Injury Prevention

Preparing for the AJC Peachtree Road Race: Answers to your Running Questions

Dr. Amadeus MasonLast week I had the opportunity to chat online with over one hundred members of the Atlanta running community to answer their questions about running and how to prevent running injuries to help not only those participating in the AJC Peachtree Road Race, but all runners in our city and state. We had so many questions from the chat that I didn’t get a chance to get to all of them, so I wanted to circle back with the participants that didn’t get answers to their questions. You’ll find my answers below in a Q&A format. If you didn’t get to attend the live chat, or just want a recap, check out the chat transcript (which you can also print), and don’t forget to check out the additional resources and questions and answers below.

For those that are running in the AJC Peachtree Road Race, I wish you a healthy and successful race!

Debunk the Myths of Running

Peachtree Road RaceIf you are a runner, you have probably heard someone you know say something about running and your health like “You can die of a heart attack if you run too much” or my favorite “If you run too much, you will need your knees replaced later in life”.  Running can be a very safe and healthy sport.  There are so many advantages of running – It makes you feel better, keeps you mentally and physically in shape and can even improve your social life.   Let’s debunk the myths others may have told you so you can feel confident you are enjoying the sport you love.

Your heart and running

Consistent running reduces your risk of heart disease.

o Your increased heart rate from running for an extended period makes your heart stronger!

o Running can help lower blood pressure by helping to maintain the elasticity of your arteries.  When you run, your arteries expand and contract more than normal so this keeps the arteries elastic and your blood pressure low.  Most elite and very serious runners have very low blood pressure.

o Running can help reduce or maintain your weight.  Running burns more calories than most other exercise and it can be done relatively inexpensively.  A 150 pound man will burn over 100 calories for every mile running at moderate pace.    With a lower body weight you also have less chance of developing type II diabetes.  Type II diabetes is typically associated with obesity.

o Running often can help improve cholesterol numbers.  Bad cholesterol (LDLs) typically go down and good cholesterol (HDL) can go up.

I recommend consulting with your physician before starting to run if you are not a runner to get a full physical to ensure your heart is in tip top shape to start a running schedule.

Your bones and joints and running

Your body was built to run!  Evolution has developed our bodies so that we have the necessary tools to move and stay physically active.  To prove this, a recent study by the American Journal of Preventive Medicine revealed that long distance-runners did not have accelerated rates of osteoarthritis.  In fact, weight-bearing exercises like running can help maintain or build bone mineral density by helping you avoid osteoporosis. Therefore, experts tend to agree that running can help you fight against arthritis and other bone and joint problems.  Injuries that runners usually suffer are typically from doing too much too soon or at a quicker than natural pace for your body.  Runners will also see injuries due to wearing incorrect shoes, shoes that are too old or running with incorrect form.  Eliminate bad running habits and you will run injury free!

One myth that is true and you should take careful note of is the dangers of developing skin cancer as a runner.   The more miles you put in, the more time you are probably spending in the sun.  I recommend wearing sunscreen on every run, regardless of the time of day you run and wearing a hat and/or sunglasses.  I also recommend  running in the very early morning or in the evening instead of running when the sun is the hottest.  If you suspect any abnormal lesion or marking, see your dermatologist right away!
So get out there and run!  You will be happy you did!

Upcoming Live Chat with Emory Sports Medicine Specialist

UPDATE: CHAT TRANSCRIPT

Are you training for the AJC Peachtree Road Race or another running race this summer or fall? If so, join Emory Sports Medicine physician, Dr. Amadeus Mason for a live online web chat on Tuesday, May 14 to learn how to run injury free.  Dr. Mason will be available to answer questions on training, stretching, how to prevent common running injuries and treating injuries when they occur.

Emory Healthcare is a proud sponsor of the AJC Peachtree Road Race.

Emory Healthcare is the largest, most comprehensive health system in Georgia and includes Emory University Hospital, Emory University Hospital Midtown, Emory University Orthopaedics & Spine Hospital, Wesley Woods Center, Saint Joseph’s Hospital, Emory Johns Creek Hospital, Emory Adventist Hospital, The Emory Clinic, Emory Specialty Associates, and the Emory Clinically Integrated Network.

