New findings published in the Mayo Clinic Proceedings suggests that you can have too much of a good thing when it comes to running and exercise.
According to a statistical analysis of frequent runners, individuals who run 30 miles or more a week have a significantly higher mortality rate than those who run less. Researchers believe certain cardiovascular events can be trigged by what they call, “excessive exercise.”
“[This is] the first data in humans demonstrating a statistically significant increase in cardiovascular risk with the highest levels of exercise,” said lead researchers Paul Williams and Paul Thompson. “Our analysis suggests that the benefits of running and walking do not accrue indefinitely, and that above some level, perhaps 30 miles a week of running, there is a significant increase in cardiovascular mortality.”
Thompson cautioned that the results apply to “cardiac runners,” or those runners who have suffered a previous cardiovascular event.
“It’s a big deal that these were cardiac runners,” he said. “We can’t say that the same results will apply to healthy runners. The two groups are very different.”
In their findings, researchers suggested that runners who suffered a previous cardiovascular event exhibited a “reverse J-shaped curve” in terms of mortality rate. In laymen’s terms, doctors found that some exercise was better than none, but at a point, too much exercise becomes more problematic than less exercise.
“The evolving picture on exercise is becoming more clear: no other lifestyle factor confers more benefits to health and longevity than does regular moderate physical activity, but excessive exercise may erode some of the benefits,” said cardiologist James O’Keefe.
For their study, researchers followed 2,377 runners and walkers who suffered a previous heart attack for more than 10 years. After analyzing the data, they found:
- Mortality rates decreased by 40 percent if the person ran/walked for roughly 18 miles a week.
- Mortality rates decreased by 60 percent if the person ran/walked about 27 miles per week.
- Those running 30+ miles a week had a similar risk as those who only ran/walked 7-9 miles a week, and they were 2.6 times more likely to suffer a cardiovascular event than those who ran in the mid-20s per week.
Dr. Silverman comments
This is an interesting study. Just like overstressing your feet can lead to stress fractures, overworking your heart after a heart attack can lead to another episode.
Although the findings are significant, the biggest takeaway form the article is that people who exercised in moderation after a heart attack SIGNIFICANTLY lowered their risk of another event, by 40-60 percent. Please, make time to get your workout in a few times a week.
Related source: Runner’s World
Kory Sheets was a standout for the Canadian Football League’s Saskatchewan Roughriders for the last two seasons, but his dream has always centered around making it in the National Football League. After leading the Roughriders to a Grey Cup championship in 2013, Sheets set his sights on an NFL roster spot with the Oakland Raiders for the upcoming season, but he’ll have to wait at least another year after suffering a torn Achilles in Oakland’s third preseason game.
Sheets had been competing with Latavius Murray for the starting kick returner duties, but he’ll once again be forced to battle back from injury. A previous attempt to make the Miami Dolphins in 2010 was short lived after he suffered the same injury.
“A dream deferred…out for the year,” Sheets tweeted after doctors confirmed the tear. He also expressed his gratitude to both Raider and Roughrider fans
— Kory #1Time Sheets (@Sheets24K) August 23, 2014
Roughrider quarterback Darian Durant said he was sad to see one of his teammates fall short of his dream because of an ankle injury.
“I’m sad for him, but the positive side of it is he’ll make a lot more money this year than he’s made in a long time,” said Durant. “But as far as a friend, a football player a former teammate, it’s definitely sad to see that happen to him.”
Durant said he spoke with Sheets after the injury and the running back is in good spirits, while Roughrider head coach Corey Chamblin said he was really hoping Sheets would make it to the pros.
“They watch those guys, you never want to see the guys get hurt,” said Chamblin. “You want to see him make it, you want him to become a star. So, you can say ‘hey, that’s my friend’ and all that.”
Dr. Silverman comments
This is an unfortunate development for Sheets. At least he’ll have some of the best sports medicine doctors helping him along with his rehab.
Although the story doesn’t specify if this is the same Achilles tendon he tore back in 2010, it’s certainly going to be difficult to recover from another torn tendon. I have no doubt that with the right care he can regain nearly all the same strength in his foot, but you have to wonder if this injury will affect him mentally. Will he be hesitant to run or cut at full speed on his surgically repaired Achilles?
