Sports Injuries – Spring into Action

by Tim “Trapper” O’Connell MS, LAT

MCHS Divisional Director/Pro Care Orthopedics/CHW Family Med/Occupational Med

 

As seen in Odessa American Medical Matters:

http://www.oaoa.com/people/health/medical_matters/article_de944cda-3eba-11e8-959f-af0df70315ea.html

Sports injuries occur in the spring due to many conditions and it is now the time of the year to address preventive measures. As a parent, coach or athlete, preparation and understanding your level of fitness will help reduce pain, injury, lost playing time and money.

The first tip is to continue to hydrate.

Yes, you have to drink more water to compensate for fluid loss during exercise. A loss of body fluid is a set up for dehydration and cramps. This will ultimately be a step in prevention of muscle strains and possible tendon injuries. Drink water before, during and after practice and games. Warming up five to seven minutes before your activity is essential and good time to start drinking water. Are sports drinks good to drink before your activity? Let’s address that at a later time. The short answer for now is, drink more water.

A consideration for all age groups is skin care.

Use generous amounts of sunscreen products and of course SPF 30 is recommended as starting strength in most cases. Take into account for younger age group, face protection and wearing clothing and/or a hat in peak UV exposure. Burns are painful and can be debilitating.  Re-application is a strong method to boost skin coverage for those extended hours in the sun.  Follow instructions on the container.

Shoes

Great fitting and supportive shoes will prevent the blisters, shin splints and “kneecap” (patellar) bony and tendon inflammation.

Warm up and Cool down

Another good rule of thumb for all athletes is “warm up and cool down”. Use heat to increase circulation before the event and ice after the event to decrease pain and inflammation. Rest and recovery are good to allow the body to charge back up. Take frequent breaks and ease back into activity after your break.

Basic first aid kits are an excellent tool to have available in your car or at sports events. If you do incur an injury, here are some simple tips.

Bleeding

If bleeding occurs, apply pressure with a clean cloth. Clean and/or rinse area. Cover with bandage and secure area. If bleeding continues, seek advanced medical help.

Swelling

If swelling occurs, assess area for instability (dislocated, unable to walk or move body part). Compare to opposite limb if possible, ice or cool compress for injured area. Seek advanced medical help in regard to his/her perceived level of pain or level of disability.

Prevention

Consistency in exercise is a key factor to physical conditioning and starting your spring and summer outside activities. Short periods of exercise each day need to include a functional, dynamic warm up. Take a walk or jog, depending on your physical restrictions. I recommend walking for time and not distance. This will allow you to exercise in minutes and not concern yourself with how far you have moved in your activity. We will also address your heart rate and exercise heart rate in another article. For now, address your exercise and heart rate with your primary physician.

If you have questions or concerns about an injury, please don’t hesitate to call Trapper, ProCare Orthopedics, at 432-640-2793.

Get outside and have a SUPER SPRING! 

 

Blueberries and Bone Health

Adding blueberries to breakfast cereal or snacks may help your children ward off osteoporosis later in life.

That’s the hypothesis of U.S. Department of Agriculture researchers who fed young, growing rodents a diet with 10 percent freeze dried blueberry powder. The berry eating animals ended up with significantly more bone mass than a comparable group that didn’t eat berries. Blueberries contain polyphenols, compounds that give the fruit its distinctive color and which may also have bone-building benefits.

Studies are still needed to determine whether the berries have the same effect on young human bones. But with their high vitamin C and dietary fiber content, blueberries are already a delicious way to eat healthy.

Sports Physicals – One of the most important visits to your doctor

by Dr. Bonnie Carter

 

As seen in the Odessa American Medical Matters:

http://www.oaoa.com/people/health/medical_matters/article_2c3a7a7e-9063-11e7-919c-133b45db6b47.html

 

It’s that time of year again …time for sweaty teenage boys and girls to flock to clinics and gyms for sports physicals. While parents and kids just want to get in and out as quick as possible, there’s a method to our madness and why we do these physicals. And, no, it’s not an initiation or torture ritual to embarrass you!

