Wednesday, June 14, 2017

Rookie Stripe: Why Pit Crews are Susceptible to Injury Based on Position

Photo credit: Logan Stewart for Skirts and Scuffs
By Logan Stewart

Pit stops amid a tension-fraught race can be a place of peril for NASCAR pit crew members; almost a hopscotch-like game of cars to get to the pit box. Even at a not-so-mere 50 mile per hour speed limit on pit road, there’s a clear and present danger.

Bill Heisel, PA-C, leads OrthoCarolina Motorsports, which has contracts to provide medical care to NASCAR teams including Hendrick Motorsports, Stewart Haas Racing, Joe Gibbs Racing, Roush Fenway Racing and Richard Petty Motorsports. Besides medical care for the teams at the track and in the shop, Heisel is part of a medical research team tracking injury trends among NASCAR pit crews. According to Heisel, pit crew members are some of the most intense, physically adept athletes in professional sports, and heightened risk for injury extends beyond just pit road. He shared his insiders’ perspective with Skirts and Scuffs on a topic many people don’t even consider.
Photo credit: Logan Stewart for Skirts and Scuffs
S&S: We know that pit crew can get injured in the pit box, but you say there are trends in pit crew injuries?

Bill: About 10 years ago, carriers and changers had a high rate of tennis elbow which made us think there was a common link between the injury and their jobs, and we began to track it. Sure enough, it’s a frequent issue we see in those particular positions on the car. People who follow NASCAR know that acute injuries occur on and off the track, but many don’t think about the overuse that comes with the repetitive motions in pit crew jobs.

S&S: Have position-specific injury patterns been studied before in NASCAR?

Bill: Most professional sports have a lot of written literature on injury trends because it’s been tracked for many years. In NASCAR very little research about NASCAR injury trends has ever been done. Dr. Glenn Gaston [Chief Hand Surgeon, OrthoCarolina] and I tracked several injuries based on position over 10 years. Some things we weren’t surprised by, but some things we were.
Photo credit: Logan Stewart for Skirts and Scuffs
S&S: What injuries did you discover were more prevalent?

Bill: Rear tire changers who had been in that position seven to 10 years often had right hip impingement problems. When a race car comes into the pit box the rear changer comes off the wall and is chasing after the car quickly. They hit the ground on their knees to remove five lug nuts and replace them with five more. While doing so they rock on their right hip, over and over again. This creates what we call a consistent impingement pattern. After 10 years it becomes pathologic and can lead to early arthritis.

S&S: What’s an example of an injury trend you’ve seen in recent years with pit crews?

Bill: Femoral acetabular impingement (FAI) injuries have increased among rear tire changers. Our research team tracked its incidence and found higher incidences of FAI among rear tire changers. Over the past seven years, 14 out of 80 total Cup Series NASCAR rear tire changers were diagnosed with FAI. Rear changers are ‘chasing’ the car coming into the pit, and flexing and internally rotating while weight bearing as they start to change the tire. As they shift positions to change the right side, they post coming into extension and internally rotate and push off to get to the opposite side. This is what causes the impingement, as the repeat this motion time and again.

Hook of hamate fractures in the palm of the hand have increased among changers and carriers. Of 118 upper extremity injuries tracked over a 10 year period, five among changers were hook of hamate fractures (a 7% incidence rate) as were three among carriers (a 12% incidence rate), with two more cases since the study concluded. The hamate is a bone in the palm on the small finger side of the wrist and the injury occurs typically from the impact of blunt force to the hand. In NASCAR hook of hamate injuries often occur from a direct blow to the palm. For pit crew members this can happen when carriers put tires on the car or when changers adjust the gun.

S&S: You say adamantly that NASCAR pit crews are athletes. Tell us more.

Bill: As racing has gotten more competitive and cars have gotten faster, especially at the Monster Energy Cup Series level teams are recruiting pit crews much the way professional sports teams recruit. Many pit crews are former pro athletes who want to extend their career beyond the field, or they may be post-college athletes who are not going into another pro sport. Football wide receivers or corner backs often become tire changers because of speed and dexterity. Defensive ends make great gas men because they can carry a heavy load. Teams workout and train together during the week at their race shops.

S&S: How do you work with teams to make sure pit crews don’t re-injure themselves?

Bill: We do position-specific bracing and monitor the crew members frequently. A brace is molded to fit the limb they use for their work. A gasman for example would have his brace molded to fit the way it will when he’s gripping a gas can.
Photo credit: Logan Stewart for Skirts and Scuffs
S&S: Are you working with NASCAR to reduce injuries?

Bill: NASCAR tracks driver injuries on its own. Our Motorsports research team through OrthoCarolina has created a database looking at NASCAR pit crew injuries for research purposes. We work closely with the NASCAR Research & Development Center on many initiatives including safety. With individual teams, we work on ways to prevent injuries to pit crews and when they happen to heal them quickly and efficiently. For example, with the hip impingement issue we may limit repetitions but we also have them go the opposite way around the car in almost a reverse pit stop scenario. They are using muscles in another direction to strengthen and balance things out.

William "Bill" Heisel and his Motorsports team provide care in the race shops during the week and travel with teams on weekends. The overall scope of care ranges from preventative medicine to rehabilitation, to minor and major injuries and surgeries.



Disclaimer: Logan Stewart is the Director of Public Relations for OrthoCarolina.





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