TheAthletesLawyer

Just when you think you have seen every kind of pre- and post-race oddity, you are surprised by some new twist at an international competition. In this time of Thanksgiving, I am thankful that I have been able to finish every race I have started in other countries, despite crashes, dashes and frigid splashes. In tomorrow’s post, I will relate some of the unusual pre- and post-race anomalies that I have experienced abroad. In the mean time, in order to help the United States 2009 Maccabiah Team prepare for these 19th quadrennial games, I make the following recommendations:

1. Avoid jet lag and dehydration – bring one of your large bike water bottles on the plane, fill it & use it. Stretch gently, sleep, relax. Enjoy the company of your teammates, travelers and you significant others. Alcohol, salty snacks and a long flight will ensure your dehydration. Save them for after the event. There will be plenty of opportunities to “eat, drink & be merry.”
2. Know the weather. You are well-advised to bring: SPF lotions, clothes, caps, visors, good sunglasses, etc. As a red head who is at risk for retinal cancer, I brought several pair of good sunglasses and often wore the team-issue visors and caps. One athlete got a severe sunburn before his event and it compromised his performance significantly. Another got a terrible jelly fish burn, and it ruined his honeymoon as well.
3. Bring everything you will need to fix your bike. For example, if you ride a Kestral KM-40 with 650 wheels, do not assume that the shops will have spare tubes for you. There were several terrific bicycle stores and mechanics all on the same block in Tel Aviv. If you arrange ahead of time, either as a group or solo, they can really be an enormous help. However, there are always last-minute adjustments, and if not for team member Rob Urbach’s mechanical skills, my wife and I would not have had a good day at the races.
4. Nutrition – assume NOTHING ! My smarter teammates carried Read the rest of this entry »

A verdict of $300,000 was rendered by a jury in Prince William County, Virginia for a 25-year-old man as the result of an exercise regimen that resulted in his hospitalization. The plaintiff was on active duty from the Navy and in good physical condition. At the Manassas World Gym, he was asked to try a session of CrossFit exercises. He was assigned a personal trainer, and, after 20-30 minutes of CrossFit, focusing on his lower extremities, he was unstable walking and sore. Forty eight hours later, he was in considerable pain and passing dark, discolored urine. To treat his condition, he was admitted to the hospital at Andrews Air Force Base. The diagnosis was Rhabdomyolysis, which is due to the breakdown of muscle protein. The muscle protein can then spill into the bloodstream and block up the kidneys leading to coma and death if not timely treated. The breakdown continues after the exercise session ends. The plaintiff had medical bills of over $13,000 and alleged: negligence, a failure to warn leading to rhabdomyolysis due to acute overexertion, hospitalization and some limited disability to both legs. The full case report is in the December 1st, 2008 issue of Virginia Lawyers Weekly (23 VLW 729).

Returning to the Tenafly Racquet Club, where he had taught tennis for several summers in New Jersey, TriathlonTrialLawyer Doug Landau and his Mum got pounded by the grandkids.  The Herndon  Reston area injury and disability lawyer had no excuses.  Virginia Tech Junior (and former all prep wrestler and Hotchkiss soccer player) Zach Landau and his sister, Madeira’s senior goalkeeper and Soccer Captain Danielle Landau, beat up on their elders something awful.  Even though they never practice, the younger Landaus split sets and gave  their father and grandmother quite a fright.  Dates and terms for a re-match are currently being negotiated.   Stay tuned !

As I have done for over 25 years, I run on Thanksgiving Day. I do so to raise money for a worthy charitable cause, because I am thankful that I can do so, and because my clients cannot. This year I took part in the Literacy Volunteers of Morris County and The Interfaith Food Pantry 2nd Annual 5K Turkey Trot in Morris Township, New Jersey. My Overall Place: 42 of 660 finishers. My time on the USATF certified 5K race course 20:51.1, for an average pace of 6:43.6 per mile. Not bad on a cold, hilly course, but a far cry from where I want to be. However, I am thankful for being able to toe the line, run the race, be in the lead pack if only for a moment, and then finish and enjoy the company of friends. I did the race to support my pal and Maccabiah teammate Jed Kwartler. Dr. Kwartler, of UMDNJ and the Ear Specialty Group, raced despite crashing during the bike portion of Ironman Arizona. Jed was sporting some impressive road rash Thanksgiving morning. He was thankful to be able to beat his son Zach (shown in the middle), a Sophomore at Princeton University, despite the younger Kwartler’s negative splits and closing kick.

