Early sports specialization tied to increased injury rates in college athletes

Sixty million kids participate in organized athletics each year with ever increasing amounts of children specializing in one sport before the age of 14 with hopes of a college scholarship or professional career on the line. However, researchers presenting their work at the AOSSM/AANA Specialty Day today reveal that this early intense participation might come at the cost of increased injuries during their athletic careers.

“Our research indicated that athletes who specialized in their varsity sport before the age of 14 were more likely to report a history of injuries and multiple college injuries during the course of their athletic career,” said author, Brian M. Cash, MD from the Department of Orthopaedic Surgery at the University of California at Los Angeles.

Cash and his colleagues sent a voluntary survey to 652 athletes who participated in athletics at a single institution. Participants were asked about demographics, scholarship status, reasons for sports specialization, age of specialization, training volume, and injury/surgical history. A total of 202 surveys were available for analysis after some were excluded due to incomplete or incorrect survey completion. Injuries were defined as those which kept an athlete out of participation for more than one week. High training volume was defined as greater than 28 hours per week during pre-high school years. 86.9% vs. 74% of individuals who specialized early reported a history of injury, (64.6% vs. 49.4%) reported multiple injuries and these athletes were held out of sport participation an average of 15.2 vs. 7.0 weeks in those that did not specialize early. However, early specializers were also more likely to receive a college scholarship (92.9 vs 83.1%). Full-scholarship athletes were more likely to report multiple surgical injuries (11.7 vs 3.5%).

In addition, those who trained more than 28 hours per week in their varsity sport before high school were more likely to report multiple injuries (90.0 vs. 56.7%). Individuals with a pre-high school training volume greater than 28 hours/week were not more likely to be recruited (90.0 vs. 89%) or receive a scholarship (80% vs. 74.5%).

“Sports participation is an excellent way for kids to maintain their health and possibly even receive a college scholarship. However, our research further highlights that avoiding sports specialization before the age of 14 and minimizing training time to less than 28 hours per week, may significantly minimize a child’s injury chances and promote long-term, athletic college or even elite success,” said Cash.

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Materials provided by American Orthopaedic Society for Sports Medicine. Note: Content may be edited for style and length.

Is ‘Breaking the Seal’ When You Drink Alcohol Really a Thing?

I’m no stranger to hearing my friends warn that I’m “breaking the seal” as I hurry to the bar bathroom. As someone who tends to drink a lot of water, I’m pretty used to constantly having to relieve myself. That need can feel even more urgent after adding alcohol to the mix. This raises the question: Is breaking the seal actually a thing, or is it a funny lie we tell ourselves—and our bladders?

“Breaking the seal” refers to the notion that if you pee after drinking alcohol, you’re breaking some kind of biological seal that will result in you needing to pee excessively for the rest of the night. (Thank you to the always handy Urban Dictionary for laying it out so clearly.) In contrast, the theory goes that if you drink the same amount of alcohol but don’t let yourself pee until the booze is out of your system, your urge to go won’t be nearly as strong.

The term “breaking the seal” has no basis in science.

There’s no such thing as a “seal” that you break when you pee for the first time after drinking alcohol, Benjamin Brucker, M.D., associate professor in the departments of urology and obstetrics and gynecology at NYU Langone Health, tells SELF. But it can certainly feel that way. To understand why, let’s dive into how your body processes fluids.

After you drink something, your kidneys filter the liquid, producing the waste and excess fluid you know as pee, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Your urine goes through tubes called ureters to the bladder. Once your bladder fills up—usually holding about 1.5 to 2 cups of urine at a time—it sends a “hey, where’s the toilet?” signal to your brain. When you do actually let loose that stream, you’re emptying your bladder to make more room for more urine.

Notice that you didn’t see any mention of a “seal” or anything like it in that explanation. “There’s not really any seal, so to speak,” Dr. Brucker says.

But it is true that drinking alcohol can make you produce more pee.

It’s totally normal to feel like you’re kicking off a string of bathroom trips with that first pee break, Blaine Kristo, M.D., a urologist at Mercy Medical Center in Baltimore, Maryland, tells SELF. And you really might have to pee a ton when you drink, but that’s not because a seal is involved.

Alcohol has a diuretic effect on the body, meaning that it causes increased urination. Although the relationship here isn’t fully understood, a lot of this seems to come down to the fact that alcohol suppresses a hormone in your body called vasopressin (also known as antidiuretic hormone). Vasopressin tells your kidneys to absorb less fluid from your bloodstream, meaning you don’t create as much pee. “By suppressing the release of vasopressin, alcohol causes excess urination,” George F. Koob, Ph.D., director of the National Institute on Alcohol Abuse and Alcoholism, tells SELF.

Koob also points out that alcohol can irritate the bladder, which can contribute to excessive peeing in some people. This doesn’t happen to everyone, but if you have a condition like interstitial cystitis, which causes bladder pressure and frequent urination, it can be more of a problem.

Beyond that, your drinking habits might make you pee more. If you’re drinking a lot (or taking the smart step of alternating each alcoholic beverage with water), there’s the simple fact that you might be taking in more fluid in a shorter time period than usual.

You probably also give the fluid some time to build up in your system, leading to you feeling like a racehorse once you sit on the toilet. “The first time you go to the bathroom after [drinking], usually that’s happening after you’ve been there for a while and have been consuming a fair amount of liquid,” Dr. Brucker says. The thing is that this liquid doesn’t all become urine at once. Even as you pee, you might still be processing earlier drinks. “Your body is continuing to filter out that fluid,” Dr. Brucker explains.

