Tuesday, August 30, 2011
Monday, August 8, 2011
Tennis Elbow (Lateral Epicondylitis)
Tennis elbow, or lateral epicondylitis, is a painful condition of the elbow caused by overuse. Not surprisingly, playing tennis or other racquet sports can cause this condition. But several other sports and activities can also put you at risk.
Tennis elbow is an inflammation of the tendons that join the forearm muscles on the outside of the elbow. The forearm muscles and tendons become damaged from overuse — repeating the same motions again and again. This leads to pain and tenderness on the outside of the elbow.
There are many treatment options for tennis elbow. In most cases, treatment involves a team approach. Primary doctors, physical therapists, and, in some cases, surgeons work together to provide the most effective care.
Anatomy Your elbow joint is a joint made up of three bones: your upper arm bone (humerus) and the two bones in your forearm (radius and ulna). There are bony bumps at the bottom of the humerus called epicondyles. The bony bump on the outside (lateral side) of the elbow is called the lateral epicondyle.
Muscles, ligaments, and tendons hold the elbow joint together.
Lateral epicondylitis, or tennis elbow, involves the muscles and tendons of your forearm. Your forearm muscles extend your wrist and fingers. Your forearm tendons -- often called extensors -- attach the muscles to bone. They attach on the lateral epicondyle. The tendon usually involved in tennis elbow is called the Extensor Carpi Radialis Brevis (ECRB).
Cause Overuse
Recent studies show that tennis elbow is often due to damage to a specific forearm muscle. The extensor carpi radialis brevis (ECRB) muscle helps stabilize the wrist when the elbow is straight. This occurs during a tennis groundstroke, for example. When the ECRB is weakened from overuse, microscopic tears form in the tendon where it attaches to the lateral epicondyle. This leads to inflammation and pain.
The ECRB may also be at increased risk for damage because of its position. As the elbow bends and straightens, the muscle rubs against bony bumps. This can cause gradual wear and tear of the muscle over time.
Activities
Athletes are not the only people who get tennis elbow. Many people with tennis elbow participate in work or recreational activities that require repetitive and vigorous use of the forearm muscle.
Painters, plumbers, and carpenters are particularly prone to developing tennis elbow. Studies have shown that auto workers, cooks, and even butchers get tennis elbow more often than the rest of the population. It is thought that the repetition and weight lifting required in these occupations leads to injury.
Age
Most people who get tennis elbow are between the ages of 30 and 50, although anyone can get tennis elbow if they have the risk factors. In racquet sports like tennis, improper stroke technique and improper equipment may be risk factors.
Unknown
Lateral epicondylitis can occur without any recognized repetitive injury. This occurence is called "insidious" or of an unknown cause.
Symptoms
The symptoms of tennis elbow develop gradually. In most cases, the pain begins as mild and slowly worsens over weeks and months. There is usually no specific injury associated with the start of symptoms.
Common signs and symptoms of tennis elbow include:
•Pain or burning on the outer part of your elbow
•Weak grip strength
The symptoms are often worsened with forearm activity, such as holding a racquet, turning a wrench, or shaking hands. Your dominant arm is most often affected; however both arms can be affected.
Doctor Examination Your doctor will consider many factors in making a diagnosis. These include how your symptoms developed, any occupational risk factors, and recreational sports participation.
Your doctor will talk to you about what activities cause symptoms and where on your arm the symptoms occur. Be sure to tell your doctor if you have ever injured your elbow. If you have a history of rheumatoid arthritis or nerve disease, tell your doctor.
During the examination, your doctor will use a variety of tests to pinpoint the diagnosis. For example, your doctor may ask you to try to straighten your wrist and fingers against resistance with your arm fully straight to see if this causes pain. If the tests are positive, it tells your doctor that those muscles may not be healthy.
Tests Your doctor may recommend additional tests to rule out other causes of your problem.
X-rays
These may be taken to rule out arthritis of the elbow.
Magnetic Resonance Imaging (MRI)
If your doctor thinks your symptoms are related to a neck problem, an MRI scan may be ordered. This will help your doctor see if you have a possible herniated disk or arthritis in your neck. Both of these conditions often produce arm pain.
Electromyography (EMG)
Your doctor may order an EMG to rule out nerve compression. Many nerves travel around the elbow, and the symptoms of nerve compression are similar to those of tennis elbow.
TreatmentNonsurgical Treatment
Approximately 80% to 95% of patients have success with nonsurgical treatment.
Rest. The first step toward recovery is to give your arm proper rest. This means that you will have to stop participation in sports or heavy work activities for several weeks.
Non-steroidal anti-inflammatory medicines. Drugs like aspirin or ibuprofen reduce pain and swelling.
