What's best between eating 3 Big Meals or Several Smaller Meals throughout the Day?

Diet question of the Year...  Is it more healthy and more apt to increase our metabolism (i.e., easier to lose weight) by eating several smaller meals throughout the day rather than three big ones?  Lately, we've heard lots more advocacy for the "grazing" strategy for our daily food consumption if we wanted to keep the weight off and increase our energy levels. I mean, have you've ever seen a fat deer?  Of course, we've all seen plenty of fat cows, and they they graze throughout the day, right?

Well... the verdict is in - at least for now - from the nutrition and fitness experts at Men's Health. Here's what they found. Wait for it....  there's no difference at all.  Really???  Yep, really!  As long as the daily caloric intake and nutritional value is the same, their study found no discernible difference between grazing and the conventional 3-meals a day diet. With that said, other studies have shown that smaller, nutritious meals throughout the day can have a positive affect on maintaining more consistent energy and concentration levels throughout the day,  as opposed to 3 Big meals, and feeling bloated and sleepy after each one.  Of course, we don't always have to eat like every meal was Thanksgiving Dinner.

So, Men's Health's finding was actually a positive one, because it supports whichever way we personally feel more comfortably eating throughout the day.  As long as we are consistent, and eat healthily, staying away from processed foods, sugary foods, GMOs, high fats, etc., and keep it natural with lots of veggies and fruit, then our health outlook will remain positively affected.

Here's to your Health!

Lubbock Sports Medicine

Dr. Kevin Crawford, MD
4110 22nd Place Lubbock, TX 79409

(806) 792-4329

How to Avoid Sports Injuries

While "warming up" before the championship football game or our afternoon jog is a must to help avoid Sports Injuries, there are many other precautionary steps that we could take.  A comprehensive approach can be the key for prolonged sports fitness, while keeping our bodies strong and flexible to help meet the demands of whatever sports activities that we undertake.  

Let's start with the basics:

The Warm Up

A critical need to help avoid sports injuries is The Warm-Up.  How vigorous your sports activity is will determine the recommended time to properly warm up your body.  A typical warm-up session could be 5-10 minutes, and should involve gently stretching, and increasing the blood flow to the muscles throughout the body, and then build the warm-up to a more brisk pace through light to medium cardio. A proper warm-up will allow for increase body flexibility of joints and muscle fibers, which will help help mitigate the risk of pulling or straining a muscle or incurring a painful joint injury. 

Technique Rules!

Doing a sport activity, such as weight lifting, working out quickly and unfocused, rather than with purposeful and proper technique, has caused many strained or torn muscles.  Methodical technique rules the day with regard to minimizing sports injuries, and is a must to ensure your desired results.  If you don't know a proper technique for any sports activity, simply ask a qualified sports medicine expert or trainer. Most gyms have certified trainers on hand just for this purpose.  They are there to help.  Remember...  "A perfect game requires perfect practice".

Crawl before you fly

Whether you are a sports beginner or a top professional, learn to listen to your body.  The only way to get better, stronger, and faster is to push yourself.  However, there's a big difference in taking that extra step or cranking out that last rep. verses hitting it so hard that your body starts to break down. Increased fitness and improved results take time and consistency to achieve, but when a shoulder or hip or knee starts sending your pain signals (or "something is not right" signals), maybe it's time to cool off to train for another day.  So, test yourself and push yourself.  Unless you are training to become an elite athlete, just don't go all for broke, especially at the beginning of your fitness journey, and always under doctor consultation.

Correct Equipment

Virtually all sports requires some form of equipment, with some sports requiring more equipments than others. Even sports activities such as jogging requires quality running shoes, and even apparel that 'breathes" and doesn't chafe.  On the other end of the spectrum is football, that requires a full body of equipment (certified helmet shoulder pads, mouthpiece, knee, thigh, and butt pads, quality cleats, and other items depending your your position.  Any of these pieces could be the weak link the chain, so select quality equipment to help avoid injury to the most vulnerable parts of the body.

