Archive for the ‘pain’ Category

Researchers at The University of Auckland have shown for the first time that the mere presence of carbohydrate solution in the mouth immediately boosts muscle strength, even before it is swallowed.

The results suggest that a previously unknown neural pathway is activated when receptors in the mouth detect carbohydrate, stimulating parts of the brain that control muscle activity and producing an increase in muscle strength.

Previous research had shown that the presence of carbohydrate in the mouth can improve physical performance during prolonged activity, but the mechanism involved was not known and it was unclear whether a person must be fatigued for the effect to be seen.

“There appears to be a pathway in the brain that tells our muscles when energy is on the way,” says lead researcher Dr Nicholas Gant from the Department of Sport and Exercise Science.

“We have shown that carbohydrate in the mouth produces an immediate increase in neural drive to both fresh and fatigued muscle and that the size of the effect is unrelated to the amount of glucose in the blood or the extent of fatigue.”

The current research has been published in the journal Brain Research and has also captured the attention of New Scientist magazine.

In the first of two experiments, 16 healthy young men who had been doing biceps exercises for 11 minutes were given a carbohydrate solution to drink or an identically flavored energy-free placebo. Their biceps strength was measured before and immediately afterward, as was the activity of the brain pathway known to supply the biceps.

Around one second after swallowing the drink, neural activity increased by 30 percent and muscle strength two percent, with the effect lasting for around three minutes. The response was not related to the amount of glucose in the bloodstream or how fatigued the participants were.

“It might not sound like much, but a two percent increase in muscle strength is enormous, especially at the elite level. It’s the difference between winning an Olympic medal or not,” says co-author Dr Cathy Stinear.

As might be expected, a second boost in muscle strength was observed after 10 minutes when carbohydrate reached the bloodstream and muscles through digestion, but no additional boost in neural activity was seen at that time.

“Two quite distinct mechanisms are involved,” says Dr Stinear. “The first is the signal from the mouth via the brain that energy is about to be available and the second is when the carbohydrate actually reaches the muscles and provides that energy,” says Dr Stinear.

“The carbohydrate and placebo solutions used in the experiment were of identical flavor and sweetness, confirming that receptors in the mouth can process other sensory information aside from the basic taste qualities of food. The results suggest that detecting energy may be a sixth taste sense in humans,” says Dr Gant.

In the second experiment, 17 participants who had not been doing exercise and were not fatigued simply held one of the solutions in their mouths without swallowing. Measurements of the muscle between the thumb and index finger were taken while the muscle was either relaxed or active.

A similar, though smaller effect was observed as in the first experiment, with a nine percent increase in neural activity produced by the carbohydrate solution compared with placebo. This showed that the response is seen in both large powerful muscles and in smaller muscles responsible for fine hand movements.

“Together the results show that carbohydrate in the mouth activates the neural pathway whether or not muscles are fatigued. We were surprised by this, because we had expected that the response would be part of the brain’s sophisticated system for monitoring energy levels during exercise,” says Dr Stinear.

“Seeing the same effect in fresh muscle suggests that it’s more of a simple reflex – part of our basic wiring – and it appears that very ancient parts of the brain such as the brainstem are involved. Reflexive movements in response to touch, vision and hearing are well known but this is the first time that a reflex linking taste and muscle activity has been described,” she says.

Further research is required to determine the precise mechanisms involved and to learn more about the size of the effect on fresh versus fatigued muscle.

———————————–

Article adapted by MD Sports from original press release.
———————————–
Contact: Pauline Curtis
The University of Auckland

Advertisements

Football players who suffer the dangerous head injury known as concussion are three times more likely than other players to suffer a second concussion in the same season, according to a new University of North Carolina at Chapel Hill study.The study, published in the September-October issue of the American Journal of Sports Medicine, suggests that the brain is more susceptible to injury when it has not had enough time to recover from a first injury. Researchers say the finding is important because concussions can lead to permanent brain damage, vision impairment or even death if not managed properly.

