The Incredible Streak is Over

Brett Favre's streak of 297 consecutive games started at quarterback in the NFL is over. To me, this is the most incredible streak in all of sports. Favre has battled through many injuries during his career, but the latest one ended the streak. During last week's game against the Buffalo Bills, Favre was hit hard and landed on the tip of his right shoulder. I recently blogged that this mechanism of injury could cause a fracture of the clavicle. Well, another injury this mechanism can cause and did cause to Favre is a sternoclavicular joint fracture. This joint is where the proximal end of the clavicle (the end closest to the center of the body) articulates with the sternum. You can see in the above picture that many ligaments help hold this joint together. Anytime you move your shoulder, the clavicle will move/rotate as well. Place your left hand on your right sternoclavicular joint, move your right shoulder up and down, and you can feel the clavicle move. Now, imagine the amount of pain you would be in as you moved your shoulder if the ligaments that held the clavicle and sternum together were injured. As a quarterback, this pain would be intensified due to the throwing motion, plus the probability of getting hit around the shoulder. It just wasn't worth the risk for Favre to play. It would have been very risky for him to get an injection near the joint to numb the joint for the game, because of the arteries, nerves, and veins that pass right behind the clavicle.

Now, for a little background on myself and how I've followed Brett Favre. Growing up in Hattiesburg and attending Southern Miss football games since before I could walk, I remember watching Brett Favre play when I was just a kid; I especially remember being at Legion Field in 1990 and watching Favre lead the Eagles to a victory over Alabama just weeks after he had a car wreck and lost a portion of his large intestine. I became a Packers fan as soon as he was traded there, and watched every game I could growing up. I eventually got to see Favre play as a professional with the Jets two years ago, and couldn't believe how close he got to the Super Bowl last year. I was five years old when Favre first started at Southern Miss, and 10 when his NFL streak began. I am just shy of 29 years old as the streak ends. I can't remember what football was like without Brett Favre. The NFL just won't be the same without him.

Clavicular fracture

In anatomical kinesiology, we have been discussing the upper extremity, and a common upper extremity injury is a clavicular fracture. The clavicle, or collarbone, connects the shoulder to the sternum. The clavicle is among the most frequently fractured bones in sports. There are three main mechanisms of injury: 1) falling on an outstretched hand, in which the force from the ground is transmitted up the arm and through the clavicle 2) falling onto the tip of the shoulder, and 3) a direct impact to the clavicle. Tony Romo recently fractured his left clavicle when he was hit after throwing a pass and landed on the tip of his left clavicle (you can view the video here). During the Mississippi State-Ole Miss game Saturday night, MSU receiver Chad Bumphis fractured his clavicle after diving to catch a pass and landing on the tip of his shoulder (no video available, but you can read about it here). When I was an athletic trainer at Auburn, one of our wide receivers fractured his clavicle in much the same manner during practice. He dove to catch a pass and landed right on the tip of his shoulder. The recovery time for most clavicular fractures is approximately 6-8 weeks, although each injury and person is different. A suspected clavicular fracture has to be initially treated as a major medical emergency, because the subclavian artery and vein, in addition to the brachial plexus (a group of nerves) run right behind clavicle, and it is possible for a piece of the clavicle to disrupt the artery, vein, or nerves. Most clavicular fractures will heal on their own, but sometimes surgical fixation is required.

Power Balance: Helpful or a Gimmick

Balance. Strength. Flexibility. This is the reported benefits a person gains from wearing the Power Balance bracelet. However, many people, including myself and some colleagues at Mississippi State, are very skeptical of these claims. First, how do these bracelets improve balance, strength, and flexibility? Second, when you watch the demonstrations of the tests on their website, the tests in which the athletes wear the bracelets is always performed second. This creates what is known as an order effect, in which a person performs better on a test the second time they attempt it. We had even discussed conducting scientific testing on the Power Balance bracelets. Well, it seems researchers at the University of Wisconsin at LaCrosse beat us to it. They tested 21 athletes wearing both the $30 Power Balance bracelet and a $.30 placebo plastic bracelet performing similar tests to those found on the Power Balance website. They found no difference in performance between the Power Balance trials and the plastic placebo trials (neither the participants nor researchers knew which bracelet they were wearing). They did find an order effect, in which participants did perform better during the second trial regardless of which bracelet he or she was wearing. So, what does this mean? The Power Balance bracelet does not improve balance, strength, or flexibility. Why spend $30 on a bracelet when a $.30 bracelet will give you the same results? Check out this link to view the full report from Outside the Lines.

