Energy drinks are popular among teens and, surprisingly, even younger children. The potential dangers are not well publicized, but are very real. A person at any age can have an adverse reaction to the high levels of caffeine found in most energy drinks, but, for the smaller developing bodies of children, these reactions can be devastating.

In a Nov 28, 2011 article by Medscape Medical News, it was reported that “the number of emergency department visits associated with non-alcohol energy drinks is surging, according to a report from the US Substance Abuse and Mental Health Services Administration (SAMHSA). In 2005, the agency recorded 1,128 such visits and in 2009 it recorded 13,114 such visits, with the highest number occurring in 2008 (16,055). Data are not yet available for 2010.”

Recently, the worst possible outcome occurred for a young girl. “Fourteen-year-old Anais Fournier downed two 24-ounce energy drinks on one December day, while hanging out with her friends at the mall. The next day, the Maryland teenager went into cardiac arrest — and just six days later, she was dead. The official cause of death, according to the teenager’s death certificate, was cardiac arrhythmia due to caffeine toxicity.” Read more…

I personally know of a 15-year old who had a mild heart attack following a several month habit of two energy drinks per day that he thankfully lived to tell about. Even in recent conversations with my oldest child, I continue to hear that use of these beverages, along with other sources of caffeine, including coffee and sodas, is common among his middle school aged peers. With advancing age comes increased independence and freedom for our children to make choices throughout their day. We can help them make better choices with a little education. I’m sure most of them don’t know that too much caffeine can be deadly. In our coffee and soft drink loving culture, I’m not even sure that most adults know this. It’s important to help our kids understand when overindulgence can cause them actual harm. Please look further into this issue if you are inclined, and share your findings with your community.

Thank you for all the wonderful support during Helios Natural Healthcare’s first three years. Working in this vibrant community has inspired me to expand the clinic, and I can’t wait for you to see it! It’s easy to find – just one door down from the previous office, in the Saratoga Barn. The new address is 20640 Third Street, Suite 200. I’m also extending my hours and now have appointments available on Tuesdays, Thursdays and Fridays, 10am to 7pm. Please come visit!

Marcie Morton, DC – 415.728.5791 – marcie@heliosnaturalhealth.com

Matheson EM; Mainous AG; Everett CJ; King DE
Department of Family Medicine, Medical University of South Carolina, Charleston, South Carolina, USA. Matheson@musc.edu

PURPOSE: Hot tea and coffee have been found to have antimicrobial properties. The purpose of this study was to determine whether the consumption of tea, coffee, or both is associated with less frequent nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA).

METHODS: We performed a secondary analysis of data from the 2003-2004 National Health and Nutrition Examination Survey to investigate the relationship between the consumption of coffee, hot tea, cold tea, and soft drinks, and MRSA nasal carriage among the noninstitutionalized population of the United States.

RESULTS: An estimated 2.5 million persons (1.4% of the population) were MRSA nasal carriers. In an adjusted logistic regression analysis controlling for age, race, sex, poverty-income ratio, current health status, hospitalization in the past 12 months, and use of antibiotics in the past month, individuals who reported consuming hot tea were one-half as likely to have MRSA nasal carriage relative to individuals who drank no hot tea (odds ratio = 0.47; 95% confidence interval, 0.31-0.71). Similarly, individuals who reported consuming coffee had about a one-half reduction in the risk of MRSA nasal carriage relative to individuals who drank no coffee (odds ratio = 0.47; 95% confidence interval, 0.24-0.93).

CONCLUSIONS: Consumption of hot tea or coffee is associated with a lower likelihood of MRSA nasal carriage. Our findings raise the possibility of a promising new method to decrease MRSA nasal carriage that is safe, inexpensive, and easily accessible.