“We believe recurrences are more likely because injured players are returning to practice and to games too quickly after blows to the head,” said Dr. Kevin M. Guskiewicz, assistant professor of exercise and sport science at UNC-CH and study leader. “Many clinicians are not following the medical guidelines that players should be symptom-free for several days before returning.”

Guskiewicz directs the Sports Medicine Research Laboratory and the Undergraduate Athletic Training Education Program, both at UNC-CH. Co-authors of the new paper are Nancy L. Weaver, research associate for the N.C. High School Injury Surveillance Program; Darin A. Padua, doctoral student in sports medicine at the University of Virginia; and Dr. William E. Garrett Jr., professor and chair of orthopaedics at the UNC-CH School of Medicine.

For three years, the researchers surveyed a random sample of 242 certified athletic trainers across the United States who worked with high school and college football teams. More than 17,500 football players were represented in the study, which covered 1995 to 1997. About 5 percent suffered concussions each year. Researchers also conducted telephone interviews with a smaller group.

“We wanted to learn more about concussions — the incidence of injury, the mechanism of injury and whether players seemed to be injured more frequently on artificial turf than on grass,” Guskiewicz said. “We found the incidence of injury to be highest at the high school and Division III level, while Division I and II college players suffered fewer concussive injuries.”

Possible explanations include poorer quality and fit of protective equipment, he said. Another possibility is that college players are more skilled on average, and better players are known to be less susceptible to injury.

The UNC-CH professor and colleagues found that 31 percent of athletes with concussions began playing again the same day they were injured.

“This didn’t surprise us, but it does worry us,” Guskiewicz said. “Eighty-six percent of players reported having at least a headache after the incident, and you should never return to play with a headache. It was probably all right for the 14 percent of players with no symptoms to return.”

Artificial turf didn’t produce more head injuries than natural grass, the researchers found. Concussions on artificial turf, however, were more serious. Artificial athletic fields are sheets of synthetic grass over shock-absorbing pads stretched across concrete slabs.

Another key finding was that only one in 20 players suffered a concussion during the season rather than the one in five reported in 1983. Almost 15 percent of injured players suffered a second concussion in the same season, and it tended to be more serious than the first. The most common symptoms were headache, dizziness and confusion.

“That earlier 20 percent figure appears to have been a gross over-estimation,” Guskiewicz said. “Still, the rules have changed to make the game safer and the equipment, especially helmets, are safer and have to be approved by the National Operating Committee on Standards in Athletic Equipment (NOCSAE). Also, many coaches are being smarter in limiting physical contact time in practices. They are stressing the importance of players keeping their heads up during blocking and tackling, not dropping their heads, which is against the newer rules and is much more dangerous.”

Defensive backs, offensive linemen and linebackers were the most frequently concussed players, but special team players and wide receivers were more likely to suffer more serious concussions. During the 1999 season, all six U.S. high school players killed as a direct result of football accidents died from injuries to their brains, according to a different UNC-CH study released in August.

—————————-
Article adapted by MD Sports Weblog from original press release.
—————————-

Contact: David Williamson
University of North Carolina at Chapel Hill

Sports medicine specialists in the University at Buffalo’s Sports Medicine Institute have developed a new method for treating athletes who sustain post-concussion syndrome that, unlike the conventional approach, allows athletes to maintain conditioning while recovering gradually from the injury.

For unknown reasons, 5-10 percent of people who experience a concussion have symptoms that persist beyond six weeks. These people are diagnosed with post-concussion syndrome (PCS). Previously there has been no treatment for the condition with proven success.

“The most common approach by physicians is to recommend no exercise and prescribe antidepressants,” said Barry Willer, Ph.D., UB professor of psychiatry and rehabilitation sciences. Willer is lead author on the paper describing the new method, published in the September issue of Current Treatment Options in Neurology.

