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Ask The Athletic Trainer! Archives

Following are questions asked by our readers concerning injury management and prevention, as well as other aspects of sports medicine. If you have a question for trainers Tom Geary and Dorrell Morrison, send it to trainer@sjsports.com

Disclaimer:   Information provided on this web site is intended for educational purposes only. This information should not be a substitute for professional medical care.

Question:

The other day I got an E-mail about anabolic steroids. Throughout the letter it kept saying that these were legal and worked the same as steroids. If these are so great and legal how come I haven't heard of them? And if they are legal, do they work as good as they say they do?   (Mark from Berlin)

Answer:

In your question you compared anabolic steroids to steroids. In regards to increased sports performance and or body building there is essentially no comparison. Sports performance drugs tend to be anabolic in nature due to the ability to promote muscle size, strength, and or endurance. There are a number of different types of steroids but your interest lies in two in particular. They are either classified as a glucocorticoid and or anabolic steroid. Glucocorticoids' primary function is to inhibit certain processes and or reactions that take place within the body. This is not the type of steroid that you are talking about, but we need to understand the function of a glucocorticoid which will enable us to grasp the function of a anabolic steroid a little better. Anabolic steroids are the opposite of glucocorticoids in which they excite and or act as a catalyst in certain processes or reactions within the body.

Are anabolic steroids legal? Yes, they are when they are dispensed with good intent for a particular medical condition by a licensed physician. They are banned from organizations such as the IOC, IAAF, NCAA, NFL, NBA, NHL, and the list goes on. Knowing this, I would be willing to bet that the information that you received is false. The reason that you have not heard of this is it does not work. It is a get rich scam. People tend not to make a big deal of things that don't work and are relatively inexpensive because they don't want to be seen as a joke. In conclusion, when dealing with anabolic steroids you need to compare their benefits to their adverse affects. In my opinion, the adverse affects far outweigh the benefits drastically, and I know there is a significant amount of literature to support my opinion. I hope that I answered your question fully.

P.S. If you still have that e-mail please forward it to me. I would like to take a look at it. - D.M.

Click here for a report on anabolic steroids from the National Institute on Drug Abuse.

Question:

How do you know whether or not you have injured your spleen? I play football and I took a helmet to the abdomen.   (Doug from Waterford)

Answer:

I'm glad that you are able to write in and question your injury about your spleen. This leads me to believe that your injury is not as complex as you may think or does not involve that specific structure. An injury to the spleen in athletic events is a rare occurrence.

The mechanism of this type of injury is in some form of direct blow to the abdomen region. Severe injury to this structure often displays symptoms of feeling cold, clammy and shows signs of shock at the time of injury. Nausea and vomiting may also be present. There may also be pain in the left shoulder. - D.M.

Question:

I have recently sustained a groin pull and it is painful. Of course, I keep aggravating it by refereeing soccer. What should I really do to let it heal properly, and how long should it take?   (Jim from West Berlin)

Answer:

The adductor (groin) muscle strains occur frequently in sports where cutting, side stepping, or pivoting are required. The mechanism is commonly a violent external rotation with the leg in a wide stance. The severity can vary in nature from mild to moderate, which is more common. A severe strain, which is less common tends to be very visible to the athlete where a dip and/or bulge occurs at the site of injury. The athlete will typically experience a pull or a pop followed by pain, weakness, swelling, and stiffness in the adductors.

The adductor muscles consist of the adductor magnus, brevis, and longus muscles. It also contains the gracilis and pectineus muscles. There primary function is to adduct the hip and/or draw the hip toward the center line of the body. Their secondary function is to assist in flexion and extension at the hip and knee joint. The adductors tend to be the weakest muscle group of the hip and knee joint. This muscle group is often neglected in resistance training programs which predisposes them to injury.

