Sports

Drive through the Stanford campus on certain days and you’re likely to see a group of people, some sporting kilts, doing things like tossing long, heavy wooden pools around. In today’s Inside Stanford Medicine, my colleague Sara Wykes tells the fun story of a group of medical school researchers and staff who participate in Scottish heavy athletics, such as caber tossing. From her article:

“I saw cabers out here by a tree, and saw Alan around with the kilt and made the connection,” [Brian Grone, PhD,] said. Alan Hebert is a computer research associate at the Beckman Center for Molecular and Genetic Medicine, which isn’t too far from the Sand Hill Road recreational fields where the team practices twice a week. Hebert is the team’s unofficial recruiter, but the sport really sells itself.

“For some people, it’s the heritage,” Hebert said. “There really is something to be said for picking up a weight and knowing that 120 years before, somebody else with a kilt did the same thing.” Hebert is talking about the most modern tradition of the games, though these kinds of sports have taken place for many centuries.

Others, like Brady Weissbourd, a Stanford PhD candidate in biology and onetime captain of Harvard’s volleyball team, find appeal in the physical challenge. “It’s basic strength,” Weissbourd said. “Who can throw this heavy rock the farthest? It’s also fun and a good way to get out of the lab.”

Photo of Brian Grone doing the weight throw by Norbert von der Groeben

In an effort to better evaluate and prevent concussions and head traumas, researchers at Johns Hopkins University have developed a computer model to identify what types of jarring movements to the body can cause injury to the brain. As explained in a university release:

[Researchers] used a powerful technique called diffusion tensor imaging, together with a computer model of the head, to identify injured axons, which are tiny but important fibers that carry information from one brain cell to another. These axons are concentrated in a kind of brain tissue known as “white matter,” and they appear to be injured during the so-called mild traumatic brain injury associated with concussions. [The] team has shown that the axons are injured most easily by strong rotations of the head, and the researchers’ process can calculate which parts of the brain are most likely to be injured during a specific event.

…

Beyond its use in evaluating combat and sports-related injuries, the work could have wider applications, such as detecting axonal damage among patients who have received head injuries in vehicle accidents or serious falls. “This is the kind of injury that may take weeks to manifest,” [ Johns Hopkins researcher K. T. Ramesh, PhD,] said. “By the time you assess the symptoms, it may be too late for some kinds of treatment to be helpful. But if you can tell right away what happened to the brain and where the injury is likely to have occurred, you may be able to get a crucial head-start on the treatment.”

Researchers plan to combine the findings with additional data, including reconstructed motions from serious sports-related collisions and information about athletes’ protection gear, to provide guidance on treatment and rehabilitation of injured players.

The study comes at a time when concerns about sports-related concussions continue to grow. Yesterday, the National Football League and General Electric Co. announced a significant investment to accelerate research on brain trauma and the development of technology to prevent concussions among athletes, soldiers and others.

Similarly, Stanford researchers are continuing to study data from mouthpieces equipped with tiny sensors to measure the force of head impacts sustained by football players during games and practices. The goal of the project is to determine which types of football collisions cause concussions and whether any positions or particular plays are associated with greater risk of brain injuries.

Previously: Stanford researchers working to combat concussions in football, Mental and emotional costs of a concussion, A conversation with Daniel Garza about football and concussions, High-tech mouthpieces used to advance medical understanding of concussions in football and When can athletes return to play? Stanford researchers provide guidance
Photo by situnek34

If you, like me and countless other NFL fans out there, have Super Bowl fever this week, you may find this Stanford Daily Q&A with Daniel Garza, MD, of interest. Garza is medical director for the San Francisco 49ers, as well as an assistant professor of orthopaedic surgery at Stanford, and here he talks about his work with the football team, the scariest injury he’s seen on the field, and his experience “soak[ing] up the craziness” in New Orleans, the site of this year’s big game.

Previously: A conversation with Daniel Garza about football and concussions, High-tech mouthpieces used to advance medical understanding of concussions in football and Stanford Hospital and 49ers team up to study biomechanics of football injuries

Today’s New York Times offers a look at something that “exists at every level of sports” but is often ignored: Mental illness. William C. Rhoden writes:

Sports too often is a masking agent that hides deeply rooted mental health issues. The better the athlete, the more desperate to reach the next level, the less likely he or she will reach out for help. The gladiator mentality remains a primary barrier.

“Mental health has a stigma that is tied into weakness and is absolutely the antithesis of what athletes want to portray,” said Dr. Thelma Dye Holmes, the executive director of the Northside Center for Child Development, one of New York’s oldest mental health agencies, serving more than 1,500 children and their families.

