Published by
Stanford Medicine

Category

Sports

Neuroscience, Pediatrics, Sports, Stanford News

Kids and concussions: What to keep in mind

Kids and concussions: What to keep in mind

Back to school means to back to sports for many, and it’s a good time for parents and coaches to be thinking about – and watching out for – concussions. In a recent Q&A from Lucile Packard Children’s Hospital, two experts offer ways to reduce the effects of a concussion, provide guidance on when an affected player can get back on the field, and remind readers about sex differences in symptoms. Stanford’s Paul Fisher, MD, chief of pediatric neurology at Packard Children’s, says:

Girls and boys tend to report different symptoms of a concussion and may also describe the same symptoms differently. Boys often report symptoms that are fairly severe – confusion, bad headaches, forgetting – while girls may report milder symptoms, such as drowsiness, malaise, or noise sensitivity. But that doesn’t mean a girl’s concussion is any less severe.

A big problem here is that when a girl reports milder symptoms to a male coach – and a lot of coaches in girls’ sports are male – her concussion could be missed if the coach isn’t alert to the differences in how boys and girls report symptoms.

Previously: Study shows concussion recovery may take longer for female, younger athletes, Report finds brain injuries rising among high school football players, Can high-tech helmets safeguard young athletes against concussions?, Study suggests teens are more vulnerable to effects of sport-related concussions, Should parents worry about their kids playing football? and A conversation with Daniel Garza about football and concussions

Ask Stanford Med, Sleep, Sports, Stanford News

Last day to submit questions on sleep and athletic performance to Stanford expert

CARTERAs a reminder, today is the final day to submit questions for our Ask Stanford Med installment spotlighting sleep and athletic performance. Questions related to research on the subject and to sleep patterns or exercise habits can be submitted to Cheri Mah either by sending a tweet with the hashtag #AskSUMed or by posting a comment here. We’ll accept questions until 5 p.m. Pacific time.

In our earlier post, we included details on Mah’s research:

Sleep and sports are the focus of Mah’s work, dating back to a 2002 study during which collegiate swimmers reported they had beaten personal swim records after getting extra hours of sleep as part of their participation in the trial. A light bulb went off in Mah’s head, who decided then to investigate whether sleep extension could have an impact on physical performance. Since then she has researched the effects of sleep on numerous groups of athletes, including elite college-level basketball players (as detailed in a 2011 study), and she has two soon-to-be-published papers measuring the impact of sleep on Stanford football players and on NFL players. Over the last several years, Mah has also worked with many of the Stanford sports teams and coaches to integrate optimal sleep and travel scheduling into their seasons, and she consults on sleep issues with professional hockey, football and basketball teams.

Previously: Ask Stanford Med: Cheri Mah taking questions on sleep and athletic performanceStanford expert: Students shouldn’t sacrifice sleepA slam dunk for sleep: Study shows benefits of slumber on athletic performanceCould game time affect a baseball player’s at-bat success? and Want to be like Mike? Take a nap on game day
Photo by ASSOCIATED PRESS

In the News, Orthopedics, Research, Sports

Barefoot running: the conversation continues

Barefoot running: the conversation continues

footprint

Running au naturel could feel freeing or painful, and runners and sports medicine specialists argue both ways about going bare…foot. As previously reported on Scope, sans-shoe or reduced-shoe running has been shown to promote landing further forward on the foot, which may prevent injury, but the practice could introduce other physical problems if adopted into a routine too quickly.

At this year’s British Science Festival in Newcastle, U.K., an overview of research suggested that runners who wish to begin running barefoot should introduce the practice slowly into their routine. A BBC News article on the conference proceedings reports that experts differ on recommendations for running footwear, but they agree that more research needs to be conducted.

From the article:

[Mick Wilkinson, PhD, an exercise physiologist from Northumbria University] was one of the first people to run the Great North Run completely barefoot, which he did in 2011. But he believes that those using thin-soled shoes which claim to emulate barefoot running may be missing out on the potential benefits from running without footwear.

“Studies in the late 80s suggest there needs to be a sense of friction before the impact avoidance behaviour is triggered. So if you put anything between you and the ground, even if it’s only 4mm thick, people tolerate extremely high vertical loads, without doing anything about it,” Dr Wilkinson explained.

Other researchers suggest that thinner-soled shoes still encourage front-foot striking and the associated benefits. According to Mark Burnley, PhD, a senior lecturer in exercise physiology at the University of Kent, barefoot running “will save you money on shoes, but is not some injury-eliminating/performance-enhancing panacea.”