All of these factors can make it seem you spend half of your drinking nights in the bathroom. Unless you’re peeing so much that you’re regularly surpassing the average urinary frequency (four to eight times a day), this is just an annoying fact of life, not something to worry about.

Don’t hold in your pee for fear of breaking a metaphorical seal.

To be clear, chances are extremely low that anything bad will happen if you ignore the call of nature here and there. Sometimes you just need to hear about how your friend’s latest Bumble date ended, and before you know it, the night has passed without a single bathroom trip.

However, regularly holding in your pee can theoretically put you at higher risk for urinary tract infections. The more you pee, the more you can flush out any bacteria lurking in your urinary tract, ready to wreak infectious havoc, the Mayo Clinic explains. Of course, some people can hold in their pee for a long time and be just fine, so a lot of your risk may depend on how UTI-prone you are.

There’s no way to curb alcohol-related peeing except for drinking less.

Not to be a buzzkill, but it’s true. “The best strategy for reducing excess urination as a result of drinking alcohol is to drink less alcohol,” Koob says.

OK, fine, you could try choosing drinks with urine output in mind, Dr. Brucker says, like by opting for a smaller cocktail over a huge one. Even then, at some point, what goes in must come out.


Restless Legs Syndrome: 9 Facts to Know About This Health Condition

The symptoms of restless legs syndrome sound like the plot of a horror movie. If you have this condition, you might sink into bed at the end of each day aching for a good night’s sleep. Then it begins. An irresistible urge to move your legs won’t allow you any peace. You feel creeping, crawling, tingling, aching, or twitching sensations in your lower extremities, making it almost impossible to sleep. If you don’t have restless legs syndrome (RLS for short), this may sound unimaginable. But for people with intense cases of RLS, this might be just another typical night.

In 1685, a doctor named Sir Thomas Willis recorded the first written case about RLS, according to a 2012 review in Sleep Medicine Reviews. Fast forward to 1945, when a doctor named Karl-Axel Ekbom came up with the name “Restless-Legs Syndrome.” Though both milestones happened some time ago, doctors are still searching for a definitive cause and cure for this condition, alternatively called Willis-Ekbom disease. Here are nine facts explaining what doctors know so far about this baffling disorder and which mysteries still need investigating.

1. Restless legs syndrome causes unusual physical sensations and movement.

RLS is a neurological disorder involving a powerful impulse to move body parts, usually because of uncomfortable sensations, according to the National Institute of Neurological Disorders and Stroke (NINDS). Although this condition nearly always affects the legs—they’re right there in the name, after all—it’s also possible for RLS to affect areas like the arms, chest, and head, according to the NINDS.

Sometimes RLS sensations are so weird that people have trouble describing them, according to the Mayo Clinic. With that said, the following descriptions are generally agreed upon to come pretty close:

  • Aching
  • Crawling
  • Creeping
  • Electric feelings
  • Itching
  • Pulling
  • Throbbing

These symptoms may affect up to 7 to 10 percent of people in the United States, according to NINDS estimates. It can begin at any age, but RLS becomes more common as people get older, the Mayo Clinic says. If symptoms start before age 40, it’s more likely that there’s a genetic component involved (more on that later).

It’s possible to experience these symptoms at varying levels of severity every night, a few times a week, or even less often than that, according to the NINDS. However, RLS typically becomes more frequent and severe with age.

2. Moving the legs can temporarily tame these odd feelings.

It’s only natural that if you have an uncontrollable urge to move your legs, you’re going to do just that. Interestingly enough, moving the body parts affected by RLS can get rid of or lessen the symptoms temporarily, according to the Mayo Clinic.

This is why many people with RLS will do things like pace, tap their feet, stretch, and generally move their legs as much as possible when they have symptoms. But the sensations return once the motion stops, which is a huge reason why this condition can be so life-disrupting depending on its severity.

3. RLS can make it almost impossible to sleep well.

In a cruel twist, symptoms are most likely to strike when you’re most desperate for rest: as you try to go to sleep. Since most people work during the day and sleep at night, symptoms tend to arise in the late afternoon and evening, becoming exacerbated at night when a person is at rest, the NINDS explains. (This is because RLS appears to follow a person’s circadian rhythm.)

As such, RLS can lead to issues like excessive daytime sleepiness that can put stress on relationships and work. It can also harm mental health. Feelings of frustration and helplessness are only to be expected when your own body robs you of sleep, and that can eventually contribute to conditions such as depression and anxiety.

This chronic lack of sleep is part of why there’s fervent interest around whether or not RLS may increase the risk of physical health issues such as cardiovascular disease. Although the existence of an association is still up for debate, some researchers believe that the connection lies, at least in part, in a lack of sleep. (This could be due to a constellation of factors, like how a lack of sleep is a risk factor for obesity, which can then contribute to heart disease.)

4. RLS can cause another sensory issue called periodic limb movements of sleep.

In addition to the (sometimes literal) pain of falling asleep, it’s estimated that more than 80 percent of individuals with RLS also experience periodic limb movements of sleep (PLMS), the NINDS says. These are basically involuntary leg and/or arm spasms that can happen as often as every 15 to 40 seconds all night long, causing constant disruptions that might further harm your sleep.

It appears as though blood pressure and heart rate spike temporarily during these jerky movements, which is why some experts posit that PLMS and, relatedly, RLS may raise a person’s risk of heart issues over time.

