News Category: General

Maybe you’ve heard about “the graying of America.” If you were born between 1946 and 1964, then you are a “baby boomer” and part of the aging or “graying” of America. In fact, by the year 2030, more people in the United States will be over 65 years of age than under. The number of people over 85 years will increase by 133 percent.

Baby boomers are increasingly concerned about the effects of aging and willing to do something about it. But what? Physical therapists are helping answer this question by looking at the effects of aging on muscles. Therapists are especially interested in understanding how exercise affects aging skeletal muscles.

At the present time, it is known that muscle strength declines with age. Many older adults (those over 60) have trouble with physical activity because of this. Research has shown that muscle fibers decrease in number and elasticity with age. These changes lead to a decrease in the force of muscle contractions and a decline in muscle strength.

What can be done to prevent these changes as we age? Exercise! The right kind of exercise can slow or even reverse some of the age-related changes in muscle. Regular exercise that includes both strength and endurance training can reduce some of the effects of aging.

Two types of strength training are being studied: progressive resistance training (PRT) and high-intensity training. PRT starts with a set number of repetitions for each exercise and gradually increases the number of repetitions and intensity over a period of eight to 10 weeks. PRT can be done three times a week. High-intensity training starts by finding out the maximum weight a person can lift one time. Then three sets of eight repetitions are done twice a week at 80 percent of that maximum.

Physical therapists are studying the effects of different kinds of exercise on muscles. This information will help them train older people at intensities that will prevent loss of muscle and strength. Knowing the effects of exercise training on muscles can help baby boomers and other aging adults maintain their strength and activity level into their 80s and beyond.

Physical activity, especially jumping, is known to increase bone strength. So why do young figure skaters get bone fractures? Changes occur in the outer layer of bone when the bone is subjected to repeated strain. These bone reactions are actually tiny breaks called stress fractures. In this study, researchers compared the bone density of female skaters who had stress fractures to that of healthy, nonathletic girls of the same age.

The researchers discovered that stress fractures in young skaters were not caused by low bone mass. Skaters had normal bone density compared to other girls their age who did not skate. However, skaters with stress fractures had much lower bone mass than skaters without fractures. It seems that stress fractures may be caused by extreme forces placed on normal bone.

What accounts for the range in bone density among young skaters? Researchers looked at the number of hours trained, age training began, type of training, body size, menstrual history, and calcium intake. They found that higher bone density occurs when girls master their first double jumps before age 10.

Differences in fracture rates were not based on when the girls learned single jumps. How quickly girls progressed from single to double jumps seemed to be the most important factor. This may be related to the fact that skaters without fractures exercised more hours per week. Perhaps this increased training time enabled the skaters to progress faster.

Skaters who practiced double jumps had the highest bone density. The greater impact on landing of a double jump compared to a single jump is the key to bone strength. Additionally, the landing leg had significantly greater bone mass than the take off leg.

These findings will help with injury prevention in young skaters. Skaters who do not start double jumps until after age 10 or 11 must progress slowly. They may not be able to handle the greater impact of jumping at first. Exercises to strengthen both the take off and the landing leg should begin when skaters start to learn jumps. These exercises are especially important as skaters moves from single to double jumps.

Have you ever heard of cryotherapy? Sounds like having a good cry to feel better. Actually, cryotherapy, or cold therapy, refers to cooling body tissue to relieve pain and swelling. Using cold as a form of therapy started back in ancient Greece. Today, we know that cold also changes how fast the nerves send messages. It lowers the metabolic rate and blood flow in the treated area, and it relaxes the muscles.

There are many ways to apply cold to an injury. Some people use a simple cold pack. Others apply ice directly to the area in a circular motion called “ice massage”. Athletic trainers and physical therapists may recommend an “ice bath.” This refers to placing part of the body such as the hand or foot into a bucket of cold, icy water.

Sound too cool to be true? We know how cold affects the skin. But what about the joints, muscles, tendons, and ligaments? How deep does cold go? And how long does it last? Inquisitive physical therapists conducted an experiment to find out.

A cold pack was applied to the thigh muscle (quadriceps) for 20 minutes. Temperature was measured at various depths before, during, and after cold therapy. Within the first eight minutes, the skin and top layer of muscle tissue (about a quarter-inch) were cooled. This area remained cold throughout the rest of the treatment. During that time, the temperature of the deeper tissues remained unchanged.

