MRSA- Does Your School Have a Plan?

What is MRSA?

More than 130,000 Americans contract a potentially fatal staph infection called MRSA every year. It's increasingly common among young, healthy athletes. Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterium responsible for several difficult-to-treat infections in humans. MRSA was first discovered in 1961. It's now resistant to methicillin, amoxicillin, penicillin, oxacillin, and many other antibiotics which makes it a very difficult disease to deal with. Staph is one of the most common causes of skin infections in the U.S. Usually, these are minor and don't need special treatment. Less often, staph can cause serious problems like infected wounds or pneumonia.

How is MRSA Spread?

MRSA is especially troublesome in hospitals and nursing homes where patients with open wounds, invasive devices and weakened immune systems are at greater risk of infection than the general public. This is called Hospital Acquired (HA). The other transmission method is called Community Acquired (CA), and one can acquire it from coming in contact with a person, mat, exercise equipment, etc. that has been contaminated.

This disease is contagious by touch only, so you would have to come in contact with someone else or an object that had been contaminated to contract it. MRSA can be transmitted when an infected person contaminates an object like a treadmill at the gym. If you use the equipment and get the bacteria on your hands, then inadvertently touch your nose, the bacteria can enter your nasal canal. The bacteria will begin to show up externally as a skin infection.

Hand Washing and MRSA

At the Society for General Microbiology meeting in Harrogate on March 31, Dr Peter Wilson from University College Hospital, London, reported in Science Daily Mar. 31, 2009 on a year-long study in two hospital intensive care units. Results showed that hand washing was more important than isolation in controlling MRSA infection. This study suggests regular hand washing by hospital staff and visitors did more to prevent the spread of the MRSA superbug than isolating infected patients.¹ Researchers have found that patients of doctors who wash their hands are less likely to contract a serious infection that can cause pneumonia or surgical wound complications. According to a new study done by Johns Hopkins Hospital, patients at risk for MRSA (methicillin-resistant staphylococcus aureus) that had doctors and nurses who washed their hands were less likely to contract the infection.² Read more about hand hygiene in sports >>

View several MRSA combating products for training rooms, offices, clinics and other athletic facilities >>

For further information see
1. Protecting Athletes- Microbiologists Invent Coating To Protect Athletes From Infection September 1, 2007. http://www.sciencedaily.com/videos/2007/0905-protecting_athletes.htm
2. http://www.webmd.com/skin-problems-and-treatments/news/20071024/mrsa-experts-answer-your-questions
3. The Johns Hopkins Newsletter, 11/5/04 http://media.www.jhunewsletter.com/media/storage/paper932/news/2004/11/05/Science/Hand-Washing.Lessens.Mrsa.Risk-2244064.shtml


Phil Hossler, ATC has been an athletic trainer on the scholastic, collegiate and Olympic levels. He has authored 4 books and numerous articles and served as an officer in state and regional athletic training associations for 20 years. He is a member of four halls of fame including the National Athletic Trainers’ Association’s.

How to Begin a Running Regimen

Running is one of the more accessible exercise activities available to athletes - all you really need is a good pair of shoes and a place to run; no fancy equipment or special skills. A word of caution however - it takes time to build up the endurance to run for even a short period of time, even if you've been walking, cycling or doing other activities in the past. Keep in mind that “it is wiser to prepare than to repair," so before you open the door and take off, visit your doctor, get the okay to start a running program and start working on your flexibility - particularly your lower back, hamstrings and calf muscles.

For most exercising adults, slower and longer is both safer and more productive than running hard (like you remember) and getting it done in 8 minutes. Use the “I can still talk while doing this” rule of thumb to gauge your intensity.

Don’t save money on your shoes. The soles of your feet only make up 2-4% of your skin surface, but the other 96% is resting (and counting on) the soles of your feet, so make them comfortable. Read 13 Tips for Selecting the Best Fitting Running Shoe >>

Running for exercise can be done when convenient to your schedule or your body’s schedule. Some people are morning exercisers and simply cannot get it done in the evening. There is no right or wrong time and each time slot has advantages. Just make certain to make the time, or you may never find the time. (Learn more about finding the right time to exercise.) There is bound to be some discomfort and occasional injuries associated with physical activity. Take care of them when they are small to reduce how long they last. Anything that hurts or persists should be seen by a medical professional.
To care for aches and discomforts, shop at http://www.esportshealth.com/running.

