Inflammation is the body’s way of healing or fighting off an infection. This can be beneficial initially.  However, if the inflamed state is continued longer than needed, then the inflammation can cause pain and decrease performance for athletes.

Exercise will increase the body’s inflammation in response to intense exercise. Through diet, and rest, the inflammation can be reduced so that further damage can be prevented. Free radicals are also created with intense exercise. These free radicals can cause damage to cells that can also contribute to inflammation. Long-term exercise can help the body adapt to the inflammation and free radicals by creating its own antioxidant defense. Another way of helping the situation, or to provide more of a safeguard, would be to consume fruits that are high in antioxidants. Some of these fruits include cherries, blueberries, and pomegranates.  These fruits can potentially help reduce inflammation and help fight off free radicals after a strenuous workout. Consumption of these fruits is great not only for their antioxidant properties, but also for their carbohydrate source. After long strenuous exercise, glycogen (stored carbohydrate) stores are low and need to be replenished immediately to help promote recovery.

Here are a few ways to include these fruits in a post-workout meal:

1. Make a smoothie and mix in frozen or fresh cherries, blueberries, or pomegranate. Add some whey protein to make it an even more powerful post-workout beverage.
2. Mix the fruits into some low-fat Greek yogurt
3. Whole Grain cereal with low-fat milk and add in any of the mentioned fruits
4. Add dried berries to some trail mix and eat as a snack throughout the day

Foods to be avoided that can possibly lead to increased inflammation: Foods high in saturated and trans-fats. Limiting fried foods, processed pastries and white, thick, creamy sauces/spreads/gravies will lower saturated and trans fat intake. By consuming higher antioxidant foods, the body should be able to fight off inflammation more effectively. Also eating more fruits will help athletes replenish glycogen stores, consume more fiber, and obtain more healthy vitamins.

Have a question?  Ask at amygoodson@texashealth.org

Amy Goodson, MS, RD, CSSD, LD

References:

Abed, K. E., Rebai, H., Bloomer, R. J., Trabelsi, K., Masmoudi, L., Zbidi, A.,… Tabka, Z. (2011). Antioxidant status and oxidative stress at rest and in response to acute exercise in judokas and sedentary.  Journal of Strength & Conditioning Research, 25 (9), 2400-2409. doi: 10.1519/JSC.0b013e3181fc5c35

Thrombold, J. R., Reinfeld, A. S., Casler, J. R., & Coyle, E. F. (2011). The effect of pomegranate juice supplementation on strength and soreness after eccentric exercise.  Journal of Strength & Conditioning Research, 25 (7), 1782-1788. doi: 10.1519/JSC.0b013e318220d992

All massage treatments are designed with a specific result in mind. Some modalities focus on relaxation and restoration of the mind, but today we will focus on the medical massage treatment. Medical massage is comprised of neuromuscular nassage, myofascial release technique and manual lymphatic drainage. These three individual techniques work great when performed individually. However, when you utilize all of them in one session, they can produce greater results.

How can this be applied to sports injuries?

The simple application of all three techniques starting with neuromuscular massage increases muscle activation and elasticity of tight muscle. Myofacial release focuses on the stretch of the connective tissue to increase range of motion. Finally, manual lymphatic drainage speeds the removal of lacitic acid (muscle soreness) and some inflammatory processes in the body.

What does all this mean?

It means you recover faster from competition and minor injuries. This allows you to get back on the field faster and fully recovered.

For more information, email: hadl98@yahoo.com or text 817.308.9958.

Nicholas Hadl, LMT, NCTMB, NSCA-CPT
Licensed Massage Therapist

Myth: “Snacking is not good for me!”

Fact: Snacks can be a great nutrition benefit for athletes if they snack healthfully.  Try to eat a whole grain carbohydrate (granola bar, whole grain cereal, whole wheat crackers, pretzels, etc) or a fruit and a lean protein (yogurt, 2% cheese, 2% cottage cheese, turkey jerky, lunch meat, etc) or a healthy fat (peanut butter, nuts, seeds, avocado, etc.) at every snack.  Examples include peanut butter crackers, fruit and string cheese, yogurt and whole grain cereal, granola bar and nuts, etc.)

Have a question?  Ask at amygoodson@texashealth.org

Amy Goodson, MS, RD, CSSD, LD

Have you ever met an athlete who didn’t want to “get in the zone?”  Me either!  However, getting in The Zone is overrated.  “What?”…you say.  “But that’s why I play my sport.” Of course it is and it’s an awesome experience when it happens.  But, what we know about peak performances and getting in The Zone are two important things.