5. Primary RLS happens with no known cause.

“When you’re dealing with the brain, it’s very complex,” John Winkelman, M.D., Ph.D., chief of the Sleep Disorders Clinical Research Program at Massachusetts General Hospital, tells SELF. “There are no simple explanations.”

With that in mind, let’s talk about possible causes of primary (or idiopathic) RLS, meaning when doctors can’t pinpoint an underlying reason why someone has this condition.

One major theory revolves around the neurotransmitter dopamine, which is necessary for creating and maintaining normal muscle movement, according to the NINDS. Some experts think malfunctions in the dopamine pathway can create the uncontrollable movements involved in disorders like RLS.

It also appears that there is a hereditary element. A 2017 study in The Lancet Neurology analyzed DNA from 428,534 people, concluding that there are at least 19 genetic risk variants for RLS. Additional research is needed to understand the link between these genes and the biological component of RLS.

6. Secondary RLS is tied to specific risk factors.

For instance, doctors believe that an iron deficiency may predispose a person to RLS. One theory is that low levels of iron can impact dopamine signaling; another is that RLS genetic risk variants may affect iron stores.

This iron connection may be part of why pregnancy is a major risk factor for RLS. Pregnant people are more at risk of iron deficiency because their blood volume increases by 20 to 30 percent, calling for more iron to create hemoglobin that can send oxygenated red blood cells all over the body. Rising hormones in pregnancy, such as estrogen and progesterone, may also contribute by impacting dopamine production, though the scientific jury is still out. In any case, if someone develops RLS during pregnancy, the symptoms typically subside after giving birth, according to the NINDS.

Taking specific medications is yet another risk factor. Some antidepressants that increase serotonin (including the popular antidepressant class selective serotonin reuptake inhibitors), antinausea drugs, and antihistamines may bring about or worsen RLS, the NINDS says. All of these mechanisms appear to be tied to those critical dopamine pathways.

7. RLS diagnosis primarily hinges on symptoms.

There is no lab test to detect RLS, the Mayo Clinic explains. Instead, RLS is diagnosed based on a set of symptoms defined in 2003 guidelines published in Sleep Medicine:

  • A strong urge to move the legs, which typically occurs with additional unpleasant sensations (but doesn’t always)
  • The need to move happens during periods of rest or inactivity
  • Temporary relief with movement
  • Worse symptoms in the evening and at night (or symptoms only in the evening and at night)

Your doctor may also perform medical exams like a blood test to check for an iron deficiency, according to the Mayo Clinic.

8. Treatment for RLS revolves around relieving symptoms.

To start, your doctor may recommend non-pharmaceutical tactics to ease your RLS. Here are some ideas from the Mayo Clinic and the NINDS:

  • Cutting out or reducing caffeine, nicotine, and other substances that can affect your sleep
  • Exercising (but not too soon before bed, when it might energize you)
  • Taking a warm bath and massaging your legs to loosen up your muscles
  • Applying heat and cold packs to your legs
  • Trying to stick with a regular sleep schedule if at all possible

It may also help to try to organize your day around your symptoms when possible, like by scheduling sedentary activities such as traveling or watching a movie during the times when your RLS tends to be least active. (Since RLS appears to follow circadian rhythms and most people work in the day and rest at night, this may be in the morning for you. However, for those who, say, do shift work, RLS could actually be worse in the morning and better at night.)

Then there are the medical treatments. Some drugs work to raise dopamine levels in the brain, the NINDS says. Anti-seizure drugs that can calm muscle movements are also gaining prominence in RLS treatment. And people with proven iron deficiencies may find some relief in doctor-approved supplementation.

Sometimes doctors prescribe opioids for RLS as they tend to be successful in alleviating some of the discomfort, but with stricter regulations and the growing concern over addiction, this option is becoming more of a last resort. The same goes for the class of sedatives known as benzodiazepines, which can help you sleep but can counterintuitively also cause problems like daytime sleepiness, the NINDS says.

Finally, there are devices approved by the U.S. Food and Drug Administration (FDA) to relieve RLS symptoms. Relaxis is a vibration pad that goes under the legs, and Restiffic is a pressure wrap that goes around the legs or feet.

9. There’s hope on the horizon for people with RLS.

In the past, many people with RLS had no idea what was happening, Dr. Winkelman says. Those with this condition often feared what others would think if they tried to explain these strange phantom resting pains, he explains.

Now, Dr. Winkelman explains, awareness continues to increase due to more research and newer treatments. Although scientists haven’t fully figured out this condition, there’s less mystery surrounding RLS, so more people are seeking—and hopefully getting—the help they need.


Palliative Care: Symptom Relief During Illness

If you or a loved one has a serious or life-threatening illness, you might have thought about palliative care. To understand palliative care and how it can help relieve pain and improve quality of life, consider the following questions.

What is palliative care?

Palliative care is specialized medical care that focuses on providing patients relief from pain and other symptoms of a serious illness. A multidisciplinary care team aims to improve quality of life for people who have serious or life-threatening illnesses, no matter the diagnosis or stage of disease.

Palliative care takes into account your emotional, physical, and spiritual needs and goals—as well as the needs of your family. It’s offered alongside curative or other treatments you may be receiving.

How is palliative care different from hospice?

Palliative care is available at any stage of a serious or life-threatening illness. Hospice care is available only at the end of life—when curative or life-prolonging treatments have been stopped. You don’t have to be in hospice to receive palliative care.

Who can benefit from palliative care?

Anyone who has a serious or life-threatening illness can benefit from palliative care, either to treat symptoms of the disease, such as pain or shortness of breath, or to ease the side effects of treatment, such as fatigue or nausea.