Come visit us at the AJC Peachtree Road Race expo in booth 527 to get your blood pressure checked and learn more about how Emory Healthcare can help you and your family stay healthy!

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About Dr. Brandon Mines

Brandon Mines, MDBrandon Mines, MD, is an assistant professor of orthopaedics. Dr. Mines started practicing at Emory in 2005 after completing his Sports Medicine Fellowship at University of California – Los Angeles. Dr. Mines is board certified in both family practice and sports medicine. He has focused his clinical interest on sports injuries and conditions of the shoulder, elbow, wrist/hand, knee, foot and ankle. He is head team physician for the Women’s National Basketball Association’s (WNBA) Atlanta Dream and Decatur High School. He is also one of the team physicians for the Atlanta Falcons.  His areas of interest are diagnosis and non-operative management of acute sports injuries, basketball injuries, tennis injuries, golf injuries and joint injections.

What is an Osteosarcoma and What is the Best Way to Treat it?

Bone and soft tissue sarcomas are rare conditions that affect approximately 13,000 people each year. In the US, 10,000 are diagnosed with soft tissue sarcomas and approximately 3,000 are diagnosed with bone sarcomas, of which 1,000 are osteosarcomas.

The most common type of sarcoma that develops in the bone is called an osteosarcoma while sarcomas that develop in the connective tissue are called soft tissue sarcomas. Soft tissue sarcomas can develop in soft tissues like fat, muscle, nerves, fibrous tissues, blood vessels, or deep skin tissues. The rarity of sarcomas means most doctors seldom see one, which explains why patients are often referred to specialty hospitals where experienced surgeons utilize limb-sparing (no amputation) surgery whenever possible.

Understanding Osteosarcomas

Osteosarcomas are aggressive malignant bone tumors and are the most common type of bone cancer in young people. They usually occur between the ages of 10 and 25, but can occur at any age and are more common in males than females. They encompass about 20% of all primary bone cancers and it is estimated that the incidence rate in U.S. patients under 20 years of age is 5 per million. Osteosarcomas most commonly start in the ends of long bones of the arms or legs where new bone tissue rapidly forms.

Symptoms of Osteosarcoma

  • Pain near the affected bone is the most common osteosarcoma symptom
  • Swelling of the bones and joints. Noticeable swelling or protrusion near the location of the tumor
  • Brittleness/weakness of the bone which can lead to fractures
  • Difficulty moving during physical activity
  • Noticeable limp when the osteosarcoma is in the leg

Treatment for Osteosarcoma

Typically chemotherapy is given to shrink the tumor before surgery. Most often, chemotherapy results in a necrosis (or death) of the tumor and allows the physician to treat possible cells in the blood stream. In most cases, surgery is required to remove the section of cancerous bone. Limb sparing surgery (LSS) is a special operative procedure performed by oncology orthopedic surgeons and has become the accepted standard of care for patients with sarcomas of the extremities. Limb sparing surgery can be accomplished in approximately 90% of the cases. During limb sparing surgery, the cancer in the bone is removed surgically and the portion of the bone that was removed is either replaced with special metal prostheses or a bone allograft. An allograft is a bone transplant obtained sterilely from a person that has died and agreed to be an organ donor. Emory Orthopaedic surgeons have mastered the limb-sparing surgery in order to save as much bone as possible without compromising the ability to cure the patient.

Emory offers a unique multi – disciplinary treatment approach to bone sarcoma care. Emory Orthopaedic oncology surgeons collaborate with medical oncologists, radiation oncologists, pathologist, radiologists, thoracic surgeons, plastic surgeons and vascular surgeons to develop a treatment plan catered to each individual patient.


Dr. David MonsonAbout Dr. Monson
David K. Monson, MD, assistant professor of Orthopaedic Surgery and Chief of Orthopaedic Surgery at Emory University Hospital Midtown, started practicing at Emory in 1988. Dr. Monson is an expert in the treatment of rare tumors (sarcomas of the bone and soft tissue). Dr. Monson’s specialties are Orthopaedic Surgery (Board certified since 1990) and Orthopaedic Oncology. His areas of clinical interest are orthopaedic tumors, sarcoma, and limb reconstruction.