“Most people with PCS have symptoms of depression,” said Willer, “so anti-depressant treatment makes sense. However, antidepressants do little more than relieve some of the depression symptoms. We were interested in a treatment that didn’t just treat the symptoms, but actually improved the patient’s brain function.”

The researchers call their new treatment “regulated exercise.” The approach consists of determining the ideal exercise program for each athlete based on a number of individual physiological indicators at baseline.

Patients are tested every two to three weeks with specialized equipment at the sports medicine clinic to determine their progress, and a new program is developed based on those results.

Willer and co-author John Leddy, M.D., clinical associate professor of orthopaedics and rehabilitation sciences, indicated it is too early to call the treatment a cure, but they are optimistic about the results so far.

The researchers described the treatment method in mid-September at the 2006 Brain Injury Conference of the Americas in Miami, where the response was very favorable, according to Willer.

“Professionals at the meeting were delighted that our approach to treatment of post-concussion syndrome doesn’t involve any medications and is very cost-efficient. We were surprised to learn that we are among only a few investigators interested in people with symptoms that won’t go away.

“There is no other known treatment specifically for PCS, which we define as persistent symptoms of concussion past the time they should have cleared, usually around three weeks,” said Willer. “As far as we can determine, there is only one other group in North America that is using regulated exercise as part of the treatment for PCS.”

Willer and Leddy have used regulated exercise successfully with people who were as much as six months post-concussion. Their regimen is based on the hypothesis that the regulatory system responsible for maintaining cerebral blood flow, which may be dysfunctional in people with a concussion, can be restored to normal by controlled, graded symptom-free exercise.

“The treatment program is well tolerated by patients” Willer said. “Just being able to exercise often reduces the depressive symptoms. But it’s imperative that the patient not go beyond the exercise limits.

“After the first three weeks of regulated exercise, we reassess the patient to see if there has been any change in physiology. The exercise program then is realigned successively to respond to the changes. In our experience thus far, symptoms disappear within several months for at least some of the patients,” he said.

The specialists have worked with a small number of patients to date. They have included a UB soccer player who has returned to play and now is one of the team’s leading scorers. Another young athlete was able to return to cross-country running and attend school full-time.

—————————-
Article adapted by MD Sports Weblog from original press release.
—————————-

Contact: Lois Baker
University at Buffalo

To celebrate Allied Health Professions Week, the National Athletic Trainers’ Association has prepared a 10-step guide that people of all ages can use to reduce body stress, prevent back pain and thereby improve quality of life – especially with holiday plans and travel just around the corner. Along with the season comes the lifting of heavy suitcases and holiday gifts that can put additional pressure on the back. NATA represents certified athletic trainers who are among the more than 80 professions being honored during Allied Health Professions Week (Nov. 4-10, 2007).

“The human body is an incredible machine that adapts to the stresses we give it every day,” said certified athletic trainer Darrell Barnes, LAT, ATC, CSCS, performance center coordinator, St. Vincent Sports Performance Center in Indianapolis, Ind. “Stresses such as poor posture, unusual movement or activities or even a sedentary lifestyle can lead to poor mechanics and pain. Disability from back pain is second only to the common cold as a cause of lost work time.”

According to the Arthritis Foundation, back pain affects 80 percent of the adult population at some point in their lives. In fact, back pain, limited mobility and stiffness end up costing American consumers $24 billion in treatment costs annually.

Following are recommendations to prevent and reduce back pain now and year-round:

1. Identify negative stresses that may be exacerbated by the holidays – Everybody has physical limitations that can lead to body imbalances, so it’s important to identify problematic areas and correct these imbalances. Look at your sitting/standing posture. Do you complain that your muscles “feel tight” or weak? Do you use poor mechanics when lifting heavy items? Are you putting unusual stress on the back with certain activities and lifting during the holiday season? Learning correct lifting techniques and strengthening your back can help to alleviate pain. Use a luggage cart or lighten your load when lifting heavy packages or luggage.

