Performance-Enhancing Drug Case Assignment

Performance-Enhancing Drug Case Assignment

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Performance-Enhancing Drug Case Assignment

2 PARTS !

PART 1: Answer the 3 questions below. (150-200 words for each question)

PART 2: Respond to the 8 responses below. (100-200 words for each response)

DUE Saturday July 20, 2019

1. What advice would you give a sprint athlete who plans to carbohydrate-load for competition?
2. Advise an Olympic-caliber weightlifter who plans to bicarbonate load because the competitive event requires all-out-effort of an anaerobic nature.
3. After reading the assigned article on creatine, what would be your recommendation to an athlete inquiring about the use of creatine?

LINK FOR ARTICLE: http://www.stack.com/a/creatine-benefits-for-athletes

Response 1: Adam Jent

While reading the article by Ryan, DeBurca, and McCreesh (2014), one statistic that jumped out at me was the percentage of those impacted by hip or groin injuries.  According to Ryan et al., chronic hip and groin pain makes up approximately 10% of all complaints at sports medicine offices.  Additionally, groin injuries specifically are said to account for 2-5% of all sports injuries.  Although I do not have a lot of experience in a rehabilitation setting, I did not expect this number to be as high as it was.  I cannot remember experiencing an issue of this type during my athletic career and thus have not really considered the common occurrence of these types of injuries.  As Ryan et al. point out, groin and hip injuries are especially common in athletes who participate in sports that involve rapid changes in direction, kicking, rapid acceleration/deceleration, and motions requiring turning or twisting.  I personally feel this is a fairly all-encompassing set of variables that are present in most sports to some degree.  Having been presented with this information on the common causes of these types of injuries, I am not more surprised that the percentage of people presenting with these issues isn’t even higher than that proposed by Ryan et al.  I feel there is a likelihood this number is in fact higher; however, the data may be limited.  Personally, I feel that I generally will not see a doctor for an injury unless I feel it is getting worse, is not getting better, or if I feel it isn’t that bad and will correct itself over a short period of time through self-care.  I do not believe I am the only person like this, and therefore the occurrence of hip and groin injuries may be underreported.  Despite this possibility, having an understanding of the risk factors that can lead to a hip or groin injury presents an important piece of the puzzle when working with patients having these issues.  By understanding the mechanics leading to these injuries, I feel we can design better treatments to help these athletes return to sport at a faster, but healthy, rate.

Response 2: Kendra Clamors

With playing soccer I have seen a lot of injuries during games. The only traumatic injury I sustained was a severely sprained ankle. Thankfully that was it. I know a lot of female soccer players tear their ACL’s. The chance of ACL tear in female athletes has been found to be 2 to 10 times higher than in male counterparts (Cluett, 2018). Also, with working at a physical therapy clinic we have a lot of patients that come in with hip injuries. So, with that being said and reading this article about injuries to the hip was very interesting. The section that stood out to me the most was about subluxations and dislocations. The most common traumatic mechanism of injury during athletic competition is a fall with a posteriorly directed force onto a flexed and adducted hip. Atraumatic and lower energy mechanisms of hip instability also have been described. Hip dislocations have been reported in American football, skiing, rugby, gymnastics, jogging, basketball, biking, and soccer (Kelly et al., 2013). Patients present with painful limitation of hip motion and often report discomfort in the hip when at rest. A high index of suspicion is needed to avoid missing this injury, which is often misdiagnosed as a muscle strain. Forceful impact on a hyperextended, internally rotated knee can result in posterior hip subluxation in the athlete with underlying limited internal rotation. To help with this type of injury Protected weight bearing for 2 to 6 weeks is recommended depending on the size and location of the acetabular lip fracture. Early surgical intervention is required if the bony fragment renders the hip unstable. If after a course of protected weight bearing followed by progressive strengthening and attempts at a functional return to sports there is persistent pain or a sense of instability, surgery should be delayed (Kelly et al., 2013). Athletes are allowed to return to play after radiographic union of the acetabular lip fragment and after progression to asymptomatic full strength and range of motion. A progression to sport-specific activities in a supervised environment is advised to ensure that there is no residual instability or pain(Kelly et al., 2013).