 

Dr. Shervin OskoueiAbout Dr. Oskouei
Shervin V. Oskouei, MD, assistant professor of Orthopaedic Surgery at Emory University, is an expert in the treatment of musculoskeletal (extremity) tumors, total hip and total knee replacements and revisions. Dr. Oskouei started practicing at Emory in 2004. Dr. Oskouei is board-certified and fellowship trained in orthopaedic surgery. Combining his experience and interests with the state-of-the-art facilities of Emory University and the Winship Cancer Institute of Emory University allows Dr. Oskouei to treat patients with the latest modalities using a multi-disciplinary approach.

About Emory Orthopaedic Oncology
Dr. Monson and Dr. Oskouei lead the Emory Musculoskeletal Oncology and Limb Reconstruction program at Emory. The world – class program treats a variety of conditions, including benign and malignant tumors of the extremities and spine, as well as metastatic disease. Together, they offer a combined 34 years of clinical practice experience. They care for both pediatric and adult aged patients.

Both of these physicians belong to the Musculoskeletal Tumor Society which requires fellowship training in orthopaedic oncology. Physicians belonging to this group must also have a primary clinical focus in orthopaedic oncology. This is important for patients because it means the specialist you are seeing has had extra training in this area and is viewed by peers as an expert in the care of orthopaedic oncology. Patients should take the time to research physicians in their area to determine if they are seeing an orthopaedic oncology specialist that belongs to this organization.

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Understanding & Preventing Tennis Elbow

Tennis Elbow PDFLateral epicondylitis, or Tennis Elbow, is marked by pain over the bone on the outside of the elbow. The piece of bone that can be felt on the outside of the elbow is called the lateral epicondyle. When the tendons attached to this bone are overused, they can deteriorate and become irritated and painful. This damages the forearm extensor muscles, which are active when something is gripped, such as a tennis racquet. However, the condition is not restricted to tennis players. In fact, only a fraction of people who suffer from Tennis Elbow actually play tennis.

So what causes Tennis Elbow? Aside from playing tennis, some of the conditions or activities that can cause tennis elbow include:

  • Improper technique of hitting tennis ball
  • Improper size of tennis racquet or tension of racquet strings
  • Use of a racquet that is too heavy
  • Repetitive arm motions in activities such as golf, tennis, raking, pitching, rowing, painting and using a hammer or screwdriver
  • Improper golf swing technique
  • Insufficient stretching
  • Advancing age
  • Work that requires repetitive gripping

When it comes to Tennis Elbow preventive measures, there are a few steps you can take to avoid injury.

  • Appropriately warm up and stretch before practicing or competing in any sport.
  • Ensure proper equipment (tennis racquet, golf club, etc.) fit
  • Use proper technique when swinging the racquet. Consult with a coach or specialist if you need guidance on proper technique.
  • Maintain appropriate conditioning, including:
    • Wrist and forearm flexibility
    • Cardiovascular fitness
    • Muscle strength and endurance
  • Wear a tennis elbow (counterforce) brace

If you suspect you have Tennis Elbow, treatment would be provided by a hand and upper extremity orthopedist, or sports medicine specialist, who may recommend treatments ranging from a rest/heat/ice regimen, to eccentric strengthening exercises, or the prescription of anti-inflammatory medications or injections. In extreme cases, your physician may recommend outpatient surgery for Tennis Elbow.

For more information, you can download our Tennis Elbow PDF, which includes details on Tennis Elbow prevention, risks, treatment options and more.

About Dr. Claudius Jarrett
Claudius Jarrett, MDClaudius Jarrett, MD is an assistant professor in the Department of Orthopedic Surgery. He started practicing at Emory after completing an orthopedic hand, microsurgery, and upper extremity fellowship at Allegheny General Hospital in Pittsburgh, Pennsylvania. After finishing medical school at Northwestern University, he completed his orthopaedic residency here at the Emory University Hospitals. His clinical practice and research interests focus on addressing hand, wrist, elbow, and shoulder injuries.

