Elbow Injuries in Volleyball Players

As mentioned in my blogs throughout this semester, we have noticed how the knee and the shoulder take quite a bit of brutality throughout the sport of volleyball. The majority of the workloads are centered on those two joints, but an area of the body that we don’t give enough credit to is the elbow. This joint actually takes a lot of the brute force to provide the shoulder the energy it needs to provide a powerful kill shot.

A hinge joint just like the knee, the elbow only flexes and extends which is supported by multiple ligaments on either side of the joint. When the elbow is forced past its normal range of motion of flexion or extension, as well as injured from either side of those ligaments, damage can be done; tendons or muscles can also be strained due to injury.1,2

The injury discussed in this blog today is lateral epicondylitis, otherwise known as tennis elbow. This is a chronic injury that comes from overuse of the elbow; tendon damage occurs where the forearm muscles attach to the lateral epicondyle of the elbow.1 Signs and symptoms of this injury are pain on the outside of the elbow, strength deficits when lifting or grasping objects, and radiating pain down the arm.1,2,3 Direct impact or overuse of the forearm muscles are the more common causes of this injury occurring.1

Treatment options focus on the acronym RICE: which stands for rest, ice, compression, and elevation.1 Anti-inflammatory medicine such as ibuprofen can be prescribed to decrease the swelling and pain within the joint.1 Also, elbow braces can be used to put pressure on the distal end of the elbow to release the tension from the forearm muscles.1 Lastly, physical therapy can be extremely beneficial in the recovery process so that modalities such as ultrasound can be used to alleviate pain and strengthen muscles surrounding the joint.1

In conclusion, lateral epicondylitis is a very nagging-like injury that typically won’t go away on its own. It takes time, rest, and rehabilitation to truly resolve the pain.

References:

1.      Quinn, E. (2015, August 27). Do You Have Tennis Elbow? Retrieved November 6, 2015, from http://sportsmedicine.about.com/cs/elbow/a/elbow2.htm

2.      Elbow Injuries and Elbow Pain. (2014). Retrieved November 6, 2015, from http://softtissuecenter.com/elbow-injuries-and-elbow-pain/

3.      Volleyball is played by an estimated 800 million people in 130 countries. (2009). Retrieved November 6, 2015, from http://www.armrehab.com/non_surgical_sports_medicine_volleyball.html

Popping Pills for Weight Loss (and other unhealthy ideas)

Brace yourselves. There is a new pill on the market called Vysera CLS that was recently approved by the FDA. But given the FDA’s history for allowing harmful products to be introduced to the American people, we should move with certain caution. Once again, a pill is being touted as the “miracle pill,” the pill that can transform a body in 30-days! In a way that imitates a gastric bypass, the pill reportedly reduces the stomach. 

Here’s how: The pill dissolves in the stomach cavity, leaving a balloon which can be will with fluid in an outpatient procedure. Enlarged to the size of a grapefruit, there is little room for food and patients reportedly felt full, thus the weight loss. After six months, the balloon is deflated and removed through the mouth.

Pros

• ReShape, the company of the miracle pill, released amazing results in which subjects lost up to 25% of their body weight. Enthusiastic early reports backed by the British Journal of Nutrition and Obesity Surgery found that improvement in liver function, insulin resistance, triglycerides and A1c levels, in addition to the weight loss. Even more amazing are the claims that ReShape melts away fat on those trouble spots – hips, thighs, buttocks, belly, and love handles, while the patient can consume up to 2,000 calories per day.

Cons

• While the product was aggressively pushed for approval, there is little known about the pill other than seven out of eight subjects who received the balloon experienced nausea and five vomited in the first week. Of the 264 subjects, 15% asked to have the balloon removed early due to the continued discomfort.
• The cost is estimated to be between $5,000 to $10,000. And with unknown long-term effects, this is a pricey “miracle” for many.
• Too many professionals with a vested interest in the price tag that comes with this “miracle” are endorsing the product without further research and results.