Previously: Seeking to reduce stress on the body, some runners are reversing their strideIs barefoot running better for the body? and “Barefoot” running craze still going strong
Photo by Gordon Tarpley

Ask Stanford Med, Sleep, Sports, Stanford News

Ask Stanford Med: Cheri Mah taking questions on sleep and athletic performance

football kidIt’s football season and back-to-school time, which means evening routines in households across the country may be changing to accommodate homework, practice, dinner, and perhaps Monday Night Football-watching. For athletes of all ages and stripes, conversations may also be focused on optimizing performance and reducing the risk of injury, with such topics as conditioning technique and nutrition getting playing time in the discussions. But one thing that may not be getting enough attention is sleep, and its role in sports.

To boost the conversation of sleep’s part in athletic performance, we’ve asked Cheri Mah, a researcher with the Stanford Sleep Disorders Clinic and Research Laboratory, to respond to your questions on the topic. Sleep and sports are the focus of Mah’s work, dating back to a 2002 study during which collegiate swimmers reported they had beaten personal swim records after getting extra hours of sleep as part of their participation in the trial. A light bulb went off in Mah’s head, who decided then to investigate whether sleep extension could have an impact on physical performance. Since then she has researched the effects of sleep on numerous groups of athletes, including elite college-level basketball players (as detailed in a 2011 study), and she has two soon-to-be-published papers measuring the impact of sleep on Stanford football players and on NFL players. Over the last several years, Mah has also worked with many of the Stanford sports teams and coaches to integrate optimal sleep and travel scheduling into their seasons, and she consults on sleep issues with professional hockey, football and basketball teams.

Questions can be submitted to Mah by either sending a tweet that includes the hashtag #AskSUMed or posting your question in the comments section below. We’ll collect questions until Tuesday, September 17 at 5 p.m.

When submitting questions, please abide by the following ground rules:

  • Stay on topic
  • Be respectful to the person answering your questions
  • Be respectful to one another in submitting questions
  • Do not monopolize the conversation or post the same question repeatedly
  • Kindly ignore disrespectful or off topic comments
  • Know that Twitter handles and/or names may be used in the responses
  • Mah will respond to a selection of the questions submitted, but not all of them, in a future entry on Scope.

Finally – and you may have already guessed this – an answer to any question submitted as part of this feature is meant to offer medical information, not medical advice. These answers are not a basis for any action or inaction, and they’re also not meant to replace the evaluation and determination of your doctor, who will address your specific medical needs and can make a diagnosis and give you the appropriate care.

Previously: Stanford expert: Students shouldn’t sacrifice sleep, A slam dunk for sleep: Study shows benefits of slumber on athletic performance, Could game time affect a baseball player’s at-bat success? and Want to be like Mike? Take a nap on game day
Photo by Nick Weiler

Health and Fitness, In the News, Mental Health, Sports

Third down and ommm: How an NFL team uses yoga and other tools to enhance players’ well-being

Third down and ommm: How an NFL team uses yoga and other tools to enhance players' well-being

football fieldWith so much negative news about the health and well-being of professional football players (concussions, long-term brain injuries, and the like), it’s refreshing to read about something good happening in that arena.

A lengthy article in the current issue of ESPN The Magazine describes the kinder, gentler way that the Seattle Seahawks are conditioning their players – we’re talking meditation sessions, team-mandated yoga classes, and a trial program where the coach uses a fancy iPad app to track “what’s going on in [players'] lives, how much sleep they’re getting, their goals and how they’re dealing with stressors.”

A skeptic, or perhaps even the casual observer, would say that team ownership – and the coach - are only implementing such things to increase the number of wins. As ESPN writer Alyssa Roenigk rightly points out, “the big idea is that happy players make for better players.” (And one is reminded of a recent WIRED article discussing how meditation and mindfulness are being promoted and used by Silicon Valley types as a way to increase productivity.) But I would argue that anything that helps, not hurts, the health of these athletes deserves kudos. More from Roenigk:

Here’s the thing about the Seattle experiment: It’s only the beginning of what the Seahawks intend to be a total revamp of the way a football franchise approaches the physical and mental well-being of everyone in the organization. Team chef Mac McNabb feeds the players fruits and vegetables from local organic farms. He takes any leftovers to a nearby family-run farm to feed free-range chickens, which are raised specifically for the Seahawks cafeteria. Ramsden and Gervais spend their spare time attending conferences, meeting with nutritionists and sleep experts, and, judging by the mound of boxes in Ramsden’s office, buying any new tech gadget that could be the next breakthrough in maximizing athletic performance. At the start of last season, Ramsden gathered data on most of the Seahawks, including blood and vision analyses and sleep and conditioning profiles. At practice, player movement is tracked via GPS so the team can monitor workloads. Ultimately, Ramsden would like to have players and coaches wear wristbands to track sleep habits and, when necessary, adjust practice schedules to maximize rest.

