Posted by: mdegeorge | August 28, 2010

Weekly Diagnosis, 8-27

The medical front has been buzzing this week, for circumstances other than thoseTank making Washington, DC sports fans think, “Hey, since that bandwagon crashed and burned, I guess Daniel Snyder isn’t all that bad.”

Anyway, here are just a few of the highlights—from throughout North America—of just what has been entering the trainers’ rooms in the last week.

Rhabdo-what?

Not content to call it faking like most (Mike Shanahan included), doctors earlier this week debunked the original diagnosis of Albert Haynesworth’s problems as malcontent-itis, deciding instead he suffered from rhabdomyolysis, a broadly defined muscular syndrome that causes rapid breakdown of muscle tissue. The revelation came after Haynesworth, a hold out through the early junctures of training camp, failed 87 attempts at his conditioning test (ok, it was only three) and complained of pain in his knees.

[picapp align=”center” wrap=”false” link=”term=albert+haynesworth&iid=9500592″ src=”http://view.picapp.com/pictures.photo/image/9500592/washington-redskins/washington-redskins.jpg?size=500&imageId=9500592″ width=”500″ height=”356″ /]

So, let’s get to know the new muscular disease craze sweeping the nation. The causes of rhabdomyolysis are myriad: hereditary diseases that effect energy storage or metabolism (ATP synthesis or glycogen storage diseases), systemic metabolic and electrolyte imbalances (e.g. ketoacidosis or hypocalemia), drug interactions (statins like Zocor and fibrates like TriCor are one potentially pernicious reaction in some cases), or chronic abuse of alcohol or drugs such as cocaine, heroin, or methamphetamines. There are also infectious causes, ranging from viruses and bacteria such as malaria, herpes, and Salmonella to poison by heavy metals or small doses of hemlock.

But more than likely in Haynesworth’s case, rhabdomyolysis has brought on by some type of physical trauma. Excessive muscular effort can be to blame, along with less common physical problems such as blood clots, crush syndrome (as in earthquakes or situations where a person is in the same position for an extended period of time), or electric shocks.

While Haynesworth’s case may be minor due to his relative level of physical fitness, rhabdomyolysis is a very serious condition. The local swelling of muscle tissue in response to damage heavily taxes the kidneys (as Haynesworth discovered by his frequent bathroom trips, the urine of which probably was a dark brown color consistent with the disease). In extreme cases, of which Haynesworth’s is not one, that fluid loss can have major ramifications for systemic ion balance and metabolism, even causing shock or complete renal failure (such as when a crush syndrome victim has the pressure released on the affected area and it rapidly and uncontrollably swells).

This may be a one-time occurrence for Haynesworth, and it’s entirely likely he can play out his career and his post-professional life without having to deal with it again. But if he doesn’t fully recover from this bout, or has a genetic predisposition that makes him more susceptible to the condition, it may once again be more of an issue that his feelings on Mike Shanahan’s 3-4 defense.

TKO for UFC in the Great North

UFC might be enjoying a ratings boost in the States thanks to the intervention of major network carriers (once ESPN get’s television rights, I guess it’s automatically a sport, but that’s another story).

But our neighbors to the north don’t seem to be of the same mind. The Canadian Medical Association this week began to petition the government to ban mixed martial arts fighting in the nation, citing its inherent violence and long-term health ramifications. The sport is currently sanctioned in seven provinces, with formerly fervent holdout Ontario also bending to allow MMA prize fights beginning in 2011.

It’s hard to tell what took the CMA so long to conclude that getting beat about the head with a serious of punches, kicks, and knees without any protection was detrimental to your health. I guess I’m just surprised that it was a bunch of doctors that soured a country on MMA, not Tank Abbott.

Not just punch drunk

The Canadian doctors so vehemently opposed to MMA may have stumbled across the work of Dr. Ann McKee at some point in their research, and had another opportunity to do so last week.

McKee and her colleagues at the Boston University Center for the Study of Traumatic Encephalopathy reported last week that they found similar toxic proteins in the spinal cords and brains of subjects suffering from Lou Gehrig’s disease as those in chronic traumatic encephalopathy (CET) patients.

McKee, who’s worked on a number of studies on CET in athletes (see here, here, and here), noticed an unusually high number of athletes who suffer ALS (amyotrophic lateral sclerosis). The exact cause of the neurodegenerative disease isn’t known, but a large body of evidence suggests that free radicals or aberrant proteins in specific chemical pathways create a cascade that gradually robs patients of all motor function. Some of those toxic proteins may be the same ones present in CET (also known as dementia pugilistica or punch drunk syndrome), a condition becoming increasingly common in contact sport participants such as hockey and football players and boxers that results from repeated, potentially concussive blows to the head and the long-term effects there of. The condition is a dire cause for concern for many, as it may contribute to early-age dementia and psychosis in such high-profile cases as Barret Robbins and Justin Strzelcyk.

It’s been dire enough by the NFL to warrant a donation of $1 million earlier this year to BU to fund research into the disease. Anyone that can make the NFL grab its crowbar and pry its way into the coffers to give has to doing something important (sorry, Congress).

A hamstringing humdinger

Injuries and inconsistency have blighted plenty of the top contenders in France’s Ligue 1 just three weeks into the season, with a number of title contenders breaking form the gate in less-than-convincing fashion.

The case of Olympique Lyonnais, though, is unusual even for this group. They’ve been plagued by injuries, which isn’t anything to capture headlines. But the similarity of those injuries is freaky.

So far, four major first-teamers have succumbed to almost identical hamstring injuries. The tendon terror began in the Meadowlands (where these things so often do) with Brazilian international Ederson, who according to team doctors, “totally ruptured the hamstring muscles in his left leg” in the friendly against the United States. His injury will put him on the sidelines for up to eight months.

He apparently packed the curse away in his luggage and brought it back across the Atlantic with him, as just four days later, teammates (and countrymen) Cris and Michel Bastos both joined him on the training table with similar ailments in Les Gones’ 3-2 loss against Caen. Cris (left leg) and Bastos (right) received more minor injuries, but are looking at about a month on the sidelines, though the spell isn’t definite.

Not to be left out, teammate and French international Aly Cissokho helped break the Brazilian aspect of the jinx by tearing his hamstring muscle, the identical injury as Cris, ruling him out for at least three weeks. This is all on top of an Achilles’ injury to striker Lisandro Lopez and has been a large factor in OL’s ability to take home only four points from its first three matches.

There’s no word yet on any black cats hanging around their training ground or broken mirrors, but I think it’s time to look into the effects of a various Beaujolais vintages on muscle fragility.

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Responses

  1. Weekly Diagnosis, 8-27…

    I found your entry interesting do I’ve added a Trackback to it on my weblog :)…

  2. […] remember, that muscular disease that everyone misdiagnosed as goldbrickitis in Albert Haynesworth when he failed 18 conditioning […]


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