Then again, the previous injury could work to his advantage. He’s already worked his way back from an Achilles tear to become a Grey Cup MVP, so he knows he’s capable of returning to top form. I hope he recovers and gets another shot at the NFL.
Related source: CKOM.com
After this story was posted it came to our attention that Josh Shaw lied about the incident in question. He did not hurt his ankles saving his cousin. The facts are still being sifted out, but we will leave our story up as it contains actual medical advice.
USC Cornerback Josh Shaw makes a living preventing wide receivers from catching passes, but his best move came off the field this weekend when he jumped off a balcony to prevent his 7-year-old cousin from drowning in a pool.
Shaw, who had just been voted team captain that day, was on a second story balcony when he noticed his 7-year-old cousin, who doesn’t know how to swim, struggling to stay afloat in the pool below. Throwing caution to the wind, Shaw jumped from the balcony onto the concrete below and suffered injuries to both his ankles in the process. He crawled to the pool and was able to get his cousin to safety.
“I would do it again for whatever kid it was, it did not have to be my nephew,” said Shaw. “My ankles really hurt, but I am lucky to be surrounded by the best trainers and doctors in the world. I am taking my rehab one day at a time, and I hope to be back on the field as soon as possible.”
The media reports that Shaw is dealing with high ankle sprains in both of his feet, but Dr. Silverman is hesitant to rely on the early reports. Here’s what he had to say about the story.
This is truly an inspirational story and I commend Shaw for his heroic actions, but I think the media may be overcharacterizing his double high ankle sprains. This is the proverbial over call of a high ankle sprain.
See, as we’ve detailed before, a high ankle sprain isn’t considered “high” because a person fell or jumped from a high height, it’s classified this way because it involves the syndesmosis joint, the highest joint involved in ankle motion and stability. These usually happen when a sudden and forceful outward turning of the foot occurs, not because of a fall from great heights.
When you consider the physics of his fall, it’s unlikely that both of his feet twisted outward as he landed. It’s certainly possible that he sustained one high ankle sprain, but it’s more likely that one of his ankles sustained a regular sprain. In fact, I think it’s probably more likely that he’s dealing with two high-grade ankle sprains, not two high ankle sprains. Again, it’s possible that he does in fact have two high ankle sprains, but misinformation can occur when you have news outlets covering a story, not doctors or team trainers.
I wish Shaw the best of luck in his recovery, and I hope he’s not dealing with two syndesmosis injuries. That would certainly force him to miss some games.
Related source: ESPN
The Vikings didn’t believe the injury was too serious, since Loadholt was able to return to the game after missing one offensive series, but they didn’t want to take any chances. Loadholt underwent an X-ray after the game and had an MRI on Sunday. The X-ray came back negative, while the MRI revealed a contusion.
For a large individual tasked with pushing against a charging defensive lineman, having strong ankles is a must. Team doctors initially thought Loadholt suffered a sprain, but it looks like it’s just a bruise.
“If it’s simply a bruise, Loadholt will just have to deal with some pain and discomfort over the next few days,” said Dr. Silverman. “Had it been a sprain, his mobility would likely have been limited, which would be problematic for any right tackle.”
Dr. Silverman added that Loadholt will have two full weeks to recover before the Vikings hit the field for their regular season opener against the Rams. The Rams have one of the best defensive fronts in football, so Minnesota will do everything in their power to ensure Loadholt is back to full health come September 7.
One such action is holding Loadholt out of Thursday’s preseason finale. Since the starters usually sit out the final preseason game regardless of health, it’s likely that Loadholt wouldn’t have been on the field anyways. With his minor injury, it’s all but certain he’ll be in street clothes come gameday.
Related source: ESPN
If the San Francisco 49ers want to make another run at the NFC Championship game, they’ll have to put their best foot forward. That foot may be the fully healed left foot of quarterback Colin Kaepernick.
Speaking openly for the first time about the injury, Kaepernick revealed that he suffered a chipped bone in his forefoot and a ruptured capsule in the ball of his left foot during a Week 2 loss to the Seahawks. Kaepernick said he believes the injury occurred when a linebacker landed on his foot after a running play, but he never detailed specifics about the injury to the media until this week.
