Wimbledon Injuries

In what seems to be an annual occurrence, Wimbledon organisers have again had to come out and defend the courts. After last year’s injury laden first week, early signs are that players are not faring better this year. But could there be another reason for these injuries, rather than the playing surface?

A study by McCurdie et al. (2017) looked at injury data from 2003-2012 at The Championships. They found that female players suffered more injuries per 1000 sets played than males (23.4 v 17.7) as shown in the graph below.

Can these injuries be attributed to the court?

Interestingly, McCurdie et al. published a breakdown of injury type. Their results showed a high percentage of injuries sustained at The Championships had been sustained prior to the tournament, whether acutely, recurring or chronic (the below table shows the breakdown).

In 2016, Tim Gabbett looked at the effect of workload and injury. His paper proposes the training-injury prevention paradox.

Gabbett suggests that physically hard (and appropriate) training may protect against injuries as high training loads are generally associated with better developed fitness and thus, good performance. One cost of high training load is often considered to be soft tissue injury risk. To address this risk, training loads could be reduced to decrease the incidence of injury, however low training loads (in the form of reduced training volumes) have also been associated with increased injury risk.

The competitive schedule

The schedule of modern tennis is so fierce (eg. Eastbourne finished the day before Wimbledon’s opening day), it is possible that a reduced training load and increased competitive load may be contributing to the injuries sustained, particularly at Wimbledon.

Sources:

Gabbett TJ. The training—injury prevention paradox: should athletes be training smarter and harder? Br J Sports Med 2016;50:273-280.

McCurdie I, Smith S, Bell PH, et al. Tennis injury data from The Championships, Wimbledon, from 2003 to 2012. Br J Sports Med 2017;51:607-611.


Arthritis and weather

You probably know someone who swears they can predict the weather by their arthritis pain. You may even be one of these people. There’s plenty of anecdotal evidence about the relationship between arthritis symptoms and weather.

Most people who believe their arthritis pain is affected by weather say they feel more pain in cold, rainy weather than in warm, dry weather. There is some research to support the arthritis-weather connection, but some studies fail to provide conclusive evidence.

A 2015 study by Timmermans et al. of 810 people with osteoarthritis, published in Journal of Rheumatology, found significant links between humidity, temperature and joint pain. The effect of humidity on pain was stronger when the weather was colder. In essence, they found that wet, winter days are no fun. Another 2015 study of 133 rheumatoid arthritis patients published in Rheumatology International found that their disease activity (swollen joints, pain) was lower when their days were sunny and dry (Savage et al., 2015).

According to the Arthritis Foundation

Some studies show a relationship between barometric pressure – a measure that refers to the weight of the air – and arthritis pain. A 2014 study of 222 patients with osteoarthritis of the hip seemed to support that barometric pressure and relative humidity influence symptoms (Dorleijn et al., 2014).

Changes in barometric pressure seem to be more important for pain levels than the actual barometric pressure, meaning that either a cold front or warm front coming in can ramp up the ache in your joints. But once the weather has settled in, pain will reduce. One study showed that each 10-degree temperature drop was linked with an incremental increase in pain. And that rising barometric pressure also triggered pain in people with arthritis (McAlindon et al., 2007).

The human body is made up of 70 to 80% water

It’s hardly surprising that changes in barometric pressure can have an effect on arthritis, and living in places in the world that have fewer barometric changes can lead to a more comfortable life for arthritis sufferers. No wonder that so many older folk move to warmer climates.

Sources:

Weather and Arthritis Pain

Dorleijn, D. M., Luijsterburg, P. A., Burdorf, A., Rozendaal, R. M., Verhaar, J. A., Bos, P. K., & Bierma-Zeinstra, S. M. (2014). Associations between weather conditions and clinical symptoms in patients with hip osteoarthritis: a 2-year cohort study. PAIN®155(4), 808-813.

McAlindon, T., Formica, M., Schmid, C. H., & Fletcher, J. (2007). Changes in barometric pressure and ambient temperature influence osteoarthritis pain. The American journal of medicine120(5), 429-434.

Savage, E. M., McCormick, D., McDonald, S., Moore, O., Stevenson, M., & Cairns, A. P. (2015). Does rheumatoid arthritis disease activity correlate with weather conditions?. Rheumatology international35(5), 887-890.

