October 2014

BA15298

There is more to staying active than going to the gym

I hate crunches. I hate squats. I hate push-ups. I hate medicine balls. I hate treadmills, ellipticals, and stairmasters. I can give two good weeks of my life to any of the above before I lose interest in it.

Since my college days, the only forms of exercise I’ve been able to enjoy consistently have been running and pick-up basketball. It is in these activities that, every time, I enter an endorphin-fueled state of flow (something that never happens at the gym for me).

There is more to “staying active” than dumbells, barbells, and ellipticals, I realized. What matters is the dozen or so waking hours everyday when we’re not exercising, yet burning a majority or the day’s calories.

That is why I have embraced what is known to doctors as NEAT– Non-Exercise Activity Thermogenesis. In normal people terms: burning calories without exercising.

It is about building active habits. I’ve built a few and I’m working on building more. This is what has worked for me.

Standing desk

Our bodies weren’t built to sit. Sitting makes us sleepy and moody. It also puts us at greater risk of heart attack. Standing for 3-4 hours per workday can burn 30,000 calories (ten marathons worth) over the course of a year.

I still do a good chunk of work, especially writing, while sitting. But if I can do my email correspondence and toy with my fantasy football team while standing every day, then that’s plenty.

Do a little research, there’s a good chance your company’s health insurance provider also knows the perils of sitting. Your company is probably eligible for some big insurance deductions if you get yourself a standing desk.

Stairs instead of stairmasters

Unless you are making a journey up 5 or more floors, elevators hardly ever save you time. Elevators save your legs from doing work and, more often than not, put you in a painfully awkward social situation.

Do the work. Spare yourself a minute of avoiding eye contact with a semi-stranger. Your legs will thank you when you get to the fifth floor for a boring hour-long meeting.

Dog ownership

There is no better indicator of an inactive day than restless dog. Some fetch or a 15-minute walk is sometimes the only activity either my pooch or I get in a given day, but it’s better than nothing.

Biking to work

I live about three miles from where I work. If it isn’t pouring rain, I’ll take the bike on over, and much like taking the stairs instead of the elevator, I’m much more chipper when I arrive.

It has also been found that those who take public transit to work tend to be healthier than those who drive to and from work.

Different solutions work for different people. But we can all build better, more active habits.

Beware of squats

If you are a regular Inside Sports Medicine listener, you have surely heard one of Dr. Souryal’s countless warnings about the perils of including squats in your exercise routine.

Squats have always been popular among athletes, as almost every sport requires the player to generate power and explosiveness from a squatting position. Still, it makes sense that squats are scary to an orthopedist. They can wreak havoc on your back.

According to the American College of Sports Medicine, there are three main factors that lead to back and injuries among those who squat.

1) Lifting too much weight or lifting to failure

Taking on too big of a load can lead to a herky-jerky lift, which can in turn lead to sudden and drastic spinal compression.

2) Leaning forward too much

The more a lifter leans forward, the greater the load on the back. The greater the load on the back, the greater the spinal compression force. The greater spinal compression force, the higher incidence of stress fractures and slippage of the vertebrae.

3) Lack of flexibility

If the squatter cannot adequately bend his or her knees and hips, or cannot properly arch his or her back, the weight will be unevenly distributed. Unevenly distributed weight is bad news.

It is for these reasons that Dr. Souryal recommends the leg press. The leg press targets the same group of muscles as the squat, but the back is stabilized and the spinal compression force is therefore negligible.

Also worth mentioning is new research from the European Journal of Applied Physiology, which indicates that squats and leg presses do not work our hamstrings nearly as much as they work our quadriceps. If not paired with a deadlift or another hamstring-focused exercise, the quads will be disproportionately strong, potentially leading to knee, hip, or ankle injuries.

If you do insist on doing squats, do so with proper form. Here is a good video to help you do just that.

 

 

 

 

Vontaze Burfict deserved a suspension.

It is well-understood among football fans that there is plenty of dreadlock-pulling, groin-grabbing, and eye-poking at the bottom of a dog pile. While these are all unjust cheap shots, they generally take place where neither the referees nor the TV cameras can pick upon them and they almost never cause serious injury.

