Friday, February 22, 2013
Injury Prevention
ACL Tears: Information and Prevention
As upright walkers, humans rely on the knee to aid in efficient navigation and interaction with our surrounding world. Our knees are one of the most complex and important joints in our bodies, and maintaining the health and integrity of this joint should be a priority for athletes and recreationalists alike.
The knee joint is made up of a network of ligaments, cartilage, muscles and bones that interact and work together in order for fluid, coordinated movements between the upper and lower leg to occur in a stabilized fashion. The integrity of the knee is established predominantly by four ligaments that act to hold the joint together and prevent dangerous movements from occurring. One of these ligaments, the anterior cruciate ligament (more commonly referred to as the ACL), can be particularly vulnerable to tears and injuries in athletes. The American Academy of Orthopaedic Surgeons ranks ACL tears among the most common injuries to the knee, citing an incidence of nearly 200,000 tears per year, with nearly half requiring surgical reconstruction. These surgeries are quite spendy, ranging anywhere from $25,000-$50,000 and typically cost the athlete an average of 6-12 months playing time. The injured are at a significantly increased risk for developing depression and anxiety, as well as recurrent knee injuries for the rest of their life.
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| Normal Knee Anatomy |
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| Torn ACL |
The mechanism of injury for ACL tears can vary, but most commonly are associated with deceleration in combination with a rapid change in direction or pivoting. It is not uncommon for tears to occur alongside other injuries such as cartilage damage and fractures. Though there isn't a single clear-cut explanation, a growing body of evidence is suggesting that tears can be as high as 10 times more likely among female athletes in some sports. Experts hypothesize several factors are at play, interacting and possibly working together to account for the increased incidence seen among female patients. Some of the most common and widely accepted explanations include:
- Anatomical Differences: women have a wider pelvis and an increased Q-angle. This, in combination, can place an increased amount of strain on the ACL.
- Hormones: some studies have indicated that the increased estrogen levels associated with ovulation can lead to an increased laxity in tissues. This allows joints to move in a "greater-than-normal" range of motion during menstruation, which can increase the strain placed on surrounding ligaments.
- Biomechanical differences in landing and jumping patterns between male and female athletes.
- Differences in physical conditioning, muscular strength, and neuromuscular control
Whatever the reason, the evidence suggests that female athletes in particular need to be paying close attention to their form and technique while in practice and exercising. Santa Monica ACL Prevention Project has designed a dynamic 20 minute warm-up routine designed to engage, strengthen, and properly warm-up the stabilizing muscles and ligaments surrounding the knee joint. It has been designed specifically to reduce the injuries to the ACL in athletes of all abilities by increasing flexibility and strength with a focus on developing and ensuring proper posture and form. The complete program can be found here, and should be completed three times per week for best results.
Resources:
1. American Academy of Orthopaedic Surgeons (AAOS). ACL Injury: Does it Require Surgery? http://orthoinfo.aaos.org/topic.cfm?topic=a00297
2. Slauterback, J. et al. ACL Injuries in Women: Why the Gender Disparity and How Do We Reduce It? Orthopaedics Today. 23:1, July 2003
3. Arnim, Juliana. The Biomechanical Gender Gap: ACL Injuries in Female Athletes. Leading Medicine. 7:1, January 2013.
Tuesday, February 5, 2013
Fitness for the Economically Conscious
For the first time since the survey's creation, body weight training has appeared in the 2013 Worldwide Survey of Fitness Trends from the American College of Sports Medicine (read the results in entirety here). Logically fueled in part by a sluggish global economy, economically conscious individuals all across the world are turning to body weight training programs in the New Year to shed weight and stay in shape while evading the sometimes over-the-top membership fees charged at gyms. While new to the survey, body weight training programs have in fact been in use and employed as a form of resistance training by individuals as well as fitness professionals working with clientele for many generations. Today, several organizations are now packaging workout plans and selling them as an inexpensive and effective way to workout due to the very minimal exercise equipment needed.
Below you will find a list containing several of my favorite body-weight exercises designed to inspire workout ideas and methods for incorporating resistance training into your daily workout regimen. While engaging in these, and other body-weight resistance training exercises, be sure to alternate between exercises designed to overload your cardiovascular system and exercises targeted towards strength gains in specific muscle groups in order to get a more holistic workout. Incorporating exercises that challenge your cardiovascular system will help to keep your heart rate high and all of your major muscle groups warm and engaged.
Actively adjust sets, reps, and intensity based upon your level of fitness. If you find these exercises are easy to perform, I suggest increasing the weight, changing the site of weight application, or incorporating some sort of modification to the movement to make it more challenging. Likewise, if you find these exercises too difficult to begin with, start with a modified variation and slowly build up so that you can complete the move in its original form. As always, be sure to pay close attention to your body and form in order to minimize your risk of getting injured.
- Burpees: Begin in standing position. Slowly lower your trunk towards the ground, passing through the squat position until your hands touch the ground between your feet. In one rapid motion, jump your feet back so that you are in a stationary push up position. Return to the deep squat position in one rapid motion by hoisting your legs forward between your hands. Return to standing position. Repeat. *To increase intensity: add an explosive jump to the end of this move and incorporate a push-up.
- Plank: Get into push-up position but come down onto your elbows so that they are supporting your body weight rather than your hands. Make sure that your spine is entirely neutral and your body is aligned. Engage your abdominal muscles and lift your entire body off of the ground; hold for 30 seconds, then release. Rotate 90 degrees so that all of your weight is on one elbow and your non-supportive hand is raised perpendicular to the floor. Hold for 30 seconds and release. Repeat on other side. *To increase intensity: try elevating one leg at a time and/or increase the duration of the exercise.
- Mountain Climbers: Get into push-up position, with hands slightly wider than shoulder width. While on your fore-feet, swing one leg up between your hands. In one quick motion switch legs, repeat.
- Vertical Leg Lifts: Lie on your back with your arms at your sides, palms facing down. Slowly raise your feet toward the ceiling until your legs make an approximately 60 degree angle with the ground. Hold for 5 seconds, and then slowly lower your legs back toward the ground until feet are roughly 4-6 inches above the ground. Hold for 5 seconds, repeat.
- Frog Jumps: Crouch your body into a very deep squat and rapidly explode into a jump so that all of your extremities are extending outward from your core. Repeat.
- Squats: While holding a medicine ball (or other source of weight) at your waist, stand with your feet shoulder width apart and your knees slightly bent. Slowly move your hips back and bend at your knees, effectively lowering your body until your thighs are parallel with the floor. Hold this position for a few seconds, and slowly return to the starting position. Repeat. *To increase intensity: try one (or several) of the following common variations: incorporate a jump, increase the weight or change the location of weight application, perform squats on one leg at a time, add a twisting component while in the down phase of the squat, or try adding a punch, kick, etc.