Reality

• We must not judge or berate those suffering with obesity looking for a medical help. Instead, we must change general attitudes about healthy living and losing weight which includes identifying marketing gimmicks that may be unhealthy, even dangerous and reintroduce the once tried-and -true solution – fitness and nutrition.
• The statistics of failed gastric bypass procedures is incomplete as many patients are too embarrassed or frustrated to report their results but we know that there is a significant increase in failure following five to ten years following the procedure. Similarly, sleeve gastrectomy have poorer long-term results throwing further red flags for "miracle" promises.
• With instant results and no effort, none of these procedures can be effective long-term. It is a lifestyle change that requires commitment to exercise, healthy eating, learning to cook, downsizing meals while still maintaining good nutrition that will ultimately bring success and happiness.

What is Adaptive Physical Education? And Why Do We Need it in the School System Today??

Adapted Physical Education (APE) is a specially designed physical education program which uses accommodations and modifications to meet the needs of students who require developmental or corrective instruction in PE. For example, a game of catch can be adapted in multiple ways based on the needs of a student. A ball with a bumpy texture or with a bell inside can be used for students with tactile or auditory needs, the distance the ball is thrown or bounced can be decreased for students , or a scarf could be used for students who do not have full ability of their arms.

In the school systems that I have been in there has seemed to be a shortage in APE teachers and programs. For example, in the Stephenville schools I have noticed that students with special needs or disabilities are basically getting pushed to the back of the line. This is by no means right in any way at all. Congress enacted a law in 1975 that gave all children with disabilities the opportunity to receive a free public education just like normal children. This was to be called IDEA, “Individuals with Disabilities Act”.(1)  Over the last year and half while substituting for schools in Erath County,it seemed  that the APE program did not exist at all. I did notice that from the 6th grade and below there was a small amount of PE or recess time for these students. Then once the students were between 7-12th grade there was no PE or recess for them. The students in the high school only go outside for 30 minutes a day, otherwise they stay inside the school the entire day. During PE class they attend normal PE however the students who are confined to wheelchairs just sit off to the side with the teachers. The students who are able to walk/run on their own are basically just told to walk around the outside of the basketball court. None of the students with disabilities get any sort of physical activity that.

The national standards for APE are set by the Adaptive Physical Education National Standards APENS.(2) Federal law mandates free and appropriate public education services for all children with disabilities. Subsequently, the law mandated that these services be provided by qualified professionals. The definition of special education within this law included the discipline of physical education.

Adaptive Physical Education Standards

“APENS”

At the end of my last blog “The Need to have Adaptive Physical Education in the School Systems”, I ended by giving a brief introduction to APENS. Federal law mandates free and appropriate public education services for all children with disabilities. Subsequently, the law mandated that these services be provided by qualified professionals.Within this law, the definition of special education included the discipline of physical education.(3) In the United States there are only 14 states that have defined an endorsement or certification in adapted physical education. The worst thing,in my opinion,  is that 36 states don’t do not recognize nor endorse the certification their teachers need to provide adequate adapted physical education to the students with disabilities.

The sole purpose of APENS is to ensure that physical education is taught to students with disabilities by a certified and qualified teacher of physical education. The APENS devised a set of 15 National Standards that must be met in order to become a qualified adaptive physical education teacher. Along with this APENS established a national certification exam to measure specialized content.

15 National Standards:(4)

1. Human Development
2. Motor Behavior
3. Exercise Science
4. Measurement and Evaluation
5. History and Philosophy
6. UNIQUE ATTRIBUTES OF LEARNERS
7. CURRICULUM THEORY AND DEVELOPMENT
8. ASSESSMENT
9. INSTRUCTIONAL DESIGN AND PLANNING
10. Teaching
11. CONSULTATION AND STAFF DEVELOPMENT
12. STUDENT AND PROGRAM EVALUATION
13. CONTINUING EDUCATION
14. Ethics
15. COMMUNICATION

To see all of the standards in their full description you can acquire the guide Adapted Physical Education National Standards Guide.(5)

The goal of APENS is to promote a nationally certified Adapted Physical Educator (CAPE) – the one qualified person who can make meaningful decisions for children with disabilities in physical education – within every school district in the country.(4)

How to become an Adaptive Physical Education Teacher

Adapted physical education teachers are physical education teachers that are trained to evaluate and assess motor competence, physical fitness, play, recreation, leisure, and sports skills. Adapted physical education teachers are then capable of developing and implementing an IEP program based on the findings of their assessment.