SI joint injuries are a common cause of low back pain, affecting 15 to 25 percent of people who go to their doctors with low back problems. Symptoms include relatively constant soreness that is localized to one side of the low back and ranges from aching to sharp. SI joint pain often radiates to the buttocks and groin, and may also spread to the leg, causing it to be mistaken for sciatica. Symptoms are generally worse when standing or walking, and can become excruciating when sitting on a hard surface or rolling over in bed. Pain and stiffness upon getting out of bed in the morning or after sitting for long periods, especially while driving, is common.

SI joint pain occurs when an injury or condition irritates the joint surfaces or supportive muscles and ligaments around the joint. It may be the result of a single traumatic event, such as a hard fall on the buttocks, or come on over a longer period of time as a result of altered biomechanics, such as overpronation of the feet or muscular imbalance around the pelvic girdle. Hormonal changes during pregnancy increase laxity of ligaments, which changes the dynamics around the SI joints and places women at greater risk for injury during and after pregnancy. Normal wearing of the joint surfaces that occurs with aging is another possible reason for SI joint pain.

Regardless of cause, the first steps in recovering from acute SI joint injury involve reducing pain and inflammation. Taking a break from activities that stress the joint, such as running, is a necessary start. Anti-inflammatory medications provide relief for most people in the early stages while symptoms are most acute. Always consult a doctor before taking any new medication. Cold therapy is also useful, but never apply ice packs directly to skin or for more than 15 minutes at a time. Chiropractic and physical therapy such as pulsed ultrasound and mobilization of the SI joints may also be helpful.

Once inflammation has been controlled, treatment focus should switch to restoring normal function in the joint and preventing future problems. Anti-inflammatory nutrition, including spices such as turmeric and ginger, along with supplementation of key antioxidants and omega-3 fatty acids, will help keep inflammatory pain at bay. Pelvic stabilization and core exercises are essential for correcting muscle imbalances and adding supportive strength around the SI joints. Regular stretching of hip and leg muscles is necessary for further balancing muscles around the pelvic region and ensuring normal motion across all joints.

Unfortunately, SI joint injuries can take weeks to months to resolve, and running through the pain only increases the likelihood of further damage. An extended break from running, while continuing non-weight-bearing activities such as cycling, will increase your odds for recovery and a full return to your pre-injury activities.

Stroke, or cerebrovascular accident, is the third leading cause of death in the United States, behind heart disease and cancer. It is the top cause of serious, long-term disability. More than 50 percent of strokes are preventable when contributing factors are addressed proactively. Sometimes called “brain attack,” stroke is caused by vascular dysfunction that occurs when blood flow to one or more arteries supplying the brain is impeded, either by a clot or internal brain bleeding. This impediment prevents delivery of needed oxygen and nutrition to tissues and causes brain cells to start to die. If the condition is not caught and treated early, permanent brain damage can occur.

High blood pressure, or hypertension, is a major risk factor for stroke and is also often associated with suboptimal serum potassium levels. High sodium intake, which is prevalent in the American diet, has long been associated with hypertension. Less well-known is that dietary potassium has the opposite effect, in that it lowers above-normal blood pressure. Limiting sodium intake and eating potassium-rich foods is helpful in keeping blood pressure normal and diminishing related stroke risk. If you have hypertension, work closely with a medical professional to determine a management strategy.

Of all the food choices, sweet potatoes and beet greens contain the highest levels of potassium. One cup of boiled beet greens has 1,309 mg of potassium; one large baked sweet potato has 855 mg. Baked potatoes, including the skin, are another excellent source. Prune, carrot and orange juices offer a sweet solution for increasing dietary potassium, as do banana, kiwi, peach and cantaloupe. Mix any of these fruity choices in a blender with plain yogurt for a creamy double dose of potassium. Granola or bran can also be mixed with yogurt for an extra potassium boost. Tomatoes, peas and winter squash are a great start to a potassium-rich soup or stew. Lima or canned white beans add protein, fiber and extra potassium. Meaty sources of the mineral include halibut, yellowfin tuna, Pacific rockfish, flounder, salmon, cod, clams and chicken.