- Lunges: Begin in standing position with your knees slightly bent while holding a medicine ball (or other source of weight). Step forward with your right foot so that your feet are roughly 3-4 feet apart. Slowly bend at the knees, making sure to keep your front knee behind your toes and lowering your back knee straight down towards the ground. Maintain an erect spine, and engage your abdominal and gluteal muscles as your descend. Hold in this position for a few seconds, and then slowly return to the starting position. Switch legs, repeat. *To increase intensity: try adding a twist to the down portion of the exercise or try adding a jump to the exercise while switching legs. **To more specifically target the gluteal muscles rather than your quads, try increasing the distance between your feet; this decreases the load carried by this muscle group as you extend your knee, causing your glutes to pick up the slack instead.
- Single-Leg Deadlifts: Begin in standing position, holding a medicine ball. Step one foot forward with your back foot lightly touching the ground (be sure that you are not supporting any of your body weight with this foot). Slowly tilt your hips forward and lower the weight towards the floor, keeping all of your weight on the front leg. Try to keep the supporting leg as straight as possible without locking your knees. Be sure to keep your shoulders back so that your spine stays neutral and your abdominal muscles are engaged, bending at the waist only. Lower the weight as close to the ground as your flexibility and level of balance will allow, then slowly push into your heel to return to the starting position. *To increase intensity: remove non-supportive foot entirely off of the ground as your lower the weight so that your leg is fully extended and parallel with the ground during the down phase of this exercise. Ease into this slowly as you improve your balance to avoid injury and improper form.
- Push-Ups: Get into standard push-up position. Make sure to keep your spine straight and shoulders pushed back. Slowly bend at the elbows until your chest is roughly one inch from the ground. Push into your hands to extend your elbows and return to the starting position. Repeat until point of fatigue. *To increase intensity: lift one leg entirely off of the ground, do the push-ups on one arm at a time, or bring your hands together so that your index fingers and thumbs create a diamond; then, try to get your nose to the middle of this diamond.
Monday, December 17, 2012
Foot & Ankle
Understanding the Structure of Your Feet: A Critical Element for Staying Injury-Free
In recent years, a great deal of research has been published that suggests a possible link between arch development and injury patterns in runners and athletes. Due to the change in mechanics associated with varying arch heights, understanding how your arch is potentially affecting the biomechanics of your leg is crucial for athletes wishing to stay injury-free and prevent painful, chronic conditions and deformities that negatively impact athletic performance.
The relationship between arch height and injury pattern is fairly straightforward; feet with low-arches tend to be hypermobile and are more susceptible to medial injuries of the leg and ankle, while high-arched feet tend to be rigid and stiff, more frequently leading to stress fractures and injuries on the lateral side of the leg. As demonstrated in a 2001 study by Williams and McClay, this discrepancy is largely due to altered mechanics associated with different arch structures and types. In their study they were able to demonstrate that individuals with low arches tend to display a greater degree of rearfoot inversion upon initial ground contact, followed by a significantly faster rate of calcaneus eversion when compared to individuals with higher arches. This rapid motion is dampened by supporting muscles and ligaments, and often places a great deal of stress on these structures, thereby aiding in the development of related injuries. This excessive pronation tends to force the shin to rotate internally, which in turn forces the thigh to rotate outwardly to compensate for this structural change. In this sense, the altered mechanics and subsequent structural compensation travels up the entire kinetic chain, causing an increase in the amount of strain placed on the ACL, as well as the hip and pelvis.
Understanding these biomechanical interactions is useful not only for health practitioners, but also for athletes of all abilities wishing to improve their athletic performance and prevent injury development and recurrence. In addition to making sure you are getting enough rest and recovery while training, a significant body of research strongly supports a link between properly warming-up before engaging in rigorous physical activity and a decreased incidence of injury. Being too aggressive with training progression frequently leads to injuries in even the most experienced athletes; as a general rule of thumb, make sure you are not increasing your weekly mileage by more than 20%. Slightly less talked about are the benefits barefoot activity may have on arch development and strength. The physical stimulation that occurs while barefoot theoretically helps to produce a protective increase in surface muscle tone, helping to elevate the arch and strengthen the involved muscles and tendons. This may be particularly relevant and useful for individuals with lower foot arches as it theoretically helps to diminish some of the less desirable mechanical aspects of having low-arches. As always, be sure that you are wearing proper shoes that fit your foot-type and meet your needs. For helpful tips on selecting a shoe, check out our Guide to Buying Running Shoes here!
Thursday, November 1, 2012
Portland Better Half Half-Marathon
OHSU Sports Medicine is pleased to announce the launch of a brand new half-marathon event in the Portland metropolitan area. In collaboration with Hood to Coast Relays, this event's creation was largely inspired by the popularity and success of Hood to Coast, PDX to Coast and the Portland to Coast High School Challenge. $10 from each entry fee will support wellness-focused research, care, education, and outreach initiatives for OHSU's Sports Medicine Program, Knight Cancer Institute and the Multiple Sclerosis Center. The event will include both a male and female half marathon run and walk, as well as a four-person relay event taking place within the gorgeous city of Portland. Registration is open now; to register and for more information visit www.portlandbetterhalf.com
The information below is a summarization of the press conference held this morning at OHSU's Center for Health and Healing, where the Portland Better Half was revealed publicly for the first time.
PORTLAND, OR. - November 1st, 2012 - The Hood to Coast / Portland To Coast Relays are proud to announce that the popularity of "The Mother of All Relays" has led to the launch of a second Portland area race, the Better Half. The race, primarily focused on women's wellness, will include a half marathon run and walk, and four-person relay race. The Better Half will provide runners and walkers with the opportunity to experience the most scenic and exciting race course in the Portland area. Local charities and individuals will also have the opportunity to earn money through the Better Half one-of-a-kind incentive program.
"I'm proud to help introduce an event that focuses on women's wellness, gives to local charities, and provides opportunities for people of all skill levels to participate", said Sarah Mensah, Executive Vice President and Chief Operating Officer of the Portland Trailblazers.
The women's half marathon run and walk, and the four-person relay race, will begin and end at Oregon Health & Science University. Participants will travel south from the OHSU campus to cross the Sellwood Bridge. Then through Southeast Portland and along parts of the Eastbank Esplanade, eventually crossing the Morrison Bridge and heading south to OHSU via SW Naito Parkway and Terwilliger Boulevard.
"We believe the Better Half offers a local race route that is second to none. The course offers spectacular views of mountains, the Willamette River, a world class university, and historic Portland neighborhoods", said Felicia Hubber, Race Director and Vice President of the Hood to Coast / Portland to Coast Relays.
The Better Half plans to donate portions of the events proceeds to the Police Activities League and Oregon Health & Science University's Knight Cancer Institute, Sports Medicine program, and the University's Department of Neurology. "We are proud to work with the Better Half because the event aligns with our mission of improving the health and well being of Oregonians," said OHSU President Joe Robertson, M.D., M.B.A. "We're also pleased the event will benefit cancer and MS patients and support the OHSU Sports Medicine program. We look forward to the inaugural event this summer."