Wrist stretching exercise with elbow extended. Equipment check. If you participate in a racquet sport, your doctor may encourage you to have your equipment checked for proper fit. Stiffer racquets and looser-strung racquets often can reduce the stress on the forearm, which means that the forearm muscles do not have to work as hard. If you use an oversized racquet, changing to a smaller head may help prevent symptoms from recurring.
Physical therapy. Specific exercises are helpful for strengthening the muscles of the forearm. Your therapist may also perform ultrasound, ice massage, or muscle-stimulating techniques to improve muscle healing.
Brace. Using a brace centered over the back of your forearm may also help relieve symptoms of tennis elbow. This can reduce symptoms by resting the muscles and tendons.
Counterforce brace. Steroid injections. Steroids, such as cortisone, are very effective anti-inflammatory medicines. Your doctor may decide to inject your damaged muscle with a steroid to relieve your symptoms.
Extracorporeal shock wave therapy. Shock wave therapy sends sound waves to the elbow. These sound waves create "microtrauma" that promote the body's natural healing processes. Shock wave therapy is considered experimental by many doctors, but some sources show it can be effective.
Surgical TreatmentIf your symptoms do not respond after 6 to 12 months of nonsurgical treatments, your doctor may recommend surgery.
Tennis elbow is an inflammation of the tendons that join the forearm muscles on the outside of the elbow. The forearm muscles and tendons become damaged from overuse — repeating the same motions again and again. This leads to pain and tenderness on the outside of the elbow.
There are many treatment options for tennis elbow. In most cases, treatment involves a team approach. Primary doctors, physical therapists, and, in some cases, surgeons work together to provide the most effective care.
Anatomy Your elbow joint is a joint made up of three bones: your upper arm bone (humerus) and the two bones in your forearm (radius and ulna). There are bony bumps at the bottom of the humerus called epicondyles. The bony bump on the outside (lateral side) of the elbow is called the lateral epicondyle.
Muscles, ligaments, and tendons hold the elbow joint together.
Lateral epicondylitis, or tennis elbow, involves the muscles and tendons of your forearm. Your forearm muscles extend your wrist and fingers. Your forearm tendons -- often called extensors -- attach the muscles to bone. They attach on the lateral epicondyle. The tendon usually involved in tennis elbow is called the Extensor Carpi Radialis Brevis (ECRB).
Cause Overuse
Recent studies show that tennis elbow is often due to damage to a specific forearm muscle. The extensor carpi radialis brevis (ECRB) muscle helps stabilize the wrist when the elbow is straight. This occurs during a tennis groundstroke, for example. When the ECRB is weakened from overuse, microscopic tears form in the tendon where it attaches to the lateral epicondyle. This leads to inflammation and pain.
The ECRB may also be at increased risk for damage because of its position. As the elbow bends and straightens, the muscle rubs against bony bumps. This can cause gradual wear and tear of the muscle over time.
Activities
Athletes are not the only people who get tennis elbow. Many people with tennis elbow participate in work or recreational activities that require repetitive and vigorous use of the forearm muscle.
Painters, plumbers, and carpenters are particularly prone to developing tennis elbow. Studies have shown that auto workers, cooks, and even butchers get tennis elbow more often than the rest of the population. It is thought that the repetition and weight lifting required in these occupations leads to injury.
Age
Most people who get tennis elbow are between the ages of 30 and 50, although anyone can get tennis elbow if they have the risk factors. In racquet sports like tennis, improper stroke technique and improper equipment may be risk factors.
Unknown
Lateral epicondylitis can occur without any recognized repetitive injury. This occurence is called "insidious" or of an unknown cause.
Symptoms
The symptoms of tennis elbow develop gradually. In most cases, the pain begins as mild and slowly worsens over weeks and months. There is usually no specific injury associated with the start of symptoms.
Common signs and symptoms of tennis elbow include:
•Pain or burning on the outer part of your elbow
•Weak grip strength
The symptoms are often worsened with forearm activity, such as holding a racquet, turning a wrench, or shaking hands. Your dominant arm is most often affected; however both arms can be affected.
Doctor Examination Your doctor will consider many factors in making a diagnosis. These include how your symptoms developed, any occupational risk factors, and recreational sports participation.
Your doctor will talk to you about what activities cause symptoms and where on your arm the symptoms occur. Be sure to tell your doctor if you have ever injured your elbow. If you have a history of rheumatoid arthritis or nerve disease, tell your doctor.
During the examination, your doctor will use a variety of tests to pinpoint the diagnosis. For example, your doctor may ask you to try to straighten your wrist and fingers against resistance with your arm fully straight to see if this causes pain. If the tests are positive, it tells your doctor that those muscles may not be healthy.
Tests Your doctor may recommend additional tests to rule out other causes of your problem.
X-rays
These may be taken to rule out arthritis of the elbow.
Magnetic Resonance Imaging (MRI)
If your doctor thinks your symptoms are related to a neck problem, an MRI scan may be ordered. This will help your doctor see if you have a possible herniated disk or arthritis in your neck. Both of these conditions often produce arm pain.
