20 research outputs found

    Swimming anatomy and lower back injuries in competitive swimmers: A narrative review

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    Context: Competitive swimmers are at high risk of overuse musculoskeletal injuries due to their high training volumes. Spine injuries are the second most common musculoskeletal injury in swimmers and are often a result of the combination of improper technique, high loads on the spine in strokes that require hyperextension, and repetitive overuse leading to fatigue of the supporting trunk muscles. The purpose of this review is to summarize the current evidence regarding swimming biomechanics, stroke techniques, and common injuries in the lumbar spine to promote a discussion on the prevention and rehabilitation of lower back injuries in competitive swimmers. Evidence acquisition: From a PUBMED/MEDLINE search, 16 articles were identified for inclusion using the search terms swimming, low back or lumbar, and injury or injuries. Study design: Narrative review. Level of evidence: Levels 4 and 5. Results: The trunk muscles are integral to swimming stroke biomechanics. In freestyle and backstroke, the body roll generated by the paraspinal and abdominal muscles is integral to efficient stroke mechanics by allowing synergistic movements of the upper and lower extremities. In butterfly and breaststroke, the undulating wave like motion of the dolphin kick requires dynamic engagement of the core to generate repetitive flexion and extension of the spine and is a common mechanism for hyperextension injuries. The most common lower back injuries in swimming were determined to be lumbar strain, spondylolysis and spondylolisthesis, facet joint pain, and disc disease. Most overuse swimming injuries can be treated conservatively with physical therapy and training adjustments. Conclusion: Managing swimmers with low back pain requires a basic knowledge of swimming technique and a focus on prevention-based care. Since most swimming injuries are secondary to overuse, it is important for providers to understand the mechanisms underlying the swimming injury, including an understanding of the biomechanics involved in swimming and the role of spine involvement in the 4 strokes that assist in stabilization and force generation in the water. Knowledge of the biomechanics involved in swimming and the significant demands placed on the spinal musculoskeletal system will aid the clinician in the diagnosis and management of injuries and assist in the development of a proper rehabilitation program aimed at correction of any abnormal swimming mechanics, treatment of pain, and future injury prevention

    sj-pdf-1-sph-10.1177_19417381231225213 – Supplemental material for Swimming Anatomy and Lower Back Injuries in Competitive Swimmers: A Narrative Review

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    Supplemental material, sj-pdf-1-sph-10.1177_19417381231225213 for Swimming Anatomy and Lower Back Injuries in Competitive Swimmers: A Narrative Review by Connie Hsu, Brian Krabak, Brian Cunningham and Joanne Borg-Stein in Sports Health</p

    Two cases of paradoxical hypothermia in a Sahara desert multi-stage ultramarathon

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    Exertional hypothermia in a hot environment, a seemingly contradictory state, is a clinical presentation that has not been previously described in the medical literature. We present two cases of symptomatic hypothermia of 34-35°C (95°F) which resolved with ingestion of calories in otherwise healthy men competing in a multi-stage ultramarathon in the Sahara desert, Egypt 2012 with ambient temperatures of approximately 38-39°C (100- 102°F). Hypothermia is well documented in the medical literature as a presenting sign of hypoglycemia in both conscious and comatose patients. The mechanism by which hypoglycemia contributes to hypothermia is poorly understood, but may represent a compensatory response that reflects a decrease in energy demand during glucose deprivation. Wilderness medicine practitioners at endurance events should be cognizant of hypothermia as a potential presenting sign of hypoglycemia, as it can be empirically treated and rapidly reversed

    The Practice of Physical Medicine and Rehabilitation in subSaharan Africa and Antarctica: A White Paper or a Black Mark?

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    Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/147120/1/pmr2421.pd
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