There will be an added incentive to participate for individuals, schools, youth sports programs, and other local non-profits. The Better Half will offer a one-of-a-kind incentive program that allows individuals and groups to earn $10 per registered race participant by referring a friend, contact, or supporter.
The Better Half will take place on Sunday, June 30th, 2013 with an expected 12,000 participants. To learn more, go to www.portlandbetterhalf.com
Friday, October 19, 2012
Squats: An Effective Weapon for Combating Osteoporosis
Whenever a force is applied to your body, and thus to your bones and joints, cells respond by increasing the density and strength of the bone in order to better handle this stress. As humans, and as animals, we are highly adaptable beings. When we get hot, we sweat. When we get cold, we shiver. All of these adaptations we have work together to maintain equilibrium and ensure our survival as an animal. Similarly, when we place stress and force on our bones and joints, our body responds by strengthening those bones and joints so that we can better handle that stress in the future without getting injured. From this perspective, it’s easy to see why engaging in weight-bearing exercises on a regular basis is critical for women and other individuals at risk for developing Osteoporosis. Unfortunately however, many women shy away from hitting the weight room at the gym and instead seek refuge on the elliptical or treadmill, rarely cranking up the resistance high enough to place much stress on the skeletal system. Largely responsible for this shyness is a social stigma among women against participating in strength training due to an irrational fear of “bulking up.” Most women are terrified of the possibility of developing the thighs and biceps of a body builder – however this is entirely unfounded because that degree of hypertrophy does not typically occur except in the presence of testosterone- something that the vast majority of women do not produce. And sure, while there certainly are female body builders, a large number of them are probably ingesting steroids or other hormones facilitating muscular growth – not to mention that they spend hours each day striving to obtain those results.
A good example of a common and valuable
weight-bearing exercise is the squat. Squats are one of the most effective
weight-bearing exercises for controlling the prevalence of Osteoporosis-related
fractures due to the distribution of force that occurs among the bones as the
exercise is performed. During the down-phase of a squat, your knees should be
behind your toes and your femur should break a 90 degree angle with the ground.
With weight applied at the shoulders, the spine is compressed and the entire
core is working to stabilize and balance the body. From a mechanical
perspective, the force applied during this exercise is predominately being
absorbed by the femur, the hip girdle, the vertebral column, as well as in the
wrists as they work to stabilize the weight. Considering that the hip, spine,
and wrist are the three of the most common sites for osteoporosis-related
fractures, it’s fairly obvious why this particular exercise can be so effective
at strengthening the bones – and thus helping to decrease the number of fractures
– that are seen at these sites.
Something I love about squats
that make them such a critical component of any well-balanced exercise routine
is the amount of variation that you can apply to this basic movement pattern.
Introducing slight variations can effectively shift the weight distribution and
subsequent force absorption occurring at various bones and joints throughout
the body. One of the simplest variations is to change the site of weight
application. Instead of using a bar, use a medicine ball; this works to engage
your core and abdominal muscles, both of which are critical for a healthy and
strong back. Another very simple variation is to add a plyometric component to
the exercise. For those of you unfamiliar with the term, plyometrics is basically
just any exercise that produces fast, powerful movements. A very simple way to
incorporate this into the squat is to simply add a jump to the up-phase of the
exercise. By jumping – and more importantly, having to land – a
whole new aspect of force absorption is introduced as your body touches back down to the ground.
In addition to engaging the bones of the entire lower leg and feet, adding the
jump also provides a pretty decent cardiovascular overload as well. By
combining these variations with the original move, you will actually get a more
holistic workout for the entire back and core, and eliminate the receptiveness
that sometimes causes boredom during workouts.
Squats are a very simple, widely-practiced
exercise that can be very effective at increasing bone density, especially at
the sites most common for osteoporosis-related fractures. Since there are an
endless supply of variations that you can apply to this type of movement, it’s
nearly impossible to get bored with, making squats a very easy, realistic
exercise that everybody should incorporate into their daily life and exercise
routine.
Friday, August 17, 2012
Choclate Milk: A Suitable Recovery Drink?
The first time I remember having chocolate milk was at my Grandma’s house when I was about three. I had to pry open a Nestlé’s instant chocolate milk tin, that was significantly older than I was, pour in three or four spoonfuls of the powder into my Sippy cup, stir for what I thought was an eternity, and finally enjoy my delicious treat while watching Saturday morning cartoons. Cut to now where I see a commercial of a sweaty Carmelo Anthony drinking this same substance after a hard workout. Times have changed indeed. And while it is easy to scoff these new ads, touting that chocolate milk is a great exercise recovery drink; studies have shown there is some credence behind them.
First off, the logistics of eating
after a workout. The American
College of Sports Medicine states that consuming a 300-400 calorie snack
within 30 minutes post-exercise is ideal for recovery. With that snack, it
should contain roughly a 2:1 carbohydrate to protein ratio or a 3:1 ratio for a
longer and/or more intense workout. Keep in mind that this is mostly useful for
endurance athletes who exercise for 90 minutes or more. The logic behind eating
a snack heavy on carbohydrates post-exercise is to help restore glycogen stores
that deplete during the workout; the protein helps rebuild muscle tissue as
well. The interesting thing about low-fat chocolate milk is that it can
actually fall within this carbohydrate to protein ratio that is ideal for a
recovery drink and a few studies had shown it to be just as effective as other
commercial sports drinks.
In 2009, a study compared chocolate
milk with a carbohydrate recovery drink using 10 athletes. The two drinks had the
same amount of carbohydrates and protein, with chocolate milk having a slightly
more fat content. The results of this study showed that there were no
significant differences in these two drinks in terms of muscle recovery and
time to exhaustion during exercise. These were similar results to a study
conducted in 2006 comparing the same drinks with cyclists. Humorously, these
studies also noted that most of the athletes enjoyed the chocolate milk more
than the other recovery drink.
So is chocolate milk an acceptable
post-exercise drink? Sure! It is cheap, does not have a lot of additives
(depending on what kind you buy), and, most importantly, it tastes awesome.
Obviously, with any kind of nutritional endeavor, it is important to know what
exactly you are buying, and chocolate milk is no different. When I went to the
grocery store, I noticed that some chocolate milk had more protein than
carbohydrates and some of the bottles actually contained 2 servings per bottle,
so just peak at the nutritional facts before buying anything. However, if you
follow the dietary guidelines from the ACSM there is no reason why chocolate
milk cannot be a good choice for a post-exercise recovery drink.
Resources:
Karp, J. R., et al. Chocolate Milk as a Post-Exercise
Recovery Aid. International Journal of Sport Nutrition and Exercise Metabolism,
2006: 16, 78-91.
Pritchett, K., et al. Acute effects of chocolate milk and a
commercial recovery beverage on postexercise recovery indices and endurance
cycling performance. Applied Physiology Nutrition Metabolism 2009: 34:
1017–1022.
Monday, August 6, 2012
Concussion Incidences Higher in Women’s Sports
In recent years, young women participating in sports have increased dramatically. In the 2005-2006 school year, over 2.95 million women were in high school sports, an almost 80% increase from 1975. Naturally, this increase in participation also comes with an increase in sports-related injuries, most notably concussions.