Playing with a torn biceps tendon

If you are a fan of baseball, you know that we are well into the playoffs. My Dad asked me a question the other day that I thought would make a good blog post. His question was how could Edgar Renteria, a shortstop for the San Francisco Giants, continue to play with a torn biceps tendon? This is a good question, and from media reports, it seems Renteria tore the tendon in his left biceps brachii while swinging at a pitch against the Braves last week. The biceps brachii is the large (well, large in some people) muscle located on the anterior (front) part of the upper arm. There are actually two parts to the biceps brachii, as biceps means two heads. In the picture to the left, the number 5 is pointing to the tendon that attaches the long head of the biceps brachii to the upper part of the scapula (shoulder), and the number 9 is pointing to the short head of the biceps brachii, which attaches to the lower part of the scapula. The number 4 points to the common tendon of both heads that attaches to the radius (elbow). The biceps brachii actually has 3 jobs, or functions. 1) It helps with shoulder flexion (raising your arm straight up in front of you), 2) it helps with elbow flexion (bending your elbow), and 3) it helps with supination of the proximal radiounlar joint (holding your palms up). I say it helps with these motions because there are other muscles that cause these motions as well, such as the anterior deltoid for shoulder flexion, the brachialis for elbow flexion, and supinator for supination. It is not clear from the article which biceps brachii tendon that Renteria tore, but since there are other muscles that cause the same motions as the biceps brachii, it is possible to perform without the muscle. Renteria is probably in less pain now that the tendon has completely torn than he was when it was only a partial tear.

It's a Boy!!

Well, my wife is 17 weeks pregnant, and yesterday we found out that we are having a boy!! We are very excited (me especially), and the best news was that the baby is developing normally. I've attached some pictures, you can really see the development of his spine, legs, arms, and skull in these pictures. It is truly amazing that even though he is a little less than a foot in length and weighs about half a pound you can see all these body structures. We discussed prenatal development in class a few weeks ago and it is really cool to be able to see this in your own child. By this point, his brain configuration is nearly complete, his heart muscle is developed, and he has begun motor activity. The skeleton, which begins as a cartilage model, is beginning to ossify. Many other changes will occur during the next five months until we welcome him into the world.

Using Correct Terminology

An issue that came up recently in class was the use of incorrect terminology to describe muscle actions and joint actions. Many times, people will say things such as "flex" your muscle, or he/she "over-extended" a muscle. When we describe motion, there are two things to look at; how the joint angle changes, and how the length of the muscle changes. To keep things simple, I will use the knee as an example. The primary motions, or joint actions, at the knee are flexion and extension. When a persons straightens his/her knee, this is called knee extension. When a person bends his/her knee, this is called knee flexion. The terms flexion and extension refer to changes in a joint angle, not changes in a muscle. Flexion and extension also occur at other joints, such as the hip, shoulder, and elbow. Now, let's examine what happens to the large muscle group located on the anterior (front) portion of the thigh. This is the quadriceps muscle group. Muscles either shorten, lengthen, or stay the same length. When you extend your knee, such as during the upward phase of a squat, the quadriceps muscle group shortens. This shortening of a muscle under tension is known as a concentric muscle action. When you flex your knee, such as during the downward phase of a squat, the quadriceps muscle group lengthens under tension. This is called an eccentric muscle action. If you were to squat down and hold your knee at a constant joint angle (90 degrees of knee flexion), the length of the quadriceps muscle group would remain constant under tension. This is known as an isometric muscle action. To summarize, terms such as flexion, extension, abduction, and adduction refer to changes in joint angles, terms such as concentric, eccentric, and isometric refer to changes in muscle length. It is correct to say a person hyper-extended his/her knee or elbow, but it is not correct to say that he/she hyper-extended a muscle.

The dangers of wooden bats

There was a very scary incident during the Cubs-Marlins game this past Sunday. You can watch the video by clicking here. Tyler Colvin was the runner on third base, when Wellington Castillo hit a line drive into the left field corner. Normally on a play like this, there is no danger for the runner on third base, as he can just jog home and score easily. On this play, Wellinton's bat broke, and a piece of it hit Colvin in the chest, right under the clavicle. Colvin was watching the ball to see if it would be fair or foul, and did not see the broken bat flying towards him. The puncture wound caused by the broken bat allowed air to enter the pleural cavity, basically trapping air in the space between the lung and chest wall, causing a pneumothorax. If not treated immediately, the lung on the side of the injury will collapse, resulting in pain, difficulty breathing, and a lack of oxygen. Colvin received immediate medical attention and was transported to the hospital, and he will make a full recovery and be able to play again next season. Hopefully this incident will cause Major League Baseball to re-examine the quality of bats used by players, especially the maple bats.

Hyperextension ACL Tear

I've blogged a few times in the past about ACL injuries, including Chipper Jones and Wes Welker. Both of these injuries were non-contact ACL tears. On Sunday, Leonard Weaver of the Eagles suffered a contact ACL injury when his knee was forced into hyperextension. You can watch the video here. I'll warn you, it is a pretty gruesome injury. His left foot is planted in the turf and the motion of his lower leg is stopped by the tackler as his upper left leg and body continue to move forward, forcing his knee into hyperextension and tearing the ACL. This is actually a good example of inertia (resistance to change in motion); his lower leg was stopped by the force applied from the defender, but his upper leg and upper body continued to fall forward due to their inertia (there was not a force applied to stop their motion), causing a bending moment at the knee, resulting in the hyperextension. Basically, the knee is not designed to bend in that direction, and when it does, an injury will occur. Many knee injuries in football are caused by blocking or tackling below the knee. There are some rules in place to prevent this from happening (chop blocks, clipping), but these injuries will always be a part of football.

