Post-Event Meals

Winter Tips from the Training Room

Summer Tips from the Training Room

Ice vs. Heat

• Typical sensations that a person should feel during an ice treatment include a cold feeling, followed by a burning sensation, after which aching will be felt and then numbness.
• Ice is most commonly used for muscle strains, ligament sprains, and contusions, but it can also be used in the acute phases of bursitis, tenosynovitis and tendinitis, where the application of heat may cause more pain and swelling.
• It is used for the initial treatment of acute injuries to help decrease pain and control swelling.
• Ice should be applied for 20 minutes on followed by 90 minutes off and repeated throughout the day, for the first 24-72 hours, depending on the severity of the injury.
• Treatment should be limited to 20 minutes at a time because leaving ice on for an extended length of time can lead to additional tissue damage.
• DO NOT apply frozen gel packs or chemical ice packs directly to skin, use a plastic bag or towel as a barrier.

When to use Ice	When not to use Ice
Acute or chronic pain	Decreased cold sensitivity &/or hypersensitivity
Acute or chronic muscle spasm	Cold allergy
Acute inflammation or injury	Circulatory or sensory impairment
Postsurgical pain and swelling	Raynaud's disease
Superficial 1st degree burns	Hypertension
	Uncovered open wounds
	Cardiac or respiratory disorders
	Arthritis

Heat

• Used to increase blood flow and promote healing in the later stages of rehabilitation.
• It is typically used before stretching exercises, joint mobilization and active exercise to help increase range of motion (ROM).
• Heat should not be applied to a new/acute injury because it can lead to increased pain and swelling.
• Heat helps decrease muscle spasm, pain and joint stiffness and should be used with injuries/conditions that would benefit from it.

When to use Heat	When not to use Heat
Subacute or chronic injuries, to reduce swelling, edema, ecchymosis, and muscle spasm	Acute inflammation, swelling or injuries
Increase blood flow to increase ROM before activity, resolve hematoma and facilitate tissue healing	Impaired or poor circulation
	Subacute or chronic pain
	Impaired or poor sensation
	Impaired thermal regulation

Fall Tips from the Training Room

What is MRSA?

Staphylococcus aureus:

• Otherwise known as staph.
• Bacteria commonly found on the skin and in the nose of 25-35% of healthy people.
• Usually does not cause illness or infections.
• Instead the person is known as a staph carrier.

Illness or infections occur when:

• Bacteria gets into the body through cuts, abrasions, wounds, or surgical incisions.
• Infections can look like pimples, pustules, or boils.
• Appearance of the infection can be red, swollen, and painful.
• There can be an increase in skin temperature around the site of infections and a possibility of pus or other drainage coming from the infection.
• Not properly referred or taken care of, a more serious infecetion can cause pneumonia, a bloodstream infection, surgical wound infections or infection of the bones and/or joints.
• Be careful, some pustules or pimples can be confused with insect bites, a previous abrasion or a "common" infection.

Treatment:

• Usually with antibiotics.
• However in some cases, certain strands of staph especially MRSA are resistant to many antibiotics.
• MRSA, otherwise known as methicillin-resistant staphylococcus, is a type of staph that is resistant to antibiotics called beta-lactams, which include methicillin, penicillin and amoxicillin.

Infections caused by MRSA:

• Cause serious damage if not properly treated.
• If the signs and symptoms above continue or get worse, getting to your primary care physician is of utmost importance.
• Can only be identified through microbial testing, which occurs when the doctor takes a sample or specimen of the infection and submits it to a laboratory.
• Testing the sample by using various antibiotics to see if the bacteria are resistant or sensitive to those antibiotics.
• MRSA is treated with the use of one of the following drugs, vancomycin or teicoplanin. Both are administered by either infusion or injection.

Whom does MRSA affect?

• Patients in the hospital.
• Becoming more common in the community setting especially in health clubs, athletes and the physically active.
• People with a deficiency in their immune system (low white cell count) or who are already ill can also be infected.

Proper Hydration Guidelines

Pre-Exercise Hydration Strategies

• 500-600 mL (17-20 fl oz) of water or a sports drink should be consumed 2-3 hours prior to activity.
• 200-300 mL (7-10 fl oz) of water or a sports drink should be consumed 10-20 minutes prior to activity.
• Individuals should begin all physical activity properly hydrated to help prevent dehydration from occurring.

Exercise Hydration Strategies

• 200-300 mL (7-10 fl oz) of water should be consumed every 10-20 minutes during activity in order to try to maintain hydration levels.
• Individuals participating in activities with frequent breaks, such as baseball, football, softball, and track & field, should consume small volumes of fluid at regular intervals. Amount of fluid intake and frequency of intake should be based on their rate of sweating and environmental conditions.
• Individuals participating in activities where breaks only occur during time-outs or between quarters, like distance running, field hockey, lacrosse, and soccer, should ingest enough fluids to maximize hydration.

Post-Exercise Hydration Strategies

• The primary goal of rehydrating after activity is to immediately return physiologic function.
• Rehydration fluids should be consumed within 2 hours after activity.
• Rehydration fluids should consist of water, carbohydrates & electrolytes in order to restore hydration status, restore glycogen stores & speed up the rehydration process, respectively.

General Hydration Guidelines

• Fluids with a temperature of 10-15 degrees C (50-59 degrees F) are recommended for rehydration.
• Fluids containing 6-8% of carbohydrates will be beneficial, however, fluids with more than 8% carbohydrates, such as fruit juices, sodas and some sports drinks, should be avoided.
• Additionally, fluids containing fructose, caffeine, and carbonation should also be avoided.

