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Sports Medicine Specialist Dr. Victor Khabie Emphasizes Prevention for Young Athletes

(HealthNewsDigest.com) – Carmel, NY, – Wrestling as a sport can be traced back to the ancient Olympics and has been practiced throughout the world in many forms and styles ever since. Today, wrestling is offered at various levels, from youth wrestling in middle school through high school, college and the Olympics. It’s a sport for people of all sizes, both male and female, and competition rules that pair athletes against each other according to their weight class reduce the risk of injury.

Nevertheless, injuries do occur. According to sports medicine specialist Dr. Victor Khabie of Somers Orthopaedic Surgery and Sports Medicine Group, “Wrestling is an intense and demanding sport, requiring a great deal of muscular endurance and strength. And it is a contact sport in which the body is contorted into many different positions, putting the muscles and joints under great stress. Overall conditioning, proper technique and the right equipment are essential to prevent injuries.”
According to Dr. Khabie, who serves as team physician for several schools, “As with all sports, injury prevention must be a primary goal of all participants, coaches, and trainers. The wrestler should be coached and supervised at all times, stressing proper technique, proper equipment and discipline to avoid injury. Coaches and referees need to strictly enforce rules to encourage safe wrestling technique and the use of proper safety gear and equipment.

At both the high school and collegiate levels, wrestling ranks second only to football in injury rate. Most injuries are not serious and are similar to those seen in other sports: bruises, scrapes, strains and sprains. The most serious wrestling injuries affect the shoulder, knee and neck and are most commonly caused by forcing a joint beyond its acceptable range of motion.

The majority of upper body and shoulder injuries in wrestlers are caused by the combination of leverage and twisting during competition. Rotator cuff pain is common in young athletes, usually caused by muscle strains and tears that arise from overuse. An acute tear is more serious and might result in wrestling from falling on an outstretched arm. The most common traumatic shoulder injury in wresting in young people is dislocation, in which the head of the upper arm bone comes out of the socket, either partially or completely. Shoulder strengthening exercises, braces and, in some cases, surgery may be recommended to prevent recurrence.

Dr, Khabie adds that shoulder flexibility should be an essential goal of a conditioning program. “Wrestling-specific workouts for the shoulder should include both weight-bearing and non-weight-bearing exercises. Weight-bearing exercises such as push-up variations improve the stability of the joint. Also, rotator cuff strength, endurance and proper muscle balance should be addressed.”
Knee injuries constitute a significant number of all wrestling injuries. During a match, the knee may be twisted and turned in many different directions.

The ligaments supporting the knee are under a great deal of stress trying to hold the knee together and may be stretched or torn. The anterior cruciate ligament (ACL), the posterior cruciate ligament, and both the lateral and medial collateral ligaments are subjected to external forces that could cause tearing. The ACL is the most commonly sprained in wrestling. A partial tear will require immobilization, ice, and rest to help with recovery. A complete rupture may require surgery and many weeks of recovery.

Prepatella bursitis, the inflammation of the sac (bursa) located in front of the kneecap (patella), is caused by the front of the knee constantly hitting the mat. It is treated by anti-inflammatory medication, ice, and rest.

The meniscus is a “C”-shaped disc made of tough cartilage and is very important for absorbing shock between the femur (thigh bone) and the tibia (shin bone). Most injuries to the meniscus occur from a hit or other direct trauma to the knee. Sudden turning or twisting motions of the knee may also cause a tear. Serious meniscal tears typically require surgery that either repair the tear or completely remove the torn portion of the ligament. It may take 6-8 months to fully recover after surgery.

Maintaining strength of the quadriceps and hamstrings, as well as flexibility through the lower extremities, can help prevent injury to knee ligaments. The best way to prevent bursitis is to wear knee pads during practices and competitions. Knee pads help to limit the stress on the knee and reduce the force of any direct impact to the front of the knee.

Neck injuries can be caused by throws, especially those done incorrectly, and holds where the wrestler’s head is caught at an awkward angle. The cervical vertebrae are often forced into vulnerable positions, which can result in several types of neck injuries. Most are strains, sprains and whiplash (hyperextension) injuries. However, every neck injury should be treated as a spinal cord injury until ruled out by a medical professional. Spinal immobilization is the most important step in treatment. This will help prevent future damage to the spinal cord if it is involved. Dangerous holds and “slamming” moves should be avoided to prevent neck injuries. Some coaches teach wrestlers to keep their heads up when performing take-downs, to avoid compression or flexion of the spine, which can lead to serious injury.

