Training for a Triathlon

The 2014 Seattle Seafair Triathlon and Kids Seafair Triathlon will take place on July 20, 2014. OSS is the Presenting Sponsor for these events and the orthopedic surgeons would like to congratulate the athletes who are coming out to be part of this event.

Training for a triathlon is tough but that’s part of the challenge. Consider this: Four out of five amateur triathletes are injured while training, and three of those four are injured badly enough to affect their daily activities.

The complexity of the sport and broad range of knowledge needed to train and compete safely are contributing factors. The triathlete must learn about appropriate equipment specifications, proper body mechanics, injury prevention and overall training programs that prepare the body for the stresses of triathlon.

Cross-training for three different events also increases the risk of certain overuse injuries, and an untreated injury in one part of the body can lead to problems elsewhere. For example, a knee injury from running can cause extra stress on the back, leading to lower back pain when cycling; and the cumulative effects of swimming and cycling can fatigue calf muscles, making legs more susceptible to injury during a run.

The good news is, most nontraumatic injuries are related to training errors that can be corrected – and professionals with specialized knowledge in triathlon training and injury prevention can help.

Prevention: Training Smart

The best way to avoid a traumatic injury is a training program that balances strength, flexibility and endurance through appropriate weight-lifting, stretching and cross-training. But training techniques are not one-size-fits-all. Every individual has a unique combination of anatomy, strength, endurance, and flexibility – so what works well for one athlete is not always the best advice for another.

Understanding the complex interactions between musculoskeletal groups related to swimming, cycling, and running is essential in triathlon training. An OSS surgeon can evaluate your physical conditioning, analyze your training techniques and correct errors that can lead to future injuries, and provide a training program optimized for you as an individual.

The best training program can’t prevent all injuries. When injuries do occur, there are three things you need to know: (1) how to evaluate the severity of an injury, (2) how to self-treat an overuse injury, and (3) when to seek professional help.

Dr. Weil has this to say about the upcoming triathlon and words of wisdom when it comes to training for a triathlon, “I’d like to congratulate all the triathletes participating in the 2014 Seafair Triathlon! I’d also like to send a special congratulations to the first time triathletes participating in this year’s event. As you all know training for and participating in the sport of triathlon involves a huge commitment on the part of athletes and their families. Unfortunately, sometimes things don’t go as planned and injury can derail even the most experienced triathletes. I have experienced this issue first hand from all perspectives, as a treating physician, as a 2013 Ironman Canada Finisher, and currently as an injured athlete in rehabilitation trying to get back to the sport. When the unforeseen occurs, it is always best to seek medical evaluation. Often times if issues are addressed early on, they can be treated without significant time loss from training and without surgery. It is my goal as a treating physician to understand athletes needs and to work together with athletes to help them return to sport as soon as possible.”

If you believe you are suffering from a sport-related injury and need specialized orthopedic care, the orthopedic surgeons at OSS provide excellent treatment options for your injury. Please feel free to contact OSS at (206) 633-8100 to schedule an appointment.

2014 FIFA World Cup Injuries Affecting Field of Players

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Several prominent figures for this year’s World Cup event have been lost to injuries. The list includes:

  • Franck Ribery – France
  • Radamel Falcao – Columbia
  • Marco Reus – Germany
  • Kevin Strootman – Netherlands
  • Luis Montes – Mexico
  • Riccardo Montolivo – Italy
  • Christian Benteke – Belgium
  • Theo Walcot – England
  • Roman Shirikov – Russia

Leg fractures to rolled ankles have plagued this year’s field of players throughout the world. It’s not unusual for injuries to strike before the World Cup, due in part to the increasing demand on players during the club season and the brief turnaround before reporting to national team duty ahead of the sport’s premier competition.

Sepp Blatter, president of FIFA, which puts on the World Cup, blamed “too long a [club] season and always the same players [from the elite clubs] are always in the same competitions. Now they are tired.”

Fatigue is not responsible for all injuries. Muscular ailments occur at all stages of the season, while missteps and reckless tackles are also to blame. Falcao suffered a knee injury in January.

According to U.S. midfielder, Michael Bradley, “There [are] certain things as players you do to try to prevent injuries, to try to stay fit, but at the end of the day, you step on the field, you play, you leave everything out on the field and unfortunately things happen at times.” He goes on to say, “No player ever wants to see anybody else get hurt and have to miss a big game, a big tournament.”

Common soccer injuries include:

  • Lower extremities – Sprains and strains are the most common lower extremity injuries. The severity of these injuries varies. Cartilage tears and anterior cruciate ligament (ACL) sprains in the knee are some of the more common injuries that may require surgery. Other injuries include fractures and contusions from direct blows to the body.
  • Overuse of lower extremities – Shin splints (soreness in the calf), patellar tendonitis (pain in the knee), and Achilles tendonitis (pain in the back of the ankle) are some of the more common soccer overuse conditions. Soccer players are also prone to groin pulls and thigh and calf muscle strains.
  • Upper extremities – Injuries to the upper extremities usually occur from falling on an outstretched arm or from player-to-player contact. These conditions include wrist sprains, wrist fractures, and shoulder dislocations.
  • Head, neck and face injuries – Injuries to the head, neck, and face include cuts and bruises, fractures, neck sprains, and concussions. A concussion is any alteration in an athlete’s mental state due to head trauma and should always be evaluated by a physician. Not all those who experience a concussion lose consciousness.