First, it is a rare experience. Second, it’s not something an athlete can MAKE happen.  Let’s look at those two points. We know that elite athletes are only in The Zone about 10% of the time.  If the best of the best can only get in The Zone 10% of the time, what about the rest of us?  Most likely less than that.  So, the question then is: How do you handle the other 90% when you are NOT in The Zone?  Now, the second point.  No athlete can make themselves get into The Zone.  All an athlete can do is set the conditions to ALLOW themselves the chance to get in The Zone.  So, what are those conditions?

First, it’s important to be clear about what you want to do.  For example, a runner should be clear about his race strategy.  A basketball player shooting a free throw should be focused on staying true to her routine and focused on the basketball goal (but not worried about whether she will make it or not).

Second, it’s important to have a back-up plan for the unexpected.  For example, a soccer player should be mentally prepared to respond to getting the ball stolen.  Of course he doesn’t want that to happen, but must be prepared to quickly switch to defend if it does (rather than criticizing himself for losing the ball or for making a bad play).  A golfer should have a plan on how to cope with a bad shot or with hitting a ball OB (out of bounds) because it’s going to happen!  It’s silly to pretend (and unrealistic to expect) that she will never hit a bad shot.

Third, it’s important to focus on the things you CAN control and let go of what you cannot control, which starts with winning.  No athlete can control winning.  That’s right.  I said NO ATHLETE can control winning.  If they could, then wouldn’t they win every time?  Now, this doesn’t mean they don’t or shouldn’t want to win.  Depending upon their abilities, they should.  However, focusing on and/or worrying about winning usually translates into more anxiety, less confidence, and less than optimal performance, particularly if it’s a reasonably challenging situation (i.e., if you’re a competitive 32 year old runner, competing against a 10 year old is not reasonably challenging).

In terms of what an athlete CAN control, there are two main aspects:  your effort and your focus.  Giving 100% effort is within your control and focusing on what you want to do in the sport is too.  For example, a baseball pitcher knowing his pitch, focusing on the target, and firing away is within his control.  The ability of the pitcher to STAY FOCUSED on these things may be difficult in a pressure situation (e.g., game tied, bases loaded with only 1 out), but IS within his control.  HOW to do that is a mental skill to be discussed in another blog.

In sum, if you are focused on the right things, you are increasing your chances of getting in The Zone.  And, that’s what it’s all about, giving yourself the best chance for success.

Dr. Matt Johnson, CC-AASP
Sport Psychology Consultant

It used to be thought the Female Athlete Triad was caused by low body fat, over exercise, under-eating or combinations of these.  However, we now know that it appears to be caused by a decrease in energy availability which is defined as dietary energy intake minus exercise energy expenditure.  Low energy availability appears to be the factor that impairs reproductive and skeletal health in the Triad.  However, the good news is that it can be reversed with proper nutrition.

From a nutrition perspective, the goal is to fuel the body to perform the sport or activity at an optimal level.  Thus, in effort to increase energy availability, the female athlete must increase the nutrient density of her food intake.  Here are three easy ways to start:

Eat more frequent meals/snacks

• Consuming meals and snacks of carbohydrate, protein & healthy fat often throughout the day can help keep the athlete’s energy levels high

Increase the nutrient density of the food instead of increasing the amount of the food

• Choose bagels over bread for sandwiches & toast
• Choose granola instead of regular cereal
• Choose milk or juice instead of water at meals
• Add peanut butter to bagels, crackers, oatmeal, waffles & fruit
• Add nuts to granola, yogurt, and dry cereal as a snack
• Add avocado to wraps, sandwiches & dips

Optimize calcium intake to increase bone density

• Aim to eat 4 servings of dairy a day (1 serving = 8 oz milk, 6 oz yogurt, 1.5 oz cheese)
• Use milk to make common foods like pudding, oatmeal and sauces
• Use milk & yogurt in smoothies as a snack
• Put cheese on toast or tortillas as a meal or snack

Have a question?  Ask at amygoodson@texashealth.org

Amy Goodson, MS, RD, CSSD, LD

The word “research” often brings to mind the idea of a scientist working in a lab with test tubes and mice with no real-life application. However, research in sports medicine can also include everyday experiences such as physical therapists and athletic trainers taking range of motion, balance, and strength measurements in order to determine how a patient is progressing or to predict future return to sports. The clinical research performed at Ben Hogan Sports Medicine focuses on using clinical measurements to identify a patient’s function. For example, we know that after a surgery to fix an anterior cruciate ligament (ACL) tear, the earlier after surgery a patient is able to recover his or her motion, the better their function will be later on in their recovery.

