Miami Herald (Sunday)

Punter’s hamstring injury needs attention from a doctor

- BY ALLYSON CHIU The Washington Post BY HARLAN SELESNICK, M.D. Special to the Miami Herald

Humans have long benefited from nature’s offerings. But beyond being an essential source of food, water and raw materials, the natural world can contribute to people’s overall well-being through a host of intangible effects — and, according to new research, there are many more critical connection­s between humans and nature than one might think.

After reviewing hundreds of scientific papers on “cultural ecosystem services,” or the nonmateria­l benefits of nature, researcher­s have identified 227 unique pathways through which people’s interactio­ns with nature can positively or negatively affect well-being, according to a paper published recently in the peer-reviewed journal Science Advances.

The paper is believed to be the first of its kind to provide a comprehens­ive framework for understand­ing and quantifyin­g the complex ways in which people and nature are connected. And its findings could have significan­t real-world implicatio­ns, said Lam Thi Mai Huynh, the paper’s lead author and a doctoral candidate at the University of Tokyo.

“For the modernized world, people tend to disconnect from nature,” she said. “For ecosystem management, the best solution, the most sustainabl­e solution, is to connect people back to nature and let the local people be the ones who help to maintain and manage the ecosystem services.”

For Huynh, the ambitious research — an undertakin­g that even her academic supervisor initially thought might not be possible — stemmed from a desire to improve understand­ing of the complicate­d underlying processes behind how nature’s intangible effects — such as opportunit­ies for recreation and leisure or spiritual fulfillmen­t — have an impact on well-being. One major challenge, though, is that much of the existing scientific literature on cultural ecosystem services has been “highly fragmented,” the review noted.

“You have all sorts of different people looking at [the intangible benefits of nature] through a different lens,” said Alexandros Gasparatos, an associate professor at the Institute of Future Initiative­s at the University of Tokyo who co-authored the paper. Although having diverse research is critical, he said, “it becomes a little bit difficult to bring everything together.”

But the new study, a systematic review of roughly 300 peerreview­ed scientific papers, creates “an excellent knowledge base,” Gasparatos said.

“The whole point of doing this exercise is to understand the connection,” he added. “We give names to phenomenon.”

The review breaks down the hundreds of possible links between individual aspects of human well-being (mental and physical health, connectedn­ess and belonging, and spirituali­ty, among others) and cultural ecosystem services, such as recreation and tourism, aesthetic value and social relation. The researcher­s then went a step further and identified more than a dozen distinct underlying mechanisms through which people’s interactio­ns with nature can affect their well-being. Researcher­s found that the highest positive contributi­ons were seen in mental and

physical health. Recreation,

tourism and aesthetic value appeared to have the greatest impact on human health through the “regenerati­ve” mechanism, or experienci­ng restorativ­e effects from being in nature such as stress relief, according to the paper. Meanwhile, the highest negative effects are linked to mental health through the “destructiv­e” mechanism, or direct damages associated with the degradatio­n or loss of cultural ecosystem services, the researcher­s wrote.

“In reality, you don’t just have one pathway,” and the effects aren’t always positive, Gasparatos said. “It’s not that if I go to the forest, I receive one thing.”

A well-designed park, for example, can be a place for recreation and leisure as well as connecting with other people. You might also find yourself appreciati­ng the sight of towering trees and lush greenery or birds and other wildlife. On the other hand, a poorly maintained natural space could lead to an ugly or visually threatenin­g landscape that might make you feel uncomforta­ble or scared to be there.

The paper can provide a road map of sorts, Huynh said, to help people, particular­ly decision-makers, understand that there are not only various intangible benefits to interactio­ns with nature, but also how to try to achieve them.

“If we understand the underlying process, we can help to design better interventi­ons for ecosystem management,” she said. “We can help to improve the contributi­ons of nature to human well-being,” in addition to potentiall­y bettering sustainabl­e management practices and eliminatin­g some of the negative effects on well-being.

The research was widely applauded by several outside experts who were not involved in the work.

“It’s a long time coming to have a study like this that makes some of these linkages a little clearer,” said Keith Tidball, an environmen­tal anthropolo­gist at Cornell University. “This stuff has been scattered all over the place for a long, long time, and this paper takes a huge step forward in sorting out what has been previously pretty muddled.” Anne Guerry, chief strategy officer and lead scientist with the Natural Capital Project at Stanford University, agreed. “They did a really nice job of bringing together extraordin­arily diverse literature,” she said. It’s been a challenge, she noted, among researcher­s to be able to present the science in a way that reveals where and how nature provides the greatest benefits to people, which could in turn help “inform and motivate investment­s in conservati­on and restoratio­n that lead to better outcomes for both people and nature.”

For instance, the research could have an impact on the role nature potentiall­y plays in human health. “What this is going to be seriously useful for is to be able to continue to work to make the case that physicians and clinicians can actually prescribe outdoor time, outdoor recreation, even outdoor space because of these pathways that they’ve identified in this paper,” Tidball said.

But the review does have limitation­s, prompting some experts to caution against overinterp­reting or overemphas­izing its results.

One potential issue is that the existing research included in the review disproport­ionately focuses on individual­s rather than groups.

Research gaps should also be taken into account, Guerry said. While the review suggests that some connection­s between certain human well-being characteri­stics and cultural ecosystem services appear stronger than others, it doesn’t mean those other relationsh­ips might not be significan­t, she said.

“We have to be careful in terms of oversimpli­fying the results and thinking that a lack of a documented relationsh­ip in this paper means that something isn’t important,” she said. Instead, it may mean that “it hasn’t been studied and we haven’t found ways to quantify it and bring it into the scientific literature and out of our sort of implicit understand­ing.”

I am a punter on my high school football team, and at yesterday’s practice while kicking I felt a pop and a sharp pain in my buttock. My trainer said I pulled a muscle and to rest a few days and see how I feel. As this is my senior year, I am worried as to the extent of the injury and how long I will be out. What are your recommenda­tions?

Hamstring injuries are common in kickers, sprinters and soccer players. Your hamstring muscles attach to the pelvis where you sit and proceed down the back of your thigh to the knee. The hamstring muscles’ function is to flex your knee and extend your hip.

Most hamstring injuries occur in the middle third of the muscle and are managed with rest and rehabilita­tion. A hamstring injury that occurs near the pelvis can be more serious, sometimes requiring surgery to fix. I recommend you see your team doctor or an orthopedic sports specialist to be evaluated. X-rays of your pelvis and an MRI scan may be necessary to establish an accurate diagnosis and timetable for return to football.

Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send your questions to HarlanS@baptisthea­lth.net.

 ?? MICHAEL S. WILLIAMSON / The Washington Post ?? An elk walks past the Roosevelt Arch, near the north entrance to Yellowston­e National Park in Gardiner, Mont., on June 20.
Walkers enjoy the 11-acre Copeland Sculpture Garden at the Delaware Museum of Art. A paper published recently in the peer-reviewed journal Science Advances provides a comprehens­ive framework for understand­ing and quantifyin­g the complex ways in which people and nature are connected.
MICHAEL S. WILLIAMSON / The Washington Post An elk walks past the Roosevelt Arch, near the north entrance to Yellowston­e National Park in Gardiner, Mont., on June 20. Walkers enjoy the 11-acre Copeland Sculpture Garden at the Delaware Museum of Art. A paper published recently in the peer-reviewed journal Science Advances provides a comprehens­ive framework for understand­ing and quantifyin­g the complex ways in which people and nature are connected.

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