"High" Ankle Sprains

We have been discussing the ankle in class, and one of the topics has been the "high" ankle sprain. The most common type of ankle sprain is the "lateral" ankle sprain, which damages the ligaments on the outside of the ankle that connect the talus to the fibula. Most of the time when people "roll" their ankle, they sustain a "lateral" ankle sprain. While not as common, the "high", or "syndesmosis" ankle sprain, can be much more debilitating. With a "high" ankle sprain, there is damage to the ligaments of the distal tibiofibular joint, primarily the anterior inferior and posterior inferior tibiofibular ligaments, and sometimes the interosseous membrane. To sustain a high ankle sprain, the talus, through hyperdorsiflexion, is forced up between the tibia and fibula, thus separating the bones from each other. This often occurs during a pile up in football when a player lands on the back of the leg of a lineman. Recovery for a high ankle sprain is often lengthy. Every time we walk or run, the talus is forced up into the distal tibiofibular joint. In a healthy person, this is not a problem, but in a person that has damaged these ligaments, it makes recovery difficult.

Rate limiters

I apologize for the length of time between posts. We have been discussing the concept of rate limiters recently in motor development. A rate limiter is an individual constraint, or system, that holds back of slows the emergence of a motor skill. One example would be a five year old trying to shoot a basketball on a ten foot goal. He or she will lack the muscular strength to shoot the ball at a goal this high. Therefore, the muscular system would be the rate limiter. We had a really good discussion in class about how a single rate limiter of one system can affect numerous systems. As we age, certain parts of our body begin to break down. A common problem is arthritis. As people develop arthritis, which affects the joints, they tend to decrease their amount of physical activity. Well, a lack of physical activity leads to a loss of bone mass, muscle mass, degeneration of the nervous system, and many other health problems. So, what starts off as one problem eventually leads to the development of several problems. It is important to determine what rate limiter may be holding a person back and attempt to correct it before more problems arise.

Uralacher's Wrist Injury

If you follow the NFL, then you know that the Bears All Pro linebacker, Brian Urlacher, dislocated his "wrist" Sunday night against the Packers and will be out the remainder of the season after undergoing surgery yesterday. The term "wrist" only describes a general area of the body, and the exact bone that was dislocated was not disclosed in any of the press releases. The actual "wrist" is the articulation of the distal end of the radius with the proximal row of carpal bones (four bones). The most commonly dislocated carpal bone is the lunate, which is located almost directly beneath the middle finger. This bone helps hold the wrist together, and often times when it is dislocated, it must be put back into place with pins via surgery. This type of surgery requires a lengthy recovery. I was able to do some digging and Urlacher did, in fact, dislocate the lunate.

MCL "Sprain"

I blogged a couple of weeks ago about the difference between a "sprain" and a "strain." Well, during the Steelers-Titans game last night, there was a great example of a MCL sprain. The Medial Collateral Ligament is the ligament on the inside of the knee. It helps prevent the knee from "buckling" on the inside. It is frequently injured in football and injured much more frequently than the Lateral Collateral Ligament. Typically, the ligament is damaged by a valgus force, which is a force directed in the lateral to medial direction. In the above picture, the Titans player landed on the lateral aspect of the knee of Troy Polamalu, which stretched and damaged the MCL on the medial side. Football players are hit much more frequently on the lateral or outside of the knee, which causes damage to the MCL. Polamalu is reported to be out for 3-6 weeks, which would lead me to believe it is a Grade II MCL sprain. If the ligament was completely torn, as in the top picture, he would probably be out much longer, if not the entire season. With a grade II sprain, there is some tearing of the ligament, but not a complete disruption. He will likely wear a knee brace when he returns to help protect against a repeat of this injury.

Exercise is Medicine Part II

I blogged a couple of weeks ago about the "Exercise is Medicine" campaign and how the president of ACSM was coming to Mississippi State to help promote the campaign. Well, that day was today. There was a great turnout in front of the student union at the press conference and a standing room only crowd at question and answer session, which featured our own department head, Dr. Brown. Many students came out to support the event, and hopefully more people in the community, state, and nation will become more active. As professionals in the field of Health, I feel we have to set an example for others on the importance of physcial activity, and the best way to do this is to be active ourselves. It would be difficult for anyone in the field of health, kinesiolgy, etc., to stress the importance of exercise if they don't exercise themselves. Every journey begins with a "step", and hopefully this campaign will encourage more people to exercise. Check out the link below for more information on the program. I'll be back Friday with another football injury blog for the weekend.
http://www.exerciseismedicine.org/public.htm

Did he really fully "extend" to catch the ball?

Since this is the opening weekend of college football, we will stick with that theme. Over the course of the season, you'll undoubtedly see many diving catches like the one above. Often times, the announcer will say that the player "fully extended" to catch the pass. Well, this just isn't true. We have been discussing joint actions in class this past week, and I'm sure all of my students could tell you why this isn't true. First, we must identify the joint where the action is taking place. To say a player "fully extended" really does not give an indication of what happened. We must specify the joint where this action, such as flexion, extension, abduction, etc., is taking place. After identifying the joint, we must then identify the proper joint action. I believe that when announcers say a player "fully extended", they are referring to the shoulder/arm. Well, in the above picture, and almost all cases where a player dives for a ball, the motion at the shoulder is not extension, but flexion. The definition of flexion is a motion that decreases the angle of a joint, or moves the segment into the fetal position. In the above picture, it is clear that the athlete's shoulders are moving into the fetal position, therefore, he has shoulder flexion. He also has elbow flexion, wrist flexion, and knee flexion, making the "fully extended" statement even more incorrect. So the next time you are watching a game or Sportscenter and see a diving catch, pay close attention to the description of the movement. It just might not be accurate.