American Football 101
Are you looking for a way to increase the capabilities of your football team? Is your football team leaving something to be desired? Are you looking to skyrocket your team's effectiveness with the most effective drills and plays?
To use Shannon entropy as a measure of uncertainty and choice, we must first say about what we are uncertain. Suppose our uncertainty is the outcome of the football or baseball season, and we wish to choose the winner of the season. Without apology, we may establish a probability for each team, because these probability measures are our personal degree of belief. We only are required that the sum of all probabilities be equal to one. As the season progresses, some teams will lose games, while others will be winners. Then, one may adjust the appraisal of each team's probability of winning according to the record. At the end of the last game, the winner has prevailed, one is no longer uncertain of the winner, and Shannon entropy goes to zero (see Shannon, 1948, para. 6 Choice, Uncertainty and Entropy).
Injuries to the cervical spine range from mild to severe. Certain athletic activities (football, diving, gymnastics) are associated with an increased incidence of cervical spinal injury in comparison with other sports. Prompt recognition and treatment of persons who suffer cervical spinal injuries may prevent the progression or severity of the associated neurologic injury.
A 37-year-old right hand dominant high school teacher and coach of the football team comes to the office because he got his finger caught in a football helmet during a drill. He said that he felt a crack and looked down and noticed his long finger on his right hand was pointing toward his thumb. He reports taking hold of it and pulling back straight and had the team trainer tape it to the index finger. He has no history of diabetes or vascular disease, and is presently not on any medications.
51 , or by congenital changes, such as an accessory acromial ossicle 52 or a thick coracoacromial ligament 53 . Primary impingement is commonly seen in football quarterbacks, because of the direct overhead motion of the throw, and in other overhead athletes, such as tennis players during the serve and freestyle swimmers.
Future fear give way to the frightening awareness that a painful injury or condition may have a permanent effect. Despair and despondency develop as the suffering remains partially unrelieved, and activities become restricted. The seductiveness of seeking, demanding, and receiving help from significant others, including doctors and family, the mildly pleasant and or euphoric effects of medication, or the sedation and induced sleep which avoids pain, can produce a reinforcement contingency for which the pain is a sufficient, and eventually a necessary precursor. Feelings of helplessness lead to depression, guilt, and internalized anger concerning perceived loss of bodily parts or functions, and diminished self-control. Gradually, a time-protracted pattern is established involving helplessness and depression which reinforces pain behavior (Fordyce, 1976 Sternbach, 1968). Pain is sometimes positively reinforced by its pleasant consequences, and sometimes negative consequences are avoided...
Watching your children compete at a sport, your favorite team play football, a thriller on TV, or a good film at the cinema experiencing anger and frustration at work, at home, in traffic, or in a line or having a frustrating telephone conversation or argument are all well-known, common triggers of angina in people with coronary heart disease. The excitement and tension quicken the heart rate, increase the blood pressure, and, in some cases, cause the heart arteries to go into spasms and close down. The blood and oxygen supply to the heart decreases, causing chest tightness. It usually passes off quickly when the person cools down or walks away from the stress, or takes a spray of their GTN (glyceryl trinitrate is a spray medication to relieve attacks of angina). Only rarely, and if the stress is severe, would these attacks lead to a heart attack.
M.L., a 56-year-old business executive and former college football player, was referred to an orthopedic surgeon for recurrent shoulder pain. M.L. was unable to abduct his right arm without pain even after 6 months of physical therapy and NSAIDs. In addition, he had taken supplements of glucosamine, chondroitin, and S-adenosylmethionine for several months in an effort to protect the flexibility of his shoulder joint. M.L. recalled a shoulder dislocation resulting from a football injury 35 years earlier. The surgeon recommended the Bankart procedure for M.L.'s complete tear to restore his joint stability, alleviate his pain, and permit him to return to his former normal activities, including golf. T.D., a 16-year-old high school student, had a severe football accident 3 months before his admission. He sustained a right brachial plexus injury, resulting in a flail arm. He had no recovery and was on medication for neurologic pain. He reported that he had no feeling or motion in his right...