Electromyography (EMG)
Your doctor may order an EMG to rule out nerve compression. Many nerves travel around the elbow, and the symptoms of nerve compression are similar to those of tennis elbow.
TreatmentNonsurgical Treatment
Approximately 80% to 95% of patients have success with nonsurgical treatment.
Rest. The first step toward recovery is to give your arm proper rest. This means that you will have to stop participation in sports or heavy work activities for several weeks.
Non-steroidal anti-inflammatory medicines. Drugs like aspirin or ibuprofen reduce pain and swelling.
Wrist stretching exercise with elbow extended. Equipment check. If you participate in a racquet sport, your doctor may encourage you to have your equipment checked for proper fit. Stiffer racquets and looser-strung racquets often can reduce the stress on the forearm, which means that the forearm muscles do not have to work as hard. If you use an oversized racquet, changing to a smaller head may help prevent symptoms from recurring.
Physical therapy. Specific exercises are helpful for strengthening the muscles of the forearm. Your therapist may also perform ultrasound, ice massage, or muscle-stimulating techniques to improve muscle healing.
Brace. Using a brace centered over the back of your forearm may also help relieve symptoms of tennis elbow. This can reduce symptoms by resting the muscles and tendons.
Counterforce brace. Steroid injections. Steroids, such as cortisone, are very effective anti-inflammatory medicines. Your doctor may decide to inject your damaged muscle with a steroid to relieve your symptoms.
Extracorporeal shock wave therapy. Shock wave therapy sends sound waves to the elbow. These sound waves create "microtrauma" that promote the body's natural healing processes. Shock wave therapy is considered experimental by many doctors, but some sources show it can be effective.
Surgical TreatmentIf your symptoms do not respond after 6 to 12 months of nonsurgical treatments, your doctor may recommend surgery.
Saturday, July 30, 2011
Performance Enhancing Drugs: Know the Risks
Most serious athletes will tell you that the competitive drive to win can be fierce. Besides the satisfaction of personal accomplishment, athletes often pursue dreams of winning a medal for their country or securing a spot on a professional team. In such an environment, the use of performance-enhancing drugs has become increasingly common.
But using performance-enhancing drugs — aka, doping — isn't without risks. Take the time to learn about the potential benefits, the health risks and the many unknowns regarding so-called performance-enhancing drugs such as anabolic steroids, androstenedione, human growth hormone, erythropoietin, diuretics, creatine and stimulants. You may decide that the benefits aren't worth the risks.
Anabolic steroids
What are they?
Some athletes take a form of steroids — known as anabolic-androgen steroids or just anabolic steroids — to increase their muscle mass and strength. The main anabolic steroid hormone produced by your body is testosterone.
Testosterone has two main effects on your body:
•Anabolic effects promote muscle building.
•Androgenic effects are responsible for male traits, such as facial hair and a deeper voice.
Some athletes take straight testosterone to boost their performance. Frequently, the anabolic steroids that athletes use are synthetic modifications of testosterone. These hormones have approved medical uses, though improving athletic performance is not one of them. They can be taken as pills, injections or topical treatments.
Why are these drugs so appealing to athletes? Besides making muscles bigger, anabolic steroids may help athletes recover from a hard workout more quickly by reducing the muscle damage that occurs during the session. This enables athletes to workout harder and more frequently without overtraining. In addition, some athletes may like the aggressive feelings they get when they take the drugs.
Designer steroids
A particularly dangerous class of anabolic steroids are the so-called "designer" drugs — synthetic steroids that have been illicitly created to be undetectable by current drug tests. They are made specifically for athletes and have no approved medical use. Because of this, they haven't been tested or approved by the Food and Drug Administration (FDA) and represent a particular health threat to athletes.
Risks
Many athletes take anabolic steroids at doses that are much higher than those prescribed for medical reasons, and most of what is known about the drugs' effects on athletes comes from observing users. It is impossible for researchers to design studies that would accurately test the effects of large doses of steroids on athletes, because giving participants such high doses would be unethical. This means that the effects of taking anabolic steroids at very high doses haven't been well studied.
Anabolic steroids come with serious physical side effects as well.