Liquify

Water is absolutely your best friend to help avoid sports injuries, and helps keep you in peak performance during your strenuous sports actively.  Taking in enough fluids is vital to your body's wellbeing, and is necessary to your muscles' recuperatory stage after a killer workout or after a demanding match.

Cool it Down

Like the warm-up, but in reverse, the cool-down is essential to complete your sports activity.  A 5-10 minutes cool-down would include a more gentle exercise, like walking and stretching, and allows for the heart to return to its normal rate. It also lengthen the muscles, to help alleviate some of their bulkiness and tightness. Additionally, a proper cool-down allows the body to remove the bad waste-products created during the workout, and replaces them with oxygen and needed nutrients.

Modify your Intake

You want better performance on and off the field?  Change your diet, and of course no smoking.  Simple as that.  A good engine does not work so well with a poor source of energy, right?  So, eat your greens and fruits, and make sure you are getting sufficient protein, especially if you are strength training.  Keep it natural and healthy.  Stay away for the processed foods, which can be heavy on sodium, fats, preservatives, and sugars with minimal nutritional benefits. 

Get your Zzzz...

Help ensure that your body recuperates and heals from a day of hard activities by getting sufficient sleep - every night!  This is the main time when your muscles have a chance to mend themselves and get stronger. Besides all the health benefits to a good night's sleep (7.5 - 8 hrs for an adult), it also allows for higher productivity during the day.  Here's to your Zzzz, and start getting better:

• Daytime Performance

• Muscle Recuperation

• Brain Function

• Emotional Outlook

• Safety & Alertness

Disclaimer:  This information has been provided by Dr. Kevin Crawford, Lubbock Sports Medicine as general information only. It is not intended for any patient or specific situation.  Exercise with care and under a doctor's supervision.

Dr. Kevin Crawford, MD
Lubbock Sports Medicine
4110 22nd Place Lubbock, TX 79410
Tel. (806) 792-4329

ImPact testing, legislation changing how coaches, doctors detect concussions

By Nicholas Talbot

Stan Kotara stood in the middle of the room on one leg, holding his smartphone to his chest.

The concussion management director at Lubbock Sports Medicine was demonstrating the future of concussion testing. And for the most part, it seems alarmingly simple — the smart phone does most of the work as it measures a players’ balance.

But, there is far more to concussion testing than most people realize. 

The tests that athletes go through to be able to play again are more than reciting the alphabet backward or asking the time, date and location of the game. 

It has evolved into a scientific process. Currently, the most accepted form of testing across the NCAA and the University Interscholastic League is ImPACT testing.

“(ImPACT testing) does a couple of things for us. It helps us kind of confirm our suspicions that yes, a particular student athlete has had a concussion and it helps us track their recovery and then maybe as important as anything, it helps us determine when it’s safe for that student athlete to return to the field of play,” said Kotara, a certified ImPACT consultant.

Research cited by the American Association of Neurological Surgeons suggests that more than a third of college football players have had one concussion and 20 percent have had more than one.

The smartphone Kotara was holding in his hands was a technology that is currently under development. With the smart phone trainers are going to be able to measure a player’s balance and coordination after suffering from a possible concussive hit on the football field. 

“That is kind of new technology,” Kotara said. “So, we haven’t really quite implemented it just yet, but we are going to and that is measuring, a different area of our brain function. ... The ImPACT test measures our neurocognitive abilities, our attention to detail, our reaction time, your concentration ability, our working memory. This is more of the motor domain of our brain functions so that kind of incorporates our whole body.”

According to Kotara, it has also been proven that younger athletes are more susceptible to suffering from these types of injuries. 

“Younger kids, their symptoms of a concussion seem to linger on several more days than say a college player or certainly at the professional level,” he said. “Younger kids recover slower, we know that now.”

Still Kotara said he would not limit or ever recommend for parents to not let their children play sports. 

“Despite all of our latest evidence that we have now — and we’ve learned more about this injury in the last 10 to 12 years than the 50 years before that — There’s more about this injury that we don’t know, still,” Kotara said. 

