VAIDS

Wednesday, February 1, 2017

LESSON FOR KIDS: What Tom Brady can teach parents to protect their kids from injury

Every 25 seconds, a kid gets injured in sports. About 2 million high school kids will suffer an injury this year along with 75% of all college athletes.

As an interventional spine specialist treating athletes, I've seen the heartbreak and pain these injuries inflict on my patients and their parents. For some young people, the resulting disappointment discourages them from other worthwhile pursuits.

Sports accelerate the aging process, especially football, which can shred tendons and ligaments, bang up joints and break bones.
Yet, NFL quarterback Tom Brady seems to avoid all these injuries and seems to age at a slower rate while continuing to win.
What's his secret for success and how we can translate his methods into a injury prevention program for our children?
First, we have to shift our focus from managing sports injuries to preventing them.
Certain risks of acute injury are unavoidable, but many are preventable.
When we are younger we feel invincible, although our musculoskeletal and nervous systems have not fully matured.

Vulnerability also can arise from the complicated dynamics among young athletes, parents and coaches. According to a 2013 survey by the nonprofit advocacy group Safe Kids Worldwide, researchers talked to thousands of kids, coaches and parents. They found that 42% of young athletes had downplayed an injury so they could keep playing, while 53% of coaches said they have felt pressure from parents to put an athlete back in the game even after they had been injured.

About 54% of kids said they had played injured and of those, 70% said they did so even after they told their coaches or parents they were hurt.
This is a real problem.
I've taken care of kids and high-end professional athletes after the fact for an injury that should have healed in three to four weeks. Most of the time, the athlete tried to force activity before they were truly recovered.

This sets off a chain reaction where the body compensates to offset the painful area. This creates unbalanced, tight muscles, and throws off proper form along with the gait and posture.
In addition, because these functional changes don't show up on an anatomical x-ray or MRI, the real diagnosis is missed and subsequently the medical treatment fails.
I treated a professional baseball pitcher who had a chronic pain issue with his hip. His prior treatments focused on a diagnosis based on what was seen on his x-rays. Once we mapped out the true source of his pain and treated it, the force and accuracy of his pitches dramatically improved. This reversed the years of compensation and imbalance that was throwing off his form. He went on a winning streak and achieved incredible success.

Are we pushing our kids too hard?
Overall, in my clinical experience, the crazed youth sports culture is good. It teaches team building, self-confidence and physical fitness habits that hopefully will be followed into adulthood. It combats obesity and can lead to a healthy self-esteem.
What we have to be vigilant about are two types of sports injuries: acute ones, such as sprains or ligament tears after a missed step or a traumatic collision; and overuse injuries, which are caused by repetitive motion that damages the body over time.
These types of injuries used to be rare in our practice among teens and children, and were seen mostly in college athletes and high-end professional athletes. But we have been seeing an alarming increase in these repetitive use injuries in younger athletes.
Why is this happening?
Overuse and overtraining account for 70% of these injuries. Young people's training can be intense. They have so many sports events weekly that there's really no time to recover and grow.
Overtraining keeps you revved up in "survival mode" and releases cortisol, which is the "stress hormone" and causes a breakdown of the body's defenses and tissues.
My associate, orthopedic specialist Dr. Jack Jensen, cites the example of a very young elite gymnast, Dominque Moceanu, who he treated. Because of the intense year-long Olympic training, she suffered an overuse stress fracture a few weeks before the 1996 Olympic competition in Atlanta. She went on to win the Olympic gold medal for the U.S. Women's Gymnastics Team, but was almost derailed as a consequence of over-training.

Secrets of NFL quarterback Tom Brady
In football years, Brady is considered to be of advanced age at 39.
Right. Advanced age of 39.
That definitely does not fit my definition of "advanced age," especially as I get older myself.
To understand Tom Brady's unconventional diet and training program, you first have to understand what makes Brady tick.
Brady is ultra-competitive and has an insane drive to be the best.
He has broken down the functional essentials of the athletic requirements of a quarterback and focused all his energies in an obsessive way to maximize that potential.
For example, he looks more like a GQ model then the bulkier quarterbacks we've seen in the past, such as Warren Moon and Joe Namath.
This is on purpose. Brady's diet and training are designed to make him lighter and quicker, thereby putting less stress on his joints. He tries to reverse the effects of aging through healthy nutrition and hydration.
He doesn't plan to have as much muscle mass as a linebacker, for example, because he has a strong offensive line and he is quick to get rid of the ball, thereby minimizing the number of times he is tackled.

Where he breaks conventional thinking is in a unique, distinctive Brady term he calls developing muscle "pliability." For example, when a muscle is sore, many believe that is because of muscle weakness. As a result, the focus becomes on building dense muscle, which actually sometimes contracts the muscle, making it shorter and more prone to injury.
Brady works on building muscle "pliability," and flexibility to reduce injury and maximize functional ability.
Brady keeps his muscles elongated, flexible and soft.
Traditionalists will question the keeping muscles "soft" part as there is nothing wrong with building strong muscle. Brady gets some heat for that, but I believe what he is referring to is that by keeping the muscles long and relaxed, they will be less prone to injury. Remember the familiar term "you have to roll with the punches."
Maybe that's the reason drunken drivers don't generally get as severely injured as the people they crash into. Because of the alcohol, their muscles are unusually relaxed and bend to the force of the crash, whereas the people they hit reflexively tense up.
When I take my 8-year-old nephew to karate practice, I've felt my heart skip a beat when I've seen him take a hard hit. Parents will understand that feeling of helplessness at watching their child suffer.

Now, we can do something about it.
In my opinion and in our practice, the most important part of your injury prevention program involves not overtraining, having adequate recovery, keeping muscles flexible, focusing on having your muscle and joints go through the full range of motion, maintaining the ideal length-tension relationship in the muscles, and making sure the flexor and extensors muscles are balanced and in a relaxed state.
Tight muscles lead to injury. Hydration, rest and balanced nutrition round out a proactive injury prevention program.

Dr. Pawan Grover, M.D. (inovospine.net), is an interventional specialist who prides himself on being an advocate for patients. He believes in pulling back the medical curtain to explain how Big Medicine works, so patients can take the power of health care back into their own hands. Dr. Grover has more than 20 years of experience as a medical doctor, and has served as a medical correspondent for CNN, NBC, CBS and PBS. Dr. Grover is a graduate of the UMDNJ-Robert Wood Johnson Medical School (Rutgers Medical School). He completed his residency at the Texas Medical Center, and did a special fellowship in Sydney, Australia, with professor Michael Cousins, who is considered the father of regional blockade and pain management for cancer and non-cancer pain. Dr. Grover has worked extensively with top neurosurgeons from MD Anderson Hospital in the Texas Medical center for cancer pain management.


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