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.