APE teachers must have knowledge and competencies in the following areas: (6)

• Developmental teaching methods in physical and motor fitness, fundamental motor skills, and skills in individual sports and other activities, as well as group sports and games
• Knowledge of motor control for teaching physical education to individuals with disabilities
• Knowledge of developmental sequences and motor characteristics associated with a number of disabilities
• Skills in a number of physical education techniques and procedures for developing individualized education programs in PE

APE teachers are not occupational therapists (OT) or physical therapists (PT). OT’s are trained to address skills associated with activities of daily living, work activities, and play and leisure activities. PT’s are trained to provide services that address mobility assistance, range of motion, gait therapy, and other interventions. Both OT’s and PT’s provide their services through a physician’s prescriptions to address medical conditions, as opposed to working with students in a physical education environment.

If specially designed instruction, such as adapted physical education (APE), is required in a student's Individual Education Program (IEP), then the services must be provided by a qualified teacher. A certified physical educator is legally qualified to provide adapted physical education for students who require specialized physical education as defined in the IEP. Adapted Physical Education certification is not required in Colorado. However, it is suggested that the teacher providing APE services become Nationally Certified through the National Consortium for Physical Education and Recreation for Individuals with Disabilities, earning a CAPE (Certified Adapted Physical Education) certification. Course work in APE is strongly recommended and additional education and/or experience in special education would be beneficial. (7)

Reference:

1. http://www.parentcenterhub.org/repository/idea/
2. http://www.apens.org/national_standard.html
3. http://www.apens.org/national_standard.html
4. http://tsukinegradprogram.blogspot.com/2015/09/the-need-to-have-adaptive-physical.html
5. http://www.humankinetics.com/home
6. http://www.peteacheredu.org/adapted-physical-education/  
7. https://www.cde.state.co.us/cdesped/ape

Can You Work Out Too Much? Muscle Hypertrophy

I see the way people look at me the first time they walk into my fitness classes. I don’t fit the fitness mold. I’m solidly built. I’m over 140 lbs. So when I get that ‘how good can you be’ look I chuckle to myself. I’ll see you in six minutes when you’re licking the floor and I’m still counting!

My background is powerlifting, martial arts, competitive fighting, US women’s bobsled team, and (briefly) women’s professional football. While on the bobsled team, it was my lifting that made the history books because I was pregnant at the time. Upon retirement, my goal was to lean out but it proved impossible. Couldn’t do it. No diet, no shake, no training could transform my body back to what it once was. So I did what any other sane person would do. I tripled the work. It worked for bobsled, why not real life? One example: While training for a marathon and teaching fitness classes, I was logging more than 30-40 miles of running per week with 10 hours of fitness classes (kickbox, boxing, bootcamp, cardio, and Pilates), and weightlifting yet the scale never budged. People would openly ask how it was I wasn’t a size 0 or why I wasn’t “skinny.” My diet was critiqued. My thyroid was pondered. My dedication was questioned. It sucked.

While pregnant on the bobsled team, researchers at Case Western documented my workouts and so I returned almost two decades later to ask why I was stuck in my present state. I have studied and know all about plateaus. Would I die in a perpetual state of bobsled plateau or was something else going on? That was when I learned about muscular hypertrophy and it all made sense. In essence, my workloads exceeded pre-existing capacity of the muscle fiber.

My what exceeded what? It goes like this: When you work out there is cell/muscle injury causing cell swelling. It is the recovery that then helps the muscle mend and, in response, swell but with hypertrophy the enlarged muscle cells perform at a far greater level of activity. The muscle breakdown does not occur (or certainly, not as much), each muscle fiber manages the workload more easily and, to the frustrated athlete working harder and harder and harder, physical results are fewer and fewer and fewer. The good news was my body was handling the workload like a champ. The bad news was my champ body resembled a Russian wrestler on steroids.