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6 Tips for an Injury-Free Transition from Indoor to Outdoor Sports

Outdoor Sports TransitionWarm weather is right around the corner and athletes of all ages will be out in force tearing it up on the athletic fields playing the games they love! Injury prevention during the seasonal sports transition is key. It is important to take care of your body and follow certain precautions as athletes transition from winter to spring sports. This is especially important for the young athletes. Outdoor elements such as soggy, muddy field conditions or bad weather, can negatively affect young athletes. Many times young athletes don’t have as much opportunity to train in an environment similar to which they will be playing in during their season. This can greatly increase the risk of athletic injury.

Below is a list of suggestions to help athletes adjust and prepare for the transition from indoor to outside venues and prevent injuries in the process!

All outdoor and field sport athletes should know:

  1. Stretching is extremely important in all sports. Typically, you should hold stretches for 30 seconds! Do some 20 – 30 yard runs, starting out slower and ending up at full speed to loosen the muscles up.
  2. Make sure your cleats are “broken in.” W e highly recommend that the young athlete begin wearing cleats outside on the field surface which they will be playing before the season starts. This will help ensure the cleats fit well and feel comfortable on the playing surface during practice and games.
  3. Arrive to the field early on game day and allow your body to adjust to the outside temperature.
  4. If you are able to arrive early, take a few minutes to walk the field to assess for soft or uneven spots in the field. If it has rained, scout the field for standing water puddles. This is especially important if you haven’t ever practiced or played on the field.
  5. Keep your muscles warm as long as possible before the game. Keep your warm-up gear on til the last second. You can also wear thermal type clothing like Under Armour under your uniform if you are playing in cold temperatures.
  6. Do not let muscles get cool during the game. If you are not playing, stand and keep moving as much as possible.

Spring sports are exciting for the athletes and for all the spectators! We want to help you make sure you stay healthy so you can enjoy them from the field!

About Dr. Brandon Mines

Brandon Mines, MDBrandon Mines, MD, is an assistant professor of orthopaedics. Dr. Mines started practicing at Emory in 2005 after completing his Sports Medicine Fellowship at University of California – Los Angeles. Dr. Mines is board certified in both family practice and sports medicine. He has focused his clinical interest on sports injuries and conditions of the shoulder, elbow, wrist/hand, knee, foot and ankle. He is head team physician for the Women’s National Basketball Association’s (WNBA) Atlanta Dream.

Dr. Mines is a rotational physician for United States soccer teams and a consulting physician for the NFL’s Atlanta Falcons along with various local high schools, colleges, and community club teams. He enjoys giving talks and lectures regarding the prevention of sports injuries. In fact, as an active member of the American Medical Society for Sports Medicine and the American Society for Sports Medicine, Dr. Mines has attended and presented at various national conferences. Through the years, he has helped all levels of athletes return to the top of their game.

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Back to Life After an ACL Injury!

Prevent Joint PainACL, anterior cruciate ligament, injuries are one of the most common knee injuries among athletes. The American Orthpedic Society for Sports Medicine estimates there are over 150,000 ACL injuries each year in the US. ACL injuries can happen to everyone – from the professional athletes to the weekend warriors. The good news is that with proper treatment with an ACL specialist and adequate recovery, you can get back to the sport you love! Watch this short video of Neil, an Emory Sports Medicine patient, who has recovered from ACL surgery and is back to playing tennis and doing the things he loves to do.

About Dr. John Xerogeanes
Dr. Xerogeanes is Chief of Sports Medicine at the Emory Orthopaedic & Spine Center. Known as Dr. “X” by his staff and patients, he is an Associate Professor of Orthopaedic Surgery at Emory University as well as an Adjunct Professor at Georgia State and Mercer University. Dr. X is entering his 12th year as Head Orthopaedist and Team Physician for Georgia Tech, Emory University, Agnes Scott College and the Atlanta Dream of the WNBA. He specializes in ACL and ACL revision surgery performing over 200 of these operations each year. He is board certified in orthopaedic surgery and has his sub-specialty certification in orthopaedic sports medicine.

Dr. Xerogeanes has been recognized as one of US News & World Report’s Top Doctors with a special distinction listing him among the top 1% in the nation in his specialty. 

