Concussion

concussion
A blow to the head that makes the brain hit the skull

What’s up ? This is THE stephane ANDRE. With my training, I’m interessed in biomechanics to avoid injuries. I read « Sport Medicine Media Guide » and I learned some good stuff.

A concussion is a traumatic brain injury that alters mental state or creates others symptoms. Many people think they have no concussion because they have not lost consciousness. You must know that it’s possible to have a concussion without losing consciousness. Often football or rugby players say : « I just got my bell rung » when they have been hit on the head that makes the ears rings, but these symptoms are often consistent with concussion.

Signs

  • Balance problems

  • Difficulty communicating, concentrating

  • Dizziness

  • Drowsiness

  • Fatigue

  • Feeling emotional

  • Feeling mentally foggy

  • Headache

  • Irritability

  • Memory difficulties

  • Nausea

  • Nervousness

  • Numbness or tingling

  • Sadness

  • Sensitivity to light or noise

  • Sleeping more than usual or difficulty falling asleep

  • Visual problems (blurry or double vision)

  • Vomiting

Diagnostic

diagnostic

As soon as a concussion is suspected, a trained coach, certified athletic trainer or the team physician should immediately perform an initial « sideline » evaluation, including :

  • Symptoms list review

  • Focused neurological exam

  • Focused orientation exam that tests short-term memory recall such as the event, play, opponent, score or last meal.

  • Focused orientation exam that tests long-term recall such as name, birth date, place of birth.

  • Assessment of athlete’s ability to stay attentive to a complex task such as reciting months backwards.

If a person is suspected of having a concussion and there is no diagnosis, a concussion may place an athlete at risk of developing second impact syndrome. It’s a potentially fatal injury that occurs when an athlete suffers a second head injury before the old head injury has completely healed.

Second impact syndrome

Second impact syndrome is a potentially fatal injury that occurs when an athlete suffers a second head injury before the old head injury has been fully healed. Unfortunately, it’s complicated to know if the brain has been healed from the first injury. Even after all symptoms resolved, it’s possible that the healing isn’t complete and that it increases the risk to the brain of having the second impact syndrome. Neurocognitive testing can help doctors or physician decide when the athlete can return to the competition in the best conditions.

Neurocognitive testing

Neurocognitive testing

Neurocognitive testing is a questionnaire (usually on the computer) that athletes do that deals with several areas of brain function, including memory, problem solving, reaction times, brain processing speed and post-concussion symptoms. It’s most valid if the athlete has a pre-injury baseline test on file to compare the post concussion test. This information can be really helpful for the doctor or physician to decide when the athlete can return to the competition.

When to return to the competition

All athletes suffer concussion (whatever the gravity) should pass an evaluation by a qualified health care provider before returning to the competition. Athletes should return to competition after they have been completely cleared of all concussion symptoms and have no symptoms during and after physical tests.

Baseline testing is important for assessing concussion symptoms after an incident. The baseline testing often includes neurocognitive tests, symptom checklists, sideline assessment tools such as the Sideline Concussion Assessment Tool and balance testing.

Statistics

  • Athletes who have already had a concussion are more likely to have another concussion.

  • Children and teenagers are more likely to have concussion and take longer to heal than adults.

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-Steph

Anterior Cruciate Ligament Injuries

anterior cruciate ligament injury tear

What’s up ? This is THE stephane ANDRE. With my training, I’m interested in biomechanics to avoid injuries. I read « Sport Medicine Media Guide » and I learned some good stuff.

Knee is the largest and most complex joint of the body. There are 4 primary ligaments (with their muscles and tendons) and secondary ligaments for the knee to function properly. Here are the ligaments of the knee : there are 2 ligaments on the side the medial collateral ligament (MCL) and the lateral collateral ligament (LCL) and two crossed ligaments in the center of the knee, the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL).

Anterior cruciate ligament connects the front top part of the shine bone to the back bottom part of the thigh bone and keeps the shin bone from sliding forward.

anterior cruciate ligament

Injury

anterior cruciate ligament injury tear

There are several ways to have an injury to the anterior cruciate ligament :

  • The injury can be done because of a direct hit on the knee, which often happens in team sport.