According to American
College of Sports Medicine, A concussion is an injury to the brain that
results in temporary loss of normal brain function, usually caused by a blow to
the head. Some basic features of a concussion include:
·
Inability to maintain a coherent stream of
thought
·
A disturbance of awareness with heightened
distractibility
·
Inability to carry out a sequence of
goal-directed movements
With more specific symptoms being:
·
Prolonged headache
·
Dizziness
·
Nausea or vomiting
·
Impaired balance
·
Confusion
·
Ringing ears
·
Sensitivity to light
Its important to note that only about 10% of athletes
suffering a concussion actually lose consciousness. This is no longer a requirement for diagnosis
of a concussion.
Sports concussions are often associated with high impact
sports such as American football. Studies have now shown that concussions are
often higher in women’s sports than men’s sports. Women’s high
school basketball has approximately 9,100 more concussions per year than men’s
basketball. Women’s soccer has the second
highest reported rate of concussions among all other sports in young athletes.
There are a variety of theories on the factors that lead
to the higher incidence of concussions in women, among them may be that
women are better self-reporters of injuries than men. Others studies say that
weaker neck muscles in women could lead to more concussions, but the research
is still unclear. Additionally, distracted playing, illegal or 'dirty' play and improper use of equipment are also factors that correlate with higher incidence of concussion among both men and women. Researchers have shown that women sustain
more concussions than men and maintain symptoms from concussions longer than
men.
One study used the Concussion Resolution Index
(CRI), a computerized test that helps track cognitive function after a
concussion by testing reaction times. High school females showed a more
significant decline in these tests than their male counter parts, with no
apparent differences in the severity of the concussions. While this study did
not go into the specifics of why this occurred it was noted that there are
neurophysiological differences among the sexes such as blood flow rate and
neuronal densities that may contribute to the observed discrepancies.
It has become more apparent that concussions do not only
occur in traditional high-contact sports such as football or hockey. Concussions are a significant portion of
injuries in mens and womens sports alike. As research continues perhaps we will better
understand concussions in young athletes and what factors may contribute to the
gender differences in the rate of, and rehabilitation from concussions.
Resources:
Broshek, D., et al. Sex differences in outcome following
sports-related concussion. J Neurosurg 2005; 102:856–863.
Gessel, L., et al. Concussions Among United States High
School and Collegiate Athletes. Journal of Athletic Training 2007;42(4):495–503.
Rauh, M. et al. Subsequent Injury Patterns in Girls’ High
School Sports. Journal of Athletic Training 2007;42(4):486–494.
Friday, July 27, 2012
High Altitude Training for Endruance Sports
With the 2012 London Olympics upon
us, it would seem pertinent to talk about one of the more popular training
methods elite endurance athletes use today, high altitude training. The logic behind this is that at higher
altitudes (usually around 2000-3000 meters), your body produces more erythropoietin, a hormone that helps the production of red blood
cells thereby increasing athletes’ hematocrit. With more red
blood cells, the body can transport more oxygen to the muscles, which prevents
muscle fatigue, and thus increases endurance in competition.
In the past,
athletes would live at high elevation as well as train there, aptly called
“Live High Train High.” However, athletes who actually exercised at higher
elevations could
not achieve their normal intensity of training. This was mainly because
their bodies fatigued much faster due to the low amount of oxygen in the
environment. Today, athletes tend to utilize the “Live High Train Low” method,
which allows them to continue living at high altitudes without compromising
their workout routines.
And while many, if
not most, elite athletes use it, there is some controversy over the
effectiveness of high altitude training. For one thing, some studies suggest it
only works for a subset group of athletes, based on certain genetic factors,
which have not really been defined as of yet. But the biggest issue with high
altitude training is the research itself. For instance, current studies only
have a small number of subjects, ranging from 5 to 39 different athletes. In
addition, some studies had subjects with different training programs, levels of
performance, or even came from different sports all together. These issues make
it difficult to give substantial claims on the effectiveness of this training
method and are why current research is unclear about it.
It seems logical that increasing the
hematocrit, by living in higher altitudes, would be a great way to increase
endurance during performance; however, with so many factors (endurance, speed
and power at threshold) being highly related to performance in endurance sports
and inconsistent research results and methodology, it is hard to definitively
say what specific factors related to high altitude training may be providing an
athletic advantage for athletes utilizing it.
Reference:
De Paula, P, Niebauer, J. Effects of high altitude training
on exercise capacity: fact or myth. Sleep Breath 2012; 16:233–239.
Monday, July 23, 2012
Athletic Biological Passport
It is always great to see
an athlete succeed. Whether it is breaking a world record or winning for the
tenth time in a row, we all cheer for their success. However, performance-enhancing
drugs (PEDs) have tarnished some of these successes and the athletes themselves.
To prevent this issue, athletes are directly tested for PEDs (i.e. anabolic
steroids) in their bodies, through either blood or urine. However, advances in
pharmacology have made it much easier to produce new PEDs every year and more
difficult to detect in tests, so a new method has been introduced-The Athletic
Biological Passport.
The Athletic Biological Passport
is a new way to detect use of PEDs through multiple and reoccurring measurements
of certain “biomarkers” in an athlete, rather than the substances directly. These
biomarkers are physiological levels in an athlete (i.e. number of red-blood
cells or hemoglobin) that are affected by PEDs even long after the drugs have
left the body. Using this method makes sense because these levels are relatively
constant among athletes, rather than the increasing variety of PEDs that they
could potentially be taking.
Here are two examples of
what an actual biological passport would look like in two different athletes:
These are four different measurements of various
biomarkers, which I boxed in red. The red lines represent the parameters for
which the test is set and the blue line is the actual value the athlete
produced throughout the nine different testing occurrences (the x-axis). The
colored bar is just the measured probability that these test results are
physiologically abnormal. Because these values of this particular athlete are
within the parameters, it can be concluded that they are not taking any PEDs.
However, this biological passport shows many
abnormalities in the different test, which can be inferred that this athlete
did not achieve these values under normal physiological conditions.
What
began primarily in the cycling community, biological passports are quickly
gaining acceptance in many other areas. This year will mark the first time
biological passports will be used in the Olympic games and has actually caused
a few athletes to be disqualified
from them already. For more information, please check out the papers below.
Thursday, July 19, 2012
Hood to Coast Training Program
OHSU Sports Medicine has created a beginner and intermediate training program for Hood to Coast available for download below. These 9 week programs offer runners a well rounded training routine including:
-'Double day's to prepare for the HTC frequency of running
-Tempo and steady state runs to improve the specific endurance needed for HTC
-Strides (short fast runs) to improve running economy and offset 'staleness'
-Long runs to improve general endurance
Beginner's HTC Training Program (recommended for those currently running 15-20 mpw in 3-4 runs)
Intermediate's HTC Training Program (recommended for those currently running 25-30 mpw in 4-5 runs)
Additional resources useful for your preparation for HTC:
Dynamic stretching routine
Shin splints (Medial Tibial Stress Syndrome) prevention routine
Pelvic stability routine
Hip mobility routine
OHSU Sports Medicine will see you in Seaside!