Once the cold pack was removed, the skin and top layer returned to normal in less than an hour. At the same time, the temperature in the deeper tissues (down a half-inch) actually went down. This happened when blood in the deeper tissues moved up to rewarm the cold tissues above. Blood vessels in the skin and first layer of tissue also widened when the ice was removed. This brought more blood to the area and helped warm it up.

Cold can be used to decrease pain, muscle spasms, and swelling. It causes a direct decrease in skin temperature and an indirect decrease in the temperature of deeper tissues. This is important information for physical therapists in deciding what kind of cold therapy to use for different kinds of injuries.

Here’s a new one for the Baby Boomers. People who are 50 years old and up step down with greater impact, especially with shoes on. This happens about the same time that hip and knee osteoarthritis increase dramatically. What’s the connection? And what do shoes have to do with it?In the last ten years, scientists have made the discovery that joint arthritis isn’t part of a natural aging process. For a long time, it was said that “wear and tear” from daily activities caused arthritic changes in joint surfaces. After years of study, researchers realize that this just isn’t so. There are plenty of active people who never get osteoarthritis.Data collected over the years show that there is an obvious increase in hip and knee arthritis at age 50. This seems to occur whether or not the cause of the arthritis is known. Doctors measured the force of impact when stepping down off a step in a small group of men between the ages of 17 and 72. Impact remains the same until age 50, and then it increases. The increase is much greater when the person is wearing shoes than when they’re barefoot.Around age 50 (considered late middle-age), people lose their sense of foot position. This means the foot isn’t as fine-tuned about its location or position at any point in time. It has also been shown that softer shoes with flexible soles fail to absorb impact. This includes both running and walking shoes. The combined effects of aging on the foot and the shoes that are popular today may actually cause middle-aged adults to step down harder when walking. This may speed up the development of arthritis. Should we get rid of shoes on our fiftieth birthdays and go barefoot? A better solution may be to replace flexible, soft-soled shoes with firmer footwear. Wearing a shoe that can absorb impact may slow the process of osteoarthritis. Keeping up with strength and balance activities is also important.

You’ve probably heard that exercise builds healthier bones. But different types of exercise may have different effects on bone size and strength. Marathon runners have been found to have smaller, weaker bones in areas not “loaded” by running, such as the low back. Compared to distance running, soccer ranges in intensity from standing and walking to sprinting and kicking. Women soccer players have been shown to have stronger (more dense) bones than other women who don’t play the sport. What about men?

These authors wanted to find out whether adult men who’d started playing soccer before puberty (age 12) had healthier bones than those who didn’t do sports. In particular, the authors were interested in the hip, low back, and leg bones. They looked at both the amount and density of bone, thinking that even if the bones weren’t particularly dense, they’d be better able to fend off injury if there was more bone tissue.

Thirty-three recreational soccer players were compared to 19 men who didn’t do sports. The two groups were about the same age, size, and height, and they had about the same calcium intake. The soccer players trained four to 10 hours a week. They’d been in the sport for about 12 years.

Compared to controls, the soccer players had more lean body mass and less body fat. They also had greater overall bone mass.

Dividing the body into regions, the authors found that soccer players had more bone in every skeletal region than controls except the arms. Soccer players’ bones were also more dense, which makes for better bone strength. These findings were especially noteworthy in soccer players’ hips and low backs. Soccer players also had greater amounts of bone in their legs. This was mostly because of greater bone density, as well as thickening of bones. There were no differences between soccer players’ kicking and nonkicking legs. It may be that kicking doesn’t affect the bones, or that the effects are balanced out by the effort it takes to stabilize the standing leg while kicking.

From these results, it looks like men may get an even greater bone boost from playing soccer than women. Starting exercise early in life improves both the amount and density of bone, leading to better skeletal health. These developments may help prevent injury and osteoporosis in the long run, though more research is needed.

High blood pressure has been called the “silent killer.” This is because you can have high blood pressure (hypertension) without knowing it. Untreated, it can lead to heart attacks and strokes. It is estimated that 43 million adults in the United States are hypertensive. Men and postmenopausal women are the most likely to have hypertension.

Medication used to be the first treatment for hypertension. Today, doctors recommend lifestyle changes first, such as regular physical activity and exercise along with changes in diet. From observing many people over a long time, researchers have been able to show that health improves and blood pressure goes down with physical activity. As a result, the Centers for Disease Control and Prevention (CDC) have announced activity guidelines for all adults in the United States.