It has began

The college football season began last night. While my first Alma mater, Southern Miss, did not play well at all, this is still an exciting time of the year. After spending parts or all of the season working with football teams at Southern Miss and Auburn as an athletic trainer during the middle of the past decade, it's nice to be a fan and just watch the games. However, many people take college football way too seriously, and forget that these are 18-22 year old student athletes. They are not paid to play football like players in the NFL. In addition to the countless hours spent on the practice field, film room, and game room, they also have to take 5-7 classes a semester. They are going to make mistakes on the field, and many fans get extremely upset when this happens. It's ok to get excited when good things happen and upset when they don't, but the outcome of a football game should not affect your mood for the entire week or cause you to yell derogatory comments at the players or other fans. Enjoy the game, but when it's over, remember that it is just that, a game.

Healthy Debate

In Motor Development, we are discussing how different constraints, such as individual, environmental, and task interact to influence movement and the development of movement. An interesting case to examine is that of Oscar Pistrorius. If you are not familiar with Pistrorius, he is a double leg amputee from South Africa that nearly qualified for the 2008 Beijing Olympics. He has shattered all Para-Olympic sprinting records. There was much debate, and still is, in the track world and the academic world about whether Pistorius should be allowed to compete against able bodied competitors. There are many that claim he has an unfair advantage due to the prosthetic legs, and others that claim he does not have an advantage and should be allowed to compete. This article examines both sides of the issue. Without going into too much detail, one of the arguments against Pistorius is that his prosthetic legs are less massive than the legs of able bodied competitors. One of the key determinants of running speed is stride frequency, or how fast the runner can place his or her foot on the ground, exert force, and swing the leg back through and touch the ground again. A less massive leg would require less force to accelerate than a more massive leg, which would increase stride frequency. One of the arguments for Pistorius is that the prosthetic legs put him a major disadvantage at the start of the race. As you can see in this video (Pistorius is in lane 5), he loses considerable ground at the beginning of the race because the design of his prosthetic legs cause him to stand up quickly, which results in more vertical force than horizontal force. As you can see, there are arguments on both sides of the coin. In this instance, there probably is not a right or wrong answer, but from a biomechanical and developmental perspective, it is good to debate.

My take on P90X

There are many workout programs on the market today, and many of them promise results in as little as 10 minutes a day, 3 days a week. Needless to say, I am skeptical of most of these. If you watch any amount of television, then you have undoubtedly seen the infomercials for P90X. A few months ago, my wife suggested that she would like for us to try and complete the P90X program together. I did some research on it, and since I had grown tired of just going to the gym and doing the same routine 4-5 days per week, we decided to give it a try. All you need is some space, dumbbells, pull-up bar, and yoga mat. We completed the 90 day program a few weeks ago and I have started on the P90X Plus program. I'll post some information about our experiences and opinions below.

1. This is an intense program, and you have to be dedicated to finish it. It requires a little over an hour of your time 6 days per week, and some days you may just not feel like working out. But, once you start the program, or pretty much any exercise program, you will likely be motivated to complete it. That said, with P90X, it requires a lot of time and effort, but we saw very positive results, such as strength gains, flexibility improvements, and an increase in cardiovascular endurance. It is not a "gimmick" workout program.
2. The workouts target every major muscle group in your body, which is good if you are a person like me that rarely ever concentrated on his lower body at the gym.
3. You can modify the workouts. Based on your fitness level and goals, you can change the number of repetitions of an exercise you perform, the amount of weight you use, etc. This is extremely helpful for those starting at a lower fitness level or not wanting to "bulk up."
4. The Yoga and flexibility workouts were extremely beneficial for me. Before starting this program, my flexibility was terrible. I knew it was terrible and knew that I needed to spend more time performing flexibility exercises, I just wouldn't do it on my own. Well, since this was part of the program, I was forced to do it. My hamstring flexibility was awful before beginning, I could probably only reach down about halfway between my knees and foot in either a standing or sitting position. After completing the program, I can bend over and put all 5 fingers on the floor, and I can also touch the bottom of my feet in a seated position.
5. We really enjoyed the workouts, they didn't seem to last an hour and we had a lot of fun. The workouts also have good warm-up and cool down periods.

Now, let me offer a few words of caution about the program.

1. This is an intense program, so you should be in relatively good shape before beginning. If you have any questions about whether or not to start, a visit to your physician is probably a good thing.
2. Tony Horton uses the terms "muscle memory" and "muscle confusion" during the infomercials and workouts. I've already blogged about the fallacy of muscle memory, and muscle confusion also does not exist. While a positive of the program is that you perform different exercises and routines, this does not result in muscle confusion. I'll have to do a blog post on muscle confusion in the near future.
3. Depending on what your goals are, this program may not be for you. If you are looking to make larger strength gains and really bulk up, or are just looking to lose a few pounds, then I wouldn't recommend P90X.