Other information we have gathered from our clinical research includes the importance of balance after ACL surgery. Ben Hogan clinicians look at balance on a regular basis and use it to gauge progress of their ACL patients. If balance is diminished, this alerts the clinician to incorporate more or different exercises to address the deficit. If balance measurements are good, then the clinician knows that the patient is progressing appropriately and their function is on target. These simple research measurements provide objective data that allow clinicians to provide the best possible care for their patients. Ben Hogan Sports Medicine is using science to improve the rehabilitation process for athletes.

Craig Garrison, PhD, PT, ATC, SCS Research Physical Therapist

 

Myth: “I don’t have time to eat a snack before practice…no big deal!”

Fact: The truth is that a pre-workout snack is essential to give you a burst of energy to start practice.  The goal is to have complex carbohydrate and some protein plus 8-16 oz fluid.  So bring something you can through in your gym bag like an energy bar & apple, peanut butter crackers & banana or a baggie of homemade trail mix with granola/nuts/dried fruit.  Avoid foods that are fried, high in fat or loaded with sugar.

Have a question?  Ask at amygoodson@texashealth.org

Amy Goodson, MS, RD, CSSD, LD

 

High carb, low carb, some carb, no carb…are there better carbohydrates for pre and post workout?  The answer is YES!  Carbohydrates are the body’s #1 source of energy, but certain carbohydrates are better than others to maximize energy and recovery.

Looking at the Glycemic Index (GI) of a carbohydrate is one of the keys in determining which type of carbohydrate is optimal for a specific activity.  The GI is a scale that ranks carbohydrate-rich foods in order of how they affect the body’s blood sugar (glucose) levels compared to pure glucose or white bread. The glycemic index of glucose is 100 and thus the highest ranking on the GI scale.  It is important to note that not all carbohydrates have the same effect on the body’s blood sugar levels; some spike the level and some gradually increase it.  Thus, we categorize carbohydrates as high, medium and low glycemic.

High Glycemic: GI of 70-100

• Grains: White bread, whole wheat bread, bagel, gluten-free bread, Bran Flakes®, Coco Pops®, Puffed Wheat®, Cornflakes®, Cheerios®, Shredded Wheat®, Grapenuts®, wild rice, jasmine rice, white mashed potatoes (skinless), instant mashed potato, baked potato, graham crackers, rice cakes, pretzels, popcorn
• Fruits: Watermelon
• Legumes: Broad beans
• Starchy Vegetables: Other potatoes, French fries
• Other: Candy, table sugar, doughnut

Medium Glycemic: GI of 56-69

• Grains: Hamburger bun, rye bread, croissant, wholemeal, Basmati rice, wild rice, couscous, cornmeal, tapioca, Oatbran® Cereal, Raisin Bran®, untoasted muesli, quick oats, cream of wheat, bran muffin, carrot muffin
• Fruits: Apricots, mango, raisins, cantaloupe, pineapple
• Starchy Vegetables: New potato, corn, pumpkin, pea soup, black bean soup
• Other: Potato Chips

Low Glycemic: GI of 55 or less

• Grains: All Bran® cereal, barley, pasta, oatmeal, bulgur, semolina, pumpernickel bread, brown rice, long grain white rice
• Fruits: Cherries, grapefruit, peach, apple, pear, plums, orange, grapes, kiwi, banana, strawberries, prunes,
• Legumes: All beans, peas, lentils
• Starchy Vegetables: Sweet potato
• Non-starchy Vegetables: All, tomato soup, minestrone soup
• Other: Skim milk, plain yogurt, soy milk, low-fat ice cream, chickpeas

A variety of factors affect the GI of a carbohydrate including the type of starch, cooking & processing, fat/protein content and the acid level of the food.  For example, instant oatmeal is higher glycemic than steel cut rolled oats (a very low glycemic food) because it is pre-cooked and thus more processed.  On the reverse side, you can add fat and/or protein to a high glycemic food and lower its overall glycemic index.  For example, adding  2 Tbs. peanut butter to a bagel (a high glycemic food).  Fat and protein both slow down digestion so when added to a high glycemic food they cause a less dramatic spike in blood sugar.

So now that you know what the glycemic index is and which foods fall into which categories, how do you apply that to exercise/training and playing golf?  You have to look at the goal…

Pre-exercise

Pre-exercise there is one main goal with food: supply the body with energy to fuel the activity.  As an athlete, you don’t just want energy for 20 minutes, you want sustained energy throughout your whole workout…thus, you want low-medium glycemic carbohydrates with a lean protein and a small amount of healthy fat.  This will digest slower and as a result give you energy for a longer period of time.