These guidelines recommend that adults build up to at least 30 minutes of moderate-intensity physical activity on most days of the week. This activity can be in small amounts such as 10 minutes at a time throughout the day, or it can be done all at once. It can include household or work-related activities. It can also be simple exercise such as walking.

These suggestions are for the general public. What about specific groups more likely to develop hypertension? For example, will this kind of physical activity lower blood pressure in menopausal women? Researchers set out to answer this question. The participants were 24 postmenopausal women who were just beginning to develop high blood pressure called “stage 1 hypertension.” Without changing anything else in their lifestyle, these women began a 24-week walking program.

Each woman walked at a comfortable pace (2.5 to 4.0 mph) for three kilometers (1.88 miles). Blood pressure at rest was taken before starting the program. This measurement was repeated at 12 weeks and at 24 weeks. The results? Blood pressure was reduced at 12 weeks and again at 24 weeks. Some women showed a return to normal blood pressure by the end of the study.

Thirty minutes of moderate-intensity activity every day seems to benefit postmenopausal women who have increased blood pressure. Walking less than two miles a day at your own pace is a proven way to reduce blood pressure. Lowering your blood pressure also decreases the risk of heart disease, stroke, and death.

For some, dieting could almost be considered a hobby, particularly among younger women. We’ve heard it’s better not to be overweight, but what are the health downsides on the road to achieving ideal body weight? These researchers intended to determine the effects of dieting practices and exercise on bone health.

Specifically, they examined the effect of dietary restraint–a type of dieting guided by a mental awareness of the types and amounts of food eaten, not simply by feelings of hunger or fullness. Scientists have found that women with high measures of dietary restraint often show disturbances in their menstrual cycles. These women also tend to consume fewer calories than others with low dietary restraint.

Problems with the menstrual cycle aren’t always obvious. In other words, the individual may still have a period as usual. Behind the scenes, however, there can be measurable changes in hormones, including those that help build bone. Scientists have found a definite connection between menstrual disturbances and lower bone density.
 
Exercise helps build bone, but is it enough to counter the effects in women with high dietary restraint? This study compared 62 women, most in their early 20s, all of whom exercised two to four hours a week. From the results of a diet questionnaire, they were grouped as either “high restraint” or “low restraint” eaters. Both groups had regular menstrual cycles and similar body composition.
 
The bone mineral content of the high restraint group was significantly lower than that of the low restraint group. This was true even though those with higher dietary restraint exercised more each week than low restraint eaters. The authors consider whether this difference was from higher levels of cortisol in the blood stream of high restraint eaters.

How does cortisol play into bone health? Cortisol is released into the body during times of stress. High dietary restraint poses stress on the body. As cortisol levels in the blood stream go up, they signal a reduction in other hormones that are in charge of ovulation and menstruation. This causes the body to absorb less calcium, which in turn lowers bone mass.

The authors conclude that high dietary restraint and higher levels of cortisol may lessen the positive effects of exercise on bone health in younger women.

Many studies have shown that exercise and physical activity lower the risk of breast cancer. But how much exercise is enough? And what kinds of activity are best?

The first study to look at all types of activity over a woman’s lifetime has been reported. A large number of women up to age 80 were included. Each participant filled out a survey and was interviewed. Activities at work, home, and play were evaluated. Women were asked to report what kinds of activity they did, for how long, and how vigorously. Light activity was defined as anything that was easy to do while standing or walking slowly. Moderate activity increased the heart rate and caused a light sweat. Heavy activity increased the heart rate and caused heavy sweating.

Which kind of activity reduces the risk of breast cancer? Is it how long a woman exercises? How hard? How many years she does it? It seems the intensity of the activity (getting the heart rate to go up and breaking a light sweat) makes a difference. Light or vigorous activities did not lower the risk of the women who took part in this study. The authors thought this might be because most women in the study did not exercise vigorously or did not remember to report easier activities.

At the moment, it looks like lowered risk for breast cancer occurs with work and household activities. These activities must be of moderate intensity over a lifetime. According to this study, recreational activities at any intensity level do not lower breast cancer risk. But for those of you who have traded in the couch for a bowling bowl, don’t despair. Scientists admit they don’t know what it is about certain activities that helps reduce risk. More studies may yet find the answer and show which recreational activities are best.

Incontinence happens when the muscles at the base of the abdomen–the pelvic floor muscles–can’t build enough pressure to support the inner organs. The pelvic floor muscles have to work when pressure in the abdominal cavity increases. Otherwise the organs in the abdomen push against the bowels or bladder, which can lead to incontinence.