Programs created by a certified coach through USATF and RRCA
Monday, July 16, 2012
Dr. Jim Chesnutt on AM Northwest
OHSU Sports Medicine's Dr. Jim Chesnutt providing expert advice on how to maintain a healthy lifestyle and achieve the ACSM's recommended exercise, even with a busy schedule.
Thursday, June 21, 2012
Community Blogger: Marni Renison - Split
Community Blogger and Runner Marni Renison shares her challenges coming back with injury with the demands of working and family life in her latest post.
Tuesday, June 19, 2012
Meet the Rose City Rollers: Compound Fracture - My Feet Know
I tried out for Fresh Meat again, and I have to say, my feet
knew the truth before my brain did.
“Erica, you are ready.”
But my mind saw something different. My crossovers had
regressed into steps. My stops eroded into an extended, wobbly slide. “Quick”
was something I drank with milk. Elegance was something I watched on film. And tough? Nothing about me felt tough.
I was a hippo on skates, weakened by injury. But my broken
bones were not the worst of it. Losing my faith in myself - that was the hardest injury to recover
from.
My ascent from the depths began with a smile from a friend.
She offered me a safe harbor - private lessons, where I could focus on my form
and not on my fear. Every Saturday, I woke early and spent two hours pushing
myself past my mental limits. The feeling of skating was achingly familiar, but
I lamented the loss of speed and grace. I knew what it felt like to skate fast,
and I had to try to be proud of just skating (and not falling… I fell a lot in
those first weeks). Every week, I worked with my physical therapists to find my
limits; then I knew where to push myself. We found my weaknesses and adjusted
the therapy.
Then something clicked.
See, my friends and fellow skaters, my physical therapists,
my husband – they all knew I was fully capable of not only getting back on
Fresh Meat, they knew I would kill tryouts. It took a while, but I started to
realize it too. The ache of sore muscles, the burn in my lungs; it transformed
from “I’m too slow and have no endurance,” to “One step closer to success.”
My body will do what ever I ask of it. Granted, sometimes it
does it with less grace, but if I count out steps – one, two, one, two – it
will move. Each measurement is a breath. Each breath, a crossover. Each
crossover, a corner of the track. Each corner, a part of a lap. Each lap is one
lap towards my goal.
During my last private lesson, I knew I had the tools to
succeed at tryouts. My form had improved. My endurance increased. I trusted my
wounded ankle because my physical therapists made me jump laterally, squat, and
bend to give it flexibility and strength. The only way I would fail tryouts is
if I let the fear creep back in. I didn’t.
Now, nerves are normal. Fear, well fear is an animal that
will slowly devour you. A wise woman once told me, “If you cannot be kind to
yourself, be kind to someone else.” While the butterflies in my stomach felt
like they would consume me, I found that others feared failure more than I. I
hugged them. Told them to give it everything.
Told them to watch their form, to breathe, to smile and enjoy the
journey. And the more I told them that, the more I realized I was smiling,
laughing, and having the time of my life. Was every stop perfect? Heavens no.
But was I proud of myself when I finished? Yes. And everyone that tried out
with me should have been proud too.
Being on Fresh Meat is different this time. I want it more.
Rather, I know what I want: I want to be on a team. My body hasn’t gotten the
message about the team yet. We are still under negotiations, because honestly,
we need to work out more. But right now, in this moment, I am proud. I came
back from two broken bones and a broken derby heart. I found my limits, and
pushed past them. I met my walls, and broke through them. I learned how to be
kind to myself. The fun part about roller derby is that there is always one
more thing to aspire to. If I get on a team, I will work to get rostered. If I
get rostered, maybe I will tryout for the travel team… and so on. Roller derby
is a journey, and I feel like I’ve just begun.
Friday, June 15, 2012
NeoCart Shown Superior to Microfracture in Two Year Follow Up - Journal of Bone and Joint Surgery
Dennis Crawford, MD, PhD is an Associate Professor and Orthopaedic Surgeon Sports Medicine Specialist. He is the principal investigator and first author of a recent report describing the superior results for patients treated with a tissue engineered cartilage implant technology (NeoCart) in comparison to the current standard of care, microfracture surgery, for cartilage injuries.
The manuscript published by the Journal of Bone and Joint Surgery this week describes NeoCart, an autologous cartilage tissue implant, in comparison with microfracture in a multisite prospective, randomized trial of a tissue-engineered bioimplant for treating articular cartilage injuries in the knee.
The findings from this randomized, two year follow up suggests that the safety of autologous cartilage tissue implantation, with use of the NeoCart technique, is similar to that of microfracture surgery and is associated with greater clinical efficacy at two years after treatment.
NeoCart utilizes a unique structure and application of an implant combined from a bovine collagen frame with the cartilage cells (chondrocytes) of the individual being treated which are then incubated in a bioreactor treatment to increase their size to appropriate dimensions for application to the wounded area of cartilage.
The implant is then adhered with a novel collagen adhesive creating a suture-less fixation cartilage repair technique. This process creates a mature tissue-like implant for more rapid and sustained therapeutic effect with decreased pain and improved physical function.
The findings from this randomized, two year follow up suggests that the safety of autologous cartilage tissue implantation, with use of the NeoCart technique, is similar to that of microfracture surgery and is associated with greater clinical efficacy at two years after treatment.
NeoCart utilizes a unique structure and application of an implant combined from a bovine collagen frame with the cartilage cells (chondrocytes) of the individual being treated which are then incubated in a bioreactor treatment to increase their size to appropriate dimensions for application to the wounded area of cartilage.
The implant is then adhered with a novel collagen adhesive creating a suture-less fixation cartilage repair technique. This process creates a mature tissue-like implant for more rapid and sustained therapeutic effect with decreased pain and improved physical function.
Friday, June 8, 2012
IT Band Injury Prevention
Stretching from the hip to just below the knee the Iliotibial band is a tract of fibrous tissue. This soft tissue stabilizes the knee and works in coordination with muscles in the hip while running. Because of its location and length this is a common tissue to have inflammation issues arise in when running. As an ounce of prevention to keep all runners safe and healthy this summer OHSU Sports Medicine offers the following tips to keep that ITB tract healthy and functioning properly.
1. Always take the time to do a dynamic warm up before your run. There are more comprehensive and less time consuming options for a dynamic warm up, but engage your key muscle groups and increase blood flow to them before beginning a run.
2. Get a strong butt. The gluteal muscles play an important role in stabilizing and propelling the body through the running motion. Weakness of the gluteus medius is a common occurrence in injured runners.
Strengthen these by starting with the clam shell and progressing to the quadraped hydrant.
3. Stretch. Finish each run or end of your day with some static stretching and/or foam rolling on the iliotibial band tract to keep it supple and lengthened.
