It happens every spring. A young pitching ace that started strong is now beginning to lose some speed on his fast ball. A third baseman that had no problems last week can’t throw to first without pain. Shoulder pain in young baseball players occurs every spring just as the first robin, warmer temperatures, and the emerging sprouts of the spring flowers. The cause of the condition was the usual: not properly preparing the arm for the season.
Gino Tempesta, former baseball coach at Dunmore High School and new coach at Scranton Prep, has spent this winter recovering from a total shoulder replacement. He is eager to throw batting practice and ultra-conscious about the need to properly prepare the shoulder for throwing to prevent injury. My associate, Scott Griggs and I conducted a conditioning seminar this winter for Coach Tempesta and his players to help prevent injuries. Another associate, Dr. Gary Mattingly, was kind enough to write this column to assist other players and coaches.
Spring shoulder pain may be prevented with the proper preparation for the season. Throwing a baseball requires the shoulder to be very strong. In the off season, a shoulder can lose much of its essential strength. This loss will result in a deconditioned shoulder at the start of the first spring practice. Practicing with a deconditioned shoulder commonly results in sprain, strain and pain.
To avoid spring shoulder pain it is necessary to maintain shoulder strength. Strengthening exercises need to concentrate on three groups of muscles: the large power muscles of the shoulder, the muscles which stabilize the shoulder and the all important rotator cuff muscles. Strengthening power muscles of the shoulder is fairly easy. Pushups, lat pulldowns, bench presses, and bicep curls will cover all bases. While these exercises are important in maintaining strength and power of the throwing shoulder, they are not as important as the exercises for shoulder stabilizers and rotator cuff muscles.
The shoulder stabilizer muscles connect the arm to the torso. They serve as the foundation of the arm helping to stabilize the arm to the torso. The many stabilizing muscles include the trapezius and the rhomboid muscles. Exercise for theses muscles include: shrugs, T’s and Y’s.
The rotator cuff muscles have many functions. They are essential for the stability and proper function of the shoulder joint and in the throwing athlete they serve as brakes during the follow-through phase of a pitch. Exercises for the rotator cuff muscles include internal and external rotations.
While exercise is essential for conditioning the shoulder in the off-season, a graduated throwing program is also important. In the book The Athlete’s Shoulder, a throwing program is suggested. Training is every other day with a day’s rest in between. A ten minute warmup such as light jogging is suggested before throwing.
Day 1: 45ft – 25 throws - rest - repeat
Day 3: 45ft – 25 throws - rest – repeat – rest – repeat
Day 5: 65ft – 25 throws - rest - repeat
Day 7: 65ft – 25 throws - rest – repeat – rest – repeat
Day 9: 90ft – 25 throws - rest - repeat
Day 11: 90ft – 25 throws - rest – repeat – rest – repeat
Day 13: 120ft – 25 throws - rest - repeat
Day 15: 120ft – 25 throws - rest – repeat – rest – repeat
Day 17: 150ft – 25 throws - rest - repeat
Day 19: 150ft – 25 throws - rest – repeat – rest – repeat
Day 21: 65ft – 25 throws - rest - repeat
Day 23: 65ft – 25 throws - rest – repeat – rest – repeat
With the proper preparation, spring shoulder pain can be avoided in any baseball player.
Contributor: Gary E. Mattingly, PT, PhD is a professor at the University of Scranton, Dept of Physical Therapy and an associate specializing in the prevention and rehabilitation of shoulder injuries at Mackarey & Mackarey PT Consultants in Scranton, PA.
The winter and spring seasons present a great opportunity to work on your tennis game. You may be able to do this even if you’re busy with other sports in order to prevent serious shoulder problems when you jump back into tennis full force for the spring, summer and fall seasons. In a sport that relies so heavily on the use of the shoulder, it is very common to develop occasional shoulder pain or a more chronic problem such as shoulder rotator cuff tendinitis. That is exactly what happened to professional tennis star, Maria Sharapova this past summer. On a local level, young Peter Cognetti, former Scranton Prep tennis standout, who is presently playing Division I tennis at Saint Joseph’s University, was recently in my office for shoulder pain. With this in mind, I decided to research this problem further and had several discussions with Bill Steege, member of the United States Professional Tennis Association and general manager of Tennis & Fitness Club in Clarks Summit, PA.
