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Thursday, 29 May 2014

Why Proper Injury Management is Important

I recently treated a young dancer who hurt her leg at school.  The story of how she hurt her leg and her subsequent recovery is a perfect example as to why safety recognition and proper injury management is key. 

Now her mechanism of injury is somewhat amusing but totally preventable.  While at school she slipped on a pencil and awkwardly caught her balance.  She was unable to extend her leg fully and was walking around on her tippy toes when I saw her.  She complained of pain in her upper calf.  She had no swelling or deformity.  Her hamstring and calf were in spasm which was causing her pain.  I sent her home with instructions to RICE (rest, ice, compress & elevate).  This is where the story turns ugly.  She went to school the next day feeling better, that was until she was not allowed to ice during recesses and lunch.  When her mother arrived home, her ankle was swollen, bruised and sore.  She was in so much pain, you could not touch her leg without her crying.  Click here to see her ankle.  After one day of ice, elevation and rest the swelling had gone down and by day five full range of motion had returned and she is back to dance.
Her injury was totally preventable, making sure that things are not left on the floor and encouraging kids to be aware of their surroundings.  However, kids will be kids and that can't always happen.  What could have happened is the proper management post injury.  As was seen by her recovery once the RICE principle was initiated, if this had been done the day after injury then the swelling, pain and bruising would not have been so severe. 

Basic injury management principles are just that basic and simple.  The RICE principle has been around for many years and does not require much advanced knowledge of injury management.  Correct management obviously creates a more ideal situation for healing, which is in the best interest for everyone.  A similar situation is a friend of mine who hurt her knee during soccer.  Her husband told her to heat it that night.  These two situations show the importance of more education on basic injury management.  

As health professionals we may feel that everyone knows how to deal with acute injuries, but everyday athletes both young and old are getting improper advice which in turn prolongs their injury and taking them away from being active and achieving success. 

For more information on injury prevention and management follow us on Twitter @EliteInjuryMgmt and check out our website 

Thursday, 22 May 2014

Fruits & Veggies in a Capsule

Juice Plus+ is whole food based nutrition, including juice powder concentrates from 25 different fruits, vegetables and grains.  Everyone wants to eat right and maintain a healthier lifestyle - whether you're a busy mom hustling to feed on-the-go children, a business traveler trying to stay fit, or an active boomer keeping up with grandkids.   All of us try to eat better for good health, but a healthy diet is often a challenge. We simply don't eat enough fruits and vegetables and that hurts our health and wellness.  Juice Plus+ helps bridge the gap between what you should eat and what you do eat every day.  Not a multivitamin, medicine, treatment or cure for any disease, Juice Plus+ is all-natural and made from quality ingredients carefully monitored from farm to capsule so you can enjoy improved nutrition and wellness.
There’s no complete substitute for eating the real thing. But shopping for and cooking fruits and vegetables every day takes a lot more time than most of us have.  How many people really consume the antioxidants and other nutrients they need in a wide variety of fruits, vegetables, and grains every single day?  Juice Plus+ is a convenient, inexpensive, less than $3.00/day, way to ensure you and your family receive the benefits over time from adding more nutrition from fresh fruits and vegetables to your diet. It’s an easy way to feed a healthier lifestyle.

Whole food based nutrition delivers powerful antioxidants that provide your body protection, because it relies on fruits and vegetables.   According to the National Cancer Institute, antioxidants are “substances that may protect cells from the damage caused by unstable molecules known as free radicals.  Examples of antioxidants include beta-carotene, lycopene, vitamins C and E and other substances.  Many of these antioxidant substances come from fruits and vegetables.” 

