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Nutritional Intake of Overtrained Athletes May Be Insufficient In a pre-release article from the British Journal of Sports Medicine (1st March 2007) on the Risk of Hepatitis B infections in Olympic wrestling, it was identified that, although Hepatitis B is classified as a blood-borne pathogen and one of the 10 leading causes of death, it is not just found in blood placing people more at risk of infection of Hepatitis B without blood exposure. The research was done on 70 Olympic wrestlers and although none of those studied had experienced Hepatitis B, 12.9% of them had positive results for detection of Hep B DNA. This could have occurred as a result of the surprising finding that Hepatitis B DNA was detected in 11.4% of those studied through their sweat. The incidence of sweat Hepatitis B DNA (11.4%) is reportedly close to that reported to occur in blood (12.2%). This has huge implications on how we deal with injured players. As a result of this finding it has been identified that transmission of Hepatitis B may also occur through sweat. Based on this it is recommend that you have your Hepatitis B status reviewed and if your not covered have the vaccines. If you have had them and, if you have not been tested in the last 5 years, you should go and check your Hep B status to ensure your covered. It may just mean one more shot to complete this conversion. Nutritional Intake of Overtrained Athletes May Be Insufficient June 5, 2007 (New Orleans) — There is a significant difference in nutritional intake between overtrained and nonovertrained athletes, according to a study presented at the 54th annual meeting of the American College of Sports Medicine. Overtraining syndrome (OTS) commonly affects athletes of all levels; is characterized by symptoms that mimic depression, apathy, fatigue, exhaustion, irritability, and appetite loss; and is associated with a decrease in motivation and athletic performance. The study, presented by Dina Christina Janse van Rensburg, MD, a specialist in sports medicine at the University of Pretoria, in Hutfield, South Africa, compared nutritional intake in OTS athletes and non-OTS athletes. A total of 33 study volunteers (12 to 48 years old) from athletic clubs who completed questionnaires detailing their nutritional intake each training day, the average time they spent training per week, and their emotional states were divided into 2 groups: OTS and NOTS athletes. To exclude other causes of fatigue and depressive symptoms, the researchers also examined general clinical history, history of performance, and nutritional data; clinical examinations and bloodwork were also performed. Computer analysis (Food Finder program) was used to obtain exact levels of macro- and micronutrients for each athlete. There was a significant difference in the time spent training per week claimed by the 2 groups (mean OTS, 17.5 hours vs mean NOTS, 11.5 hours; P = .0311). Although there was no significant difference in nutritional intake per kilogram of weight in total energy, protein, carbohydrate, fat, or micronutrient intake between the groups, more of the NOTS athletes ate a recovery meal than the OTS athletes (41.6% vs 27.27%). The energy intake per kilogram weight divided by the hours of training per week showed significant differences in total energy intake for protein and carbohydrates, but not fat. The researchers concluded that the nutritional intake of the OTS group was insufficient to meet their energy demands, which probably contributed to their OTS symptoms. Further study and larger trials are needed to investigate the decreased use of recovery meals following exercise and the relatively greater ingestion of fat in OTS athletes. Dr. van Rensburg said, "We found that the overtrained athletes are usually the very ambitious ones, with more training sessions [than the others], and they don't give themselves enough recovery time; added to that, they don't take enough calories. But they don't lose weight. Their bodies go into a sort of starvation mode." Lexa W Lee A New Test for Detecting Subscapularis Muscle Tears A new and relatively sensitive test for Subscapularis muscle tears was found while perusing the literature by one of our members. This study compared the Bear-Hug test with the other standard tests of subscapularis function (lift-off, belly-press, and Napoleon tests). The hypothesis was that the bear-hug test would be the most accurate of all tests for detecting relatively small tears of the upper subscapularis. As most subscapularis tears are considered early surgical priority, the ability to diagnose them clinically and refer for specialist assessment with minimal delay would potentially result in better surgical outcomes. The 2 senior authors in this study (S.S.B. and J.F.B.) noted arthroscopically that many tears of the subscapularis were not detected preoperatively by these standard tests and they developed the new “Bear Hug” Test to attempt to improve clinical accuracy in diagnosing subscapularis tears. Method: The Bear-Hug test uses resisted internal rotation as the palm is held on the opposite shoulder while the elbow is held in a position of maximal anterior translation.
The bear-hug test was considered positive if the patient could not hold the hand against the shoulder or if he or she showed weakness of resisted internal rotation of greater than 20% compared with the opposite side. If the strength was comparable to that of the opposite side, without any pain, the test was negative. A painful bear-hug test without weakness was recorded as a separate category but was presumed to be negative. The strength was measured using a dynamic tensiometer, and results of the test were compared with diagnostic arthroscopy for sensitivity and specificity in diagnosing subscapularis muscle tears, and the extent of tear. Results: The Bear-Hug test exhibited higher sensitivity and negative predictive value, and % accuracy than the other tests for subscapularis muscle tear. Positive Bear-Hug and Belly Press tests suggest a tear of at least 30% of the subscapularis muscle.
Conclusion: The bear-hug test is the most sensitive clinical test for subscapularis function. Clinical examination should include the lift-off test, belly-press test, Napoleon test, and bear-hug test to optimize the chance of detecting and predicting the size of a subscapularis tear. Positive bear-hug and belly-press tests suggest a tear of at least 30% of the subscapularis, whereas a positive Napoleon test indicates that greater than 50% of the subscapularis is torn. Furthermore, a positive lift-off test is not seen until at least 75% of the subscapularis is torn. Even so, 40% of subscapularis tears were missed clinically on preoperative physical examinationin this study. Reference: (2006). Barth JRH, Burkhart SS, De Beer JF. The Bear-Hug Test: A new and sensitive test for diagnosing a subscapularis tear; Arthroscopy, 22 (10), 1076-1084. Swollen ankles-recalcitrant paratendon effusion (achilles/patella etc.)-post total knee surgery effusion?? Have you tried Washing Soda????? Here is snippet that I learnt from Craig Purdam at the Australian Institute of Sport some years ago and since have refined the application myself over the years with startling success.This is a treatment I have my patients use overnight to allow more mobility in the morning and a substantial decrease in associated pain.
Voila!!! Reduced swelling and clean clothes!!! How does it work???? Sodium carbonate decahydrate (Na2CO3·10H2O) is a colorless, transparent crystalline compound commonly called sal soda or washing soda. Pure sodium carbonate is a white, odorless powder that absorbs moisture (hydrophilic), has an alkaline taste, and forms a strongly alkaline water solution. It is one of the most basic industrial chemicals. Because seaweed ashes were an early source of sodium carbonate, it is often called soda ash or, simply, soda. The principal uses of sodium carbonate are in the manufacture of glass and the production of chemicals. Domestically it is used as a water softener during laundry. It competes with the ions magnesium and calcium in hard water and prevents them from bonding with the detergent being used. The reason why it works to decrease swelling is because as mentioned above, it is hydrophilic. Hydrophile, from the Greek (hydros) "water" and φιλια (philia) "friendship," refers to a physical property of a molecule that can transiently bond with water (H2O) through hydrogen bonding. This is thermodynamically favorable, and makes these molecules soluble not only in water, but also in other polar solvents. There are hydrophilic and hydrophobic parts of every cell membrane. So the washing soda draws any moisture from the subcutaneous tissues. That is also why when using a topical NSAID for phono /ionto-phoresis the cream/gel should contain both properties. i.e Voltaren Emugel-but that’s another story!! Tony Schneiders PhD
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