Palliative care may be a good option for children and adults with a serious illness who need help:

  • Managing symptoms
  • Addressing concerns that matter most to them
  • Understanding what to expect with their care plan
  • Understanding programs and resources available to support them throughout their illness
  • Understanding the pros and cons of treatment options
  • Making decisions in line with their personal values and goals

How does palliative care work?

Palliative care can be provided throughout treatment for a serious illness—whether you or your loved one is being treated in a hospital, at home, or in a care facility. This specialized medical care is provided by a team of doctors, nurses, and other specially trained people. They work with you and your family to create a care plan to prevent and ease suffering and improve your daily life. This plan will be carried out in coordination with your primary care team in a way that works well with any other treatment you’re receiving.

A palliative care specialist can also help you or your loved one communicate with doctors and family members and create a smooth transition between the hospital and home care or nursing facilities. The palliative care team will educate you and your family members about what to expect and schedule routine meetings to discuss ongoing care throughout the course of your illness.

What are some real-life examples of palliative care?

Here’s one example of how palliative care works: You have a history of heart failure and are increasingly short of breath. This makes it hard for you to do even simple chores around the house. You live at home with a partner who also has health problems. You find that getting all of the care you and your partner need is becoming more difficult, and you’re not sure how to plan for the future. This has been stressful for you and your family physically, psychologically, spiritually, and financially.

Your primary care doctor suggests that you consider palliative care and explains that a palliative care team will work with you to determine how to ease your symptoms and improve your quality of life.

How can I learn more about palliative care?

If you’re interested in obtaining palliative care for yourself or a loved one, ask your doctor or your loved one’s doctor about palliative care options and if a program is available in your area.

Updated: 2016-02-20

Publication Date: 2010-02-05

7 Foam Rolling Mistakes You Should Avoid

You’ve probably heard your runner friend or gym buddy mention how their foam roller is both their best friend and worst enemy. How it hurts so good. While it’s true that foam rollers can be a great recovery tool, there’s more to rolling for relief than just lying on the floor and digging into whatever hurts.

“Like [with] any rehabilitation tool, improper use can cause injury. Overuse of a new injury that has not been fully healed can cause the injury to worsen or cause bruising,” says Fei Jiang, P.T., D.P.T., O.C.S., of Providence Saint John’s Health Center’s Performance Therapy in Santa Monica, California. And yes, foam rolling can contribute to overuse, too. “For example, if someone has a strained hamstring, one should let the area heal rather than foam rolling on it; that can cause the injury to worsen,” he says.

Using the right techniques will also make you more likely to reap the benefits of foam rolling,, says Austin Misiura, D.P.T., O.C.S., C.S.C.S., owner of Pure Physical Therapy, a rehab and movement retraining center in Miami. While research on foam rolling is still limited, what’s out there suggests it may help you recover better after a workout, improve circulation, and relax and loosen tight, achy muscles.

As long as you do it properly, foam rolling is a pretty low-risk way to potentially improve your workout performance and simply feel better. If you’re new to foam rolling or just not sure if you’re doing it right, here are some common mistakes to look out for.

Mistake #1: You’re rolling in the wrong direction.

If it feels hard to balance on the foam roller, you might be rolling the wrong way. “Likely, you are misaligning the foam roller by placing it parallel to the muscle. Instead, try rotating the foam roller so that it is perpendicular to the [length of the] muscle,” says Jiang. Then roll up and down the entire length of the muscle.

By keeping the roller perpendicular to the muscle or tissue you’re targeting, you’ll be able to balance better, roll with a steady flow, and increase the surface area you cover with each roll, Jiang says.

Mistake #2: You’re not rolling your upper body.

It may seem like foam rolling is primarily a lower-body activity—especially since so many vocal foam-rolling faithfuls are runners. But you can and should roll out your upper body, too.

That includes your pectorals (chest), lats (the broad muscle on the sides of your mid-back), triceps, and the muscles around the shoulder blades. Some of these muscles might be a little hard to reach with a big roller, so you might want to roll them out with a lacrosse ball instead. For example, the spot between your armpits and chest that gets wildly sore if you do too many push-ups can be awkward to drape over a tubular roller, and the muscles in the upper back can sort of get lost under the shoulder blades. In both cases, it’ll be easier to get a ball in there to target the tight spots (more on that in a minute).

Mistake #3: You’re not using the right pressure.

If you’re rolling too gently, it may not make much of an impact, and if you’re going too hard, you could add to the pain and end up tensing up your muscles in response, which is the opposite of the goal.

Though you can ultimately control the pressure as you roll—pressing all your weight onto one spot will feel much more intense than if you prop yourself up with your leg or hand—different types of rollers can make it easier to apply different amounts of pressure. “Typically, the hollow rollers apply more pressure than the full cylinder,” Misjura says. Full-cylinder rollers are usually a bit softer; the hollow ones usually have harder plastic in the middle, which puts more pressure on your body with less effort on your end.

Misjura suggests “applying pressure up to a self-rated 5 out of 10 in tenderness; any more and you are very likely to guard or stiffen while you are rolling, which will be counterproductive.” Either type of foam roller will work, so it comes down to personal preference.

When targeting smaller, deeper muscles, like those in the hip and upper back, try using either a lacrosse ball (harder) or a tennis ball (a bit softer and gentler). A ball allows you to target the smaller spots in between bones and really reach the places you are trying to roll, he explains. “It is pretty much impossible to get to a smaller or deeper muscle using the roller because it has a huge surface area so it covers too big of an area to be specific,” he says.