These authors wondered whether nearby abdominal muscles could help the pelvic muscles do their work. Specifically, the authors wanted to know whether squeezing the abdominals would trigger the pelvic floor muscles, and how strongly. They also wanted to find out whether the pelvic floor muscles tighten in preparation for increases in abdominal pressure.

Six women and one man participated in the study. Five of the women had given birth vaginally. The other woman had never given birth. None of the subjects was incontinent, though two had mild symptoms now and then.

Electrodes were used to measure pelvic and abdominal muscle activity. An electrode probe was inserted into the anus of all participants as a way to monitor pelvic muscle actions. The women also wore this type of electrode inside their vaginas. Two round electrode pads were attached to the sides of the abdominal cavity over the surface of the lateral abdominal muscles. The authors also watched the way the muscles worked by hooking up an ultrasound imaging machine.

Electric readings and ultrasound images were monitored as participants did a series of exercises. While lying down with their hips flexed forward, they tightened their abdominal muscles gently. Then they worked the muscles harder and harder. A second group of exercises included muscle tightening and relaxing for the pelvic floor and abs while standing.

When participants tightened their abs, their pelvic muscles also contracted. And the stronger the abdominal contraction, the stronger the response from the pelvic floor muscles.

Surprisingly, pressure from the pelvic muscles went up before pressure from the abdominals started. This suggests that increased pelvic muscle activity isn’t just an afterthought. The authors think that the pelvic muscles respond first because they anticipate the pressure that will be needed to keep continence.

Results also showed that, for women, pelvic muscle activity during abdominal exercises was the same as the activity that came from working the pelvic muscles themselves. This suggests that, even if women don’t do special exercises to strengthen the pelvic floor, they may get strong pelvic muscles just by staying active and keeping their abs toned.

This is the first study to show that working the abdominal muscles activates the pelvic floor muscles. Doing specific abdominal exercises may strengthen the pelvic muscles and help prevent incontinence. More research is needed to find out whether these types of abdominal exercises can help people who already have problems with incontinence.

Stretch here, stretch there–it seems like everyone’s limbering up. On the track and field, stretching is believed by many to enhance performance and prevent injuries. Stretching is even recommended in the workplace, to relieve the tightness that can come from sitting at a desk all day. But how exactly does stretching work? Why does it help most people feel better?

Researchers have long believed that stretching reduces muscle stiffness. But a recent study found that stretching reduces muscle stiffness only briefly–or not at all. Stretching produces a physical sensation. A forceful stretch initially gives a strong sensation of stretching, which soon eases up. When the stretch feeling begins to decrease during the stretch, is there an actual change in muscle stiffness? Or does the feeling let up because the body adapts to the stretch?

These authors studied the effects of a two-week stretching program for the rectus femoris, a muscle on the front of the thigh. The participants were 29 men at a military base in Sweden. They did two supervised stretching programs. One program was for the thigh. The other was for the calf, to act as a comparison. Participants stretched each leg for 80 seconds, four times a week. The flexibility of their thigh muscles was tested before and after each two-week period. The amount of tension they felt in a stretch was also recorded, from “nothing at all” to “extremely strong.”

After stretching the thigh for two weeks, participants noted less of a stretch sensation in the muscle. A stretch that was experienced as “strong” before the two-week program was only “somewhat strong” afterwards. Notably, after stretching only the calf for two weeks, the thigh stretch felt just as strong as it had before.

Participants’ flexibility didn’t change after two weeks of stretching. The authors suspect that the stretching program was not intense enough to change muscle stiffness and range of movement. Also, participants were tested in the same stretch positions each time. But when participants were told to stretch until the feeling was as intense as it had been before they did the stretching program, range of movement actually increased 15 degrees.

The authors conclude that changes in the way a stretch feels are important to how stretching works. The more you stretch, the less stretch sensation you’ll have in a stretch over time. Changes in muscle stiffness may come later. This study raises the question of whether stretching works mainly on sensation in a muscle rather than on the physical structure of the muscle.

Do you ever leak or dribble urine when you stand up after sitting for a while? Do you have trouble holding your urine when you lift a bag of groceries or other heavy items? You may think this happens because you are “out of shape,” but even top athletes can have the type of leaking called incontinence.

Urinary incontinence is defined as the uncontrolled loss of urine; in other words, the person can’t hold back the urine before getting to a restroom. Women are affected more often than men, but both sexes can have this problem.