Phil Hossler, ATC has been an athletic trainer on the scholastic, collegiate and Olympic levels. He has authored 4 books and numerous articles and served as an officer in state and regional athletic training associations for 20 years. He is a member of four halls of fame including the National Athletic Trainers’ Association’s.

How To Find the Best Time to Exercise

Is There a “Best” Time to Exercise?

That depends on a number of factors, including your body’s natural rhythms, your metabolic rate, your work and eating schedules and exposure to environmental factors.

Some people are early risers and want to get at it. Others start slower but can maintain longer throughout the day. These natural rhythms, called circadian rhythms, demonstrate peaks and valleys throughout the day. You are most likely to exercise when your energy level is high. Hopefully, you are able to match your meals, job, family, social and exercise activities with your natural rhythms.

6 Guidelines for Selecting the Best Time to Exercise:

1. Eat little before exercise
2. Avoid fat and protein sources if you plan to exercise shortly after eating since they digest slower than carbohydrate sources
3. Exercise after a meal should be enjoyable and mild in intensity so as to aid digestion and weight control
4. Exercising in the evening may aid metabolism during a normally slower time of the day, but may also cause “energy highs” making sleeping difficult
5. Carbohydrate sources digest more easily and are the body’s first choice for energy. This does not mean candy though!
6. If you are healthy enough for your exercise selection, there is no wrong time. Just make it a habit and stick with it.

Track Your activity with a pedometer or heart rate monitor >>

7 Health Considerations for Summer Athletes

Summertime & the Living is Easy

Like the song says, “summertime and the living is easy”. While they may be true for some, activity enthusiasts know that maintaining or achieving a level of fitness and enjoyment during the non-school year days may not be so easy. With school sports and school schedules, time and activity is monitored and managed. Both parents and their teens are in the routine of eating, working, exercising and sleeping.

Anytime you or your parents become the coach, athlete, motivator and injury specialist, you may need some help. Sports programs outside of school often have limited budgets, volunteer coaches, and few or no athletic trainers, but still the best of intentions.

Runners and cyclists have unique summertime needs while so do tennis players and golfers. Summer sports leagues for young, middle and older all have unique concerns to address.

Heat Safety

Here are some items I found at www.esportshealth.com which will make dealing with these times easier and safer. Two items which are of tremendous value to parents and exercising adults and their children are something to actually assess the ultraviolet (UV) intensity of the sun and a towel which has cooling properties.

Heat safety must be foremost in the attitude of exercising adults and teens/children. The young do not have the advanced heat control/sweating mechanisms as adults do; they actually feel the heat more intensely.

2 Products to Help Beat the Heat:

• UV Detector
  
• Stay Cool Towels
  

Summer Nutrition & Fluid Replacement

Proper nutrition and fluid replacement is critical to performance and to health. During the summer months adequate fluid and nutrient replacement must be maintained. Take the time to learn about heat and fluids; find what works best for you. Studies have shown that fluid losses as little as 1-2% of your body weight can negatively affect stamina, endurance and performance. Find products that maintain energy and fluids.

Improve Your Summer Nutrition & Fluid Intake:

• Drinks and Nutrition bars
  

Tennis & Golfing

Tennis enthusiasts and golfers often can use items to support sore muscles and reduce discomfort. Simple supports can make activity more enjoyable.

Get the Support You Need:

• Look at wrist/tennis elbow supports - See if a simple wrap or brace will increase your enjoyment of tennis or golf. Even yard work, painting and home repairs can produce symptoms of tennis or golfer elbow which would benefit from supportive straps or sleeves.
  

Running & Walking

Runners and walkers must pay close attention to their shoes and feet. (Tips for Selecting the Proper Size Athletic Shoe >>)Small problems can be accentuated with activity. Joggers and walkers step many more times each day than non-activists; each foot strikes the ground about 800 times per mile. Being able to select and view products that are designed specifically for these problems is important.

3 Products For Runners & Walkers:

• heel,arch supports
  
• wound/blister care
  
• anti-fungal/ anti itch
  

Performing Self Assessments

There are many important health assessments that require physician involvement. Yet serious exercise devotees can perform some basic self assessments and would benefit from those measurements. Measuring exertion, health responses to exercise, blood pressure, pulse rate and oxygen uptake during exercise has value to measure effort as well as to protect from overtraining.

