Indoor Athletes Often Lacking in Vitamin D

Indoor Athletes Often Lacking in Vitamin D

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TUESDAY, March 24, 2020 (HealthDay News) — Indoor athletes may be vitamin D-deficient, putting themselves at risk of injury and poor performance, a small study finds.

Researchers assessed vitamin D levels in players on George Mason University’s men’s and women’s basketball teams. For the 2018-2019 season, players were given a supplement with a high dose, low dose or no vitamin D.

Vitamin D is essential for building and maintaining healthy bones. Without it, bones can weaken, leading to diseases like osteoporosis.

It’s found in many foods, including dairy products and dark, leafy greens, as well as in sunlight.

“Many athletes are now engaging in supplementation, and we don’t currently know what the optimal or safe amount of supplementation may be,” said study co-author Sina Gallo, assistant professor of nutrition and food studies at George Mason in Fairfax, Va.

Gallo noted that other investigators have reported data from older, non-athletic populations.

“Because athletes may not get the necessary vitamin D through natural dietary sources, supplementation offers a safe, affordable, efficacious method to combat deficiencies,” she said in a university news release. “This may be particularly beneficial for athletes living at higher latitudes during the winter months.”

Working with Mayo Clinic researchers, her team analyzed the athletes’ body composition, skin pigmentation, sun exposure, dietary intake and blood.

They found that 13 of the 20 athletes — 65% — were “vitamin D-insufficient” at the outset.

Co-author Margaret Jones said that’s consistent with another study that reported 56% of 2,000 athletes in nine countries had low vitamin D levels. Jones is a sports scientist at the university’s Frank Pettrone Center for Sports Performance.

Additionally, study participants with darker skin pigmentation showed a higher risk of vitamin D insufficiency at baseline.

Study co-author Andrew Jagim, a sports medicine researcher with the Mayo Clinic Health System in Onalaska, Wisc., said though the study was small, it offers more evidence of the high prevalence of vitamin D insufficiency among college basketball players.

“We, as authors, agree that a larger sample is warranted to aid in the development of screening protocols which will enable medical and sports nutrition staff around the country to identify key risk factors of athletes becoming vitamin D-deficient,” he said in a news release.

The study was recently published in the journal Nutrients.

— Kayla McKiski

MedicalNews
Copyright © 2020 HealthDay. All rights reserved.




QUESTION


Walking can maintain your body weight and lower many health risks. True or false?
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References


SOURCE: George Mason University, news release, March 9, 2020

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An Expert's Guide to a Safe Run in Cold Weather

An Expert's Guide to a Safe Run in Cold Weather

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SATURDAY, March 14, 2020 (HealthDay News) — Some people love to run no matter the season, even cold weather, and that is OK as long as you take proper precautions, a physical therapist says.

“It’s up to the runner. As long as he or she is healthy, wearing appropriate attire and highly visible, the cold doesn’t have to deter you from being outside,” said Grace “Annie” Neurohr. She’s a therapist and running specialist at Sinai Hospital’s Rubin Institute Running Injury Program, in Baltimore.

But, if it’s icy, stay inside and use the treadmill, she advised.

When you do run outside in the cold, wear the proper clothing and layer it.

“A good base layer is crucial,” Neurohr said in a news release from LifeBridge Health. “A wool or wool hybrid base layer will wick away moisture while maintaining warm body temperature.”

A warm hat is important for maintaining core temperature “since the majority of our heat is lost through our heads,” Neurohr said.

Gloves are also essential. “Since the majority of your blood is getting pumped to your larger muscles, your hands need a little extra help staying warm,” she explained.

Before heading out, warm up for five to 10 minutes to reduce the risk of muscle strains or joint pain.

“A dynamic warm-up typically will consist of various types of skips, high knees, walking lunges, inchworms and leg swings, so typically larger full-range-of-motion movements at a slightly quick speed,” Neurohr said.

And don’t forget to hydrate.

“You may not need the amount of electrolytes or total water intake as you do when it’s hot out, but you should still be taking in an adequate water intake,” Neurohr said. How much varies based on your size and the intensity, length and frequency of your workouts.