The most common type of urinary incontinence is stress urinary incontinence (SUI). This is loss of urine during coughing, sneezing, laughing, running, jumping, heavy lifting, exercise, or a sudden change of positions. Another type of urinary incontinence is called urge incontinence. Urge incontinence is loss of urine that happens when there’s a strong desire to urinate (called urgency). These two types of incontinence can occur alone or together. When a person has both types, they have mixed incontinence.

The bladder is the body’s holding tank for urine. The urine collects in the bladder until the bladder is full enough to signal the urge to go to the bathroom. When the muscles and ligaments that help hold and support the bladder (pelvic floor muscles) become injured, weak, or overstretched, urine can leak out in small–or sometimes large–amounts.

Loss of urine can happen in anyone’s life at any age, but it is most common in women after childbirth and in men after prostate problems. Recently, a large number of young, physically fit women who had not had babies were found to have urine leakage. If this problem was not caused by muscle weakness after pregnancy, why would athletic women have urinary leakage?

In the past, some people thought incontinence in female athletes was caused by exercising too much, eating disorders, or a combination of both. These can cause hormonal changes that affect the muscles of the pelvic floor. In particular, decreased amounts of the hormone estrogen can cause the muscles to lose their tone (muscle tightness). The result is poor support of the bladder with leakage of urine.

Researchers used surveys and interviews to ask about incontinence among women who were college athletes. The results were compared with those of women in the same age range (15 to 39 years) who were not athletes.

After studying 660 female athletes on college national teams and 765 nonathletes, it was discovered that symptoms of both stress and urge incontinence occur in female athletes. In fact, athletic women were more likely to have both kinds of urinary incontinence than nonathletic women of the same age. There was one difference between the two groups. The frequency of incontinence was much higher in athletes who had eating disorders such as anorexia (loss of appetite and refusal to eat).

The problem of urine leakage can be treated successfully. This is true whether or not the woman is athletic, has had children, or has an eating disorder. Treatment depends on the cause of the incontinence. When there is damage or weakness of the muscles, treatment may include pelvic floor muscle exercises, electrical stimulation, or surgery. In the case of decreased hormones from excessive exercising and eating disorders, treatment is more involved, including medical advice, and nutrition and psychological counseling.

Muscle contusions, along with muscle strains, account for about 90 percent of all sports injuries. Contusions are bruises caused by impact with a blunt object. They most often happen to the upper arms and thighs. Except for muscle strains, contusions are the most common type of muscle injury.

Contusions cause pain and swelling. They also reduce range of movement. In some cases, extra blood pools within the muscle tissues, forming a hematoma. Added problems can occur if the hematoma causes extra pressure on nearby tissues. Hematomas that form in the front of the upper arm or thigh run the risk of forming bone tissue inside the muscle, a condition called myositis ossification.

This article reviews current research on contusions, to help with diagnosis and treatment. What determines the severity of a contusion? Does tightening your muscles before impact lighten the blow? Research shows that, compared to relaxed muscles, contracted muscles do a better job of absorbing the energy of a direct hit. Tightened muscles stiffen against the impact, forming a wall against injury.
 
Muscles that are tightly taped or padded don’t fare as well. This is probably because they have less room to move as they absorb the force of the impact. Tired muscles are also more susceptible to injury, as are those that haven’t been warmed up. After injury, younger muscles may have more pain and swelling than older ones, yet younger muscles heal more quickly.

Diagnosis of contusions is usually straightforward. If patients have concentrated swelling and tenderness along with poor range of movement, they probably have a contusion. The extent of the injury may be harder to figure out. Ultrasound and magnetic resonance imaging (MRI) may help.

Researchers have studied the natural healing of contusions in animals. Most of the healing happens within the first few days. Inflammation draws healing cells to the injured area to help repair the injured muscle. Scar tissue forms. In rats, healing is complete within two to three weeks, with no lasting signs of injury.
 
Treatment depends on the severity of the contusion. If there’s a large tear in the muscle, healing may be improved with surgery to hold the torn edges together. However, it is sometimes challenging to surgically stitch the muscles together.

Rest is often recommended in the treatment of contusions. But too much rest can make joints stiff and muscles weak. Researchers generally agree that rest is best right after the injury (24 to 48 hours), followed by light movement. Resting early on can limit the formation of hematoma without affecting the muscles and joints. Icing may help, too, especially right after the injury.

Nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce pain and swelling in the short term. So can corticosteroids. However, these treatments may reduce muscle strength and healing in the long run. The authors suggest only using NSAIDs within 24 to 48 hours of injury. More research is needed to fully understand the effects of these treatments. Other medications, such as growth factors and certain types of steroids, should also be explored.