There have been other technologies developed to help track and detect concussions and concussion-like symptoms, including devices in helmets and mouth guards that transmit signals back to a team’s training staff and coaches.

When a player gets hit the mouth guard or helmet sends a signal to a wireless receiver on the sideline in real-time so a trainer can be alerted by their laptop or smartphone.

However, Kotara said this has done little to curb the frequency of concussions. He believes legislation, combined with technology and knowledge will instead help diagnose and treat concussions. Part of that legislation requirement in the state of Texas is that every two years high school coaches must have documented training in the recognition of the signs and symptoms of a concussion. 

“Our treatment policies that are in place, that is required now by the state and it’s working,” Kotara said. “We’ve had several examples of some local high school coaches that have suspected something’s happened and … a kid’s pulled out and sure enough they’ve had a concussion. 

“So, it’s working.”

Lubbock Sports Medicine

Dr. Kevin Crawford, MD
4110 22nd Place Lubbock, TX 79409

(806) 792-4329

Microfracture of the Hip in Athletes

Most studies addressing treatment of chondral injuries have involved the knee. Various techniques have been used in the knee. Microfracture has shown excellent results in the knee. Chondral injuries of the hip are common in athletes with labral tears and femoroacetabular impingement. The microfracture technique is now being used in the hip joint. Indications include full-thickness cartilage loss or unstable flap on a weight-bearing surface. An important contraindication is the patients unwillingness to follow the postoperative protocol and rehabilitation plan. The microfracture technique in the hip is similar to that in the knee. Postoperatively, patients use a continuous passive motion and are flat foot (20 lbs.) weightbearing for 8 weeks. Early results following microfracture in the hip have been encouraging.

Lubbock Sports Medicine

Dr. Kevin Crawford, MD
4110 22nd Place Lubbock, TX 79409

(806) 792-4329

Meniscus Injuries of the Knee

Reliability, Validity, and Responsiveness of the IKDC Score for Meniscus Injuries of the Knee

 Kevin Crawford, M.D., Karen K. Briggs, M.P.H., William G. Rodkey, D.V.M., and J. Richard Steadman, M.D. 

Arthroscopy Association of North America’s Research Essay Award Winner

Purpose: The purpose of this study was to determine the psychometric properties of the International Knee Documentation Committee (IKDC) score for meniscus injuries of the knee. Methods: Testretest reliability, content validity, construct validity, and responsiveness to change were determined for the IKDC score. Knees were excluded if they had ligament pathology or a chondral defect greater than Outerbridge grade 2. All patients had meniscus pathology requiring treatment. The study comprised 4 subsets of patients. Group A consisted of 31 patients who completed an IKDC form at least 2 years after surgery for meniscus pathology and were then retested within 4 weeks of the primary questionnaire. Group B contained 264 patients with preoperative IKDC scores that were used for construct and content validity. Group C contained 50 patients who had a preoperative IKDC score and completed a short form 12 survey. Group D contained 100 patients with preoperative and postoperative IKDC scores used to measure responsiveness. Results: The overall IKDC score showed acceptable test-retest reliability with an interclass correlation of 0.95. There were acceptable floor and ceiling effects. All constructs tested showed significant differences. These included lower IKDC score with the following: lower activity level, difficulty with activities of daily living, difficulty with sports, abnormal knee function, and complex/degenerative meniscus tears. Responsiveness to change showed a large effect size (2.11) and a large response mean (1.5) for the overall score. The SE of the measurement was 3.19, and the minimum detectable change was 8.8 points.

Conclusions:

The overall IKDC score showed overall acceptable psychometric performance for outcome measures of meniscus injuries of the knee. Level of Evidence: Level III, testing of previously developed diagnostic criteria in nonconsecutive patients.

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Lubbock Sports Medicine

Dr. Kevin Crawford, MD
4110 22nd Place Lubbock, TX 79409

(806) 792-4329