Response 3: Delania Adams

After reading the article, “Risk Factors for groin/hip injuries in field-based sports: a systemic review”. It reminded me of my athletic training time for my college baseball team. I saw many groin and hip injuries in baseball. Field sports such as football, baseball, and soccer are the most common sports where hip and groin injuries occur. Prior to reading this article, I was aware that a groin injury includes areas surround the hip as well as the thighs area. During a groin injury, an athlete is not able to fully perform using their lower limbs. After reading this article I did learn that a groin injury shows a greater abductor to adductor strength ratios (Ryan et al., 2014). There is a sports training specifically done in the preseason that is dedicated to training individuals who pose a higher risk for groin strain injuries (Ryan et al., 2014). I think during this time of the season it is very necessary to do have to train session with those athletes who play sports that are at a higher risk of groin injuries, this is something I found interesting about the article. Another interesting thing I read in the article was the biomechanics of an athlete performing a field base action. Biomechanical requirements include the axial and rotational loads of 12 times the player’s body weight experience in a competition (Ryan et al., 2014). With the two different types of studies being conducted intrinsic risk factors related to the person’s age and modifiable risk factors that can be used to prevent injury (Ryan et al., 2014). Once the study was conducted it showed groin risk factors were identified by older age, and weak adductor muscles (Ryan et al., 2014). In players who were still developing and maturing in age who had a smaller dominant femur diameter, increased or decrease BM, a decreased hip abduction ROM, total hip rotation ROM, abduction and adduction rotation peak torque, strength ration of hip muscle groups, and bilateral difference in extension peak torque also showed to be at significant risk for a groin/hip injuries (Ryan et al., 2014). All in all, I believe that age, muscle, and strength development play a major role in players understanding the biomechanics of their bodies and using it to their advantage to help prevent future injuries.

Response 4: Scott Walker

I am guilty of being a sports fan that always wants an ‘update’ on an injured athlete and when they will be returning to the field. One part of the article that I found interesting was the part about returning to play “Patients usually can return to play if the pain resolves following a period of rest and education to correct the movements causing the mechanical abnormality or after successful surgical treatment. In either circumstance, return to play is not recommended until adequate hip abductor strength is achieved. The patient should return to play in a graduated fashion and in a structured, supervised environment” (xxx, year). The authors used the line ‘education’ as a part of rehabilitation process, and that really got me thinking about what the athletes have to learn when they are going through their rehab. There is a mental component that needs to be addressed as well. “Injury is more than physical; that is, the athlete must be psychologically ready for the demands of his or her sport. Many individuals assist athletes through the recovery process and can foster psychological readiness, but they can also identify those who are physically recovered but require more time or intervention to be fully prepared to return to competition. Thus, rehabilitation and recovery are not purely physical but also psychological” (Kraemer, Denegar, Flanagan, 2009). Over time there have been cases where an individual was physically ready to return to the field, but perhaps they were not mentally ready to return. Additionally, there are times when an athlete returns back to the field too quickly and was not prepared for the full onslaught on the physical demand of their respective sport.

Response 5: Josh Young

I really enjoyed reading this article. This article helped to shed some light on the intricacies of hip injuries for me. I was surprised to learn how important adductor strength is in preventing hip/groin injuries. It makes sense, though, when you think about it. We know that when there is an imbalance between opposing muscle groups, injury or dysfunction is likely to occur. So, it would stand to reason that a muscular imbalance between the abductors and adductors would lead to injury. For me, it’s hard to justify training the adductor muscles because those are not muscles that you consciously use every day, nor is hip adduction something you do on a regular basis. After reading the article, I’m beginning to rethink my approach to training the adductors, especially when it comes to injury prevention. I agree with the quoted study that hypothesized that hip/groin injuries are the result of eccentrically loading the hip adductors (Tyler, Nichols, Campbell, et al., 2001 as cited in Ryan, DeBurca, & McCreesh, 2014). Muscles experience the greatest amount of force during an eccentric contraction (LaStayo et al., 2003), so if the adductor muscles are not proportionately as strong as the abductors, they are more prone to injury during an eccentric contraction. One thing I did not know about hip/groin injuries was that early maturing athletes are more prone to injury than their normally maturing counterparts. I would have thought that individuals who mature faster than normal would have a decreased risk of injury because of more muscle mass/strength/power than those around whom they compete, but that does not seem to be the case. Knowing that now helps to make sense of a groin injury that I encountered about a year ago. This particular patient was a 16 year old baseball player that presented with groin pain. We treated him and tried to rehab him, but he was not getting any better, so his parents wanted to get some imaging done. It turns out that this kid had a fractured pubic bone. He was tall for his age and he trained and competed heavily, so it makes me wonder if his age combined with his physical size contributed to his groin injury.