When asked about the injury last season, Kaepernick repeatedly told reporters he was simply dealing with hangnails on both feet. Kaepernick was listed on San Francisco’s official injury report for a good portion of the season, but since he never missed any time with the injury, many bought the excuse that he was just dealing with minor discomfort.
Head coach Jim Harbaugh said he noticed that Kaepernick’s mobile ability was affected by the injury, so he decided to limit the number of designed running plays for the quarterback.
“I noticed it, especially in practice. I think anytime you have a foot, a hand or a finger, it affects you throwing and running,” said Harbaugh. “We didn’t want to see Colin get hit 12 times a game. Four or five? Maybe, and that’s it. That was a conscious effort.”
Harbaugh wasn’t the only one to notice that Kaepernick was struggling to match the rushing statistics he put up just one year prior. In the first four games after the injury, Kaepernick failed to eclipse 20 rushing yards in any game. Kaepernick only averaged 5.7 yards per game in the regular season, but his foot appeared to be fully healthy by the time the playoffs rolled around. He averaged 9.3 yards per carry in the postseason, but the 49ers fell in a close battle with Seattle in the NFC Championship.
Kaepernick said he knows the importance of playing through discomfort.
“I think that’s the kind of players we have on this team: You’re not going to let something that’s minor, that’s not a true injury, keep you off of the field. You’re going to hurt, yes. You’re going to have tweaks and problems. But you’re a football player; you can play through those.”
Dr. Silverman comments
Kaepernick had a down year running the ball last season, which makes more sense now that he’s speaking about the foot injury. His yards per carry fell by one full yard, and he had one less rushing touchdown last season than he did in 2013, despite playing in three more games last year.
When he’s fully healthy, Kaepernick is arguably the best duel threat quarterback in the league. Considering he’s made two consecutive NFC Championship appearances and another duel threat quarterback – Russell Wilson – just won the Super Bowl, it’s a good bet that San Francisco is poised to be great for the foreseeable future.
I wish I could take a look at his x-rays, but it sounds as if the damage was able to heal as expected. He’ll be one to watch in 2014.
Related source: The Sac Bee
According to a report by ABC 30 in California, more than 50 million Americans are affected by some form of arthritis. Roughly 10 percent, or 5 million of those individuals suffer from arthritis of the ankle.
Arthritis of the ankle can cause a variety of different symptoms, including:
- Pain, both while standing and in non-weightbearing positions.
- Sensitivity or tenderness.
- Feelings of tightness or pressure in the area.
- Reduced range of motion.
Sometimes the pain and discomfort is so unbearable that patients are unable to preform daily activities, like working out, walking the dog, or even playing with their children. Thankfully, medical knowledge has progressed immensely in the last 50 years, and doctors can now offer ankle replacement surgeries that help people get back to their old lifestyle.
Ankle Replacement Surgery
Ankle surgery shouldn’t be the first option a person considers. Surgeons say that ankle replacement should only be considered if bracing, over-the-counter medications and physical therapy have proved fruitless. Also, the operation may not be possible if the patient is deemed too heavy. Since your ankles and feet are responsible for shouldering the weight of your entire body, the risks of failure or complications may be too great if a patient is too heavyset. Your doctor can work with you to develop a plan to get to you the optimal weight.
As for the process, ankle replacement surgery involves replacing the articulating surfaces of the tibia, fibula, and the talus. Surgeons insert a metal and plastic implant that mimics the movements and functions of a healthy ankle. Current statistics suggest that 90 percent of patients are satisfied with their replacement ankle during the first four years following surgery. The ankle implant currently lasts about 15 to 20 years, depending on activity, level of arthritis, and how the bones attach to the device.
No surgery is risk free, and ankle replacement isn’t any different. These complications are very rare, but they do occur:
- Blood clots
- Bone or device failure
- Nerve injury
Although there are a few rare risks, it hasn’t dissuaded the public from electing to undergo the operation. Surgical data shows that between 2011 and 2012, the total number of ankle replacements doubled. For more information on the operation, check out our Ankle Replacement Webpage.