If you run when it’s dark, wear bright, reflective gear. “No matter what, don’t assume a driver can see you,” Neurohr said. “Always make eye contact and demonstrate communication with a nod or wave with the driver before crossing in front of a car.”

— Robert Preidt

MedicalNews
Copyright © 2020 HealthDay. All rights reserved.




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References


SOURCE: LifeBridge Health, news release, March 5, 2020

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Iliotibial (IT) Band Syndrome

Iliotibial (IT) Band Syndrome

Iliotibial band (IT band) syndrome facts

A. Hands are held on the waist, and the injured leg is crossed behind the good leg. B. The arm on the same side as the injured leg sweeps up and over as the hips are moved laterally toward the good side, allowing a lateral bend at the waist. There should be no twisting with this stretch and no need to touch the foot of the injured leg.

  • Iliotibial band syndrome is an overuse injury of the connective issues that are located on the outer thigh and knee.
  • The iliotibial band runs along the lateral or outside aspect of the thigh, from the pelvis to the tibia, crossing both the hip and knee joints. The iliotibial band is an important stabilizer structure of the lateral part of the knee as the joint flexes and extends.
  • Inflammation and irritation of the iliotibial band can occur as it travels back and forth, crossing the bony prominence of the femoral epicondyle as the knee flexes and extends.
  • Iliotibial band syndrome is an overuse injury causing pain on the outside part of the knee especially during running when the heel strikes the ground.
  • Rest, ice, compression, and elevation (RICE) and anti-inflammatory medications are first-line treatments.
  • Physical therapy may be helpful. Surgery is rarely an option but is sometimes suggested for patients who develop chronic inflammation and who fail to respond to other treatment options.
  • Prevention includes maintaining flexibility and strength of the low back, hips, knees, and leg muscles, and is key to avoiding recurrence.
  • Iliotibial band syndrome is sometimes called ITBS, IT band syndrome, ITB syndrome, and ITBFS (iliotibial band friction syndrome).

What is iliotibial band (IT band) syndrome?

Picture of the iliotibial (IT) band

Iliotibial band syndrome (ITBS or IT band syndrome) is an overuse injury of the connective tissues that are located on the lateral or outer part of thigh and knee. It causes pain and tenderness in those areas, especially just above the knee joint. Iliotibial band syndrome is the most common cause of lateral knee pain in runners and bicyclists.

The iliotibial band is a thick band of fascia (tissue) that begins at the iliac crest in the pelvis, runs down the lateral or outside part of the thigh, and crosses the knee to attach into the top part of the tibia or shinbone. It forms from the tensor fascia lata and two of the gluteal muscles (gluteus medius and gluteus minimus) in the buttock and then stretches across the knee. The iliotibial (IT) band helps stabilize the outside part of the knee through its range of motion.

The iliotibial band is one of the hip abductor muscles, moving the hip away from the midline. The iliotibial band also helps with both knee flexion and extension.

When the knee is flexed, the IT band is located behind the femoral epicondyle, a bony outcropping of the femur or thighbone at the knee joint. The IT band moves forward across the condyle when the knee is extended. There is a sac or bursa that allows the band to glide smoothly across the condyle, but should inflammation occur in this area, the increased friction from repeatedly rubbing the iliotibial band across the bony condyle can cause pain, especially along the outer (lateral) aspect of the knee joint.

If the symptoms are ignored, the inflammation can continue and scarring develop in the bursa, decreasing knee range of motion and causing increasing pain with decreasing activity.

IT Band Symptoms


Knee Pain

Knee pain can be a result of injury or disease of the knee joint. Injury can affect any of the ligaments, bursae, or tendons surrounding the knee joint. Injury can also affect the ligaments, cartilage, menisci (plural for meniscus), and bones within the joint.


Pain can also occur in the knee from diseases or conditions that involve the knee joint, the soft tissues and bones surrounding the knee, or the nerves that supply sensation to the knee area. Overuse injury to the knee can lead to inflammation of the tendon below the kneecap (runner’s knee or jumper’s knee with infrapatellar tendinitis) and bursitis.

