MRSA Infections

mrsa infection anatomy

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.

Methicillin-Resistant Staphylococcus aureus (S. Aureaus), or MRSA, is a bacterium that creates skin infections and other types of infections. The first time that MRSA was seen in US hospitals during the 1970s. Recently, there is a new strain of MRSA know as Community Acquired Methicillin-Resistant Staphylococcus aureus, or CA-MRSA, has left hospitals and began to spread in the community.

This is the strain that is prevalent among athletes. The difference between CA-MRSA and Healthcare-Associated MRSA (HA-MRSA) is in their effects. CA-MRSA usually creates skin infections while HA-MRSA causes bloodstream, urinary tract and surgical site infections. This make CA-MRSA less dangerous than HA-MRSA. Another difference is that CA-MRSA is more vulnerable to antimicrobial.

Symptoms

Signs of infections are :

  • Redness

  • Warmth, Swelling

  • Pus

  • Pain at sites where there are skin wounds

  • Abrasions or cuts

MRSA has the ability to spread to other organs in the body and when that happens, symptoms are more severe.

At this stage, symptoms are :

  • Fever

  • Chills

  • Low blood pressure

  • Joint pain

  • Severe headaches

  • Shortness of breath

  • An extensive rash over the body

These more advanced systemic symptoms require immediate medical attention.

Treatment

The 1st choice for treating MRSA skin infection is to use an antibiotic that has been created to kill bacteria with mild side effects. Most early infections with no widespread symptoms can be treated with oral antibiotics. Because of the nature of this decease and antibiotic options, many patients think they’re « cured » after only a few doses and decide by themselves to stop taking the prescribed drugs. However, MRSA is able to re-infect the patient and become resistant to antibiotics used previously.

For moderate to severe infections, treatment may be with intravenous antibiotics.

These infections associated with deep abscesses or boils require open surgical drainage in addition to antibiotic therapy. Most infections resolve in 7-10 days with an adequate treatment despite the fact that a deep abscess can take up to 4 weeks to eradicate the infection by resolving the abscess cavity.

Early identification and treatment of MRSA infections decrease the amount of playing time lost and decrease the chance that the infection will become severe. Skin may be protected by protective clothing or gear designed to prevent skin abrasions or cuts.

Prevention

mrsa infection anatomy

It’s necessary that athletes have good personal hygiene but it must be added that athletes and visitors to athletes facilities must also keep their hands clean by washing them often with soap and water or using an alcohol-based hand rub. The minimum is to have clean hands before and after sports and activities. For example when we use weight training equipment that is shared by all gym members, it’s important to have clean hands after using toilette or when someone is injured taking care the wounds (including changing bandage).

Ordinary and antimicrobial soaps are effective for washing hands. It’s noted that liquid soap is a better option because it’s not possible to share this type of soap compared to bar soap. Alcohol-based hand sanitizer that contain at least 60% alcohol are the perfect choice.

Athletes should shower immediately after exercise and shouldn’t share soap and towels. Washing all uniforms and clothes after each use is important. Athlete should avoid sharing items that are in contact with the skin and avoid sharing personal items as they contact the skin. Fortunately, most surfaces don’t provoke a risk of spreading staph and MRSA.

Athletes who have had MRSA

Several high school, college and professional athletes have contracted MRSA infections. There have already been epidemics among athletes on the same team. A study published in « The New England Journal of Medicine » shows an infection MRSA among St. Louis Rams professional football franchise (USA) athletes. During a single season, MRSA infections were found among 5 of 58 Rams athletes (9 percents) that was tested. All infections developed on areas of the body that are common places for turf injury.

Stats

  • Today, MRSA accounts for about 50-70% of the S. Aureus infections that are present in healthcare facilities across the world.

  • Statistics fro the Kaiser foundation in 2007 indicated that approximately 1.2 million hospitalized patients contract MRSA infections.

  • Serious MRSA infection is still predominantly related to exposure in the healthcare setting, where approximately 85 percent of all serious MRSA infections occur.

  • Fortunately, in children under 18 years old, mortality rates are much lower (1%), even though the number of hospitalized children with MRSA has almost tripled since 2002.

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

-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 .

Biceps Tendon Rupture

biceps brachiitTendon rupture

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

Rupture or tear of the biceps long head is the serious injury the most frequent in sport

This injury usually appears on a muscle weakened by tendinitis caused by a sudden movement of the arm. Sudden arm movements are usually thrown like baseball, tennis, throwing sports and also Olympic weightlifting during the snatch. At this point, all tension transferred to the biceps long head which breaks most often where the tendon passes into the intertubercular sulcus of the humerus.

In bodybuilding, this injury is a little different, especially with the deadlift.

There is a technique in deadlift which consists of having a hand with a pronated grip and the other with a supinated grip to lift heavier weights and to avoid that the barbell rolls in the hands.

This simple technique is at the origin of the rupture or the disinsertion of the lower of the biceps (where the muscle is inserted on the humerus). Fortunately, this injury rarely happens.

During the positive phase of the deadlift, the muscles that work are legs, glutes, back and abs. Arms relaxed but they stretched as cranes cables.

Unfortunately, when a hand is with a supinated grip this shortens the biceps (the biceps is extremely powerful with a supinated grip). The result is that there is tremendous tension due to the heavy weights which cause the tearing or total rupture of the tendon of the radius. The biceps with a supinated grip works more than the biceps with a pronated grip.

In the deadlift, the injury is exclusively on the distal tendon of the muscle. The arms hang along the body, which causes the tension to be distributed at the top of the muscle between the tendons of the short head and the long head. For other exercises when the tension is at the bottom of the muscle, the tension is supported on a single tendon insertion.

biceps brachiitTendon rupture

The rupture of the biceps tendon causes a pain relatively moderate compared to the severity of the injury. If we compare the rupture of the biceps tendon with the major pectoralis or the adductors of the thighs, the pain is different. With a rupture of the major pectoralis tendon or adductors of the thighs, the suffering is so strong that the athlete must stop the effort.

It often happens that during a powerlifting competition, athletes who have a rupture of the biceps tendon during the deadlift, continue until the end of the movement.

When this injury occurs, there is swelling in the forearm because of hemorrhaging. But the most surprising thing is the retraction of the biceps which forms a ball at the top of the arm near to the pectoralis major and deltoid. This biceps retraction causes the brachial muscle in the lower arm to be more exposed.

biceps brachiitTendon rupture

It’s always possible to make a flexion of the arm with the rupture of the muscle, which less powerful than before, thanks to the brachial muscle, brachioradialis, long and short radial extensor of the carpus and the pronator teres muscle. On the other hand to make a movement with a supinated grip is a problem because the end of the movement is only carried out by a single muscle, the supinator muscle.

You have to be careful because this injury should be treated quickly by surgery to restore the brachial biceps tendon to the radius. If this surgical operation is not performed in time, the ball will have a fibrous transformation and retraction will be final. The arm’s mobility will always be possible but the loss of strength in flexion and supination is inevitable.

There is a solution to avoid this type of injury with deadlift with a bicep work to have a tendinous reinforcement. This exercise is to do a flexion only with forearms with a straight barbell. This exercise reinforces the biceps distal tendon but be careful by controlling the movement.

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

-Steph