  • The injury can be done without contact with an object in a situation where the knee forced to be in a abnormal position, which causes a tear in one or more ligaments of the knee. Or when an athlete in the race change direction. Or when an athlete make a hyperextend of the knee when landing a jump, which often happends in agility sports.

Diagnostic

In the majority of cases, the doctor is able to identify what is the injured ligament. But the knee can also be injured at the joint on the surface and in this situation, it’s more difficult to diagnose because of knee swelling. To make an accurate diagnosis, it will be necessary to use a MRI scan or arthroscopy.

Prevent

There are several fast, powerful movements that lengthen (eccentric phase) and shorten (concentric phase) a muscle. These prevention programs are for injuries without contact. These exercises are to improve the nerves/muscle control of the knee. These prevention programs use plymetrics, balance and strength/stability exercises.

Plymetrics

It’s a fast, powerful movement that lengthens (eccentric phase) and shortens (concentric phase) a muscle. The concentric phase increases the muscle power. Here is an example, an athlete who jumps from a box and immediately jumps into the air after touching the floor.

Balance

Balance exercices are done with the wobble or balance board. It’s also possible to perfom exercices by throwing a ball with a partner while balancing on one leg.

Strength/stability

To improve single-leg core strength and stability, there are excellent exercices such as jumping and landing on one leg with the knee flexed and momentarily maintaining this position.

Surgical treatment

In the past, there was a technique that consisted of stitching the ligament together but it was rarely successful. Currently, the technique involves reconstructing the anterior cruciate ligament by building a new ligament from tissue taken from one of the other tendons around the knee or from on organ donation. This tissue passed through drill holes in the thigh bone and the shin bone, and then ancored in place to create a new anterior cruciate ligament. Over time, this transplant becomes mature and becomes a new living ligament in your knee.

Recovery

recovery

Rheabilitation of the knee after the reconstruction of the anterior cruciate ligament requires time and work. To have a complete function, this can last between 6 weeks and 6 months depending on the severity and level of activity. Rehabilitation rate may take time depending on the specific requirements of the sport/physical activity of the individual.

The overall success rate of the anterior cruciate ligament surgery is very good. A lot of study show that more than 90% of patients are able to return to sport without symptoms of knee instability. It’s true that some patients complain of stiffness and pain after surgery, that is why it’s necessary to make an aggressive rehabilitation until the new surgical technique to reduce these problems.

Statistics

  • One of the most commonly injured ligament in the knee

  • Female athletes participating in basketball and soccer are 2-8 times more likely to suffer anterior cruciate ligament injury.

  • Athlete who suffer anterior cruciate ligament injury at increased risk of arthritis development later in life.

Subscribe to my newsletter and share this article if you think it can help someone you know. Thank you.

-Steph

Rupture Of The Pectoralis Major

rupture, tear, pectoralis, major, tendon

I read a Frederic Delavier’s book « Strength Training Anatomy » and I learned good stuff.

Pectoralis major begins on the anterior surface of the thoracic cage and its insertion is to the anterior surface of the upper end of the humerus.

Pectoralis major is a muscle which has the function of bringing the arm forward in front of the rib cage which make it possible to make hugs.

Bench press can create small tears at the pectoralis major which can sometimes cause a partial rupturing of its tendon (around upper chest).

This partial rupture of the tendon occurs in powerful athletes who have gained an abnormally rapid strength, which didn’t allow time for tendons to strengthen. This injury can also happen to athletes who make a « dry » diet, so a low-calories diet to better make muscles more visible. These low-calories diets weaken joints, tendons and muscles.

The wound always arrives during a bench press and affects only the clavicular head of pectoralis major.

The rupture of the tendon can be so painful that the athlete may lose consciousness. Often a tumefaction with eccymosis apprears on the anterior surface of the arm and the retraction of the clavicular head create a hollow around the upper chest.

Diagnostic error

how much

A problem that very often happens with this wound is that doctors, after diagnostic, considers it to be gravity-free. This is an understandable mistake because during the diagnostic, the injured person can make all movements related to the pectoralis major’s motor function. It’s for this reason that doctors consider this wound as a simple muscle tear rather than a ruptured tendon or a severe muscle tear.