What causes iliotibial band (IT band) syndrome?

Iliotibial band inflammation is an overuse syndrome that occurs most often in long-distance runners, bicyclists, and other athletes who repeatedly squat. The iliotibial band syndrome may be the result of a combination of issues, including

  • poor training habits,
  • poor flexibility of muscle, and
  • other mechanical imbalances in the body, especially involving the low back, pelvis, hips, and knees.

There can be a predisposition to develop IT band syndrome. Anatomy issues may include differences in the lengths of the legs (a leg-length discrepancy), an abnormal tilt to the pelvis, or bowed legs (genu varum). These situations can cause the iliotibial band to become excessively tight, leading to increased friction and irritation when the band crosses back and forth across the femoral epicondyle during activity.

Training errors may cause runners to develop iliotibial band syndrome symptoms. Roads are canted or banked with the center of the road higher than the outside edge to allow for water runoff. If a runner always runs on the same side of the road, it produces the same effect on the body as having a leg-length discrepancy. One leg is always downhill compared to the other, and the pelvis has to tilt to accommodate the activity. Running too many hills can also cause inflammation of the IT band. Running downhill is especially stressful on the IT band as it works to stabilize the knee.

Bicyclists may develop IT band inflammation should they have improper posture on their bike and “toe in” when they pedal. The issue may be how the toe clips are aligned, forcing the foot to be internally rotated, toed in. This can cause the same effect as bowed legs, increasing the angle of the IT band as it crosses the knee and increasing the risk of inflammation.

Other activities with increased knee flexion can cause symptoms and include rowing and weight lifting, especially with excessive squatting.



SLIDESHOW


Pain Management: Knee Pain Dos and Don’ts
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What are iliotibial band (IT band) syndrome symptoms and signs?

  • Pain on the lateral side of the knee is the most common symptom of iliotibial band syndrome and is due to inflammation of the area where the band crosses back and forth at the femoral epicondyle.
  • Initially, there may be a sensation of stinging or needle-like pricks that are often ignored. This can gradually progress to pain every time the heel strikes the ground and finally can become disabling with pain when walking or when climbing up or down steps.
  • Some patients may feel a snapping or popping sound at the knee, and there may be some swelling either where the band crosses the femoral epicondyle or below the knee where it attaches to the tibia.
  • Occasionally, the pain may radiate along the course of the IT band all the way up to the outer side of the thigh to the hip.

How do health care professionals diagnose iliotibial band (IT band) syndrome?

Often, the diagnosis of iliotibial band syndrome can be made by the patient’s story of symptoms. The patient describes the progression of lateral knee pain that is made worse when the heel strikes the ground. Physical examination is helpful because the area of pain can often be palpated with tenderness and swelling felt over the femoral epicondyle, where the bursa or sac is located.

The health care professional may also look for leg-length discrepancy, muscle imbalance, and tightness in the legs and back. There is tenderness of the outer thigh just above the knee joint, while the knee and hip joints themselves are normal to examination.

Usually, a full physical examination of the low back and legs, including the hips, knees, and ankles, is performed to detect other potential causes of lateral knee pain.

Plain X-rays are not usually required to help with the diagnosis, but MRI may be used to look for inflammation surrounding and beneath the iliotibial band. The MRI can also exclude other causes of outer knee pain. These include torn cartilage (lateral meniscus tear), sprained lateral collateral ligament, muscle tendon inflammation, and problems between the kneecap and the femur (patellofemoral pain). Most often, X-rays and MRI images are not needed.

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What is the treatment for iliotibial band (IT band) syndrome?

