Healing Shortcut

Following an injury, it is often hard having to sit out and wait to recover. This is when a new therapy has been called into play,  platelet-rich plasma (PRP) surgery. The therapy consists of placing athlete’s blood in a centrifuge and reinserting it in the wound. The end result is healed tissue. This therapy is often claims to speed up recovery.

However, studies published by the Journal of the American Medical Association have found that PRP was no better than a placebo injection of saline in treating Achilles tendinopathy. PRP has also been proven not to be effective in acute sport injuries. The reasoning for the lack of consistency is because there has yet to be an ideal formula.

One of the main controversies associated with this therapy is that the World Anti Doping Agency has judged that the process unfairly increases muscle strength. Not to forget the therapy does not come at a low cost. The $1000 price tag may put off athletes that can wait the few weeks for the injury to recover through other therapies and/or treatment.

This all leads to the question, is it all really worth it? There are alternatives to PRP, the most prominent being physical therapy. This is a much less painful and cheaper alternative. PRP should be a last resort, athletes should try all non surgical procedures before considering going under the needle.

Source from the SIRC Collection 

Reynolds, G. (2011). Heal Thyself. Outside, 36(8), 98-99.

Yoga Poses and Meditation for back pain

Yoga- the ancient physical, mental and spiritual discipline - has been found to be a great intervention for chronic back pain. And many high level athletes use yoga as a part of their training and recovery programs. The physical stretches are the most helpful part of the recovery but let us not forgot that the mental aspect of the discipline is quite beneficial to recovery as well.

By holding a pose in yoga, our muscles strengthen. If you can hold it for about a minute and start to feel a burn you are strengthening your muscle. Yoga is a workout that reduces stress, increases flexibility and coordination.

Studies have found that sixty to ninety percent of adults will suffer from back pains. Outside the athletics world, we put our back through so much lifting, heaving, twisting and shoving in every-day life. Some of the numerous causes of back pains include: poor posture, excess body weight, herniated disc and degenerative disks to name a few. With all that work our backs are doing it’s not surprising that with 20 small intricate joints building our vertebrae, our backs are taking a beating. Add to that any athletic endeavor and it is obvious that we need to be mindful of our back health.

Although yoga is ideal for back pain recovery, simple stretching activities also work to help relieve the pain. The focus on mindfulness is what makes yoga differ from simple stretching. It calms the body and gives peace of mind. A large emphasis in yoga is good posture, which help counter the initial causes of the back pain. Before stretching your way into recovery, try asking a healthcare professional what works best for you.

Contact SIRC for more information on yoga!

Reference from the SIRC Collection: 
(2012) Suffering from Low Back Pain? Maybe You Should Try Yoga. Tufts University health & Nutrition Letter, 29(12), 3.

Online Resource:
Shepley Caron (2012). Yoga for Sports Performance: Why Yoga is an Athlete’s “Secret Weapon”. Presented at the 2012 Coaches of Ontario Conference. Retrieved from the Internet March 29, 2012.

Holingshead, Sue. Yoga for Sports Performance. Retrieved from IDEA Health & Fitness Association website March 29, 2012.

Treating Tendon Injuries

Tendon injuries are common in the sport community and can affect amateur and professional athletes alike. Tendon injuries are most often the result of gradual wear and tear to the tendon from overuse, incorrect movement or aging. As debilitating as they can be, the good news is that when treated properly, minor to moderate tendon injuries can heal on their own.

While almost any tendon can sustain an injury, the most commonly occurring tendon injuries in sport are:

• "Swimmer's shoulder"- occurs when the tendons in the shoulder muscles become weakened and inflamed, sometimes resulting in a rupture.
• "Tennis elbow" - is a condition when the tendons in your elbow are overworked, usually by repetitive motions of the wrist and arm.
• "Jumper's knee" - also known as patellar tendonitis or patellar tendinopathy is an overuse injury that involves the patellar tendon, the cord-like tissue that joins the patella (kneecap) to the tibia (shin bone).
• "Achilles heel" - probably the most well-known injury, involves inflammation of the large tendon at the back of the heel.