2. Make yourself mobile – Poor posture and muscle stiffness decrease the body’s ability to move freely, which can lead to injury or pain. There are many ways to increase mobility including daily stretches or activities that increase flexibility and get the body moving in different directions. Try yoga, tai chi, swimming or pilates to keep you limber.

3. Increase strength – It’s important to get strong to improve overall balance and flexibility to reduce stress on the back. Exercises should involve the whole body, especially the core muscles of the stomach, back, hips and pelvis. At the same time, strengthening of the legs and shoulders can help you more easily squat, lift and carry even heavy items without overworking or injuring your back.

4. Add aerobic exercise – Physical activities like walking, swimming and running for at least 20 minutes three times a week increases muscular endurance and cardiovascular fitness. Aerobic activities also improve blood flow to the spine and help decrease daily stress.

5. Pay attention to posture – Try not to sit or drive for long periods of time. Get up every 15 to 30 minutes and move around or stretch to increase your mobility. When seated always remember to keep your hips and knees at right angles to one another and find a chair with adequate lumbar (lower back) support.

6. Stand up straight – When engaged in activities while standing, be sure to stand with your head up, shoulders straight, chest forward and stomach tight. Avoid standing in the same position for too long, though, and use your legs – rather than your back – when pushing or pulling heavy doors and other items.

7. Use proper lifting mechanics – When lifting objects from a position below your waist, stand with a wide stance and a slight bend at your hips and knees. Tighten your stomach as you lift and keep your back as flat as possible – do not arch or bend. When carrying heavy objects, keep them as close to your body as you can. Avoid carrying objects on only one side of your body.

8. Get a good night’s sleep – Select a firm mattress and box spring that does not sag. Try to sleep in a position that allows you to maintain the natural curve in your back.

9. Warm-up before physical activity – Engage in a low impact activity prior to playing sports or exercising. Increasing muscle temperature and mobility will decrease the chance of injury.

10. Improve your healthy lifestyle – Obesity and smoking have been found to increase the incidence of back pain. Taking steps to improve your health will decrease the chance of back pain and improve your overall quality of life.

Barnes also urges people to always listen to their bodies: “If you are participating in any fitness routines or general activity and feel any twinges of back pain, you should stop immediately and consult your physician. Identifying the cause of the pain and treating it safely and appropriately will help you gain back mobility and range of motion and feel your physical best.”

—————————-
Article adapted by MD Only Weblog from original press release.
—————————-

Contact: Robin Waxenberg 
National Athletic Trainers’ Association

About the National Athletic Trainers’ Association (NATA)

Athletic trainers are unique health care providers who specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. The National Athletic Trainers’ Association represents and supports 30,000 members of the athletic training profession through education and research. Only 42 percent of high schools have access to athletic trainers. NATA advocates for equal access to athletic trainers for athletes and patients of all ages, and supports H.R. 1846.

A study published in Angiology shows that supplementation with the pine bark extract Pycnogenol® (pic-noj-en-all) improves blood flow to the muscles which speeds recovery after physical exercise. The study of 113 participants demonstrated that Pycnogenol significantly reduces muscular pain and cramps in athletes and healthy, normal individuals.

“With the millions of athletes worldwide, this truly is a profound breakthrough and extremely significant for all individuals interested in muscle cramp and pain relief with a natural approach. These findings indicate that Pycnogenol can play an important role in sports by improving blood flow to the muscles and hastening post-exercise recovery, said Dr. Peter Rohdewald, a lead researcher of the study.

Researchers at L’Aquila University in Italy and at the University of Würzburg in Germany studied the effects of Pycnogenol® on venous disorders and cramping in two separate studies.

The first study consisted of 66 participants who had experienced normal cramping at some point, had venous insufficiency, or were athletes who suffer from exercise-induced cramping. The first two weeks of the study was an observation period and participants did not supplement with Pycnogenol®. Symptoms related to venous disorders, and the number of cramping episodes each participant experienced over the two observation weeks was recorded.