The most important thing to remember is to find some form of exercise that you enjoy doing that incorporates strength training, flexibility, and a cardiovascular component. It doesn't have to be P90X or some other fancy exercise routine. The best thing you can do for your long term health is to start moving!!

Impressive Resume

I wanted to take a few minutes to brag on a very successful coach in my family, my uncle, Larry Knight. This past Sunday, he was the manager for the East team in the Aflac All-American high school all star game, which was played at PETCO park in San Diego and broadcast nationally in High Definition. When he's not coaching in all star games, he is the head coach at Sumrall high school in south Mississippi. He has compiled a very impressive resume at Sumrall, winning 3 straight state championships, including going undefeated in 2009 and only losing one game this past season. Sumrall also set the Mississippi state record for consecutive victories this past season. Larry also won 4 state championships while coaching at Hattiesburg high school. I may be a little biased, but I think he has to be considered among the best coaches in Mississippi baseball high school history. I also have to mention that Larry's son and my cousin, Austin, is also a really good catcher for Sumrall. They have a great chance to win another championship in 2011.

Probable End of an Era

I was saddened by the news today that Chipper Jones tore the ACL in his left knee and will need reconstructive surgery. Now, although I am a huge Cardinals fan, I watched many a Braves game growing up because my mother loves the Braves. I also got to see Chipper play in person several times in Atlanta when I was doing my graduate work at Auburn. He is probably one of the best switch hitters to ever play the game, and I'm sure this is not how he wanted to end his career.

I've watched the video of the injury several times and there is really not a good shot of the injury. He jumps up in the air to make the throw to first, and tears his ACL when he lands on his left leg. It appears his left knee is almost fully extended, and there is some rotation of both the upper and lower legs as well. What likely happened to his knee can be seen in the picture above. This puts a tremendous amount of stress on the ACL and can cause a tear. Hopefully the surgery will go well and he can make a full recovery.

To Stretch or Not to Stretch

I apologize for the length of time between blog posts. I spent most of June traveling and have been busy with summer classes this past month. One of the places I went in June was to Philadelphia, PA, for the National Athletic Trainers Association annual meeting and symposium. I did a presentation on some of my ankle research and got to hear many presentations from leaders in our field. One of the talks was on stretching. There is debate in the scientific field and athletic community about the importance of stretching, when you should stretch, how much you should stretch, etc. The big questions are: does stretching improve or hinder performance, and what is the effect of stretching on injuries? I'll go through the questions now with my opinion and what was discussed at the conference.

1) What is the effect of stretching on performance? Most athletes do some type of stretching before practice or a game. There has been some debate in the literature about whether or not stretching right before a competition, especially one involving speed, will hinder performance. Basically, one theory is that stretching will make you slower. There is some evidence to support this, and some evidence that does not. The panel said that there is not enough evidence yet to support either theory, but that for most athletes, a dynamic stretching routine (one where the body is moving) is preferred over static (being still and holding a position) before practice or a game.

2) What is the effect of stretching on injuries? Another question is whether or not increasing flexibility will reduce or limit the potential for injuries. Again, there is not enough research to support the notion that increased flexibility will reduce the number of injuries. It has been established that you lose flexibility after an injury, and that regaining this flexibility is a key component of the rehabilitation program. It is also known that flexibility imbalances between the extremities, just like strength imbalances, may lead to injury. But, for example, there is no concrete evidence that says if you do not have this amount of hamstring flexibility, you are more prone to a hamstring strain.

So, to sum this up and give you my opinion, stretching and flexibility should be an important component of any exercise or rehabilitation routine. I think it is better to do more dynamic stretches before you exercise, practice, or compete, and static stretching should be done after a workout or if the goal is to increase range of motion. There is research to support that tight hamstrings and hip extensors can lead to low back pain, so it is essential to stretch these muscles. Until more research is conducted, the other questions cannot be answered.

Muscle Memory: Fact or Fiction?

A popular term that is tossed around among sportscasters and fitness professionals is "muscle memory." The basic premises behind muscle memory is the more you practice a skill, the better you become at it because the muscle "remembers" what to do. There is no doubt that proper practice yields improvement in performance, strength, coordination, etc. However, these changes are not due to muscle memory. There is no memory structure within the muscle itself, therefore, the muscle cannot remember or forget to do things. Every single muscle fiber is connected to the nervous system by the way of a motor unit. In order for a muscle to fire or contract, a signal must be sent to the fibers from the nervous system. The "memory" part is in the nervous system, and more specifically, in the brain. If you remember the first time you attempted to hit a baseball, shoot a basketball, ride a bike, etc., you were probably clumsy, uncoordinated, and had little success. Over time, you probably saw improvement. When we perform a skill we have little to no experience with, the nervous system does not know which muscles to recruit (activate), how many muscles to recruit, how frequently to recruit the muscles, and when to turn the muscles off. As we practice the skill, the nervous system begins to learn and remember, and recruits only the muscles needed to perform the skill, and at the right frequency and intensity. The nervous system also learns to turn off muscles that are not needed to perform the skill and would hinder performance. So, the theory of muscle memory is actually a complex process that involves both the nervous system and the muscular system. But, there is no memory structure within muscle, so the term muscle memory is fiction.