In studying the effects of dietary potassium on stroke risk, researchers have evaluated magnesium, calcium, sodium and iron as well. Findings suggest that high levels of dietary calcium and magnesium are helpful in lowering risk of stroke when you maintain low levels of dietary sodium. Dairy products provide high levels of calcium, as do soybean products, sesame seeds, nuts, green leafy vegetables and broccoli, and the soft bones of sardines, herring and canned pink salmon. As a general rule, foods that are high in fiber, such as legumes and whole grains, are high in magnesium. Leafy green vegetables, soybeans, almonds and dark chocolate are all good sources of magnesium.

References

1. University of Maryland Medical Center: Potassium
   http://www.umm.edu/altmed/articles/potassium-000320.htm
2. “Neurology”; Serum Potassium and Dietary Potassium Intake as Risk Factors for Stroke; D.M. Green, et al.; August 2002
   http://www.neurology.org/content/59/3/314.abstract
3. MedlinePlus: Hypokalemia
   http://www.nlm.nih.gov/medlineplus/ency/article/000479.htm
4. “American Journal of Hypertension”; Serum Potassium and Stroke Risk Among Treated Hypertensive Adults; N.L. Smith, et al.; October 2003
   http://www.ncbi.nlm.nih.gov/pubmed/14553958
5. U.S. Department of Health and Human Services: Health Facts: Sodium and Potassium
   www.csrees.usda.gov/nea/food/pdfs/hhs_facts_sodium.pdf
6. Natural Medicines Comprehensive Database: Potassium, Calcium, Magnesium
   http://naturaldatabase.therapeuticresearch.com/nd/Search.aspx?rn=2&pt=100&id=851&ds=&name=POTASSIUM&searchid=25569163&cs=&s=ND
7. “Preventing Chronic Disease”; Dietary Intake of Minerals and the Risk of Ischemic Stroke in Guangdong Province, China, 2007-2008; W. Liang, et al.; March 2011
   http://www.cdc.gov/pcd/issues/2011/mar/10_0056.htm

High blood pressure is a major risk factor for stroke. Losing weight, limiting sodium intake and eating potassium-rich foods are all helpful in keeping blood pressure normal. Atrial fibrillation (a type of irregular heart beat), uncontrolled diabetes and elevated cholesterol are other conditions that increase stroke risk. If you suffer from any of these, it’s very important that you work with a health care professional to determine a management strategy, and then make sure to follow it.

A clean and healthy diet plays an important role in any disease prevention program. Such healthy eating starts with a balanced assortment of whole food ingredients, including vegetables, fruits, lean protein, complex carbohydrates and healthy fats such as olive oil and those high in omega-3 fatty acids. Regarding fruits and vegetables, those high in folic acid, fiber and potassium are most beneficial. These include citrus fruits and cruciferous vegetables such as broccoli and cauliflower. A recent study conducted at Harvard University found that eating five servings of fruits and vegetables each day lowered stroke risk in its participants by 30%. Benefits of healthful eating extend far beyond lowering stroke risk. Wholesome fuel also contributes to lower blood pressure and cholesterol levels, as well as increased energy and improved overall sense of well being.

Regular exercise can lower stroke risk up to 24%. Based on the most current research, recommendations are to engage in 30 or more minutes of moderate to vigorous physical activity, above usual activities, on 5 or more days of the week. Starting small by adding simple active habits whenever possible is a key to success. Some examples include walking or biking in place of driving, taking stairs instead of the elevator, and taking a walk or other exercise break at work. On the subject of habits, cigarette smoking doubles risk for stroke, and quitting is one of the best things a person can do to quickly improve health. Stroke risk immediately begins to decrease once the habit is dropped. And, while a daily glass of wine or beer may help to prevent stroke, more than two alcoholic beverages per day can increase stroke risk. Alcohol consumption, at most, should be in moderation.