Iliotibial band syndrome is an overuse injury that causes inflammation. IT band syndrome treatment includes the following:

  • Rest, ice, compression, and elevation (RICE).
  • Anti-inflammatory medications, like ibuprofen (Advil, Motrin) and naproxen (Aleve), may be helpful. Note that any over-the-counter medications can have potential side effects, as well as interactions with prescription medications. If questions or concerns exist, it is wise to ask a health care professional or pharmacist about their safe use.
  • Home treatment can involve stretching, massage, and use of foam rollers at the site of pain and inflammation.
  • Should these first-line treatments not work, physical therapy may be needed to decrease the inflammation at the IT band. Some treatments focus on flexibility and stretching. Friction rubbing may occur over the IT band at the femoral epicondyle may help to break down inflammation and scarring.
  • Therapeutic ultrasound techniques may be used, including phonopheresis (ultrasound propels anti-inflammatory medications through the skin into the inflamed tissue) and iontophoresis (electricity is used instead of ultrasound) to help decrease irritation in the soft tissues surrounding the knee.
  • The physical therapist may also help evaluate the underlying cause of the problem and look at muscle strength and balance and/or flexibility and gait analysis (watching a person walk, run, or cycle). Shoe orthotics may be useful if there is a gait problem, pelvic tilt, or leg-length discrepancy as a potential cause of IT band syndrome.
  • Corticosteroids (dexamethasone, methylprednisolone, hydrocortisone) injected at the site of inflammation may be of benefit.

Research continues with other injection therapy options to find non-surgical cures.

It is unusual that the conservative nonsurgical treatment fails to help. However, orthopedic surgery may be an option for patients who fail conservative (nonoperative) treatment.

  • Arthroscopy can be used to find the inflammation surrounding the iliotibial band and cut it away. This inflammation and scarring is often found in the lateral recess of the knee between the IT band and the femoral epicondyle.
  • Other surgical options may be available, including cutting out a small triangular part of the IT band to lengthen the band and allow more room for it to slide across bone.

Before surgery is considered, other potential causes of lateral knee pain are usually considered. These include lateral meniscus tear and chondromalacia.



IMAGES


Iliotibial Band Syndrome
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What stretches and exercises are beneficial for iliotibial band (IT band) syndrome?

Exercise Builds Strong Muscles Around Joints

What exercises should be avoided with iliotibial band (IT band) syndrome?

Most patients recover from iliotibial band syndrome, but it can take from weeks to months to return to full activity without pain. Patience in allowing the body to heal is required for optimal results.

Understanding the importance of symmetry in the body is helpful in preventing iliotibial band syndrome. When activities alter that symmetry, symptoms may occur.

Symptoms may occur in runners who always run in the same direction on an indoor track or who always run on the same side of a banked road. This causes an artificial tilt to the pelvis and increases the risk of developing inflammation and pain. When running indoors, it is wise to change directions when running longer distances. Some tracks have the runners change directions every few minutes while others change direction on alternate days. While running toward traffic is an important safety strategy, finding a way to run on the opposite side of the street safely may minimize the risk of developing iliotibial band syndrome.

Bicyclists are at risk for iliotibial band syndrome if they tend to pedal with their toes turned in (internally rotated), which can cause abnormal stretching of the iliotibial band at the knee. Being aware of pedaling technique and setting the pedals and clips properly may minimize the risk of developing symptoms.

Keeping muscles and other structures stretched is an important part of prevention of many musculoskeletal injuries, including iliotibial band syndrome.

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Where can people find more information about iliotibial band (IT band) syndrome?

Iliotibial band syndrome is a common runner’s affliction. Often a local running store will be able to provide information about the signs and symptoms of the injury, including area health care professionals who can help runners and other athletes.


Medically Reviewed on 3/10/2020

References

Baker, R.L., and M. Fredericson. “Iliotibial Band Syndrome in Runners: Biomechanical Implications and Exercise Interventions.” Physical Therapy and Rehabilitation Clinics of North America 27.1 February 2016: 53-77.

Lavine, R. “Iliotibial Band Friction Syndrome.” Curr Rev
Musculoskelet Med
. 3.1-4 Oct. 2010: 18-22.

Strauss, E.J., et al. “Iliotibial Band Syndrome: Evaluation and Management.” J Am Acad Orthop Surg. 19.12 Dec. 2011.