Treatment options to soccer injuries include:

  • Stop participation immediately until any injury is evaluated and treated properly.
  • Most injuries are minor and can be treated by a short period of rest, ice, and elevation. Contact the physicians at Orthopedic Specialists of Seattle (OSS) to evaluate an injury.
  • Overuse injuries can be treated with a short period of rest, which means that the athlete can continue to perform or practice some activities with modifications.
  • In many cases, pushing through pain can be harmful, especially for stress fractures, knee ligament injuries, and any injury to the head or neck. Contact the physicians at Orthopedic Specialists of Seattle for proper diagnosis and treatment of any injury that does not improve after a few days of rest.
  • Return to play only when clearance is granted by a physician.

Orthopedic Specialists would like to offer the following tips for preventing soccer injuries:

  • Have a pre-season physical examination and follow your doctor’s recommendations
  • Use well-fitting cleats and shin guards — there is some evidence that molded and multi-studded cleats are safer than screw-in cleats
  • Be aware of poor field conditions that can increase injury rates
  • Use properly sized synthetic balls — leather balls that can become waterlogged and heavy are more dangerous, especially when heading
  • Watch out for mobile goals that can fall on players and request fixed goals whenever possible
  • Maintain proper fitness — injury rates are higher in athletes who have not adequately prepared physically.
  • After a period of inactivity, progress gradually back to full-contact soccer through activities such as aerobic conditioning, strength training, and agility training.
  • Avoid overuse injuries — more is not always better! Sports medicine specialists at Orthopedic Specialists of Seattle believe that it is beneficial to take at least one season off each year. Try to avoid the pressure that is now exerted on many young athletes to over-train. Listen to your body and decrease training time and intensity if pain or discomfort develops. This will reduce the risk of injury and help avoid “burn-out”
  • Speak with a sports medicine physician at Orthopedic Specialists of Seattle if you have any concerns about injuries or soccer injury prevention strategies

According to Dr. Peterson, “Two of the challenges the US team will have to face in addition to the “Group of Death” pairings are travel and heat. They will travel over 6000 miles during the preliminaries, and will be playing at least on of their games deep in the Amazon rain forest in the middle of summer! In these situations, it’s very important to work on hydration, proper diet, and sleep. Proper hydration is occurring when one’s urine is fairly clear to clear. Proper diet varies, but usually should include a balance of protein, carbohydrates, and fats. Eat plenty of fruits and vegetables and minimal fried foods and alcohol. Sleep can be tough with airplane travel.

Try to have a standard time to go to bed, and getting at least 8 hours per night is important. If it is hard to fall asleep, natural sleep aids like melatonin can help. Good luck, USA and Sounders players!”

If you believe you are suffering from a soccer-related injury and need specialized orthopedic care, Orthopedic Specialists of Seattle provide excellent treatment options available for you. Please feel free to contact OSS at (206) 633-8100 to schedule an appointment.

Seattle Mariners Opening Night at Safeco Field

Spring has sprung and OSS is excited that baseball season has started!

Seattle baseball fans, tonight is the night to cheer on the Mariners as they take on their division rivals, the Angels!  Seattle swept the Angels in a three-game series to open the season in Anaheim, and tonight’s meeting will be a rematch between the Mariners’ James Paxton and Halos left-hander Hector Santiago from the season’s third game, which Seattle won, 8-2. 

Tonight’s home game also a number of new faces, including new manager Lloyd McClendon and superstar second baseman Robinson Cano, who signed as a free agent this winter.  Fernando Rodney, Logan Morrison, John Buck, Corey Hart and Chris Young are also among the new Mariners set to be introduced tonight.

Other highlights of tonight’s home opener include:

  • The Mariners will salute the Super Bowl-champion Seahawks tonight as part of their Opening Night ceremonies at Safeco Field, with quarterback Russell Wilson among several players who will be part of a pre-game presentation and the ceremonial first pitch.
  • Opening Night festivities will begin at 4:40 p.m. PT, when the gates of Safeco Field open to the general public with a countdown at the Home Plate Gate. Pre-game ceremonies start at 6:30 p.m. PT.
  • With catcher Mike Zunino and reliever Dominic Leone, the Mariners are the only team in the Majors with two players from the 2012 Draft on their active roster. Zunino was Seattle’s first-round Draft pick, and Leone was a 16th-round selection.
  • Ibanez made his first start in left field on Monday. The 41-year-old designated hitter won’t come close to matching the 832 1/3 innings he spent in the outfield with the Mariners last year, but Angels manager Mike Scioscia has said he’d like to get him some time out there periodically.

OSS wants to wish the Mariners an exciting and injury-free season! Now… let’s play ball!

Softball Pitchers’ Windmill Delivery Can Cause Injury

Softball pitching subjects the biceps to high forces and torques when the player’s arm swings around to release the ball. Published in the March 2009 issue of the American Journal of Sports Medicine, the study of the “windmill” pitching motion appears to explain the high incidence of anterior shoulder pain observed in female softball players.

