Sports Medicine

Posted by Steven M. Cohen

It's been a long time since my last blog entry. I guess I was on a bit of an unintentional break from writing - a very productive break. Like many of you, I work full time, in addition to my responsibilities as a Feature Writer at here at Suite101. I also have a wife, and two young children. I've always felt that doing anything well, be it writing, acting as a supportive spouse, or being a dedicated father, requires discipline, focus and maximum effort. Sometimes, though, we wear too many hats in our lives, and performance suffers. When that happens, we must prioritize, and direct our efforts toward the roles we feel are most important in our lives. That's what I've been doing during this brief hiatus.

I'm pleased to say that during my time away from the laptop, I've had a great mental break, and feel refreshed and ready to write again. With the understanding of my wonderful editors, I'll be bringing you all the latest information on trends in sports medicine.

The take home lesson for me is: rest is as important for the mind as it is for the body. Now, let's go after it!

Posted by Steven M. Cohen

I thought I’d use this post to give another update on my quest for better health through nutrition. I’m in a terrific groove lately, following the diet plan in Dr. Gundry’s Diet Evolution pretty carefully. I haven’t had bread or pasta in weeks, and quite frankly, I don’t miss those foods. Junk food is a thing of the past, needless to say. Again, I don’t miss it (I think it’s kind of like kicking a tobacco addiction. As you get further away from it, the less you crave it).



Also, I’ve been using most of the supplements recommended in the book. Over time, I’ll be writing individual articles on each of these supplements, as I feel it is important to spread the word about them. Check out my articles on omega-3-fatty acid, and Coenzyme Q10 supplementation. Several other articles will follow shortly.



As for my measureable results, this morning I tipped the scales at 169 pounds – the first time below 170 since the Bush Sr. administration. Exercise-wise, I’m continuing to “bring it” with the principles of P90X (disclosure - I'm an independent "coach" for the parent company Team Beach Body), a workout program I’ll be discussing in future posts.

Posted by Steven M. Cohen

Since my “Diet vs. Exercise” post of April 19, I’ve been doing some reading on nutrition. A colleague of mine recommended a book by Dr. Steven Gundry titled, Dr. Gundry’s Diet Evolution. Never one to take diet books seriously, I started reading the book with a healthy dose of skepticism. By time I finished the book, I was a convert to the “Gundry way”.



The material in this book isn’t particularly ground breaking. However, the nutrition information is presented in an easy to remember manner, with plausible, if unprovable reasons for his diet recommendations. The book focuses on how the human diet has changed and evolved over millennia, and how these changes are to our detriment. The book generally recommends a diet closer to our ancestors’ with many anecdotal cases and evidence from the medical/nutrition literature presented.



Well, even though I’m in good shape, I decided to give this way of eating a try. It’s not easy, though. “White” foods, such as pasta, bread, rice, potatoes, etc are out. In their place, are vegetables, with an emphasis on green leafy produce. I started my little experiment at 6 feet, 0 inches and 176 pounds. Two weeks in, I’m at 172 pounds, and falling. I’m excited to visit the doctor, and see what my key “numbers” (cholesterol, LDL, HDL, triglycerides, blood pressure) are. Although my last physical showed all blood work to be normal, I’m curious to see if the numbers improve. I’m betting they will.



For those of you serious about using your diet to get healthier, I highly recommend this book.

Posted by Steven M. Cohen

Variety is a key element of any fitness program. Why? To prevent plateaus.

You see, our bodies are amazingly efficient machines. This is both a blessing and a curse. The blessing is the body’s efficiency enhances our ability to survive. The curse is the difficulty this efficiency can cause in an exercise program. Our muscles, when stressed by exercise, recover, and become stronger. This principle is the basis of all weight and cardiovascular training. However, as the muscles become stronger, they also become more efficient. The next time a muscle is put through the same routine, it is able to move the same load with a lower expenditure of energy – the definition of efficiency. Over time, the same exercises become less effective at changing your body, because your body can get through the routine with less effort. At that point, your fitness progress will stop.

In order to prevent stalling out in a fitness program, variety of exercises and is the key. Changing routines frequently will keep your body “confused” and will allow you to make the biggest possible fitness gains in the shortest time. Now that’s the kind of efficiency that I like.

Posted by Steven M. Cohen

In a fitness program, which is more important, diet or exercise? That’s kind of a loaded question, as both are important. But, which is more important?

The answer to that question is another question – what are your goals? Exercise, of course, is vitally important for all of us. Without exercise, all of our muscles will slowly atrophy, leaving us weak, inflexible, and prone to injury and illness. On the other hand, a poor diet will leave us either fat (too many calories/fat/sugar) or weak (too few calories, as seen in some “weight loss” programs). The key is to find a happy medium.

So, which is it? Again, the answer is related to one’s goals. If one is looking at general overall health, then diet and exercise are equally important. But if the goal is peak athletic performance then diet, in my opinion, becomes the more important variable. That’s because no matter how hard one exercises, without proper fuel in the form of adequate numbers of calories, proteins and carbohydrates, the body will be unable to repair itself from the “damage” done by exercise. It is the repair process that leaves us stronger.