Perfect Game

This past Sunday, Dallas Braden, of the Oakland A's, threw a perfect game against the Tampa Bay Rays. There are many amazing feats in athletics, but to me, a baseball purist, throwing a perfect game may just top them all. There have only been 19 perfect games in the 100 year plus history of Major League Baseball. A perfect game requires a complete team effort. Twenty seven hitters are all retired without any of them reaching base. The pitcher cannot make any mistakes, such as walking a hitter, hitting a batter with a pitch, or leaving a pitch out over the middle of the plate that is likely to be crushed for a base hit. It also requires a tremendous effort on the part of the defense, to commit no errors, and likely make a great play or two to preserve the perfect game. Braden also accomplished this feat against the Rays, who at the time had the best record in baseball. A perfect truly is a rare and remarkable feat.

Just Admit It

Cincinnati Reds starting pitcher Edinson Volquez was suspended for 50 games yesterday by Major League Baseball for violating the substance abuse policy. His excuse: he was taking fertility pills to increase he and his wife's chances of having children. Sound familiar? Manny Ramirez was suspended for roughly the same thing last year. As a baseball fan and scientist, I have three issues with these athletes and their excuses. First, if Volquez, or Ramirez were using these drugs to increase fertility, they could have requested an exemption through MLB to use the drug. Last year, MLB granted 108 such exemptions. Many times fertility drugs are cycled along with steroids in an attempt to make the body produce more testosterone. So, if these drugs were really being taken for fertility reasons, why not get an exemption. Second, there is no scientific evidence that performance enhancing drugs make you a better pitcher or better hitter. However, there is research about the many negative side effects of these drugs. Why take a drug where there is no scientific evidence that it will enhance performance, but there is evidence of the negative side effects? Third, and this is more of a baseball issue, Volquez is currently on the disabled list recovering from Tommy John surgery, and isn't projected to be back in the majors until July/August. However, MLB is allowing him to serve his 50 game suspension while on the disabled list. This does not seem very fair, allowing a player to serve a suspension when the cannot play due to injury? Hopefully this issue will be addressed in the future.

Bad Injury, Amazing Play

This weekend during a college baseball game between Vanderbilt and Florida, there was an amazing play and horrific injury. Vanderbilt pitcher Corey Williams took a line drive off his right patella, but was able to find the ball and flip it to first base in time for the out. The x-ray of this patella is on the left, and you can see that it is clearly broken. He is to have surgery later this week to repair the bone. If anyone has ever broken their patella or just bruised it, they will tell you how painful it is. It is truly remarkable that he was able to gather himself and still throw the ball to first base for the out. Now, for a little information on the patella. The patella is a seasmoid bone located on the anterior (front) aspect of the knee. Anytime we flex and extend (bend) our knee, the patella moves in the femoral groove. The patella provides protection to the front of the knee, and it also increases the mechanical advantage of the quadriceps muscle. The patella is imperative to normal function of the knee. Corey is going to have a tough road ahead, but hopefully he will be able to return to pitching next season.

Corey Williams amazing play and injury

Switch Pitching

Being a big baseball fan, this story really caught my attention. I was listening to the radio on the way home from work yesterday, and they were talking about Yankees minor league pitcher Pat Venditte appearing in a minor league game agains the Braves and pitching both right handed and left handed. I'm sure that most people are familiar with the concept of "switch-hitting", where a hitter can bat either left-handed or right handed depending on the pitcher. In recent years, however, the number of switch hitters in the major leagues appears to be dwindling. It is very difficult to put in the practice hours to be an expert hitter from both sides of the plate. Even more difficult than switch hitting is switch pitching. But, that is what Pat Venditte is able to do as he attempts to work his way up the major leagues with the Yankees. Venditte has a special six finger glove so he can easily switch from a right handed pitcher to a left handed pitcher between batters. According to Rick Reilly of ESPN, only 3 pitchers have appeared in a Major League game and pitched with both arms. What is remarkable to me is that he has the ability to pitch proficiently with both arms. From a Motor Learning and Biomechanics perspective, that is very difficult to do; to achieve optimal neural activation of the muscles and movement coordination pattern of his non-dominant arm. Most people I know, including myself, look rather clumsy and uncoordinated when trying to throw with their non-dominant arm. Also, in order for him to be a proficient left handed and right handed pitcher, he has to put in twice the amount of work that a normal pitcher would. That includes rotator cuff exercises for both arms, drills using both arms, warming up both arms, practicing with both arms, etc. It really is a remarkable achievement and hopefully he will be able to progress and pitch in the Major Leagues.

