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Danny Zhang

Brain Injuries and the Fencing Response

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Brain Injuries and the Fencing Response

Chargers’ Donald Parham on a gurney, following fall in mid-game. Image from [1].


A couple of weeks ago, many die-hard football fans witnessed one of the scariest injuries that can occur on the field. Only in the first quarter, it seemed all but certain that the Chargers would score the first touchdown of the game. However, a dropped pass in the endzone by the team’s tight-end, Donald Parham, suddenly turned into a moment of chaos. Taking an abnormal fall, his arms suddenly locked up in the air as he laid out on the turf unconscious. The cameras zoomed into the scene to display his unmoving body, showing the hundreds of thousands of viewers exactly what a traumatic brain injury looks like. Though Parham was ultimately taken to the nearby medical center and discharged the following day, fencing response — the reflex that Parham exhibited in that Thursday Night Football game — has been a hot topic among football fans and non-football fans alike. Let’s get into the science behind this frightening experience. 

Image from [2].


Fencing response is often seen in those who are knocked down or violently hit during full-contact sports such as football, rugby, and boxing, to name a few. After one experiences a substantial blow to the head that impacts the brainstem, a possibility is that their arms lift up into the air with their forearms flexed for several seconds [3]. Specifically, rotational forces resulting from a hit can shock the reticular activating system (RAS), which is the region that maintains consciousness in the brainstem. Since concussions are not able to be detected via methods such as MRI or CT scans, this fencing response position is one of the most noticeable indicators for medical professionals to determine the severity of the head injury. In fact, a 2009 study found that after analyzing 35 videos showcasing a hit to the head and an immediate loss of consciousness, roughly 66% showed the fencing response [4]. It’s completely reflexive; the shock of the trauma suddenly activates primitive muscle reflexes that are present in human infants [5]. For example, lifting a five-year-old infant off of a bed will cause them to flex and extend their arms — exactly what these athletes seem to do. As a result, they appear to lie limp and reach out into the air for something that’s not there.

Whenever an athlete falls awkwardly on the field and stretches their arms out for a few seconds, that’s not a unique celebration. As a definite indicator of a traumatic brain injury, there’s a reason that they don’t return for the remainder of the game.



References

  1. ESPN. ​​https://www.espn.com/nfl/story/_/id/32885083/los-angeles-chargers-te-donald-parham-put-neck-brace-carted-off (accessed Jan 24, 2022)

  2. Semantic Scholar. https://www.semanticscholar.org/paper/Brain-injury-forces-of-moderate-magnitude-elicit-Hosseini-Lifshitz/3e44f46ea098f4f63317fb95070053202c2a79e6 (accessed Jan 24, 2022)

  3. Healthline. https://www.healthline.com/health/fencing-response (accessed Jan 24, 2022)

  4. Hosseini A.H.; Lifshitz J. Brain injury forces of moderate magnitude elicit the fencing response. Med Sci Sports Exerc. [Online] 2009 Sep;41(9):1687-97. https://pubmed.ncbi.nlm.nih.gov/19657303/ (accessed Jan 24, 2022)

  5. Bleacher Report. https://bleacherreport.com/articles/1494620-stevan-ridleys-concussion-biomechanics-of-his-injury-fencing-response (accessed Jan 24, 2022)

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The Physiology Behind Mastering the Pull-up

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The Physiology Behind Mastering the Pull-up

We’ve all been here: in front of you hangs a metal bar dauntingly suspended a couple of feet in the air — and you think to yourself, how do I do a pull-up?

Muscles used during a pull-up excercise. Image from [1].

For those who don’t yet know how to do a pull-up, there’s a long road ahead. But just like any other exercise, with proper training, mastery is possible by properly activating the groups of muscles involved through repetition. The muscle groups most involved in the pull-up are the rectus abdominis (one of the many muscles that constitute the core) latissimus dorsi (lats), middle and lower trapezius (traps), and biceps brachii (biceps) [1]. It’s especially important to understand the physiological aspects of each exercise to find the most effective ways to master it in the least amount of trips to your local gym. 

Image from [2].

Pull-up training begins with kneeling lat pulldowns. This variation of a lat pulldown, which is a common workout that targets your shoulder and back for an upper-body workout, activates muscles to a similar magnitude and pattern as pull-ups, more so than other exercises such as assisted pull-ups and seated lat pulldowns [3]. To properly perform a kneeling lat pulldown, you first kneel and use an overhand grip on a lat pulldown attachment. Afterward, set the weight until it is heavy enough to pull your knees above the ground by about an inch. Then, for the actual pulldown part, make sure that your back is aligned straight and pull your shoulder blades together to achieve maximum muscle activation. Make sure to do 3 sets of 5 reps!

Another great exercise is a negative pull-up, which essentially constitutes the downward half of the pull-up. Many studies have shown that this “negative” portion of the exercise (known as eccentric exercise) might be more effective at building muscle than performing the entire rep [4]. The negative pull-up is especially suited for beginners. Even though you might not have the strength for the upward part of the pull-up, many will have the strength to execute the downward motion with the right technique. To properly perform a negative pull-up, you first raise yourself to the top of the pull-up position using a stool or other high platform and simply do 5 sets of 1 rep [1].

With these two exercises, you will begin to see progress in your pull-up attempts. It might take a while, but we all have to start somewhere!


References

[1] AMM Fitness. https://www.ammfitness.co.uk/information-advice/pull-ups-benefits-muscles-worked (accessed Nov 15, 2021)

[2] Fitness Lane. https://fitnesslane.com/product/kneeling-lat-pulldown/ (accessed Nov 15, 2021)

[3] Hewit J.K.; Jaffe D.A.; Crowder T. A Comparison of Muscle Activation during the Pull-up and Three Alternative Pulling Exercises. J Phy Fit Treatment & Sports [Online] 2018, 5.4, 1-7. https://juniperpublishers.com/jpfmts/JPFMTS.MS.ID.555669.php (accessed Nov 15, 2021).

[4] Hedayatpour N.; Falla D. Physiological and Neural Adaptations to Eccentric Exercise: Mechanisms and Considerations for Training. BioMed Research International [Online], 2015, 2015. https://doi.org/10.1155/2015/193741 (accessed Nov 15, 2021)

[5] Muscle & Performance. https://www.muscleandperformance.com/training/killer-pull-up-workouts/ (accessed Nov 15, 2021)





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