Most people know that exercise helps make bones stronger. It’s also well known that in the teen years, we lay down most of the bone mass we’ll depend on throughout adulthood. Can the form of exercise or sport chosen by teenagers make any difference in the process of building stronger bones?

Two main forms of activity that can affect bone building are impact loading and active loading. Impact loading includes activities that put a force on the skeleton through contact with a hard surface (e.g. running, gymnastics). Active loading includes activities such as swimming, in which the muscles are active but minimal forces act on the skeleton. Past studies have shown that impact loading has a greater affect than active loading on bone health.

This study was designed to view how these two different forms of activity affected bone mass and development of boys around puberty (ages 12 to 18). Forty-five boys were selected, 18 of whom were involved in impact sports (basketball, tennis) and 27 who were involved in active sports (swimming, water polo). These two groups were also compared to a control group of 12- to 18-year-old boys who were not involved in any kind of organized sports.

Bone density was higher in the impact sports group when compared to both other groups. Participants in both athletic groups had higher bone mineral content than their nonexercising counterparts. They were taller and heavier yet also leaner, too.

Testosterone levels were higher in the impact group compared to the active group, though this did not appear to have any affect on bone density, growth, and development (including sexual development). Impact sports improve bone density more than active sports. But any form of physical activity during the teen years is better than no activity for bone development and body composition.

The possibility of injury isn’t usually the first thing on an athlete’s mind. But in many sports, injury is part of the game. Just how common is injury among professional soccer players?

To find out, these authors studied injury reports from the first season of United States Major League Soccer. There were a total of 237 players on 10 teams. Players ranged in age from 18 to 38 years. Their average age was 27. Each player spent about 241 hours practicing over the course of the season. That’s eight times more hours than they spent in competition (28 hours per player).

The overall rate of injury was six injuries per 1000 hours of playing time. Although players spent much more time in practice than in competition, games resulted in more injuries. There were roughly three injuries per 1000 hours of practice time, versus 35 injuries per 1000 hours of competition. That means players were 12 times more likely to get hurt during games. This makes sense given the fact that games are often more rigorous than practice.

About a third of the injuries didn’t cost the athletes any playing time. Of the remaining 256 injuries, most (59 percent) were “minor,” meaning they kept players off the field for less than a week. Twenty-eight percent put players out for up to a month. Thirteen percent were major injuries that caused absences of more than a month.

The last month and a half of the season resulted in more injuries than any other part of the season. This could be due to the intensity of playing when teams vie for play-offs. Or it could be due to the build-up of exertion over the course of the season.

Seventy-seven percent of the athletes’ injuries involved the lower extremities. Knees were injured the most (21 percent of injuries), followed by ankles (18 percent). Injuries to the knee resulted in the most time lost from competition and the greatest number of surgeries. For players suffering from strains, the hamstring and hip abductor muscles were most often affected.

Mid-fielders accounted for 38 percent of the injuries. Defenders had 30 percent of the injuries. Forwards and goalkeepers each had 20 and eight percent of the injuries. When the authors looked at the number of players in each position, they found that none of the positions was more prone to injury than another. Players’ ages also didn’t make a difference in whether they were injured or how severely.

Clearly, injuries happen in soccer, especially during games. But the authors feel that soccer players may be safer from injury than athletes in other sports. At the very least, this study suggests that injuries generally don’t keep professional soccer players off the field for long.

Patients who have major pelvic injuries are at risk for developing deep vein thrombosis, blood clots that form in the veins. Without preventive care, the rate of thrombosis for patients with this kind of injury may be as high as 61 percent. This condition can be serious–even fatal. Pulmonary embolism, or a clot that breaks loose and travels into the lungs, is the most common cause of death beyond the first week of the initial pelvic injury.

Doctors have some reservations about medications to prevent blood clots. Since these drugs work to thin the blood, they can increase the risk of internal bleeding. There are a few mechanical devices that patients can use to prevent blood clots. In this study, the authors compared the effectiveness of two such devices.

These devices wrap around and squeeze the lower limbs, putting pressure on the blood vessels. This action keeps the blood moving, and can help prevent the formation of a clot. One device used in this study gave a low-pressure pulse, first to the calf and then to the thigh. The second device gave a high-pressure pulse to the calf and foot at the same time. The authors thought the second device would be more effective in preventing clots than the first.