Article and video from mlb.com of Pat Venditte

Tommy John Surgery

With spring training in full gear and opening day right around the corner, baseball injuries are starting to crop up. A common injury among pitchers is a tear of the ulnar collateral ligament (UCL). This ligament is found on the medial (inside) of the elbow and is critical to stabilize the elbow during the overhand throwing motion. Most of the time it is injured over time due to the repetitive stress placed on the ligament from overhand throwing. In 1974, Tommy John, a pitcher for the Dodgers, tore the UCL in his pitching arm. Up until this point, this injury was considered to be a career ending injury, much like an ACL tear was to a football player. Tommy John was not ready to quit playing baseball, so he asked Dr. Frank Jobe to invent a procedure to repair the ligament. Dr. Jobe took a tendon from John's forearm, and used this tendon as a replacement for the UCL. The surgery was a success and John won over 170 games after the procedure, which bears his name. Today, many of the best pitchers in baseball have had Tommy John surgery, including Chris Carpenter, John Smoltz, Josh Johnson, and A.J. Burnett. The tendon that is now commonly used as a replacement for the UCL is the palmaris longus. Rehabilitation after surgery generally takes 12-18 months, and will vary depending on whether the pitcher is a starter or a reliever.

Multiple Sclerosis

We are covering the nervous system in Applied Anatomy, and one of the diseases we have discussed is multiple scleroris (MS). I'm sure that most people have heard of MS or know someone that has this disease, but may not truly understand it. To really understand MS, we first have to discuss the axon. The axon is the long, cylindrical process of a neuron (nerve cell) that transmits the signal to the next neuron or muscle. Many axons are covered by a myelin sheath, which is made of lipids. The myelin sheath insulates the axon and increases nerve conduction velocity, meaning the signal travels down the axon faster with myelin. Multiple scleroris is a disease of the central nervous system (CNS). The myelination degenerates, and causes sclerosis (hardening) to occur at different places along the axon. In a way, MS is similar to atherosclerosis, in which arteries become hardened and blood flow is reduced or cut off. With MS, the nerve signal is either transmitted very slowly or not at all. MS affects both sensory neurons and motor neurons. Most people are diagnosed with MS between the ages of 20-40. The original symptoms are typically transient, unilateral blindness, or double vision. MS is diagnosed with a lumbar puncture. Because the nerve signal cannot reach the muscle, atrophy will occur (wasting away of skeletal muscle). Persons with MS will also have difficulty with fine motor movements and whole body coordination. There is no known treatment for MS, but most people can live fairly normal lives if the symptoms are managed properly. Here is an article on a former Auburn football player I worked with and his life with multiple sclerosis.

Physics of Curling

One of my favorite sports to watch during the winter Olympics is curling. Curling may seem simple and boring on the surface, but it is really a complex sport with much skill and strategy involved. There are two important principles of physics that influence curling. The first principle is friction. According to Newton's third law of motion, for every action there is an equal and opposite reaction. So, as the stone slides along the ice, it exerts a force on the ice, and the ice exerts a force back on the stone. Friction can be defined as the reaction of the ground to the forces exerted on it in the horizontal plane by the person or object (in curling, we are concerned with the stone). The friction force on the stone will act in the opposite direction in which the stone is moving, and will decrease the stones velocity, thus slowing it down. If the curlers want the stone to travel further, then they need to reduce the amount of friction. This is done by "sweeping" the ice in order to make it smoother and reduce friction. Sweeping is also done to make the stone "curl."

Another important principle of curling is collisions. One of the strategies in curling is to knock the other teams stone(s) out of the house (scoring area). This involves the collision of one or more stones. Collisions occur frequently in sports, such as hitting a baseball, tennis ball, volleyball, etc. Again, because of Newton's third law, when two objects collide, they exert equal and opposite forces on each other. The sum of the momentum of the two objects will be the same before and after the collision, therefore, there is a conservation of linear momentum. Momentum is defined as the mass of an object or system multiplied by its velocity. Most curling stones have a mass of around 20 kg. So, a stone with a mass of 20 kg and velocity of 7 m/s (meters per second) linear momentum (G) would be 140 kgm/s. When the stone that has been delivered collides with a stone in the house, a change in momentum will occur between the two stones. Because the mass of the stones will remain constant, the change in momentum will be related to the change in velocity of the two stones. Because of the conservation of linear momentum, if the stone in the house's velocity increases to 4 m/s (from 0 m/s before the collision because it was stationary) after the collision, than the stone that was delivered will have a decrease in velocity from 7 m/s to 3 m/s. Check out the video below for some good curling throws.