Men may develop:
•Prominent breasts
•Baldness
•Shrunken testicles
•Infertility
Women may develop:
•A deeper voice
•An enlarged clitoris
•Increased body hair
•Baldness
Both men and women might experience:
•Severe acne
•Increased risk of tendinitis and tendon rupture
•Liver abnormalities and tumors
•Increased low-density lipoprotein (LDL) cholesterol (the "bad" cholesterol)
•Decreased high-density lipoprotein (HDL) cholesterol (the "good" cholesterol)
•Hypertension
•Heart and circulatory problems
•Suppression of the hypothalamic-pituitary-gonadal axis
•Prostate gland enlargement
•Aggressive behaviors, rage or violence
•Psychiatric disorders, such as depression
•Drug dependence
•Infections or diseases such as HIV or hepatitis if you're injecting the drugs
•Inhibited growth and development, and risk of future health problems in teenagers
Taking anabolic-androgenic steroids to enhance athletic performance, besides being prohibited by most sports organizations, is illegal. In the past 20 years, more effective law enforcement in the United States has pushed much of the illegal steroid industry into the black market. This poses additional health risks because the drugs are either made in other countries and smuggled in or made in clandestine labs in the United States. Either way, they aren't subject to government safety standards and could be impure or mislabeled.
Androstenedione
What is it?
Androstenedione (andro) is a hormone produced by the adrenal glands, ovaries and testes. It's a hormone that's normally converted to testosterone and estradiol in both men and women.
Andro is available in prescription and nonprescription forms. The prescription version is a controlled substance. Andro is also sold without a prescription as a nutritional supplement. Manufacturers and bodybuilding magazines tout its ability to allow athletes to train harder and recover more quickly. However, its use as a performance-enhancing drug is illegal in the United States.
Scientific studies that refute these claims show that supplemental androstenedione doesn't increase testosterone and that your muscles don't get stronger with andro use. In fact, almost all of the andro is rapidly converted to estrogen, the primary hormone in females.
Risks
Side effects of andro in men include:
•Acne
•Diminished sperm production
•Shrinking of the testicles
•Enlargement of the breasts
In women, side effects include:
•Acne
•Masculinization, such as deepening of the voice and male-pattern baldness
In both men and women, andro can decrease HDL cholesterol (the "good" cholesterol), which puts you at greater risk of heart attack and stroke.
Human growth hormone
What is it?
Human growth hormone, also known as gonadotropin, is a hormone that has an anabolic effect. Athletes take it to improve muscle mass and performance. However, it hasn't been shown conclusively to improve either strength or endurance. It is available only by prescription and is administered by injection.
Risks
Adverse effects related to human growth hormone range in severity and may include:
•Joint pain
•Muscle weakness
•Fluid retention
•Carpal tunnel syndrome
•Impaired glucose regulation
•Cardiomyopathy
•Hyperlipidemia
Erythropoietin
What is it?
Erythropoietin is a type of hormone used to treat anemia in people with severe kidney disease. It increases production of red blood cells and hemoglobin, resulting in improved movement of oxygen to the muscles. Epoetin, a synthetic form of erythropoietin, is commonly used by endurance athletes.
Risks
Erythropoietin use among competitive cyclists was common in the 1990s and allegedly contributed to at least 18 deaths. Inappropriate use of erythropoietin may increase the risk of thrombotic events, such as stroke, heart attack and pulmonary edema.
Diuretics
What are they?
Diuretics are drugs that change your body's natural balance of fluids and salts (electrolytes) and can lead to dehydration. This loss of water can decrease an athlete's weight, helping him or her to compete in a lighter weight class, which many athletes prefer. Diuretics may also help athletes pass drug tests by diluting their urine and are sometimes referred to as a "masking" agent.
Risks
Diuretics taken an any dose, even medically recommended doses, predispose athletes to adverse effects such as:
•Dehydration
•Muscle cramps
•Exhaustion
•Dizziness
•Potassium deficiency
•Heart arrhythmias
•Drop in blood pressure
•Heatstroke
•Death
Creatine
What is it?
Many athletes take nutritional supplements instead of or in addition to performance-enhancing drugs. Supplements are available over-the-counter as powders or pills.
The most popular supplement among athletes is probably creatine monohydrate. Creatine is a naturally occurring compound produced by your body that helps your muscles release energy.
Scientific research indicates that creatine may have some athletic benefit by producing small gains in short-term bursts of power. Creatine appears to help muscles make more adenosine triphosphate (ATP), which stores and transports energy in cells, and is used for quick bursts of activity, such as weightlifting or sprinting. There's no evidence, however, that creatine enhances performance in aerobic or endurance sports.
Your liver produces about 0.07 ounces (2 grams) of creatine each day. You also get creatine from the meat in your diet. Creatine is stored in your muscles, and levels are relatively easily maintained. Because your kidneys remove excess creatine, the value of supplements to someone who already has adequate muscle creatine content is questionable.
Risks
Supplements are considered food and not drugs by the FDA. This means supplement manufacturers are not required to conform to the same standards as drug manufacturers do. In some cases, supplements have been found to be contaminated with other substances, which may inadvertently lead to a positive test for performance-enhancing drugs.
Possible side effects of creatine that can decrease athletic performance include:
•Stomach cramps
•Muscle cramps
•Nausea
•Diarrhea
•Weight gain
Weight gain is sought after by athletes who want to increase their size. But with prolonged creatine use, weight gain is more likely the result of water retention than an increase in muscle mass. Water is drawn into your muscle tissue, away from other parts of your body. This puts you at risk of dehydration.