Similarly, if one is looking to lose weight, or develop a “beach body” for summer, diet is vitally important. One must be careful to stay within the recommended daily amount of calories and protein, in order to promote the fastest possible metabolism and shed excess body fat. If the diet is bad, no amount of exercise will help one look “ripped”. Only “clean” eating habits (no junk food) will give the desire results.

Posted by Steven M. Cohen

Lots of people work hard and exercise, in order to prevent sports injuries. For those of you who are over 40, like me, and still work out hard, good for you. I’ve been at it since I turned 21, and felt that I was becoming an out-of-shape blob before my time. I had a like-minded roommate at the time, and we invested in a weight bench and a standard weight set and started training in our apartment. Over time, I added running to my repertoire, for cardiovascular conditioning. The weight training and running regimen has served me well through the years. But, something was missing.

Until recently, I had never worked on my flexibility – and I paid for it. After years of running, I had become so tight, especially in the hamstring region that I couldn’t come close to touching my toes. However, I recently started doing yoga with my wife. I always felt that yoga was more of a women’s thing, but I was wrong. After three months of flexibility training, I’ve become reacquainted with my toes. I feel stronger, and more durable than I’ve felt in years. For all you active adults, I highly recommend adding flexibility work to your exercise routines.

Posted by Steven M. Cohen

This morning, after exercising, I took a minute to “inspect” the ugly, 8 inch scar that tracks along the inner aspect of my left patella. That’s the remnant of an anterior cruciate ligament surgery I had almost 28 years ago. I tore the ligament playing soccer at age 15, and had surgeries at ages 16 and 17. As I contemplated my long-ago ordeal, it got me thinking how far treatment for sports injuries has progressed since my injury.

For example, when I was initially injured, I was diagnosed as having “internal derangement” of the knee. That is doctor-speak for “something’s wrong with your knee, but I’m not sure what”. I was injured in the late 1970’s – the MRI scanner hadn’t been developed yet. Instead, I underwent regular a regular x-ray exam, which was negative (ACL tears do not show up on routine x-ray). I also underwent two arthrogram procedures. This (now antiquated) procedure was somewhat effective in diagnosing meniscal (cartilage) tears, but was ineffective for visualizing my problem, a ligament tear. If I had been injury today, a 20 minute non invasive MRI would reveal my ACL tear – no fuss, no muss.

I suffered along for almost a year and a half, before my doctor finally tried a newly developed diagnostic technique on me – arthroscopy. At arthroscopy, my true problem, the ACL tear, was revealed. He then went on to do a repair, using “open” technique, resulting in the large scar I carry today (arthroscopic surgery hadn’t been developed yet). Had I undergone surgery today, the repair would have been less invasive, arthroscopic surgery, with equally good results. Yep, it’s really amazing how far sports medicine has come.

Posted by Steven M. Cohen

Today, the Los Angeles Times ran a story in the Health Section following the results of six runners from last weeks’ LA Marathon. As I read the piece, I couldn’t help think that each of these runners is insane – not because they ran the marathon (I did that myself in 1996, and I don’t consider myself insane) – but because each ran with either an illness or an injury. These runners describe back pain, calf pain, cramping, sinus infections and the flu. It seems to me that each of these runners had a very good reason to either skip the race entirely, or drop out early. Yet, all six runners finished the race. Luckily for them, they didn’t seem to do any long term damage to their bodies.

Exercise is great. I work out every day. But they idea of exercise is to improve your health, not ruin it. Injuries and illness are reasons to back off of exercise. It’s neither smart nor “courageous” to finish a race under those conditions. Just ask the family of the unfortunate individual who died at the last Chicago Marathon.

Posted by Steven M. Cohen

Repetitive motion injury strikes again. This time, Chinese NBA star Yao Ming, was the victim. The Houston Rockets announced that their star center is suffering from a stress fracture in his foot. He is scheduled to undergo surgery that will likely end his NBA season. Yao is expected to be ready to represent his home country in this summer’s Olympic Games in Beijing.

While Yao has a professional obligation to try to play through pain, his stress fracture illustrates the consequences of meeting that obligation. Instead of taking a few days off to allow recovery, the continued pounding cost the Rockets their center until next year. By playing smart, and listening to your body, you can prevent falling victim to stress fractures in the lower extremities.

Posted by Steven M. Cohen

Tiger Woods has picked up in 2008 where he left off in 2007 – as the best golfer in the world, by far. He showed his dominance again this week, winning the Accenture Match Play Championship, for his fourth straight PGA Tour win, and his sixth win in his last seven tournaments worldwide. Aside from his monster talent, Woods’ dedication to fitness and flexibility that has kept him on top of the golf world, even after two decades of repetitive wear and tear on his body.

Although Woods usually declines to discuss the details of his fitness regime in the media, he clearly incorporates both strength training (look at him in those form fitting shirts he wears!), and stretching/flexibility work. As I’ve emphasized in this space, strength and flexibility are both necessary to maintain peak athletic performance, and to avoid injury. Although Woods suffered from a knee injury earlier in his career he has remained remarkably healthy. This is in stark contrast to many other professional golfers who look (how can I say this diplomatically?) like pro golfers - and not in a good way. Many a talented member of the PGA Tour has underachieved in his career secondary to injury (see Fred Couples, David Duval, et. al.). An overall commitment to fitness is the best way to avoid this fate.