References:
1. National Stroke Association; Stroke Risk Reduction: A Healthy Nutrition Guide
2. National Center for Health Statistics, Deaths and Mortality Data for the US
3. Ornish Takes on Cancer (from Dr. Greger Newsletter, Fall 2005)

Most expectant mothers will experience some degree of lower back pain during their pregnancy. In order to make room in the pelvis for the growing baby and prepare for delivery, a pregnant woman’s body secretes a hormone aptly named relaxin, which causes the ligaments to relax and loosen. Add to this the extra weight, weakened abdominal muscles, and shifted center of gravity that are unavoidable during pregnancy, and you have a recipe for back pain. While you may not be able to completely avoid back pain during pregnancy, there are some ways you can help make it more manageable.

First of all, prevention is key. Although heavy lifting will not hurt your baby, it is likely to hurt you. Even though I know better, I stupidly tried to move a 300 lb table during my first trimester and ended up spraining my pelvis. Please don’t follow my example! Let someone else do the heavy lifting. How often in life do you have such a great excuse for sitting back and letting others do the work? If you must lift something, make sure to bend your knees and lift with your leg muscles.

Proper foot wear is also essential to prevent back pain. Heels may look cute, but they are horrible for your back, especially during pregnancy. High heels push your center of gravity forward, causing you to arch your back in order to keep from falling over. During pregnancy, your back is already arched due to your big belly, so adding heels to the equation effectively causes you to squish the facet joints in your spine- ouch! My advice: ditch the heels at least during your pregnancy (but preferably forever!) Get some supportive flats, sandals, and walking sneakers. On a side-note, it is also a good idea to have your feet measured before making your purchase. Chances are, your feet have grown a size or two!

So what can you do if you find yourself with back pain despite these precautions? My four recommendations are: exercise, bracing, chiropractic, and massage. Gentle exercise such as walking, swimming, and yoga can do wonders for back pain. A few specific exercises that may be helpful are: lunge stretch, tailor stretch, cat-cow, and leg extensions. To do the lunge stretch, go down on one knee with the other leg bent in front of you at a 90 degree angle with the foot on the floor. Lunge forward slowly at the hips but keep the torso up straight. You should feel a stretch in your hip/groin area. Hold for 30 seconds and repeat on the other side. You can do the tailor stretch while seated. Cross one ankle over the opposite knee and lean forward, keeping the back as straight as possible. Cat-cow and leg extensions are done on your hands and knees. To do the cat-cow, arch your back up like an angry cat and tuck your buttocks under for a few seconds, then let your back relax and your belly sag for a few seconds. Repeat 10-20 times. For leg extensions, slowly move one leg straight behind you, hold for a few seconds, and then return to starting position. Repeat on the other side. Do 10-20 of these, making sure to keep your back as flat as possible.

If you find yourself getting sudden twinges of pain in your pelvis/buttocks whenever you stand up from sitting or if it feels like your hip sometimes “gives out” when you are walking, you may benefit from a sacroiliac brace. Essentially this is a belt that goes around your pelvis and helps hold the joints in place. The best ones that I have found are the “SI-LOC” and “Mother-to-Be” belts. Both can be found online at www.OPTP.com. The SI-LOC is better for earlier stages of pregnancy. The Mother-to-Be is better for the later stages of pregnancy when the belly is very big, or for women who are overweight to begin with. Both can be worn inconspicuously under your clothes.

Chiropractic treatment is another safe, effective option for back pain during pregnancy. A chiropractor can mobilize the joints in your spine and pelvis that have become stuck in the wrong position, thereby reducing inflammation and pain in the joints and helping the surrounding muscles relax. Theoretically, a well-aligned pelvis also maximizes the size of the pelvic opening, which many women have said leads to an easier delivery. Some chiropractors can also adjust your aching feet and address other problems you might be having, like headaches or carpal tunnel disorder. When shopping around for a chiropractor, ask if they regularly treat pregnant women and whether or not they have a special table or pillows to accommodate your expanding belly. Ask if you can meet with or talk to the doctor before making an appointment. It is important to find someone you like and trust. Chances are, you’ll need your chiropractor after having the baby as well; holding and breastfeeding an infant tends to cause some upper back tightness and pain.

