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Competitive Edge: Fall 2013


Acupuncture Beneficial for Lingering Concussion Symptoms

By Jamie Starkey, LAc

If you think you may have suffered a concussion, it is crucial to seek medical attention immediately. When concussion symptoms linger, care from different medical specialties — including integrative medicine — may help.

The initial symptoms of concussion are headache, nausea, balance problems, fatigue, sensitivity to light or noise, trouble concentrating or paying attention, and feeling “just not right” or “in a fog.” Sometimes symptoms can linger for days, weeks, months and even years, leading to post-concussion syndrome.

A team approach to concussions

Athletes, especially those involved in contact sports, are at high risk for sustaining concussions. Physicians in the Cleveland Clinic Concussion Center (from Cleveland Clinic Sports Health, the Neurological Institute, the Orthopaedic & Rheumatologic Institute and the Pediatric Institute) use a multidisciplinary, comprehensive plan of care for concussion evaluation and management.

The Center for Integrative Medicine has a unique relationship with Cleveland Clinic Sports Health physicians. Sports health physicians may prescribe traditional treatments for post-concussion syndrome, such as medications, physical therapy, speech pathology, neuropsychology and behavioral psychotherapy.

Adding acupuncture to the mix

They also may encourage certain patients to try another integrative treatment option: acupuncture. Patients looking to expedite their recovery, or who have not seen much progress with conventional treatments, may find the relief they are looking for through acupuncture. Skilled acupuncturists in our Center for Integrative Medicine can address these post-concussion syndrome symptoms:

  • Lingering headache
  • Persistent dizziness
  • Insomnia
  • Unrelieved neck pain
  • Anxiety/depression
  • Fatigue

Acupuncture involves gently inserting very fine needles to stimulate or calm certain areas of the body, promoting a healing effect. During the first acupuncture appointment, the center acupuncturist performs a detailed assessment and suggests a treatment plan based on these findings.

Shared visits reduce costs

The plan may involve regular acupuncture visits to decrease overall symptoms, including pain scores if pain persists. Shared medical appointments (SMAs) for acupuncture are an economical option, allowing you to experience its proven benefits at a reduced cost.

Individual appointments are $100, and insurance coverage for them varies. SMAs for acupuncture are $40.

Jamie Starkey, LAc, is the lead acupuncturist at the Center for Integrative Medicine. For more information, or to schedule an appointment, call 877.440.TEAM.


5 Tips for Dressing for Cold Weather Exercise

By Elizabeth Sprogis, MA

Did you know?

Understanding Core Temperature

A drop in your body’s core temperature causes:

  • A decrease in blood flow to the skin
  • An increase in heat production through shivering
  • Lowered dexterity that can inhibit performance in activities that require catching, throwing or marksmanship
  • An increased amount of energy needed by the body at a given exercise intensity

The mercury may be falling, but that doesn’t mean you have to sideline your outdoor workout for the winter. A little preparation can go a long way toward full enjoyment and high performance levels during colder weather.

Proper attire can help you maintain your core body temperature and reduce cold weather-related risks. Keep these five tips in mind to make sure Jack Frost doesn’t sideline your sport this season:

1. Layers, layers, layers!
Layering is your best winter sports strategy. The layer closest to your skin should be a moisture-wicking material, like lightweight polyester or polypropylene, to take moisture away from your skin to the outer layers to evaporate. The second layer is the insulating layer, which should be wool or polyester fleece. The third, outer layer ought to be wind and rain repellent. When exercising in the cold, this third layer should be removed unless it is raining, snowing or very windy. If worn during exercise, this layer can trap sweat and not allow for proper evaporation. You can always put the top layer back on during any outdoor rest times.

2. Cover your head
Be sure to cover your head with a hat or helmet to decrease heat loss.

3. Mittens or gloves?
If finger dexterity is not important for your cold weather activity of choice, wear mittens instead of gloves. If gloves are necessary, consider wearing a thin liner under the gloves for better insulation.

4. Protect your feet
Dry, warm feet are essential for decreasing the risk of a cold weather injury and preventing blisters. Socks should wick moisture away from your feet to your boot. Avoid cotton socks. Cotton keeps moisture next to the skin. More appropriate fabrics include wool or synthetic fibers with a moisture-wicking capability.