Top Curling throws

Southeast ACSM

This past Thursday, Dr. Hale and myself traveled to Greenville, S.C., for the annual meeting of the Southeast Chapter of the American College of Sports Medicine. This three day conference involved meetings and research presentations by faculty and students from across the southeast. I did an oral presentation Friday morning on lateral ankle sprains, and Dr. Hale had a couple of graduate students making presentations. Generally, ACSM is composed more of exercise physiologists than biomechanists, which was never more evident than at the student quiz bowl when they decided to skip the Anatomy category (this was not a popular move with the non exercise physiologists). However, the president of SEACSM, Dr. Grandjean, made a concerted effort to have more biomechanics presentations and tutorials at this year's meeting, and hopefully this trend will continue in the future. Regional conferences are generally more laid back than national conferences, and it is easier to network and discuss research and teaching with other professionals. As you can tell in the picture, we got about 3-4" of snow Friday evening, which was nice for me because we don't get a lot of snow in Mississippi. We plan on returning to the conference next year with a greater number of our students. We want to make Mississippi State a force at this regional meeting.

Dwight Freeny's Ankle Injury

One of the big stories leading up to the Super Bowl this weekend is the status of Dwight Freeny's ankle. Freeny, a defensive end, is one of the best players in the NFL. The media is not giving a very accurate description of Freeny's injury, calling it a "lower" ankle sprain, or "basketball" ankle sprain, so I thought I would try to help out. From watching the video of the injury, Freeny jumped up in the air, and his right foot lands on the foot of Jets quarterback Mark Sanchez. This forced his ankle into excessive inversion (pointing the bottom of the foot in) and plantar flexion (pointing the bottom of the foot down). This mechanism of injury will sprain the lateral ligaments of the ankle, which include the anterior talofibular ligament (ATFL), the posterior talofibular ligament (PTFL), and the calcaneofibular ligament (CFL). The lateral ankle sprain is the most common type of ankle sprain, accounting for about 85% of all ankle sprains. The media is also reporting that Freeny has a Grade III ligament sprain. A grade III sprain indicates a complete rupture of the ligament or ligaments. This would cause a great deal of pain and instability of the lateral ankle, making it difficult for him to push off and change directions. It typically takes several weeks or months to return from a grade III sprain, and may require surgery. I'm sure the Colts athletic trainers and doctors will be working with Freeny around the clock so that he can play Sunday, but I would say if the reports of the extent of his injury is true, he will have a hard time getting on the field.

What is going on?

I try to stay away from talking about coaching rumors and things like that, but since we have a lot of future coaches in our department, I feel like this is a topic worth discussing and learning from. The question is, what in the world is going on with Urban Meyer? On December 26, he announced that he is retiring from coaching due to "health reasons." We later learned that he had lost 20 pounds during the season, and had to be taken to the hospital after the SEC championship game due to chest pains. Most people know that college football coaches work very long hours, have poor diets, and do not get much sleep. The fact that he was stepping away due to his health and wanting to be there for his family seemed noble. But, the next day, he apparently changed his mind, deciding only to take an undefined "leave of absence" in order to take care of his health. Then, news came out this weekend that he apparently is not taking any time off. He said he tried to take a day and a half off, but that didn't work. So, the question becomes, does he really have health issues, more specifically, cardiac issues, that need addressing, or was he just tired at the end of the season and made a rash decision? I just don't understand how he can go from retiring one day because he is afraid of the consequences coaching has had and will have on his health, to now not taking any time off at all. I can only come to two conclusions based on these sequences of events. 1) His health is really not a problem, and he just overreacted initially, or 2) His ego is so big that he can't step away from coaching in order to take care of himself or his family. I just think that he owes some sort of explanation for all of this. Hopefully future coaches can learn from this situation, that they need to take care of themselves, and be honest with people, because the facts around Urban Meyer do not add up.

Incredible Streak

I know that most people are aware that UConn is one of the elite program's in women's college basketball, along with Tennessee. However, I'm not sure how many people are aware of the incredible streak that this team is on. After their win over Duke on Monday, UConn has now won 57 straight games. That by itself is very impressive. Any win streak over 10 games in any sport is difficult. But 57 wins in a row is almost impossible. However, that is not the most impressive thing about the streak. UConn has won each of these 57 games by at least 10 points, indicating that no team has even come close to challenging them. They recently defeated several top 10 teams by 30 points or more. They have an impressive collection of highly skilled athletes as well as a great coach. There is little doubt that they will shatter the previous top winning streak in women's basketball of 70, also held by UConn from 2001-2003. If you have a chance to watch them play on television, then take the time to do it. This is history in the making.