One of the most important things to evaluate during a sports physical is your heart. Sudden cardiac death can occur in an athlete due to hypertrophic cardiomyopathy that is undiagnosed. Names like Hank Gathers and Reggie Lewis echo in our minds when we put that stethoscope to your chest. These, and others like them, were young athletes in the prime of their life and peak physical condition that dropped dead during their sport from a silent heart condition. There are signs and an astute clinician can pick up on them. This is one of the reasons that I hate mass physicals in gyms … you just can’t hear as well when you’re listening for an arrhythmia or heart murmur. Truly the best place to have your physical done is with your primary care physician because we know you and are more likely to pick up on a minute difference from your baseline.

The other major thing we are evaluating is your neurologic status and history of concussions. Recent studies have brought the long-term effect of concussions to the forefront, and both physicians and coaches are more aware of their consequences. The management and our approach to concussions has changed drastically just in my time in medicine. When I was a resident in 2003, we would only pull someone from the game if they had a complete loss of consciousness or their symptoms lasted more than 15 minutes. Now, we pull anyone who has symptoms of a concussion and they can’t return to activity for at least a week. (There is a protocol established by the U.I.L.) This is safer for the athlete because cumulative injury is a risk and can lead to much worse damage and even death. A lot of questions on the sports physical forms are centered around concussions, and this is why.

While working as the university physician at West Texas A&M, I saw a lot of concussions in our athletes. Additionally, I saw some sequelae (a condition that is the consequence of a previous disease or injury) of multiple prior concussions including memory issues, personality changes, attention deficit and depression, to name a few. Can you guess which sport had the most history of concussions when I would do the physicals at W.T.? It wasn’t football … it was actually cheerleading!

Now that we’ve covered your head and your heart, that leaves the rest of your body. Yes, we are looking at all your joints to make sure your body can handle the stress of the sport, but we are also looking at your vision, your blood pressure, your skin, your thyroid, your abdomen, if your periods are regular, your gait and several other things. Every question on that form is a clue to the mystery that is you. We clinicians are really just detectives, trying to follow the clues and make the diagnosis. And yes, the dreaded hernia check is important because if you have a defect and you work out, you can make it worse. An incarcerated hernia is no laughing matter and is a medical emergency.

So next time you drag your child to their sports physical, remember it is not just a rubber-stamp visit. In fact, it is probably one of the most important visits they may make to the doctor’s office.

 

Medical Matters: Osteoporosis – Are You at Risk?

As seen in the Odessa American “Medical Matters”: 

Osteoporosis – Are You at Risk?
by Dr. James Ingram

Osteoporosis is a disease of the bones that many people will experience in their lifetime as it is the most common bone disease in humans. Osteoporosis is a silent disease until it is complicated by a broken bone.

Osteoporosis means porous bone (full of holes). When a person has osteoporosis, the pores become larger which makes the bones brittle and weak. Because the bones are then weak and brittle, they can fracture easily … even with simple activities like sneezing or bumping into furniture.

Osteoporosis is diagnosed by a medical evaluation that includes an examination of your height and a bone density test. This bone density test is the only way to diagnose osteoporosis prior to a broken bone. The most common bone breaks are of the spine, hip and wrist.

It is estimated more than 10 million Americans have osteoporosis. Osteoporosis is not just a disease that affects women. After the age of 50, more than 50 percent of women and 25 percent of men will break a bone due to osteoporosis.

All women who have experienced menopause and men over the age of 50 should be evaluated for osteoporosis risk factors to determine if they need to be tested.

There are many factors that put us at risk for developing osteoporosis. Some factors are modifiable while other factors are not.

Factors leading to Osteoporosis that cannot be altered include:

  • Age greater than 50
  • Caucasian and Asian women
  • Petite women
  • Family history of osteoporosis

Although you cannot control the factors from age and genetics, you can alter the following factors that lead to Osteoporosis:

  • Smoking – Smoking makes the bones less healthy and more prone to breaking or not healing after a break.
  • Low vitamin D levels – A healthy diet with calcium and vitamin D is essential for bone health. Add fruits and vegetables daily to improve your bones.
  • Lack of exercise – Regular exercise is important for strong bones. Activities like walking, swimming and biking can improve the health of your bones.