In the study, seven women — three collegiate and four professional pitchers — underwent motion analysis and surface electromyography to evaluate the muscle firing pattern of their biceps in the course of a windmill pitch. Electromyography detects electrical potential generated by muscle cells when they contract.

The researchers found that even though the upper arm movement in both baseball and fast-pitch softball gives the ball about the same velocity, the muscle force during the windmill pitch was much higher, according to the press release.

Moreover, the maximum force, or maximum contraction, occurred not when the arm was cocked, as in baseball’s overhand pitching, but when the arm circled around from the 9 o’clock position (i.e. almost fully extended back) to the 6 o’clock position (i.e. perpendicular with the ground), completing the windmill motion with the release the ball.

In one case, a pitcher had ruptured her tendon during play, which implicated the long head of the biceps tendon as the source of stress. Female softball pitchers are prone to overuse injury not only because of windmill pitching dynamics, but also because they pitch so many games.

Common Softball Injuries

Common injuries in softball players include tendonitis, rotator cuff and tendon strain, and ulnar nerve damage, but there are also plaguing lower body injuries that affect softball pitchers. So what is the source of injury? In simplest terms, the hips provide the platform for the scapula, and the scapula is the platform for the shoulder. If there is dysfunction in that system, this leads to injury. If a pitcher complains of shoulder pain, the shoulder may not be at fault for the pain, but rather faulty mechanics in the lower body.

Many times, softball pitchers experience upper body injuries that may be a result of faulty lower body mechanics. Force is produced in the ground, transfers through the legs and torso, and finishes in the upper body. If something along those lines isn’t functioning properly, injury will present itself.

Anterior shoulder pain is one of the most common complaints among windmill pitchers. A typical overhand pitch sees around 108 degrees of motion, whereas the windmill pitch has around 360 degrees of motion; which is an increase in the eccentric action of the biceps.

Strength and conditioning for softball pitchers takes on a significant meaning because all of the energy is transferred from the ground up to the hand (the final point of contact with the ball) and pitch from a flat surface vs. baseball players who pitch off of a mound; this means that a softball pitcher would need to train in ground reaction-force, emphasizing gluteal exercises. Strong glutes will provide a strong base for the pelvis, then transferring energy through the core to the upper body.

When considering training regimens for windmill softball pitchers, much of the conditioning should focus on strengthening the lower extremity and lumbopelvic-hip complex. The lower extremities and lumbopelvic-hip musculature can often be addressed in the same exercises. Ideally, the lumbopelvic-hip complex should be addressed first in the training cycle in order to maintain a base of stability throughout all the conditioning exercises.

Dr. Shapiro states, “Warming up prior to the game and using the proper technique while playing will reduce the opportunity for injury; however, if you are experiencing pain this may be from overuse or an acute injury. It is best to seek medical attention and be evaluated by an Orthopedic and Sports Medicine Specialist.”

If you believe you are suffering from a softball-related injury and need specialized orthopedic care, Orthopedic Specialists of Seattle provide excellent treatment options available for you.

2014 Sochi Olympic Injuries

sochi-injuries-sick-300x199The 2014 Sochi Olympics has had a fair share of injuries, none more so than the extreme sports that were added to the winter games as a way to attract a younger audience to watch and show interest in the Games.

OSS admires all the Olympians competing for the Gold as well as glory for their respective country; and as the final week rounds out this year’s Winter Olympics, we want to wish all the athletes who were involved in some kind of injury, a speedy recovery.

Sochi-Closing-Ceremony-300x225According to Dr. Charlie Peterson, “These events demonstrate that even at the elite level of competition, injuries are part of the game for all athletes. It re-emphasizes the need for maximum fitness and proper techniques and equipment to minimize the chance of injury, as well as the timely treatment of injuries when they occur.”

Here is a rundown of athletes and their injuries:

  • Ski-cross racer Maria Komissarova of Russia broke her spine during a practice run at the Extreme Park and is being treated in Munich after undergoing surgery in Krasnaya Polyana, the nearest town to the venue.
  • Canadian skier Yuki Tsubota suffered a mild concussion and a fractured cheekbone in a Feb. 11 crash during the women’s slopestyle event, where athletes soar and slide over obstacles before launching themselves off progressively larger jumps. The 20-year-old landed short and was taken off the course on a stretcher. She has returned home to see if she needs surgery.
  • During the women’s snowboard cross event on Feb. 16, Jacqueline Hernandez of the U.S. was carried off after she banged her head, as was Norway’s Helene Olafsen with a knee injury.
  • Islanders star John Tavares is out for the season after suffering a left knee injury in Team Canada’s win over Latvia on February 18.
  • Bode Miller owns a U.S.-record six Olympic Alpine medals, including a bronze in the super-G from last weekend that made him the oldest ski racer to win a Winter Games medal. He said Wednesday, February 18 that his knee bothered him after that race, and it’s been swollen during the Sochi Olympics.
  • Heidi Kloser of Vail injures right knee in crash, out of Sochi Olympic moguls