Mike Leach Firing

I promised to give my take on the Mike Leach firing at Texas Tech, so here it is. In case you aren't familiar with the details, one of Tech's players, Adam James, claimed that Leach locked him in a closet and made him stand for 3 hours during practice on two occasions because he had a concussion and could not practice. There is this release where Texas Tech head athletic trainer Steve Pincock stated that Leach instructed him to "lock" James in a dark place, and that he disagreed with Leach's treatment of the player. Team physician Dr. Michael Phy also stated he did not agree with this treatment. However, Leach says that he did not force James to stand in a closet, and has filed a lawsuit against Texas Tech over the firing. But other players have come out and publicly questioned Leach's handling of players. The fact of the matter is, we will never know the entire truth. As an athletic trainer, I can promise you that the protocol for handling a player with a concussion during practice is not locking them in a dark closet and having them stand for 3 hours. If Leach truly had the player do this, then he deserved to be fired. From all indications, Leach appears to be a "quirky guy", who did not exactly have the best people skills. Treating an injured player in this manner is just not acceptable. Some people may question the athletic trainer for following Leach's orders. In his defense, he was really in a tough position. The head coach is essentially your boss, and most of them make millions of dollars and have the power to fire the athletic trainer. It can be a tough relationship. As an athletic trainer, your job is to look out for the medical interests of the athletes and place their personal health above everything else. As a coach, your job and goal is to win, and sometimes these two areas collide. If this alleged abuse of an injured athlete was true, then hopefully this incident will shed light on the situation and prevent these circumstances from occurring again.

Mark McGwire Comes Clean

I don't think anybody will be surprised by Mark McGwire's admission (see link below) today that he used steroids during his playing career. Almost 9 years after he retired, he finally came clean about his use of steroids, beginning in 1989. Now, as most people know, I am a huge Cardinals fan, and was a huge McGwire fan after he was traded to the Cardinals in 1997. I remember going to St. Louis for the first time in 1999 and watching McGwire launch balls during batting practice into the 3rd deck at Busch stadium with little effort. It still remains one of the most amazing sporting spectacles I have ever seen. As we have learned lately, steriod usage during this time in baseball was rampant, with confirmed use by Jose Canseco, Ken Camminiti, Andy Pettite, Alex Rodriguez, Mark McGwire, and Rafael Palmerio, just to name a few, and it is highly likely that others such as Barry Bonds, Roger Clemens, and Sammy Sosa were also using steroids. As a baseball purist, I feel this drug use tainted the game, but so many players were using them, that it is hard to determine what to do with the statistics during this era. Although I do not condone the use of steroids, there is some good that can come out of these admissions. Hopefully McGwire will use his platform as a star athlete and current hitting coach of the Cardinals to educate young athletes on the many dangers of steroid use (see second link below) and how it is a shortcut to success. If he will continue to answer all questions about his past usage, and become a spokeperson against the use of sterioids, then I think he deserves our forgiveness and the right to continue his professional career now as a hitting coach. Hopefully others that have made this mistake will also come clean and speak out against steroids.

Mark McGwire comes clean

Dangerous effects of steroids

Keeping those New Year's Resolutions

With the new year comes many resolutions to start or increase the amount of exercise. However, many people struggle to maintain these exercise habits for a month, let along the entire year. Here are some tips to keep those resolutions and get into shape.

1. Start off small. If you haven't exercised regularly for a long period of time, don't begin by trying to run 5 miles a day. Start off walking 1-2 miles, and gradually build up to alternating between to jogging and walking, and eventually jogging if this is your goal.
2. Be realistic. Again, do not start off trying to exercise 6-7 days a week. Begin by exercising 2-3 days a week, for 30-45 minutes at a time, and gradually build up to 4-5 days a week.
3. Make exercise a priority. On the days you plan to exercise, make sure it is a priority. Schedule a time during the day to go to the gym or exercise outside, and stick with this schedule.
4. Try to alternate resistance training with aerobic exercise. You do not have to become a power lifter, but mixing some light weight training 2-3 days a week in with walking/jogging, etc. will not only help build/tone muscle but will also burn more calories.
5. Realize there are many ways to exercise. You do not have to run 3-5 miles a day to enjoy the benefits of exercise. If you like to walk, walk. If you want to swim, swim. If you like to cycle, ride a bike. Get on the elliptical machine. Alternate between different modes of exercise in order to avoid burnout.
6. Have fun. If you make exercise part of your routine, and view it as a way to become healthy and relieve stress, you will be much more successful at maintaining a regular exercise routine.

Wes Welker Knee Injury

If you watch the NFL or SportsCenter, you have probably heard/seen the injury to Patriots wide receiver Wes Welker yesterday. During the 1st quarter, after making a catch, Welker planted his left foot into the turf and attempted to cut to avoid a defender (see link below). When he did this, a large valgus and rotational force was applied to his knee, causing excessive stress on the medial and anterior side of his left knee, resulting in a tear of both the medial collateral ligament (MCL) and anterior cruciate ligament (ACL). He also likley injured his medial meniscus, which along with the MCL and ACL comprises the "unhappy triad" of the knee. He will need surgery to repair the damaged ligaments and likely damaged meniscus, and the rehabiliation from this type of injury will be lengthier than a typical ACL reconstruction due to the multiple structures involved. His return for next season will depend on many factors, such as how his body responds to the surgery, potential setbacks during rehabiliation, and getting back into playing condition. Hopefully he will be able to make a complete recovery but this will defnitley increase the debate about resting players for the playoffs.

Wes Welker Injury Video

Happy New Year

Just wanted to wish everyone a Happy New Year!! I'll be back next week with a blog sharing my opinion on the Mike Leach-Adam James situation from a medical/athletic training perspective after more information has been released.