Last but not least, I recommend that every mother-to-be gets at least one massage during her pregnancy. Growing a baby puts a lot of strain on the body. Muscles tend to get tight and sore, and you may be retaining water. You also may be feeling tense and anxious about your upcoming bundle of joy. A good massage can not only reduce muscle tension and reduce pain, but also provide mental relaxation and decrease swelling. And besides, every pregnant woman deserves a little pampering, right? Look for a licensed massage therapist who specializes in prenatal massage. He or she will know how to accommodate your changing body, either by doing the massage in a side-lying posture or using special pillows to support your breasts and belly.

In most cases, pregnancy related back pain will resolve several weeks after delivery, when you have lost some of the pregnancy weight and your ligaments have tightened back up again. That being said, there is no need to just wait and suffer throughout your pregnancy. By trying some of the tips that I have mentioned here, you will be more comfortable and able to enjoy the miracle that is happening within you.

We’ve all heard the stories of people who’ve abruptly changed their nutrition and lifestyles after a scary diagnosis, and have completely turned the illness around and become healthier from it. This phenomena has even been studied. In a 2009 article published in the Journal of the American Medical Association (JAMA), Yale researchers found that “people newly diagnosed with health problems were more likely to change their health habits than those without a new diagnosis.” For example, “smokers newly diagnosed with at least one condition were 3.2 times more likely to quit than those without a new diagnosis [2].”

In 1990, Dean Ornish, MD published a study showing that “heart disease could be not only slowed down, but actually reversed with a plant-based diet and other lifestyle changes. People learned they could literally take their life in their own hands and cure themselves of a debilitating life-threatening disease once thought to be incurable [3].” More recently, in a study of men diagnosed with prostate cancer, Dr. Ornish studied the impact of a plant-based diet, “predominantly fruits, vegetables, whole grains, legumes and soy products,” on patients who already had cancer. “Dr. Ornish found 93 men with early biopsy-proven prostate cancer who volunteered to forgo radiation, chemo and surgery. He then randomized the cancer patients into a lifestyle modification group, which included a strictly plant-based diet along with other healthy behaviors such as walking 30 minutes six days a week, or a control group which just watched and waited. A year later the results were tallied and published in the September 2005 issue of the Journal of Urology. By the end of the year-long study, six of the control group patients had dropped out because their tumors were growing (MRI’s or diagnostic tests of cancer activity showed that their tumors were growing at such a rate that they decided they could wait no longer and opted for a combination of radical surgery, chemotherapy or radiation). However, not one of the vegan diet group suffered the same fate. In fact, while on average cancer activity increased in the control group, as measured by PSA tests, the cancer markers DECREASED in the lifestyle modification group. By the end of the year the cancer growth rate, as measured by these tests, was highly significantly different between the two groups [4].”

Of course, genetics and previous environmental exposures play a role, but people have more power than they might think over their health destiny. So, are you wondering yet, what are these simple changes that can be incorporated? According to the American Cancer Society (ACS), and many other experts and panels, for the purpose of optimizing health, it is recommended that everyone maintain a healthy weight, eat a healthy diet that is high in plant sources, adopt a physically active lifestyle, and avoid both cigarette smoke and drinking too much alcohol.

Eating a healthy diet is something that can be started immediately with a little education about what is most unhealthy, then replacing any sugary, salty, high fat, processed foods in the diet with the whole food versions of them. A good rule of thumb, taken from author, Michael Pollan’s, 7 Rules for Eating, is “eat food, not too much, mostly plants. Don’t eat anything your great grandmother wouldn’t recognize as food,” i.e. “choose food over food-like substances.” Also, drink plenty of clean, pure water and few or no sugary beverages. Don’t drink diet beverages at all.

