Another win for Danielle Musto

Congrats again to TOP athlete Danielle Musto for winning the Stony Creek 6 hour bike race. She did close to 82 miles in a little over 6 hours. She was first female and 3rd overall. It was another impressive performance. Originally she was supposed to race in Wisconsin, but with some logistic problems ended up staying in the Mitt. Congrats!

Orthopedic Test for Meniscus: Thessaly Test

Evaluating a meniscus injury can be a tough task. There are a lot of false positives, and some can actually create more damage to the meniscus if it is indeed hurt. The best identifier for a meniscal injury is the history and mechanism of injury. The rest of the orthopedic tests seem to lack sensitivity and specificity. Joint line tenderness has always been an ok test, but only for the lateral meniscus.

Most doctors if suspecting a meniscal injury will go right to an MRI. Well, MRI's have an accuracy rate of 98%, but they are expensive. If you don't have great health insurance, your looking at a pretty penny out of pocket. This should in fact be a 2nd line of screening.

The Thessaly Test is a new test that has a 94% accuracy rate for medial meniscus and 96% for the lateral meniscus. It is performed with the patient firs standing on the good leg to get the maneuver down. Then on the suspected leg. On one leg bend the knee so there is 20 degrees of flexion. Internally and Externally rotate the body as the foot stays in place. This places a torgue on the knee. It helps to have the examiner hold the hand of the patient for balance.

The study done with the Thessaly Test was done with 213 patients. A pretty solid sample pool. No acute knees (knees hurt with in 4 weeks) were evaluated. Exclusion criteria included, multiply knee injuries, history of knee surgery, osteoarthritis and synovium disorders.

This seems to be a pretty solid test to add in your tool bag for a first line screen for meniscal injuries. My only thought on this study is if the exclusion criteria were included would the rate of accuracy go down?
Here is an abstract of the STUDY.

Bulgarian Split Squat Variations @ Train Out Pain

More on the Importance of Sleep

Every one knows that sleep does a body good. But do you know a few of the finer things of why this is? In short, sleep lets you recharge your body and mind. A common torture method is in fact keeping someone up for days, they mentally go crazy. But for 99.9% of us, were looking at the more common, squeezing in a few days of 6-7 hours of sleep a night.

Lets look at a few hormones and their implication on metabolism and health. When your sleep restricted your level of the hormone cortisol doesn't go down as much as it should as you approach evening, it should be close to nil, when you go to bed. When cortisol stays high your at more risk for insulin resistance.

Another hormone that is affected by sleep restriction is Leptin. Leptin is released by the fat cells that signals satiety to the brain and thus suppresses appetite and lets your body feel full. When your not getting the sleep you need, your levels of Leptin go down, so you will end up ingesting more calories then your body needs. This correlates with an increase in the hormone Ghrelin. Ghrelin increases your appetite. So you lose a few hours of sleep over a few days and cortisol levels don't decrease like they should, Leptin goes down, Ghrelin goes up.

An aside is I just read a study where exposure to artificial light disrupted the circadian cell division in rats. 12 hours of darkness, 12 hours of light. Compared to a group that had an hour of light during the normal darkness time and found that cell division was harmed and a large number of genes was affected.

So what to take from all this, maybe today's obesity epidemic is the result of sleep deprivation. It probably doesn't help that when your not sleeping your not going to the fridge for an organic apple, but a tub of Hudsonville ice cream. Oh, and make your bedroom a cave. Dark and cool.

New Post Workout Snack

I went to Iowa a few weekends ago to do another ART (active release technique) seminar. I was introduced to Greek Yogurt for the first time. I think I may have found a new quick post workout snack when I'm in a time crunch. It pops a whopping 14 grams of protein with about 20 grams of carbs. Thats twice as much protein and half the carbs as most yogurts. It has 5 probiotic live cultures as well. I've been doing some reading about taking probiotics after workouts to help bolster the immune system after training, as intense exercise may in fact blunt your immunity a bit. Try it out.

Congratulations

Congrats to T.O.P. mountain bike athlete Danielle Musto for winning the Cohutta 65 last weekend down in Tennessee. What was impressive is that she did this coming off a top ten finish in Canada. So in 5 days went from sub 40 degree weather to 80 degree weather and won. Very hard to do.

Also Congrats goes out to Grand Rapids Brazilian Ju-jitsu club. They had several fighters that dominated in there fights this past Saturday night. It was impressive to see the skill and toughness that some of these guys displayed. Clint Crabtree and Mitch Stapley are doing a tremendous job with these guys. It was awesome to be there ringside and see the action.

Monday Motivation

I have to say thanks to Mike T. Nelson over at Extreme Human Performance for showing me this video on his blog. Simply Awesome!