The Research
Clinical research has showcased the benefits of adding Juice Plus+ to your diet. More than 20 Juice Plus+ research studies have been conducted in leading hospitals and universities around the world.  The research has shown that Juice Plus+ delivers key phytonutrients that are absorbed by the body, reduce oxidative stress caused by free radicals, positively impacts markers of systemic inflammation, helps support a healthy immune system, helps protect the structural integrity of DNA and promotes cardiovascular wellness.   A study conducted at the Medical University of Graz, Austria showed that with following a standardized diet and extremely rigorous training program for 7 months with orchard (fruit) garden (vegetable) and vineyard (berry) blends compared to a placebo group,  had reduced markers of induced oxidative stress (protein carbonyls) and improvement of several indicators of immunity and inflammation. There was a trend for fewer duty days lost to illness in this special police forces of men (Cobras).

Healthy Children
In 1999 Juice Plus+® asked parents to share in a formal and quantifiable way what they experience in their own families as a result of beginning to take Juice Plus+®.   As an incentive to participate, we offer free Juice Plus+® to the child participant.  The Children's Health Study has since proven what we knew to be true all along: Juice Plus+® makes a real difference in family health and nutrition. 
The study is based on three important concepts:
  1. Good nutrition is the foundation of health and inspires other healthy lifestyle choices.
  2. The best time to establish good health and nutritional habits is in childhood.
  3. The key to getting children to adopt good health habits is parental involvement.
How does it work?

The way the Children's Health Study works is simple. For every parent, grandparent, or other adult that signs up as a Juice Plus+® customer, the study provides Juice Plus+® Orchard Blend and Juice Plus+® Garden Blend free to a child, teenager, or college student for up to four years. At various intervals — after 4-8 months and then at the end of each year — adult participants are asked to fill out a voluntary survey to determine whether (and how) their families' health habits have changed as a result of taking Juice Plus+®.  The results of the first 150,000 families who have responded to our surveys are documented here — and the news is very, very good!  Including more consumption of fruits and vegetables, fewer days missed at work and school due to illness and less over the counter medication taken. 

Click here for more information on Juice Plus+ including more research and health professional videos or contact us at 780-699-8084 or 

Follow us on Twitter @EliteInjuryMgmt or website at

Monday, 19 May 2014

A Cog on the Wheel

I spent the past weekend at a conference where the speakers and attendees ranged from coaches to sport medicine physicians.  I gained lots of things from the weekend in regards to lower body injuries, what I gained the most was how each profession in the world of sports medicine is just a cog on the wheel. 

Our speakers included a registered massage therapist, registered dietician, physical therapist, physical therapist with a PhD and an athletic therapist with a PhD in sports medicine and biomechanics.  They all pointed out how each profession plays a role in all aspects of sports. 
 Though many of our professions overlap in terms of scope, we need to work together to as part of a team to help our athletes and patients achieve their success.  

Everyone from coaches, parents, teachers, exercise therapists, kinesiologists, strength and conditioning coaches, chiropractors, massage therapists, athletic therapists, physical therapists, and sport medicine physicians all are part of the athletes support team.  Remember all of our goals are the same, to keep the athletes playing and achieving their goals. 

Follow us on Twitter @EliteInjuryMgmt and check out our website at 

Thursday, 15 May 2014

Year Long Sport and Early Specialization

Early sport specialization and year long sport has become a major problem for our young athletes.  There are many reasons and justifications for this by parents, coaches and administrators as there is a perceived success for those who do specialize early.  Some are unaware of the detriment to their athletes bodies and some just choose to ignore what they see and hear.  Athletes can achieve success in their careers even when starting to specialize as late as age of fifteen.  

There are both physical and psychological negatives to the early specialization of young athletes. Overuse injuries and burnout are the most common, which lead to early retirement.  By the age of thirteen 70% of adolescent and child athletes will have dropped out of their given sport or activity.  By encouraging and registering them in a cross spectrum of sports benefits include an increase of joy, talent and the use of the full body.  

By involving your child in sports that involve the full body, you decrease the likely hood of overuse injuries.  Repetitive strain injuries such as Osgood-Schlatter, Sever's disease, Little League Elbow, tendinosis, and stress fractures are all linked to excessive repetitive motions and repetitive training cycles.  Gymnastics, diving and figure skating are the only sports to show some benefit with early specialization due to their use of periodization.  Graded increases in activity, are the most beneficial for the physical and skill development of athletes.  Rest both during the season and off season, is imperative to keeping young athletes engaged and injury free.  

