Jan 29, 2015
Bulletin Board

FDA Warns of Hidden Steroids in Supplements

After receiving several reports about unsafe substances in some popular supplements, the U.S. Food and Drug Administration (FDA) recently released a warning about eight products found to contain hidden steroids. All the supplements are manufactured by American Cellular Laboratories, Inc.

The products in question are TREN-Xtreme, MASS Xtreme, ESTRO Xtreme, AH-89-Xtreme, HMG Xtreme, MMA-3 Xtreme, VNS-9 Xtreme, and TT-40-Xtreme. Since the FDA has little regulatory power over supplement producers, it typically issues such a warning only after a product has been on sale to the public and consumer groups or independent labs report that it poses health risks.

In this particular warning, the FDA notes that supplements with steroids or steroid-like substances can lead to acute liver injury and kidney failure. Beyond the health risks, athletes who are subject to doping tests may jeopardize their eligibility by taking substances with impermissible ingredients, even if the product label is misleading or incomplete.

As a general rule, the FDA recommends avoiding any supplements that make outlandish promises, and those that claim to alter the effects of hormones such as estrogen, testosterone, and progestin. Athletes should also be wary of products displaying words like “anabolic” and “tren,” and the phrases “blocks estrogen” and “minimizes gyno,” which suggest that a supplement attempts to mask steroid-related side effects such as breast swelling in men and female fat distribution.

High-Risk High School Football Hits

As football players progress from high school to college, they tend to get bigger, stronger, and more powerful. That leads to more forceful and dangerous hits on the field, right? A new report published by the NATA found just the opposite.

The goal of the report was to analyze risk for cervical spine injuries and concussions among high school players. Using a combination of new research and existing injury data, it found that tackles in high school games may pose a greater injury risk than those in college.

Researchers from the University of Illinois fitted 35 varsity high school players with helmets containing sensors to measure force and impact to the head and neck during the 2007 season. The helmets measured linear and rotational acceleration–the speed at which the head moves after being struck, and the intensity and duration of the impact.

Over 55 practices and 13 games, the researchers tracked 19,224 hits, and compared the data to similar studies conducted on college players. They found that the average linear acceleration from a tackle in a high school game was greater than in a college contest, and that impact to the front of the helmet was about 10 percent more common in high school than college and typically packed three more Gs of force. They also observed that high school defensive linemen took the most hits, blows to the top of the head were the most intense, and tackling in games was much more powerful than in practices.

Several factors likely contribute to the disparity between high school and college hits. For one, high school athletes are less skilled in tackling. The researchers called on coaches to teach athletes to tackle with their head up to avoid impact to the crown of the helmet, which increases injury risk.

The authors also noted that neck strength, endurance, and physical maturity could play a role. The average college athlete weighed 30 pounds more than his high school counterpart, but was only 1.2 inches taller. They said this means the college players have a “more developed musculature system that is better able to control head motion after impact.”

High school football players suffer more sports-related concussions than any other group of athletes, but researchers could not determine if the increased linear acceleration resulting from tackling is the cause. Of the 1.2 million U.S. high schoolers who play football each year, between four and six percent suffer concussions.

To view the report, go to: www.nata.org and search “Head Impacts During High School Football.”

Sideline Ultrasound on the Horizon

Do you wish there was a cheaper, faster, easily portable way to diagnose orthopedic injuries? In the near future, musculoskeletal ultrasound may be the answer.

“It’s very likely that this type of ultrasound will be on the sidelines in a couple of years,” says Joshua Hackel, MD, Primary Care Sports Medicine Physician for the Andrews Institute for Orthopedics & Sports Medicine and Team Physician at the University of West Florida. “It is already being used in some college settings. We are trying to start an ultrasound training program for high school athletic trainers and hope to implement a sideline ultrasound unit at the high schools our clinic takes care of here in Florida.”

Musculoskeletal ultrasound works by emitting sound waves from a probe. The waves bounce off body tissue to determine depth and density, and use that information to create an image. Thanks to recent technological improvements–as well as its proven ability to identify injuries such as muscle and ligament tears–ultrasound now boasts many advantages.

“The technology has been used for decades, but the portability has improved a lot recently,” says Hackel. “Not only have the images gotten much better, but the unit itself is now the size of a laptop computer. It’s also much less expensive than a CT scan or x-ray.”

Hackel feels the device is much easier on athletes, too. “You don’t have to worry about the patient being claustrophobic like with a CT scan or an MRI,” he says. “With those methods, the patient has to remain extremely still–if they move at all, it creates an artifact in the picture and gives you an unusable image. With ultrasound, claustrophobia is not an issue.

“Another big advantage is that you can evaluate a patient dynamically,” continues Hackel. “You can look at tissues as they are moving and gliding.”

Hackel says learning to analyze ultrasound images requires a medical education course, basic and advanced ultrasound courses, and at least six months of working with ultrasound on a regular basis. But with so much upside, he predicts many athletic training programs will eventually be convinced to make the investment.

“It gives athletic trainers very useful information to make a decision on how a player is progressing,” Hackel says. “It’s an objective way to advance rehabilitation and make more informed decisions on return to play.”

The Brain’s Role in ACL Injuries

It’s well established that fatigue increases ACL injury risk. But is that effect limited to fatigue in the knee itself? Researchers at the University of Michigan suggest the answer is no.

In a study published in the August issue of Medicine & Science in Sports & Exercise, a group of female college athletes performed one-legged squats to fatigue on only one side, then underwent reaction time tests through a number of movements. During the tests, both legs displayed equally dangerous movement patterns that heightened the risk for ACL injury–not just the leg that completed the squats.

This finding suggests that not only localized fatigue, but also the brain and reflexive response may play a key role in ACL injuries. The authors believe visualization, virtual reality technology, and quick-reaction drills could train the brain to make better split-second decisions in fast-paced situations, thereby decreasing fatigue-induced ACL injury risk.

To view the abstract of the study, entitled “Fatigue-Induced ACL Injury Risk Stems from a Degradation in Central Control,” go to: www.pubmed.gov and search “fatigue-induced ACL injury.

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