Another high ankle sprain

I like to blog about ankle injuries, since this is my primary research interest, and have blogged in the past about high ankle sprains. Well, another happened this weekend, this time to New England Patriots tight end Rob Gronkowski. After catching a pass in the 3rd quarter, he was tackled from behind, and the defender landed on his lower leg, forcing his ankle into hyper dorsiflexion and eversion. You can see the video here. Many times lineman suffer high ankle sprains when their lower leg gets hit from behind during a pile up, but this injury happened in the open field. Both of these players had a lot of momentum (which is the product of mass and velocity) and when Gronkowski was hit from behind, much of the defender's momentum was transferred to his lower leg, causing the hyper dorsiflexion and eversion. This mechanism of injury will stretch or possibly tear the ligaments above the ankle that help hold the tibia and fibula together. The good news for Gronkowski is that there is two weeks before the Super Bowl. The bad news is that high ankle sprains have a slow rate of healing, due to the mechanism of injury and because when he does return to practice, he will place stress on the joint. My best guess is that he will be able to play but will be limited due to the injury.

First Post of 2012

I apologize for the lengthy delay between posts. I got caught up with the holidays and the end of the year and neglected my blogging duties. It was nice to have a break from work and spend some time with the family. Cameron continues to grow at a rapid pace, weighing in at 22.65 pounds and measuring at 28 inches at his 9 month appointment. He is now in the 90% for weight and 50% for height, which is remarkable considering he started out in the 5-10% for both when he was born. He has learned to clap and wave and I'm sure he will take off crawling any day now. I was able to use him as an example in my Motor Development class last semester and hope to use him again this semester in Motor Learning. He is really doing well with his fine motor skills, such as reaching and grasping, but struggling some with his gross motor skills. In addition to Motor Learning, I am teaching Anatomical Kinesiology and Sport Biomechanics this semester. I plan to continue with my ankle research and also begin a couple of new research projects as well. My goal is to blog at least once a week in 2012, which I have already failed to do since it is the second week of the year. I'll be back next week with more.

To Stretch or Not to Stretch: Part II

About a year and a half ago, I did a blog post on whether or not you should stretch before or after exercise. Yesterday, an article came out in the New York Times summarizing recent research on the role of stretching in preventing injury, muscle soreness, etc. Basically what the authors summarized was that stretching does not reduce the number of injuries or muscle soreness. On the other hand, stretching does not increase the number of injuries or muscle soreness. This does not mean, however, that stretching is bad and that you should not do it. If you like to stretch before or after a workout, and it makes you feel better, then you should continue to stretch. If you do not stretch or do not want to stretch, then at this point, there is no scientific evidence available that states you are at greater risk for an injury or muscle soreness.

Dislocated Elbow

The elbow, being a true hinge joint, is one of the most stable joints in the body. It is formed by the articulation of the humerus, radius, and ulna. Dislocations of the elbow are rare, however, there seems to have been a few more elbow dislocations lately. It takes a very large force to dislocate the elbow, and most dislocations occur in the posterior (backwards) direction. If you do not like to look at pictures of injuries, I would advise you not to scroll down any further. But, if you do and would like to learn, take a look at the pictures and video.

This injury occurred this summer during the NBA playoffs. Rando, the injured player, got tangled up with Wade. As he landed, he put his arm out to brace his fall, and the force from the ground caused the resulting elbow dislocation.
This injury occurred during the 2008 Bejing Olympics. The weightlifter was attempting to lift a very large amount of weight, and the force from the barbell caused the forearm to be forced posteriorly (backwards) in relation to the upper arm.

This injury occurred last week during the Oregon-California game, and was very similar to the basketball injury. The running back was being tackled and when he attempted to brace his fall, he dislocated his elbow. Once a physician reduces the dislocation, it is possible to make a fairly quick return to play (except for the weight lifter) while wearing an elbow brace to stabilize the joint. This must be treated as a serious injury, because there are many nerves and blood vessels that run behind the elbow that could be damaged by the dislocation.

Motor Milestones

We have been discussing infant reflexes, spontaneous movements, and motor milestones in motor development the past few classes. Since Cameron is now 6 months, I thought I would post pictures of him achieving these milestones. I will do another post once he turns 12 months in order to show the next stage of milestones he will progress through.

Spontaneous arm and leg movements

Lifting head

Smiling

Lifting head and shoulders, rolling over

Reaching and grabbing feet

Smiling some more

Sitting with support
Reaching and grasping

Sitting with slight support

Dangerous situation

If you keep up with the NFL, then you know that Peyton Manning just had his third neck surgery in the past two years. This one was more serious than the first, and involved removing the disc between two of his cervical (neck) vertebrae, which will allow the two bones to fuse together. If you look at the picture above, you can see the nerve roots coming out of the side of the spinal cord, and the herniated disc is pressing, or impinging on the nerve root. These nerve roots carry motor signals from the brain down to the muscles, telling them when to contract and relax, and they also carry sensory information, such as touch, temperature, and pain, up to the brain. When the disc impinges on the nerve root, it disrupts these signals, causing muscle weakness (because the signal has trouble getting to the muscle), pain, discomfort, etc. Peyton's first two surgeries were less invasive and attempted to increase the space for the nerve root to pass through. The first surgery allowed him to play last year, but he began having many of the above symptoms after the season concluded so he had a second surgery in May. As Peyton prepared for this season, he was still having some of these symptoms, including weakness in his triceps muscle. This muscle extends the elbow and is crucial for a quarterback attempting 40 to 50 passes a game. Cervical nerve root seven innervates the triceps, so this leads me to believe his problem was the disc between the sixth and seventh cervical vertebrae. The doctors say Peyton should regain full function and be able to play football again. However, the risk of future injury is greater, and when you are dealing with the neck, it is an especially delicate situation. Peyton is only 35 years old, and hopefully has a long life ahead of him. I am not sure it is worth the risk to continue to play football if it could jeopardize his quality of life. But, that is his decision.

Motor Development

One of the classes I am teaching this semester is Motor Development, and I have such an invaluable resource to use this semester. That would be Cameron, my almost five month old son. I was working on some future lectures and came across his two month ultrasound picture from a year ago (above). I've also attached a recent picture of him (below) to show just how much he has grown and developed in a year. It will be fun and interesting to watch and track his growth and development as I teach about it this semester.