Response 6: Kennedy Rensing

When talking to a group of highschool boys, I would most likely go for the scare tactic approach. Thus, I would highlight the risks more than the benefits of using the performance enhancing drugs. The first and most important negative is the fact that the long term effects from the use of these drugs is not studied as much as it should be. There is an array of these drugs and more come out each day. So, it is scary to think that we dont know how these effect our bodies long term. In addition, these drugs can produce side effects including: joint pain, weakness, vision problems, dehydration, female characteristics, weight gain, etc. (Understanding the risks of performance-enhancing drugs, 2019). I would then discuss how to get the changes we desire through hard work versus trying to cheat it and take these drugs and supplements. This would be a great segway into good workouts and health outside the gym.

Response 7: Jessica Laidlaw

“Among teens, common performance-enhancing drugs and supplements include:

• Creatine is a naturally occurring compound in the body that’s also sold as an over-the-counter supplement. It’s used to improve performance during high-intensity bursts of activity and to help increase muscle mass and strength.
• Anabolic steroids.Anabolic steroids are synthetic versions of the hormone testosterone, used to build muscle and increase strength.
• Steroid precursors.Steroid precursors, such as androstenedione (“andro”) and dehydroepiandrosterone (DHEA), are substances that the body converts into anabolic steroids. They’re used to increase muscle mass. Most steroid precursors are illegal without a prescription. DHEA, however, is still available in over-the-counter preparations.” (Mayo Clinic, 2018)

The use of these substances can be due to insecurities or “because everyone else is doing it.”

As stated in the article I found, “Factors that might increase the chances that a teen will use performance-enhancing drugs include:

• Desire to gain muscle mass or strength
• Negative body image or a tendency to compare one’s appearance with others’
• Pressure from parents, other adults or peers regarding weight or muscles
• Steroids and their precursors can have severe, long-lasting health effects. In growing adolescents one of the major risks of using anabolic steroid precursors is the permanent stunting of height. Other side effects include:
• Blood-clotting problems
• High blood pressure and cholesterol
• Liver problems
• Mood swings
• Reduced sperm production

Creatine can also cause nausea, abdominal pain and kidney damage.

Possible red flags of performance-enhancing drug use include:

• Behavioral, emotional or psychological changes — particularly increased aggressiveness (“roid rage”)
• Changes in body build, including muscle growth, rapid weight gain and development of the upper body
• Increased acne
• Needle marks in the buttocks or thighs
• Enlarged breasts, male-pattern baldness and shrinking of the testicles in boys
• Smaller breasts, voice deepening and excessive growth of body hair in girls” (Mayo Clinic, 2018)

To prevent the use of these substances in these athletes they need to be told/reminded that the performance enhancing in any way is unethical and is cheating. Not only that, but the short term “benefits” can cause serious health issues. Also remind them that they can achieve the same performance outcome by not using the easy way out but by training hard and eating right. Another way to prevent the use of these substances is by educating athletes on what substances are okay to use, like vitamins and proteins, and what substances are not okay. Then remind them that they could be drug tested and that we, we being the coaches and health professionals, will be looking out for signs of substance use.

Response 8: Kelsey Clemons

Some points in a talk I would make would be first that I personally don’t think these high school athletes should be considering enhancing products.  First off y promoting these types of products this could lead these children into taking steroids or another type of dangerous hormones or drugs.Secondly, many of these enhancing products have false claims and adverse side effects that could harm these athletes. However, our textbook does mention the benefits of creatine which can be found in many meats as well as taking a supplement. In our textbook it says creatine, “improves performance in muscular strength and power activities” (McArdle, Katch, & Katch, 2015). It also says that there has been no adverse effects from creatine as well. However, I would still be weary about telling highschool kids to take performance substances.

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