Mistake #4: You’re trying to roll out bony areas.

Foam rollers are meant to release tension in soft tissue, so rolling over bony spots is unnecessary and will probably just be painful, says Jiang. Bony areas include the shoulder blades, ankles, and parts of the hips and legs (like the knees and shins).

For example, “people tend to roll over the shoulder blades while attempting to roll out the thoracic region [the upper part of the spine],” he says. Rolling on these bones isn’t going to help you—you want to roll the muscles and tissues that are beneath. To do that, pull your elbows together in front of your body, or simply cross your arms over your chest, and pull your shoulder blades forward. Then, place the roller horizontally underneath your upper back, and roll so it moves up and down your spine.

Same goes for the bony spots in your hips and pelvis, and the spot just below the hip bone where the thigh bone (femur) begins (called the greater trochanter). “[Rolling there] is painful and does not help loosen muscles and tendons in the leg,” Jiang says. Instead, locate and roll out the soft areas above and below the hard areas on the side of the hip to help improve mobility of the leg, he says. If you can’t get in there with a foam roller, try a tennis or lacrosse ball instead.

Beyond these bony areas, you also don’t want to roll your IT band, the tendon that runs along the outside of your thigh from the top of the pelvis to the shin bone. Contrary to what you might think, it’s considered “not stretchable,” as it’s composed of taut tissue, says Misiura. Plus, since discomfort in the IT band often stems from tightness in connected muscles, focusing on the quads, hamstrings, and glutes will likely be more productive, he says.

Misjura suggests specifically rolling the tensor fascia lata, a small muscle that works with the IT band and the glutes to stabilize the hip and knee as you walk and run. It’s on the outside of your hip (think: side butt) from the top of your pelvis to about halfway down your thigh, where it connects to your IT band. “Rolling this area will assist in the treatment of IT band [discomfort] and improve hip mobility much more than trying to roll the IT band,” says Misjura.

Mistake #5: You’re spending too much time on trigger points.

“A common mistake is to foam-roll directly and only on the knots for a long period of time. People often spend several minutes rolling on areas of pain, only to create more pain and irritation in those areas,” says Jiang. At best, overdoing it in one spot won’t make a difference in terms of relief, and at worst, it can lead to more pain, he adds.

The goal here is to relax the muscle, and sometimes that means you have to start with the less tense areas that connect to the trigger point. “Instead, roll the general larger surface around the area for 60 to 90 seconds before targeting the knotted tissue for 30 seconds at a time,” Jiang says. When you loosen up the areas around a trigger point, you’ll likely indirectly decrease tension a bit in the spot you feel you need to roll the most, says Jiang. That way, once you focus on the trigger point, it should feel a little more comfortable to roll.

Mistake #6: You’re rolling your lower back.

It’s okay to roll your upper back and midback, specifically the areas around the shoulder blades and the lats. But even though you might be tempted to foam-roll your lower back, it’s not a good idea.

It’s difficult to balance a foam roller on the lower part of the back, says Jiang. Trying to get into the right position to roll out the area can ultimately force you to overarch your spine, which can cause discomfort or even a strain. This can be especially harmful if you already have too much extension (an exaggerated arch) naturally in your lower back or any other pre-existing lower-back issue, Jiang says.

Instead of rolling, Jiang suggests using a lacrosse ball to target the spots along your spine that feel tight and need to be released—don’t roll in the middle of the spine, but rather along the muscles that run down either side of it. With the lacrosse ball, you’re less likely to put your back into a compromised position. If you have chronic lower-back pain or a past or current lower-back injury, talk with your doctor before using any tools to apply pressure to the area.

Mistake #7: You’re not contracting and relaxing your muscles while rolling.

While this isn’t exactly a mistake, it is a missed opportunity for efficiency. “If you contract and relax your muscles as you are applying the pressure with the roller, you are likely to see [better] effects,” says Misjura.

“Any active treatment works better than a passive one. Your nervous system will adapt better if you are actively working by contracting and relaxing your muscles,” he explains. The more you can actively get your muscles moving from a contracted, tense state to a lengthened, relaxed one, the better. Using this technique, you’ll likely notice bigger improvements in your mobility in less time, Misjura adds.

When you find an area of tightness, keep the pressure of the roller on that spot for 30 seconds, and as you do, move the connected joint slowly to contract and release the muscle. “For example, if you are rolling your calf, apply the pressure with the roller underneath your leg, keep it on the tender spot, and point and flex your foot back and forth 10 times,” Misjura says. “Another example is the quads. Find the tender spot while you are lying face down on the roller, and hold there as you bend and straighten your knee 10 times,” he says.

It’s worth a try—if you’re going to take the time to foam-roll, you might as well get as much out of it as you can.


SkinStore’s Anniversary Sale Just Gave Me an Excuse to Buy More Beauty Products (As If I Needed One)

As an editor, I have the privilege of testing lots of new beauty products on the regular, but I always leave room in my closet for more. I never turn down the chance to stock up on products that actually work for me—especially when they’re on sale.

Starting now through March 23, SkinStore is having an anniversary sale in honor of their 22nd birthday. Products from brands like Paula’s Choice, Dermalogica, La Roche-Posay, and more are up to 22 percent off sitewide using code 22SALE. But that’s not all: From March 24 through March 26, SkinStore will be offering 25 percent off products on site. If you’re looking for even bigger bargains, sale items on the site will be available for up to 30 percent off.

This definitely gives me even more incentive to overload my shopping cart! Read on for a few of the products I currently have my eye—and my mouse—on.