Indeed, many muscles compensate the functional loss of clavicular head of pectoralis major to continue to move the arm. I spit of the rupture of the clavicular head of pectoralis major, it’s possible to raise the arm forward by the sternal portion (middle chest) and abdominal portion (lower chest) of the pectoralis major which also compensates.

When there is rupture of the pectoralis major, it’s necessary to have it reinserted as quickly as possible on the humerus with a surgery operation.

If not done as quickly as possible, there is retraction and fibrous transformation of the muscle. In this case, surgery is no longer feasible.

It’s true that the injured person can still move his/her arm without the upper portion of the pectoralis major but the injured person can never regain its initial strength and will be seriously handicapped to continue to do heavy bench press.

Share this article if you think it can help someone you know. Thank you.

-Steph

Future Of Entrepreneurship Is Knowledge

knowledge

I watched an Olivier Roland’s video  and there is good stuff.

Knowledge is the future of web entrepreneurship. Bill Gates published a text on 1st march 1996 « Content is king » . Read these sentences :

« Content is where I expect much of the real money will be made on the Internet, just as it was in broadcasting ».

Since 1996, we see that his prediction is confirmed.

Today with content, we can do more than most of companies did until now. Usually companies try to have loyal customers. With content we can create a truly tribe of fans. Seth Godin explains this in his book « Tribe » .

Seth Godin is a marketing’s visionary of 21st century. He anticipated a lot of change with the irrution of new technologies. As the way how companies communicate with theirs prospects, customers and now theirs communities.

All companies should create content even bakers, shoemakers or plumbers. We know today, content allow you to create a tribe of fans to have a truly privileged relation with your community.

The future

the future

Content is the future because more and more functions in the job will be done by softwares, robots or outsourcing to low-cost countries. It’s the last years we can see humans taxi drivers and truck drivers. Quickly automatic cars will come and they will disrupt the entire industry of taxi and truck. Uber made its first delivery with an automatic truck (https://www.wired.com/2016/10/ubers-self-driving-truck-makes-first-delivery-50000-beers/). Uber invest a lot in automatic truck technology.

A lot of jobs will be do by algorithms. A book talk about this « Homos Deus » . Even a job as doctor will be disrupt by new technologies. Within 20 years, we will have sensors in our body or in watches, jewels, smartphones. Theses sensors will measure a lot of parameters in our body, upload those data in the Cloud and we will have access to diagnostic softwares more efficient than doctors. It already exist, IBM sell its Watson’s system to hospitals to reduce the number of medical error .

The truth is we can’t guarantee to anyone that his/her job will still exist in 20 years. And if you job still exist in 20 years, it will be deeply disrupt by new technologies.

It’s here knowledge’s economy intervent. We had agricultural revolution then industrial revolution and now we’re in information revolution. It means if you’re in information industry in 2016, you will be placed among jobs which are going to be the most difficult to disrupt by softwares, robots and outsourcing in low-cost countries. I can’t guarantee you that your job will still exist in 20 years but you will be well placed to accompany this wave of change. May be you can cause it a little bit on your scale.

The key to ressources and wealth in 21st century, it’s how to circulate information and knowledge freely. Old companies try to stop this revolution, they try to stop companies like Uber, Airbnb, etc. but it’s like beavers that make dams to stop a tsunami. We must embrace change, we must have a flexibility of mind and initiative that allow is to adapt to 21st century. If not all industries will be finished like music industry. Do you remember Napster  ?

Learn online

learn online

There will be more and more important place for people who teach this kind of state of mind because school don’t do it. Beyond this state of mind, there will be an ongoing need for training on key competencies because the school has a too much great inertia. If you follow a computer course at the school, you can be sure that school is behind on what is happening now on the internet. It’s cool to have the basics but it’s better to have computer courses online with competent person.

There will be enormously weath that will be exchanged for richess of content,because this content is necessary to be able to adapt continuously to the change of 21st century.

If today, you want to be in the knowledge’s economy like blogger, youtuber, eBook writer, etc. Don’t hesitate, it’s now to create your place and consolidate it to be among people well placed in 21st century to bring value to others and generate value (added value).

Each entrepreneur should check the value he/she brings to the world. Create a new Pepsi is good but like said Steve Jobs : « it’s just sell water with sugar to people. It’s not what will improve the world ».

-Steph