5. Don’t forget about fit
If you layer socks, be sure the boot is large enough to ensure proper circulation.

Besides your choice in clothing, other factors to consider in preparing for cold weather exercise are age and fitness level.

People over 60 years of age as well as children are at an increased risk of hypothermia. These populations should use extra caution when being active outside in the cold. Be sure to follow the above tips and avoid getting wet by keeping hats and gloves on at all times.

While a higher physical fitness level does not directly improve the body’s ability to regulate temperature in the cold, it can allow people to exercise for longer periods of time at a higher intensity, which can help maintain core body temperature.

Elizabeth Sprogis, MA, is an exercise physiologist with Cleveland Clinic Sports Health. She can help individuals of any age improve their wellness and sports performance, and set goals. For more information or to schedule an appointment, call 877.440.TEAM.


Strength Training: An Important Part of an Exercise Routine

By Tom Iannetta, ATC, CSCS

Most exercise programs consist of aerobic conditioning, flexibility exercises and strength training. In strength training, resistance is added to the particular movement in order for muscles to be overloaded, thus working harder and becoming stronger.

There are many benefits to strength training, including increased muscle tone, strength, endurance and bone density. Strength training also improves balance and coordination and decreases the risk of injury when you are active.

As we age, we lose muscle mass which decreases metabolism, so establishing a strength program will not only increase muscle, it will boost metabolism. Finally, a strength program will make daily activities such as doing the laundry or yard work easier, and of course, it will increase your performance in your favorite sport.

The most common strength training routines involve free weights such as weight plates added to barbells, fixed barbells, dumbbells, kettlebells and medicine balls to name a few. Weight machines are another option as well as body weight exercises such as push-ups and pull-ups.

Getting Started

The number one factor to consider when beginning a strength training program is safety. Check with your physician prior to starting a strength training routine. As noted, there are many benefits to strength training, but performing the exercises incorrectly will put you at risk for injury.

If you are a member of a fitness center, health club or recreation center, you can ask the staff for guidance on how to use the strength machines. Many people prefer to do their strength program at home, so before beginning, it would be beneficial to consult with a strength and conditioning specialist. He or she can help you develop a safe program that uses the proper lifting techniques.

A general guideline for improving strength is to exercise each major muscle group at least twice a week. This could be performed as a whole body workout or by doing a split routine performing upper body exercises twice a week, then lower body exercises twice a week. Be sure to give yourself proper rest between strength training sessions. Always begin with a light warm up such as riding a stationary bike or an elliptical machine; 5 to 10 minutes should be sufficient.

Three sets of an exercise with 8 to 12 repetitions has been a long-time standard for an effective strength program. However, finding time to exercise may be a challenge, and recent research shows that many people see results with one or two sets of 8 to 15 repetitions of a particular exercise. Pushing the muscle to fatigue is a key factor. Choose a weight that is heavy enough to fatigue your muscles in 8 to 15 repetitions. As exercise becomes easier, you can progressively increase the amount of resistance.

Finally, as you get stronger in your strength-training program, try varying the exercises you perform. Different exercises or varying the weight training equipment in your routine should keep your program fresh and exciting.

Tom Iannetta ATC, CSCS, is a Senior Athletic Trainer with Cleveland Clinic Sports Health and a certified Strength and Conditioning Specialist. He also serves at the Head Athletic Trainer for Brecksville-Broadview Heights High School. For more information, or to schedule an appointment, call 877.440.TEAM.


Benefits of Omega-3 Foods for Athletes

By Katherine Patton, MEd, RD, CSSD, LD

Chances are you’ve been hearing about omega-3 fatty acids. Whether you’ve heard them talked about in the news or have seen them listed as an ingredient in your breakfast cereal, omega-3 continues to be a trendy topic thanks to a plethora of research touting its benefits. Omega-3 fatty acids have been shown to reduce risk of heart disease and arthritis. One of the key benefits is their ability to act as an anti-inflammatory.

