TheAthletesLawyer

Having raced (and crashed) in races in Italy, Canada and elsewhere where the city streets are closed off and competitors bike and run at top speeds around 90 degree corners and hairpin turns, I appreciate the steps taken by race directors to provide protection to participants and spectators alike.  The Associated Press reported today that professional bicycle racer Paolo Bettini released from hospital after a cycling crash.  The report from Milan, Italy noted, “Two-time world champion Paolo Bettini, who crashed and hit his head during the Six Days of Milan indoor cycling event, was released from a hospital Tuesday.  In the final race of Bettini’s career, Ukrainian rider Yaroslav Popovych fell in front of the Italian. Bettini slammed his head into a protective barrier and broke his helmet, the Gazzetta dello Sport reported on its Web site.

A collar was attached to immobilize the neck of Bettini, who remained conscious and could talk, the ANSA news agency reported. Bettini later walked out of the Sacco hospital without assistance.  The 34-year-old Bettini won the world championship road race in 2006 and 2007. He also won the road race at the 2004 Athens Olympics.”

Luckily for Bettini, there was a protective barrier and he was wearing his helmet.  Tomorrow’s post will discuss safety barriers, fencing and other structures that are intended to reduce injury in cycle racing events.

In past posts, I have discussed sports and recreational activities other than swimming, running and biking that I and my family engage in.  Another activity that we enjoy is camping.  We had the opportunity to camp out during the “Tour of Oregon” bicycle tour.  We also have camped out with CANUSA in the Canadian Rockies, as well as at the Charlottesville Sprint Triathlon, Zurich Switzerland, the New Jersey shore and the Blue Ridge Mountains.  Virginia has a number of wonderful state parks, and we are lucky to have so many choices that are not too far away.

[Doug Landau and Maccabiah Teammate Gary Bub showing off the TriathlonTrialLawyer’s king-sized sleeping bag (visible from outer space !) after a long training run through the Will Rogers’ Estate in Pacific Palisades California.]

Many of my friends tend to gain weight in the winter. They race less. They do not worry how they look in a bathing suit. And they eat more when they are cold. Here are some half dozen strategies I plan on following so that I can be in top form next year:

1. Eat a healthy breakfast,
2. Pack healthy, smaller meals and snacks to take to work,
3. More hot soups, cereals and oatmeal - they keep you warm, and when your core temperature is up, you tend to eat less. Conversely, when you are cold, you tend to eat more.
4. Drink more water. Dry winter air can dehydrate you. Rather than the empty calories of soda, warm herbal teas, water and low-salt boullion for me !
5. STOP EATING after 9:00 p.m. Do not go to bed “stuffed” and uncomfortable. This just makes for fat production and makes for less restful sleep.
6. Get a full night’s sleep. OK, this is not a “diet” stratagem per se. However, the less I sleep, the more I eat. And, while I am sleeping, my body uses the good nutrition I have taken in all day to repair the damage caused by intense training. Napping helps too.

[TriathlonTrialLawyer Doug Landau getting a cooking lesson from top Richmond area Chef Tim Clinton. They are preparing egg white and Challah french toast and vegetables cooked in olive oil breakfast prior to a long spin class cycling workout]

When the temperatures are warm outside, it is easy to get in and get your yardage. But when it is cold, courage and an ability to fight off hypothermia are required. Several strategies that have worked for me include:

• Long sleeved wetsuit
• Shirts on under wet suit
• Double capping or wearing a thick, neoprene cap with a chin strap under the race-issued swim wave colored cap
• Keeping a bag of ice near the start, applying it to my face so I will not experience shock when I hit the cold water
• Warming up NOT in the water, and losing valuable body heat in a sprint distance triathlon, but by jogging along the beach.

But the best idea was given to me by Rehab2Racing Coach Allen Delaney. He advised
having a thermos or gallon jug of very warm (but not so hot as to scald) water at the start. About a minute before my wave goes off, I have someone pour the water inside and down my wetsuit, so that there is a layer of very warm water next to my skin. This also keeps the cold water from rushing in, I have been in races like the frigid “Kinetic Sprint” VTS race at Lake Anna, where this stratagem kept my torso and legs warm and happy through the entire swim. Only my uncovered hands and feet were cold. However, be aware, if you wade out into the lake for in “in water” start,” steam and smoke may emanate from your parts when the hot water makes contact with the cold water. Other competitors may move away from you quickly, while muttering things like, “Why didn’t you use the port-o-john or pee in the woods before getting in ?” The good news, is that I had “clear sailing” for several hundred yards, as no one wanted too be near me a the start of the race !