Yellow Mucus: Here’s What It Means If You Have This Symptom

If you’ve ever peeked into your tissue after blowing your nose and glimpsed yellow mucus, you may have wondered what your body was trying to tell you. Fear not! Mucus the color of lemonade is a sign that your body is doing what it’s supposed to do when faced with outside intruders.

Mucus is critical for the health of your respiratory and immune systems.

This slimy stuff helps to warm and humidify the air you breathe, Anthony Del Signore, M.D., assistant professor of otolaryngology and director of rhinology and endoscopic skull base surgery at Mount Sinai Beth Israel, tells SELF. This is important because breathing air that’s too cold and dry can aggravate your airways, which is why it can burn like hell to breathe outside in wintertime. So, even though mucus is kind of gross, it contributes a fair amount to your physical comfort.

Mucus is meant to keep you comfortable in another way, too: as a vigilant guard on the frontlines of your body’s biological defense system, Michael Benninger, M.D., chairman of the Cleveland Clinic Head and Neck Institute, tells SELF. Mucus traps foreign invaders that could make you ill, including viruses, bacteria, and allergens. Ideally, little hair-like projections called cilia then shuffle those invaders to the front of your nose so you sneeze them out, meaning they can’t enter your lungs and make you sick. (This dirty mucus can also slip down your throat, but if invaders get to your lungs, you might cough to clear them out.)

Your mucus usually turns yellow when your body is fighting an infection.

When your mucus traps potential illness-causing debris, like pathogens that cause the common cold or flu, your immune system sends inflammatory cells such as white blood cells to the area to help destroy the invaders, Dr. Benninger explains. It’s this inflammatory response—not the agents of infection themselves—that causes the signature shift in mucus hue, Dr. Benninger says.

One of the first responders to microbial invaders is a type of white blood cell called a neutrophil. Neutrophils are full of myloperoxidase (MPO), an enzyme that contains green-colored heme, or iron. When super-concentrated, these green neutrophils can make your mucus appear straight-up verdant. But when less concentrated, the mucus appears pale green—which, depending on how your eyes work, might look yellow to you instead.

You may also notice that your mucus is a deeper shade of yellow (or looks like it has gone from yellow to green) after several days of being sick, not blowing your nose for a while, or when you wake up in the morning. When mucus sits around in your nasal passages for prolonged periods, these inflammatory cells can build up and tint your mucus more intensely, Dr. Benninger explains. “The less you clear it out, the more it becomes discolored,” he says.

So, when you’ve got yellow mucus, you should blow your nose often to clear out any trapped debris and keep things moving.

Yellow mucus isn’t necessarily a sign you need to see a doctor.

What really matters is your accompanying symptoms and how long they stick around, Dr. Benninger says. While you know your body better than anyone and should take a trip to the doctor if you’re feeling unusually horrible, it’s good to know that some of the most common illnesses involving yellow mucus will typically clear up on their own without medication.

For example, the common cold usually lasts seven to 10 days, according to the Mayo Clinic. A viral sinus infection typically begins to clear up after five to seven days, while a bacterial sinus infection may last seven to 10 days, hang around for longer than that, or even worsen around a week in before eventually fading, according to the Cleveland Clinic.

In the meantime, you can use over-the-counter meds and at-home care to manage symptoms of these kinds of illnesses. Methods include anti-inflammatories for pain and fever, nasal irrigation, and decongestants if you have an especially clogged nose, Dr. Benninger says. (You shouldn’t use decongestants that constrict your nasal blood vessels for more than three days, though, or they can cause rebound congestion. Learn more about that here.)

If you still feel like something stuck on the bottom of a shoe after around a week of being sick, you might want to check in with a doctor. It’s possible that you could need something like antibiotics to clear up a bacterial sinus infection. No matter what’s going on, your doctor can help determine the cause of your yellow mucus and get your snot crystal clear again.


How Does Cancer Kill You?

Cancer is almost unspeakably awful, from the potential hardships of treatment to the prospect of leaving behind grieving loved ones. This horrible illness has a sweeping reach. An estimated 1.7 million people in the United States were diagnosed with cancer in 2018, according to the National Cancer Institute (NCI). Around 610,000 people were estimated to die from the disease by the end of the year.

While the emotional and physical tolls of cancer are often clear, it can be confusing as to how, exactly, cancer kills someone. Is it due to the cancer itself? Or is it usually a more indirect result of how cancer can affect a person’s health? And does it vary depending on the type of cancer a person has?

This can be a terrifying topic to discuss with a doctor or loved one, depending on your situation. But sometimes you need answers to even the scariest questions. Here, we spoke to several oncologists to explain how cancer can lead to death.

Cancer happens when cells grow out of control.

It can be easy to forget how intricate human biology is, but your body is made up of trillions of cells. In order to function properly, these cells are constantly growing and dividing to form new cells, the NCI explains. In the normal cellular cycle, cells that become old or damaged die off and get replaced by newer, healthier versions.

Cancer forces this usual process to go terribly wrong. If someone has cancer, their old and damaged cells don’t die off, and new cells form without reason. These cells can start to divide uncontrollably and, as a result, form tumors, the NCI says.

Cancer is more likely to be fatal when it’s metastatic, meaning it has spread throughout the body.

You might have heard of metastatic cancer but not known exactly what it means.

Metastatic cancer happens when cancerous cells disperse into surrounding tissues or even travel to other parts of the body through the blood or lymph systems, according to the NCI. These cells can then form tumors in their new locations.