The Seahawks hope to one day have daily mental health check-ins to monitor players’ off-the-field problems. Owner Paul Allen, no stranger to innovation, has indicated that he wants his MLS franchise, the Seattle Sounders, to follow the Seahawks’ model.

Previously: A season of hits may impair some football and hockey players’ cognitive function, Mental and emotional costs of a concussion, Deceased athletes’ brains reveal the effects of head injuries and A slam dunk for sleep: Study shows benefits of slumber on athletic performance
Via Emma Seppala, PhD, on Facebook
Photo by GioPhotos

Behavioral Science, Health and Fitness, Medicine and Society, Sports

Engagement in arts or sports linked with greater well-being, Scottish report shows

Dunedin Dance Festival 2009_8264Okay, so I’m biased in flagging a study showing that participation in cultural events is linked with self-reported good health and life satisfaction. Perhaps Scotland is, too, given that the Scottish government-commissioned study was released the day that tickets go on sale for next year’s Commonwealth Games in Glasgow, as BBC News notes.

It’s not surprising that people who have the means to take dancing lessons or read for pleasure might also have access to fresh food, decent medical care, and other factors positively affecting health. But what’s striking about the data, drawn from the Scottish Household Survey 2011, is that the correlation between engagement in culture and perceived well-being was found across variables such as age, income, education and disability status among the 9,683 adults surveyed on this topic.

BBC News reports key findings of the study:

  • Those who attended a cultural place or event in the previous 12 months were almost 60% more likely to report good health than those who did not
  • Those who participated in a creative or cultural activity in the previous 12 months were 38% more likely to report good health than those who did not
  • Those who visited a library or a museum were almost 20% more likely to report good health than those who had not
  • Those who visited a theatre were almost 25% more likely to report good health than those who did not
  • Those who participated in dance were 62% more likely to report good health than those who did not
  • And those who read for pleasure were 33% more likely to report good health than those who did not

Previously: Research suggests art lovers may fare better after a strokeDancing with cerebral palsy and Making museums more inviting for autistic children and their families 
Photo by I Robertson

Pediatrics, Public Health, Sports

Sports medicine specialists, educators endorse checklist to reduce injuries among youth athletes

Sports medicine specialists, educators endorse checklist to reduce injuries among youth athletes

soccer_water_breakGrowing up in Texas, I always dreaded the beginning of the fall soccer season – when grueling after-school trainings coincided with peak daily temperatures. Our coaches lectured us about staying hydrated, but it wasn’t uncommon for someone on the team to collapse from heat exhaustion.

So I was interested to read about recently released guidelines (.pdf), which have been endorsed by sports doctors, athletic trainers, research physiologists and high school administrators, aimed at preventing youth athletics-related injuries, or worse death. A Shots piece published today highlights some of the recommendations, including:

Have an (automated external defibrillator) within easy reach during practices and games to jump-start a heart that suddenly fails. “Cardiac problems are becoming much more survivable, but the AED has to be out on the field with the athletic trainer and on the kid’s chest within a minute after the heart stops to save a life,” says [Douglas Casa, PhD, who helped draft the guidelines]. Running inside the school to pull the device from the hallway case isn’t fast enough, he says.

Have water freely available at all times, and give student athletes a tightly structured, several-day acclimatization period at the start of every season — especially in summer — with shorter, less intense practices that will help their bodies adjust to the big shifts in heat and exertion of a full game or regular practice.

Previously: Should high-school and college athletes be routinely screened for heart conditions?, When can athletes return to play? Stanford researchers provide guidance, ECG screening of young athletes is cost-effective way to save lives and Stanford team writes new recommendations for reading athletes’ ECG results
Photo by lothlaurien

Neuroscience, Pediatrics, Research, Sports

Measuring vs. reporting concussions in cheerleading

6255579856_f43e167c27The subject of athletes’ concussions might call to mind a collision between sturdily built practitioners of contact sports, such as football or wrestling. Recently, the New York Times brought attention to head injuries among cyclists. As the sister of a petite former Los Angeles Rams cheerleader, who frequented the emergency room after many a stunt or tumbling accident, though, I wasn’t surprised to read that concussions are also prevalent at the top of the pyramid, so to speak.

Now a Journal of Pediatrics release reports that cheerleading has the highest rate of catastrophic injury among sports, with some studies reporting that concussions account for approximately six percent of total cheerleading injuries.

A recent study (.pdf) in the journal measured neurocognitive testing results in cheerleaders against their self-reported presence of symptoms. Vanderbilt University researchers followed 138 junior and senior high school cheerleaders with concussions using pre-season neurocognitive testing followed by at least one Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) evaluation within a week of injury.