Playing tennis at any level requires the shoulder to be very strong. Unfortunately, studies show that playing tennis often, throughout the year fails to develop an increase in shoulder strength. Couple this finding with the fact that most high school tennis players are engaged in other sports throughout the year. Tennis is more of a seasonal high school sport (Fall for girls and Spring for boys). In the off-season, a shoulder can lose much of its essential strength. This loss will result in a deconditioned shoulder at the start of the season and making it more susceptible to injury. Practicing with a deconditioned shoulder commonly results in sprain, strain and pain. Pain and weakness will significantly interfere with the ability to perform at a high level.
To prevent shoulder problems one must participate in a exercise program specifically designed for tennis. A well-balance shoulder strengthening program includes; rotator cuff and scapular (shoulder blade) muscle exercises, reeducation, biomechanics, and a stretching program pre and post hitting. This column will discuss some of these principles to properly prepare your shoulder for the tennis season and avoid injury.
To avoid shoulder pain it is necessary to maintain shoulder strength. Stretching exercises are also important and will be discussed in a future column. Strengthening exercises need to concentrate on three groups of muscles: power muscles (the large muscles of the shoulder), shoulder blade stabilizer muscles (the muscles which stabilize the shoulder blade, and the all important rotator cuff muscles (the muscles which move the shoulder and control the cocking and follow through phases of the tennis stroke, while keeping the joint in proper position). Strengthening the power muscles of the shoulder is fairly easy; latissimus pull downs, pectoralis bench presses, and bicep curls will cover all bases. While these exercises are important in maintaining strength and power of the throwing shoulder, they are not as important as the exercises for the shoulder stabilizers and rotator cuff muscles.
Perform with comfortable weight 15-20 repetitions. Advance weight once 25 reps becomes easy. Perform slowly and smoothly.
Latissimus Pull downs - Kneeling or sitting
Tie resistive tubing overhead and pull down toward the floor
Begin with elbows bent and advance to elbows straight
Bench Press - Lying on back with knees bent
Hold a 5-10-15-20# dumbbell in each hand
Press both arms up to a straight elbow
Biceps Curls - Sitting or standing
Hold a 5-10-15-20# dumbbell in one hand
Bend elbow up
Use other hand to support arm under elbow
Repeat with other arm
Visit your doctor regularly and listen to your body.
Contributor: Gary E. Mattingly, PT, PhD: Professor, University of Scranton, Dept. of Physical Therapy, Shoulder Rehab Specialist, Mackarey & Mackarey Physical Therapy
The winter and spring seasons present a great opportunity to work on your tennis game. You may be able to do this even if you’re busy with other sports in order to prevent serious shoulder problems when you jump back into tennis full force for the spring, summer and fall seasons. In a sport that relies so heavily on the use of the shoulder, it is very common to develop occasional shoulder pain or a more chronic problem such as shoulder rotator cuff tendinitis.
Last week, in part one of “Prevention of Shoulder Injuries in Tennis,” I presented the basics principles of strengthening the large muscles of the shoulder. This week will demonstrate how to stabilize the important scapula muscles and smaller muscles of the shoulder such as the rotator cuff.
The shoulder stabilizer muscles connect the arm to the torso. They serve as the foundation of the arm helping to stabilize the arm to the torso. The many stabilizing muscles include the trapezius and the rhomboid muscles. Exercise for theses muscles include: shrugs, T’s and Y’s.
Holding a 5-10-15-20# weight in both hands
Keep arms at side with elbows straight
Shrug shoulders up, hold 5-10 seconds & repeat
Lying on belly in crucifix position – shoulders at 90 degrees
Hold 1-2# weight in each hand with palms down
Keep elbows straight and pinch shoulder blades together. Your shoulder blade muscles will lift your arms up off table 4 inches, making a "T."
Hold 5 seconds & repeat.
