Breastfeeding rates and factors related to cessation in a military population.

Evidence continues to accumulate showing the benefits of breastfeeding to infants, mothers, and society as a whole. However, breastfeeding success rates nationwide have consistently fallen short of recommendations set forth by the American Academy of Pediatrics. There are several potential barriers to successful breastfeeding, and many of these could be magnified in the demanding careers of military members and their families. We surveyed 254 women at a regional military medical facility, both active duty members and dependents of active duty members, regarding their ability to successfully breastfeed their infants. We found that American Academy of Pediatrics target goals in this population as a whole were indeed nearly met at this facility, but also found that active duty members and those who encountered military-related difficulty fell well short of these goals. These findings suggest potential barriers to breastfeeding success that warrant further study from the U.S. Department of Defense.

Swimming overuse injuries associated with triathlon training.

Most triathlon overuse injuries occur due to the running and cycling aspects of the sport. By nature of swimming being a non-weight-bearing sport, triathletes have a tendency to use swimming for rehabilitation and recovery. Swimming has a significantly lower injury rate than the other 2 disciplines in a triathlon. Most triathletes use the freestyle stroke, because it is typically the first stroke learned, it is for many the fastest stroke, and by lifting the head the freestyle stroke allows triathletes to sight their direction, which is important in open water swimming. During the freestyle stroke, the shoulder undergoes repetitive overhead motion, and shoulder pain is the most common and well-documented site of musculoskeletal pain in competitive swimmers. It is felt that the pathologic process is attributable to repetitive overhead motion causing microtrauma in the shoulder from either mechanical impingement or generalized laxity or both. Without sufficient rest and recovery, the development of inflammation and pain may result. Depending on the age of the triathlete and the exact etiology of the shoulder pain, treatment options range from nonsurgical to surgical in nature.

Training on a knife's edge: how to balance triathlon training to prevent overuse injuries.

The sport of triathlon offers athletes the chance to build and/or maintain cardiovascular fitness across 3 endurance disciplines. Swimming, biking, and running each have a host of overuse injuries that can occur as a result of overtraining. High running mileage, a history of previous injury, inadequate warm up or cool down, and an increase in the years of triathlon experience are a few of the factors that have been linked to triathlon overuse injuries. Early identification of overtraining symptoms and a corresponding reallocation of balance between each discipline, perhaps with an emphasis on increasing swimming, may help prevent many overuse injuries.

Triathlon: how to mentally prepare for the big race.

With the mastery of 3 sports required, a triathlon can be a daunting mental challenge. Some liken a triathlon to a physical game of chess. A triathlete must mentally assess their physical ability across 3 sports against their competitors, the environment, and, most of all, themselves. The mental preparation required for a triathlon is often minimized, but its importance should not be underestimated. Appropriate mental planning should be carried out during training. The need for nutrition, race planning, visualization, imaging, and possible changes in conditions should all be anticipated. Anxiousness at the start of the event is normal, but this energy needs to be channeled appropriately, or it can be detrimental. Athletes who arrive at race day with a sound mental strategy typically perform better.

The triathlon tips from the top: practical tips for racing and training for a triathlon.

Training for a triathlon is a very demanding pursuit. There are a multitude of problems, such as overuse injuries, overtraining, and inappropriate training that can derail even the best athlete. We present some of the symptoms to look for to avoid overtraining, some training tips to maximize your training time, and look at some popular myths that surround endurance training.

Evaluation for ulnar neuropathy at the elbow in Ironman triathletes: physical examination and electrodiagnostic evidence.

OBJECTIVE: Evaluation of the elbow in Ironman triathletes for ulnar compression neuropathy caused by aerobar use. DESIGN: Descriptive laboratory study. SETTING: Ironman California 70.3, Ironman Arizona, Ironman New Orleans 70.3, San Antonio, Texas. PARTICIPANTS: Study 1: (n = 712) Ironman California 70.3/Ironman Arizona participants. Study 2: (n = 54) Ironman New Orleans 70.3 finishers. Study 3: (n = 11) participants training for an Ironman triathlon. INTERVENTIONS: Pilot questionnaire (study 1). Pilot questionnaire and prerace and postrace physical examination (study 2). Pilot questionnaire and preride and postride (and postseason) physical examination, and electrodiagnostic testing (study 3). MAIN OUTCOME MEASURES: Participants with symptoms, physical examination findings, and electrodiagnostic findings (amplitude or conduction velocity decrease) (P < 0.05). RESULTS: In study 1, 20.8% reported a history of ulnar symptoms. In study 2, 35.2% reported a history of ulnar symptoms. Preevent physical examination testing of the elbow showed 39.5% with positive Tinel sign and 41.5% with positive flexion/compression test. Postevent testing showed 70.4% with positive Tinel sign and 75.9% with positive flexion/compression test. In study 3, 46% reported ulnar symptoms. Preride physical examination testing showed 4.5% with positive Tinel sign and 9% with positive flexion/compression test. Postride testing showed 95.5% with positive Tinel sign and 91% with positive flexion/compression test. Postseason testing showed 64% with positive Tinel sign and 82% with positive flexion/compression test. Electrodiagnostic testing comparing preride and postride showed that ulnar nerve latency increased in 82%, amplitude decreased in 50%, and conduction velocity slowed in 64%. Electrodiagnostic testing comparing preseason and postseason showed that ulnar nerve latency increased in 73%, amplitude decreased in 64%, and conduction velocity slowed in 82%. CONCLUSIONS: The findings support the hypothesis of an ulnar compression neuropathy at the elbow occurring at high rates in aerobar using Ironman triathletes.