Recommendations for exercise, based on the most current research, are to engage in 30 or more minutes of moderate to vigorous physical activity, above usual activities, on 5 or more days of the week. Don’t let these numbers psych you out though. Start small and strive for progress, adding simple active habits to your lifestyle whenever possible. Some examples include walking or biking in place of driving (that’s healthy for the environment too!), taking stairs instead of the elevator, taking a walk or other exercise break at work, going out dancing with friends, or spending time playing with your kids. Always keep in mind that any extra activity is valuable to your health and, therefore, worthy of your effort. Once you get moving, your increased activity levels will soon feed your energy capacity and, before you know it, you’ll be out running, biking, or playing a pick-up game of your choice with colleagues over lunch. Maybe you’ll even join a sports team, cycle a century, or run a marathon!

The remaining lifestyle habits – don’t drink too much alcohol and don’t smoke – can be tough to incorporate, but are really important for rounding out your good health. While there may be health benefits related to modest intake of certain alcoholic beverages, such as red wine, the American Cancer Society (ACS) writes that, in general, moderate to heavy drinking is known to contribute to cancers of the mouth, throat, larynx (voice box), esophagus, liver and breast, and may contribute to colon and rectal cancers. The ACS recommends that people who drink alcohol limit their intake to no more than 2 drinks per day for men and 1 drink a day for women, with a drink being defined as 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof distilled spirits. Regarding cigarette smoking, by this point in our history, most people know that quitting smoking is one of the best things one can do for improving, not only their own health, but also the health of the people around them. To kick the habit for good, motivation, dependable support, and sound strategies are needed. And no one needs to take quitting smoking on alone. There are many resources available, including these from the Centers for Disease Control (CDC) and the ACS.

While the prospect of lifestyle changes can be intimidating and challenging, the known risks to your health from not making them can be just plain frightening. At the end of the day, it’s nothing more than a simple informed decision. Would you like to take control of your long-term health status, or would you rather just do nothing and wait to see how it all turns out as the subject of your own experiment? There’s only one of you, so please make this choice carefully.

1. National Center for Health Statistics, Deaths and Mortality Data for the US
2. Disease Diagnosis Can Spur Change in Lifestyle, HealthDay News, SOURCE: JAMA/Archives journals, news release, Feb. 9, 2009
3. Ornish D, et al. 1990. Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial. Lancet 336(8708):129-33.
4. Ornish Takes on Cancer (from Dr. Greger Newsletter, Fall 2005)

Before delving into more details, let’s all get on the same page with some basic information. The ACL is a tough band of tissue that runs from the thigh bone (or femur) to the shin bone (or tibia). It plays an important role in stabilizing the knee joint. When the ACL tears, it’s often the result of a sudden, forceful twist, such as an awkward landing from a jump that torques the knee. Athletes in sports that require quick pivots and jumps have the highest rates of ACL injury.

Following the well-known “pop” and the scream that often follows, the scenario for most of these injured athletes involves reconstructive surgery and a difficult six to nine months of rehabilitation, as well as a pre-disposition to irreversible post traumatic degenerative joint disease in early adulthood. ACL injuries among young female athletes have reached epidemic levels in many countries, which has athletic trainers, coaches, athletes, parents, and administrators concerned. The prevalence of these injuries has also motivated the athletic and sports medicine communities to work on uncovering the mechanisms underlying the increased susceptibility in these athletes and developing preventative measures. Many theories have subsequently been proposed, having found significant variations between female and male hip and knee anatomy, muscular balance around the knee, and movement patterns. Female sex hormones, including estrogen, progesterone and relaxin, are also thought to play a role, as they are known to fluctuate considerably during the menstrual cycle, most extremely at the onset of menses (first 1-2 days). Reportedly, these swings in hormone levels result in increased ligamentous laxity, and subsequent compromise of neuromuscular coordination, due to inconsistent tautness of these passive tissues.