Lying on belly in crucifix position
Except shoulders are at 120 degrees (not 90)
Hold 1-2# weight in both hands with thumb up
Keep elbows straight and lift arms up toward the ceiling, making a "Y."
This will lift your arms up off table 4 inches.
Hold 5 seconds & repeat.
The rotator cuff muscles have many functions. They are essential for the stability and proper function of the shoulder joint. In tennis they serve to work in cooperation as the accelerators and brakes during the backswing, impact and follow-through of the forehand, backhand and serve. Exercises for the rotator cuff muscles include internal and external rotations.
NOTE: These muscles are very weak require only light weights or light resistance bands at slightly faster speeds to improve strength.
Turning the arm in is stronger than turning out and usually requires 50 to 75% more weight/resistance. Start with red or green band/tube.
Tie resistive tube to a doorknob.
Standing with arm at side, bend elbow at 90 degrees.
With band on outside, turn arm in toward belly
Turning the arm out is weaker than turning in and usually requires 50 to 75% less weight/resistance. Start with yellow band/tube.
Tie resistive tube to a doorknob.
Stand with arm at side, bend elbow at 90 degrees.
With band on inside, turn arm out away from belly
Training should be performed every other day with a day’s rest in between. A ten-minute warm-up such as light jogging followed by mild stretching is suggested before playing. Also, after exercise and hitting, a ten-minute cool down with an ice pack is valuable to prevent pain and inflammation.
While exercise is essential for conditioning the shoulder in the off-season, it is important to talk to your tennis professional to develop a graduated hitting program focusing on proper form and technique. It is also important to ask about proper grip size, racket style and string tension.
Visit your doctor regularly and listen to your body.
Contributor: Gary E. Mattingly, PT, PhD: Professor, University of Scranton, Dept. of Physical Therapy, Shoulder Rehab Specialist, Mackarey & Mackarey Physical Therapy
Last week we discussed the importance of strengthening and stabilizing the shoulder muscles to prevent injuries in tennis. This week we will focus on stretching the shoulder for injury prevention. As with the exercises for strength, it may be better to do nothing at all than to so improperly. For example, the shoulder must be adequately warmed up and in the proper position and alignment to fully benefit from stretching. New research is demonstrating that proper stretching to promote good posture may help or even prevent shoulder problems.
Part of the rotator cuff, a group of muscles that stabilize the shoulder, passes between the arm bone (humerus) and a bone in the back (scapula). Due to a tennis player’s stoke or the overuse of the rotator cuff with constant hitting, the rotator cuff can be repetitively pinched between the two bones. This produces a painful inflammatory condition known as rotator cuff tendonitis of the shoulder.
If the shoulder blade is tipped downwards, such as the position the shoulder assumes when slouching, it will place the shoulder in a position which pinches part of the rotator cuff. Stretching, strengthening or hitting a ball in this position will ultimately lead to problems. Add excessive training and practicing to the mix and this overuse may cause the muscles and tendons of the rotator cuff to become inflamed and swell. The swelling of the muscles and tendons will make the shoulder more prone to impingement.
A tight neck, chest and muscles in the front of the shoulder may cause a tennis player to assume a hunched over posture. This poor posture decreases the distance between the humerus and scapula making the shoulder more prone to impingement. Good posture with head and shoulders back increases the distance between the humerus and scapula. Therefore, proper stretching and good posture is important for prevention of shoulder pain because it decreases the impingement.
Warm Up:
Never stretch a cold muscle because the muscle can tear instead of stretch. To warm up the muscle one can run or jog for 5 minutes, place a heating pad on the area to be stretched, slowly move the arms in the direction that imitates various tennis strokes at 25-50% speed (dynamic stretching) while never moving far enough to cause discomfort. After practice, one can perform stretches that are more aggressive and held for 5-10 seconds with slight discomfort to improve flexibility. Aggressive stretching before competition may weaken the muscle and effect performance.
The Nicholas Institute of Sports Medicine and Athletic Trauma suggests the following stretches to be performed actively (dynamic) without discomfort to 90% range of motion before competition and passively and hold to 100% end range of motion (static) with slight discomfort after practice.