Fatigue fractures usually result from alteration of the duration, intensity, or manner in which a physical activity is performed. Stress fractures of the foot are relatively site specific based on the type of athletic activity. Recreational and competitive runners, basketball and football players, ice skaters, ballet dancers, and military recruits are particularly at risk. There are three different types of stress fracture of the proximal to midshaft fifth metatarsal. Fracture of the tip of the styloid process results from an inversion injury and results from avulsion either by the lateral cord of the plantar aponeurosis or by the peroneus brevis 14 (Fig. 8). A Jones fracture occurs approximately 1.5 to 2.0 cm distal to the tip of the tuberosity as a result dorsiflex-ion with the forefoot in supination 14,15 (Fig. 9) the distinction is important because of the tendency toward delayed healing or nonunion for these fractures at the junction of the metaphysis and proximal diaphysis....
Former college football linebacker with chronic left groin pain. Iliopsoas bursa aspiration and injection. (A) Axial CTscan demonstrates distended iliopsoas bursa (arrow). (B) Needle is placed into the center of the bursa under CT guidance (arrow). The cyst fluid is then aspirated and bursa is injected with anesthetic and steroid combination. Fig. 9. Former college football linebacker with chronic left groin pain. Iliopsoas bursa aspiration and injection. (A) Axial CTscan demonstrates distended iliopsoas bursa (arrow). (B) Needle is placed into the center of the bursa under CT guidance (arrow). The cyst fluid is then aspirated and bursa is injected with anesthetic and steroid combination.
American football cleats have evolved to include an increased numbers of cleats, with greater flexibility of the forefoot. Both of these adaptations have been associated with an increased incidence of turf toe 25 . Although it has not been proven, hardening of the artifical turf over time may have a small contributory role to the increased incidence of turf toe 26 .
Spinal images of an 11-year-old boy who presented with intractable neck pain associated with an aneurysmal bone cyst after a football match. A pre-operative transarterial PVA em-bolization was performed. (A) Lateral plain spine x-ray film shows a sharply demarcated os-teolytic lesion of the posterior part of the C5 vertebral body (arrow) and narrowing of the spinal canal. (B) T1-weighted image shows the C5 lesion with well-defined calcified boundaries (arrow). There is no epidural extension or spinal cord compression visible.
Acute insertional tears are infrequently reported in the literature but are probably more common. These injuries have been surgically repaired in professional footballers (two cases) with full return to play and no manual loss of strength. Repair was the chosen method as adductor tenotomy has shown to result in loss of muscle strength and decreased activity 59,60 . Clinically, many others treat these injuries conservatively and some partial entheseal tears are lysed to alleviate symptoms. Fig. 16. Coronal IR image showing complete acute avulsion of the left adductor longus insertion on the pubic symphysis in a professional football defensive lineman (A). Football linebacker with chronic injury of the right adductor tendon that has healed but develops intermittent pain. Note irregularity and enlargement of the tendon without surrounding edema (arrow) as compared with the opposite side (B). Fig. 16. Coronal IR image showing complete acute avulsion of the left adductor longus insertion...
Although the majority of Lisfranc fracture dislocations result from highvelocity trauma or crushing injuries, sports-related Lisfranc injuries typically occur as a result of low-velocity indirect force. In athletes, the typical mechanism of injury is an axial load on a plantar flexed and slightly rotated foot 2 . These injuries are particularly common in but not unique to American Football, with offensive linemen most commonly affected 3 . Sports-related Lisfranc injuries are considered in a spectrum of midfoot sprains. Midfoot sprains may or may not include diastasis or fracture at the first intermetatarsal space or second metatarsal base, respectively, and therefore may elude conventional radiographic detection.
From this perspective we probably are 'doing' hypnosis work when we engage our young patients in conversation in which they are absorbed, paying attention, listening, and responding as requested. Most children move in and out of spontaneous hypnotic-like states as they focus their concentration, for example on video games, favourite movies (e.g., the Lion King, Pocahontas), TV football, playing 'house', listening to a story, enjoying puppet play, or otherwise engaging in fantasy. Kuttner has noted (1988), that especially young children have blurred boundaries, and move frequently, naturally, and easily from fantasy to reality.