About Dr. Spero Karas
Dr. Karas is the Director of the Orthopaedic Sports Medicine Fellowship Program and an Associate Professor of Orthopaedic Surgery at Emory University. His specialties include sports medicine, surgery of the shoulder and knee, and arthroscopic surgery. He came to Emory in 2005, after serving as Chief of the Shoulder Service and team physician at the University of North Carolina in Chapel Hill. He is Board Certified in Orthopaedic Surgery, with a subspecialty certification in Orthopaedic Sports Medicine. He currently serves as head team physician for the Atlanta Falcons and is a consulting team physician for Emory University and Georgia Tech athletics. He cares for patients and athletes of all levels: professional, collegiate, scholastic, and recreational.

Dr. Karas was recognized as one of America’s “Top Orthopaedic Doctors” in Men’s Health Magazine April 2007 and “Top Sports Medicine Specialists for Women” in Women’s Health Magazine. Atlanta Magazine has named him “Atlanta’s Most Trusted Sports Medicine Specialist” for the past three years. Dr. Karas is an internationally recognized expert in the field of shoulder, knee, and sports medicine.

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Takeaways from Running Injury Live Chat

Dr. Amadeus MasonOn Tuesday, Dr. Amadeus Mason of Emory Sports Medicine, held a live chat that answered your questions about preventing running injuries. Dr. Mason provided some great answers to some very interesting questions; from how to prevent running injuries to the ideal length of time one should consider when training for a 5k and other long distance races.  Dr. Mason also provided participants with resources on things like: knee pain and strengthening and IT Band Syndrome.

The following is a recap of the live chat, or you can check out the transcript from Dr. Mason’s Preventing Running Injuries chat.

Q. Is it better to stretch before a run? After a run? Or Both?

A. For runners stretching for flexibility, it’s better to stretch after their run, because muscles are looser and more receptive to the stretch at that time. Dr. Mason also noted that while stretching before a run doesn’t hurt, runners should keep in mind that it’s best to spend at least ¼ of the time you spend running on stretching. As an example, Dr. Mason suggests if a runner trains for an hour, it’s best to stretch for at least 15 minutes.

Q. How does a runner prevent shin splints from reoccurring and preventing the pain’s longevity?

A. Runners experiencing recurrent shin splints, or moderate to severe pain in the shin that lasts for a long period of time, should see a specialist. Make sure not to train too much, too quickly, that’s one of the most common causes of shin splints, according to Dr. Mason. If shin splints occur, it’s recommended that a runner modifies their training regimen to accommodate for pain relief. Females, who experience shin splints on a fairly regular or recurrent basis, should contact their Physician.  Continuous shin pain is a possible indication that there’s some sort of hormonal imbalance or insufficient caloric intake from a female runner’s diet.

For more information on preventing running injuries, check out Dr. Mason’s chat transcript. You can also download the resources he shared in the chat by using the links below.

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Athletic Injuries: Young Athletes Play Through the Pain

Athletic Injury Young AthletesA new study shows that many young athletes keep on playing after they’ve been injured. And all too often, those injuries could have been prevented. Safe Kids Worldwide, a global nonprofit organization with a mission of preventing unintentional childhood injury, found that kids are suffering from overuse injuries, dehydration, and even head injuries.

Kids are under pressure to play at a much higher level and with more intensity than they did decades ago. A pitcher who shows potential may play on two or three different teams during a single season. And Safe Kids found there’s a lot of pressure to stay in the game—even when you’re hurt.

A new Safe Kids study shows a third of young athletes who play team sports suffer injuries severe enough to require medical treatment. But nearly 90% of parents underestimate how much time kids need to recover.

As a result, Emory pediatric orthopedic surgeon Dr. Nicholas Fletcher says, a lot of kids play hurt.

“Kids think if they take a week off, they’ll get kicked off the team, or their parents won’t let them play anymore. It’s very important for the kid to stay on the team, so a lot of times they’ll mask the injury,” says Dr. Fletcher.

Safe Kids found that half of the coaches said they’d felt pressure—either from kids or parents—to put an injured child back in the game. And nearly a third of kids said they would play hurt unless their coach made them stop.

“One of the biggest take-home messages I try to convey to coaches is that this 11-year-old also has a 12-year-old and a 13-year-old and a 14-year-old season,” says Dr. Fletcher, who sees a lot of young players with ACL tears, hip injuries, and throwing injuries. Many of those problems are from overuse. He says if a young athlete is not given time to heal and given proper treatment, he or she can be left with lifelong problems.