Triceps stretch:
Begin by raising your arm directly over your head with your palm facing front. Bend your elbow and try to reach the shoulder blade on the same side of you body. Use your opposite arm to push your elbow back.
Doorway stretch to the pectoralis major:
Begin by placing your elbow against the frame of a door. Keep the angle between your trunk and your arm at 90 deg. Rest your forearms against the door frame. Step forward with one foot to feel the stretch.
Infraspinatus stretch:
Extend your arm out directly in front of you and bend your elbow across your body. With your other hand gently pull your elbow across your body.
Levator scapulae stretch:
Begin by placing one arm as in the first part of the triceps stretch. Look towards your opposite hip and use you free hand to gently pull your head towards your hip.
Upper trapezius stretch:
Lean your head to the side trying to bring your ear towards your shoulder without lifting your shoulder
Latissimus dorsi stretch:
Raise both arms overhead and place palms together interlocking fingers. At shoulders lift arms upwards with fingers remaining intertwined.
Axial extension:
Pull your chin down and backwards as if trying to make a double chin.
Middle Back Stretch into Extension:
Pinch shoulder blades together
Lower Back Stretch into Extension:
Lie on belly, prop up on forearms, then extend lower back.
Keep in mind that avoiding bad posture in your day to day activities can help keep your shoulder and back healthy, so remember “Sit up straight!”
Visit your doctor regularly and listen to your body.
Contributor: Gary E. Mattingly, PT, PhD: Professor, University of Scranton, Dept. of Physical Therapy, Shoulder Rehab Specialist, Mackarey & Mackarey Physical Therapy
I have been practicing physical therapy long enough to see patients return for rehab for a following a revision of their first joint replacement. The focus of this column is to present the “current wisdom” on joint replacement longevity. How long will it last? How active should I be? This is a hot topic for discussion in light of the fact that significantly more young people (under 65) are getting joint replacements in order to continue an active lifestyle. Jerry Langan, President and CEO of Goodwill Industries of Northeastern Pennsylvania, is a good example. Jerry had a serious knee injury while playing basketball in high school. Years later, severe osteoarthritis developed in his knee and he required a total knee replacement at age 48. Following the replacement, he continued to play basketball, softball and other activities. 13 years later, at age 61, Jerry had a revision of his 1st replacement. He states that he is grateful for the first replacement because it improved his quality of life. He feels that the second replacement will last longer because he is older and less active. This series of events is typical of many “baby boomers” that are having joint replacements at a much younger age.
Osteoarthritis is the number one reason people have knee pain leading to a joint replacement. It slowly develops in the weight-bearing joints, most commonly in the hip and knee, creating pain, stiffness, swelling and loss of function. There are many nonsurgical options such as: rest, weight loss, medication, physical therapy, steroid injections, and viscosupplementation injections. However, when conservative measures fail, surgical intervention, such as a joint replacement, becomes the next option. A total joint replacement uses a prosthesis to replace the end of the bone damaged from arthritis. These new metal and plastic surfaces in the joint allow pain free movement and function in the hip and knee. These procedures have been performed since the early 1970’s. The outcomes for active people continue to improve with advances in technology, prosthetic materials and new techniques. As a result, many active people are eager to use their new joint to continue their active lifestyle. The ability to remain active, while not compromising the integrity of the new joint, continues to be the source of some controversy. It will be the purpose of this column to review the literature and provide recommendations to safely return to activity without compromising the life expectancy of the implant.
According to the American Association of Hip and Knee Surgeons (AAHKS), patients 65 years old and younger will comprise more than 50 percent of the total hip replacements by 2011 and total knee replacements by 2016. Therefore, improving implant reliability and durability will be critical. Presently, 94% of total hip patients can expect the implant to last approximately 15 years with 7% of the patients requiring revision. Long term studies also find that 91% of total knee patients will have a 14 – 15 year implant life expectancy. Keep in mind that most of this data was collected from joint replacements in an older and less active patient population. Studies also show that implant longevity decreases with activity level, especially aggressive weight bearing and torsion activities such as running and singles tennis.
