LAURA BRADFORD
"In December 2004, I saw Dr. Horwitz for recurring lower back pain. I had finally realized that I needed to get committed to my health if I expected my back to regain strength and me to regain energy and vitality back in my life. Enter Laura Bradford. Laura is my angel and drill sergeant in my rebuilding of a strong and energized body. Rebuilding is not easy, but Laura is there, with her expertise, building a rehabilitation program designed for me. But expertise is not enough; Laura brings so much life and energy to her work. Coaching and pushing, encouraging and, yes, pushing all with humor and compassion. I am so grateful for the opportunity to work with her. I am getting my life back. It's about time. Thanks Laura." Terry Kinney

ANKLE SPRAINS
"I sprained my ankle." "I twisted my ankle." "I rolled my ankle." "He's got a high ankle sprain." Many terms are thrown about to describe ankle sprains. There are different types of sprains and different degrees of sprains. First, here are some definitions:

1. A sprain is an injury to a ligament. A ligament attaches bone to bone (tendons attach muscle to bone).
2. When a ligament is strained it means that the fibers of the ligament have torn.
3. There are three grades of sprain:
   a. Grade I: mild to moderate pain and mild to moderate loss of function (range of motion and strength).
   b. Grade II: moderate pain and moderate loss of function.
   c. Grade III: severe pain and complete or almost complete loss of function.

Now let's understand some anatomy. The two bones of the leg are called the shin or tibia (inside bone) and fibula (outside bone). The two bones end at the ankle joint. The two bones are joined by ligaments to the ankle bones called the talus and calcaneus (heel bone). The inside bump on the ankle is called the medial malleolus (end of the tibia) and the outside bump on the ankle is called the lateral malleolus (end of the fibula). It is at these junction areas that ankle sprains typically occur.

The most common type of sprain occurs when the ankle is rolled inward. Damage is done to the ligaments that run on the outside of the ankle (lateral malleolus to the talus and calcaneus). This type of sprain is called an inversion sprain. Less common is a sprain that occurs when the ankle is rolled outward. This type of movement causes damage to the ligaments that run on the inside of the ankle (medial malleolus to the talus and calcaneus). These ligaments are much tougher and thicker than the ligaments on the outside of the ankle, so they need a much greater force to cause an injury. This type of sprain is called an eversion sprain.

Many of you have probably heard the term "high ankle sprain." This injury is becoming more and more prevalent in professional sports (football, basketball, soccer). The ligaments and tissues between the tibia and fibula (interosseous membrane) are damaged in this type of sprain. This is a much more serious injury than the above two sprains. Frequently, surgery must be done to repair the injury as in Terrell Owen's case. He had 3 injuries: he sprained the interosseous membrane, he sprained the ligaments on the inside of the ankle and he fractured his fibula.

Proper diagnosis of these sprains is critical to proper treatment. Initial treatment must include RICE: rest, ice, compression and elevation. Cessation of activity must occur. Frequently, some type of brace (like an Aircast) is needed for support and compression. Crutches may be necessary for several days. Hands on treatment should begin as soon as possible to remove the fluid from the area and break up the scar tissue that forms (Active Release Technique and Graston Technique). Fluid that just "sits around" is the worst thing for proper healing. Restoration of range of motion should begin as soon as possible. Spelling the alphabet with your foot is a great way to start. Next is restoration of strength by turning the ankle in and out against resistance (like exercise tubing or bands).

ANEURYSM SCREENING URGED!
A federal advisory panel "recommended screening for potentially lethal aortic aneurysms, suggesting that high-risk male smokers from ages 65 to 75 get an ultrasound test." "The aorta is the body's main artery, and when an aneurysm ruptures, it is almost always fatal." The recomendation is for any man between 65 and 75 who smokes now or ever did smoke.
Wall Street Journal 2/1/05, p. D3


ANYONE CAN MAKE YOU TIRED!
What makes up a proper sports performance program? The first and foremost component of a SAFE and EFFECTIVE program is TECHNIQUE! Many of our athletes have experienced "training" sessions that leave them dripping wet and exhausted. Is training harder the only way to train for sports performance? The answer is NO!

According to a recent article published in the National Strength and Conditioning Journal, "Studies show that the incidence of overuse injuries sustained by young athletes could be reduced by 50% if more emphasis was placed on the development of fundamental fitness abilities before sports participation." The missing ingredient in sports performance training is TECHNIQUE.

A good analogy for the importance of proper athletic technique is having your tires properly balanced on your car. Properly balanced tires allow the car to be driven faster, prevent uneven tire wear, permit the slowest rate of tread wear possible, and provide the greatest protection against blowout. The same goes for proper exercise technique and the human body, especially the musculo-skeletal system (bones, joints, muscles, ligaments and tendons).

So many injuries are the result of the combination of poor technique and overtraining. We have seen too many young athletes (ages 8-18) come to our facility with a long list musculo-skeletal injuries like stress fractures, acute and chronic muscle strains (hamstrings, calves, etc.), and ligament sprains (knees, ankles, etc.). This is NOT NORMAL! Most of these injuries start with an acute episode followed by chronic pain and loss of motion. They occur because the athlete is not properly balanced due to years of poor technique.

Take running for example. Training for speed is NOT the same as training for conditioning. You can make athletes run wind sprints all day until they drop, but will this actually make them faster? NO! When fatigue sets in, running mechanics deteriorate. This is a critical point because every time the foot hits the ground while running the force generated is two to five times the athlete's body weight. If running technique is poor (which is the case for most athletes we see), the aforementioned injuries will occur. It is a matter of WHEN they will occur, not IF they will occur. This is why our programs spend so much time on running technique. Once technique is perfected, then the athlete can increase training intensity and volume safely.

The same goes for strength training. We have seen few athletes who can squat up and down correctly when they start training with us. The "athletic position" or partial squat is used in virtually every sport. Learning to squat properly is essential in learning to land properly after jumping. Poor landing technique is one of the primary reasons for the increasing number of ACL injuries, especially in young girls! So, are you going to have an athlete run and jump until they drop or are you going to improve through technique?

Remember, anyone can make you tired. At Maryland Sports Performance, technique comes first - we guarantee the results will come next!