A more recent study of 30 MRI-proven hamstring injuries in Australian Rules football players showed high correlation with volume of involvement (range 0.04 cm3 to 175.6 cm3, median 16.8 cm3) and maximum cross-sectional percentage (8 to 100, median 46 ) with time lost from competition (13 to 48 days, median 27) 14 . Linear fluid signal representing the length inter- and intramuscular fluid and edema showed strong correlation but was not statistically significant in this study. More injuries occurred distally (19 versus 11 defined as above or below origin of biceps femoris short head) but there was no correlation with location of injury and missed competition (Fig. 6). In terms of predicting recurrence and length of convalescence another study imaged 31 Australian Rules footballers with clinical grade 1 injury. Forty-five percent had a negative MR exam and returned to full team training in 6.6 days versus 20.2 days for the MR-positive group. In this study the length of the injury had a...
A more recent longitudinal study of hamstring muscle injures compares so-nography with MR in 60 professional Australian Rules football players 9 . All players were imaged within 3 days, at 2 weeks, and 6 weeks with both modalities. Sonography detected 45, 25, and 10 cases of injuries over the three time frames and MR detected 42, 29, and 15 injuries respectively. All injuries appeared larger (length and cross-section) on MRI at all time points. The length of the tear measured on coronal images and the cross-sectional area on MRI
Muscular strength, power, and speed or endurance) (103,104). These agents are used by athletes involved in many sports. However, sports such as track and field (mostly in the throwing events), weight lifting, bodybuilding, and football report the highest prevalence of use (104-106). For the remainder of the discussion, anabolic-androgenic steroids will be referred to as anabolic steroids.
A 57-year-old man experienced several months of vague pains in his left chest and shoulder when climbing stairs. During a touch football game at a family picnic, he had much more intense pain and had to rest. After about 45 minutes of intermittent pain, his family brought him to the emergency department.
Astigmatism simply describes a cornea that is more curved in one axis than the other - it has a surface contour shaped like a rugby ball as opposed to a football - which is spherical. It is not a disease, and is usually correctable with glasses or contact lenses. Progressive astigmatism may be associated with keratoconus (see p. 92). Reading glasses will be required for middle-aged patients postoperatively.
The most important aspect of the management of cervical spinal injury is immobilization. Neck immobilization should be maintained until a definitive diagnosis has been made. For example, football-related cervical spinal injuries are managed by transporting the patient (with helmet in place) on a backboard. The patient is log-rolled onto a backboard with vigilant head stabilization. The face guard is left in place unless respiratory difficulty is encountered, in which cases it is removed. The neck is never moved passively until a fracture or dislocation is ruled out. 1. Burners or stingers. These injuries represent a stretch of the brachial plexus with a transient loss of motor power and transient pain radiating down the arm(s). This phenomenon usually occurs in football players. Most often, the symptoms are temporary and usually resolve within 1 to 2 minutes. The person can generally return to play the day of injury. With more severe brachial plexus injuries (i.e.,...
Determine the nature of the knee injury. Valgus versus varus stress Hyperflexion versus hyperextension injury If a ski injury, ask the patient in which direction the ski pointed at the time of injury. If a football injury, determine how the foot was planted at the time of impact and the site and direction of the injury force.
Proximal nonapophyseal avulsions of the rectus femoris tendon have been described but considered rare, although with increasing awareness of intra-artic-ular hip pathology and imaging of unilateral hips, recognition may increase. A recent case report describes injury in two professional football kickers in the NFL 35 . Each had MR findings of retraction of the direct head (1 and 3.5 cm). Both were treated conservatively with the patient with the 1-cm retraction injury ultimately returning to competition. Another case report describes a surgically corrected chronic rupture of proximal myotendinous junction of the rec-tus femoris in a soccer player with good clinical outcome 36 (Fig. 11).
Patient activity affects implant survival. The type of activity is an important consideration. Activities without high levels of impact loading, such as walking, swimming and golf, are recommended after hip arthroplasty. Activities that create high levels of impact loading, such as basketball, hockey, and football, are generally not recommended because of their potentially adverse effect on implant survival 21 .