Even though metastatic cancer has by definition moved from its point of origin, it’s still considered a form of that primary cancer, the NCI explains. So, if you had ovarian cancer that spread to your stomach, it would be considered metastatic ovarian cancer, not stomach cancer.

It’s often this spread—and its impact on one or several major organs—that ultimately kills someone, Jack Jacoub, M.D., medical oncologist and medical director of MemorialCare Cancer Institute at Orange Coast Medical Center in Fountain Valley, California, tells SELF. For this reason, cancer staging is largely dependent on how extensively the cancer has traveled. Stage IV cancer, the most severe form, means the cancer has wound up in distant body parts.

But metastatic cancer doesn’t kill people in any one specific way. Instead, this disease can take a few avenues to end someone’s life.

These are the complications that are most likely to be fatal for someone with cancer.

1. Malnourishment or dehydration

Cancer can interfere with the function of your all-important digestive system, which is comprised of organs like your stomach, pancreas, and intestines. Tumors can clog up this system, creating obstacles that don’t allow food or food waste to get through, the NCI explains. That, in turn, can cause issues such as frequent nausea and vomiting. But cancer-related digestive issues are most likely to become life-threatening due to malnourishment or dehydration.

“The body stops being able to use nutrients properly,” Martin J. Edelman, M.D., deputy cancer center director for clinical research at Fox Chase Cancer Center, tells SELF. This means that even if someone is receiving nutrients via IV, they can still die from malnourishment.

Malnourishment can be accompanied by difficulty maintaining fluid levels. “Dehydration is almost universally a side effect of advanced cancer,” Ishwaria Subbiah, M.D., assistant professor in the department of palliative care and rehabilitation medicine at The University of Texas MD Anderson Cancer Center, tells SELF.

While doctors can give a patient with advanced cancer IV fluids, at a certain point, it’s difficult for the body to hold onto these necessary liquids. “The fluids don’t stay where they’re intended to stay, and will seep from the blood vessels into surrounding tissue,” Dr. Subbiah says. This can lead to dehydration.

2. Respiratory failure

Whether cancer originates in the lungs or affects these organs after becoming metastatic, this disease can kill off healthy lung tissue or block off portions of it, making it far too hard to breathe, the NCI says.

Someone with advanced cancer may receive oxygen in a facility like a hospital. But that doesn’t necessarily fix the problem if their lungs can’t properly inhale, exhale, or transport oxygen and carbon dioxide through their respiratory system. So, over time, a person with advanced cancer can have too much difficulty maintaining the oxygen levels that their body needs to survive, and their organs can begin to fail as a result, Dr. Subbiah says.

Cancer can also create infections that cause the lungs to fill up with fluid, which can then prevent a person from getting in enough oxygen over time, Dr. Subbiah says.

3. Loss of brain function

If cancer impacts the brain, it can lead to loss of consciousness, seizures, and the brain’s general inability to perform the way it needs to, Bryan McIver, M.D., Ph.D., deputy physician-in-chief at Moffitt Cancer Center, tells SELF. Brain bleeding or injury that harms the function of another critical body part, like the lungs, can also kill someone, the NCI says.

Another complicating factor: The brain is in the contained space of the skull, so there’s nowhere for it to go if it swells due to pressure from a tumor, Dr. Subbiah says. “In certain cases, the pressure is so high that it leads to a herniation where part of the brain slips down from the base of the skull,” she says. “That’s [almost] always fatal.”

4. Bone marrow issues

Cancer can spread to the bone marrow, the matter in the center of large bones that makes new blood cells. If this happens, it can lead to a host of life-threatening issues.

A lack of sufficient red blood cells can bring about anemia (not having enough oxygen in your blood), which can kill someone if severe enough. If your bone marrow can’t create enough platelets to help your blood clot, it’s harder to prevent dire levels of bleeding.

5. Infections

Cancer in your bone marrow can make your levels of white blood cells designed to help fight infection drop to precipitously low levels, the NCI says. On a related note, some cancer treatments such as chemotherapy can incapacitate a person’s immune system, thus raising their risk of life-threatening infection, according to the American Cancer Society (ACS).

“Serious infections like sepsis can be deadly, although someone can have a more [local] infection like pneumonia or a urinary tract infection that could [become] serious,” Dr. Edelman says. The likelihood of this varies based on the type of cancer someone has, Dr. Edelman says. But, in general, people with cancer in blood-forming tissues, like leukemia, are often most at risk because the cancer can more easily kill off too many white blood cells.

6. Blood clot complications

Unfortunately, cancer and cancer treatments can generally increase a person’s risk of developing blood clots, according to the ACS. There’s also the fact that a person with advanced cancer is often in bed for long periods of time—another blood clot risk factor. Together, this can raise a person’s odds of developing a blood clot that may lead to a deadly stroke or pulmonary embolism (a clot that blocks blood flow in the lungs), Przemyslaw Twardowski, M.D., professor of medical oncology and director of clinical research in the department of urology and urologic oncology at John Wayne Cancer Institute at Providence Saint John’s Health Center in Santa Monica, California, tells SELF.

7. Liver failure

Your liver juggles a lot of important jobs including separating toxins from your blood and helping you to digest food, the NCI explains. Cancer that starts in or spreads to your liver can cause this organ to fail and have trouble completing these duties. Eventually, this can cause life-threatening complications like excessive bleeding, including in the GI tract, and blood infections, the Mayo Clinic says.

8. Excessive calcium levels

When cancer damages a person’s bones, too much calcium can leach into their bloodstream, the NCI says. That’s a condition known as hypercalcemia, and it can devastate the heart and brain’s abilities to work properly, according to the Mayo Clinic. This means that, in severe cases, hypercalcemia can lead to coma and death.

