Cramer Sports Med.

THE FIRST AIDER

Risks for many football players go beyond impact: Diabetes and heart disease among long-term threats to linemen

In sports medicine news, the risks and dangers of concussion, particularly among football players, is a topic that has recently received a great deal of attention-for good reason. But there's another health risk of concern for Division I and professional football players-especially the big, burly linebacker types. These athletes shield the quarterback from would-be tacklers, but their "super size" is one of the reasons they face serious health threats. And exercise alone won't solve the problem, according to new research from the American College of Sports Medicine.

Two-thirds of Division I linemen studied were obese, putting them at significant risk for metabolic syndrome and insulin resistance compared with players at other positions. High levels of physical activity-shown to help prevent obesity, diabetes and other chronic diseases-weren't enough to counteract the health threats brought on by the linemen's weight and lifestyle factors, researchers found. The study is the first to report on the prevalence of the metabolic syndrome and insulin resistance in a large cohort of Division I collegiate football players.

"These findings are consistent with a recent study showing retired NFL linemen were twice as likely to develop metabolic syndrome as were players of other positions," said lead researcher James R. Borchers, M.D. "Given the serious health consequences of these conditions, we need to study college football players over time, and counsel them about managing their health risks."

Borchers pointed out that while this study revealed similarities between Division I linemen and their professional NFL counterparts, the comparison may not apply to football players at Division II and Division III schools.

The study measured 90 football players, grouping them according to positions played. Group A comprised offensive and defensive linemen; Group B included wide receivers and defensive backs, and Group C consisted of tight ends, linebackers, quarterbacks, punters and kickers. Participants were measured for body composition, blood pressure, insulin level, cholesterol and other factors. Eight percent were overweight (20-25 percent body fat) and 21 percent (all linemen) were obese, with at least 25 percent body fat. Twenty-one percent of participants were found to have insulin resistance, a condition associated with coronary artery disease and diabetes.

Forty-two percent of obese participants had metabolic syndrome, defined as showing abnormality in at least three of the following five measures:

Triglyceride

HDL-C

Abdominal obesity

Glucose

Blood pressure

Metabolic syndrome is thought by some to be a more significant risk factor than tobacco use in the future development of coronary artery disease. While high levels of physical activity reduce the rate of metabolic syndrome among adolescents, the relationship between activity and metabolic syndrome in obese adults is unclear. Today's Division I football players have significantly higher body fat and total body mass than their counterparts of the 1980s and '90s, giving rise to additional concerns about their long-term health.

Two-thirds of Division I linemen studied were obese, putting them at significant risk for metabolic syndrome and insulin resistance compared with players at other positions.

Profile of Vince Stilger, HSD, ATC

As a student at Lanesville High School in Lanesville, Indiana, Vince Stilger played baseball and was the basketball team's statistician. (The school didn't have-and still doesn't have-a football team!) During his junior year, the basketball coach invited Vince to attend a weekend athletic training student workshop in a nearby town. Though Vince didn't know what athletic training was, he was honored with the invitation, and found it extremely interesting. So as a senior, Vince was an athletic training student for the basketball team. "I knew it was my career path," he says. "I loved sports, and discovered an interest in medicine, too."

Vince received a B.S. in Heath and Safety Education and Athletic Training from Indiana State in 1980, and a Master's from ISU in 1981. From 1981-1985 he was an athletic trainer and assistant professor at St. Joseph's College in Rensselaer, Indiana. He returned to ISU from 1985-1990 as head athletic trainer and assistant professor, and in 1988 was named athletic training program director.

In 1991, Vince pursued a doctorate at Indiana University, receiving a Health and Safety Doctorate in School and College Health Education in 1993. He also worked with the IU football team. He joined his current employer, West Virginia University, in 1994 as undergraduate athletic training program director and associate professor. He also assists with WVU football.

While head athletic trainer at ISU in 1988, Vince was asked to be head athletic trainer for Indiana Special Olympics. He enthusiastically agreed, loved it, and has filled that role ever since. "I return to Indiana every summer to work with Special Olympics," he says. "It's a way of giving back to my home state and is exceptionally rewarding"

Vince's long list of wonderful professional experiences includes the U.S. luge team European World Cup Tour in 1989; the track and field team, 1996 U.S. Paralympic Games in Atlanta; the field hockey team, 1996 Olympic Games in Atlanta; and the U.S. Special Olympics Great Lakes Region team, 2003 World Games in Dublin.

Vince is pleased that athletic training has shifted from focusing only on returning athletes to play, to recognizing medical conditions and helping prevent chronic problems. "We help athletes-professionals, amateurs, and anyone that is physically fit-learn to listen to their bodies. Athletic trainers create awareness that health issues cannot be ignored, because minor problems may become acute and debilitating." His wisdom for athletic training students: "You can't be afraid of long hours, hard work, or getting your hands dirty. You must like and relate to a wide variety of people and have a good personality. You've gotta be flexible and manage your time."

As a member of the Governmental Affairs Committee of the WVATA, Vince is working with the state legislature to pass an athletic training regulatory bill. And last year, he was invited to join Cramer's Athletic Trainer Advisory Council.

Vince loves woodworking, golf, yard work, softball, and the St. Louis Cardinals. Last summer, he bought a Harley, and he and his wife look forward to riding it this summer!

Vince's wisdom for athletic training students: "You can't be afraid of long hours, hard work, or getting your hands dirty. You must like and relate to a wide variety of people and have a good personality. You've gotta be flexible and manage your time."