The long term effects of overuse injuries can be seen in the number of baseball players especially pitchers in both the college and professional levels who are suffering ulnar collateral ligament sprains.  The philosophy of no pain, no gain has long been shown detrimental in both coaching and conditioning realms.  By engaging in multiple sports different parts of the body and brain are engaged, making turning the child into a better overall athlete.  People marvel at college athletes who compete and excel in more than one sport.  What we should be doing is using them as an example of how non-specialization actually leads to success.

By allowing our young athletes to engage in more than one sport and delaying specialization we will create not only better athletes but better adults as well.  By reducing overuse injuries and burnout at the younger ages, athletes will continue on being active throughout their adult lives.  That is true success over medals and accolades.

Follow us on Twitter @EliteInjuryMgmt and check out our website at

Resources used for this post

 Overuse injuries and burnout in youth sports: a position statement from the American Medical Society for Sports Medicine, DiFiori et al; Br J Sports Med 2014;48:287-288

Any Given Monday: Sports Injuries and How to Prevent Them for Athletes, Parents, and Coaches - Based on My Life in Sports Medicine, Dr. James Andrews

Thursday, 8 May 2014

Anaphylactic Reaction

Anaphylaxis is a serious allergic reaction to a food or environmental stimulant.  The most common stimulants in Canada are peanut, tree nuts, milk, eggs, fish, shellfish, sesame seeds, soy and wheat.  Insect stings such as yellow jackets, hornets, wasps and honey bees are can also trigger an anaphylactic reaction.  Medications as well as rubber latex can also trigger a reaction. 
Signs and symptoms of a anaphylactic reaction can be categorized into five categories:
  • Skin system: hives, swelling, itching, warmth, redness, rash
  • Respiratory system (breathing): coughing, wheezing, shortness of breath, chest pain/tightness, throat tightness, hoarse voice, nasal congestion or hay fever-like symptoms (runny itchy nose and watery eyes, sneezing), trouble swallowing
  • Gastrointestinal system (stomach): nausea, pain/cramps, vomiting, diarrhea
  • Cardiovascular system (heart): pale/blue colour, weak pulse, passing out, dizzy/lightheaded, shock
  • Other: anxiety, feeling of “impending doom”, headache, uterine cramps, metallic taste
Any sign or symptom should be dealt with immediately as the severity can change rapidly.  Every athlete with severe allergies should have an emergency plan.  Included in this plan should be knowledge of past reactions, location of epinephrine auto injector.  Anaphylaxis policy changes depends on your province and school board, it is important to check what is allowed or not allowed in your jurisdiction.  
In North America there available auto-injectors include Twin Jet, Epipen and Allerject.  The amount of epinephrine comes in two dosage strengths and is based upon weight.  Consultation with your physician and pharmacist as to the appropriate dosage.  
The management plan for an anaphylactic reaction:
1) Give epinephrine auto-injector at first sign of reaction
2) Call 9-1-1
3) Administer second dose of epinephrine if available
Having a well planned out plan for any emergency is important, knowing what to do when that emergency is an anaphylactic reaction is the difference between life and death. 
Please follow us on Twitter @EliteInjuryMgmt and check out our website at 

Monday, 5 May 2014

The Art of Taping

As an Athletic Therapist one of the things that we do on a regular basis and by regular I mean multiple times daily is taping.  Be it an ankle, thumb, knee or wrist we have to know that exact place to put the tape and what way the that piece of tape needs to go to prevent and stabilize the joint.  
Recently I was instructing a class of high school students on various tape jobs.  There were varying degrees of experience with taping as well as degrees of interest in doing them properly.  One of the first steps we went over was reviewing the motions of the joints we were going to tape.  Before you even can touch a roll of tape you have to know what way the joint your going to tape moves.  It would be very detrimental to tape an ankle inversion sprain and pull the ankle into inversion instead of eversion.