Related sources: Washington.edu, ABC 30
Despite the overly ominous title of this post, the Ice Bucket Challenge is a pretty safe and fun way to raise awareness and donations for those battling ALS. For those of you who haven’t heard, the Ice Bucket Challenge involves dumping a bucket of ice cold water over your head. Once you complete the challenge you can nominate three friends to take the challenge within 24 hours.
If they decline, they are supposed to donate $100 to the ALS Association. If they accept, they are asked to videotape themselves completing the challenge and make a donation of their choosing to the ALS Association.
The trend is sweeping the nation, but there are some precautions you should take. We discuss the potential dangers below.
- Cold Shock – The elderly, anyone with a heart condition and pregnant women should avoid the challenge as the cold sensation can cause your body to go into a temporary shock. If you’re really keen to participate, use warmer water or simply donate.
- Eyewear – Goggles or protective eyewear are smart choices if you really load up the bucket with ice. You wouldn’t want to have your eye damaged by a rouge ice cube.
- Hypothermia – Although you’re unlikely to suffer hypothermia from a second or two of ice cold water, avoid the challenge on particularly cold days, and always have towels and dry clothes nearby.
- Head trauma – If done incorrectly, a person can suffer serious head injuries if they try to make the challenge more extreme. A simple Youtube search of “Ice Bucket Fail” shows people attempting to dump plastic bins from 10-15 feet in the air. As you can see in the video below, if the pourer has a loose grip, the unsuspecting challenger can be injured badly. Avoid dumping the bucket from high heights, avoid large bins that weigh a lot, and don’t use a glass container.
What is ALS?
ALS stands for Amyotrophic Lateral Sclerosis, and it’s also known as Lou Gehrig’s Disease. ALS is a progressive neurodegenerative disease that weakens the nerve cells in the brain and throughout the spinal cord. As the ALS Association describes on their website, “Motor neurons reach from the brain to the spinal cord and from the spinal cord to the muscles throughout the body. The progressive degeneration of the motor neurons in ALS eventually leads to their death. When the motor neurons die, the ability of the brain to initiate and control muscle movement is lost. With voluntary muscle action progressively affected, patients in the later stages of the disease may become totally paralyzed.”
ALS is an awful disease because a fully functioning person slowly loses his or her ability to preform even the simplest tasks. That’s why it’s so important we find a cure. For more information about ALS, or to donate, click here.
Sims was expected to be a change-of-pace runner behind starter Doug Martin, but the new regime in Tampa wouldn’t have selected Sims in the third round of the draft if they didn’t have plans for the rookie. Head coach Lovie Smith spoke highly of Sims prior to the injury.
“I think you can tell, especially at skill positions, does a guy have it?” Smith said. “Charles Sims, I would say, has it. He hasn’t played a game and right now we’re not live an awful lot. But you can see enough in him to like his future with us. Just talking about it, that’s the last thing. He can carry the ball or he can catch the ball. Protections for any young back, that’s the thing that they will have the most trouble with early on. But he’s picked things up fairly well quickly.”
Unfortunately for Sims, he’ll have to put his development on hold for the foreseeable future. He suffered the injury in practice Tuesday, and although he was seen wearing a walking cast on Thursday, he needed to undergo an operation to stabilize the injury.
[It’s] unfortunate with his ankle injury, but that happens,” Smith said Thursday after practice. “You know, you saw him in the cast with the walking boot outside. He won’t play in the immediate future for sure.”
The injury may have been more severe that Smith initially realized, as the team announced on Friday that Sims would undergo surgery over the weekend to address the fracture. Team doctors said rehabilitation from this type of fracture takes roughly 12-14 weeks before a player can tolerate the rigors of professional football. If he were healthy enough to play exactly 12 weeks after the surgery, Sims would rejoin his teammates prior to their Week 10 contest against the Atlanta Falcons.
Dr. Silverman comments
Puns aside, this is truly an unlucky break for this young man. Many NFL insiders projected Sims to be one of the biggest surprises of the 2014 season, but now he’ll have to work his way back from an injury.
I don’t have access to his X-rays, but it sounds as if it was a pretty significant break, or at least in a significant location. 12-14 weeks is often on the longer side of the recovery spectrum when it comes to ankle rehab, but again, he’s not just looking to get back to the point were he is able to walk pain free, he’s trying to elude some of the NFL’s biggest and fastest players. He’ll want to adhere to his rehab schedule, as it’s important to make sure the affected ligaments heal as they should. I wouldn’t be surprised if he beat the 12-14 week timetable, but I understand that the Bucs will want to make sure their young running back is fully healthy before rushing him back on the field. Best of luck, Charles.