[TriathlonTrialLawyer Doug Landau with California triathlete and coach Jonathon Vakneen at the Santa Monica College pool complex]

Today is Halloween.  At the traditional Madeira School Halloween Parade, my daughter dressed up as a college sports professor who was shot in the leg by a student who did not listen to the archery instructor’s safety instructions.  While the teacher and the student both recovered, the serious message here is to LISTEN TO THE SAFETY RULES and wait until it is safe to start the athletic activity. 

Although archery is a sport with a low reported incidence of associated injury to the archers themselves, injury does occur because of the repetitive nature of the action of drawing a bow and the force levels required to accomplish correct shooting form.  The International Archery Federation (or “FITA”) medical committee launched a survey to try to determine the incidence of sports injury in archery.  http://www.qsl.net/gi4fum/page5.html

Archers do not appear to recognize chronic aches and pains as being due to injury. Injury reports relate to overuse or damage of muscles and tendons of the upper limb relating to the shoulder, elbow, wrist and finger joints. According to the survey results,  far the most frequently injured area is the shoulder. A small number of reports relate to direct trauma. It has been surprising to note that only under half of those reporting injury seek help from a physiotherapist.

A breakdown of injury reports gives the following results -

• Shoulder injuries (including rotator cuff) 47%
• Elbow injuries (common flexor & extensor tendon origin problems)                         17%
• Wrist injuries                                         12%
• Finger injuries                                         6%
• Back injuries                                           5%
• Forearm injuries                                     4%
• Other injuries                                         9%

Every year, more than 3.5 million children ages 14 and over receive medical treatment for sport-related injuries including falls, collisions, concussions, heat illness and overexertion, according to the U.S. Consumer Product Safety Commission. And more than 775,000 are treated in emergency rooms, reports the American College of Sports Medicine.

What can be done to reduce the incidence of such accidents and to ensure that injured children receive medical attention? According to the California Athletic Trainers’ Association, Qualified Athletic Trainers Can Reduce Number of Serious Injuries and Keep Young Athletes Safe.

“Immediate care given to young athletes by a qualified athletic trainer can reduce the severity of their injuries,” says Chino Hills High School Athletic Director Mike West. “As physical medicine specialists, a properly certified athletic trainer can offer a range of services, including injury prevention, immediate evaluation and treatment, and rehabilitation, to reduce the risk of serious injuries.”

West, who is also a certified athletic trainer and member of the California Athletic Trainers’ Association (CATA), believes the need for a qualified athletic trainer and comprehensive healthcare program in high schools and club-level sports is imperative because sports participation among boys and girls has increased more than 37 percent in the past 20 years, according to the National Federation of High Schools. Read the rest of this post.

[TriathlonTrialLawyer Doug Landau shown with experienced Hotchkiss School Athletic Trainer Pat Kelly at the sidelines of recent Bearcat soccer matches.]

JAMA (The Journal of the American Medical Association) is one of the world’s preeminent, peer-reviewed medical science periodicals.  A study  by Harborview Injury Prevention and Research Center, in Seattle, Washington, looked at the “Effectiveness of bicycle safety helmets in preventing head injuries.”  JAMA published the work of D. C. Thompson, F. P. Rivara and R. S. Thompson ( dct@u.washington.edu)

Their objective was to examine the protective effectiveness of bicycle helmets in 4 different age groups of bicyclists, in crashes involving motor vehicles, and by helmet type and certification standards.  The case subjects were all bicyclists treated in Emergency Departments for head injuries, all who were hospitalized, and all who died at the scene. Control subjects were bicyclists treated for nonhead injuries.  There were 3390 injured bicyclists in the study; 29% of cases and 56% of controls were helmeted. Risk of head injury in helmeted vs unhelmeted cyclists adjusted for age and motor vehicle involvement indicate a protective effect of 69% to 74% for helmets for 3 different categories of head injury: any head injury , brain injury, or severe brain injury.  The researchers also found similar levels of helmet protection by age.  Helmets were equally effective in crashes involving motor vehicles and those not involving motor vehicles .

