About Sickle Cell Disease and Athletes

Sickle cell trait needs to be identified in athletes

Sickle cell disease (SCD) is a condition in which  red blood cells can develop a “C” shape similar to the old farm tool called a sickle that was used to harvest grains. The danger of the “C” shape blood  cells is that they die early which causes a shortage  of red blood cells. Due to their non-round shape they can also become stuck and clog smaller blood vessels resulting in pain and other complications.  Tissue that does not receive a normal blood flow eventually becomes damaged. This is what causes the complications of sickle cell disease. Read more: http://www.nhlbi.nih.gov/health/health-topics/topics/sca/

Disease (SCD) or Trait (SCT)?

SCD is a genetic condition that is present at birth having been inherited from one or both of their parents. Persons who have inherited one sickle cell gene and one normal gene have SCT. This means the person won’t have the disease, but will be a trait “carrier” and can pass it onto their children. Sickle cell trait is not a type of sickle cell disease. People with sickle cell trait are generally healthy. Persons with SCD can pass either SCD or sickle cell trait (SCT) onto their children.

SCT affects 1 in 12 African Americans in this country. Estimates are that 3 million people in the United States have SCT and many are unaware of the condition. SCT is also frequently found in people living in or have families in South and Central Americans, Caribbean, India, Arabia and Mediterranean counties such as Turkey Greece and Italy.

Chances of Inheriting SCD or SCT

• Both parents have SCT = 50% chance of SCT in their children; no symptoms in children of SCD; but they can pass SCT onto their children
  
• Both parents have SCT=25% chance of SCD in their children; 25% of no SCD in their children
  
• One parent has SCT= 50% chance of SCT; 50% chance of no SCT
  

How do you know?

A simple blood test is used to detect SCT. For several decades now blood testing for sickle cell and other blood conditions has been standard on newborns. Families with inherited SCD and SCT tendencies should see a genetic counselor (contact your family physician or local hospital) to investigate the number of relatives on the husband’s and wife’s side of the family who are carriers before deciding on having children of their own.

Knowledge of medical problems possibly associated with sickle cell trait and their appropriate management is good clinical practice for athletic programs so check with the school physician and/or the athlete's physician.

How Improving Listening Skills Can Improve Athletic Healthcare

Being is a good listener is half of being a good speaker. Americans spend 80% of their waking hours communicating. We spend 45% of the time listening, but we only listen at about 25% of our ability to do so.

Student-athletes need to understand their assignments, know the techniques of the sport and to listen to -  not just hear - instructions. The following guidelines will help student-athletes and student trainers become more effective communicators by improving their listening skills:

• In order to listen you have to stop talking.
• Listen actively. You can hear someone without really listening to them. 
• Don’t get ahead of the person talking. 
• Wait. Don’t jump to conclusions. 
• Listen to them without turning their story into your story.
• Don’t finish other people’s sentences. Be patient and do not interrupt. 
• Become a student of human behavior. Observe their nonverbal language. 
• When appropriate, summarize to show you were actually listening. 

When tending injured athletes, care providers must pay attention to details that affect decisions. Asking and listening are key evaluative tools used by all health care providers. Injured athletes need to feel comfortable and reassured by the person who is caring for them. Powerful body language, positive facial expression, eye contact and professional verbal skills are trademarks of successful people in all walks of life. This is especially true in the emotional, fast paced world of athletic healthcare.

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Successful Verbal and Non-Verbal Communication Key to Success in Athletics

Communication is the key to successfully accomplishing any task in athletics. From the catcher’s signals with the pitcher to the coach’s pep talk before the game, effectively conveying your message is crucial. Successful leaders throughout history have been effective communicators.

People use as many as 40,000 words in a normal day. Each day we typically spend 45% of our day listening, 30% speaking, 16% reading and 9% writing. Unfortunately, most of our training is just the opposite - with most of our time being taught how to write and very little time spent teaching how to be an effective listener. Effective communication is made easier by finding what you have in common. Focus on the common goals, not the common obstacles.

Your appearance is how someone initially molds their opinion of you. First impressions are lasting ones and are often formed with the first three minutes.

Your body language conveys a powerful message. Learn to stand and sit tall. When speaking, stand firmly on both feet and make eye contact with the person, but don’t stare or will make them uncomfortable. Don’t clench your fist or tap your fingers. Take a breath; relax and speak slowly and deliberately. Avoid quick snappy answers that you later take back.

Most of what you say goes without saying; actions and body language speak louder than words.

