Expert Advice

Author: Avinash Patil, MD Overview Motion sickness is a common problem, with enormous variability on who is susceptible and to what degree.  Symptoms can be mild such as simply a feeling of uneasiness, to severe vomiting, and dizziness.  The most common symptom is nausea, derived from the Greek word for ship (naus), indicating this disorder’s tendency to affect seafarers. Symptoms Clinically, the first symptom usually described is feeling aware of one’s own stomach, such as fullness and disco...

By Pearly Ng, M.D.  OVERVIEW Accidental hypothermia is defined as an involuntary decrease in core temperature to less than 35ºC (Celsius) / 95 ºF (Fahrenheit). This may be primary or secondary in nature.  Primary hypothermia occurs when a person's ability to retain or produce heat is overcome by heat loss.  Secondary hypothermia is seen in people who are ill with coexisting medical conditions such as sepsis or trauma. Our bodies lose heat through several mechanisms: conduction, convection, ra...

Author: Jack Forrest, MD Overview Sales of compression gear has jumped 170% from 2008 to 2010.  Compression gear comprises 5% of the sports apparel market. Under Armour claims compression shorts “increase muscle power.”  Adidas states their compression shorts “focus muscle energy and endurance.”  Most compression clothing is made from a blend of nylon or polyester and elastane (spandex).  Compression clothing for calves, forearms, and entire suits are available for purchase.  Compression calf...

Study of injury and illness rates in multiday ultramarathon runners. Brian Krabak, MD MBA Brandee Waite, MD and Melissa Schiff, MD MPH Abstract Department of Rehabilitation, Orthopedics and Sports Medicine, University of Washington, Seattle, WA, USA. bkrabak@uw.edu PURPOSE: This study aimed to describe injury and illness rates in runners competing in 7-d, 250-km off-road ultramarathon events. METHODS: Three hundred ninety-six runners competing in the RacingThePlanet© 4 Desert Series ultram...

By Arthur J De Luigi, DO and Brian J Krabak MD MBA Overview Iliotibial Band Syndrome (ITBS) is a frequently encountered condition in athletes and is the most common cause of lateral knee pain in runners. The Iliotibial band (ITB) is a dense fibrous band formed by the tensor fascia lata and the gluteus medius and minimus muscles. The ITB is a wide, flat superficial thickening that originates at the anterior sacro-iliac spine and inserts at Gerdy’s tubercle on the lateral aspect of the proximal...

By Chris Hall, MD and Brian Krabak, MD MBA Introduction Pain relief is one of the commonest reasons for a visit to the medical tent during a 4 Deserts event. Even in the absence of injuries, taxing races like these can be expected to produce discomfort which can be eased through the use of a variety of pain killers. Many of these are available over the counter, making them options for competitors even without medical consultation. The following is a review of some of the common medications t...

By Ilona Barash MD, PhD and Brian Krabak MD MBA Overview Everyone who tries any physical exercise will at some point experience Delayed Onset Muscle Soreness (DOMS). The symptoms typically start approximately 24 hours after the exercise, peak at about 48 hours, and resolve over the next few days, usually with complete recovery by 7 days after exercise. This is in contrast to immediate muscle pain that starts right after or during activity, and which may represent a muscle or bone injury. It ...

By Robert Ripley, MD, DTMH and Brian Krabak MD MBA Overview Diarrhea is the most common illness encountered by travelers. Between 20-70% of travelers will suffer from diarrhea (about 10 million people a year), hence the diagnosis of Traveler’s Diarrhea (TD). Most cases of TD are cleared by the body’s gastrointestinal tract and immune system in a few days without need for medical treatment. However, a case of TD, which would be a mere nuisance on a beach in the Yucatan, might be devastating w...

By Rebecca Walker, MD, MPH and Brian Krabak MD MBA Overview Injuries to the Achilles tendon can be debilitating for both the elite sportsperson as well as the recreational athlete. Severity ranges from a mild tendonitis to complete rupture of the tendon requiring surgical repair. In most cases, overuse or disease leads to a weakening of the tendon that causes inflammation and degeneration. Partial or complete tendon rupture usually results from an acute acceleration or deceleration event suc...

BY Carmie Chan, MD Importance of Sleep Everybody needs sleep. Sleep is important in maintaining the healthy functioning of the human body, and in fact has been shown in rat studies to be essential for survival. Sleep affects all aspects of the human body, from immune function, physical performance, memory and concentration, and mood. There is also an increased production of proteins and decreased breakdown during sleep, which can help the body recover after a day of physical exertion. Stages...

BY Erica Grimm, MD Overview The ultraviolet radiation from the sun that affects human skin is composed of UVA and UVB wavelengths. Sunburn is caused 90% of the time from overexposure to UVB radiation (10% of burns are attributed to the deeper penetrating UVA wavelengths)[4]. UVB is more often implicated in skin cancers such as basal cell and squamous carcinoma. While UVA is less likely to cause a sunburn, it is more likely to cause structural skin breakdown and long term sun damage like wrin...

By Melita Moore, M.D. and Brandee L. Waite, M.S. Definition/Anatomy: Iliotibial band syndrome (ITBS) is an overuse injury and is the most common cause of lateral knee pain in long-distance runners (1). The iliotibial band (ITB) is a thick band of tissue that originates on the pelvis and extends along the outside part of the thigh and attaches at two different points on the knee. One attachment is at the top of the tibia (shin bone) to a point called Gerdy’s tubercle. The other attachment, is ...