High-dose creatine use may potentially damage your:
•Kidneys
•Liver
It appears safe for adults to use creatine at the doses recommended by manufacturers. But it's unknown what kind of effect taking creatine has over the long term, especially in teens and children.
Stimulants
What are they?
Some athletes use stimulants to stimulate the central nervous system and increase heart rate and blood pressure.
Stimulants can:
•Improve endurance
•Reduce fatigue
•Suppress appetite
•Increase alertness and aggressiveness
Common stimulants include caffeine and amphetamines. Cold remedies often contain the stimulants ephedrine or pseudoephedrine hydrochloride. The street drugs cocaine and methamphetamine also are stimulants.
Risks
Although stimulants can boost physical performance and promote aggressiveness on the field, they have side effects that can impair athletic performance.
•Nervousness and irritability make it hard to concentrate on the game.
•Insomnia can prevent an athlete from getting needed sleep.
•Dehydration
•Heatstroke
•Athletes may become psychologically addicted or develop a tolerance so that they need greater amounts to achieve the desired effect, meaning they'll take doses that are much higher than the intended medical dose.
Other side effects include:
•Heart palpitations
•Heart rhythm abnormalities
•Weight loss
•Tremors
•Mild hypertension
•Hallucinations
•Convulsions
•Stroke
•Heart attack and other circulatory problems
The bottom line
Do performance-enhancing drugs boost performance? Some athletes may appear to achieve physical gains from such drugs, but at what cost? The long-term effects of performance-enhancing drugs haven't been rigorously studied. And short-term benefits are tempered by many risks. Not to mention that doping is prohibited by most sports organizations. No matter how you look at it, using performance-enhancing drugs is risky business.
But using performance-enhancing drugs — aka, doping — isn't without risks. Take the time to learn about the potential benefits, the health risks and the many unknowns regarding so-called performance-enhancing drugs such as anabolic steroids, androstenedione, human growth hormone, erythropoietin, diuretics, creatine and stimulants. You may decide that the benefits aren't worth the risks.
Anabolic steroids
What are they?
Some athletes take a form of steroids — known as anabolic-androgen steroids or just anabolic steroids — to increase their muscle mass and strength. The main anabolic steroid hormone produced by your body is testosterone.
Testosterone has two main effects on your body:
•Anabolic effects promote muscle building.
•Androgenic effects are responsible for male traits, such as facial hair and a deeper voice.
Some athletes take straight testosterone to boost their performance. Frequently, the anabolic steroids that athletes use are synthetic modifications of testosterone. These hormones have approved medical uses, though improving athletic performance is not one of them. They can be taken as pills, injections or topical treatments.
Why are these drugs so appealing to athletes? Besides making muscles bigger, anabolic steroids may help athletes recover from a hard workout more quickly by reducing the muscle damage that occurs during the session. This enables athletes to workout harder and more frequently without overtraining. In addition, some athletes may like the aggressive feelings they get when they take the drugs.
Designer steroids
A particularly dangerous class of anabolic steroids are the so-called "designer" drugs — synthetic steroids that have been illicitly created to be undetectable by current drug tests. They are made specifically for athletes and have no approved medical use. Because of this, they haven't been tested or approved by the Food and Drug Administration (FDA) and represent a particular health threat to athletes.
Risks
Many athletes take anabolic steroids at doses that are much higher than those prescribed for medical reasons, and most of what is known about the drugs' effects on athletes comes from observing users. It is impossible for researchers to design studies that would accurately test the effects of large doses of steroids on athletes, because giving participants such high doses would be unethical. This means that the effects of taking anabolic steroids at very high doses haven't been well studied.
Anabolic steroids come with serious physical side effects as well.
Men may develop:
•Prominent breasts
•Baldness
•Shrunken testicles
•Infertility
Women may develop:
•A deeper voice
•An enlarged clitoris
•Increased body hair
•Baldness
Both men and women might experience:
•Severe acne
•Increased risk of tendinitis and tendon rupture
•Liver abnormalities and tumors
•Increased low-density lipoprotein (LDL) cholesterol (the "bad" cholesterol)
•Decreased high-density lipoprotein (HDL) cholesterol (the "good" cholesterol)
•Hypertension
•Heart and circulatory problems
•Suppression of the hypothalamic-pituitary-gonadal axis
•Prostate gland enlargement
•Aggressive behaviors, rage or violence
•Psychiatric disorders, such as depression
•Drug dependence
•Infections or diseases such as HIV or hepatitis if you're injecting the drugs
•Inhibited growth and development, and risk of future health problems in teenagers
Taking anabolic-androgenic steroids to enhance athletic performance, besides being prohibited by most sports organizations, is illegal. In the past 20 years, more effective law enforcement in the United States has pushed much of the illegal steroid industry into the black market. This poses additional health risks because the drugs are either made in other countries and smuggled in or made in clandestine labs in the United States. Either way, they aren't subject to government safety standards and could be impure or mislabeled.
