Football Hydration

By: Kirby Talman, ATC

It’s August and football two-a-days are starting today; have you had enough fluids? You want to make sure your body is properly hydrated to be able to perform to the best of its ability and to prevent the risk of dehydration and other heat illnesses. These are recommendations for fluid replacements for athletes during a performance.football sweatEvaporation of sweat from the skin is the primary way the body is cooled down as the core temperature rises during exercise. Sweating is the release of fluids from the body’s glands.  The sweating rate is related to exercise intensity, individual differences, environmental conditions, acclimatization, clothing, and baseline hydration. It’s important that your body has adequate fluids pre-, during, and post- exercise.

football hydrationAccording to the National Athletic Trainers’ Association, the athlete should consume 17 to 20 fluid ounces (fl oz) of water or sports drink 2 to 3 hours prior to exercise. About 10-20 minutes pre-exercise, consume 7 to 10 fl oz of water or sports drink. During exercise, the athlete should consume 7 to 10 oz of water or sports drink every 10 to 20 minutes. If bouts of exercise exceed more than 45 to 50 minutes, include carbohydrates in the drink. The optimal concentration of carbohydrates in the drink should be 6 to 8% per a liter, for example sports drinks. Fruit juices and sodas are not recommended and have concentrations higher than 8%. During games or long distance running, the athlete should consume the most fluids possible to maintain hydration. Fluids should be readability available, flavored football hydration 2to the athlete’s preference, and at a cool temperature. After exercise, athletes should replenish their fluids lost within two hours and no more than six hours.  One way to ensure you are properly hydrated is by the color of your urine. If your urine is clear, or has just a light yellow hue to it, you are doing well on hydration.

If an athlete is not properly hydrated, they are at risk for dehydration and other heat illnesses. Dehydration occurs when the loss of fluids, mostly water, exceeds the amount that is taken in. General signs and symptoms include headache, weakness, dizziness, cramps, chills, vomiting, nausea, and decreased performance. Dehydration occurs when the athlete loses more than 1 to 2% of body weight and if the athlete loses more than 3% they are at risk for other heat illnesses (heat cramps, heat exhaustion, or heat stroke). Proper hydration plays a key role in athletic performance.

References:

Casa, D. J., Armstrong, L. E., Hillman, S. K., et al.  (2000) National Athletic Trainers’ Association Position Statement:  Fluid Replacement for Athletes.  Journal of Athletic Training, 35(2), 212-224.

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ACL Injury Prevention

ACL Program 2015

This class meets twice a week on Tuesdays and Thursdays for six weeks

Go to www.chkd.org/classes to register

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What Are Bruises?

By: Kate Elkins, ATC

Thigh BruiseHave you ever wondered what a bruise is? We all get them, some more than others. Why is that? Have you ever seen a bruise heal? Such a bright array of colors: reds, purples, blues, greens, and yellows. A beautiful rainbow of pain. Where do they all come from? Anyone can tell you how to get them, whether banging your shin on the coffee table or taking a line drive right to the thigh, but almost no one can tell you their physiology.

Definition

A bruise is caused when tiny blood vessels are damaged or ruptured as the result of trauma to the skin, muscle, or even bone. The raised area of a bump or bruise results from blood leaking from these injured blood vessels into the tissues as well as from the body’s response to the injury. A bruise is medically referred to as a contusion.4

Why do some people bruise more easily than others?

Age plays a large role when it comes to bruising. The capillaries (tiny blood vessels) are more delicate in the elderly population. Minor bumps and scrapes that leave no trace on a child may leave significant bruising on an elderly person.

The amount of bruising may also be affected by medications which interfere with blood clotting (and thus cause more bleeding into the skin or tissues). These drugs include many arthritis medications called nonsteroidal anti-inflammatories (for example, ibuprofen [Advil, Nuprin] and naproxen [Aleve]) and over-the-counter medications, such as aspirin. Warfarin (Coumadin) is often prescribed by doctors specifically to prevent clotting in patients who have had blood clots in their legs or heart. Warfarin can cause severe bruising, especially if the level of the medication becomes too high. Cortisone medications, such as prednisone, promote bruising by increasing the fragility of the tiny blood vessels in the skin. 2

Why do bruises change color?