Learning to tear tape is another skill that needs to be mastered prior to applying tape to the body.  Poor tears cause wrinkles and tight spots which are both huge no-no's with any tape job.  The use of scissors or tape sharks to cut regular white taping tape is not efficient nor practical.  
You may be asking by now why is this post called the Art of Taping.  It may seem more technical than artistic.  As much as you need the technical knowledge as to the body and its motions, taping is truly an art.  No body part is the same.  For example no arch in the foot is the same.  Being able to recognize this and know the difference, while taping essentially on the fly is part of the artistic aspect. 

 Many of you may not think so but tape jobs are pretty.  They should be viewed like a sculpture.  The absence of wrinkles and windows (where skin shows through between two pieces of tape) makes for a smooth, flawless tape job.  This combined with the ability of the strength of the tape to prevent injury is beautiful.  

If you still doubt how taping can be art.  Watch an Athletic Therapist at work.  The fluidity of their motions as they move the roll of tape around the body of their athlete or patient is at times as graceful as a ballerina or pianist.  

I hope that after reading this you have gained a little more appreciation for those of us who tape.  It is not as simple as throwing on a piece of tape as though it is a bandage.  Each piece is in its place for a reason and put there purposefully, as a painter puts each brush stroke on their masterpiece.  

Please follow us on Twitter @EliteInjuryMgmt and check out our website for more tips and services that we offer in keeping everyone in the sport of life.  

Thursday, 1 May 2014

Fatigue in Athletes

Many athletes become fatigued during the season.  With the prevalence of year round sport, young athletes are becoming fatigued more often that before.  As a coach and parent there are two main ways you can help deal with athlete fatigue.  Firstly you must plan a schedule that will help prevent athlete fatigue, secondly you must be able to recognize the signs and symptoms of athlete fatigue.  

Signs to look for when seeing if your athlete is becoming fatigued come as both physical, mental and emotional.  Physically athletes may become more prone to sickness.  Missing practices, games and competitions due to illness more often than normal is an easy sign for parents and coaches to see.  An increase in pain as well as slower recovery from work outs or injuries occur as athletes become more fatigued during the season.  As the body uses its energy to try to keep up with normal daily activities, It finds it harder to find the energy to heal, compete and learn new skills.  Skills that were once automatic become harder to complete.  

Mental and emotional fatigue can end up leading to depression, so it is imperative that early recognition occurs.  Athletes may appear moodier or more emotional.  The happy go lucky athlete who cheers everyone on, soon becomes withdrawn and irritable.  You may notice an increase in irritability.  Snapping at parents, siblings or teachers without cause or over reacting to situations can be early indicator of fatigue.  

Altered sleep patterns, both a increase or decrease in the amount of sleep is a sign of both mental and physical fatigue.  When or wear an athlete chooses to sleep as well.  You may find that an athlete is falling asleep during dinner or needing naps after school.  If this is typically abnormal and becomes more than an occasional occurrence, further investigations as to the cause need to occur.  
One of the major clues or signs to look for is a decreased enthusiasm for their sport.  Not wanting to attend practices or competitions, coming up with excuses as to why they don't want to go or wanting to leave early are all signs of this loss of enthusiasm.  This type of fatigue is associated with burnout and is typical with athletes involved in sports with early specialization and year round sport.  
Prevention of fatigue as with all types of injuries is simpler than dealing with it after it occurs.  When organizing an athletic year follow the principles of periodization.  Both physically and mentally the athlete can not be at peak performance all the time.  There must be highs and lows of training and competition. 

As parents, coaches and teacher-coaches; a balance between school, sport and social life must be achieved.  When scheduling practices and games allow time for both the body to recover as well as time for your athletes to complete homework and spend time with friends and family.  
Communication is pivotal for both recognition and prevention of fatigue.  Talking and listening to your athletes to both verbal and non-verbal actions will allow you to take any steps needed before it is too late.  

Athlete fatigue is more than just being tired and can lead to long term health problems.  Preventing and recognizing this before it becomes severe is important in truly making the athletes health a priority. 

Follow us on Twitter @EliteInjuryMgmt and check out our website at