Has your son or daughter suffered a sports injury and kept on playing? We welcome your questions and feedback in the comments section below.

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Can Yoga “Wreck” Your Body? A Physical Therapist’s Perspective

Emory’s David Pasion, MPT, physical therapist at the Emory Orthopaedics and Spine Center was recently interviewed by the team at CNN in response to a recent article in the New York Times titled, “How Yoga Can Wreck Your Body.”

yoga physical therapist perspectiveAs Pasion put is, “Reading that article, if somebody wasn’t familiar with yoga or let’s say they were planning on doing yoga, if they read that article, they’d say, let me find something else to do. And so, in that aspect, no, I don’t think it was fair. There was too many negatives thrown out.”

While David Pasion agrees that it is possible to sustain injuries while practicing yoga, he also believes the article was “alarmist” and lacked context to present a fair assessment of the health benefits and risks of practicing yoga.

To get David’s take on the article and potential risks of participating in yoga, check out the video from CNN below:

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What is a Biomechnical Injury?

Dr. Amadeus Mason of Emory Sports Medicine explains biomechanical injuries and how they can be prevented and treated.

Biomechanical Injury

In sports medicine, we see a lot of biomechanical injuries. A biomechanical injury is caused by the overuse or incorrect use of a joint or muscle. This type of injury generally occurs when the joint has been stressed in the wrong way or overstressed repetitively over a short period of time. While any joint can sustain a biomechanical injury, at the Emory Sports Medicine Center, I see a lot of runners who come in complaining of knee pain.

Iliotibial band syndrome, or ITBS, is a biomechanical injury. It usually presents as pain on the outer side of the knee and is a common complaint among middle-distance runners or in athletes when they try to do too much running too quickly. This usually occurs early in the season or when athletes increase the intensity of their training, e.g., moving up from 5K to 10K distance.

To prevent a biomechanical injury, no matter where in the body it is, you need to be cognizant of how you’re stressing your joints and give your body enough time to accommodate the increased stress. If you’re a runner, start slow with low mileage (1–2 miles) and a moderate pace and slowly increase distance or intensity, but not both. If you’re lifting, start with a lighter amount of weight and a higher number of reps in each set and then, as you increase the weight, decrease the number of reps per set.

If you think you might have a biomechanical injury, you should be evaluated by a sports medicine specialist who understands biomechanical injuries. He or she can correctly determine the source of your pain and initiate the appropriate interventions so you can get better. If you’re in pain but not sure what type of injury you have, don’t take chances—come see a specialist here at the Emory Sports Medicine Center.

Things to Keep in Mind if You Have (Or Suspect You Have) a Biomechanical Injury:

  • This type of injury will not just “heal on its own” with rest. You need to address the cause of the pain, or the symptoms will come back when you return to whatever activity caused the pain in the first place.
  • Don’t push through the pain. This pain is telling you that you’re doing something wrong. This is not a no-pain, no-gain situation.
  • There’s no quick fix. There’s no pill or quick shot that can cure a biomechanical injury. The best approach is to correct the problem using a holistic approach, which may include therapy, medications, modalities, and injections (as needed). Physiotherapy, in conjunction with steroid injections or platelet-rich plasma (PRP) injections, can help reduce inflammation and, in turn, alleviate pain and facilitate addressing the underlying biomechanical issues. This is why it’s important to seek the help of someone who understands this type of injury.

Have you had a biomechanical injury? We’d like to hear about your experience. Please take a moment to give us feedback in the comments section below.

Dr. Amadeus MasonAbout R. Amadeus Mason, MD:

R. Amadeus Mason, MD, is an assistant professor in the Orthopaedics and Family Medicine departments at Emory University. He is board certified in Sports Medicine with a special interest in track and field, running injuries and exercise testing. He has been trained in diagnostic musculoskeletal ultrasound and platelet rich plasma (PRP) injection. Dr. Mason is Team Physician for USA Track and Field and the National Scholastic Sports Foundation Tucker High School, and Georgia Tech Track and Field.

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