From our Friend,  Elite Bicycles Athlete,  and Role model Dr. Metzl, who is as charismatic and handsome as he is brilliant.  Hope you all enjoy.

Greetings and welcome to our sports medicine newsletter. This is our “spring is here and let’s get moving” edition of the newsletter. We hope you find information that is interesting and helpful to you. If you’ve been forwarded this newsletter and want to sign up yourself, just click subscribe on our website at www.DrJordanMetzl.com and you’ll get the next one.

Athletes of the Month

We are starting a neat new project in the office. In addition to the athletes of the month below, we have a digital frame of all the athlete photos from our practice so that we can see you at your best every day! As such, we’d love for you to send one or two of your favorite photos to Meghan in our office. I don’t care what the sport or your age, just send us your pictures and we’ll put ’em up! Race photos, sports photos, or whatever you want is fine with me.

As for the athletes of the month, we’re still looking for your stories. I don’t care if you are first place or last place, as long as you are trying! Send us your story with a photo and you too can be the athlete of the month. Please send your photo and entry to Meghan in my office.

Elene Gedevanishvili

An upbeat, positive, and amazingly talented skater, Elene hasn’t let anything stand in her way. Her determination was in full view at this year’s Olympic games in Vancouver where she came in 14th place in the women’s figure skating competition while competing for her home country of Georgia. Her amazing short program stunned the crowd in Vancouver. Have a look!

Way to go Elene! We are so proud of your accomplishments!

Joseph Tafuri

Athletes come in all shapes, sizes, and sports. Ballroom dance is a sport that Joe credits with about 75 pounds of weight loss and great joy and satisfaction in his life. “I love this sport and I want to keep doing it forever,” says Joe. As I always say, it’s all about the enthusiasm. Way to go, Joe! You keep dancing and having a great time- we’re behind you all the way!

Coaches Symposium: June 16th

We’re sponsoring a free coach education symposium on Wednesday morning from 9-11AM, June 16th, here at HSS. This free program is designed for those who coach athletic kids and teens, and will include brief lectures on topics such as concussions, nutrition, ACL injury prevention, and effective stretching techniques. If you’re interested in attending, please send an email with your name and affiliation to http://wsw.com/webcast/drjmetzl2/

Multisport World NYC: April 18th 2010

On Sunday, April 18th, the JCC Manhattan will host Multisport World, an exciting conference for triathletes that is complete with a vendor expo, expert-led seminars, and training clinics.  Admission to the expo and seminars is free and runs from 10am-4pm.  More information including registration can be found at the following link:


Core Strengthening: Why is it all the rage?

This article from the Wall Street Journal examines the issue of core strength for athletes. It provides helpful information about the benefits of core strength and has some nice videos to show the exercises.


Teen/Kids News: ACL Injuries in Adolescents

A news station for teens by teens? That’s Teen/Kids News. This story is about teenage ACL injuries and includes topics such as how this injury happens, why it happens more in girls than in boys, and what can be done to prevent ACL injuries. The kids do a great job as newscasters. http://www.youtube.com/watch?v=QeQc5Z3VSVM

TriCenter: Shin Splints

For our triathletes: TriCenter is the new on-line version of ESPN’s SportsCenter, but made for triathletes. Produced by Triathlete magazine, it gives weekly updates on issues of importance for triathletes. To check out a story on TriCenter that we did on shin splints, have a click below.


If you’re interested in seeing more episodes of TriCenter, this is the link to follow: http://triathlon.competitor.com/

An Interview from NPR’s Brian Lehrer Show: Sports Specialization in Kids, Chasing Olympic Dreams

Those of you in the New York area know Brian Lehrer as the host of a thoughtful program on the local NPR station that deals with a variety of issues. In this clip below, we discussed the issues of sport specialization in young athletes and how parents, coaches, and kids can better navigate the increasingly competitive and specialized world of youth sports. Featured as well is Katrina Hacker, a former high level skater and current Princeton student.


Muscle Cramps: What are They?

I thought that this article on muscle cramping might be helpful as we head into spring. I hope it’s helpful to you.

Muscle Cramping: A Common Problem in Athletes

Jordan D. Metzl, MD

Rebecca, a thirty year old triathlete and runner comes into the office with a common problem. “Doc, I’ve got a problem.” “Tell me,” I said. “I love my training, both my running and triathlon training are going great. But several times during the past months, especially during peak training, I have been having troubles with muscle cramps.” “Rebecca,” I said, “we need to talk about muscle cramping so we can fix this problem.”