If you have employees, then you have Workers Compensation[i] (work comp). It is one of the most basic forms of insurance a company has yet often comes with the most questions from my clients. There are a lot of misconceptions with Work Comp that lead to a lot of poorly managed programs. Over the next few weeks we’ll try to will focus on a series of work comp topics.

Addressing:

• The basics / History (today),
• Loss prevention,
• How to report and manage a claim,
• Importance of a return to work policy,
• How you can dispute a claim
• Understanding what is an Experience Modification factor and how it affects your premium.

There are varying reports but some point to the first history of Work Comp in the states as being adopted in Wisconsin back in 1911. Prior to Work Comp the only source of compensation for an injured worker was through the courts. As an injured worker, it put you in a compromising position taking your employer to court  in an attempt  to prove their negligence. Today’s Work Comp laws are “no-fault”. Simply meaning employers give up the right to defend and sets up exclusive remedy for employee. They no longer have to prove negligence but they can also no longer come back and sue employer.

That’s the history here are the basics. Work Comp base premiums are compiled through an equation derived from the amount of payroll per job function within your business.  Each job function is assigned a class code rate per $100 of payroll.  These rates are set by the state using a three year average loss ratio factor for each class code.  

Example:

A small sales organization will have a sales force and clerical office back-up. Their rate might look something like this:

• Outside Sales : Class Code 8742, Rate $.77, Payroll $350,000 = $2,695 in premium
• Clerical support: Class Code 8810, Rate $.30, Payroll $75,000 = $225[ii] in premium

This is the base premium. Then your personal rating history is factored into the equation with your Experience Modification factor (a future topic). This is how you compare to your competitors in your specific industry. Once this is totaled you add in a small Terrorism Charge and Catastrophe Provision Charge (since 9/11 this is mandatory on all Work Comp policies to help fund future incidences and not crippling the insurance industry). Last you have your paper filing charge from the state the expense constant. This is a flat $220 regardless of if you pay $200,000 in premium or $2,000.

So if your premium’s are determined by rates set by the state and your loss history how do companies compete for your business? This is the question you need to be asking your agent.

The answer is in the form of dividends paid out post audit and more impotently services provided. What types of loss prevention, risk management strategies can they help implement that will directly affect cutting your bottom line (also a topic for a future article).

I’m looking forward to contributing to this series on Workers Compensation over the next month. The goal is to shed some light on a serious topic, help give insight to long term cost savings solutions, create a safe working environment for your employees and as always help you understand what your paying your insurance company for.

For more information on workers compensation in the state of Wisconsin checkout www.wcrb.org

Good luck and stay safe.

[i] All employees working for an employer (other than farmers) with three or more workers are protected immediately by the Worker’s Compensation Act. Employers with fewer than three workers come under the law if they pay wages of $500 or more in any quarter of a calendar year. Their workers are covered 10 days after the end of that quarter. Farm workers are covered if the farm employer has six or more employees on 20 or more days in a calendar year.

[ii] Minimum premium would apply to a work comp policy $900 at inception, if it audits out less the least amount of   exposure would be $220. 

From 2004 to 2011, the number of people who have died or were injured while walking and wearing headphones rose from 16 to 47. The Guardian points us to a new U.S. study, published by Injury Prevention journal, which notes that most victims were men under the age of 30 (around 68% in both cases). 89% of the 116 total incidents occurred in urban areas, with 55% being struck by a train. Looks like these numbers are pointing directly at us, NYC!

In the cases, of which 70% were fatal, headphones were always involved, and playing “a direct part in the incident, as the users could not hear warnings that they were in danger,” even in the cases where sirens were used. Researchers say the link between headphone use and pedestrian injury is either distraction or environmental isolation. They added, “The use of headphones with handheld devices may pose a safety risk to pedestrians, especially in environments with moving vehicles. Further research is needed to determine if and how headphone use compromises pedestrian safety.”