Signs & Symptoms of Dehydration

• Thirst
• Irritability
• General discomfort
• Headache
• Weakness
• Dizziness
• Cramps
• Chills
• Vomiting
• Nausea
• Head or neck heat sensations
• Decreased performance

Treatment of Dehydrated Individuals

• An individual who is dehydrated, conscious, and cognizant can be treated with aggressive oral rehydration.
• Immediate treatment is important to help prevent the occurrence of a heat illness.

If an athlete is not properly hydrated before and during activity or does not properly rehydrate after activity, it can lead to one of the three following types of heat illness:

Heat Cramps:

Signs and symptoms include muscle twitching, cramps in arms, legs and abdomen. Treatment of heat cramps should consist of an increase in fluid intake, passive stretching, and rest in a cool place.

Heat Exhaustion:

Profuse sweating, excessive thirst, weakness, dizziness, headache, and skin that is gray, ashy, cold and/or clammy are signs and symptoms that may arise. Treatment includes an increase in fluid and salt to the diet and rest in a cool place. In addition, IV fluids may be necessary. Activity should be discontinued until the situation is under control.

Heat Stroke: THIS IS A MEDICAL EMERGENCY

Signs and symptoms include skin that will be hot and dry, irritability, disorientation, glassy eyes, rapid pulse, and a decrease in blood pressure. Treatment should involve decreasing body temperature by ice or ice towels and transportation to an Emergency Room immediately.

Spring Tips from the Training Room

There are many high school athletes who do not have the advantage of seeing a certified athletic trainer. Mainly this is due to the fact that there may not be an athletic trainer on staff. The following information provided is to inform the athlete and/or parent of the signs and symptoms that should be recognized after an injury occurs.  If these signs and symptoms are present in the athlete after incurring a sport injury, either a certified athletic trainer or physician should see the athlete.

When to see an ATC:

• Swelling over or around the injury site
• Pain with specific activities (running, kicking, cutting, jumping, etc)
• Noticeable favoring or limping of injured body part
• Limited range of motion
• Limited strength (feeling of weakness) in or around injury site

When to see a physician:

• Referral by an ATC
• Inability to feel or move one or more limbs
• Significant chest pain
• Difficulty breathing
• Obvious fracture or joint dislocation
• A cut requiring stitches
• Head, neck or face injuries

If the athlete needs to see an athletic trainer, the athlete is able to be seen by a certified athletic trainer at Towson Sports Medicine’s Walk-in Clinic.

Eating Disorders

Eating disorders are commonly found in females from adolescence to middle age.  Even though there is a lack of statistics from people hiding their problems, many men, children, and older adults also deal with having an eating disorder.  An eating disorder is mainly characterized by someone who is terrified of gaining weight, becoming fat and has a strong desire to be thin.  The two most common eating disorders seen especially in athletes are anorexia nervosa and bulimia.

            Anorexia nervosa is mainly caused by a distorted body image and an intense fear of becoming fat or gaining weight.  This disorder mostly affects females and can begin in early adolescence.  Even though, he/she sees him/herself as being really fat in actuality they are extremely thin usually weighing about 85% or less of his/her expected height and age.  To become even thinner, the individual will avoid food or divide food into “safe” or “dangerous” categories.  The anorexic will excessively and compulsively exercise even when they become extremely tired, to rid him/herself of any ingested calories.  You will also find that the individual will show signs of depression, irritability, low self-esteem but strives for absolute perfection.  He/she would rather help others and put others first rather than him/herself.  Some individuals might actually be very dependent on loved ones while others claim to be very independent but feel very out of control in every other aspect of his/her life except where food and weight are concerned.

            Bulimia is an eating disorder characterized by periods of starvation followed by binging on thousands of calories and the finally purging those ingested calories by vomiting or using laxatives. This is called a binge-purge cycle and is kept very secretive.  Mainly an individual with bulimia has little self-worth but believes this is defined by being thin.  Unlike anorexics, bulimics are usually of normal or near-normal weight.  The individual tries to be a perfectionist by being obedient, over complaint, highly motivated, and successful in both academics and athletics but underneath he/she is depressed, lonely, ashamed, or has a feeling of emptiness.  These underlying feelings make individual feel that food is their only comfort.  One thing that separates these two disorders is that most bulimics have a problem with impulse control and give little to no consideration for the consequences of his/her actions.

Warning Signs

1. Food Behaviors

• skipping meals
• will no eat in front of others
• may chew food but spits it out before swallowing
• always has an excuse not to eat
• chooses primarily low-fat, low-nutrient foods
• decreases fat intake
• religiously reads food labels
• eats normal or large portions followed by vomiting after being excused from table

2. Appearance & Body Image Behaviors

• wears baggy clothes
• layers clothing to hide body or stay warm
• obsesses about clothing size
• spends a lot of time inspecting self in mirror
• usually finds body part to criticize

3. Exercise Behaviors

• exercises excessively and compulsively
• tires easily but continues to push oneself
• athletic performance suffers
• develop strange eating patterns
• consumes sport drinks and supplements, total caloric intake is less than caloric output

4. Thoughts & Beliefs

• becomes irrational
• denies that anything is wrong
• argues with people who are trying to help
• trouble concentrating
• obsesses about food and weight
• holds to rigid, perfectionistic standards

5. Feelings

• trouble talking about how they feel
• escapes stress by binging or exercising
• moody, irritable, cross, snappish, or touchy
• experiences depression, anxiety, guilt, and loneliness

6. Self-harm & Self-injury

• to cope with above mentioned feelings
• cutting or burning of flesh
• swallow foreign objects
• not consciously trying to commit suicide
• a symptom of Borderline Personality Disorder that co-exists with eating disorders

7. Social Behaviors

• tries to please everyone
• tries to take care of others
• tries to control what and where family eats
• relationships tend to be superficial or dependent
• terrified of true intimacy