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FEBRUARY 2003

Welcome to this issue of SIH e-zine. We're right in the middle of the ski season, but that doesn't mean you should stop working out in between shushing down the slopes. In this issue we'll give you valuable tips on a mid-season equipment check for maximum performance, how to tighten up those "rubbery" ski legs, and more.

We hope you enjoy this newsletter and invite you to pass it on to a friend. We welcome your suggestions for improvements and additions. If you'd like to be removed from our list at any time, just follow the instructions below.

Yours in health,
Allan M. Levy, MD and Mark L. Fuerst


In this issue, you'll find:
  • Check Your Ski Equipment
  • Q & A - Tightening Up "Rubbery" Ski Legs
  • In the News - NFL Players Prone to Sleep Apnea - Dr. Allan Levy's study
  • Book Review - The Young Athlete: A Sports Doctor's Complete Guide for Parents (Little Brown), by Jordan Metzl, MD and Carol Shookhoff
  • Disclaimer

    Check Your Ski Equipment
    Part of your performance in skiing depends on the quality of your equipment. Have your equipment checked every year to ensure that the ski bindings are properly set. In practically every case Dr. Levy sees of a bad knee from skiing, the patient says, "I fell, and my binding didn't release." It's also good to do a mid-season check, and to wax the bottoms of your skis after every 3 or 4 days of skiing.

    All skiers should wear goggles or sunglasses that prevent reflected sunlight from reaching the eye. Normal sunglasses reduce glare form the front, but do not protect the eye from glare from the side. A maximum-protection UV sunblock cream is essential in preventing severe sunburn. Apply a sunscreen lotion with a sun protection factor of at least 15 before you ski and throughout the day. And, of course, all downhill skiers -- including children -- should wear a helmet.

    Q & A - Tightening Up "Rubbery" Ski Legs
    Q: My legs feel tired and "rubbery" at the end of a day of hard skiing. What can I do to prevent this? TB, Williamsville, VT.

    A: The muscles subjected to the greatest stress in skiing are the quadriceps in the front of the thigh. These leg muscles handle all of the strain in the bent-knee position and absorb the shock of bumps and moguls. The best way to strengthen these muscles is the 90-90 Wall Sitting exercise. Put your back against a wall with your knees bent as if you were sitting in a chair. Both your knees and hips should be at 90 degree angles. Maintain this position until your quadriceps burn and begin to give out. Do this at least once a day. You can also build up your quadriceps with leg extension exercises at the gym.

    For endurance, which is a necessity for skiing several hours, do any type of aerobic conditioning, such as power walking, jogging, or riding a bike. Building strong muscles and increasing cardiovascular endurance can reduce injuries and add to the enjoyment of skiing.

    In the News - NFL Players Prone to Sleep Apnea - Dr. Allan Levy's study
    A study presented in the January 23, 2002, New England Journal of Medicine showed that National Football League players are five times more likely than other men their age to suffer from sleep apnea, a disorder characterized by lapses in breathing during sleep. Major daily newspapers across the country and ABC's "Good Morning America" interviewed the three study authors: Charles George, MD, the principal investigator and a professor of medicine at the University of Western Ontario; Vyto Kab, a former NFL tight end and now a co-director of Sleep Tech, a sleep disorders center based in New Jersey; and Dr. Allan Levy, the New York Giants team physician, whose original pilot study found that 11 of 16 New York Giants linemen had sleep apnea. "For years, the NFL has been in the forefront of such areas as nutrition, weight training, and stretching. Sleep is the next logical final performance frontier," says Dr. Levy.

    The study found that of the more than 300 players (average age 25) who were tested, 34% of the linemen, who, of course, are very large men, had sleep apnea. "We had always thought this was a disease of big people, but was not significant until middle age. Now we have to start looking at younger people," says Dr. Levy. Most people are not as physically fit as these players, so the incidence of sleep apnea in the general population -- it affects up to 18 million Americans -- is probably even higher, he says.

    Snoring is usually the first indicator of sleep apnea, which has been associated with high blood pressure, heart disease, and strokes. "Any large person who snores should go for a consultation with a sleep doctor," says Dr. Levy. The most common effective treatment is CPAP, or continuous positive airway pressure, which involves wearing a mask over the nose during sleep. Pressure from an air blower forces air through the nasal passages to keep them open. A number of surgical procedures are available, but none of them are very successful.

    Book Review - The Young Athlete: A Sports Doctor's Complete Guide for Parents (Little Brown), by Jordan Metzl, MD, and Carol Shookhoff
    This book offers helpful and often provocative insights into the young athlete's world. Dr. Metzl, MD, cofounder and medical director of the Hospital for Special Surgery's Sports Medicine Institute for Young Athletes and a former member of the US Olympic Committee Medical Advisory Board, and education writer Shookhoff explore essential issues, such as how to be a good sports parent, the hallmarks of good coaching, nutrition and nutritional supplements, and keeping values and perspective intact, including preventing sports from taking over the family's life, good sportsmanship, and ethics. They also provide solid information about preseason conditioning, overuse injuries, and upper body (elbow, back, and shoulder) injuries and lower body (ankle and knee) injuries.

    Disclaimer
    This newsletter is designed to provide accurate and authoritative information in regard to the subject matter covered. We are not engaged in rendering medical or other professional services. If medical advice or other expert assistance is required, the services of a competent professional person should be sought.

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