Monday, November 15, 2010

November newsletter from WellBodyKC

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wellbody has started working with the Kansas City youth Tri-athlon Team. WE CONTINUE TO GROW and remain passionate in helping Kansas City's young athletes!
Congratulations to the seniors who signed athletic and academic scholarships- this is just another example of your hard work paying off- wellbody celebrates with you and your family, friends, and coaches!
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TOP 10 List for November
1. Dark colored sodas (even if they are diet) are OUT!      
Milk, water, Gatorade, Powerade, (and occasional light colored, non caffeinated colored soda like Sprite) is IN
2. Lots of stretching before exercise is OUT!                      
Warming up with jogging/jumping/pylometrics is IN with stretching at the END of practice.
3. Energy drinks with creatine, taurine, caffeine have always been OUT! (DUH!) (We might see these drinks outlawed in the next 5-6 years, don't be a part of it with your kids!)
4. Carb loading is "on the way" OUT!                                  
Carbs still important before competition and PROTEIN, PROTEIN, PROTEIN is IN!
5. Calorie counting (for active adolescents) is OUT!         EATING, EATING, EATING for muscle strength, bone strength, and a healthy immune system is IN!
6. Max lifting with open growth plates has always been OUT!     Sets of 15 repetitions with weights that can be done with good technique is IN! (even if in gradeschool as long as being watched by a trained coach!)
7. Old school medicine is OUT!                                             Massage, accupuncture, YOGA, functional PT is IN! (at least in the beginning- surgery and medication may also be necessary in certain cases)
8. Old Concussion guidelines are OUT!                              
New Concussion guidelines are IN! (see below)
9. Therabands (in many cases) are OUT!                            Functional rehab for preventative injury to ankles and ACL/knee are IN!
10. Summer is OUT! (too bad!)                                             
THE WINTER SEASON IS IN!!
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Concussion Guidelines- Have we swung too far the other way?
Definition:    A concussion is the temporary alteration of base line neurologic status from an impact or whip lash injury (the athlete does NOT have to lose consciousness).
http://www.wellbodykc.com/?page_id=415
New Guidelines:      About every three to five years- someone re-addresses an already approved policy and changes it! Concussion guidelines were the topic this year in sports medicine, neurology, and orthopedics. Many youth sports organizations, colleges, and even the NFL have re-done "rules" for return to competition/practice. In three to five years- will things swing back to a more relaxed position? Time will tell.
With the recent tragedy of a Spring Hill football player's death (that appears at least now to have been concussion related), coaches, athletic trainers, and sports interested physicians must remain on the athlete's side (of safety) and not get "caught up" in the excitement of the "big game", the "enthusiastic parent", or the "play for anything" (but possibly naive) athlete. As we learn more about concussion- the guidelines will most likely change again- but when it comes to the head/brain/neck- wellbody will remain following recommendations offered by current national policy.
The Old Guidelines Suggested:
1. It was sometimes ok to return an athlete to play if symptoms from a concussion resolved within 20 minutes while at a game/competition/meet
2. Return to play was based on symptoms, on field examination,  whether or not there was loss of consciousness, and number of concussions that season
3. Exam and recommendations could be made by an athletic trainer- and often was made by a coach or parent
The New Concussion Guidelines Recommend;
1. NO return to play the same day as a concussion- even if "ok" in 20 minutes.
2. Return to play is based on symptoms, sleep, school focus, physical exam by a medical provider, symptom score list test, and total number of concussions in career (not just one season)
3. Three concussions in an athlete's life should trigger a discussion on break from the sport (one season, one year, forever depending on the case)
4. Exam and recommendations should be done by a physician or NP/PA that is comfortable with the diagnosis/evaluation/expected recovery of head injury, no longer an ATC alone (*an ATC remains the most valuable first responder and decision maker for recognizing concussion), and NEVER a coach or parent
5. School and other activity may need to be missed (not just the sport) while an athlete is recovering.
6. Consideration for all athletes in contact sport to have a pre-head injury evaluation before the season starts (along with the state mandated sport's physical) to have individual base line information to consider if an athlete gets a concussion during the season.
The bottom line is:    recurrent head injuries in a child with not yet fully mature neurons (compared to an adult in the NFL for instance) increases the risk of another concussion, second impact syndrome (death from a second concussion before a first concussion is completely resolved), and potentially chronic neurologic trouble (such as ALS and dementia pugilistica).
When it comes to head injury, neck injury, and concussion- a coach, parent, teacher, ATC, or physician can always be sure they made the correct game time decision if they take the approach of SAFETY FIRST!
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Wishing our patients and athletes a safe, healthy, successful season!
Happy Thanksgiving!
Dr. Goldstein