From the release:

Overall, 62% of the cheerleaders reported an increase in symptoms after a concussion (e.g., headache, nausea, and dizziness) compared with their baseline. Of the cheerleaders who denied an increase in concussion symptoms from baseline, 33% had at least one ImPACT score that exceeded index criteria. This means that these cheerleaders reported their symptoms inaccurately, overestimated their recovery, or were unaware of their decreased neurocognitive performance.

The results show that the addition of a neurocognitive assessment could be a useful tool to evaluate when cheerleaders with concussion have returned to normalized baseline measures. They also support the idea that self-reported symptoms and decreased neurocognitive test scores after concussion may differ.

The paper references a previous study that found that most of the stunt-related injuries occurred while the cheerleader was stationed at the base of a pyramid or supporting a teammate above.

Previously: Study shows concussion recovery may take longer for female, younger athletesStudy suggests teens are more vulnerable to effects of sport-related concussionsWhen can athletes return to play? Stanford researchers provide guidance and Researchers develop new test for diagnosing concussions on the sidelines
Via ScienceBlog
Photo by SouthernArkansasUniversity

Cancer, Pediatrics, Sports

From leukemia survivor to top junior golfer

From leukemia survivor to top junior golfer

patient-golfer-storyTwelve year-old golfer Grace Chen is on a winning streak. She has won 25 golf trophies and recently earned a first place finish at the Junior Golf Association of Northern California’s annual tournament. This impressive string of successes began at the tender age of six when Grace achieved her first major triumph: She successfully completed treatment for acute lymphocytic leukemia (ALL).

This early success was a team effort. When she was only two years old, Grace began treatment for leukemia under the care of pediatric oncologist Gary Dahl, MD, at the Bass Center for Cancer and Childhood Blood Diseases at Lucile Packard Children’s Hospital. Grace’s treatment and successful recovery is noteworthy for many reasons. In a recent Packard story, Dahl explains:

Grace represents a very important trend in leukemia treatments… In the early 1960s, before chemotherapy was used, only about 3 percent of patients like Grace were long-term survivors. But in the late ’60s and ’70s, we made major inroads in treatment. ALL now has a cure rate of around 90 percent.

The story also describes how once treatment ended, Chen’s golfing career began:

“My wife and I wanted something to help her physically and mentally,” said Grace’s father, Weixing Chen. “We figured golf — with open, fresh air and beautiful settings — would be right for her, and she could do it at her own pace and get good exercise.”

Golf quickly became more than just exercise. At age 7 Grace won five medals in a national competition.

Grace will compete in the U.S. Kids Golf World Championship at Pinehurst, N.C. this year.

Holly MacCormick is a writing intern in the medical school’s Office of Communication & Public Affairs. She is a graduate student in ecology and evolutionary biology at University of California-Santa Cruz.

Previously: Training the immune system to attack cancer throughout the body: A new clinical trial at StanfordChildhood leukemia patient on methotrexate shortage and Study shows deaths from acute leukemia higher in minority patients.

Cancer, Dermatology, In the News, Sports, Stanford News

Working to protect athletes from sun dangers

Working to protect athletes from sun dangers

sunsport2SUNSPORT, Stanford’s new program to educate student-athletes about the dangers of sun exposure, was featured in the health section of today’s San Francisco Chronicle.

The piece (subscription required) tells the story of Stanford distance runner Erik Olson, who was diagnosed with melanoma last summer at age 20. Following successful treatment, Olson has adopted healthy sun-protection habits and is working with SUNSPORT to encourage other outdoor athletes, and fans, to do the same.

SUNSPORT, a collaboration of the Stanford Cancer Institute, the medical school’s Department of Dermatology, Stanford Athletics, and Stanford Hospital & Clinics, provides student-athletes with information about their heightened risks for sun-related skin damage and works with the teams’ coaches and athletic trainers to reinforce skin-protection practices on a daily basis.

“Outdoor athletes are an at-risk group for skin cancer, and SUNSPORT offers structured prevention strategies as well as research into skin protection behaviors,” Beverly Mitchell, MD, director of the Stanford Cancer Institute, told me.

Susan Swetter, MD, director of Stanford’s Pigmented Lesion & Melanoma Program, is quoted in the article. Swetter, who recently published research showing that young white men have a 55 percent higher risk of death from melanoma than their female counterparts, is one of SUNSPORT’s founders.

More information on the program is available at SUNSPORT’s website.

Michael Claeys is the senior communications manager for the Stanford Cancer Institute.

Previously: As summer heats up take steps to protect your skin, Stanford study: Young men more likely to succumb to melanoma, How ultraviolet radiation changes the protective functions of human skin, Image of the Week: Stanford SUNSPORT and Working to prevent melanoma

Stanford Medicine Resources: