Steroids

sport injury steroids performance enhancing drug

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.

We regularly read in news articles, the use of anabolic steroids or performance enhancing drugs by elite athlete. But you should know that these dangerous drugs are more and more used by children in college, high-school and middle school.

What

sport injury steroids performance enhancing drug

Anabolic steroids are synthetic derivatives of testosterone. Testosterone is a male sex hormone. Steroids help to create new proteins to increase the size and strength of muscles. The body is already doing this process naturally but steroids increase the activity of this normal process. Find performance enhancing drugs in communities, gyms or internet is easy.

Steroids are consumed orally or by injection. Anabolic steroids in themselves aren’t effective. However, when they’re used at the same time with a strength training, they increase the strength in an impressive way.

Side effects

sport injury steroids performance enhancing drug side effect acne

sport injury steroids performance enhancing drug side effect acne

sport injury steroids performance enhancing drug side effect acne

Performance enhancing drugs allow an athlete to have bigger and more powerful muscles, but users may have deadly health problems. Performance enhancing drugs have several side effects that continue to work even after you stop using them. Users are also more likely to have risky behaviors such as having unsafe sex or taking illegal drugs.

Symptoms of use of anabolic steroids are :

  • Acne (often severe) visible on the face and back

  • Severe mood change such as extreme aggression or suicidal behavior

  • Premature balding, breast enlargement (gynecomastia), irreversible shrinking of testicles in boys.

  • Deeper voice, shrinking breast and clitoral enlargement in girls

  • Dangerous enlargement of the heart that can increase bad cholesterol and blood pressure.

  • Irreversible liver damage

  • In children, premature closure of the growth plates, stopping normal growth of bones.

sport injury steroids performance enhancing drug side effect gynecomastia

sport injury steroids performance enhancing drug side effect gynecomastia

sport injury steroids performance enhancing drug side effect gynecomastia

A reason to take anabolic steroids

Anabolic steroids may be advisable for people who have lost testicular function like men with a testicular tumor. They’re also advised in some type of anemia to stimulate the bone morrow.

Prevent

The true is the problems of performance enhancing drugs aren’t solely related to elite athletes. Children are also exposed to this every day. Ask kids what they know about these drugs. Ask them if they know anyone in their school class who uses these drugs. Ask them if they know the dangers of these drugs. If you think that your children or children in your family might be experiencing these drugs, talk to your doctor.

It’s also important to talk to coaches and ask them if leagues or schools require annual physical exams for athletes. A physical examination by a doctor can detect the use of performance enhancing drugs in athletes (doping test). Ask coaches if any of their athletes have experienced performance enhancing drugs.

Stats

As many as four 4 American children and teens are using performance enhancing drugs such as anabolic steroids.

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-Steph

P.S. If you’re in Miami and you like Caribbean food, go to my cousin’s bistro to eat Haitian food, click here .

Shoulder Impingement

shoulder impingement

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.

Impingement is the fact of having mechanical compression and/or tendon wear of the rotator cuff. Rotator cuff is composed of a serie of 4 muscles connected to the shoulder blade at the humeral head (upper part of the shoulder joint). The function of the rotator cuff is to maintain the humeral head within the glenoid (socket) during normal shoulder function and to participate in shoulder strength during activity. Normally, the rotator cuff glides gently between the inferior surface of the acromion, the bone at the point of the shoulder and the humeral head.

Causes

Any process that can interfere with rotator cuff being able to glide normally can cause impingement. The causes are :

  • Weakening

  • Degeneration of the tendon due to aging

  • Formation of the bone spurs

  • Inflammation of tissues on the space above the rotator cuff

  • Injury due to overuse

Overuse activities that can lead to impingement are most commonly seen in tennis players, pitchers and swimmers.

Diagnosis

shoulder impingement

Diagnosis can be made with the patient’s history and physical examination. Patients suffering impingement often complain of pain in the shoulder. This pain worsens with overhead activity and can be so strong that it causes an awakening during the night. Manipulation of the shoulder in a specific way by a doctor will usually reproduce the symptoms and confirm the diagnosis. X-rays are also useful for the evaluation of the presence of bone spurs and/or the narrowing of the subacromial space.

Treatment

The first thing to do is to eliminate identifiable causes or factor that contribute to the pain. This means temporarily avoiding activities like tennis, pitching or swimming. A non steroidal anti-inflammatory medication may also be recommended by your doctor. The treatment is based on exercises aimed at restoring flexibility and normal strength to the shoulder girdle, especially by strengthening the muscles of the rotator cuff and the muscles responsible for the normal movements of the scapula (shoulder blade). This program may be performed by a doctor, a certified athletic trainer or a qualified physiotherapist. Sometimes a cortisone injection may be helpful in the treatment.

Surgery

Surgery isn’t necessary in most case of shoulder impingement. But if the symptoms persist despite non-surgical treatment, surgical intervention may be beneficial. Surgery involves deriding or surgically removing, tissue that is irritating the rotator cuff. This can be done with open or arthroscopic technique. The result is favorable in about 90% of cases.

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-Steph

P.S. If you’re in Miami and you like Caribbean food, go to my cousin’s bistro to eat Haitian food, click here .

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

Articular Cartilage Injuries

articular cartilage injury

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

Definition

Articular cartilage is difficult to understand because there are 3 types of cartilages in the body : articular of hyaline cartilage (covers joint surfaces), fibrocartilage (knee meniscus, vertebral disk) and elastic cartilage (outer ear). These cartilage’s types differ in their structure, elasticity and strength.

Articular cartilage is a complex element, it’s a living tissue that is on the joint’s surface. The function is to provide a low friction surface to allow the joint to withstand weight loads through the range of motion needed to perform activity of daily living. To put it simply, articular cartilage is a very thin shock absorber. It’s built in 5 distinct layers and each layer has a structural and biochemical difference.

Injury

articular cartilage injury

Articular cartilage injury may be due to trauma or progressive degeneration (wear and tear). This can be mechanical destruction, a direct blow or other trauma. The healing of articular cartilage cells depends on the severity of the damage and the location of the lesion. Articular cartilage has no direct blood supply so it has very little ability to repair itself. It the lesion penetrates the bone under the cartilage, the bone provides blood in the area which improves the chances of healing.

Mechanical degeneration (wear and tear) of articular cartilage occurs with progressive loss of normal cartilage structure and function. This loss begins with the softening of the cartilage, then progresses to fragmentation. As the loss of articular cartilage lining continue, the underlying bone no longer has any protections against normal wear and tear of daily life and begins to get damaged leading to osteoarthritis.

In many cases, a patient experiences knee swelling and vague pain. At this stage, continuous physical activity isn’t possible. If a loose body is present, words such as « locking » or « catching » might be used to explain the problem. With wear and tear , the patient often experiences stiffness, decreased range of motion, joint pain and/or swelling.

Diagnostic

The physician examines the knee to look for a decrease in range of motion, pain along the joint line, swelling, fluid on the knee, abnormal alignment of the joint’s bones, and ligament or meniscal injury.

Cartilage lesions are difficult to diagnose and it’s possible that the use of magnetic resonance imaging (MRI) or arthroscopy may be necessary. Plain X- rays don’t usually diagnose articular cartilage problems but they used to rule out other abnormalities.

Treatment

articular cartilage injury treatment

 

Articular cartilage injury that doesn’t penetrate the bone doesn’t repair itself. A lesion that penetrates the bone can heal but the type of cartilage created is structurally unorganized and doesn’t work as well as the original cartilage.

Lesion less than 2 cm have the best prognosis and the best treatment options. These options are arthroscopic surgery using techniques to remove damaged cartilage and increase blood flow from the underlying bone (drilling, pick procedure or microfracture ).

For smaller lesion of articular cartilage surgery is not required.

For larger lesion, it’s necessary to transplant the articular cartilage from another area of the body. Talk to your doctor or specialist to have more information about the decision to have a surgical operation.

For patients with osteoarthritis, non-surgical treatment consists of physical therapy, lifestyle modification (for example reducing activity), bracing, supportive devices, oral and injection drugs (like non-steroidal inflammatory drugs, cartilage protective drugs) and medical management.

Surgical options depend on the severity of osteoarthritis and may provide a reduction in symptoms that are usually short-lived. Total osteoarthritis may relieve the symptom of advanced osteoarthritis but this usually requires a change in the lifestyle and/or level of activity of the patient.

Statistics

Based on published studies, the overall prevalence of articular cartilage injury in the knee is 36% among all athlete and 59% among asymptomatic basketball players and runners.

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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.

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-Steph

Proteins And Kideys

protein

I watched a Jamcore DZ’s video  and I learned a lot of stuff.

When I started to train in a gym. I often asked myself this question : « How much protein do I have to eat at each meal ? ». I asked this question to people in the gym and I had several different answers. For example, someone told me that if I ate too much protein, it could destroy my kidneys or that whey (shaker) was better protein than protein from food (chicken, beef, eggs, etc).

I think you also ask yourself this type of questions so I will help you understand better.

Firstly, everyone knows that protein is very used in fitness and bodybuilding. You can find protein in food or as a dietary supplement such as whey, casein and amino acids. Protein are composed of amino acids.

kidney

1) How much daily protein is recommended for someone who doesn’t do fitness  ?

It’s 0.8 grams (gr) of protein per kilogram (kg) of body weight or 0.36 grams per pound. For this article, I will use the unit of mesure kilograms (kg).

I will take the example of Jamo who is a former professional bodybuilder who continues to train. Jamo weighs 95kg. 95kg at 0.8gr per kilo of bodyweight gives as a result that Jamo eats 76gr of protein per meal. Jamo want to keep his bodybuilder body without steroids. For this, he must eat several times a day and that makes a total of 360gr per day.

2) With sport, do these recommendations change ?

Yes, because a sedentary person will use more of his/her body, which means that this person will use more his/her muscles. The meals content changes with the sport and the type of sport. If we compare a person who is doing fitness and a person doing marathons, we see that the meals are different.

A person doing marathons needs to eat more carbohydrates than protein to have endurance. A person who does fitness/bodybuilding need to eat more protein than carbohydrates for muscles rebuilding and muscle growth.

3) Depending on the intensity, do these recommendations change ?

Depending on the intensity, the answer is yes and no. It also depends on the muscle mass. When a person is doing a really intensive workout, the most important marcro is carbohydrate.

An increase of protein is necessary when a person decreases carbohydrates to be shredded. Increase protein helps maintain muscle mass.

4) With age, these recommendations change ?

change

With the latest scientific studies, we learned that proteins need to be increased with age. When a person start to become old, that person loses muscle mass naturally (and it’s normal). It’s for this reason that it’s important to play sport to maintain muscle mass. And to help to maintain this muscle mass, it’s necessary to increase protein.

This a scientific study about it, click here

5) Consume a large amount of protein destroys kidneys ?

The answer is yes and no. In a case where a person has pre-existing kidney problems before playing sport, it’s important to see a nephrologist (kidney specialist) or a doctor. For people who have healthy kidneys, proteins don’t destoy the kidneys. Kidneys are the most detoxifiying organs of the human body and we (human being) have been created to eat meat. The human being is made to eat a lot of meat. Until now, no study has shown that the protein destory kidneys, except for people with pre-exiting kidney problems.

Here is a scientific study on the effects of high protein intake on the kidneys, click here . This study shows that is a myth and a lie.

6) Assimilation and MPS (mass protein synthesis)

Assimilation is when you eat protein. A part of the protein you eat will be assimilated for protein synthesis. Everything else, your body will assimilate because your body is made of 80% amino acids, so these proteins will be used for your skin, your hair, your eyes, your organs. Absolutely all the protein that you eat will be absorbed by your body, nothing is thrown away. There is no protein in you pee.

The goal of protein synthesis is to repair or eliminate damaged proteins and to build new proteins that are copies of the original. New proteins are stronger, denser and more resistant to stress. Muscle Protein Synthesis (MPS) is the reconstruction of muscle caused by stress placed on the body. This can be an injury (muscle tear) or because you intentionally damage a muscle (lifting weights creating micro tears in muscles). MPS process activated right after micro tears and can last up to 48 hours on a damaged site before being repaired.

A part of protein you eat is used for protein synthesis, which will create the state of hypertrophy with hormones. Protein synthesis doesn’t buid muscle, it’s muscle protein synthesis (MPS).

I just read again my text and I see that it’s a bit difficult to understand (for me too ?!?). To make it simpler, protein synthesis repairs your skin, your hair, your eyes, your organs and create the state of hypertrophy. Muscle protein synthesis repair only your muscles.

Here is a scientific study on nutrition and muscle protein synthesis, click here .

7) Liquid and solid protein

Liquid proteins are whey and casein (shaker). Solid proteins are chicken, beef eggs, etc. The diffrence is that the body assimilates liquid proteins faster than solid proteins. The problem is that the quality of liquid proteins is 75% bad on the market, so it’s up to you to study ingredients (as for food in supermarkets) to find the best quality possible. I wrote an article on this subject, click here

8) Number of grams of protein per meal

  • For men, it’s about 30-35gr of protein per meal. For women, it’s about 20-25gr of protein per meal.
  • For older men, it’s about 35-40gr per meal. For older women, it’s about 25-30gr per meal.

Here is an interesting study for women. Eating a large amount of protein has harmful effects on the bones. Click here .

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

-Steph

Spinal Disc Herniation

disc herniation

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

First we can say : « disc herniation » or « herniated disc » but I prefer use « disc herniation » in my article.

Disc herniation is a common pathology in bodybuilding. This often occurs because of poor back placement during exercises such as squat, deadlift and rows (barbell bent row, seated row, etc).

During the execution of theses exercises, the main defect observed is the rounding of the back or a flexion of the spine. Because of that discs are pinched forward and loosened backward.

disc herniation

If an intervertebral disc cracked or aged, the gelatinous fluid of the nucleus pulposus moves backwards and can compress the spinal cord or roots of the spinal nerves. The symptoms of a disc herniation depends on the nature of the lesion, the amount of nucleus displaced and the surface that nucleus compresses.

The disc may have a bump or even worse, the nucleus may explode through the surrounding annulus fibrosus. It’s also possible that the posterior ligament that joins the vertebrae to each other is broken. The compressions caused by the rupture of the annulus fibrosus are always painful and incapacitating.

In bodybuilding, disc herniation are mainly at the lumbar level. Often between the 3rd and 4th lumbar vertebrae or between the 4th and 5th lumbar vertebrae. The pain is dull and deep and sometimes with numbness and tingling. Often the pain is in the middle of the back or on one side. The pain extends onto the glutes, pelvis and pubis. Sometimes pain can be felt throughout the leg following the path of the sciatic nerve because the sciatic nerve is compressed at the root (hence the name of sciatic to define this type of pain).

disc herniation sciatic nerve

Usually disc herniation resolve spontaneously and the pain gradually disappears. But in some cases the bump on a vertebral disc doesn’t disappear and can continue to painfully pres on the nerves or it’s a loose piece of intervertebral cartilage that compresses the nervous elements.

In these 2 cases, the doctor will think of doing a surgical operation to remove the part that compresses the nerves.

To avoid having a disc herniation, it’s essential to do squat, deadlift, « good morning » and rows (rows, barbell bent row, seated row) with excellent positioning technique.

Attention

For all exercises done with very heavy weight, it’s necessary to perform a « blocking » :

  1. Take a deep breath and block the breathing to fill the lungs like a balloon. This stiffens the ribcage and prevents the top of the torso form tilting forward.

  2. Squeeze abs stiffens the belly, This increases the intra-abdominal pressure and prevents the torso from sagging forward.

  3. By slightly arching the lower back with lumbar squeeze, this allows to have the spine’s bottom in extension.

These 3 simultaneous actions is what we call « blocking ». This « blocking » has the function of avoiding the rounding or bending of the spine because with very heavy weights, it can create disc herniations .

Note

After a training session with very heavy weights, it’s advisable to do stretching for the spine. There is an excellent exercise to relax the back muscles and rebalance the pressure inside the intervertebral discs. Click here .

Bad position

disc herniation bad positon squat deadlift

For exercises such as deadlift or squat, it’s important not to round your back to avoid lower back injuries.

Disc herniation

disc herniation

Flexion of the spine with heavy weights can create disc herniations at the level of the lumbar vertebrae.

These disc herniations are common at squat and deadlift. This is caused by a bad back position during exercise. That’s why it’s important to work the technique for these exercises.

Disc herniation according to the age

disc herniation intervertebral

From the age of 30 years old, intervertebral discs degenerate and don’t worry, it’s normal, The annulus can crack and the nucleus pulposus dries progressively.

Vertebral discs of people over 30 years old are more rigid, less elastic and the mobility of the spine is more limited. But as the viscous gel of the nucleus pulposus deacreases due to drying, the risk of the vertebral discs moving and compressing the nerves diminished.

Vertebral discs of people under 30 years old are more flexible, more elastic and there is more mobility with the spine. There is a greater amount of viscous gel in the nucleus pulposus which increases the risk that vertebral discs will move and compress the nerves. Disc herniation is very common among young athletes.

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

-Steph