Bryan W. Smith

Effect of mouthguards on dental injuries and concussions in college basketball

PURPOSE Dental injuries can be permanent and disfiguring. They are also universally expensive to treat. Many dentists, sports physicians, and athletic trainers recommend mouthguards for athletes participating in certain competitive sports, including mens college basketball, because of a common perception that mouthguards afford protection from dental injuries, and even some concussions. However, there are few reliable reports of the incidence of dental injuries and concussions in mens college basketball, and good evidence that mouthguards reduce the risk of these injuries in this population of athletes is notably lacking. This study prospectively recorded dental injuries and concussions among 50 mens Division I college basketball teams during one competitive season, then compared injury rates between mouthguard users and nonusers. METHODS During the 1999 to 2000 basketball season, athletic trainers from 50 mens Division I college basketball programs used an Internet Web site to submit weekly reports of the number of athlete exposures, mouthguard users, concussions, oral soft tissue injuries, dental injuries, and dentist referrals. RESULTS Response rate was 86%. There were 70,936 athlete exposures. Athletes using custom-fitted mouthguards accounted for 8663 exposures. Injury rates were expressed as number of injuries per 1000 athlete exposures. There were no significant differences between mouthguard users and nonusers in rates of concussions (0.35 vs 0.55) or oral soft tissue injuries (0.69 vs 1.06). Mouthguard users had significantly lower rates of dental injuries (0.12 vs 0.67; P < 0.05) and dentist referrals (0.00 vs 0.72; P < 0.05) than nonusers. CONCLUSION Custom-fitted mouthguards do not significantly affect rates of concussions or oral soft tissue injuries, but can significantly reduce the morbidity and expense resulting from dental injuries in mens Division I college basketball.

Creatine supplement use in an NCAA Division I athletic program.

OBJECTIVE To determine the prevalence and pattern of creatine use among varsity athletes at a National Collegiate Athletic Association (NCAA) Division I athletic program. DESIGN Anonymous descriptive survey. SETTING Institutional. PARTICIPANTS Collegiate varsity and junior varsity athletes. MAIN OUTCOME MEASURES Self-reports of creatine use, including pattern of use and dose, source of information on creatine, and expected and perceived effects from creatine use. RESULTS Surveys were obtained from 93% of 806 eligible athletes. Overall, 68% of athletes had heard of creatine and 28% reported using it. Forty-eight percent of men reported having used creatine as compared with 4% of women. With two exceptions, all mens teams had at least 30% of athletes who reported a history of creatine use. Of athletes that had used creatine, about one-third had first used it in high school. Friends and teammates were the most common sources of creatine information. Increased strength and muscle size were the most common effects the athletes expected and perceived from creatine use. CONCLUSION In this population of collegiate athletes, creatine use was widespread among men but was minimal among women. Athletes learned about creatine supplementation primarily from their peers, and substantial numbers began to take creatine while still in high school. Most athletes could not report their dosing of creatine. This study reported findings at one location for one academic year. Studies are needed at multiple locations and over time to further delineate creatine use patterns.

Back injuries in the pediatric athlete

Pediatric and adolescent athletes presenting with back pain are much more likely to have a pathologic cause for their symptoms than are adult patients. For this reason, it is important for those caring for younger athletes to maintain a high index of suspicion for some of the more common pathologic causes of back pain in this population. Diagnostic evaluation should be undertaken more quickly in pediatric and adolescent athletes. Sports-related diagnoses that must be considered include disc-related back pain, atypical Scheuermanns kyphosis, spondylolysis, and spondylolisthesis. Patients of this age may also present with conditions not associated with activity, including discitis, classic Scheuermanns disease, rheumatologic disease, and spinal tumors. History and physical exam provide valuable information to help guide further diagnostic studies which, in turn, will determine necessary treatment. No definitive studies are available regarding the diagnosis and treatment of spondylolysis and spondylolisthesis. Health professionals need to consider the expertise of a local radiologist when deciding upon diagnostic imaging procedures. The athletes age and sport played can contribute to the appropriate treatment plan.

A comparison of leg-to-leg bioelectrical impedance and skinfolds in assessing body fat in collegiate wrestlers.

A comparison of the leg-to-leg bioelectrical impedance (BIA) system and skinfold analysis in estimating % body fat in a large number of National Collegiate Athletic Association (NCAA) collegiate wrestlers was conducted. A series of 5 cross-sectional assessments, including the NCAA Division I and III Championships, were completed throughout the 1998–1999 wrestling season with samples ranging from (N = 90–274). Body density was determined from the 3 skinfold measures using the Lohman prediction equation. BIA measurements were determined using the Tanita body fat analyzer, model 305. Significant correlations between methods ranging from (r = 0.67–0.83, p < 0.001) and low standard error of estimates (SEE) for % body fat ranging from 2.1–3.5% were found throughout the 5 assessment periods. This preliminary study demonstrated that the leg-to-leg bioelectrical impedance system accurately estimated % body fat when compared to skinfolds in a diverse collegiate wrestling population.