Soccer is a contact sport.  Just because soccer players wear less padding than America footballers, there is still plenty of physical contact in any high-level match.  Shin to shin and other leg injuries are common.  The Soccer Injuries FAQ notes that: “Other than contusions, injuries to the upper body in soccer are less common. The collisions in the sport will occasionally cause a shoulder separation, which is damage to the acromioclavical (AC) joint, the connection between the shoulder blade and the collarbone. Soccer goalies are more exposed to shoulder injury as a result of diving across the crease to make saves and striking the goal post.

Head injuries may occasionally arise due to collisions with opponents—concussion and damage to the player’s teeth are the greatest risk. Many players wear mouth guards to protect their teeth, which has the additional benefit of reducing the effect of concussions by keeping the tempomandibular joint (TMJ) from being driven upward into the skull. Since the mid-1990s, there has been controversy in the international sports science community as to whether the repeated heading of a soccer ball will cause damage to the brain or to the muscles and structure of the neck. Various studies initiated by soccer nations have not yet resolved this question.”

[Senior Goal Keeper Danielle Landau lays on the field during the ISL Tournament after being kicked in the neck making a save at the Bullis School in her final high school soccer match.  She was put in a neck brace and did not return to the field.]

James Hilaire of the Stamford Times reported that former Stamford High School soccer player James Hilaire, a senior goalkeeper at the University of New Haven, suffered a broken jaw and a serious head injury during a game at Merrimack College.  Hilaire went out in front of the UNH goal, hoping to grab a loose ball before a charging Merrimack player got there. As both players made a move for the ball the opposing player’s knee slammed into Hilaire’s head. Hilaire, who suffered serious head trauma on the play, later underwent surgery to repair his broken jaw.

At least one report referred to these injuries as “life-threatening.” Hilaire was a patient at the Surgical Intensive Care Unit at the Boston Medical Center where he was listed in critical condition.  He was eventually discharged to begin the next phase of his recovery – rehabilitation – on Oct. 16 at Gaylord Hospital in Wallingford, according to the Stamford Advocate.  The Goalie was talking clearly, or at least the best he can communicate when he returned to the campus a week and a half later.  He reportedly still has some physical deficiencies on his right side, from his shoulder on down to his leg.  It is anticipated that this young athlete will get back to 100 percent.  We are glad that he is making progress and hope that he makes a full recovery.  As the father of a goal keeper, who has seen his own daughter taken from the field with a neck injury and also after getting kneed in the gut, I can empathize with the Hilaire’s family, friends and teammates.

Doug Landau had a Thallium Isotope Stress Test.  You can see what a lab that performs these tests look like at heartsite.  The MRI provides a very comprehensive evaluation of the heart, displaying the function, structure, blood flow, and coronary arteries.  Standard stress tests, such as treadmill exercise tests, can indicate how well an individual’s heart handles increased physical exertion, and can help physicians find a blockage or other problem in the blood vessels of the heart. A thallium stress test uses a radioactive substance that is injected into the bloodstream to show how well blood is flowing to the heart muscle.  It is usually done in conjunction with an exercise stress test on a treadmill or bicycle.

The fast cine MRI stress test uses a new form of high-speed MRI to view the wall of the heart as it beats. The fast cine MRI is able to capture the heart’s movement at almost the same time the heart is contracting and relaxing, or close to ‘real time.’  With the high-speed imaging, the physician can evaluate the ability of the left ventricular wall to move during physical stress. The fast cine MRI uses the highest speed available to visualize the rapid movements of the heart and obtain a nearly immediate image of the heart in motion.

The test is an alternative for patients who aren’t well suited for standard stress echocardiograms, such as obese patients, individuals who have undergone previous cardiothoracic surgery, or who have lung disease. However, the fast cine MRI stress test should not be used in patients with pacemakers, cochlear implants, metal clips, or defibrillators.