There are three stages of injury progression:

1. The reactive phase, where no overt signs of injury are apparent but if an athlete is training heavily, good prevention measures mean allowing adequate rest and recovery. 
2. The second stage is tender-to-the touch, tendons are progressing into a state of disrepair, usually coupled with inflammation and pain. Pro-active methods for recovery are recommended, icing and a longer recovery period is required. 
3. The third stage occurs when the tissues start to degenerate and are more likely to rupture with continued demand for force. If left to this state, it is not likely that an athlete will be able to progress in their training. Proper treatment requires a clinical diagnosis and a strict recovery plan.

When recovering from a tendon injury, full immobilization is not recommended - some movement is necessary for repair (depending on the severity), therefore allow relative rest, meaning minimal load bearing and reduced activity. Any activity that causes pain to the injury should be avoided while allowing the body to heal. If pain persists or becomes chronic, please contact your physician for treatment.

References from the SIRC Collection:

1. Bjöörnsson H, Norlin R, Johansson K, Adolfsson L. The influence of age, delay of repair, and tendon involvement in acute rotator cuff tears. Acta Orthopaedica. April 2011;82(2):187-192.
2. Lin W, Weiwei G, Kaiyu X, Ning L, Bo W. The effects of an early return to training on the bone-tendon junction post-acute micro-injury healing. Journal Of Sports Science & Medicine. June 2012;11(2):238-244.
3. Nessel E. Athletes Needing to Treat Sore Muscles and Tendons. ASCA Newsletter. April 2010;2010(4):24-27.
4. Tonoli D, Cumps E, Aerts I, Verhagen E, Meeusen R. Incidence, risk factors and prevention of running related injuries in long-distance running: a systematic review. Sport & Geneeskunde. December 2010;43(5):12-18.
5. Teramoto A, Luo Z. Temporary tendon strengthening by preconditioning. Clinical Biomechanics. June 2008;23(5):619-622.
6. Witvrouw E, Mahieu N, Roosen P, McNair P. The role of stretching in tendon injuries. British Journal Of Sports Medicine. April 2007;41(4):224-226. 
7. Wren T, Beaupre G, Carter D. Tendon and ligament adaptation to exercise, immobilization, and remobilization. Journal Of Rehabilitation Research & Development. March 2000;37(2):217-224.

The high impact of low iron

Iron is an essential mineral for both health and athletic performance. High performance athletes, because of their heavy training schedule, can rapidly decrease their body's iron stores.  Iron deficiency, if left undiagnosed, can leave your body tired, flat and unable to train. Canadian Olympic athlete Paula Findlay experienced this first hand when she was diagnosed with anemia after her performance at the London Games.

How does your body lose iron?

Iron loss occurs through the depletion of essential body fluids, for example sweat or blood. All athletes will experience iron loss to some degree while training, but when levels are dramatically reduced (anemia), it can have a serious impact on your body.

Why are athletes at greater risk?

Athletes are more sensitive to the effects of iron deficiency because they depend on the body’s ability to transport oxygen to the muscles. Anemia occurs when there isn't enough hemoglobin (an iron-protein compound in red blood cells that transports oxygen) in the blood and there are too few red blood cells. Iron, as part of the protein hemoglobin, carries oxygen throughout the body, which is especially essential for endurance athletes.

How do you treat it?

Iron deficiency, or anemia is easy to detect and simple to treat by changing your diet or taking iron supplements.  If left untreated, it can lead to extreme fatigue, rapid heart beat, difficulty concentrating, dizziness, leg cramps and insomnia.

How do you prevent iron deficiency?

For starters, if you are not iron deficient taking an iron supplement is not necessary and will not provide any benefit. Good sources of iron include: meats, fish, poultry (liver and kidney is particularly high), green leafy vegetables, legumes, herbs and nuts. Vegetarian athletes need to be extra vigilant to ensure they meet their nutritional needs.

If you are experiencing any of the symptoms listed above, please see your doctor or sports dietician for testing before adding any iron supplements to your diet.