Bruises change in appearance over time. As a result of the ruptured blood vessels, a blood pool reservoir is formed at the site of injury, appearing reddish, reflecting the color of the blood in the skin. By one to two days, the reddish iron from the blood undergoes a change and the bruise will appear blue or purple. The hemoglobin (iron-containing oxygen-transport protein in the red blood cells) starts to diffuse into the dermis and towards the skin surface.1  Simultaneously, the released blood triggers an inflammatory response in the tissue. Activated macrophages (white blood cells in charge of eating and digesting anything that does not belong) break down the hemoglobin.3 By day 6, this break down of hemoglobin forms biliverdin (responsible for a greener bruise pigmentation) which is then by day eight to nine, rapidly transformed into bilirubin (responsible for the yellower bruise pigmentation).5 In general, the bruised area will be repaired by the body in two to three weeks after which the skin will return to normal.

Bruise StagesWhat is the treatment for bruising?

There are a couple of things that you can do to prevent or minimize bruising after an injury. First, try a cold compress. This can be as simple as a frozen bag of peas or as fancy as a commercial cold pack. The cold causes a constriction of local blood vessels which reduces the blood flow to the area. In most cases blood flow is a good thing, however in this instance reduced blood flow may decrease the size of the bruise by limiting the amount of bleeding into the skin. Avoid taking the medications listed above that can contribute to bruising. Finally, apply pressure to the area by hand or bandage to reduce internal bleeding.2

References

  1. Bohnert M, Baumgartner R, Pollak S. Spectrophotometric evaluation of the colour of intra- and subcutaneous bruises. Int J Legal Med. 2000;113(6):343–348. doi: 10.1007/s004149900107.
  2. Bumps & Bruises (Contusions & Ecchymoses). MedicineNet. 2014
  3. Langlois NE, Gresham GA. The ageing of bruises: a review and study of the colour changes with time. Forensic Sci Int. 1991;50(2):227–238. doi: 10.1016/0379-0738(91)90154-B.
  4. Randeberg LL, et al. A novel approach to age determination of traumatic injuries by reflectance spectroscopy. Lasers Surg Med. 2006;38(4):277–289. doi: 10.1002/lsm.20301
  5. Stam B, et al. 3D finite compartment modeling of formation and healing of bruises may identify methods for age determination of bruises. Med Biol Eng Comput. 2010 September; 48(9): 911–921. Published online 2010 June 16. doi: 10.1007/s11517-010-0647-5
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Delayed Onset Muscle Soreness

By: Christine Minor, MSEd, ATC

Being physically active, whether it be in your sport of choice, a particularly hard workout at the gym, or an outdoor activity like a long hike that you aren’t accustomed to doing, can induce delayed onset muscle soreness (DOMS).  Symptoms of DOMS are variable and can range from slight muscle stiffness that subsides easily to severe muscular pain that can restrict normal movements. Typically the intensity of DOMS increases within the first 24 hours after exercise, reaches its peak between 24 and 72 hours and resolves within 5 to 7 days.

DOMS 2DOMS 1

 

 

 

 

 

DOMS may also have a negative impact on athletic performance.  The soreness of the muscles may result in changes in the muscle function and joint mechanics.  Various researchers have found that DOMS may reduce athletic performance by decreasing joint proprioception, decreasing joint range of motion, changing recruitment patterns of the muscles, and even may cause an increased risk of injury.  Athletes may also adapt by changing their movement patterns, which could also lead to a decrease in athletic performance.

DOMS 3So now what is there to do about DOMS?  Massage is a common treatment that can help prevent or treat DOMS, but for most it is not feasible to have done on a regular basis.  Here is where foam rolling can be used as an alternative treatment.  Foam rolling is a form of self-massage where people use their own body mass to exert pressure on the muscles. The motions place direct and sweeping pressure on the soft tissue, causing it to stretch.  This pressure resembles that of a manual massage by a massage therapist.

Foam rollers can be used on various muscles and tissues such as the Hip Flexors, IT Band, Hamstrings, Quadriceps, Glutes, Calves, and Upper/Middle Back. Foam rolling has also been shown to be effective in treating the physical pain associated with DOMS and increasing physical performance in standardized field tests when performed immediately after intense exercise and then every 24 hours after through 72 hours post exercise. In 10 -20 minutes of time it is possible to give your sore muscles a self massage and decrease the effects of DOMS.

How to videos:

http://www.runnersworld.com/running-tips/roll?page=single

Resources:

Armstrong RB. Mechanisms of exercise induced delayed onset muscle soreness: a brief review. Med Sci Sports Exerc. 1984;16(6):529-538.

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ACL Program 2015

This class meets twice a week on Tuesdays and Thursdays for six weeks

Go to www.chkd.org/classes to register

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