4 Health Assessments You Can Perform Without a Physician:

• blood pressure
• heart rate monitors/ pedometers
• pulse oximeter
• scales/body composition

“It is wiser to prepare than to repair”

While getting out and “getting to it” is the reason why exercise can be fun, remember “it is wiser to prepare than to repair”.  Giving strength development, flexibility increases and range of motion improvement the time and effort they deserve will yield considerable benefits. Get in shape to get in shape is a prudent idea.

Don't Leave Out Strength Exercises:

• flexibility,weights,body blade, tubing

Aches & Pains

Yet with improvement and physical exertion there can be injury or discomfort associated with improving your current state. The old idea of “no pain, no gain” has gone by the wayside just like “no water makes you tough”. Muscles respond to demands by becoming stronger and actually producing more blood vessels, but the production of lactic acid associated with muscular effort can be uncomfortable.

Find Relief:

• hot/cold therapy
• pain relief

It takes time and effort to take care of your health, but it is an investment that yields considerable dividends. Being aware of the factors associated with doing it wisely can be beneficial and produce better results.

Phil Hossler, ATC has been an athletic trainer on the scholastic, collegiate and Olympic levels. He has authored 4 books and numerous articles and served as an officer in state and regional athletic training associations for 20 years. He is a member of four halls of fame including the National Athletic Trainers’ Association’s.

13 Tips for Selecting the Best Fitting Athletic Shoe

Protect Your Feet and Avoid Podiatry Problems with Shoes that Fit Correctly.

Your foot-ankle area is truly an architectural wonder. While composing 2-4% of the body’s total skin surface, the sole of the foot is capable of absorbing up to 7 times normal body weight with each foot plant.

There are a few general guidelines to be remembered when shopping for activity shoes:

1. 
   Never buy new shoes early in the day; shop in late afternoon or early evening when feet have swollen to their greatest width otherwise what felt good in the morning may be too tight in the evening.
   
2. Bring the socks that you intend to wear with your activity shoes when you go shopping.
   
3. If you have an old pair of activity shoes, bring them along with you to the store. Put on one old and one new shoe as you walk, hop, jump around the store. Compare the feel and then switch again onto your other foot.
   
4. 
   Set the shoe on a flat surface and look at it from the back. Make certain the heel counter sits perpendicular to the surface without leaning in or out.
   
5. 
   Take your thumb and attempt to flatten the heel counter into the shoe; heel counters should be firm.
   
6. 
   Check for double stitching especially around the laces and toe box.
   
7. 
   Make certain that the “break” in the top of the shoe is directly above the ball of your foot to ensure that the shoe bends where the foot bends.
   
8. 
   Leather uppers wear longer but are hotter than nylon mesh. Mesh will “breath” to help keep the foot cool and dry, but may be harder to keep clean.
   
9. 
   Match the shoe to the activity.
   
10. 
    Remember that a snug shoe might stretch in width, but a short shoe will not stretch in length.
    
11. 
    Match the toe box width to the shape of your toes. Some people find a wide toe box to be more comfortable with no pinching, squeezing and eventual blister formation.
    
12. 
    Break shoes in gradually. Alternate during the activity period between old and new for a while until the new feels as comfortable as the old.
    
13. 
    If you have a history of bunions, calluses, blister, arch strains, plantar fasciitis, it may be worth a podiatrist visit to get an explanation and/or manufacturer model number for the best shoe for you.
    

Many problems can be controlled or eliminated with prudent first aid and preventative measures. Consider using products such as Spenco® 2nd Skin if your new shoes rub your toes, Cramer® Blister Foam if your new shoes are rubbing the back of your heel, Longitudinal Arch Pads if you have a high arch and the shoes just don’t seem to support your arch, or Plantar Fascia Straps to help combat plantar fasciitis.

View all podiatry products available from Sports Health >>

How To Identify and Treat Tennis Elbow - and When to See a Doctor

Tennis Elbow is a 100-Year-Old Injury.

 

Doctors first identified tennis elbow more than 100 years ago. Many medical textbooks treat tennis elbow as a form of tendonitis which is often the case, but if the muscles and bone of the elbow joint are also involved then the condition is epicondylitis.

Tennis elbow, or lateral epicondylitis, is one of several injuries that result from overuse that can affect the elbow. While playing tennis may be a cause, so are many other common activities, including using a screwdriver, painting, raking, and weaving.

Is it tennis elbow?

Consider the differences in aches in and around the elbow joint:

Tennis elbow: Gradual onset of feeling pain when gripping, lifting and carrying objects on the lateral side of elbow.