Initial treatment of a adductor strain should consist of ice and rest for the first 48 to 96 hours post injury. Active range of motion exercise should then be incorporated. Stretching and resistance exercises are to begin only when the muscle is no longer painful. Light running should begin only when your range of motion and strength levels are very close to levels of the uninvolved side. - D.M.

Question:

What is the best age to start having young athletes lift weights?   (Chris from Winslow)

Answer:

For me to say that every young person can start weight training at a certain age is like saying that every 17-year-old is competent to drive a car and we all know that is not true. (Just kidding!) Seriously, children and at what age they should begin a strength training program tends to be a controversial topic that leaves many unanswered questions. This is primarily because there is very little scientific evidence that supports this topic. Many of the current theories and or philosophies that are intended for the adolescent are modification of an older age group's program.

Children's bodies are undergoing a transformation due to puberty. During puberty there is a increase in hormonal levels which supports the change in children to young adults. Strength training alters our hormonal levels in a adult, so I feel we need not involve our typical adolescent in any program which would increase the complexity of an already difficult equation involving puberty. I personally do not think it is a good idea to involve adolescents in strength training, but I do think there is a very small percentage that may. Before you think your child or individual falls into this small percent range, I advise you to personally seek the advise of a professional. - D.M.

Question:

Why are hamstring strains so common and why do they typically take so long to heal?   (Brian from Medford)

Answer:

It is true that of all the muscles in the body, the hamstring muscle group has nearly the highest incidence of strains. The hamstring muscles have numerous functions that are extremely important in virtually all sports. Since the hamstring muscle group provides more than one function, it is often injured. The hamstring muscle group is comprised of three muscles, (Biceps femoris, semitendinosus, and semimembranosus) which work together to provide a variety of movements. The hamstring muscle group is biarticular, meaning that its attachments cross more than one joint. A short anatomy lesson will help to explain its location and function. The superior (top) attachments originate (begin) on bony projections known as ischial tuberosities. The ischial tuberosities are the bony projections that make contact with the chair when sitting. One can be felt in each buttocks. From the ischial tuberosities the hamstring muscles then extend down the back of the leg, making contact with the femur (thigh bone) in one area. The hamstring muscles then divide and cross the knee joint on either side before attaching just below the knee. Since the hamstring muscles cross both the hip joint and the knee joint they are responsible for movement at both joints. The hamstring extends the hip (pulls the thigh backward) and flexes the knee (pulls the leg backward).

Many theories have been offered to explain the exact cause of hamstring strains. Explosive starts often strain the hamstring muscle group because the muscles quickly go from knee stabilization to hip extension during running. Hamstring muscles are also strained when slowing down because they function as leg swing decelerators. It is speculated that injuries are often caused by muscle fatigue, tight hamstrings, mineral imbalances, improper form, faulty posture, and an imbalance in strength between the hamstrings and quadriceps (muscle group in the front of the thigh).

Hamstring strains take from 1 month to one year for full recovery. Injuries tend to reoccur due to inelastic scar tissue that often forms during the healing process. The scar tissue is rigid, non yielding and weak compared to the original muscle tissue. This contributes to an increased likelihood of reinjury to that site. The athletes fear of reinjury can in itself be debilitating. - T.G.

Question:

What is the best way to achieve flexibility?   (Kerri from Penn State)

Answer:

Flexibility is defined as the range of motion possible about a single joint. Increasing the extendibility of specific muscles and their associated tendons will improve the range of motion at that particular joint. Flexibility is an essential component of physical fitness. Studies have indicated that flexibility can contribute to athletic performance and actually reduce the incidence of certain injuries. Athletes with good flexibility are less likely to strain or tear connective tissues. The inflexible athlete performs with a considerable disadvantage with respect to movement. The best way to achieve flexibility is with the use effective stretching techniques.