Next, all the participants were given 200 mg of Pycnogenol once a day for four weeks. After the treatment phase, participants’ symptoms and cramping episodes were recorded for one week without any Pycnogenol supplementation.

The researchers found a significant decrease in the number of cramps the participants experienced while supplementing with Pycnogenol.® Participants who had experienced normal cramping had a 25 percent reduction in the number of cramps experienced while taking Pycnogenol.

Participants with venous insufficiency experienced a 40 percent reduction in the number of cramps, and athletes with frequent cramping experienced a 13 percent reduction in the number of cramps while on Pycnogenol.®

The second study involved 47 participants with diabetic microangiopathy (a disorder of the smallest veins commonly associated with diabetes), or intermittent claudication (a blood vessel disease that causes the legs to easily cramp).This study also used a two-week pre-trial observation period followed by a week of supplementing with Pycnogenol (200 mg per day for one week), followed by a week of observation without Pycnogenol® supplementation.

Patients with diabetic microangiopathy had a 20.8 percent reduction in pain, while participants with claudication experienced a 21 percent decrease in the amount of pain experienced while supplementing with Pycnogenol.® Results indicated participants who took placebo experienced no decrease in pain.

Cramps are a common problem for people of all ages, ranging to the extreme fit and healthy to people who suffer from health problems. Previously, magnesium was hailed as the natural approach for relieving muscle cramps, however studies continue to show magnesium to be inefficient for reducing muscle cramps.

“Pycnogenol® improves the blood supply to muscle tissue creating a relief effect on muscle cramping and pain. Poor circulation in the muscle is known to cause cramps and Pycnogenol® improved the cramping in patients due to a stimulation of blood flow to their muscle tissue. Nitric oxide (NO) a blood gas, is well known to enhance blood flow and Pycnogenol® may be influencing the activity of NO,” said Rohdewald. “The insufficient production of NO is the common denominator responsible for impaired blood flow in vascular disease.”

Strenuous exercise is known to involve muscle damage which may be followed by symptoms of inflammation. In separate studies published this year and in 2004 and 2005, Pycnogenol® demonstrated its anti-inflammatory effects in clinical trials for asthma, dysmenorrhea and osteoarthritis.

—————————-
Article adapted by MD Only Weblog from original press release.
—————————-  

Contact: Pycnogenol®

About Pycnogenol®
Pycnogenol® is a natural plant extract originating from the bark of the maritime pine that grows along the coast of southwest France and is found to contain a unique combination of procyanidins, bioflavonoids and organic acids, which offer extensive natural health benefits. The extract has been widely studied for the past 35 years and has more than 220 published studies and review articles ensuring safety and efficacy as an ingredient. Today, Pycnogenol® is available in more than 600 dietary supplements, multi-vitamins and health products worldwide.

Injuries occur to golfers of all ages and ability levels, and can significantly affect their golf game and daily life. Those who fail to warm up adequately appear to be putting themselves at greater risk of injury.

The survey involved 304 golfers, who revealed their golf activities, injury status and warm-up habits over a 12-month period. About a third of the golfers (111, or 36.5 percent) reported an injury, most frequently to the lower back, shoulder or elbow. Strains were by far the most commonly reported type of injury (37.8 percent). Other types of injuries included stiffness, inflammation, tendonitis, and sprains and, less commonly, pinched nerves, fractures, heel spurs and contusions or dislocations.

”Only a small percentage of golfers were shown to perform an appropriate warm-up prior to play or practice. The message isn’t getting across,” said Andrea Fradkin, lead author of the study.  “Golf professionals need to tell golfers to warm up, and not just hit balls.”