Early detection and treatment often lower the odds of these complications.

While doctors can treat some of these problems as they happen in otherwise healthy people, it’s much more complicated in those with advanced cancer, Dr. Subbiah says. Often, several things are going wrong at the same time, which is why advanced cancer so frequently has deadly consequences. As Dr. Subbiah explains, “These are not fixable problems when you put them all together.”

That doesn’t mean that all of these complications are unavoidable or even always deadly when they do happen. They’re much more common and harmful with advanced cancer, the experts explain, which is why early detection and treatment are of the essence. It’s also why there is hope for many people with cancer, especially in the earlier stages.

“The [overall] rate at which people are dying of cancer has fallen,” Dr. McIver says. “We’re getting much better at avoiding direct cancer deaths. And, even when cancer can’t technically be cured, it can often be controlled for many years and even decades.”


Higher egg and cholesterol consumption hikes heart disease and early death risk

Cancel the cheese omelet. There is sobering news for egg lovers who have been happily gobbling up their favorite breakfast since the 2015-2020 Dietary Guidelines for Americans no longer limited how much dietary cholesterol or how many eggs they could eat.

A large, new Northwestern Medicine study reports adults who ate more eggs and dietary cholesterol had a significantly higher risk of cardiovascular disease and death from any cause.

“The take-home message is really about cholesterol, which happens to be high in eggs and specifically yolks,” said co-corresponding study author Norrina Allen, associate professor of preventive medicine at Northwestern University Feinberg School of Medicine. “As part of a healthy diet, people need to consume lower amounts of cholesterol. People who consume less cholesterol have a lower risk of heart disease.”

Egg yolks are one of the richest sources of dietary cholesterol among all commonly consumed foods. One large egg has 186 milligrams of dietary cholesterol in the yolk.

Other animal products such as red meat, processed meat and high-fat dairy products (butter or whipped cream) also have high cholesterol content, said lead author Wenze Zhong, a postdoctoral fellow in preventive medicine at Northwestern.

The study will be published March 15 in JAMA.

The great debate

Whether eating dietary cholesterol or eggs is linked to cardiovascular disease and death has been debated for decades. Eating less than 300 milligrams of dietary cholesterol per day was the guideline recommendation before 2015. However, the most recent dietary guidelines omitted a daily limit for dietary cholesterol. The guidelines also include weekly egg consumption as part of a healthy diet.

An adult in the U.S. gets an average of 300 milligrams per day of cholesterol and eats about three or four eggs per week.

The study findings mean the current U.S. dietary guideline recommendations for dietary cholesterol and eggs may need to be re-evaluated, the authors said.

The evidence for eggs has been mixed. Previous studies found eating eggs did not raise the risk of cardiovascular disease. But those studies generally had a less diverse sample, shorter follow-up time and limited ability to adjust for other parts of the diet, Allen said.

“Our study showed if two people had exact same diet and the only difference in diet was eggs, then you could directly measure the effect of the egg consumption on heart disease,” Allen said. “We found cholesterol, regardless of the source, was associated with an increased risk of heart disease.”

Exercise, overall diet quality and the amount and type of fat in the diet didn’t change the association between the dietary cholesterol and cardiovascular disease and death risk.

The new study looked at pooled data on 29,615 U.S. racially and ethnically diverse adults from six prospective cohort studies for up to 31 years of follow up.

It found:

  • Eating 300 mg of dietary cholesterol per day was associated with 17 percent higher risk of incident cardiovascular disease and 18 percent higher risk of all-cause deaths. The cholesterol was the driving factor independent of saturated fat consumption and other dietary fat.
  • Eating three to four eggs per week was associated with 6 percent higher risk of cardiovascular disease and 8 percent higher risk of any cause of death.

Should I stop eating eggs?

Based on the study, people should keep dietary cholesterol intake low by reducing cholesterol-rich foods such as eggs and red meat in their diet.

But don’t completely banish eggs and other cholesterol-rich foods from meals, Zhong said, because eggs and red meat are good sources of important nutrients such as essential amino acids, iron and choline. Instead, choose egg whites instead of whole eggs or eat whole eggs in moderation.

“We want to remind people there is cholesterol in eggs, specifically yolks, and this has a harmful effect,” said Allen, who cooked scrambled eggs for her children that morning. “Eat them in moderation.”

How the study was conducted

Diet data were collected using food frequency questionnaires or by taking a diet history. Each participant was asked a long list of what they’d eaten for the previous year or month. The data were collected during a single visit. The study had up to 31 years of follow up (median: 17.5 years), during which 5,400 cardiovascular events and 6,132 all-cause deaths were diagnosed.

A major limitation of the study is participants’ long-term eating patterns weren’t assessed.

“We have one snapshot of what their eating pattern looked like,” Allen said. “But we think they represent an estimate of a person’s dietary intake. Still, people may have changed their diet, and we can’t account for that.”

Other Northwestern authors include: Linda Van Horn, Marilyn Cornelis, Dr. John Wilkins, Dr. Hongyan Ning, Mercedes Carnethon, Dr. Philip Greenland, Lihui Zhao and Dr. Donald Lloyd-Jones.

The study was supported in part by the American Heart Association and by the National Heart, Lung and Blood Institute grants R21 HL085375, HHSN268201300046C, HHSN268201300047C, HHSN268201300049C, HHSN268201300050C, HHSN268201300048C of the National Institutes of Health.