Golfer’s Elbow: Pain radiates throughout the joint on the medial side of the elbow.

Bursitis: Swelling on the posterior aspect often caused by leaning, falling or hitting the back of the elbow.

 Other signs of tennis elbow include:

• Pain that radiates along outside of elbow possibly into forearm and fingers
• Pain if you touch or bump the lateral side of the elbow
• Pain with wrist extension
• A weakened grip with muscle soreness along the lateral side
• A painful grip during shaking hands, turning doorknobs, lifting or bending the arm
• You may even experience pain upon extending the forearm if muscle/tendon become tight and sore

Relief of Tennis Elbow

1. Stop any activity that causes pain if possible.
2. Use NSAIDs.
3. Apply ice after use and heat before/during activity.
4. Wear a tennis strap such as Tennis Elbow Strap by Cramer, Aircase Pneumatic Armband, PRO Neoprene Elbow Sleeve, or Thermoskin Elbow Sleeve around upper forearm.
5. If you find the cause was work-related, take frequent breaks.
6. If standard conservative methods are ineffective, seek medical intervention.

For the tennis player with tennis elbow

Recreational players need to carefully monitor and check their equipment. Items to consider include:

• Racquet material - graphite composite materials are considered best for torsion and vibration control.
• Head Size - a midsize racquet (95-110 sq inches) is preferred. Oversize racquet heads may result in injury due to increased torque with off center hits.
• String tension - you might consider staying at the lower end of the manufacturer’s recommendations. While higher string tension increase ball control and spin, it also requires greater forearm strength and torque control.
• Stringing - consider using synthetic material and re-string every 6 months.
• Grip Size - a grip too large or too small lessens control and promote excessive wrist movement.

When to seek medical help

If your game has not improved due to discomfort and you have tried standard conservative methods of care (ice, NSAIDs, rest) plus have examined your equipment, seek medical assistance. If your elbow is hot and inflamed, you cannot move your elbow/forearm without pain, your elbow looks deformed, you have numbness in one or more fingers and you seem to have no grip strength anymore, also seek medical assistance.

View Tennis sports medicine products for the prevention and relief of tennis-related injuries >>

How to Choose an Effective Post-Exercise Drink

Could Milk Be Your Secret Muscle Building Weapon?

As science catches up with athletic medicine, it certainly is within the role of the certified athletic trainer to have opinions on the fuel used by athletes to replenish and recharge after exercise.  Look around you, check the internet, have conversations with colleagues and attend meetings to find out more about this area. While it is undoubtedly within the domain of sports nutritionists and dieticians, most high schools and many colleges are not fortunate enough to this caliper of professional on staff.

Cost, convenience, availability and taste are all factors to consider when urging your athletes to utilize something during that two hour post-exercise window to recharge energy stores and replenish depleted protein sources.
I started urging something as simple and yet effective as chocolate milk when I speak to teams during preseason. Consider what the research says about chocolate milk as a post-exercise drink:

1. Protein.Helps build muscle, reduce muscle breakdown and works with carbohydrates to restore muscle glycogen.
2. Carbohydrates.Refuels muscles (restore muscle glycogen).
3. Electrolytes.Helps replenish what’s lost in sweat (sodium, calcium, potassium and magnesium).
4. Fluids.Helps rehydrate the body.
5. Calcium and vitamin D.Strengthens bones and reduces the risk of stress fractures.
6. B vitamins.Helps convert food to energy.
7. 9 essential nutrients.Offers additional nutrients not typically found in traditional sports drinks.

Adding milk vending machines or selling milk at games for fund-raisers are ways to incorporate milk onto your team.

For more information on milk, go to the below links.  Or, sign up for our enewsletter to keep current on the latest sports medicine trends.

• www.milkdelivers.org
• Rolando Blackman, NBA Dallas Mavericks speaks at http://www.courier-gazette.com/articles/2010/12/16/carrollton_leader/news/163.txt
  
  • Crafting Diet for Peak Performance Discussed - go to http://www.northjersey.com/news/111578364_Crafting_diet_for_peak_performance_discussed.html

Phil Hossler, ATC has been an athletic trainer on the scholastic, collegiate and Olympic levels. He has authored 4 books and numerous articles and served as an officer in state and regional athletic training associations for 20 years. He is a member of four halls of fame including the National Athletic Trainers’ Association’s.