Team sports participation may increase the likelihood of drinking and fighting in male teens...but seems to decrease the likelihood of smoking

Contradicting conventional wisdom, participation in team sports doesn't necessarily result in teenage boys adopting healthier behaviors. Recent research finds it is associated with an increased likelihood to fight and drink.

The study, led by researcher Susan M. Connor, Ph.D., manager of the injury prevention program at Rainbow Babies & Children's Hospital in Cleveland, was presented at the American Public Health Association's annual meeting this past November. The researchers examined the responses of more than 13,000 high school students who participated in the 2007 Youth Risk Behavioral Study, an assessment of adolescent high-risk behaviors conducted by the Centers for Disease Control and Prevention.

Of the male respondents, 60.5 percent reported participation in team sports in the past
year. These male teens were slightly more likely to indicate involvement in fighting, drinking, and binge drinking than the male teens not involved with team sports. However, participation in team sports was also associated with decreased levels of depression and smoking. Respondents were not asked which sports they played.

Of the female high school students, 48 percent reported participation on one or more sports team in the past year. For this group, sports team participation was associated with decreased levels of fighting, depression, smoking, marijuana use, and unhealthy weight loss practices. There was no association between sports team participation and drinking for female students.

"Sports team participation appears to have both protective and risk-enhancing associations," said Dr. Connor. "These results indicate that healthy lifestyle benefits are not universal and do not apply equally across genders."

We asked Brian Robinson, ATC, athletic trainer for Glenbrook South High School in the Chicago area, for his reaction to this research. "I believe it depends on the coaches and student leadership of the team," he said. "I showed the findings to some of my student athletes and they said, 'No way would this happen on the team I was on,' because the leadership was so strong. But these same students said that in past years, when there was different leadership, it was possible some of the athletes participated in drinking or other risky behaviors."

Brian acknowledges it's impossible to know what kids are doing at all times when they're out with friends. "In my experience, though, there is no tolerance for drinking. I think it comes down to setting expectations. Once you get tired of telling a kid to behave a certain way, tell them again! You have to keep expectations high and keep them in front of kids every day. After a Friday night game, I'll hear our coaches saying things like, 'Be safe, make the right choices, look out for each other.'"

With the competitive nature of sports, Brian said he occasionally sees some fighting, but nothing violent. "Not knock down, drag out fights, but pushing, shoving, or arguing."

Bottom line, Brian said: "If kids are in with a good group, they won't have to worry about peer pressure. And good, successful programs hold kids accountable both on and off the field."

Of the male respondents, 60.5 percent reported participation in team sports in the past year. These male teens were slightly more likely to indicate involvement in fighting, drinking, and binge drinking than the male teens not involved with team sports.

Has your Powerflo lost its pizzazz? Is your hydration system looking haggard? Cramer's Powerflo Reconditioning Program will make it clean and shiny once again!

Your Cramer Powerflo units put in some long days, keeping athletes properly hydrated. Powerflos are sturdy, tough, and made to last. But like all machines, they need a little attention now and then to ensure peak performance. That's why Cramer created a Powerflo Reconditioning Program! We make it simple for you to box up and ship your Powerflo units to Cramer, where they are treated to some much needed pampering and TLC at our Hydration Unit Hospital.

The usual cost for reconditioning is $250.00 for the larger Powerflo 20 and Powerflo 50 units, and $200 for the smaller Powerflo. But during 2010, Cramer has lowered those prices by $50.00! The Powerflos are expensive, and you want them to last as long as possible, so don't pass up this deal!

"We give our customers value-added service whenever we can, and want to demonstrate that we stand behind our products," says Dave Caruthers, Cramer's operations manager. "The Powerflo Reconditioning Program is one way we do that. Powerflo units received for reconditioning go through a thorough process that includes replacing anything tha's broken, checking the pump and the valves, replacing the battery if it isn't holding a charge, and cleaning and sterilizing all parts. When we send the units back after about a month or so, they are in almost new condition."

Stefanie Kindt, ATC, head athletic trainer at Doane College in Crete, Nebraska, had a great experience with the reconditioning program. "I love the Powerflo," she says. "They make life much easier and I'd be lost without them. We had tried to do repairs and maintenance on our own, but I was really happy to hear about the reconditioning program from a Cramer rep at a national meeting I attended last year. Cramer reconditioned five of our ten Powerflos last summer. It was an easy process-I just printed out a mailing label Cramer provided, and Beth in customer service even told me what size of box to use for shipping! The units were returned quickly and they worked great! I'll have the other five reconditioned this year."

Jeff Carrico, ATC, assistant athletic director/sports medicine at the University of Cincinnati, is also very pleased with the reconditioning program. "Our Powerflo units get so much usage, and things are going to break down over time. It's like tuning up your car. It made good economic sense to recondition the units-it's certainly much less expensive than buying a whole new hydration system! We have six Powerflo units, and I sent five to Cramer last year at the end of April. They were returned and ready to go in time for summer workouts."

Jeff continues, "One thing we can't skimp on is hydration, but as budgets get tighter it's harder to find companies willing to provide services like this. We appreciate Cramer extending this reconditioning program to us."

Ready to send your Powerflo to Cramer's Sports Medicine Spa for a top-to-bottom makeover? Contact your Cramer representative, or call customer service at 800-345-2231.

The usual cost for reconditioning is $250.00 for the larger Powerflo 20 and Powerflo 50 units, and $200 for the smaller Powerflo. But during 2010, Cramer has lowered those prices by $50.00! The Powerflos are expensive, and you want them to last as long as possible, so don¿t pass up this deal!

The information and views of The First Aider are intended to supplement, not substitute for, the recommendations of a personal physician. Readers are urged to consult a physician for any medical diagnosis, treatment, or advice.