5 Sports Medicine Myths

Stretching is good for you …  ~Take an anti-inflammatory …. ~Don’t worry, surgery can fix that ….

Are you sure?

Many of us are still using techniques, and methods that we were taught as children in an effort to remain active and injury free.  We also try and impart those same knowledgeable tidbits upon our children as they become active.   Are they right? Is that what the evidence shows?

We search online … but there is so much noise. And a lot of misinformation.

 Common Sports Medicine Myths

1.  Stretching prevents injuries.  Static stretching actually leads to weakness in the muscles you have just stretched.  In the hamstring muscles that can be as much as a 20% loss of strength.  Counter-intuitive- right?  When was the last time you saw a professional runner hold a static stretch?  We now focus much more on warming up.  Get those muscles moving.  Walk around, hit a few tennis balls, perform a few short sprints.  DYNAMIC (Nordic Hamstring) stretching, or “eccentric” stretching may help prevent injuries*
2. Icing minimizes swelling and stops bleeding. Again, very logical.  Since we were infants we have had ice placed on a cut, or tooth to make it feel better.  But does ice help prevent swelling and bleeding?  The short answer is no.  I go into this in more detail here.  Ice will shrink small blood vessels, but it also inactivates the platelets which help control the bleeding.  It can also damage those small blood vessels further.  And once you remove the ice, and the tissue warms, the inflammation returns. your vessels and the platelets aren’t happy, and the bleeding persists.  The larger issue is that we now know that inflammation is the first of many steps in the healing cascade.  Many cells are releasing chemicals in the region of the injury to recruit other cells to the area. Those new cells will start to repair the damaged tissues.   If we interrupt the healing process at its first step, we may not benefit  as well as expected from the healing response the body is trying to mount.
3. Surgery on your elbow will make you throw harder and faster. Nonsense.  Pitchers are borne.  They are not created. Medial collateral ligament injuries are increasing exponentially.  The loss of seasonality in sports and the addition of strength coaches, pitching coaches, travel team ball and recreational throwing have added significantly to the stress our children are placing on their elbows.  Monitor their pitch counts… let them learn the art of the game from another perspective. If you injure your medial collateral ligament, you can very likely play any other position without the need for surgery and without compromising your function.  You can live a long and happy life without a medial collateral ligament in your elbow.  If you’re 16-18 and you’re not a scouted pitcher, step off the mound, give the ball to someone else, and enjoy the game from another perspective on the diamond.  Your elbow will thank you for it.
4. Taking anti-inflammatories before exercising will lessen the inflammation and pain.   Actually, it won’t.  And your body will be far worse off because of the effects of the medicine.  When you take an anti-inflammatory, your gut becomes “leaky”… that can promote an increase in inflammation within your body** When you exercise, the body diverts blood from your intestines to feed starving muscles.  That leads to a form a leaky gut in and of itself.  But it is generally reversed rapidly.  Studies have shown (see below) that athletes who have also taken anti=inflammatories before exercising have a more prolonged period of leakiness.  Researchers were able to find bacteria and digestive enzymes in their blood during these studies.  In addition, as I mentioned earlier, inflammation is the first step in healing process.  Anti-inflammatories shut down the chemical cascade that promotes inflammation.  There have been a few scientific studies that have demonstrated that routine anti-inflammatory use can inhibit or disrupt the healing process, leading to a weaker healing response, and thus a weaker tendon or muscle.   Hmmm.  Hold off on the NSAIDs until after you exercise… and then, only if you really need it.
5. Your son/daughter is the best on the team.  Sit back, enjoy, let them have fun, — and if they’re hurt, let them rest.  The team will be just fine without them.

In order for our children, and the #365Warriors among us to remain in the game … you need to have a solid #Gameplan and a set of trustworthy sources of information and providers to turn to help you achieve your goals.

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*NY Time article by Gretchen Reynolds on Stretching

* Arnason A, Andersen TE, Holme I, Engebretsen L, Bahr R. Prevention of hamstring strains in elite soccer: an intervention study. Scandinavian Journal of Medicine & Science in Sports 2008;18:40–48

** Aggravation of Exercise-Induced Intestinal Injury by Ibuprofen in Athletes

** Ibuprofen use, endotoxemia, inflammation, and plasma cytokines during ultramarathon competition

*** Anti-inflammatory management for tendon injuries – friends or foes?