Related source: CBS Sports, Tampa Bay Times, SportsTalkFlorida.com
Research by medical students at St. George’s University in London found that the loss of sensation in the feet in diabetics could be a predictor of certain cardiovascular events like heart attack or strokes.
As we’ve documented in past posts, diabetes affects how blood flows throughout the body. Diabetes can damage blood vessels and nerves, especially if a patient struggles to control their blood sugar. Damage to the circulatory system can lead to poor blood circulation, typically in the hands and feet. If the circulation is extremely poor, a person may be forced to undergo an amputation.
Researchers sought to determine if there were identifiable precursors to more severe adverse events in an effort to prevent individuals from losing limbs or suffering related health issues due to poor circulation. For example, loss of sensation in the feet is often a precursor to development of a foot ulcer. Researchers wanted to see if other sensory issues put a person at greater risk for suffering a cardiovascular event.
For their study, researchers examined 13,000 patients with type-2 diabetes and no history of cardiovascular disease. After comparing diabetics diagnosed with peripheral neuropathy (as diagnosed by their general practitioner) to those without peripheral neuropathy, researchers found that the individuals with foot sensory issues were more likely to suffer a stroke or heart attack.
“While the risk of cardiovascular disease is known to be higher in patients with diabetes, predicting which patients may be at greatest risk is often difficult,” said researcher Jack Brownrigg, PHD. “We looked at data on individuals with no history of cardiovascular disease and found that those with peripheral neuropathy were more likely to develop cardiovascular disease.”
Robert Hincliffe, co-author of the study, said the study was the first of it’s kind and could help general practitioners with their care of diabetic patients.
“This is the first study to show that it can also indicate an increased risk of cardiovascular problems like heart attacks or strokes,” said Hincliffe.”The good news is that peripheral neuropathy can be easily identified by simple tests carried out in GP surgeries. There is likely an unmet potential to reduce cardiovascular disease in this group of patients through greater monitoring and simple treatments.”
Dr. Silverman comments
Sensory deficiency is one of the side effects of diabetes that doctors and patients need to closely monitor. Thousands of Americans lose limbs each year because of circulatory complications caused by diabetes.
I’m glad the authors decided to study the impact of poor circulation on cardiovascular events. The results are more common sense than earth shattering, but the key here is that studies like these help improve social awareness about the potential deadly consequences of ignoring warning signs.
Related source: BMJ
Fans and teammates feared the worst after seeing Machado’s right leg give out during a swing. Although he stayed on the ground in pain for a short while after the injury, Machado was able to walk off the field on his own power. He was seen using crutches after the game, but reporters said he appeared to be in good spirits.
Machado is no stranger to knee injuries, as he suffered a torn patellofemoral ligament in his left knee last season when he landed awkwardly on a base. Thankfully for Orioles fans, an x-ray taken after Monday’s game came back negative, and a subsequent MRI revealed only a knee sprain.
The Orioles said they’d provide an update on the 22-year-old’s condition, including a timetable for his return, after their game Wednesday against the Yankees. Although nothing is official, sources close to the team say they believe the Orioles will place Machado on the 15-day DL and call up infielder Cord Phelps to fill his roster spot.
Dr. Silverman comments
As I noted when discussing Machado’s injury last season, I mentioned that it was probably better that the injury occurred to the left knee based on how each leg handles weight distribution and torque during the swing process.
Although this injury is less severe than a torn patellofemoral ligament, an injury to the right leg of a right-handed batter will tend to be more problematic than if the same injury had occurred on the left leg. It’s similar to a quarterback who suffers a foot injury. Your plant foot generates power, and your landing leg helps with accuracy and control as weight is transferred. If a knee injury gets in the way, a player will not be able to throw a football or hit a baseball as far as they normally would.
It sounds like Machado will be on the shelf for the rest of August, but my guess is he’ll return for a playoff push as the calendar turns to September. Hopefully the injury isn’t anything more than a sprain.