Participants included 107 patients who had pelvic fractures. After surgery, half of the patients wore the low-pressure device; half wore the high-pressure device. There were no major differences between the two groups in the severity of their injuries or the amount of time it took for them to start treatment with mechanical devices.

All of the patients were told to wear the devices on both legs as much as possible while they were in the hospital. Before leaving the hospital, patients had tests to check for blood clots.

Fifteen patients (14 percent) developed clots. There were no deaths due to thrombosis. Ten of the patients with blood clots used the low-pressure thigh-calf device. Five others used the high-pressure calf-foot device. The difference between groups was slight, though patients who formed clots while using the low-pressure device seemed to develop larger, more serious clots.

Age seemed to heighten the risk for clots. Patients who had larger clots were an average of 11 years older than those who had no clots.

The more time that passed between injury and surgery, the more likely patients were to develop blood clots. Patients who formed clots averaged a ten-day delay between injury and surgery. Patients who had surgery within about five days were less likely to show signs of clots. More severe injuries to the pelvis tended to lead to larger blood clots. Regardless of the choice of device, mechanical compression helps lower the chance a blood clot will form.

The authors feel that their sample was not large enough to show the differences between the two mechanical devices. More research is needed to determine whether one type of device is more effective than the other.

Can you imagine never being able to dribble a ball, play the piano, tie your shoes, or type? This could happen if your forearm was always held with the hand palm up, a position called “supination.” What could cause this loss of forearm motion, and what can be done about it?

Injury, infection, birth defects, and surgery to remove a tumor can leave the two bones in the forearm unable to move. These two bones normally rotate, allowing the hand to turn palm up and palm down. Since 1921, an operation to join, or fuse, these two bones together in a better position has been used in such cases. This fusion, called an arthrodesis connects the two forearm bones into one.

A new study has added another use of this type of bone fusion. Children with paralysis of the arm can now be helped with this operation. In six cases of arm weakness in which the arm was positioned palm up, the bones were fused together. These children were born with this problem because of nerve damage from birth or polio. The result was to put the forearm in a “handshake position,” with the palm turned down slightly.

This new position helped the children to hold objects, lift items, ride a bicycle, and in one case, use a keyboard. For children who can’t turn their hands over, connecting the bones together in a new position helps them use their hands in new ways.

When a person lifts weights, his or her blood pressure rises during the exercise. But how long does this increase in blood pressure last? If it lasts all day, it could potentially be a problem for untrained or first-time exercisers. Researchers at the University of Maryland sought to find out whether this increase in blood pressure lasted throughout the day.

Thirty-three healthy men and women age 18 to 26 completed the study. They were placed in groups based on their self-reported level of exercise. The categories were sedentary (no regular exercise in the preceding three months), resistance-trained (those who lifted weights three times per week for the preceding 12 months), and endurance-trained (those who exercised at least three days per week for the preceding six months in activities that required prolonged effort, such as long-distance swimming or running).

The participants’ blood pressure was measured at rest before they began exercising. Then they warmed up, stretched, and lifted weights, doing two sets of repetitions on 12 different machines. The workouts lasted 45 to 60 minutes. Afterward, a “walking” blood pressure monitor was attached to the participants for 24 hours while they did their normal activities. Heart rate and blood pressure readings were taken throughout the day and the following night at random times each hour.

Twenty-four hour blood pressure was also measured on a control day. On this day, the participants did no exercise and similar types of daily activities as on the exercising day. Their heart rate and blood pressure were monitored as before.

The results surprised the researchers, who expected that the blood pressure of the sedentary group might remain elevated longer than that of the regular exercisers. But that wasn’t the case. The researchers found no significant difference in blood pressure or heart rate between the groups or between the men and the women on the exercise day compared to the control day. They concluded that the elevation in heart rate during weight training doesn’t last through the following 24 hours in healthy young people.

More and more, women are doing physically demanding jobs typically held by men. But women don’t normally have the same muscle mass or strength as men, so how can they do these demanding jobs safely? To help answer this question, researchers compared the effects of resistance training on women’s muscle performance and their ability to do typical on-the-job tasks.

Untrained women in their early to mid-twenties were placed in one of several six-month training groups. The main comparison was between aerobic forms of training (running, stretching, and light strengthening), field training with bounding and jumping drills, and resistance exercise (weight lifting).

Participants in the resistance-exercise groups worked either their upper body or total body, and they either did heavy and explosive lifts or lifted lighter loads slowly with more repetitions. At zero, three, and six months, performance measures were taken including lifting, running, high pulls, and bench press. These measures were also compared with the performance of untrained men.