Post-exercise

Post-exercise there is also one main goal with food: RECOVER!  Within two hours after a workout your body is primed to take up carbohydrate and protein at a faster rate.  So, post-workout you should aim to eat high glycemic carbohydrates as they digest quickly, spike the blood sugar, cause a spike in insulin levels and thus help your body take up carbohydrate faster to trigger the recovery process.  Then don’t forget to add a protein to start the muscle repair process.

Have a question?  Ask at amygoodson@texashealth.org

Amy Goodson, MS, RD, CSSD, LD

It is that time of year again.  Baseball is getting started.  Our hometown Rangers were the talk of baseball with the signing of the Japanese league sensation Yu Darvish.  The talk is that the Rangers have one of the deepest starting rotations in all of baseball.  It seems that major league teams have to plan for injuries, especially in their starting rotation.  At Texas Health Ben Hogan Sports Medicine, we are very interested in the factors that might identify pitchers that are at risk for injury.  Two factors identified in research are internal rotation deficit and external rotation strength.

Internal rotation range of motion describes the movement of a pitchers arm after release of the ball.  It is the motion of the arm to slow down once the force has been imparted to the ball.  It is the opposite of the position of “cocking” the arm behind the head before the pitcher starts toward home plate.  In a study by Shanley et al, a loss of 25 degrees or more of internal rotation of the throwing arm compared to the non throwing arm was predictive of arm injury.  High school players with this limitation in motion were at a 4 to 5 times greater risk of upper extremity injury.

External rotation strength describes the rotator cuffs ability to slow the arm down and hold the arm bone in the socket during the throwing motion.  Research conducted on players in the Colorado Rockies organization has shown that preseason weakness of external rotation is associated with in-season throwing-related injury resulting in surgical intervention.

Preseason testing of strength and range of motion may help to identify players at risk for arm injury.  Talk to your athletic trainer or physical therapist for advice on how to be tested and what to do if you are identified as at risk.

Shanley E, Rauh MJ, Michener LA, Ellenbecker TS, Garrison JC, Thigpen CA: Shoulder Range of Motion Measures as Risk Factors for Shoulder and Elbow Injuries in High School Softball and Baseball Players.  Am J Sports Med, 2011

Byram IR, Bushnell BD, Dugger K, Charron K, Harrell FE, Noonan TJ: Preseason Shoulder Strength Measurements in Professional Baseball Pitchers, Identifying Players at Risk for Injury. Am J Sports Med 38(7)1375-1382, 2010

Mike Macko,PT, DPT, OCS, MTC, PES

Is your favorite food pizza?  Well, there is a healthy way to make it!  Most pizza is high in fat, but there is a way you can fuel your body with carbohydrates, protein and vegetables while eating your favorite food, pizza!

Let’s breakdown “The Flatout Pizza” ingredients…When making common recipes healthy, the key is to choose low-fat, whole grain ingredients.  In the case of the flatout pizza, we start with a whole wheat flour-oat fiber base, the Flatout wrap.  It contains 9 grams of fiber AND 9 grams of protein.  Next we add ½ cup tomato sauce & 1 cup veggies to get in a variety of vitamins and minerals.

“The Flatout Pizza” Recipe

• 1 Flatout wrap
• ½ cup Barilla Tomato & Herb Pasta Sauce
• ½ cup grated 2% Mozzarella cheese
• 2 oz lean sliced Canadian Bacon
• 1 cup non-starchy veggies of choice
• Enjoy!!!

Nutrition Facts:

Calories: 390, Carbohydrate: 36 gm, Fiber: 14.5 gm, Protein: 39.5 gm, Fat: 14 gm, Cholesterol: 60 mg

Add a salad w/vinegairette dressing and a whole wheat breadstick or piece of garlic 2% cheese toast and you are set with a protein packed pizza that tastes great!

If you have to order pizza out…

When ordering pizza at a restaurant there are some tips you can use to help make the pizza healthier.  First, start by getting thin crust as many thick crust pizzas have lots more calories.  Next, try to get a ham/veggie, chicken/veggie or veggie pizza.  Toppings such as sausage, bacon, and pepperoni are very high in fat and thus not the best option.  Then, blot your pizza with a napkin before eating to remove excess grease from the cooking process.  Finally, remember that pizza is about portion size.  Try to eat 1-2 slices and add a fresh salad or vegetable with it…this will increase the fiber content of the meal and help you feel more satisfied.

Have a question?  Ask at amygoodson@texashealth.org

Amy Goodson, MS, RD, CSSD, LD