause tendonitis.  For example, if you have not worked out for a while and then push yourself too hard, the result could be tendonitis.  

  

How long does it take to heal?

Tendonitis can take a long time to heal because of the limited blood flow to the tendons, but it mainly depends on the extent of the injury and the age of the person.

What can I do to treat it?

When you start to feel pain it's a good idea to apply ice to the affected area for at least 15 minutes.  It's also a good practice to limit the training intensity of your current workout, while you are still sore.

Is there anything I can do to prevent it?

Strong muscles help prevent tendonitis.  If you've been diagnosed with tendonitis or have had it in the past, you will want to put some extra effort into building up your strength, especially around the damaged area.

Where do I go from here?

If you're in pain and are afraid that going to the doctor will put you in an operating room, don't worry, tendonitis rarely needs surgery and if left untreated, it will worsen and become chronic.  Getting the help you need will get you back to training that much faster!

 References from the SIRC Collection

1. Brauer S. Achilles tendonitis. Journal Of Physiotherapy. March 2011;57(1):62.

2. Mayrhofer D. SALVATION FOR THE ACHING SOLE. Australian Cyclist. January 2012;37(1):20-22.

3. Metzl J. Troubleshooting Tendonitis. Triathlete. June 2012;(339):24.

4. Nessel E. Athletes Needing to Treat Sore Muscles and Tendons. ASCA Newsletter. April 2010;2010(4):24-27.

5. Reed A. Taming the Achilles Heel. Skitrax. December 15, 2011;22(2):74.

6. Romanelli D, Almekinders L, Mandelbaum B. Achilles rupture in the athlete: current science and treatment. Sports Medicine & Arthroscopy Review. October 2000;8(4):377-386.