References from the SIRC Collection: 

1. KURIEL V. IRON DEFICIENCY. Australian Triathlete. May 2013;20(6):56-58.
2.Malczewska J, Raczynski G, Stupnicki R. Iron status in female endurance athletes and in non-athletes. / Bilan biologique des niveaux du fer chez des athletes d'endurance feminines et chez des femmes non sportives. International Journal Of Sport Nutrition & Exercise Metabolism. September 2000;10(3):260-276. 
3. Peeling P, Dawson B, Goodman C, Landers G, Trinder D. Athletic induced iron deficiency: new insights into the role of inflammation, cytokines and hormones. European Journal Of Applied Physiology. July 2008;103(4):381-391. 
4. Ryan M. Preventing and Treating Iron Deficiency in Athletes. Athletic Therapy Today. March 2004;9(2):56-57.
5. Sandström G, Börjesson M, Rödjer S. Iron Deficiency in Adolescent Female Athletes--Is Iron Status Affected by Regular Sporting Activity?. Clinical Journal Of Sport Medicine. November 2012;22(6):495-500. 
6. Seebohar B. Iron Deficiency Anemia and Performance. Olympic Coach. Winter2009 2009;21(1):16.

Match Point: Treating and Preventing Tennis Elbow

Tennis elbow is a very common sport related injury. Despite its name the injury can occur in a number of different sports. While usually a fairly minor injury, the resulting pain, discomfort, and potential weakness can prevent a person from participating in their activity of choice. Thankfully if the individual is knowledgeable, tennis elbow can be easily treated and potentially prevented.

Before you can treat tennis elbow it is important to have an understanding of exactly what the injury is and what the symptoms are. Tennis elbow (lateral epicondylitis) is an injury to the tendon that attaches all the extensor muscles for your wrist and fingers to the outside of your elbow. Although this article is focusing on tennis elbow, golfer’s elbow (medial epicondylitis) is a similar injury that affects the tendon attaching the flexor muscles to the inside of the elbow; it therefore has similar symptoms and treatment just with a different location.

Symptoms of Tennis Elbow 

• Inflammation and pain localized to the outer area of the elbow 
• Reduced grip strength 
• Pain when you bend the wrist and straighten the elbow 

 Tennis elbow is an injury caused by repetitive movements and therefore can best be treated by no longer taking part in the activity or sport that is forcing the repetitive motion. Unfortunately for some people that may not be an option, in these cases there are many treatment options to consider:

• RICE (rest, ice, compression and elevation) is a great strategy to help minimize the symptoms of tennis elbow and speed recovery. 
• Anti-inflammatory medications can help relieve the pain associated with the injury. 
• Braces for the elbow can help reduce the stress placed on the tendon. Surprisingly a wrist brace can also be helpful as it limits the use of the muscles that are pulling on the tendon. 

Obviously the best way to deal with tennis elbow is to avoid it altogether. If you play a sport or have a repetitive activity that puts lots of strain on the muscles in your wrist and fingers, racquet sports are the biggest offenders, then you need to plan ahead. Here are a few things to help avoid tennis elbow:

• Ensure you have proper form while engaging in your sport or activity can help reduce the risk of injury. 
• Fatigue can lead to improper form which increases the potential for injury; by strengthening the muscles involved you can limit fatigue. 
• Use a brace for the elbow or wrist to reduce stress on the tendon. This can be done during prolonged periods of your activity or sport even before you show signs of the injury. 

When it comes to tennis elbow the best defence is awareness, look into whether any activities or sports you take part in may put you at risk for the injury. If you display any of the symptoms treat immediately, if the injury persists or the pain is severe please see your doctor right away. With proper awareness and treatment you will be able to return faster from injury and reduce the chances of it recurring.

References from the SIRC Collection: 

1. Aronen, J. (2012). How to reverse effects of reverse tennis elbow. Handball, 62(1), 66-67. 
2. Aronen, J. (2008). Serving up some help to treat tennis elbow. Handball, 58(4), 66-67. 
3. Howe, D.K. (2007). Tendon Trauma. American Fitness, 25(6), 9. 
4. Knudson, D.V. (2004). Biomechanical studies on the mechanism of tennis elbow. Engineering Of Sport 5, 1(1), 135-141. 
5. Reynolds, L. & Rolf, R.H. (2013). Health and Handball: My Elbow Hurts. Handball, 63(3), 34-35.
6. STRETCHING AIDS In Tennis Elbow Prevention. (2009). 
7. Tennis Life, 19. Waseem, M., Nuhmani, S.S., Ram, C.S., & Sachin, Y. (2012). Lateral epicondylitis: A review of the literature. Journal Of Back & Musculoskeletal Rehabilitation, 25(2), 131-142.