4. Get an assessment. Figure out your particular set of strengths and weakness, gait abnormalities and patterns of motion before ramping up your miles. The Sports Medicine Runners Clinic is an option for runners of all abilities.
OHSU Sports Medicine wants to know what your biggest concern with training or injuries are with running? Leave a comment below with how you've overcome these challenges or what you'd like more information about.
1. Always take the time to do a dynamic warm up before your run. There are more comprehensive and less time consuming options for a dynamic warm up, but engage your key muscle groups and increase blood flow to them before beginning a run.
2. Get a strong butt. The gluteal muscles play an important role in stabilizing and propelling the body through the running motion. Weakness of the gluteus medius is a common occurrence in injured runners.
Strengthen these by starting with the clam shell and progressing to the quadraped hydrant.
3. Stretch. Finish each run or end of your day with some static stretching and/or foam rolling on the iliotibial band tract to keep it supple and lengthened.
4. Get an assessment. Figure out your particular set of strengths and weakness, gait abnormalities and patterns of motion before ramping up your miles. The Sports Medicine Runners Clinic is an option for runners of all abilities.
OHSU Sports Medicine wants to know what your biggest concern with training or injuries are with running? Leave a comment below with how you've overcome these challenges or what you'd like more information about.
Thursday, June 7, 2012
The Lesson by Marni Renison
Marni Renison, OHSU Sports Medicine's running friend and community blogger, shares some lessons learned while spending some unwanted time cross training after a running injury. Proof that although a simple activity to some, running is really a lifestyle to many.
Some of her pearls include:
Some of her pearls include:
Enjoy running healthy – don’t take it for granted. Yup. I knew that.
Pay attention to your body. Pain is a signal something is wrong. I knew that, too. But, some things you can run through. The key is knowing the difference.
Focus more on your family – don’t be so wrapped up in running. Okay. I will. I promise. **Insert: I am a better mommy, wife, person, and friend when I can run. Hands DOWN**.
This is my test – In the beginning of the year, I said that I would meet challenges with maturity. And that I would fight to find my own potential. This is my fight. One of many, I’m sure. So, if this is a test to see if I meant what I said, I meant what I said.
She concludes with a Top ten things I learned during 5 weeks of cross training in her complete post, check it out.
Wednesday, May 30, 2012
RCR Bloggers: van Hellslinger
People ask me if I get hurt or hit a lot while doing Roller Derby. With a smile on my face and a twinkle in my eyes I answer YES! I wouldn’t say that I get hurt anymore than most people do who are involved in a contact sport. Mostly the usual bumps and bruises. I’m also aware of the possible major injuries that could occur. None of that stops derby from being a ton of fun. In fact the hits are part of what makes it fun. I can honestly say I love getting hit by some of the best derby players not only in our own league but nationally. As far as the hits go I always have to explain I’m not getting punched but hit legally. There is no punching in derby and there is no fighting in the middle of the track. This sport has grown a lot since the 60’s and has even changed since it’s revival in 2000. This once campy and crazy game has evolved into a legit sport with rules, strategy, and real athletes.
When people ask for more detail about the hitting and physicality in derby I break it down into a few categories: Form, Timing, and Power. All of these things combined with strategy and team work create a force to be reckon with!
Here is a bit of a break down:
The first step is always form. I think this is the case regardless of what sport you do. If you don’t have proper form anything you do will be off. For Derby this means you must get low! We hear this in practice all the time and I have heard it being yelled at home team and travel team practices too. Form for a Derby player is similar to being in a squatted position all the time. It’s often described to new skaters by having them imagine having to use a porta potty, a really horrible one. You don’t want to sit on the seat so you now have to hover over it. That’s pretty close to how our stance is. Another less disgusting way to think about it is to imagine sitting on a invisible chair. This stance allows you to be able to look behind you to the left and right. You need to have your weight in your heals and your chest needs to be up and not pointed down. All of these things are important. I’m currently trying to break the habit of having too much weight forward over my toes. I have to focus on making sure my chest is up and forward. I tell new girls to picture in their minds that they have Lady GaGa’s gun bra on and they don’t want to be shooting their own feet but out in front of them. Sounds easy right? Try doing a wall sit for just 2 minutes. Being in this good derby stance allows you to be able to do the tight turns and quick movements that are needed to hit or move around the track. As a blocker you need to be low to make perfect contact with an opponent’s legs. If you can sweep in an sit on your opponents thigh just right you will utter control her! As a Jammer being able to be low and agile in this stance gives you the ability to easily fake people out and juke around them. This stance also gives you more stability to be able to take a hard hit.
Next is timing. Once you have the form down you have to time when to go in for that hit. On the flip end of that you have to time how to avoid or take that hit that’s coming at you. I think this is a huge challenge for a lot of people, including myself. There are several ways to do legal hits in derby and several ways to block another player. Each way requires you to know exactly when to come in at another player. You need to adjust your speed and movements just right to really be effective. When many skaters start out they often go in for a hit and either swoop right past their target, slowly crash into them, or ends up trying to hit them from the behind which usually doesn’t work.
The hip check is a “bump” delivered using the hips while skating immediately next to the target. Really this hit should be right on the targets mid thigh. You don’t want to be to high up or it’s ineffective and to low could get you a low block penalty if the ref things you got them at the knee. You also can’t be too far behind them because if you catch the thigh more on the back of their leg you could actually give them a push forward which helps them and not you. When you first learn this you often end up in the wrong place and feeling like you will never get there. Repetitive practice at this while skating helps with the timing.
A Stern Buster is just that if you’re on the receiving end. This is when a blocker has say a Jammer right up behind them trying to push her way through. The blocker pops up with the back of her shoulder right up into that Jammers sternum hopefully sending her flying backwards. Sounds pretty terrible right? It is and it’s very effective if done right. The timing on this is hard because the opponent needs to be in the right place and your form has to be spot on. If it is executed just right that blocker can do a lot of damage. Yes this can knock the wind out of you but it’s worse if you get hit with it and fall straight back on your tail bone.
Many other hits are similar to these two but could be used to push someone out of bounds or out of the way of your Jammer. Many times you don’t want to know an opponent out or down because you need to keep them in play. At this point you are keeping her by positionally blocking her until your team mates can join you. Then you all work together to keep her where you want her. You do this my what tends to be called “Sitting on her” because that’s basically what you are doing. You time it so that you have the back of your thigh nearly on top of hers or are just about completely sitting in her lap. Your teammates will position themselves so that you’ve boxed her in.
These two things are hard to get but can be achieved through lost of practice. What I find hard currently is power. How do you gain power? The great thing about derby is that every body type is useful and effective. This means I’ve been hit by all types. You can’t underestimate anyone because the least suspecting person may lay you out. This is my current struggle. I skate a ton but need to build strength but I also get bad leg cramps when I skate a LOT. Apparently I’m over working my legs. When I’ve asked the professionals (aka a sports doc) how to overcome this I’m told I have to build up the strength in my legs without over doing it. Considering I skate about 6 days a week, 3 of those days are derby practice and 1 day is my speed class, I’m trying to find a way to give my legs a break. I also started 1 day of off skate work outs. This day is focused on core and overall strength. I also try to remember to stretch as often as I can. The days that I skate that aren’t practice I try to take it easy. I focus on certain skills that are less strenuous to allow my muscles some time to recoup.