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Dancer's Foot Information and Treatment Suggestions

Dancer's Foot

Sesamoid bones are one of nature’s most amazing anatomical creations. Sesamoid bones are unique in that they are “floaters” - not connected to another bone - and they are embedded in a tendon or muscle. They provide a smooth surface over which tendons can slide to increase mechanical (muscle) power. The leverage advantage produced by the exact location of this bone gives us leg power (patella bone) as well as foot movement. The sesamoids in the forefoot (directly under the first toe joint) assist with weight bearing and help elevate the bones of the great toe.

Like other bones, sesamoids can break and tendons surrounding the sesamoids can become irritated or inflamed. This is called sesamoiditis. When the patella is dislocated or the Q angle (angle between thigh bone and larger shin bone) is excessive, the patella may not glide smoothly each time the leg is flexed or extended. If the underside of the patella loses its smoothness a condition called chondromalacia may develop.

On the underside of great toe there are two sesamoid bones. The great (big) toe is critical to walking, dancing and running. These two sesamoid bones improve the angle and effectiveness of the toe-off portion of the gait cycle. When injured there may be no swelling and bruising with pain localized directly under the joint of the big toe. If this pain appears quickly you should seek physician care for an x-ray. If you experience pain bending/straightening the big toe even when non-weight bearing, suspect sesamoiditis.

The American Academy of Orthpaedic Surgeons offers the following guidance for sesamoiditis:

• Stop the activity causing the pain.
• Take aspirin or ibuprofen to relieve the pain.
• Rest and ice the sole of your feet. Do not apply ice directly to the skin, but use an ice pack or wrap the ice in a towel.
• Wear soft-soled, low-heeled shoes. Stiff-soled shoes like clogs may also be comfortable.
• Use a felt cushioning pad to relieve stress.
• Return to activity gradually, and continue to wear a cushioning pad of dense foam rubber under the sesamoids to support them. Avoid activities that put your weight on the balls of the feet. 
• Tape the great toe so that it remains bent slightly downward (plantar flexion).
• Your doctor may recommend an injection of a steroid medication to reduce swelling.
• If symptoms persist, you may need to wear a removable short leg fracture brace for 4 to 6 weeks.

There are specific pads for sesamoiditis in the foot that are intended to re-distribute body weight off of the bones upon weight bearing. Find these pads on the Sports Health’s web site >>

Easily Improve Your Fitness Level Using a Pedometer and These Walking Tips

Walking for Health

In our current fast paced world, we still can’t find enough time to do that one thing that we need: mild to moderate exercise repeated often. For the majority of Americans we do not need military-like fitness goals, we just need to do something actively and do it often.

Examples of lifestyle changes are common, well known and yet still underutilized, such as park the car in the last row at the mall instead of the closest row, stop the elevator one floor early and walk the stairs to your floor and walk yourself (or your dog) for that 15-30 minutes every night after dinner.

For many of us, we have grown accustomed to measuring, assessing and defining our lives and for this crowd using a pedometer is perfect. A pedometer is a device that senses your movements to tally up the number of steps you take. It can be worn, clipped, tucked or carried. Pedometers can be simple (clip it on your belt and start walking) or advanced (determine your stride length, weight, pulsating rhythm as you walk, calories burned and can be downloaded onto your computer). Choose a pedometer that has a display you can easily read in different lights, can be worn comfortably and has the features you want.

Prices range from $10 to over $100. If you are new to the walking idea and the keeping track of your “motion minutes”, start simple and move up when needed. Once you are ready to get started, try wearing it around your normal day for about 2-4 days just to see how many steps you take in a typical day. You can now begin to add steps by scheduling that 10, 20,30 minute walk and add them onto your total. If you want to measure distance instead of steps, find that local track or measured distance by car, walk the ¼ mile and see how many steps or strides it took you, multiply by 4 and there you have your mile number. Remember this is an estimate, but after all, we are in this to be in motion not measure in exact feet or yards!

According to the staff at the Mayo Clinic, you should

• Set long-term step goals. Think about your overall fitness and activity goals. Your short-term goals are the building blocks to these long-term goals. A long-term goal may be walking 10,000 steps a day, or about five miles (eight kilometers), several times a week as part of your new daily routine. You may also want to set a goal of walking faster as your fitness level improves. Keep in mind that the Department of Health and Human Services recommends that, in general, healthy adults get at least 150 minutes a week of moderate aerobic activity or 75 minutes a week of vigorous aerobic activity.
• Track your progress. To see how you're doing, monitor your progress over time. Your pedometer may or may not have a memory function to track your steps on a weekly or monthly basis. You can choose to use that feature or record your steps in a log of your own making. Or upload the information digitally to your computer or mobile device. Tracking your progress can help you see whether you're meeting your goals and when it may be time to set fresh goals.
• Check with your physician before beginning, especially if you have been sedentary for a while, have any orthopedic problems or have any medical issues that are being monitored.

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