Cramps in the legs and back may be more serious.

Cramps in the legs and low back during exercise may not be just a benign case of fatigue. These cramps may be a result of exertional rhabdomyolysis, a rare but potentially deadly complication when an athlete with sickle cell trait over exerts. Sickle cell trait is different from sickle cell disease in the fact that the athlete only carries one gene of sickle cell hemoglobin and instead of the two that result in disease. They also have one gene for normal hemoglobin. During intense exercise (especially without proper hydration) the sickle hemoglobin may change the shape of the red blood cell causing it to sickle and decreasing its ability to transport oxygen. Without oxygen during exercise exertional rhabdomyolysis may result. Since cardiac muscle has some skeletal muscle properties, this muscle breakdown will affect the heart as well as the skeletal muscles (mainly legs and back). According to the Columbia Tribune (Missouri), 7 of the 19 non-traumatic NCAA football deaths have been attributed to complications of the sickle cell trait. There has been enough concern, that the NCAA has recommended testing for the sickle cell trait in their pre-participation physicals. With dehydration being a complicating factor with the sickle cell trait, it may be a good idea for testing for this condition be apart of interscholastic sport as well as collegiate. National Athletic Trainers' Association (NATA) Consensus Statement.

Youth Sport Safety Alliance

Youth sport is in a crisis state due to the rising number of injuries that are sustained. This crisis has reached the point where it has become imperative that action must be taken in an effort to protect the athlete. In January, 2010, the “Alliance to Address Youth Sports Safety” summit was held to examine this crisis and to raise awareness of the health care concerns of the youth athlete. This summit was spearheaded by the National Athletic Trainers’ Association and supported by 29 health and sport organizations. With in excess of 7 million interscholastic high school athletes participating in sport, there are close to three fourths of a million sport-related injuries. In 2008 and 2009 there were 120 sport related deaths from conditions such as: brain injury, heat illness and sudden cardiac arrest. This is a true crisis state! From this summit the Youth Sport Alliance has issued a call to action. Information gleaned from the collective knowledge of the professionals in this alliance is valuable and needs to be processed out in an effort to raise awareness of the youth athlete injury crisis. Only by raising awareness, will the current sport paradigm be altered in a way to make the health of the athlete the center of importance.

The fine line between performance and dangerous

The February 10 edition of the New York Times has a feature titled “Tempting Fate”. Athletes will naturally try to perform at their best and attempt new skills. Somewhere there is a fine line between superior performance and reckless or dangerous performance. The elite athlete has found this line which has allowed them to achieve their level of greatness. Even so, it only takes a minute mistake that causes one to cross that fine line and there is exposure to injury. Kevin Pearce is an example of this. While practicing a new trick(double cork) on the Halfpipe, Shaun White made a slight mistake resulted in a fall that that is similar to Kevin Pearce's fall that caused a traumatic brain injury. This TBI may also injure any chances for Kevin to ever participate in this sport again. Athletes will always push themselves to achieve greatness in their sport. It is important that in their effort to improve and achieve greatness, these athletes are given an environment that is safe for them to perform. In our current social climate that demands excitement and entertainment in everything we do, sometimes the welfare of the athlete seems to become only a secondary concern. On Friday, 2/12/10, the opening day of the 2010 Winter Olympics, there has already been an accident that claimed the life of luge athlete from the Republic of Georgia. The sad comment here is that the athletes have previously complained that the course was too fast and dangerous.

There is no such thing as a mild brain injury.

Time magazine has provided the influence of a major news magazine in educating athletes, potential athletes, parents and fans on inherent dangers of repetitive blows to the head in contact/collision sports like football. The feature "The Problem with Football: How to Make It Safer", provides a good solid scientific analysis of the cumulative effects of repetitive concussive forces that the brain goes through hit after hit, day after day on the football field and is presented in a literary manner that is easy for the nonscientist to comprehend. As more information is disseminated with regards to multiple concussive impacts and their relationship to chronic traumatic encephalopathy (also referred to as CTE), more coaches, parents and athletes will gain understanding and be able to make informed decisions when given the options presented to them by healthcare providers.

Within this article, there is a video well worth the 9 ½ minutes in length. This is Your Brain on Football.

While this article (along with the majority of current media attention) is centered on the sport of football, it is important to note that cerebral concussion injuries do occur in other sports. Coaches and parents need to assist in recognizing the signs and symptoms of a concussion since many athletes will not report the injury. There is no such thing as a mild brain injury.

Athletic Injuries More Frequent in Females

I have long professed to my athletic injury classes that injuries are sport specific and not gender specific. At first, this article Athletic Injuries More Frequent in Females made me question myself, but then I realized what it was really saying. I still am convinced that injuries are sport specific. I totally agree that female athletes have been given the short straw (intentionally and unintentionally) when it come to strength training and their ability to obtain it. Injuries are preventable and are caused by a mistake. Apparently one of these mistakes may be a faulty research model that assumes that there are no intrinsic biological differences between males and females. I still feel that injuries are sport specific. I also feel that injuries are a result of a mistake. This article brings both of these concepts together.

Time to rethink football?

After watching the episode of Real Sports with Bryant Gumbel(on HBO) highlighting “Concussions in the NFL", I looked into the topic further and I think I like what I just read. There was an article, “Ten Point Plan to Save Football” (written by Chris Nowinski), which was referred to in this program. Searching for this article, I came across the Sports Legacy Institute. This is an organization founded by Chris Nowinski (Co-Director, Center for the Study of Traumatic Encephalopathy, Boston University School of Medicine) and Dr. Robert Cantu (Clinical Professor of Neurosurgery, Boston University School of Medicine). The Sports Legacy Institute was founded in 2007 when new medical research indicated that sport is in a national crisis concerning brain trauma. This article (Ten Point Plan to Save Football), is a good read and a beginning of further discussion and (more importantly) action. It is not just the exciting violent collision that creates dangerous consequences and a concussed athlete, but multiple lesser blows (or collisions) to the head that creates a cumulative effect that results in brain injury. After twenty-five years in the field of athletic training, I am a firm believer that there is no such thing as a “mild brain injury”. There are some points in this article which is (in my opinion) common sense and some of which will face steep opposition. American football is an “institution” in this country and has long been revered for its punishing violence and the sheer toughness of the athletes that play the game. Athletes are getting bigger, stronger and faster. Technology has produced better equipment and padding in an effort to protect the athletes. I think that it is important to note here that as athletes get bigger, stronger and faster; the forces in which they collide become greater. Also, as technology creates better protection, athletes become less inhibited when it comes to using their bodies as projectiles. As the mass gets larger and moves at a faster speed, the force of contact becomes more violent. Helmets and padding produce great protection for the exterior body surfaces, but do little for reducing the momentum of the brain inside of the cranium. This is the very reason that the entire paradigm of how the sport of football is taught and played must be rethought. The “Ten Point Plan to Save Football” article is a great place begin the shift in this paradigm.