It’s hard to give my legs a rest when all I want to do is skate. I’ve been spending most of my time focusing on my form right now. I’ve been told that the power and strength will come. I have to try to not push my body harder than it can handle and find patience. This seems to be a hard thing for many derby girls to do. I’ve known a lot of skaters who push themselves through the pain or skate with an injury. They just want to skate and want to practice and don’t want the pain to get in their way. There is nothing more frustrating than wanting to be out on the track and having a cramp, sprain, or other injury keep you from being out there. I’m trying to learn patience with my body. Everyone progresses differently and builds muscle at different rates. I know if I can mast the form and timing that when I get the strength I’ll be that much more effective on the track. I think one of the hardest lessons to learn is to listen to your body. I didn't realize when I started Roller Derby how demanding I would be on myself, both mentally and physically. It's been an amazing experience so far and I love every moment of it. Now to see if I can remember this on the track.
~Hellslinger
When people ask for more detail about the hitting and physicality in derby I break it down into a few categories: Form, Timing, and Power. All of these things combined with strategy and team work create a force to be reckon with!
Here is a bit of a break down:
The first step is always form. I think this is the case regardless of what sport you do. If you don’t have proper form anything you do will be off. For Derby this means you must get low! We hear this in practice all the time and I have heard it being yelled at home team and travel team practices too. Form for a Derby player is similar to being in a squatted position all the time. It’s often described to new skaters by having them imagine having to use a porta potty, a really horrible one. You don’t want to sit on the seat so you now have to hover over it. That’s pretty close to how our stance is. Another less disgusting way to think about it is to imagine sitting on a invisible chair. This stance allows you to be able to look behind you to the left and right. You need to have your weight in your heals and your chest needs to be up and not pointed down. All of these things are important. I’m currently trying to break the habit of having too much weight forward over my toes. I have to focus on making sure my chest is up and forward. I tell new girls to picture in their minds that they have Lady GaGa’s gun bra on and they don’t want to be shooting their own feet but out in front of them. Sounds easy right? Try doing a wall sit for just 2 minutes. Being in this good derby stance allows you to be able to do the tight turns and quick movements that are needed to hit or move around the track. As a blocker you need to be low to make perfect contact with an opponent’s legs. If you can sweep in an sit on your opponents thigh just right you will utter control her! As a Jammer being able to be low and agile in this stance gives you the ability to easily fake people out and juke around them. This stance also gives you more stability to be able to take a hard hit.
Next is timing. Once you have the form down you have to time when to go in for that hit. On the flip end of that you have to time how to avoid or take that hit that’s coming at you. I think this is a huge challenge for a lot of people, including myself. There are several ways to do legal hits in derby and several ways to block another player. Each way requires you to know exactly when to come in at another player. You need to adjust your speed and movements just right to really be effective. When many skaters start out they often go in for a hit and either swoop right past their target, slowly crash into them, or ends up trying to hit them from the behind which usually doesn’t work.
The hip check is a “bump” delivered using the hips while skating immediately next to the target. Really this hit should be right on the targets mid thigh. You don’t want to be to high up or it’s ineffective and to low could get you a low block penalty if the ref things you got them at the knee. You also can’t be too far behind them because if you catch the thigh more on the back of their leg you could actually give them a push forward which helps them and not you. When you first learn this you often end up in the wrong place and feeling like you will never get there. Repetitive practice at this while skating helps with the timing.
A Stern Buster is just that if you’re on the receiving end. This is when a blocker has say a Jammer right up behind them trying to push her way through. The blocker pops up with the back of her shoulder right up into that Jammers sternum hopefully sending her flying backwards. Sounds pretty terrible right? It is and it’s very effective if done right. The timing on this is hard because the opponent needs to be in the right place and your form has to be spot on. If it is executed just right that blocker can do a lot of damage. Yes this can knock the wind out of you but it’s worse if you get hit with it and fall straight back on your tail bone.
Many other hits are similar to these two but could be used to push someone out of bounds or out of the way of your Jammer. Many times you don’t want to know an opponent out or down because you need to keep them in play. At this point you are keeping her by positionally blocking her until your team mates can join you. Then you all work together to keep her where you want her. You do this my what tends to be called “Sitting on her” because that’s basically what you are doing. You time it so that you have the back of your thigh nearly on top of hers or are just about completely sitting in her lap. Your teammates will position themselves so that you’ve boxed her in.
These two things are hard to get but can be achieved through lost of practice. What I find hard currently is power. How do you gain power? The great thing about derby is that every body type is useful and effective. This means I’ve been hit by all types. You can’t underestimate anyone because the least suspecting person may lay you out. This is my current struggle. I skate a ton but need to build strength but I also get bad leg cramps when I skate a LOT. Apparently I’m over working my legs. When I’ve asked the professionals (aka a sports doc) how to overcome this I’m told I have to build up the strength in my legs without over doing it. Considering I skate about 6 days a week, 3 of those days are derby practice and 1 day is my speed class, I’m trying to find a way to give my legs a break. I also started 1 day of off skate work outs. This day is focused on core and overall strength. I also try to remember to stretch as often as I can. The days that I skate that aren’t practice I try to take it easy. I focus on certain skills that are less strenuous to allow my muscles some time to recoup.
It’s hard to give my legs a rest when all I want to do is skate. I’ve been spending most of my time focusing on my form right now. I’ve been told that the power and strength will come. I have to try to not push my body harder than it can handle and find patience. This seems to be a hard thing for many derby girls to do. I’ve known a lot of skaters who push themselves through the pain or skate with an injury. They just want to skate and want to practice and don’t want the pain to get in their way. There is nothing more frustrating than wanting to be out on the track and having a cramp, sprain, or other injury keep you from being out there. I’m trying to learn patience with my body. Everyone progresses differently and builds muscle at different rates. I know if I can mast the form and timing that when I get the strength I’ll be that much more effective on the track. I think one of the hardest lessons to learn is to listen to your body. I didn't realize when I started Roller Derby how demanding I would be on myself, both mentally and physically. It's been an amazing experience so far and I love every moment of it. Now to see if I can remember this on the track.
~Hellslinger
Tuesday, May 29, 2012
Meet the Rose City Rollers: Shaolin Spocker - Forty Two Inches
Forty Two Inches
A measuring tape is wrapped around my hips, and a number gets scrawled on a line sheet. I exhale a little.
I step into a wedding dress, with massive layers of skirt, and intricate pleating on the bodice. I'm a little afraid of smashing the seemingly delicate garment under my calloused feet, but it's sturdier than it looks.
"We've just had skinny girls in here all week; it'll nice to see what the dress looks like on a regular person," says the woman helping me, as she zips up the back of the garment.
