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Adult Supervision Does not Necessarily Assure Safety in the Weight Room
Many times I’ve remained an advocate supporting weight training for our young population. Research has suggested over and over the positive effects weight training offers. It improves strength, reduces body fat enhances self-esteem and improves self-confidence. Contrary to popular belief, if training properly, research has not supported the myth, “weight training will adversely effect one’s growth.” In fact, it does support the notion that when done properly, it enhances skeletal maturation and growth.
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How to support your child athlete without too much pressure: 7 easy steps
(02/10/2004)
When your son or daughter picks up that bat and glove or puts on those soccer cleats, or basketball shoes, you, as a parent, take on a new role: the parent of an athlete. It can be a scary hat to wear. You’ve heard the horror stories
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Bullying on the Sports Field... What is It?
(Aug. 8, 2004)
Fair Play vs. Foul Play. Appropriate Behavior vs. Inappropriate Behavior. Youth. Schools. Camps. Sports. What’s going on?
BULLYING! And it’s a big problem!
Recall your own school, camp or sports memories and, chances are, a bullying incident is part of them.
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Do You Really Want to Know?
The media is oh so eager to learn the identity of those who are Steroid users. Eager to be the first to print the Breaking News story: “Joe Homerun Hitter
found guilty of steroid use.”
Daily, there is the media push and the need to know who these players are.
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Who Says Kids Shouldn't lift Weights?
(07/10/2004)
Forever and a day we have been told “children should not lift weights. Lifting weights will damage growing bones; it will stunt the growth of a child.” If children are allowed to lift weights, they will get hurt. Well, guess what? That’s just not true.
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A Hit For All
(03/22/2004)
This week a local Little League hit a Home Run. By unanimous vote, board members of the New City Little League (Rockland County, New York) voted to institute a Continuous Batting Order into its boys (10-12 year olds) major league division.
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The psychology of a winner
(12/27/04)
At a certain level of professional competition, the skill difference in many top athletes becomes negligible. What is it, then, that separates the number one tennis player from the number fifteen? Why does the number ninety-ninth ranked tennis player double-fault at match point? In basketball, why do some players consistently hit the free throw when the game is on the line, and why do some consistently choke? Top-level players relate feeling calm, energized and positive during performances. This is “the zone,” that all athletes aspire to. Why do some players reach “the zone” while others with equal or even greater talent do not?
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Back Pain, a huge economic and medical burden
(Dec 29, 2003)
The economic impact for the diagnosis and treatment of Back Pain surpasses 100 billion dollars annually. Fortunately, maintaining a regular exercise program, at a minimum of three sessions/week, for 30-60 minutes/session can help to alleviate most symptoms of back pain.
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Ephedra is Banned, but will it go away?
(Dec 31, 2003)
Kudos to the United States Government for its stand and ban of the dietary supplement, Ephedra. This seemingly innocuous, over the counter, dietary weight loss aid has been linked to at least 155 deaths and there are over 16,00 reports of people suffering adverse effects from it.
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My New Year's Resolution
(Jan 03, 2004)
The Holiday Season is just behind us, 2004 is here.
Hopefully, you all enjoyed a healthy and happy year in 2003, which will continue into 2004. Like many rituals in life, the end of year holiday season reminds us of "resolution's and promises" we make to ourselves.
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How to support your child athlete without too much pressure: 7 easy steps
(02/10/2004)
When your son or daughter picks up that bat and glove or puts on those soccer cleats, or basketball shoes, you, as a parent, take on a new role: the parent of an athlete. It can be a scary hat to wear. You’ve heard the horror stories
Read More -->
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What is a Sport’s Hernia? |
Only recently gaining favor as a valid diagnosis to be considered in cases of chronic groin pain is the term, “Sport’s Hernia”. Sport’s hernia refers to a weakness or tear of the structures that anchor the abdominal musculature to the pelvis. As opposed to the more commonly known inguinal hernia, where on physical examination the intestines can be felt bulging into the scrotum in males, the physical findings for a sport’s hernia are much more difficult to find, if they are to be found at all.
What is injured in a Sport’s Hernia?
The area of injury in sports hernias is where separate layers of abdominal muscles come together to anchor onto the pelvis. These muscles provide stability to our trunk. Because very strong muscles converge into tendons that insert onto bone, there is a great amount of pull placed on the tendons. The area of weakness involves a ring where the spermatic cord in men and the round ligament in women must pass through the abdominal musculature to reach the genitals. Because a natural hole is created to allow the structures to pass, under stressful pulling forces this hole may be damaged.
How do these injuries occur?
It is thought that twisting injuries are most responsible for sport’s hernias. The injuries have been most frequently reported in soccer and hockey players. In sports where there is a lot of twisting and turning at high speeds, strong trunk control is crucial. The abdominal muscles, especially the obliques and the transversus abdominus, are key muscles groups in maintaining this stability. If the muscles are taken beyond their limits, they are likely to be injured. That injury may involve a small tear to the muscle itself, which frequently heals very quickly. An injury may also involve the tendon, which is the transitional part of the muscle where it becomes a band before anchoring onto bone. Tendons frequently heal more slowly than muscle, and in some cases, they may not heal if not surgically repaired.
How is this injury diagnosed?
This diagnosis is often made after many other possibilities are ruled out. The reason for this is that there are no consistent examination findings or imaging techniques that have great success in identifying a sport’s hernia. What frequently happens is an athlete will complain of groin pain that does not resolve after a few weeks. After a physical exam does not reveal an inguinal hernia, xray’s and ultrasound are frequently obtained and are usually normal. More expensive imaging studies, like MRI or bone scans may then be obtained, which again may not show anything unusual. Ultrasound evaluation can sometimes identify the damaged tissues and may be one of the more useful tests in evaluating one for a sport’s hernia. If a thorough workup fails to provide a valid diagnosis and conservative, non-surgical, treatment has failed; a sport’s hernia becomes the leading diagnosis. Once this diagnosis is considered, the next step is frequently a diagnostic laparoscopy, a surgical procedure where a small incision is made in the groin and a small tube is placed to allow a fiberoptic camera to enter. The camera is then used to visualize the area in question where a tear or weakened structures may be seen.
How is a Sport’s Hernia treated?
Often the treatment and diagnosis occur during the same procedure. After damage to the internal ring, associated tendons, or related tissue is found the area is repaired and reinforced during the same procedure. Often, a mesh material is also utilized which serves as a support for the weakened structures.
How successful is this procedure?
While no large trials have been completed, a number of sizeable case reports have reported promising surgical success rates ranging from 63% (1) to 97% (2) for full return to prior level of function.
How long is the recovery period after surgery?
With appropriate conditioning and rehabilitation, it is expected that an athlete may return to full activity at around 6 to 8 weeks after surgery.
How can I prevent this injury?
Core strengthening has been given a lot of publicity in the last few years as a critical component of many training programs, and with good reason. By strengthening the low back, abdominals, and hip girdle muscles, stronger core musculature may offer some protection against injuries like the sport’s hernia.
References
Poglase AL, Frydman GM, Farmer KC: Inguinal surgery for debilitating chronic groin pain in athletes. Med J Austr 1991;155(10):674-677.
Susmallian A, Ezri T, et. al.: Laparoscopic repair of ‘sportsman’s hernia’ in soccer players as treatment of chronic inguinal pain. Med Sci Monit 2004; 10(2):CR52-54.
Brian Bast, DO
Dept. of Physical Medicine and Rehabilitation
Mount Sinai Medical Center
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