Androstenedione
What is it?
Androstenedione (andro) is a hormone produced by the adrenal glands, ovaries and testes. It's a hormone that's normally converted to testosterone and estradiol in both men and women.
Andro is available in prescription and nonprescription forms. The prescription version is a controlled substance. Andro is also sold without a prescription as a nutritional supplement. Manufacturers and bodybuilding magazines tout its ability to allow athletes to train harder and recover more quickly. However, its use as a performance-enhancing drug is illegal in the United States.
Scientific studies that refute these claims show that supplemental androstenedione doesn't increase testosterone and that your muscles don't get stronger with andro use. In fact, almost all of the andro is rapidly converted to estrogen, the primary hormone in females.
Risks
Side effects of andro in men include:
•Acne
•Diminished sperm production
•Shrinking of the testicles
•Enlargement of the breasts
In women, side effects include:
•Acne
•Masculinization, such as deepening of the voice and male-pattern baldness
In both men and women, andro can decrease HDL cholesterol (the "good" cholesterol), which puts you at greater risk of heart attack and stroke.
Human growth hormone
What is it?
Human growth hormone, also known as gonadotropin, is a hormone that has an anabolic effect. Athletes take it to improve muscle mass and performance. However, it hasn't been shown conclusively to improve either strength or endurance. It is available only by prescription and is administered by injection.
Risks
Adverse effects related to human growth hormone range in severity and may include:
•Joint pain
•Muscle weakness
•Fluid retention
•Carpal tunnel syndrome
•Impaired glucose regulation
•Cardiomyopathy
•Hyperlipidemia
Erythropoietin
What is it?
Erythropoietin is a type of hormone used to treat anemia in people with severe kidney disease. It increases production of red blood cells and hemoglobin, resulting in improved movement of oxygen to the muscles. Epoetin, a synthetic form of erythropoietin, is commonly used by endurance athletes.
Risks
Erythropoietin use among competitive cyclists was common in the 1990s and allegedly contributed to at least 18 deaths. Inappropriate use of erythropoietin may increase the risk of thrombotic events, such as stroke, heart attack and pulmonary edema.
Diuretics
What are they?
Diuretics are drugs that change your body's natural balance of fluids and salts (electrolytes) and can lead to dehydration. This loss of water can decrease an athlete's weight, helping him or her to compete in a lighter weight class, which many athletes prefer. Diuretics may also help athletes pass drug tests by diluting their urine and are sometimes referred to as a "masking" agent.
Risks
Diuretics taken an any dose, even medically recommended doses, predispose athletes to adverse effects such as:
•Dehydration
•Muscle cramps
•Exhaustion
•Dizziness
•Potassium deficiency
•Heart arrhythmias
•Drop in blood pressure
•Heatstroke
•Death
Creatine
What is it?
Many athletes take nutritional supplements instead of or in addition to performance-enhancing drugs. Supplements are available over-the-counter as powders or pills.
The most popular supplement among athletes is probably creatine monohydrate. Creatine is a naturally occurring compound produced by your body that helps your muscles release energy.
Scientific research indicates that creatine may have some athletic benefit by producing small gains in short-term bursts of power. Creatine appears to help muscles make more adenosine triphosphate (ATP), which stores and transports energy in cells, and is used for quick bursts of activity, such as weightlifting or sprinting. There's no evidence, however, that creatine enhances performance in aerobic or endurance sports.
Your liver produces about 0.07 ounces (2 grams) of creatine each day. You also get creatine from the meat in your diet. Creatine is stored in your muscles, and levels are relatively easily maintained. Because your kidneys remove excess creatine, the value of supplements to someone who already has adequate muscle creatine content is questionable.
Risks
Supplements are considered food and not drugs by the FDA. This means supplement manufacturers are not required to conform to the same standards as drug manufacturers do. In some cases, supplements have been found to be contaminated with other substances, which may inadvertently lead to a positive test for performance-enhancing drugs.
Possible side effects of creatine that can decrease athletic performance include:
•Stomach cramps
•Muscle cramps
•Nausea
•Diarrhea
•Weight gain
Weight gain is sought after by athletes who want to increase their size. But with prolonged creatine use, weight gain is more likely the result of water retention than an increase in muscle mass. Water is drawn into your muscle tissue, away from other parts of your body. This puts you at risk of dehydration.
High-dose creatine use may potentially damage your:
•Kidneys
•Liver
It appears safe for adults to use creatine at the doses recommended by manufacturers. But it's unknown what kind of effect taking creatine has over the long term, especially in teens and children.
Stimulants
What are they?