I'm being fitted for what will be the third time I've worn a wedding dress for an audience. I've never been married.
The dress will make its debut in a bridal runway show, with me in full hair and makeup, wearing the highest of heels. It's been several years since I've done it, but I've actually walked a runway a few times before--sometimes for offbeat fashion designers, but usually for wedding collections. The bridal industry seems to be one of the few makers of clothing that actually appreciates my Size 12 frame, rather than shaming me for it.
I've learned to appreciate it when I connect with more size-positive folks, because I grew up with a lot of shame about my body. I was the kid whose baby fat clung to her, I was the awkward teenager who longed for a single-digit dress size, I was the undergrad whose Freshman 15 became a Freshman 50+. Having a Chinese parent played its part, too--being slim and delicate is critical for women in Asian culture, and it's also perfectly okay to make the most blunt and direct of comments about weight. Exercise exists to help a woman keep her figure, not for fun, competition, or true fitness.
So, for much of my life, I felt undesirable because I was, "big," and I always needed to lose a few pounds. TV, magazines, and mall shopping sang the same song I heard at home: that I should be ashamed of my size, and try to get smaller. I let the extra fat on my body hold me back from taking risks, trying new things, connecting with people. Even after I took up martial arts at 23, and lost some weight, I was always fixated on losing more. I still felt like a clumsy, bloated moose next to the lean-and-mean wushu players who won gold medals, and I certainly didn't want any of them seeing me in a swimsuit.
All of that started to change when I turned 30, and found my way into roller derby. Derby showed me something completely different from the messages I'd been hearing all my life: women who kick ass and take names, in all shapes and sizes. They aren't afraid to fall down, to push the limits, to skate just a little bit harder to get past an opposing player, or stop one in her tracks with a crushing hip-check. Just playing derby is a risk, but it's one that every skater accepts, and stares dead in the eye every time she straps on her gear.
The derby girls I met didn't seem to know any of the fear I grew up with--flashy, glittery garments were standard fare, and tiny shorts on a big booty was a badge of honor, not a thing to be hidden away. At the Hangar, I got to see women like me do graceful and utterly amazing things on eight wheels. I got to see small, slender women execute insane, powerful moves that you'd never expect from such a small frame.
All of these ladies had ferocity, strength, and confidence, and the more I saw that, the more I realized that I had all of those things within me, too. I could be all of those things, right now, without losing ten pounds or wearing a Size 8. Derby finally drove home the message I wished I'd heard all along: Be healthy. Think about how you feel and what your body can do, not what it looks like.
In past runway shows, I'd felt a mix of nerves and envy, and a twinge of self-loathing, and I wondered if I'd look ridiculous on the runway, next to all of the skinnier girls. When I saw the casting for this bridal runway, however, I didn't hesitate to sign on, and I'm not even slightly worried about how it's going to look. I'm going to look fabulous, with my regular-person body, my Size 12 curves, and my 175-ish pounds of ass-kicking muscle and bone.
As I pick up my bag and say my thank-yous at the bridal boutique, I take a peek at the line sheet, where my measurements are written. Bust: 39 1/2" Waist: 31" Hips: 42".
I look at those numbers, and realize that I don't feel much of anything. 42 inches, 5'7", 175-ish pounds, Size 12? It's just a jumble of arbitrary numbers, and they'll never hold me back again.
A measuring tape is wrapped around my hips, and a number gets scrawled on a line sheet. I exhale a little.
I step into a wedding dress, with massive layers of skirt, and intricate pleating on the bodice. I'm a little afraid of smashing the seemingly delicate garment under my calloused feet, but it's sturdier than it looks.
"We've just had skinny girls in here all week; it'll nice to see what the dress looks like on a regular person," says the woman helping me, as she zips up the back of the garment.
I'm being fitted for what will be the third time I've worn a wedding dress for an audience. I've never been married.
The dress will make its debut in a bridal runway show, with me in full hair and makeup, wearing the highest of heels. It's been several years since I've done it, but I've actually walked a runway a few times before--sometimes for offbeat fashion designers, but usually for wedding collections. The bridal industry seems to be one of the few makers of clothing that actually appreciates my Size 12 frame, rather than shaming me for it.
I've learned to appreciate it when I connect with more size-positive folks, because I grew up with a lot of shame about my body. I was the kid whose baby fat clung to her, I was the awkward teenager who longed for a single-digit dress size, I was the undergrad whose Freshman 15 became a Freshman 50+. Having a Chinese parent played its part, too--being slim and delicate is critical for women in Asian culture, and it's also perfectly okay to make the most blunt and direct of comments about weight. Exercise exists to help a woman keep her figure, not for fun, competition, or true fitness.
So, for much of my life, I felt undesirable because I was, "big," and I always needed to lose a few pounds. TV, magazines, and mall shopping sang the same song I heard at home: that I should be ashamed of my size, and try to get smaller. I let the extra fat on my body hold me back from taking risks, trying new things, connecting with people. Even after I took up martial arts at 23, and lost some weight, I was always fixated on losing more. I still felt like a clumsy, bloated moose next to the lean-and-mean wushu players who won gold medals, and I certainly didn't want any of them seeing me in a swimsuit.
All of that started to change when I turned 30, and found my way into roller derby. Derby showed me something completely different from the messages I'd been hearing all my life: women who kick ass and take names, in all shapes and sizes. They aren't afraid to fall down, to push the limits, to skate just a little bit harder to get past an opposing player, or stop one in her tracks with a crushing hip-check. Just playing derby is a risk, but it's one that every skater accepts, and stares dead in the eye every time she straps on her gear.
The derby girls I met didn't seem to know any of the fear I grew up with--flashy, glittery garments were standard fare, and tiny shorts on a big booty was a badge of honor, not a thing to be hidden away. At the Hangar, I got to see women like me do graceful and utterly amazing things on eight wheels. I got to see small, slender women execute insane, powerful moves that you'd never expect from such a small frame.
All of these ladies had ferocity, strength, and confidence, and the more I saw that, the more I realized that I had all of those things within me, too. I could be all of those things, right now, without losing ten pounds or wearing a Size 8. Derby finally drove home the message I wished I'd heard all along: Be healthy. Think about how you feel and what your body can do, not what it looks like.
In past runway shows, I'd felt a mix of nerves and envy, and a twinge of self-loathing, and I wondered if I'd look ridiculous on the runway, next to all of the skinnier girls. When I saw the casting for this bridal runway, however, I didn't hesitate to sign on, and I'm not even slightly worried about how it's going to look. I'm going to look fabulous, with my regular-person body, my Size 12 curves, and my 175-ish pounds of ass-kicking muscle and bone.
As I pick up my bag and say my thank-yous at the bridal boutique, I take a peek at the line sheet, where my measurements are written. Bust: 39 1/2" Waist: 31" Hips: 42".
I look at those numbers, and realize that I don't feel much of anything. 42 inches, 5'7", 175-ish pounds, Size 12? It's just a jumble of arbitrary numbers, and they'll never hold me back again.
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