Comparison of reporting systems to determine concussion incidence in NCAA Division I collegiate football

ObjectiveTo determine the incidence of concussion during the 2001 Division I-A college football season through utilization of the Internet. DesignProspective Internet survey. SettingInternet Web site. ParticipantsHead athletic trainers from Division I-A collegiate football programs. Main Outcome MeasuresDuring the 2001–2002 football season, head athletic trainers from 87 Division I-A football programs agreed to use an Internet Web site to submit weekly data on the number of athlete exposures and concussions. ResultsA total of 373 concussions were reported over the course of a season in both practices and games combined. Of these concussions, 256 (68.6%) occurred during games, and 117 (31.4%) occurred during practice. The injury rate per 1,000 athletic exposures was 5.56 in games and 0.25 in practices. There were 230 grade 1 (61.7%), 134 grade 2 (35.9%), and 9 grade 3 (2.4%) concussions reported. There was a significant (p < 0.01) difference found between the total concussion injury rate and game concussion injury rate when comparing the Internet and the NCAA injury data collection methods. ConclusionsThe results of this study suggest an underreporting of concussions using the NCAA Injury Surveillance System and demonstrate that the Internet is a simple and effective tool for data collection.

Eye injuries in women's lacrosse players

ObjectiveTo determine the prevalence of eye injuries among intercollegiate womens lacrosse players as well as the level of play, specific play settings, and particular mechanisms associated with these injuries. DesignAnonymous, retrospective, survey. SettingIntercollegiate lacrosse tournament. ParticipantsCollegiate and postcollegiate womens lacrosse players. Main Outcome MeasuresSelf-reports of eye injuries, injury circumstances, treatment received, playing time missed, and continuing problems were recorded. ResultsSurveys were collected from 667 players from 34 teams (83% of players listed on rosters). A total of 125 injuries were reported among 84 players (12.6%). Injuries occurred equally in high school and college. Athletes were injured most frequently in games (41 injuries) and practices (38 injuries), with 17 players injured during the off-season. Several mechanisms of injury were noted. Fifty-three women sustained injuries requiring medical attention. Of those athletes injured, 23 missed 1–5 days and 9 players missed more than 5 days. Four athletes (4.8%) reported residual problems from an eye injury sustained while playing lacrosse. ConclusionsEye injuries are occurring more frequently than current surveillance data suggest. Because injuries are seen at all levels of play, in many different situations, and by multiple mechanisms, mandatory eyewear is needed to prevent serious eye injuries in womens lacrosse.

Serum creatine kinase and CK-MB isoenzyme responses to acute and prolonged swimming in trained athletes

Six highly-trained male swimmers completed a maximum work capacity tethered swim and a 1-h continuous tethered swim at ~ 70% VO2max in order to evaluate total serum creatine kinase and CK-MB isoenzyme changes. Venous blood obtained before, 5 min post-, 6 h post-, and 24 h post-exercise was analyzed for total serum CK (kinetic UV method, normal = 0.05) elevation in mean total creatine kinase. No CK-MB isoenzyme was observed in any post-exercise blood sample. Swimming, performed by highly-trained swimmers at high levels of intensity or for prolonged durations, may not impose sufficient degrees of trauma producing muscular stress. Therefore, the structural integrity of the cell membrane is maintained and the loss of intracellular creatine kinase to the bloodstream prevented.

PHARMACOLOGIC TREATMENT OF EXERCISE-INDUCED ASTHMA

Exercise-induced asthma (EIA) is a complex disorder affecting a sizeable minority of athletes. Proper pharmacologic management allows most every athlete at any level to participate with EIA. This article briefly addresses the pathophysiology, diagnosis, and basic treatment principles, including nonpharmacologic management for EIA. Most of the article details the current treatment strategies and provides information on experimental treatments being investigated. In addition, ergogenic concerns and problems in treating elite athletes are discussed.

Exercise considerations in coronary artery disease, peripheral vascular disease, and diabetes mellitus

Physical inactivity is a risk factor for cardiovascular disease. Regular aerobic and resistance training increases exercise capacity and plays a role both in the primary and secondary prevention of cardiovascular disease. Patients with coronary artery disease, peripheral vascular disease, or diabetes mellitus must be considered individually when prescribing exercise because their clinical status can vary greatly. In addition, a majority of these patients have multiple comorbid disorders such as renal, neurologic, and retinal disease that may affect their ability to exercise safely. Therefore, a preparticipation medical evaluation is required. An exercise prescription should be tailored to each persons unique set of circumstances and reflect an effort to maximize the anticipated benefits while minimizing the risks.

Physiological effects of exercise on the cardiopulmonary system.

The cardiopulmonary adaptations made to dynamic and static exercise show the amazing ability of the human body to alter physiological processes in order to meet metabolic demands. A remarkable partnership that allows individuals to maximize their abilities and obtain goals exists between the cardiovascular and pulmonary systems. The adaptations of the cardiopulmonary system depend heavily on the intensity, duration, frequency, and type of exercise being performed. Although most of this article examined dynamic and static exercise separately, the majority of individuals train using a combination of these two modes. The overall adaptations will vary with the chosen degree of each exercise mode. An appropriate exercise program allows for improvements in the cardiopulmonary system that help develop and maintain fitness levels.