If you feel you are at risk for osteoporosis and have never had a bone density test, talk to your doctor today.

 

MEDICAL MATTERS: Shoulder pain can be early sign of arthritis or other injury

MEDICAL MATTERS: Shoulder pain can be early sign of arthritis or other injury

As seen in the Odessa American “Medical Matters”: http://www.oaoa.com/people/health/medical_matters/article_6d6d2726-2cef-11e7-9a68-736e9c105440.html

 

MEDICAL MATTERS: Shoulder pain can be early sign of arthritis or other injury
by Dr. James Ingram

Dr. James Ingram is a Board Certified Orthopedic Surgeon and specializes in Sports Medicine.

“I saw my Doctor about my shoulder pain. He took an X-ray and told me ‘nothing is wrong’.”

A more appropriate response would have been, “there’s nothing broken”. Most sources of shoulder pain are not obvious on an X-ray. The shoulder is a remarkable joint with more movement than any other joint in our body. Thus, diagnosis of the specific cause of pain in the shoulder can be difficult.

The earliest signs of arthritis in the shoulder typically appear in the joint connecting the collar bone to the shoulder blade (acromio-clavicular or AC joint). In the absence of injury, this joint can show signs of arthritis on x-ray as early as age twenty-five. Pain associated with this joint is increased with lying on the side, using the arm at shoulder height or higher, pulling things toward you or away from your body. The pain does not make motion impossible but the use of the shoulder increases the pain.

Rotator cuff tears may be partial or complete. Risk factors for rotator cuff problems include male gender, high blood pressure and elevated cholesterol. Trauma is also a major cause, fall on shoulder or outstretched hand, shoulder dislocation, lifting or pulling heavy objects. Partial tears are more painful, full thickness tears result in loss of motion and weakness. Many partial tears do not require surgery. Full thickness tears will not heal without surgery. But with therapy, the patient may regain an acceptable motion and use, depending on the patient’s needs.

A cartilage ring surrounds the socket of the shoulder. This cartilage ring, the rotator cuff and the joint capsule provide a stable joint with an extensive range of motion. Tears of this cartilage ring cause pain and mechanical symptoms. They usually result from shoulder dislocation or an unexpected pulling injury to the arm. The bicipital tendon, one of two tendons to the bicep muscle is attached to this cartilage ring. Tears of the bicipital tendon are common. Usually the result of lifting heavy objects. Tears of this tendon usually do not require surgery. The patient will lose ten to fifteen percent of strength bending the elbow. A cosmetic deformity of the bicep contour will occur, but does not contribute to significant weakness.

The shoulder joint contains cartilage and is prone to developing arthritis. The onset is gradual. Primary complaint is pain. As the arthritis becomes more severe the patient will eventually lose motion. The pain is described as constant, increased with use and many times associated with painful catching and grinding.

Another frequent source of “shoulder pain” is actually referred from the neck. The patient’s neck may not hurt! The pain is typically in the back of the shoulder blade. The majority of time, the pain will go below the elbow sometimes causing numbness and tingling in the fingers. Pain that is solely due to a shoulder problem may go to the elbow but not below. Unfortunately, having an injured shoulder does not mean you don’t also have a neck problem, and vice versa.

The key to minimizing shoulder pain lies in maintaining muscle fitness not only the rotator cuff, but the muscles that stabilize your shoulder blade. The shoulder allows us an incredible ability to perform complex tasks. Shoulder pain consequently can be a source of severe dysfunction.

 

 

MEDICAL MATTERS: Preserving your hips and knees

As seen in the Odessa American “Medical Matters”: http://www.oaoa.com/people/health/article_7d318b3e-0111-11e7-9e4a-a381343842e9.html

by Dr. James Ingram

Time takes a toll on our bodies and our weight bearing joints and cartilage are no exception. Watching a youngster spring up from a sitting position at the speed of a slingshot reminds us all of the creaks and squeaks of our aging joints. However, you can take control and slow Father Time with a few key non-operative interventions.