On the other end of the football cheap shot spectrum is the play of Vontaze Burfict. Burfict, who has previously been reprimanded for groin-taps, head-butts, and hitting defenseless receivers, committed two reprehensible acts on Sunday against the Carolina Panthers by twisting the ankles of Cam Newton and Greg Olsen well after each play was over.

Here’s the hit on Cam.

Here’s the one on Olsen.

On Wednesday, the NFL fined Burfict $25,000 for the ankle twists. This is pocket change for Burfict, who just re-signed for $20 million over four years.

Put in context, it is  clear Burfict’s antics warrant a suspension. By letting Burfict off, Goodell has again failed to send a clear message in terms of player safety. There are three big reasons why:

1) It was in plain sight.

Unlike the dogpile situation, where sneakily dirty players get away with it because no one can see them, Burfict committed both of his offenses AS HE WAS TACKLING PLAYERS INTO THE ENDZONE.

Not only can everyone see it. Everyone can see it multiple times from multiple angles.

2) It was premeditated.

There was no question Burfict knew going into the game that both Newton and Olsen have been playing through ankle injuries this season.

Roger Goodell set a very clear precedent during the bounty scandal that any premeditated attempt to take an opponent out of the game would result in severe punishment. In the case of the bounty scandal, there was no single replay that clearly demonstrated the Saints carrying out their bounty targets. If Goodell thought Jonathan Vilma and Scott Fujita needed to be suspended, so too does Burfict.

3) Burfict is a repeat offender.

Not only did he commit this shameless act twice in the same game, he also came into the game with a reputation for deliberately seeking to injure opponents. He was fined $31,000 for hitting a defenseless Greg Jennings last year–another mere slap on the wrist. For Burfict to learn from his actions, he needs to feel the disappointment missing games and letting his teammates down.

One last question to ponder, how would Goodell have reacted if Cam Newton (one of the league’s most marketable QB’s) was injured for 4 games as a result of Burfict’s ankle twisting? I think Burfict would get 4 games too.

 

By Jack Tiebout

11 counterintuitive facts about ankles

They wobble. They sprain. They break. They keep us upright. They can even be sexy.

Yep, ankles. Or as Dr. Patrick McKeon puts it, “the neglected stepchild of body parts.”

Let us shine some light on the neglected stepchild. The following are 11 counterintuitive facts about the ankle:

1)    Over 8 million people will sprain their ankles this year.

2)    Over 25,000 Americans will undergo ankle replacement surgery this year.

3)    Among doctors, the old acronym RICE (rest, ice, compression, elevation) is the most commonly accepted treatment for ankle sprains.

4)    RICE has not been shown effective in controlled clinical trials.

5)    This 17-second video explains ankle sprains better than I ever could.                             http://www.mayoclinic.org/diseases-conditions/sprained-ankle/multimedia/ankle-sprain/vid-20084696

6)    The best exercise for building ankle strength is a simple one. Stand on one leg for one minute. Don’t wobble. Stand on the other leg for one minute. Don’t wobble. Repeat as necessary.

7)    The greatest risk factor for an ankle sprain is a history of ankle sprains. Just ask Steph Curry…

8)    As Dr. Souryal explained last Saturday, this is because once you sprain your ankle once, the ankle ligaments never regain their initial tightness.

9)    Wearing an ankle brace can reduce the risk of re-injury by 68%.

10) Though necessary to rule out a fracture, an x-ray won’t tell you anything you need to know about your sprained ankle, as ligaments do not appear on x-rays.

11) Studies suggest that early humans sacrificed toe dexterity for control of their ankles.

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10/4/2014 – Episode 509

The show opens with a discussion the Shane Morris concussion, communication on the sidelines, and how to prevent injured players from going back out on the field.

Tony Hill joins the show to talk about his time at Stanford and with the Cowboys, and the life of a student athlete. Doctor Craig Garrison comes on to talk about sideline evaluations and answer a few questions.

The Doc gives his take on the Ebola outbreak, and what electronic medical records have to do with the case in Dallas.
Listeners call in with questions about ankle injuries, the amount of pressure that would cause a compound fracture to the arm, pain relief after spinal fusion, cryotherapy, and more.

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