At the November 2008 meeting of the AAHKS, a survey of orthopedic surgeons regarding activity level following total joint replacement was presented. 95% of orthopedic surgeons who participated in the survey reported that they place little to no limitations on low-impact activities such as: golf, swimming, walking or biking on level surfaces, stair climbing and doubles tennis. However, high impact activities carried many restrictions in order to reduce complications and improve implant longevity. For example, the percentage of surgeons discouraging the following activities are: 71% jogging, 83% skiing, 49% singles tennis. Most surgeons permitted doubles tennis with restrictions (twice per month). It is important to note that none of the respondents reported that they could sight scientific evidence to support their restrictions and relied on clinical experience.
As younger patients have joint replacements and desire to continue their activity levels, further technological advances in surgery and implant materials will be necessary. The October 2008 issue of the Journal of Bone and Joint Surgery reported that “Patients who chose to play sports after joint replacement should train for their sport, build up back, hip and knee strength and be aware of the potential risks of athletic activity after a joint replacement.” The report further states that impact activities may compromise the durability of joint replacement and new age technology and techniques have not yet proven to improve durability. Additional long-term studies are needed to determine the effect of high level activities such as running, skiing and singles tennis on implant longevity to guide the younger implant recipient.
Visit your doctor regularly and listen to your body.
Runners are addicted to running for good reason. There is nothing like it! No exercise offers so much in such little time. Caloric expenditure is higher than in most other exercises, including biking. Running also allows for fresh air, beautiful scenery, minimal investment of clothing or equipment, little skill and time to learn. Runner’s suffer from less depression, colds and flu symptoms, and experience less pain due to an endorphine release (natural chemical in the brain associated with euphoria and pain control) that is greater than found in other sports and activities. All of this is what motivates people to run every day, in spite of the constant loading and wear and tear on the joints.
This column will be dedicated to those who are interested in beginning a running program for all the reasons mentioned above and more. The program is designed to promote a safe and gradual introduction or return to running as form of exercise. The initial goal is to help you attain 30 minutes (approximately 2 miles) of running at a slow, relaxed and safe pace. This 30 minute goal is the standard used in most research that shows improvement in weight control, cholesterol, heart disease, blood pressure and adult onset diabetes. The 8 week program is a simple and safe program that begins with more walking than running and gradually reverses the proportion. The first two miles are the hardest and once mastered; one can begin to build on milage and intensity if desired.
Source: Runner’s World
(3RD of 3 Columns on Eating Disorders in Athletes)
Guest Columnist: Janet Caputo, PT, OCS
Eating disorders among athletes is not uncommon, especially in the female athlete. This is the third of three columns on this topic.
Athletes with eating disorders need referral to a health care professional. This health care professional must be a part of a team: psychologists/psychiatrists, nutritionists/dieticians, and the primary care/team physician.
The physician coordinates the management of this condition. Psychologists address issues including anxiety and depression. A psychiatrist prescribes medications indicated for a specific disorder. Insight and support from trainers/coaches is crucial for success. Optimal treatment includes lifestyle changes to attain/maintain a goal weight. Education on / monitoring for adequate nutrition is provided by nutritionists/dieticians. Focus is optimal health and performance instead of weight. Exercise is decreased 10-20% and weight monitored for 2-3 months. Involvement and education of family members is critical for a complete resolution of the eating disorder.
Additional intervention may be required to treat the female athlete triad. Hormone Replacement Therapy (oral contraceptives/cyclic estrogen/progesterone) has been used to treat amenorrhea. Daily calcium/vitamin D supplementation may be recommended. All available treatment options (bisphosphonates/calcitonin) are considered for athletes with frank osteoporosis. The ultimate goal is return of regular menses through proper nutrition, revised training, and maintenance of reasonable body weight.
Coaches, athletic trainers, and teammates, can help prevent eating disorders:
Athletes can ensure proper nutrition and avoid eating disorders:
Sports can have extreme positive effects on development and maturation of individuals. It promotes ability to work as a team member, teaches perseverance, and enhances goal attainment. With the right emphasis, coaches, athletic trainers, and teammates can promote emotional and physical health.
Visit your doctor regularly and listen to your body.