All forms of exercise yielded improvements. Upper body resistance training greatly improved the ability of the women to do tasks requiring upper body strength. Field training improved performance moderately, though these gains leveled off at three months. Aerobic training improved distance running and the ability to do general physical tasks, such as lifting a box.

Remarkably, resistance training improved nearly every aspect of physical performance, including day-to-day tasks that require extra strength. This form of training effectively closed the gender gap by reducing the differences in physical abilities between men and women.

How can women keep up in physically demanding jobs? They’ll benefit by taking part in resistance training programs that match the physical demands of their jobs.

Usually, we connect exercise with bone health. Exercise gets the remodeling cells in the bone up and going. This normally leads to stronger, more dense bones. But what about women who use oral contraceptives and who intend to exercise? Will their efforts to exercise pay off in better bone health?

The pill alters how bone is built, leading the authors to question whether the pill keeps women who exercise from building better bones.
 
The authors compared the bone density of 179 women 18 to 31 years old. These women hadn’t taken part in athletics, and just over half were using birth control pills. Four groups were formed in order to compare the effects of exercise and birth control on bone health. Both those who used the pill and those who didn’t were fairly divided into exercise and nonexercise groups. Exercisers were to train with weights three days per week and to jump rope for a total of 60 minutes each week.

Bone density was checked before and after the two-year study period. As expected, exercisers developed better bone content than nonexercisers. And women exercisers who weren’t on the pill had even better bone content than those who were on the pill.

Females in their teens and twenties lay down nearly all the bone density they will have for the rest of their lives. What they don’t get then, they can’t recapture. If they happen to be on the pill during this “bone-crucial” time, they could end up with bone problems in the future.

For example, past research has shown that women who used birth control pills before menopause had more problems later on with broken bones. These small differences in bone content earlier in life may make big differences as women become elderly, the time in life when fractures can be devastating.

Why wouldn’t exercisers who used birth control pills have improved bone content? After all, the hormones found in birth control pills are the same ones doctors prescribe to prevent and treat osteoporosis. Calcium, the authors suggest, might be the missing puzzle piece.

Numerous studies have shown that after menopause, women who exercise increased their bone density only when they took more than 1,000 mg of calcium a day. In this study, three of the exercisers using the pill avoided bone building problems (compared to other exercisers on the pill), presumably because they were also taking 1,200 mg of calcium per day. Once again, motherly advice is proven right: “Drink your milk so your bones will be strong.”

From a spectator standpoint, baseball may have lost some of its luster. But it still has more participants than any other sport in the United States. Given the wide popularity of the sport, these authors wanted to examine trends in baseball injuries. They looked to Major League Baseball, where sports medicine is most advanced.

In Major League Baseball, statistics are as much a part of the game as bats and gloves. One statistic kept by every team is the “disabled list.” This is a list of athletes who are unable to play due to an injury that’s been certified by the team physician. Once a player is on the list, he cannot play for at least 15 days. His injury may keep him on the list–and out of the game–a lot longer. In the meantime, the coach can temporarily replace the injured player to keep 25 active players on the team roster.

The authors looked at disabled lists from 1989 to 1999. They expected that improvements in sports medicine and training would result in fewer baseball injuries over time.

The opposite was true. The number of players on the disabled list actually grew over the 11-year period. When the authors compared the first three years to the last three years, they found that the number of injuries had shot up 40 percent. This increase could only be partially explained by the fact that more teams (and thus more players) had joined the league.

In addition, the number of days players spent on the disabled list went up 53 percent. This increase could not be accounted for by new medical tools that allow doctors to find previously undetected injuries. The new injuries in pitchers tended to be major, resulting in about 55 missed days per injury.

Of all the positions, pitchers were injured the most, accounting for about half of the reported injuries. They also accounted for over half of the total time lost to injuries. Over the 11-year period, both the number of pitchers injured and the number of days their injuries kept them from the game went up. This was true for both starting and relief pitchers. Third basemen also saw a rise in injuries.

Shoulder injuries most often kept players out of the game, followed by elbow injuries. Only elbow injuries showed a consistent increase over the study period.

The authors could not explain why injuries have increased in Major League Baseball. It’s possible that sports medicine is not serving athletes as well as expected. It’s also possible that sports medicine has managed to control certain kinds of injuries while other types of injuries are still on the rise. Whatever the reason, this is a trend that deserves further attention.