The diagnosis is in. I have muscular hypertrophy. For the first time in almost two decades of being the hardest working woman in a gym (or trying to be), I am redesigning my workouts for less intensity, more stretching, and muscle confusion.

Please be on the lookout for what’s next: Is Muscle Confusion Even a Thing?

Things to Know About Childhood Obesity

Childhood obesity, in the past, has never been an overwhelmingly problematic issue in the United states, but that has started to change in the past few decades with an estimated one out of every three children being obese.1,2 With the change in children’s lifestyles, evolving technology, dietary options/choices of children, along with many other contributing factors, childhood obesity in the United States has become an issue warranting attention to parents and citizens alike.

Studies have found that:

image from debbieupton.com

• 25% of kids do not participate in regular free time physical activity.1
• Obese children are 52% more likely to develop asthma.
• Obese children stand at a higher risk of developing heart disease.1
• Childhood obesity can cut the life expectancy of an individual by 5 or more years.1
• Almost 50% of diagnosed type 2 diabetes in children are related to obesity.1
• Childhood obesity related issues accrue $14 billion dollars a year in medical expenses.1

Being overweight or obese is defined as having excess body weight out of the norm for a particular height.2  The excess may be in the form or combination of fat, muscle, bone, or water.2  An overweight or obese child is nothing that warrants shame or embarrassment, but their physical health and lifestyle should be evaluated to see what changes can be made to promote their overall health and wellbeing for their present and future lives.

110 surprising facts about childhood obesity. (2014). Blank Children’s Hospital. Retrieved Nov 5, 2015, from https://www.unitypoint.org/blankchildrens/article.aspx?id=a08c96a2-c311-40d3-8eee-93d15f92b7ef

2Childhood obesity facts. (2015). Centers for disease control and prevention. Retrieved Nov 5, 2015, from http://www.cdc.gov/healthyschools/obesity/facts.htm

No, Low, and High impact exercise

A cardiovascular workout is a must for anyone looking to get into shape or maintain their current fitness level. Cardiovascular fitness is also a very important component of general overall fitness for people of all ages and physical ability. The many benefits and positive effects include; reduction in coronary heart disease risk factors, weight loss, and improved cardiovascular and respiratory function.1 There are three forms of cardiovascular works in terms of impact.  These are cardiovascular exercises that are either low, high or no impact physical activities.

image from tomcorsonknowles.com

No impact

No impact exercises are those that have no jarring or impact on the joints in your body.2 These exercises include activities such as aquatic activities, yoga, chair aerobics, rowing, isometrics.2  No impact can be good for all fitness levels but very beneficial for the elderly or others that may have some type of physical (permanent or temporary) condition that affects their physical abilities.

Low impact

Low impact exercise is an activity where at least one foot stays on the ground at all times during the exercise.3  These exercises include activities such as walking and cycling.  Low impact exercise is great for those at risk of injury or that have osteoporosis.3

High impact

High impact exercises are classified as an activity where at some point during the exercise both feet are off the ground at the same time.3   These exercises would include activities such as running, jogging, jump rope, stair climbing, or other activities that involve combinations of these exercises.  High impact exercise are recommended for healthy individuals to prevent osteoporosis and to help build strong bones.3

When deciding what form of cardiovascular workout to participate in, you should always check with your physician if you have any concerns or questions about your health.

120 benefits of cardiovascular fitness. (2012) kickstand fitness. Retrieved Nov 01, 2015 from

http://www.kickstandfitness.com/2012/11/28/20-benefits-of-cardiorespiratory-fitness/

2No impact exercise. (n.d) Frazier, Karen. Love to know. Retrieved Nov 01, 2015 from

http://exercise.lovetoknow.com/No_Impact_Exercise

3The best forms of cardio exercise. (2015) Livestrong. Retrieved Nov 01, 2015 from

http://www.livestrong.com/article/390667-the-best-forms-of-cardio-exercise/