Decreasing weight through exercise has a dramatic effect reducing wear and tear on hips and knees. Just to name a few, it improves circulation and cardiovascular health; helps the management of blood sugar; preserves and maintains joint cartilage. Low impact exercises are key. Stick with cycling, swimming or elliptical and stair stepping machines. The benefit of low impact exercise in addition to weight loss, is a reduction of shear force on weight bearing joints, minimizing cartilage loss and improving flexibility.

Supplements have a huge following but no supplement has FDA approval. Of all the supplements, the only one shown to minimize cartilage loss was Glucosamine. When trying supplements, I suggest avoiding ones with multiple ingredient, ie. Glucosamine, Chondroitin, MSM. If you have an untoward reaction with a multiple ingredient supplement, it’s virtually impossible to determine which ingredient did not agree with you. I recommend starting with Glucosamine because it’s the only one proven to be effective.

Support braces that unload the joint showing signs of wear is another intervention worth consideration. Two options are available; off-loader braces, or lateral wedge orthotics. Off-loader braces are bulky where lateral wedge orthopedics are more discretely worn. Although purely mechanical, both unload the burden to tired joints.

Anti-inflammatory, biologicals and injectable are pharmaceutical approaches to joint health. Non-steroidal anti-inflammatory drugs (NSAIDs) were the corner stone for osteoarthritis and rheumatoid arthritis until biologicals (Embrel, Humira, etc.) were developed. Over-the-counter or prescribed NSAIDs are still extremely effective but create cardiovascular risks, elevate blood pressure, can cause stomach ulcers, and even kidney failure. Injectable intervention falls into two categories; cortisone and injectable viscosupplementation. Cortisone injections have been around for decades and provide rapid but short term relief. They also exhibit side effects therefore should be used in moderation. In my practice, no more than once a quarter. Injectable viscosupplementation (“rooster shots”) are injections of a protein normally found in our joints and make a cushion to replace cartilage while improving the viscosity of joint fluid. These injections are performed in an office environment on a weekly basis for a period of 3-5 weeks.

Utilizing these recommendations will hopefully make your interaction with your orthopedic surgeon a social visit rather than professional.

 

 

 

Get the monkey off your back! How to treat back pain before it becomes chronic pain

Pain may be associated with an injury, a certain medical condition, or structural abnormalities such as a tumor, arthritis, or fracture. Some degrees of pain are normal, like discomfort during the healing process just after surgery or a healing bone fracture. However, chronic pain does not heal and may be present for months and even years.

 

Did you know?

  • Over 100 million Americans suffer with chronic pain. This is more than the number of Americans with diabetes, coronary arterial disease, stroke and cancer combined!
  • Pain costs America at least $560-$635 billion annually, which is equal to $2,000 for everyone living in America. This includes $297-$336 billion due to lost worker productivity.
  • Back pain is the leading cause of disability in Americans under age 45. More than 26 million Americans between ages of 20 and 64 experience frequent low back pain. 80% of adults experience low back pain at some point in their lifetimes.
  • 44 people die each day from prescription drug overdoses.

 

You have the power to get that monkey off your back and put a stop to chronic pain. Too often, dangerous and addictive medications or risky surgeries are presented to us to treat acute back pain when most may be treated with a more conservative and safe approach.

 

40-90% of patients will have complete relief of pain within six weeks by using these measures:

  • Anti-inflammatory medications
  • Rest
  • Physical therapy
  • Lifestyle adjustments: how you sit, lift, stand, day-to-day movements
  • Exercise just 30 minutes a day!
  • Weight and diet management
  • Spinal epidural and nerve block injection may be useful

 

For more information on the right exercises, diets and treatments for chronic pain, contact a physician who is Board Certified in Physical Medicine and Rehabilitation.

 

Submitted by:

Mandeep Othee, M.D.

Board Certified in Physical Medicine and Rehabilitation
Board Certified in Pain Medicine