A New Play to Tackle Football Knee Injuries

As the high school football season nears, a team of sports-medicine researchers has added new emphasis to an injury-prevention campaign that predictably begins about this time each year.

In a new review on injury research published in the American Journal of Sports Medicine, experts from the Hughston Orthopedic Clinic in Columbus, Ga., conclude that two combined factors may pose the greatest risk of knee injury in young football players.

If high school football programs paid more attention to maintaining their playing fields--eliminating irregularities in the turf that can trip and twist legs and knees--injuries could be significantly reduced.

But this can only work if teen-age football players wear soccer-style shoes, which lack lone toe cleats capable of causing feet to catch on the turf and a resulting knee, ankle or leg injury. Soccer-style shoes feature pairs of cleats farther back from the toe than conventional football shoes, making it more difficult for the feet to catch.

The research team also advocates stricter preseason surveillance by coaches and trainers of sloppy playing habits which can lead to injuries, and wider use of non-contact drills and other risk-free techniques.

The researchers concluded that sprains and strains--the largest single category--account for 40% of all high school football injuries, but more-debilitating knee injuries account for a quarter of the total.

Preseason practice may be the most crucial time for injury prevention, researchers said, because an injury is 5.4 times more likely to occur during this period than practice sessions after the season has begun.

Sonar Treadmill

The treadmill stress test--long a familiar, if sometimes controversial, stalwart in the detection of heart disease--may be due for a higher-tech revamp, according to researchers at the Indiana University School of Medicine.

Involved is the addition of ultrasound cardiograms to the more traditional array of electrodes, which trace the beating performance of the heart as the test subject walks at increasing speeds on a treadmill. The idea is to test the heart’s ability to pump when it is physically taxed--and experiencing, under controlled circumstances, the stresses most likely to precipitate a heart attack.

Compared to conventional electrocardiograms, the stress test with ultrasound was better able to accurately diagnose heart disease. Ultrasound works much like sonar in that it bounces harmless high-frequency sound waves through the body, electronically interpreting their pinging as they bounce off tissue. Results appear on a television screen.

Ultrasound tests are in widespread medical use for such things as evaluation of unborn children. The Indiana team concluded that mating echocardiograms, as they are called, with the conventional treadmill test makes sense as a “valuable addition” to the field.

Free-Base Pneumonia

Cocaine free-basing, which enjoyed a surge in popularity in the last five years, has been identified as the possibly unrecognized cause of a serious type of pneumonia, and doctors are being urged to consider drug abuse in diagnosing an otherwise unexplained respiratory disease.

In free-basing, cocaine is put into a solution with other chemicals and burned, with the user inhaling the fumes. But what may happen in the combustion-inhalation sequence, researchers at the Sinai Hospital of Baltimore speculate, is that dangerous impurities from other chemicals in the mixture get into the inhaled fumes and, once in the lungs, cause irritation sufficient to lead to a serious pneumonia infection.

The Baltimore report was based on symptoms experienced by a 32-year-old man, who, in addition to being a free-base cocaine user, regularly smoked tobacco and marijuana. The man’s pneumonia was severe enough that he developed symptoms of decreased oxygen supply in his bloodstream. He was treated with steroid drugs, but some symptoms of the pneumonia persisted 18 months later.

The Baltimore researchers identified free-basing as the cause of the disorder after ruling out all other possible explanations. Their findings were reported in the Annals of Internal Medicine. Advising doctors who suspect free-basing-related pneumonia to try doses of corticosteroids to treat it, the Baltimore team concluded that “given the widespread use of cocaine, a history of recent use of free-base cocaine should be consider in patients with otherwise unexplained pneumonia.”