Happy Thanksgiving!!

Just wanted to wish everybody a Happy Thanksgiving!! I hope everybody has a great holiday and I'll be back next week with a new post.

Who is Lisfranc? What is a Lisfranc injury?

An uncommon, but often misdiagnosed injury, is the Lisfranc fracture/dislocation. The Lisfranc joint, or tarsometatarsal articulation in the middle of the foot, is where the three cuneiform bones articulate with the first three metatarsals. This joint is named for Jacques Lisfranc, who was a general in Napoleon's army and performed an amputation through this joint of a soldier who fell, caught his foot in the stirrup, and developed gangreen. Lisfranc fractures account for fewer than 1% of all diagnosed fractures. It is often missed on the initial x-ray. In the everyday setting, this injury may result from a high energy car wreck or from falling from high places. In the sport of football, there have been a few prominent NFL players that have suffered this injury, including Dwight Freeny, Warrick Dunn, and this past Sunday, Ronnie Brown. If you watch the video of Brown's injury (link below), you will see that he planted his right foot, and then another player landed on his leg from behing, causing the injury. If a fracture occurs, surgery will most likely be performed, using screw fixation to repair the fracture. The rehabilitation from this injury is often lengthy, and may take up to a year.

Ronnie Brown injury

Why High Heels Are Bad!!

Instead of talking about sports injuries today, I thought I would get on my soapbox and discuss why high heels are bad. I'm not saying to absolutely never wear them, but everyday for 8 hours is not a good idea. When wearing high heels, a person must adjust their posture in order to accommodate the lift of the calcaneus. This adjustment occurs in the lower back (lumbar spine) and causes anterior rotation of the pelvis, which leads to back pain. Here are some facts about different heel heights:
1) a 1.9 cm heel increases forefoot pressure by 22%
2) a 5 cm heel increases forefoot pressure by 57%
3) an 8 cm heel increases forefoot pressure by 76%
In addition to causing low back pain and foot problems, high heels can also cause bunions if they are too narrow, nerve damage under the foot, and achilles tendon contractures. What the last part means is that by wearing high heels, it may chronically shorten the achilles tendon, which will lead to limited ankle motion, altered gait, and could possibly cause the achilles tendon to rupture. So, it is best to avoid high heels or limit their use to help avoid all these problems.

Head Up!!

This past weekend, an Auburn football player, Zac Etheridge, was involved in a serious injury during the Auburn-Ole Miss football game. While attempting to tackle Ole Miss running back Rodney Scott, Etheridge and teammate Antonio Coleman met head on in the above picture. It is never a good idea to attempt and tackle someone with your head down (neck flexion), because it lines up all the vertebrae in the neck and if the force is great enough, a domino effect will occur, fracturing the vertebrae and possibly leading to paralysis. After watching the video in class, one of my students pointed out that Etheridge likely wasn't trying to hit Scott with his head, but Coleman came into the play after he left his feet, and by then he couldn't change direction. After this collison, Etheridge lay motionless on the turf on top of Scott, and the Auburn medical staff did a great job stabilizing his cervical spine and placing him on the spineboard. As an athletic trainer, you always suspect a player has a spine injury when they get hit in the head. The most remarkable part of the play was Scott, who did not move until Etheridge was stabilized and moved off of him. The actions of Scott may have saved Etheridge from permanent paralysis, because any type of movement before he was stabilized could have caused a serious spinal cord injury. I am happy to report that Etheridge did not sustain any permanent damage, he has sprained ligaments in his neck and did fracture cervical vertebrae five. He will have to wear a neck brace for 3-4 months and is expected to make a full recovery. If you would like to see the video, click on the link below. It occurs around the 26 mintue mark of the video.

Zac Etheridge injury

Are you kidding me?

Watch this clip. BYU-New Mexico Soccer Fight


Today in motor development, we were discussing gender typing in sports. We were discussing how soccer is now viewed as both a male and female sport, and one of the students asked me if I saw the fight during the BYU-New Mexico match last night. I had not seen it, so recognizing a great opportunity for discussion, we viewed the video in class. You have to watch this for yourself. I don't know how one person could
1) do all these things to other players and 2) get away with it. You would think by the fifth incident one of the officials would have noticed. I'm not sure which was worse, pulling the girl down by her hair, kicking the ball into another player's face, or punching a player in the face. Just an unbelievable demonstration of how NOT to play the game.

Update

I found the video at http://www.secdigitalnetwork.com/default.aspx. It occurs on the very last play of the 3rd quarter. You should be able to move the video ahead to that play.

Patellar dislocations

I was originally going to do a post on why people should not wear high heels, but I was watching the Tennessee-South Carolina game this past weekend and saw an injury I just had to blog about. The patella is a seasmoid bone that lies in the trochlear groove between the medial and lateral femoral condyles. It moves up and down as we flex and extend our knee, and rarely comes out of place. A non-contact patellar dislocation may occur with a violent twisting motion of the leg, while a contact disclocation occurs when some outside force knocks it out of the groove. Three Tennessee defenders were trying to tackle a South Carolina player near the sideline, when one of the Tennessee players hit the patella of his teammate and knocked it out of the trochlear groove, resulting in a patellar dislocation. The patealla was located on the lateral femoral condyle, and clearly could be seen during the telecast. I've tried to locate the video of the injury, but have not had any luck yet. A physician will relocate the patealla back into place by flexing the hip, and gently pushing the patealla medially as the knee is extended. The athlete will likely miss four to six weeks or possibly longer after this injury. Like all other dislocations, once the patella is disclocated, it is much more likely to occur again.