3 Meyer SA, CallaghanJJ, AlbrightJP, etal. Midfoot sprains in collegiate football players. Am J Sports Med 1994 22 392-401. 24 Bowers KD, Martin RB. Turf-toe a shoe related football injury. Med Sci Sports Exerc 1976 8 81-3. 26 Nigg BM, Segesser B. The influence of playing surfaces on the load on the locomotor system and on football and tennis injuries. Sports Med 1988 5 375-85. 27 Rodeo SA, O'Brien SJ, Warren RF, et al. Turf-toe an analysis of metatarsophalangeal joint sprains in professional football players. Am J Sports Med 1990 18(3) 280-5.
Disruption of the interosseous tibiofibular ligament (A), surrounding edema (B), and anterior tibiofibular ligament disruption (C). Football injury. (Courtesy of Department of MRI, Hospital for Special Surgery, New York, NY.) Fig. 8. Disruption of the interosseous tibiofibular ligament (A), surrounding edema (B), and anterior tibiofibular ligament disruption (C). Football injury. (Courtesy of Department of MRI, Hospital for Special Surgery, New York, NY.)
Axial T1-weighted images of proximal thighs in professional football player with acute groin pain on the left. The annotated right side (A) shows normal anatomy of the adductor muscle group al, adductor longus ab, adductor brevis am, adductor magnus. The black arrows show the normal myotendinous junction of the adductor longus. The white arrows depict adductor brevis myotendinous junction and the white arrowhead shows myotendinous junction of the gracilis. (B) Edema of myotendinous strain of adductor longus on fluid-sensitive axial images. (C) Additional anatomy more distally of mid thigh. s, sartorius g, gracilis. Fig. 14. Axial T1-weighted images of proximal thighs in professional football player with acute groin pain on the left. The annotated right side (A) shows normal anatomy of the adductor muscle group al, adductor longus ab, adductor brevis am, adductor magnus. The black arrows show the normal myotendinous junction of the adductor longus. The white arrows depict...
Coronal fluid sensitive images of posterior thighs demonstrating (A) Type 1 muscle strain injury with mild feathery edema along the intramuscular myotendinous junction of biceps femoris in a professional football wide receiver (B) Type 2 injury of the proximal myotendinous junction of biceps femoris with intramuscular hematoma formation and (C) Type 3 injury proximal biceps femoris with retraction of the tendon (arrow) in a professional football cornerback. Fig. 2. Coronal fluid sensitive images of posterior thighs demonstrating (A) Type 1 muscle strain injury with mild feathery edema along the intramuscular myotendinous junction of biceps femoris in a professional football wide receiver (B) Type 2 injury of the proximal myotendinous junction of biceps femoris with intramuscular hematoma formation and (C) Type 3 injury proximal biceps femoris with retraction of the tendon (arrow) in a professional football cornerback. Epimyseal or peripheral injury not associated with...
Groin pain can be disabling to the high-performance and recreational athlete. It is often associated with sports requiring kicking and rapid change in directions, such as soccer, rugby, hockey, and American football players 16 . Injury data from the National Hockey League reveals groin injury occurs at a rate of 13 to 20 injuries per 100 players per year 71 .
The picture is quite different in the developed world, where the carrier rate is generally less than 1 except in ethnic minorities (e.g., Asian immigrants) and in injecting drug users. Perinatal spread is correspondingly less common, and sexual (including homosexual) transmission among adolescents and adults is a significant risk. Percutaneous transmission by iatrogenic invasive procedures represents the most common identifiable mode of spread, with injecting drug users constituting the largest cohort of carriers. Posttransfusion hepatitis B and infection of hemophiliacs by contaminated factor VIII have now almost disappeared as a result of routine screening of blood and organ donors, but hepatitis B can represent a major occupational risk for laboratory workers who are vulnerable to accidental infection by blood spill or needle-stick injury. Less than 1 xl of blood contaminating a syringe or needle can readily transmit hepatitis B from one individual to another. Professionals...