A full warm-up, she explained, consists of three components:
1. Aerobic exercise to increase muscle temperature
2. Sport-specific stretching (including stretching the shoulder, trunk, chest, lower back, hamstrings, forearm, and wrist)
3. Activity similar to the event, starting slowly and building in intensity (For golf, this might consist of air swings involving the club but not the ball)

Only three percent of golfers surveyed regularly performed two or more of the components, leaving them vulnerable to injury.

Fradkin and her colleagues noted that the frequency and types of injuries varied according to the golfers’ age and skill level. More experienced players—who play more often—tended to sustain more back injuries, while those with higher handicaps suffered more injuries to their hips, elbows and knees due to poor swing mechanics. Researchers noted that older golfers are likely to sustain more groin injuries due to a decrease in hip strength, and more knee and foot injuries due to degeneration of those joints.

According to Fradkin, this study underscored the results of her previous research into golfing injuries, while shedding new light. “This is the first study to look at the age, gender and handicap of injured golfers. Only two studies have looked retrospectively at injuries sustained over a 12-month period.”

—————————-
Article adapted by MD Sports Weblog from original press release.
—————————-

Contact: Communications and Public Information
American College of Sports Medicine

The conclusions outlined in this news release are those of the researchers only, and should not be construed as an official statement of the American College of Sports Medicine.

Although it’s too soon to recommend dropping by Starbucks before hitting the gym, a new study suggests that caffeine can help reduce the post-workout soreness that discourages some people from exercising.In a study to be published in the February issue of The Journal of Pain, a team of University of Georgia researchers finds that moderate doses of caffeine, roughly equivalent to two cups of coffee, cut post-workout muscle pain by up to 48 percent in a small sample of volunteers.

Lead author Victor Maridakis, a researcher in the department of kinesiology at the UGA College of Education, said the findings may be particularly relevant to people new to exercise, since they tend to experience the most soreness.

“If you can use caffeine to reduce the pain, it may make it easier to transition from that first week into a much longer exercise program,” he said.

Maridakis and his colleagues studied nine female college students who were not regular caffeine users and did not engage in regular resistance training. One and two days after an exercise session that caused moderate muscle soreness, the volunteers took either caffeine or a placebo and performed two different quadriceps (thigh) exercises, one designed to produce a maximal force, the other designed to generate a sub-maximal force. Those that consumed caffeine one-hour before the maximum force test had a 48 percent reduction in pain compared to the placebo group, while those that took caffeine before the sub-maximal test reported a 26 percent reduction in pain.

Caffeine has long been known to increase alertness and endurance, and a 2003 study led by UGA professor Patrick O’Connor found that caffeine reduces thigh pain during moderate-intensity cycling. O’Connor, who along with professors Kevin McCully and the late Gary Dudley co-authored the current study, explained that caffeine likely works by blocking the body’s receptors for adenosine, a chemical released in response to inflammation.

Despite the positive findings in the study, the researchers say there are some caveats. First, the results may not be applicable to regular caffeine users, since they may be less sensitive to caffeine’s effect. The researchers chose to study women to get a definitive answer in at least one sex, but men may respond differently to caffeine. And the small sample size of nine volunteers means that the study will have to be replicated with a larger study.

O’Connor said that despite these limitations, caffeine appears to be more effective in relieving post-workout muscle pain than several commonly used drugs. Previous studies have found that the pain reliever naproxen (the active ingredient in Aleve) produced a 30 percent reduction in soreness. Aspirin produced a 25 percent reduction, and ibuprofen has produced inconsistent results.

“A lot of times what people use for muscle pain is aspirin or ibuprofen, but caffeine seems to work better than those drugs, at least among women whose daily caffeine consumption is low,” O’Connor said.

Still, the researchers recommend that people use caution when using caffeine before a workout. For some people, too much caffeine can produce side effects such as jitteriness, heart palpitations and sleep disturbances.

“It can reduce pain,” Maridakis said, “but you have to apply some common sense and not go overboard.”

—————————-
Article adapted by MD Only Sports Weblog from original press release.
—————————-

Contact: Sam Fahmy
University of Georgia