The posts on fatalities in Triathlon, after I was contacted by a national triathlon magazine, drew a lot of very good and provocative comments, which I have set forth below:
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Roger Brockenbrough said: FYI, although intersections are usually monitored and controlled, most race courses (bike leg in particular) are NOT closed to traffic.
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Trip Garner said: What are you guys seeing as the leading cause of these deaths?
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Dr. Eric Tondera said: I don’t know if it was reported but a 39 year old male died last year at the Cinco Ranch Triathlon race. He had completed the swim and bike but had a massive heart attack during the first quarter mile of the run. Yes, this is tragic and hopefully will not happen. However, we do know that things like this will occur and thank God it happens very rarely as your article indicates. Thanks for allowing me to comment. Eric.
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Steve said: Interesting Article Read the rest of this entry »

The National Institutes of Health reported on “Preseason physical examination for the prevention of sports injuries,”  http://www.ncbi.nlm.nih.gov/pubmed/3906829

D. B. McKeag reported, “The importance of the preseason physical examination and preparticipation evaluation of sports candidates is highlighted because it constitutes one of the few occasions in which the physician can actively prevent sports injuries from occurring. As exercise participation continues to increase on a world-wide basis, an understanding of the goals and objectives of such a pre-exercise evaluation are important. The need is not for a standard evaluation form, but for a consistent understanding of adjusting the evaluation to the age of the candidate, the type of sport to be engaged in and the anticipated level of competition. Essentials of any evaluation are musculoskeletal, cardiovascular and psychological examinations.

Examinations should have clearly defined objectives, and factors determining the type of evaluation include: prospective athlete; contemplated exercise programme; and motivation. Different types of implementation are individual examinations, locker room technique and the station technique, each with advantages and disadvantages. A pre-exercise evaluation should always occur before any anticipated change in level of school or competition with an interval or intercurrent history and physical examinations occurring at regular intervals. It is important that examinations take place before the commencement of a sports season so previous injuries and problems can be dealt with; timing is vital. Contents of a pre-exercise physical examination should include history, a physical examination, laboratory testing and additional specific screening evaluations. Finally, assessment of the pre-exercise evaluation and injury prediction will aid physicians in preparticipation evaluations.”  Sports Med. 1985 Nov-Dec;2(6):413-31.

[TriathlonTrialLawyer Doug Landau physical exam from Board Certified Internal Medicine Specialist Dr. Dennis Sager, M.D., FAA inspecting doctor and often seen at the Reston Triathlon finish line]

Key to the mission of CycleSafe.org is event safety.  “Cyclesafe.org provides free course safety consultation and infrastructure to cycling events from fun rides to the top pro races in the Carolinas. The CycleSafe.org Safety Team assesses the specific needs and formulates a comprehensive safety plan with prescribed procedures and placement of barriers, fencing and other safety infrastructure to minimize risk of serious injury during a cycling event. CycleSafe.org provides the fencing, hay bales, impact barriers and other safety infrastructure to event promoters to insure that their event is safe and enjoyable. CycleSafe has an on-staff safety coordinator to assess bicycle related events and provide a safety plan complete with GPS locations and a legend for course set-up. CycleSafe.org is the first and only organization to bring cycling specific high technology safety air barriers, pole protectors and curb protectors to the cycling world.

What are Air Barriers?

Air Barriers provide the safest means for slowly stopping a rider who has gone off of the course. An air barrier is like a big air bag. Using air barriers in strategic places, like the outside of a turn, will reduce the risk of a rider being severely injured or injured at all. Air barriers will absorb an impact unlike the steel fencing, commonly used at races, which is designed for crowd control.

What are Pole Protectors and Curb Protectors?

A pole protector is a big piece of foam that can be wrapped around and strapped to utility poles and sign posts. A curb protector is a wedge shaped foam piece that is placed against a curb that prevents hard impacts on the edge of a curb.

While it is the race promoter’s responsibility to take care of its riders, CycleSafe.org can provide the knowledge and equipment for race promoters to have a fun and SAFE event. Please send an email to CycleSafe.org to reserve safety equipment for your Carolina cycling event.