Keep moving, eat healthy foods, exercise regularly
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliated faculty member at the University of Scranton, PT Dept.
(2nd of 3 Columns on Eating Disorders in Athletes)
Guest Columnist: Janet Caputo, PT, OCS
Eating disorders are becoming epidemic in athletes. This is the second of three columns addressing this topic. Eating disorders differ from dieting because of the preoccupation with body weight/shape, abnormal eating/exercise patterns, and emotional/medical problems. There are problems with self-image, mood, and interpersonal functioning. The three most common eating disorders in athletes (anorexia nervosa, bulimia nervosa, and compulsive exercise) have life threatening consequences.
Compulsive exercisers perform more exercise than needed for quality performance. Workouts purge calories. Compulsive exercise warning signs: exercising when tired/ill but not for fun or stress relief, exercising at extremely intense levels experiencing severe anxiety if a workout is missed for fear of gaining weight, absenteeism from family obligations/social events because they have to exercise to burn calories.
Anorexia Nervosa is self starvation involving a relentless pursuit of thinness and an unwillingness to maintain a normal body weight. Despite emaciation, the fear of gaining weight does not subside.
Bulimia Nervosa is consuming large quantities of food then purging to prevent weight gain. Despite vomiting, laxative abuse, and fasting, bulimics usually maintain a minimally normal body weight.
In 1993, the American College of Sports Medicine collectively termed amenorrhea, osteoporosis, and eating disorders as the female athlete triad. Intense training and insufficient caloric intake cause amenorrhea (absence of menstruation) or oligomenorrhea (irregular menstrual cycles with decreased frequency) indicating impaired ovarian function with insufficient estrogen to grow healthy bones. Since most bone development occurs during early childhood and late adolescence, female athletes need to acquire the greatest amount of bone mass during their first two decades to combat post menopausal osteoporosis. Estrogen also maintains bones. Bone damaged by daily wear and tear and intense athletic activity is repaired. However, with depleted estrogen stores, more bone is removed than replaced. The bones get thinner and break easier (Osteopenia; Osteoporosis). Estrogen’s third role is to direct calcium to bone to make bones hard. In amenorrhea, absorption of dietary calcium is impaired. The result is bone prone to fractures even during low impact activities (walking).
Low estrogen levels may also exist because estrogen storage lies within adipose tissues. Therefore, low body fat compositions could lead to decreased estrogen stores. Low body fat is a female athlete’s gauge for physical fitness.
Detection of eating disorders in athletes is critical. Knowledge of some of the signs/symptoms may help:
Visit next week to discuss treatment and prevention of eating disorders.
Visit your doctor regularly and listen to your body.
Keep moving, eat healthy foods, and exercise regularly
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliated faculty member at the University of Scranton, PT Dept.
(1st of 3 Columns on Eating Disorders in Athletes)
Guest Columnist: Janet Caputo, PT, OCS
Over the past several years I have worked with many young female athletes that have suffered from injuries often associated with low body fat and poor bone density such as repeated stress fractures. In certain sports such as running and gymnastics this can be devastating. One thought that comes to mind is whether or not the young female athlete may also have an eating disorder. This prompts a discussion with the parents and family physician. This is the first of three columns dedicated to this topic as requested by several parents of local athletes.
According to the American College of Sports Medicine (ACSM), some athletes are at greater risk for developing eating disorders:
Attributes of successful athletes predispose them to eating disorders. Athletes’ have A-type personalities: perfectionists and over-achievers, who are highly competitive, committed, compulsive, dedicated, and driven. These traits that provide success, when focused on the body, can have devastating consequences. These qualities are often found in eating disorder patients, although perhaps with a different label.
Coaches and teammates have a significant amount of influence over athletes. Coaches can be preoccupied with controlling body weight/shape to enhance athletic performance. Weekly public weigh-ins and body fat analyses which reveal personal information to the entire team/staff, causes embarrassment and fosters competition to obtain the lowest weight through dangerous dieting methods.
Judges in sports where athletes are evaluated on technical and artistic forms have admitted considering thinness an important factor in deciding excellence and have told athletes they should lose weight to achieve their athletic goals. When their bodies are being constantly assessed personally and by coaches, judges, and spectators, it is understandable why athletes develop disordered eating.
