Thursday, July 10, 2008

Soccer Concussions: Men and Women

Men and women with history of concussion mend differently, study finds

Concussion treatment needs to be more individualized, authors urge

Female soccer players and soccer players who have had a previous concussion recuperate differently from males or players without a history of concussion, new research released today at the 2008 American Orthopaedic Society for Sports Medicine Annual Meeting at the JW Marriott Orlando Grande Lakes shows. The study found that prior history of concussion and gender account for significant differences in test results following the injury. Because of these differences, the authors urge physicians and coaches to take an individualized approach to treating concussion patients.

"The results of this study suggest that physicians should not be taking a one-size-fits-all approach to treating concussions," said co-author Alexis Chiang Colvin, MD, Sports Medicine Fellow for the Department of Orthopaedics at the University of Pittsburgh Medical Center. "Our study shows that patients with a history of a previous concussion perform worse than patients without a previous history on neurocognitive tests taken after they sustain a concussion. Furthermore, females perform worse than males on post-concussion testing, as well."

The authors chose to examine concussion recovery patterns in soccer players due to the popularity of the sport among both genders. Also, it is a non-helmeted sport with identical rules for all participation levels for both genders. In the United States, there are between 1 and 4 million estimated sports-related concussions each year. The most common causes of concussion in soccer include, head-to-head contact, head contact with other body parts and head-to-ground contact.

A concussion is an injury to the brain that results in temporary loss of normal brain function, usually caused by a blow to the head. Concussions can affect memory, judgment, reflexes, speech, balance and coordination.

The study had 234 soccer players (61 percent female, 39 percent male) ranging in age from 8 to 24 years old, who were given neuropsychological tests that measured attention, memory, processing speed and reaction time after their concussion. The results of the tests were analyzed to see if there were group differences in performance between male and female participants and those with a previous history of concussion.

The study found that females performed significantly worse than males on tests of reaction time. Females were also significantly more symptomatic than males. Additionally, there was a trend, although not significant, towards females testing poorly regarding verbal memory and processing speed when compared to males.

Soccer players with a history of concussion performed significantly worse on verbal memory testing after another concussion, the study found.

"There's a theory that males typically have a stronger neck and torso that can handle forces better," said Dr. Colvin. "But when we accounted for Body Mass Index in this study, we still found a difference between males and females. Therefore, there are differences in recovery between genders that cannot simply be attributed to size difference. More studies are needed to determine the reason for differences in recovery between males and females."

Tuesday, July 8, 2008

Male cyclists risk sexual problems

Men who take up cycling in an effort to stay fit, do their bit for the environment or avoid spiralling motoring costs, could be harming their health if they don't choose the right bicycle. That's the stark warning from consultant urological surgeon Mr Vinod Nargund from St Bartholomew's and Homerton Hospitals, London, in the urology journal BJU International.

He says that the problems to look out for include genital numbness, erection problems and soreness and skin irritations in the groin area.

Men who cycle a lot can also experience changes to their sperm function, because of the excessive heat generated in the pelvic area. No general link between cycling and male infertility has been established, but it is still recognised as a possible side effect and has been noted in a number of male cyclists.

Regular cyclists also run a higher risk of testicular damage and impaired testicular function.

Mountain bikers run a particular risk, says Mr Nargund, as studies have shown that they exhibit higher levels of scrotal abnormalities than on-road cyclists.

"The bicycle saddle is in direct contact with the perineum and its underlying structures" he explains. "It makes contact just behind the scrotum where the nerves and blood vessels enter the back of the scrotum and penis.

"This area is sensitive, with hair follicles and sweat and sebaceous glands, which are all good breeding grounds for infection.

"Abrasions, chafing, damaged hair follicles and bruising are among the most traumatic cycling injuries. Sweating in this area can also cause soreness and skin problems."

He points out that more than 60 per cent of male cyclists who have taken part in research studies have reported genital numbness.