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Intense Exercise Can Trigger Heart Trouble in the Unprepared

Intense Exercise Can Trigger Heart Trouble in the Unprepared

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MONDAY, March 2, 2020 (HealthDay News) — For most people, aerobic exercise is great. However, high-intensity exercise like running in marathons and triathlons can pose heart risks for those who have inadequate training.

Sudden cardiac arrest, atrial fibrillation and heart attacks are among these risks, according to a new scientific statement from the American Heart Association (AHA).

Exercise is medicine, and there is no question that moderate to vigorous physical activity is beneficial to overall cardiovascular health,” said Barry Franklin, chair of the writing committee for the new scientific statement.

“However, like medicine, it is possible to underdose and overdose on exercise — more is not always better and can lead to cardiac events, particularly when performed by inactive, unfit individuals with known or undiagnosed heart disease,” said Franklin, director of preventive cardiology and cardiac rehabilitation at Beaumont Health in Royal Oak, Mich.

“More people are running marathons, participating in triathlons and doing high-intensity interval training. The purpose of this statement is to put the benefits and risks of these vigorous exercise programs in perspective,” he said in an AHA news release.

The committee reviewed more than 300 studies and concluded that improving physical fitness is beneficial for most. People who exercise have up to a 50% lower risk of heart attack and cardiac death.

However, while the risk of sudden cardiac death or heart attack is low among people engaging in high-intensity exercise, it is still possible. Nearly 40% of cardiac events in triathlons occur in first-time participants, suggesting that poor training or underlying conditions may be the culprit.

Before embarking on an intense training program, the AHA encourages people to start a light exercise program and slowly build up. But if you have symptoms such as chest pain, chest pressure or severe shortness of breath while exercising, check with a doctor before starting any program.

“It is important to start exercising — but go slow, even if you were an athlete in high school,” Franklin said.

The scientific statement was published Feb. 26 in the AHA journal Circulation.

— Kayla McKiski

MedicalNews
Copyright © 2020 HealthDay. All rights reserved.




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References


SOURCE: American Heart Association, news release, Feb. 26, 2020

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Heading to Work on a Bike? You Might Live Longer

Heading to Work on a Bike? You Might Live Longer

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TUESDAY, Feb. 25, 2020 (HealthDay News) — Do you ride your bike to work? If you don’t, maybe you should.

Why? People who commute by bicycle are at lower risk of dying early, a new study from New Zealand finds.

Researchers from the University of Otago, Wellington, the University of Melbourne and the University of Auckland found that those who cycled to work had a 13% reduction in death during the study period.

Lead researcher Dr. Caroline Shaw attributes this mortality reduction to the health benefits of physical activity that aren’t typically seen from walking or taking public transportation.

For the study, Shaw and her team analyzed data from 3.5 million New Zealanders.

“We studied 80% of the working-age population of New Zealand over a 15-year period, so it is highly representative,” Shaw said in a University of Otago news release.

Only 3% of those studied cycled to work. In comparison, over 80% of people in New Zealand traveled to work by car.

“There were gender differences in mode of travel to work, with 2% of women cycling compared with 4% of men, but more women walking or jogging (7%) compared with men (5%),” Shaw said. “A higher proportion of younger people cycled, walked or took public transport compared with older people.”

Details about the physical intensity of the commute were not recorded. Also, the study only found an association and could not prove a cause-and-effect relationship.

“We saw no increase in road traffic injury deaths associated with walking and cycling, although the New Zealand transport system at the time of these studies was heavily car-dominated and roads seldom made allowances for pedestrians and cyclists,” Shaw noted.

She said the findings, published recently in the International Journal of Epidemiology, suggest a need for active commuting initiatives.

“Increasing cycling for commuting to work in a country with low levels of cycling like New Zealand will require policies directed at both transport and urban planning, such as increasing housing density and implementing cycling networks,” Shaw said.

— Kayla McKiski

MedicalNews
Copyright © 2020 HealthDay. All rights reserved.




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Pictures of the 7 Most Effective Exercises to Do at the Gym or Home (and Tips to Improve Form)
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References


SOURCE: University of Otago, news release, Jan. 28, 2020

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