Athletes who compete at the highest levels of their sports are training and playing virtually year round. Unfortunately, for most young women increasing muscle mass means their bodies depart from the culturally desirable body frame. This increases body dissatisfaction and the pursuit of unhealthy weight control practices.
Athletics may be used to “legitimize” an eating disorder because of emphasis on low body fat and thinness. Coupled with the dedication and discipline required to comply, the athlete receives praise and admiration for self-control.
Emphasis on thinness and demands for self-discipline invite the female athlete to believe that food restriction will improve performance, enhance winning and achievement of more glory. Although research indicates the opposite, weight loss is equated with becoming quicker, faster, and stronger.
Since a serious athlete can never work too hard or too much, “no pain, no gain” is sought as a marker for achievement. This compulsive exerciser will use workouts to purge calories.
Athletes may use performance to define part of their identity. Their role as athletes may be the only part of their lives where they feel at least minimally competent and effective.
Some athletes insist that eating during the day will make them feel heavy and cause them to be slow at workouts, practices, and competitions. Other athletes vomit before competition to reduce high anxiety and then binge to ease depression after defeat.
There are huge demands placed on young athletes today. They are expected to specialize in a sport at a very young age. However, their mature, but larger body may be better suited for another sport in which they were never given the chance to excel because they specialized so young. This may cause them to set an unrealistic goal weight.
Athletes are expected to perform at a high level at a very young age. It is not good enough to be their best. They must be the best. They know they are not being judged on the effort of their performance, but on the outcome of their performance. Female athletes may eliminate meat and dairy from their diets to reduce calories and fat to achieve or maintain low body weight. By doing so, they are under nourishing themselves and risk developing protein, iron, and zinc deficiencies.
With a basic understanding of an athlete’s susceptibility to eating disorders, next week we will be able to discuss common eating disorders in athletes and their consequences.
Visit your doctor regularly and listen to your body. Keep moving, eat healthy foods, and exercise regularly.
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliated faculty member at the University of Scranton, PT Dept.
Sources: Otis CL, Drinkwater B, Johnson M, et al. ACSM position stand: the female athlete triad. Med Sci Sports Exerc 1997;29(5):i-ix.
(This is the second in a series of 2 articles related to diabetes:
Definition/Causes; Treatment/Exercise)
Exercise is a critical component of diabetes management. Studies show that pre-diabetics and type 2 diabetics can prevent or reverse their condition through diet and exercise. However, it is important that you do not jump into an extreme diet or exercise program without proper professional medical advice. Your program will be based on the extent of your diabetes: the condition of your heart, lungs, blood vessels, eyes, kidneys, feet and nervous system. While some people who are very deconditoned and have advanced disease must exercise carefully, others may be capable of a more advanced and strenuous program.
(According to Prevention Magazine and ADA)
As little as 10 extra pounds is unhealthy if you are a diabetic. It also makes it more difficult to maintain a good fitness and activity level. Eat well, exercise regularly and don’t smoke. Smokers have a much higher incidence of complications associated with diabetes.
Aerobic exercise will help promote weight loss or prevent weight gain and cardiovascular disease. Perform mild aerobic exercise such as walking 3-5 times per week for 30-45 minutes. If you walk or stand most of the day, wear good shoes that fit well. Avoid high heels and shoes without adequate support like sandals.
Performed 2-3 times per week, 20-30 repetitions with light weights through full range of motion. Avoid spinal loading from overhead lifting such as military or overhead press.
3-4 times per week for 30-45 minutes at moderate intensity. Treadmill, bike, recumbent bike, elliptical, walk, cross-country ski.
Abdominal Strengthening sitting on balance ball while doing bicep curls, shrugs, rows, lats, and leg extension. Contract abdominal muscles and keep balance with using arms and legs.
**This column is based on information from local physicians Kenneth Rudolph, MD, Gregory Borowski, MD and the American Diabetes Association.
Visit your doctor regularly and listen to your body.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliated faculty member at the University of Scranton, PT Dept.
