Jan 29, 2015
Bulletin Board

NCAA To Vote on Sports Medical Issues

Student-athlete health and safety is the subject of upcoming NCAA legislation thanks to a new set of initiatives developed by its Committee on Competitive Safeguards and Medical Aspects of Sports (CSMAS). At the annual NCAA Convention in January, leaders from all three divisions will vote separately on the proposals. The first change would require all member schools to retain a licensed physician for each of their sports teams. The next proposal mandates that all head and full-time coaches, including strength and conditioning coaches, become certified in first aid, CPR, and automated external defibrillator (AED) use. Strength and conditioning coaches–both full- and part-time–would also need to be certified in their field. The final rule would require institutions to report annual catastrophic injury and death data. Members of the NCAA Division I Legislative Council will vote on all four proposals during their meeting at the 2014 Convention. There has been overall support for the sports safety package, but discussions continue on the specifics of the legislation.

In Division II, the President’s Council has decided to sponsor two out of the four proposals for voting at the 2014 Convention–physicians for all athletic teams and submission of catastrophic injury data. Past legislation already mandates that all head and full-time coaches be certified in first aid, CPR, and AED use. The fourth proposal–requiring certification for strength and conditioning coaches–was sent back to CSMAS for revisions. Members of the President’s and Management Councils felt that the vague phrasing of the rule could cause complications for member schools. Division III institutions will vote on three out of the four proposals at the Convention. Strength coaches in Division III are already required to be certified.

ACL Risk Linked to Hip ROM

Sports medicine professionals have long believed that increased risk for an ACL tear can occur due to a number of deficiencies along a person’s kinetic chain. New research out of Japan is helping to prove this theory when it comes to limited hip range of motion. In a study appearing in the August online version of The Knee Journal, researchers from the Chiba Institute of Science found that young athletes with narrow hip range of motion were at increased risk for non-contact sports-related ACL injuries. From 2000 to 2008, investigators conducted a case control study at an orthopedic clinic in Japan of athletes between the ages of 13 and 17. Of their subjects, 44 had sustained an ACL tear and 123 did not. Researchers found that athletes with ACL tears had a 0.18 odds ratio increase when a 10-degree increase in the sum of the right and left internal hip rotations existed. For external rotations, the odds ratio increase for those with ACL injuries was 0.23.

To read an abstract from the study, enter “Limited hip rotation and non-contact anterior cruciate ligament injury: A case-control study,” into the search window at TheKneeJournal.com.

Recovering with Watermelon Juice In addition to being a tasty summer staple, new research suggests that watermelon, specifically watermelon juice, may have value as a muscle recovery drink. According to a study published in the July online version of the Journal of Agricultural and Food Chemistry, watermelon juice, which is rich in the amino acid L-citrulline, reduces muscle soreness after exercise. The researchers also found that L-citrulline was more readily absorbed into the body when delivered in the form of unpasteurized watermelon juice as opposed to pasteurized watermelon juice or water spiked with the compound.

Scientists from Spain’s Technical University of Cartagena began their study by chemically analyzing both pasteurized and unpasteurized watermelon juice along with water infused with L-citrulline. All three fluids were added to separate human cell cultures for eight minutes and monitored to see how much of the L-citrulline from each was absorbed by the cells. The researchers found that cells exposed to unpasteurized watermelon juice absorbed 19 percent of the L-citrulline compared to 13 percent for those given the pasteurized juice and 12 percent for the L-citrulline-spiked water. In explaining why the absorption rate was lower for the pasteurized juice, the study’s co-author, Encarna Aguayo, told Chemical & Engineering News that while pasteurization kills harmful pathogens, it also can “reduce the bioavailability of many bioactive compounds, reducing the food’s functional properties.”

During the next stage of the experiment, the researchers had seven non-competitive male athletes consume 500 ml of either natural watermelon juice containing 1.17 g of L-citrulline, watermelon juice enriched with an additional 4.83 g of L-citrulline, or a pink control drink that contained no L-citrulline. One hour after consumption, each test subject pedaled a stationary bike intensely for 11 minutes. The next day, the men were asked to evaluate soreness in their legs. The routine was repeated on three separate days. The results showed that after 24 hours, those who consumed either the natural or enriched watermelon juice reported less muscle soreness and had a lower recovery heart rate than those who took the placebo. Though the specific mechanism behind L-citrulline’s effectiveness as a recovery fuel remains unclear, Aguayo theorized that it might help speed up the process of lactic acid removal from athletes’ muscles. These findings support previous studies reporting that in supplement form, L-citrulline accelerates removal of lactic acid from muscles. Moving forward, Aguayo said she is planning future studies to determine optimal concentration of L-citrulline to prevent muscle fatigue.

To view an abstract of the study, “Watermelon Juice: Potential Functional Drink for Sore Muscle Relief in Athletes,” go to: pubs.acs.org and type, “watermelon juice” into the search window.

Neck Injuries Not Always a Knockout

For an athlete with neck pain, the decision whether or not to undergo surgery can be a difficult one. Research now provides some guidance. According to a study published in the July 2013 issue of Neurosurgery, professional athletes who had an anterior cervical discectomy and fusion (ACDF) were able to return to play and remain active for several years following the surgery.

ACDF is performed on individuals who have herniated or degenerative discs in their necks, typically those who have significant pain even after therapy and medication. The surgeon removes the disc and inserts a graft to connect the two vertebrae. After a few months, the graft and vertebrae join together solidly. In the study, conducted by researchers from the Department of Neurosurgery at the University of Pittsburgh Medical Center, the charts of 15 professional athletes–seven NFL players and eight professional wrestlers–who underwent single-level ACDF between 2003 and 2012 were reviewed. Thirteen of the 15 athletes were able to return to action after missing from two to 12 months. The other two players were cleared to return, but chose to retire due to age and orthopedic disabilities.

Of the 13 who remained professional athletes, eight are still active. Five played for one to three years before retiring following their return. “[Return-to-play] after a single-level ACDF is generally safe and the risk of subsequent cervical spine-related injury low,” wrote the authors. “After a solid arthrodesis, absence of neurological deficits, full range of motion, and the absence of symptoms, the majority of athletes, as seen here, undergoing a single-level ACDF were able to be safely cleared for return to full-contact sports.”

To view the full text of the study, go to: journals.lww.com and search “Outcomes After Anterior Cervical Discectomy and Fusion in Professional Athletes.”

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