Timmermans, E. J., Schaap, L. A., Herbolsheimer, F., Dennison, E. M., Maggi, S., et al. (2015). The influence of weather conditions on joint pain in older people with osteoarthritis: results from the European project on OSteoArthritis. The Journal of rheumatology42(10), 1885-1892.


Why we must stop counting calories

One portion of grapes: 60 calories. Three rich tea biscuits: 160 calories. One serving of cereal: 220 calories. Sound familiar? You’ve probably tried counting calories to lose weight—and maybe it even worked, at first anyway. Over time, though, those pounds climbed back on because of one important point: Calorie counting doesn’t work. Kim has worked with many patients where weight is an issue and agrees with Jonathan Bailor, author of the new book, The Calorie Myth. In fact, it’s one of the worst strategies you can use when you want to lose weight.

“I used to count calories too”

“I’d try to eat 6,000 a day because I wanted to bulk up,” says Bailor. A personal trainer at the time, Bailor’s clients were mainly women over 35 who wanted to slim down, and his advice to them was the same as what he gave himself: Count calories, but stick to 1,200 a day to lose weight. The results weren’t good for anyone. “I was getting sick and fat, and these women, even on such restricted diets, were also getting sick and fat. I stopped training because I realized that advising them to count calories was actually hurting them.”

Bailor says he noticed a disconnection between research and what experts, including him, were teaching others about counting calories, which led to his book.

Yes, calories exist

Calories are essentially a measure of how much “energy” a food contains, and if you eat too many you will gain weight. But they’re not the whole picture, not even close. Case in point: “I can sell pink slime laced with high fructose corn syrup, shrink the serving size down to 100 calories, and tell you it’s healthy because it doesn’t have many calories,” says Bailor.

 

Myth: All calories are equal

Your body doesn’t treat all calories the same way. High-quality calories come from foods that are rich in nutrients, like broccoli, leafy greens, avocados, nuts, chicken, eggs, and grass-fed beef. They fill you up quickly and keep you full for a long time, says Bailor. They also trigger the release of hormones that tell the body to burn fat, your body has to work harder to break down fibre versus processed foods. On the other hand, a diet filled with processed foods, added sugar, and refined grains aren’t inherently satisfying, so you’re more likely to overeat. They also prompt your body to store fat, he says.

Myth: 3,500 calories = 1 pound

Unfortunately, your body doesn’t run on maths. “It runs on biology,” says Bailor. The reason you can’t cut out a daily 100-calorie latte and lose 10 pounds (or won’t necessarily gain 10 pounds if you start drinking one every day) is because calories are only a small portion of the equation. Your body works hard to keep you in a set weight range by regulating your appetite and metabolism through your hormones, genes, and brain. If you eat too much one day, your body would burn more calories and lower your appetite to compensate. The lesson? If you overeat one day, the key is not to freak out and continue to overeat. That will make you gain weight.

Myth: Cut calories to lose weight.

Dieting only tackles the symptom (e.g., you need to lose weight) rather than the underlying cause (e.g., what’s keeping you from being slim). Think of it like a clogged sink, says Bailor. “What if your plumber came in and said the cure for the clog was to stop using your sink?” It fixed the symptom (the sink’s not going to overflow) but not the cause (what’s causing the clog?). The cause of that clog is, you guessed it, eating poor quality foods that throw your fat-burning, appetite-taming hormones out of sync.

Myth: Eating 1200 calories or less will make you slim.

Actually, says Bailor, “counting calories leads to failure 95.4% of the time, and often leaves people fatter.” He notes that he sees many menopausal women consume 1,000 calories a day and yet, they still can’t lose weight. If you starve yourself, your body slows down your metabolism and burns muscle rather than fat. Start eating normally again after a restrictive diet, and you’ll gain more weight because you have a pokey metabolism that can’t do its job.

The bottom line on calories:

When you eat healthy foods, you don’t have to count calories. As long as you feed your body what it needs, it’ll take care of the rest, including keeping you at a healthy weight. So relax about keeping a calorie journal and focus on quality over quantity. High quality foods include non-starchy vegetables (leafy greens, mushrooms), nutrient-dense proteins (seafood, low-fat plain Greek yogurt), and whole-food fats (avocado and flax seeds). One thing they all have in common? You don’t need a nutrition label to tell you they’re healthy.