"Numbness is common because the pressure of the saddle can impair the blood supply to this area and put pressure on the nerves in the penis" says Mr Nargund. "This can also affect the man's ability to get an erection.

"There is a greater incidence of numbness and erectile problems in men who cycle regularly and over longer training distances. That is why it is important to rest intermittently during prolonged and vigorous cycling."

Choosing the right bike is essential, stresses Mr Nargund.

"The male cyclist should know his bicycle well and a proper fit is particularly important for high-performance cycling" he says.

"The level of pedal resistance is also very important, because riding a bike using too much resistance is a major cause of health problems in the groin area.

"Cyclists can also help to ease saddle-related injuries or skin irritations by adjusting the saddle height and fore and aft position.

"Padding in the saddle and shorts are also important if cyclists want to avoid saddle-related problems."

Mr Nargund's comment piece has been published online on the BJU International website in advance of its hard copy publication later this year.

Monday, July 7, 2008

Baseball diamonds: the lefthander's best friend

Baseball diamonds are a left-hander's best friend.That's because the game was designed to make a lefty the "Natural," according to David A. Peters, Ph.D., the McDonnell Douglas Professor of Engineering at Washington University in St. Louis and ├╝ber baseball fan. Peters is a mechanical engineer who specializes in aircraft and helicopter engineering and has a different approach to viewing America's Favorite Pastime.

First of all, some numbers.

"Ninety percent of the human population is right-handed, but in baseball 25 percent of the players, both pitchers, and hitters, are left-handed," said Peters, a devoted St. Louis Cardinal fan who attended "Stan the Man's" last ball game at Sportsman's Park in 1963. "There is a premium on lefthanders for a number of reasons. For starters, take seeing the ball.

"A right-handed batter facing a right-handed pitcher actually has to pick up the ball visually as it comes from behind his (the batter's) left shoulder. The left-handed batter facing the right-handed pitcher has the ball coming to him, so he has a much clearer view of pitches."

Then, Peters says, consider the batter's box. After a right-hander connects with a ball, his momentum spins him toward the third-base side and he must regroup to take even his first step toward first base. In contrast, the left-hander's momentum carries him directly toward first.

"The left-handed batter has a five-foot advantage over the right-handed batter," says Peters. "And that means the lefty travels the 90 feet to first roughly one-sixth of a second faster than the righty. That translates to more base hits for the left-hander, whether singles or extra base hits because lefties are getting to the bases more quickly."

Even Jim Thome and Jason Giambi?

The left-handed pitcher generally is much more difficult to steal off, as, from his stretch, he peers directly at the runner; the right-hander must look over his shoulder and wheel to first base, giving the runner more of a warning of the pitcher's intent.

Positions advantageous to southpaws are pitching, first base and right field. For the positions, the advantage is the favorable angles lefties get, enabling them to throw the ball more quickly across the diamond to second, third and home. One position a lefty rarely plays is catcher, for the obvious reason that it is difficult for a southpaw catcher to throw over so many right-hand batters.

"It wasn't all that long ago when first basemen were predominantly left-handed and most right fielders were left-handed," Peters says. "That has changed, at least since the late sixties."

There's even a bias toward the lefthander in ballpark design. Right field in most parks (just think of Yankee Stadium and Fenway Park) is usually shorter than left field because of the preponderance of right-handed hitters.

While traditional thinking holds that the right-handed batter has the advantage over the left-handed pitcher, because the breaking ball goes into the batter's power threshold, it's not always the case, says Peters. And it's that familiarity thing again.

"Because only 10 percent of the population is left-handed, kids grow up and mature in baseball seeing a left-hander just 10 percent of the time they bat," he says. "So, it can be hard for both lefties and righties to face a southpaw. It's why some left-handed batters look dreadful matched against a lefty."

Some batters don't like facing southpaws because their ball is purported to have a natural movement away from a right-hander and into a lefty.

"There's no scientific evidence to support this, but I wonder if lefties get that movement from learning to write in a right-hander's world," Peters says.