Some athletes use stimulants to stimulate the central nervous system and increase heart rate and blood pressure.
Stimulants can:
•Improve endurance
•Reduce fatigue
•Suppress appetite
•Increase alertness and aggressiveness
Common stimulants include caffeine and amphetamines. Cold remedies often contain the stimulants ephedrine or pseudoephedrine hydrochloride. The street drugs cocaine and methamphetamine also are stimulants.
Risks
Although stimulants can boost physical performance and promote aggressiveness on the field, they have side effects that can impair athletic performance.
•Nervousness and irritability make it hard to concentrate on the game.
•Insomnia can prevent an athlete from getting needed sleep.
•Dehydration
•Heatstroke
•Athletes may become psychologically addicted or develop a tolerance so that they need greater amounts to achieve the desired effect, meaning they'll take doses that are much higher than the intended medical dose.
Other side effects include:
•Heart palpitations
•Heart rhythm abnormalities
•Weight loss
•Tremors
•Mild hypertension
•Hallucinations
•Convulsions
•Stroke
•Heart attack and other circulatory problems
The bottom line
Do performance-enhancing drugs boost performance? Some athletes may appear to achieve physical gains from such drugs, but at what cost? The long-term effects of performance-enhancing drugs haven't been rigorously studied. And short-term benefits are tempered by many risks. Not to mention that doping is prohibited by most sports organizations. No matter how you look at it, using performance-enhancing drugs is risky business.
Stretching: Focus on Flexibility
Stretching: Focus on flexibility
You can stretch anytime, anywhere. Just follow these tips to do it safely and effectively.
By Mayo Clinic staff
Stretching may take a back seat to your exercise routine. You may think that stretching your hamstrings and calves is just something to be done if you have a few extra minutes before or after pounding out some miles on the treadmill. The main concern is exercising, not stretching, right?
Not so fast. Although studies about the benefits of stretching are mixed, stretching may help you improve your flexibility, which in turn may improve your athletic performance and decrease your risk of injury. Understand why stretching can help — and how to stretch correctly.
Benefits of stretching
Studies about the benefits of stretching have had mixed results. Some show that stretching helps, while others show that stretching has little if any benefit. The main benefits of stretching are thought to be:
•Improving athletic performance
•Decreasing the risk of activity-based injuries
Stretching can help improve flexibility. And better flexibility may improve your performance in physical activities or decrease your risk of injuries by helping your joints move through their full range of motion. For instance, say your Achilles tendon is tight and lacks flexibility. If you do a lot of hill walking, your foot may not move through its full range of motion. Over time, this can increase your risk of tendinitis or tendinopathy in your Achilles tendon. Stretching your Achilles tendon, though, may improve the range of motion in your ankle. This, in turn, can decrease the risk of microtrauma to your tendon that can lead to overload and injury.
Stretching also increases blood flow to the muscle. And you may come to enjoy the ritual of stretching before — or better yet, after — hitting the trail, ballet floor or soccer field.
Stretching essentials
Before you plunge into stretching, make sure you do it safely and effectively. While you can stretch anytime, anywhere — in your home, at work, in a hotel room or at the park — you want to be sure to use proper technique. Stretching incorrectly can actually do more harm than good.
Use these tips to keep stretching safe:
•Don't consider stretching a warm-up. You may hurt yourself if you stretch cold muscles. So before stretching, warm up with light walking, jogging or biking at low intensity for five to 10 minutes. Or better yet, stretch after you exercise when your muscles are warmed up. Also, consider holding off on stretching before an intense activity, such as sprinting or track and field activities. Some research suggests that pre-event stretching before these types of events may actually decrease performance.
•Focus on major muscle groups. When you're stretching, focus on your calves, thighs, hips, lower back, neck and shoulders. Also stretch muscles and joints that you routinely use at work or play. And make sure that you stretch both sides. For instance, if you stretch your left hamstring, be sure to stretch your right hamstring, too.
•Don't bounce. Bouncing as you stretch can cause small tears in the muscle. These tears leave scar tissue as the muscle heals, which tightens the muscle even further, making you less flexible and more prone to pain. So, hold each stretch for about 30 seconds. Repeat each stretch three or four times.
•Don't aim for pain. Expect to feel tension while you're stretching, not pain. If it hurts, you've pushed too far. Back off to the point where you don't feel any pain, then hold the stretch.
•Make stretches sport specific. Some evidence suggests that it's helpful to do stretches tailored for your sport or activity. If you play soccer, for instance, you're more vulnerable to hamstring strains. So opt for stretches that help your hamstrings.
•Keep up with your stretching. Stretching can be time-consuming. But you can achieve the best benefits by stretching regularly, at least two to three times a week. If you don't stretch regularly, you risk losing any benefits that stretching offered. For instance, if stretching helped you increase your range of motion, and you stop stretching, your range of motion may decrease again.