While nothing can easily be done to change anatomical differences, muscular balance and movement patterns are pliable. Awareness is key as well. Some recent results, including those from a Centers for Disease Control commissioned study using an ACL injury prevention regimen called the PEP program (Prevent injury and Enhance Performance) on a season of NCAA women’s soccer players, suggest that balance and neuromuscular control play the central role in knee joint stability. Through the PEP program and others, successful methods that can be learned and practiced have been identified. The result? Protection of the knee joint complex and prevention of ACL injuries. Several high school and college level teams have incorporated such programs, consisting of a series of proprioception/balance, plyometrics, agility and strength training exercises, into their training, and have seen significant decreases in ACL injuries among their athletes.

Further information regarding the PEP training program, including a complete PEP conditioning schedule with descriptions for all activities, can be found at the Santa Monica Orthopaedic and Sports Medicine Foundation website.

References
1. Am J Sports Med August 2008 vol. 36 no. 8 1476-1483. A Randomized Controlled Trial to Prevent Non-Contact ACL Injury in Female Collegiate Soccer Players
2. Training May Cut Risk Factors for Knee Injury. Reuters, New York. Copyright © 2009 ABC News Internet Ventures.
3. Female Athletes are Beginning to Implement an ACL Injury Prevention Regimen. Jim Rapier. Reuters Blog. Sept 24, 2009.
4. Arthroscopy. 2007 Dec;23(12):1320-1325.e6. A meta-analysis of the incidence of anterior cruciate ligament tears as a function of gender, sport, and a knee injury-reduction regimen. Prodromos CC, Han Y, Rogowski J, Joyce B, Shi K. Illinois Sports Medicine & Orthopaedic Centers, Glenview, Illinois 60025, USA. research@ismoc.net
5. Orthop Clin North Am. 2002 Oct;33(4):637-51. The female ACL: why is it more prone to injury? Ireland ML. Kentucky Sports Medicine, 601 Perimeter Drive, Lexington, KY 40517, USA. ksm@kysportsmed.com
6. Curr Womens Health Rep. 2001 Dec;1(3):218-24. Prevention of anterior cruciate ligament injuries. Hewett TE, Myer GD, Ford KR. Children’s Hospital Research Foundation, Room 3057 TCHRF, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA. tim.hewett@chmcc.org
7. Instr Course Lect. 2007;56:397-406. Dynamic neuromuscular analysis training for preventing anterior cruciate ligament injury in female athletes. Hewett TE, Myer GD, Ford KR, Slauterbeck JR. Sports Medicine Biodynamic Center, Cincinnati Children’s Medical Center, Cincinnati, Ohio, USA
8. Am J Phys Med Rehabil. 2005 Feb;84(2):122-30. Sports-related knee injuries in female athletes: what gives? Dugan SA. Rush Medical College, Chicago, IL 60614, USA
9. J Orthop Res. 2006 February; 24(2): 124–131. Absolute Serum Hormone Levels Predict the Magnitude of Change in Anterior Knee Laxity across the Menstrual Cycle. Sandra J. Shultz, Bruce M. Gansneder, Todd C. Sander, Susan E. Kirk, and David H. Perrin
10. Sports Med. 2000 May;29(5):313-27. Neuromuscular and hormonal factors associated with knee injuries in female athletes. Strategies for intervention. Hewett TE
11. J Athl Train. 2002 Jul–Sep; 37(3): 275–278. The Menstrual Cycle, Sex Hormones, and Anterior Cruciate Ligament Injury. James R. Slauterbeck, Stephen F. Fuzie, Michael P. Smith, Russell J. Clark, K. Tom Xu, David W. Starch, and Daniel M. Hardy