The investigator’s conclusions: Bicycle helmets, regardless of type, provide substantial protection against head injuries for cyclists of all ages involved in crashes, including crashes involving motor vehicles.

TriathlonTrialLawyer Doug Landau suggests there are several indicators to look for when selecting a Sports Medicine specialist. Sports medicine is not a certified medical specialty. You will not find a “Board Certified Sports Medicine Doctor” or “Board Certified Team Physician.”

However doctors who have completed a CAQ (Certificate of Advanced Educational Specialization) are recognized by national accreditation organizations as sports medicine specialists. Doug Landau studied Sports Medicine in college and graduate school, and considers membership and active participation in the American College of Sports Medicine (”ACSM“) and certification by that organization to be a good indicator of serious interest and specialization in sports injuries, prevention and rehabilitation. Other criteria, such as experience and percent of time spent treating athletes, can also to determine if a doctor is qualified to diagnose and treat sports injuries. Questions to ask when looking for a sports medicine specialist:

* How long have you treated (adult or youth) athletes ?
* What kind of training have you had (with my kind of injury/condition) ?
* What percent of your patients are competitive (as opposed to recreational) athletes ?
* Are you a team doctor for any local teams ?

Since many sports medicine doctors and other professionals practice sports medicine part-time, you may want to choose a doctor, physical therapist or other health care provider who treats athletes 25 to 40 percent of the time. You should also ask friends, teammates and coaches for their recommendations, and also run them by your regular or family physician. It is also important to keep your internist, pediatrician or family doctor “in the loop” so that no one is working at cross purposes, hindering your recovery and return to the playing field.

TriathlonTrialLawyer Doug Landau’s doctor ordered a thallium stress test after recent difficulties breathing. The purpose of this procedure was to determine whether exercise causes a decreased blood flow to the heart muscle. If so, the doctors can determine whether the blood flow improves with rest. The testing also looks for disturbances in heart rhythm which may not be seen at rest.

Prior to the procedure, Doug had to be on his “best behavior.”  He had to avoid caffeinated beverages, herbal tea, and not eat after midnight the night before. An intravenous (I.V.) line was inserted into his hand, his chest shaved and ECG wires hooked up to his chest.  Herndon Reston area injury and disability lawyer Landauu then walked on a treadmill, with the technicians gradually increasing the speed and slope.

Unlike the VO2 Max testing that Landau had undergone in the past, this test did not get close to his maximum heart rate or running speed.  Also, Doug did not have to breathe through a tube and give hand signals.  He was instructed to walk or jog until he experienced symptoms such as chest pain or shortness of breath, or until he was too tired to continue.  As the technicians stopped the test when Landau’s heart rate reached only 161 BPM, Doug had not yet begun to sweat.  They did this based upon the formula for maximum exertion (220 minus your age), even though Landau routinely races at heart rates higher than the “maximum” predicted by this formula developed for the general population, and not well-traiined endurance athletes.

Technicians were present throughout the entire test and monitored Landau’s blood pressure and ECG continuously.  The thallium was then injected so that a radioactive isotope picture could be made of the inner workings of Landau’s heart. Thallium is an isotope which is “taken up” by the heart. It flows more easily through non-diseased and uninjured arteries and vessels.  The thallium enables blood flow to be seen on a camera. Landau was placed on a table with scanners overhead. The pictures were taken and then analyzed on computer shortly after.

Date:Sunday, November 09, 2008 at 8:00 AM
Venue:Rock Creek Park
Address:Race begins between the FitzGerald Tennis Center and Carter Barron Amphitheatre, Washington, DC 20008
Brief Description:
The 5K Race for Justice begins promptly at 8 am. Food and water will be available to participants before and after the race. Prizes will be awarded for: first overall (male & female), GW student (male & female), GW alum (male & female), 19U (male & female), 20-29 (male & female), 30-39 (male & female), 40-49 (male & female), 50-59 (male & female), 60+ (male and female).
Additional Information
Ever on the lookout for events that raise money for noteworthy causes and non-profit law groups, and as a law school race director himself, TriathlonTrialLawyer Doug Landau posts this race.  The Race for Justice promotes the provision of public interest legal services in two ways. First, proceeds from the race fund stipends for current law students who pursue unpaid public interest work over the summer. Second, the race benefits the G.W. Loan Reimbursement Assistance Program (LRAP) which helps recent graduates pursue public interest employment by providing forgivable loans to those who pursue low paying public interest careers.