•Bring movement into your stretching. Gentle movement can help you be more flexible in specific movements. The gentle movements of tai chi, for instance, may be a good way to stretch. And if you're going to perform a specific activity, such as a front kick in martial arts, do the move slowly and at low intensity at first to get your muscles used to it. Then speed up gradually as your muscles become accustomed to the motion.
Know when to exercise caution
In some cases, you may need to approach stretching with caution. If you have a chronic condition or an injury, you may need to adjust your stretching techniques. For example, if you already have a strained muscle, stretching it may cause further harm.
Also, don't think that because you stretch you can't get injured. Stretching, for instance, won't prevent an overuse injury. Talk to your doctor or physical therapist about the best way to stretch if you have any health concerns.
You can stretch anytime, anywhere. Just follow these tips to do it safely and effectively.
By Mayo Clinic staff
Stretching may take a back seat to your exercise routine. You may think that stretching your hamstrings and calves is just something to be done if you have a few extra minutes before or after pounding out some miles on the treadmill. The main concern is exercising, not stretching, right?
Not so fast. Although studies about the benefits of stretching are mixed, stretching may help you improve your flexibility, which in turn may improve your athletic performance and decrease your risk of injury. Understand why stretching can help — and how to stretch correctly.
Benefits of stretching
Studies about the benefits of stretching have had mixed results. Some show that stretching helps, while others show that stretching has little if any benefit. The main benefits of stretching are thought to be:
•Improving athletic performance
•Decreasing the risk of activity-based injuries
Stretching can help improve flexibility. And better flexibility may improve your performance in physical activities or decrease your risk of injuries by helping your joints move through their full range of motion. For instance, say your Achilles tendon is tight and lacks flexibility. If you do a lot of hill walking, your foot may not move through its full range of motion. Over time, this can increase your risk of tendinitis or tendinopathy in your Achilles tendon. Stretching your Achilles tendon, though, may improve the range of motion in your ankle. This, in turn, can decrease the risk of microtrauma to your tendon that can lead to overload and injury.
Stretching also increases blood flow to the muscle. And you may come to enjoy the ritual of stretching before — or better yet, after — hitting the trail, ballet floor or soccer field.
Stretching essentials
Before you plunge into stretching, make sure you do it safely and effectively. While you can stretch anytime, anywhere — in your home, at work, in a hotel room or at the park — you want to be sure to use proper technique. Stretching incorrectly can actually do more harm than good.
Use these tips to keep stretching safe:
•Don't consider stretching a warm-up. You may hurt yourself if you stretch cold muscles. So before stretching, warm up with light walking, jogging or biking at low intensity for five to 10 minutes. Or better yet, stretch after you exercise when your muscles are warmed up. Also, consider holding off on stretching before an intense activity, such as sprinting or track and field activities. Some research suggests that pre-event stretching before these types of events may actually decrease performance.
•Focus on major muscle groups. When you're stretching, focus on your calves, thighs, hips, lower back, neck and shoulders. Also stretch muscles and joints that you routinely use at work or play. And make sure that you stretch both sides. For instance, if you stretch your left hamstring, be sure to stretch your right hamstring, too.
•Don't bounce. Bouncing as you stretch can cause small tears in the muscle. These tears leave scar tissue as the muscle heals, which tightens the muscle even further, making you less flexible and more prone to pain. So, hold each stretch for about 30 seconds. Repeat each stretch three or four times.
•Don't aim for pain. Expect to feel tension while you're stretching, not pain. If it hurts, you've pushed too far. Back off to the point where you don't feel any pain, then hold the stretch.
•Make stretches sport specific. Some evidence suggests that it's helpful to do stretches tailored for your sport or activity. If you play soccer, for instance, you're more vulnerable to hamstring strains. So opt for stretches that help your hamstrings.
•Keep up with your stretching. Stretching can be time-consuming. But you can achieve the best benefits by stretching regularly, at least two to three times a week. If you don't stretch regularly, you risk losing any benefits that stretching offered. For instance, if stretching helped you increase your range of motion, and you stop stretching, your range of motion may decrease again.
•Bring movement into your stretching. Gentle movement can help you be more flexible in specific movements. The gentle movements of tai chi, for instance, may be a good way to stretch. And if you're going to perform a specific activity, such as a front kick in martial arts, do the move slowly and at low intensity at first to get your muscles used to it. Then speed up gradually as your muscles become accustomed to the motion.
Know when to exercise caution
In some cases, you may need to approach stretching with caution. If you have a chronic condition or an injury, you may need to adjust your stretching techniques. For example, if you already have a strained muscle, stretching it may cause further harm.
Also, don't think that because you stretch you can't get injured. Stretching, for instance, won't prevent an overuse injury. Talk to your doctor or physical therapist about the best way to stretch if you have any health concerns.
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