A Stanford psychiatrist, himself an accomplished athlete, also weighs in:

“They believe nothing can go wrong, they don’t need help, they can overcome,” Dr. Ira Glick, professor emeritus of psychiatry and behavioral sciences at Stanford University School of Medicine, said in a telephone interview.

He added: “And just for that alone, they don’t want to go to therapy either for psychotherapy or medication. You have to start to change the culture beginning in Little League, imbue in them from the time they are Little League players.”

Photo by j9sk9s

We’ve written extensively on Scope about concussions in football. Numerous researchers here are investigating and working to prevent the problem, and in the above video some of them describe their efforts.

Athletic trainer Scott Anderson says of one of their studies, “by doing this… we’re really looking at, for the first time, what happens to the head and the neck when someone runs into somebody else.” And in an accompanying article today, bioengineer David Camarillo, PhD, explains that once there’s a better understanding of the mechanism of a concussion, “we can start zeroing in and prototyping technologies that may reduce the likelihood of sustaining an injury in the first place.”

Previously: Mental and emotional costs of a concussion, A conversation with Daniel Garza about football and concussions, High-tech mouthpieces used to advance medical understanding of concussions in football, Researchers develop new test for diagnosing concussions on the sidelines, Deceased athletes’ brains reveal the effects of head injuries and When can athletes return to play? Stanford researchers provide guidance

Researchers here have shown that sleep may have a positive effect on athletic performance. And new findings presented at the American Academy of Pediatrics’ national conference hint that sleep might provide another sports-related benefit: In a study of young athletes, those who slept at least eight hours a night had a 68 percent lower risk of sports injury.

MedicalNews Today reports on the study:

The researchers asked school athletes - 160 students, 54 males and 58 females, mean age 15 years - from middle and high school, grades 7 to 12, who were part of the Harvard-Westlake School in Studio City, California, to complete a questionnaire which requested details of their sports, how much time they spent in each sport both at school and outside, did they have private coaching, were they involved in any strength training, what their sleeping patterns were, and how much they enjoyed their sport.

The questionnaires were completed by 112 of them. The researchers then analyzed them, specifically looking at sleeping patterns, and checked the school records for sports injuries.

They found that the more sleep the pupils got, the lower their risk of injury seemed to be.

The work relies on self-reports, which yield data that may be less accurate than if the scientists had gathered the information themselves. However, the finding are intriguing and worth exploring further. As author Matthew Milewski, MD, commented, “nobody has really looked at [lack of sleep] in terms of the adolescent athletic population” before.

Previously: A slam dunk for sleep: Study shows benefits of slumber on athletic performance, Could game time affect a baseball player’s at-bat success?, Want to be like Mike? Take a nap on game day, Sleep deprivation may increase young adults’ risk of mental distress, obesity and Lack of sleep may be harmful to a teen’s well-being
Photo by K.M. Klemencic

My husband has often told me I deserve a medal after giving birth to two girls in two years. There’s a lot of blood, sweat and tears involved with having kids, and I couldn’t help but feel amused when I saw the headline - “After a Baby, a Gold?” - of a New York Times blog entry that a colleague (also a mom with two daughters) brought to my attention today. In the piece, writer David Gendelman looks at something a handful of the women competing in this year’s Olympic high jump have in common (well, besides trying to win gold): They’re all new mothers.

Is it a coincidence that these women are performing so well after childbirth, or does having children actually make you stronger? (One mom-competitor reports that she can squat “a lot more” than the 225 pounds she could before having her second daughter.) Sports medicine specialist Elizabeth Joy, MD, isn’t sure about the purported performance-enhancing effects of pregnancy, but she offers one explanation for why athletes may feel so good and strong after delivery:

When a woman delivers, she still has this incredibly expanded blood volume, which declines over the next six weeks. But in that first six-week postpartum period, and particularly among elite athletes who are very fit, I bet they’re getting back to exercise pretty quickly. After their delivery, they just lost 15 pounds. They probably do feel like they have this huge engine with a much lighter load.

Benjamin Levine, MD, who teaches exercise sciences at the University of Texas Southwestern Medical Center, also can’t attribute a single factor to postpartum strength, but he thinks perhaps parenting has a positive change on the mental perspective of these Olympic-competing moms. “It’s a major life change, and the ones that deal with it and thrive, perhaps it focuses their concentration. Maybe they have more to win for. Maybe they’re more highly motivated.”

So even though there may be no scientific evidence indicating a link between strength and childbirth, I thought high jumper Amy Acuff said it best when she described why working out seemed easier after having a baby. “I thought about how I do almost the same thing with a 20-plus pound baby all day that I did with the medicine ball,” she said.