What Rebecca describes is a common problem that plagues many runners and triathletes, as well as soccer players, tennis players, and other athletes. Muscle cramping, a spasmodic contraction of skeletal muscle, can be tremendously painful.

Muscle cramping can occur for a number of reasons. In this article, we’ll concentrate on some of the more common types that we see in the sports medicine office. These include neurological cramping, functional cramping, and nutritional cramping.

Neurological cramping is the least common type and generally occurs in the setting of back pain and a disc herniation compressing a nerve root exiting from the spinal canal. Neurological cramping occurs when the nerve becomes irritated, and the referred pain into the muscle can sometimes cause cramping. Although somewhat uncommon, triathletes will occasionally complain of this type of cramping when riding the bike, a time when the lumbar spine is under a period of prolonged flexion. This type of cramping is generally diagnosed by an MRI and sometimes a nerve conduction test called an EMG. If it is the case, the treatment can vary from stretching, to injection, to surgery in extreme cases.

Functional cramping is much more common. By functional cramping I mean that the muscle starts to cramp during exercise due to diminished strength and/or flexibility. Common sites for this type of cramping include the shoulder muscles during swimming, and the leg muscles during running. The hallmark of functional muscle cramping is that the symptoms are often one-sided. Meaning, weakness or loss of flexibility in a particular muscle group leads to problems in a specific site. The key here is that functional muscle cramping is due to a problem in a specific muscle group, not due to a systemic problem affecting the body. Functional muscle cramps generally occur during activity and tend to occur during any time of the year, hot or cold, since the problems are due to strength and flexibility.

If functional muscle cramping is suspected, the key is to speak with your doc about seeing a physical therapist or trainer who can help figure out what the functional limitations are. These might include specific areas of weakness or inflexibility, as well as types of activity-specific issues like a poor bike fit or a faulty running or swimming style, which lead to muscle cramping. In any of these scenarios, the key point is to fix the underlying problem. Targeted strength and flexibility programs, under proper supervision, can accomplish this easily.

The final and most common type of muscle cramping is nutritional cramping. Typically occurring during the summer months, especially during periods of peak heat and humidity, nutritional muscle cramping happens for one of several reasons.

The first is dehydration related muscle cramping, which occurs when the body’s tank is depleted, meaning too much water has been lost through sweat and has not been replaced. Athletes sweat at different rates and the more trained an athlete is the more he or she sweats. For this reason, the amount of fluid that someone needs for replacement varies from person to person. If dehydration related muscle cramping is suspected, increasing the amount of fluid taken during and after exercise can help.

A more serious variant of nutritional muscle cramping is related to electrolyte depletion, particularly sodium, potassium, calcium, and magnesium. Each of these electrolytes is found in the body, and each helps create a delicate balance inside the body’s blood stream. With prolonged and intense sweating, the concentration of these electrolytes can become depleted, and one of the early manifestations of this problem can be muscle cramping. This is particularly noticeable in hot, humid conditions, but can occur during any season if electrolyte replacement is not given proper consideration.

As is true with many things in life, the best defense is a good offense. In terms of nutritional muscle cramping, both due to dehydration and/or due to electrolyte imbalance, the key is to recognize if you suffer from this, and if you do, proactively try to fix the problem. Since nutritional cramping is a systemic problem, muscle cramping tends to be generalized around the body and not muscle group specific. Since both the sweat rate and sweat concentration of electrolytes varies significantly from person to person, the best way to handle nutritional muscle cramping is to see a sports nutritionist who can help find your sweat rate, if necessary, give clues on electrolyte replacement strategies, and then help devise a plan to fix the problem. Trying sodium rich foods like pretzels is often a good first step, as well as a trial with a high sodium containing sports drink during exercise.

In our case, Rebecca was suffering from dehydration-related cramping, and by figuring out her sweat rate and providing her a more appropriate level of fluid intake and a bit more sodium in her diet, her problem was solved. She is now cramp-free!


That’s all for this newsletter. I hope you enjoyed it!

Best wishes for you all and have a safe and active spring sports season! Keep moving and have fun!

Jordan D. Metzl, MD

www.DrJordanMetzl.com- an educational website with information about our practice, articles, and educational videos about sports medicine

This post was written by: DGG

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