Exercise is a form of good stress on our bodies, but it does result in the production of inflammatory substances known as free radicals. Omega-3 fatty acids help by counteracting inflammation and reducing joint pain and tenderness associated with arthritis. It also helps to keep the lining of arteries smooth and clear allowing for the maximal amount of oxygen-rich blood to be transported to working muscles.

If you are still questioning if it is worthwhile to incorporate omega-3 fats into your diet, the answer is yes. Omega-3 fatty acids are part of the polyunsaturated fat family. They are essential fats, which mean our bodies cannot manufacture them, so we must obtain them through dietary sources. There are three types of omega-3 fatty acids, which come from different dietary sources. Let’s take a look at these types and sources and how much you should have to potentially help you.

Two sources of omega-3 fats are commonly abbreviated EPA and DHA. The best dietary sources of EPA and DHA are fish, however certain fish are richer in EPA and DHA than others. Salmon, herring, sardines, mackerel, bluefin tuna and albacore tuna are excellent sources of omega-3 fats. Don’t like fish? Fish oil supplements are an alternative. The third source of omega-3 fat is ALA. ALA is converted to EPA and DHA in the body so it needs to be consumed in higher amounts to receive the same benefits as fish. ALA comes from plant sources such as flaxseed, walnuts, canola oil and soy.

You can meet your daily omega-3 fat needs by:

  • Eating at least 3 ounces of omega-3 rich fish twice per week. After a strenuous workout, choose it as part of your recovery meal.
  • Adding 2 tablespoons of ground flaxseed to your hot cereal or smoothie each day
  • Adding 1 ounce of walnuts to a salad and yogurt or eating them alone as a snack
  • Taking a daily fish oil supplement that contains 600 to 1,000 milligrams EPA + DHA

Katherine Patton, MEd, RD, CSSD, LD, is a Certified Specialist in Sports Dietetics for Cleveland Clinic Sports Health. For more information, or to schedule an appointment, call 877.440.TEAM.


Yoga for Athletes: A Game Plan for Chronic Pain

By Judi Bar, E-RYT 500

An ancient practice from India, yoga is becoming recognized as an effective complement to traditional Western medicine. Growing research is highlighting yoga’s ability to relieve stress and chronic pain. Most of us know that yoga is a physical practice, but what sets it apart from other forms of exercise is its emphasis on awareness and breathing. Slowing and controlling the breath activates the body’s automatic nervous system, which helps reduce anxiety and stress – two key factors in chronic pain.

Athletes face many common types of injuries and pain. Repetitive motion can create imbalances, which produce tightness in some muscles and weakness in others. This imbalance is a major factor in the development of chronic pain. Cyclists and runners typically have tight hips and hamstrings, golfers and tennis players develop knee and shoulder problems, and many athletes experience low back pain. Lack of core strength also contributes to back problems and poor balance.

If you are experiencing pain, you should first see your doctor to find out what is causing the pain and learn what you can and cannot do in terms of exercise. You should not be practicing yoga if your injury is recent (acute). For easing injuries and chronic pain, you will want to find a certified yoga therapist. These specialists have additional training in the use of yoga techniques to help address specific weakness, injury or pain. You will be seen in a one-on-one setting instead of in a class to best identify and treat your individual problems. Along with physical postures, you will learn techniques to help alleviate pain and stress by activating the body’s innate relaxation response through mindful breathing.

Just because you can’t wrap your ankle behind your head doesn’t mean you can’t add the benefits of yoga to your workout. In fact, yoga can enhance your athletic performance by helping you to be aware of your movements, build better balance, calm your breath to increase mental focus, and help alleviate the pain of chronic injury. Better yet, add a regular yoga practice to your fitness routine so you can continue to participate in your favorite sports.

Lead Yoga Therapist Judi Bar, E-RYT 500, is the Yoga Program Manager for Cleveland Clinic. At the age of 45 and after a lifelong career in ballet, she became bedridden with spinal stenosis, arthritis and degenerative disc disease. Not willing to face surgery and life in a wheelchair, she turned to yoga. For more information, or to schedule an appointment, call 216.986.HEAL.

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This information is provided by Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.

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