Oh - and Hubby, if you’re reading this, a medal is nice but getting more sleep would be even sweeter.

Previously: How safe is rigorous exercise during pregnancy?, Pregnant curler competing in Olympics and Pregnant and on the move: The importance of exercise for moms-to-be
Photo by Steve Fair

It may surprise you to learn, as it did me, that the tobacco industry and the Olympic Games have a long history stretching back to the 1948 London Games, of which Craven A cigarettes was a major sponsor. As I learned from Robert Jackler, MD, chair of otolaryngology at Stanford, the relationship between the Olympics and tobacco industry grew to be quite close over the next four decades, until the International Olympic Committee (IOC) adopted a tobacco-free policy. But the adoption of the new policy didn’t necessarily translate into a “smoke-free” Olympic Games.

Below Jackler, whose ongoing research into the history of tobacco company advertising has resulted in several published studies, discusses the tobacco industry’s motivation for aligning itself with the Olympic Games, how the IOC’s tobacco-free policy affected companies’ marketing strategies and present-day tactics by the industry to capitalize on global Olympic fever.

Why would the tobacco industry want to associate itself with the Olympic Games?

The tobacco industry has long sought to affiliate its products with cherished and admired cultural icons such as sports heroes, movie stars and even Santa Claus. Few traditions possess a greater luster and aura of nobility than the Olympic Games. By allying itself with the illustrious global sporting event, the industry links smoking and tobacco use with healthfulness, physical fitness, heroism, national pride and sheer entertainment. Explicit tobacco association with the Olympics has a lengthy history that includes formal sponsorship (e.g. the official cigarette of the Olympics) but industry exploitation continues to the present day.

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The opening of the Olympic games marked the beginning of a special experience not just for the athletes competing, but also for the doctors that care for them. Like the athletes, volunteer Olympic doctors make many sacrifices to fulfill Olympic dreams. An American Medical News story today provides a closer look at the dedication of several U.S. team physicians, who all agree that sacrifices are worth the rewards. Carolyne Krupa writes:

Among them are physicians from around the country who are volunteering their time to support the U.S. team. To do so, they must be willing to leave their practices for weeks at a time, to work long shifts under grueling, high-stakes conditions for little or no pay.

Physicians working the games say it’s all worth it for the chance to be part of a global event and work with some of the world’s most elite athletes.

“It’s worth the sacrifices,” said Peter Donaldson, MD, a U.S. team physician, sports medicine specialist and assistant professor at Oakland University William Beaumont School of Medicine in Rochester, Mich. “I’ll be grinding away in clinic for the rest of my life, but there are few opportunities that come up in life that are as unique as this.”

Previously: U.S. Olympic team switches to electronic health records and Olympic health concerns - for the spectators

Numerous studies report troublesome statistics about Americans’ sub-standard fitness levels, budget cuts to physical education and climbing cases of obesity. Each time such news breaks, I panic a little and plan to move more in the interstitial times of day - yoga before work, a walk at lunch or abs with 30 Rock. I also try to think of subtle ways to build physical activity into the routines of my young nieces and nephews.

But my fears about America’s growing waistlines tapered when I came across a Booster Shots entry today discussing findings on exercise and obesity. The recent paper, published in the journal Pediatrics, determined that if every high schooler became a two-sport athlete, obesity rates in their demographic would decrease by 26 percent. More easily applied, a 22 percent decrease in obesity would follow if every teen walked or biked to school at least four days a week.

Where are we now? Booster Shots reports:

The researchers from various institutions in New York and New England surveyed 1,718 teenagers and their parents in Vermont and New Hampshire from 2002 to 2009. Twenty-nine percent of the students were overweight to obese, and 13% were obese.

Walking or biking to school, the researchers said, needs more study; they found some association with obesity but not necessarily to being overweight. Only 10.2% of the students they surveyed walked or biked to school more than 3.5 days a week.

….

Almost three-quarters of the teenagers in the survey played on sports teams, with almost 54% on two or three teams. Nationwide, 60.3% of high school students play sports, and 34.2% are overweight.

At Stanford, researchers including Thomas Robinson, MD, MPH, are exploring ways to curb childhood obesity. In a previous Scope Q&A, Robinson discussed a pediatric weight-control program he devised that motivates children through culturally specific dance classes, team sports and pollution-free transportation.

Previously: Questioning the use of video games to get kids more active, How physical activity influences health and Stanford pediatrician discusses developing effective programs to curtail childhood obesity
Photo by Noize Photography