While there are different stretching techniques, I will discuss a technique that is both effective and safe. Static stretching involves passively stretching by moving the desired muscle into stretch and holding it there. The muscle should be moved into a stretch until it feels tight or uncomfortable. Stretching should never be painful, so do not over stretch. It is recommended that the muscle be held in the stretched position for 20 to 30 seconds. During this time it is essential to breathe normally. Exhale as you place the muscle in stretch and then follow with slow relaxed breathing. Each muscle should be stretched 3 to 4 times during each stretching session. The best times to stretch are both before and after activity. However, for best results stretching sessions can be executed from 1 to 3 times per day. Before beginning, a general warm-up should be performed (jumping rope, jogging or stationary bike) until light sweating occurs. After an activity stretching is equally if not more important. The minimum number of recommended stretching sessions per week is three. For best results stretching should be done daily until designed results are achieved. Remember, flexibility is an essential component of physical fitness and should be included in any exercise regimen.

For selected stretches specific to muscle groups contact me at tom.geary@sjsports.com. - T.G.

Question:

Should I first apply Ice or Heat when I get hurt?   (Bob from Berlin)

Answer:

The use of cold is recommended initially following most acute injuries to the musculoskeletal system. Cold treatment in the form of an ice bag is recommended immediately after an acute injury. Ice bags are an efficient and effective form of cold treatment. Even bags of frozen vegetables can be used. Ice bags can be applied for 20 minutes every hour for up to 72 hours (3 days). During cooling, the body part will experience four uncomfortable sensations; cold, burning, aching and finally numbness. Cold is not recommended for individuals with an allergy to cold, circulatory impairments or hypertension.

The primary reason for the use of cold is to decrease tissue temperature, thus reducing tissue metabolism and confining tissue injury and death to a smaller area. This is important for reducing recovery time. Cold also helps to control the amount of swelling. However, since cold only controls swelling and does not reduce it once it has occurred it is important to ice as soon as possible. In addition, cold also produces a anesthetic effect, thus reducing pain. Finally, cold can also reduce muscle spasm relative to acute athletic trauma. Though ice is one of the simplest treatments available it remains one of the most effective. Remember to use cold first and heat later. - T.G.

Question:

What exactly does an athletic trainer do?   (Tish from Waterford)

Answer:

Certified athletic trainers, ("ATC" or "CAT") are unique health care professionals providing an essential service in the health care system of the 90's. The certified athletic trainer specializes in the prevention, recognition, evaluation and immediate care, and rehabilitation and reconditioning of athletic injuries. The certified athletic trainer is also responsible for health care administration, education and counseling. The certified athletic trainer can help physically active people avoid unnecessary medical treatment and disruption of normal daily activities.

Athletic training is an Allied Health Care Profession recognized by the American Medical Association. Certified athletic trainers have met educational and experiential requirements and have passed a competency examination. Certified athletic trainers practice the art and science of athletic training under the direction of a licensed physician and in cooperation with other health care workers, athletic administrators, coaches and parents. - T.G.

Information provided by the National Athletic Trainers Association 1998. For further information on Athletic Training, please see the National Athletic Trainers Association website at http://www.nata.org/

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Thomas Geary, ATC, CSCS, received his Bachelor of Arts degree in Health & Exercise Science from Rowan University. Currently he is the Athletic Trainer at Lindenwold High School and is a graduate student at MCP Hahnemann University. He is a certified member of the National Athletic Trainers Association, the Athletic Trainers Society of New Jersey, the National Strength and Conditioning Association and is a registered member of the New Jersey Board of Medical Examiners.

Dorrell Morrison, ATC, CSCS, is a graduate of Rowan University with a degree in Health & Exercise Science with a concentration in Athletic Training. Currently he is the athletic trainer for the Pennington School and a personal trainer with the Sporting Club at the Bellevue in Philadelphia. He has also worked with the New York Jets Sports Medicine Staff. He is a Certified Athletic Trainer by the National Athletic Trainers Association, and is a Certified Strength & Conditioning Specialist by the National Strength and Conditioning Association.

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