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:

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.


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.


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.


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.


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! 


Make Physical Activity a Priority for Heart Health

by Millie Gonzales, RN, BSN Cardiac Rehab Nurse


As seen in Odessa American Medical Matters:

With Heart Disease on the rise, it is vital to make cardiovascular exercise a priority. Most of us find it challenging to make time in our day to invest in our health. Although, rearranging your daily schedule and setting a reachable exercise goal every day is a start!

Benefits of cardiovascular activity

  • Decreases risk of coronary artery disease and stroke
  • Reduces symptoms and decreases chances of another heart attack
  • Improves heart and lung performance while creating healthy habits
  • Improves blood pressure, blood sugar and blood cholesterol levels
  • Maintains a healthy body weight
  • Increases energy and stamina while decreasing stress levels


How to get started and what to do. (Hint – Make it fun!)

Create a specific exercise goal including frequency, intensity, time and type of exercise. Make a personal commitment to your plan. And get started!

Walking is an easy, safe and effective way to begin. Be flexible and make it fun! Start slowly and build up gradually to at least 30 minutes a day on most, or all, days of the week.

Make this a priority for one month and work out at the same time every day. By doing so, it will become a habit. After a month, evaluate your progress and make changes accordingly.

With time, this will create great changes and benefits to your health. The American Heart Association recommends at least 150 minutes per week of moderate-intensity aerobic activity such as brisk walking and at least 75 minutes of vigorous activity, or an equal combination of both. Please note that heart patients and individuals with specific medical questions or needs should consult with their physician regarding what type of physical activity is safe for them.

Your health is so important and is worth the investment of time. Your heart will be happy you made this a priority!



Some Like It Hot

by Dr. Bonnie Carter

As seen in the Odessa American Medical Matters:


Well, it’s that time of year again … time for two-a-days, marching practice and heat illness. Heat illness is a very real threat, even in cooler climates than the Permian Basin. There are several risk factors for heat illness which I will discuss below. Heat illness actually occurs on a spectrum that ranges from heat cramps to heat exhaustion, and then to heat stroke. The physiology behind heat illness and heat regulation are very complex, and I won’t go into a lot of details here.


Risk factors for heat illness can be broken down into three main categories: medical conditions, environmental and drugs.

  • Medical conditions that can put you at risk of heat injury are obesity, heart disease, high blood pressure, diabetes, hyperthyroidism, gastroenteritis or a febrile illness to name a few.
  • Environmental factors include exercise in a hot environment, inappropriate clothing, decreased fluid intake, lack of acclimatization, enclosed hot environments such as a hot car or sauna and lack of air conditioning or proper ventilation.
  • Some common medications or drugs that make you more susceptible to heat injury include: beta blockers (Atenolol, Metoprolol), diuretics, antihistamines (Benadryl, Claritin, Zyrtec), alcohol, cocaine, amphetamines (including Adderall) and aspirin. Basically, what these risk factors boil down to is impaired heat regulation.

So, what is the body’s normal response to heat stress? The first thing the body does is dilate the blood vessels and increase blood flow to the skin, which increases heat transfer to the environment. When this happens, the heart has to increase the heart rate to increase cardiac output. There is also release of catecholamines that causes you to sweat to dissipate heat by evaporation. The body also decreases heat-producing processes. Where you get into trouble and things start breaking down is when the body reaches its cardiac output limits in the face of water and electrolyte loss. This leads to the inability to regulate heat which causes damage to the cells and organs. If not stopped, this leads to multisystem organ failure and ultimately death.

The first stage of heat injury is heat cramps. This actually occurs with adequate hydration with water. When you are sweating, you lose electrolytes as well as water. If you are only replacing those losses with water, you actually will dilute your electrolytes, leading to involuntary muscle cramps. These cramps are usually treated with an oral salt solution or, sometimes in worse cases, with IV normal saline.


The next stage of heat illness is heat syncope. This is caused by a drop in blood pressure from a loss of fluids, dilation of the blood vessels and decreased vagal tone that leads to a lower heart rate. This most commonly occurs in elderly and people not acclimated to an environment. Symptoms include lightheadedness, nausea, yawning and restlessness. After the patient is flat on the ground, consciousness returns because blood flow has been restored. People who suffer heat syncope are generally not very dehydrated or hyperthermic. Treatment for this stage of heat illness includes moving the patient to a cool area out of direct sunlight, lying flat and elevating the feet.


Heat exhaustion is the next stage in the progression of heat injury. For heat exhaustion to occur, there is a significant heat stress, loss of fluid and salt depletion. Symptoms of heat exhaustion are weakness, fatigue, lightheadedness, headache, nausea and thirst. Signs of heat exhaustion include a rapid heart rate, rapid breathing rate, profuse sweating, low blood pressure and elevated body temperature. Treatment of heat exhaustion entails immediate cessation of activities, removal to a cool area out of direct sunlight, removal of restrictive clothing, aggressive fluid and electrolyte resuscitation and active cooling measures if the body temperature is above 100.4 degrees Fahrenheit. The best method to cool the body is to use room temperature water to soak the patient, and then fan him or her to cool by evaporation. You do not want to use ice and cold water because this causes shivering which actually raises body temperature.


Heat stroke is a life-threatening medical emergency. It is differentiated from heat exhaustion by the presence of central nervous system dysfunction such as ataxia, irritability, confusion, hallucinations, seizures and ultimately coma. The core body temperature is greater than 104 degrees Fahrenheit for heat stroke. A late sign of heat stroke is the lack of sweating (anhidrosis). In addition to the treatment measures listed for heat exhaustion, rapid cooling measures should be employed. The most effective way is ice packs to the areas where large blood vessels are located such as arm pits, groin, neck and scalp. A patient with heat stroke needs emergency medical care and evacuation to a medical facility. They need constant vital sign monitoring and support. The important thing to remember is that heat injury is not independent disease processes, but one continuum (i.e., a patient can progress).


Preventing heat stroke:

Preventing heat stroke involves adequate hydration, acclimation and heat dissipation. You should drink enough fluid to have clear urine. This is a better goal than an amount of fluid to take in. If you are exercising in heat for more than two to three hours and are only drinking water, you should add salt to the fluid (¼ to ½ teaspoon per liter) or eat salt-containing foods. You can drink sports drinks such as Gatorade if you dilute it 50/50 with water. Otherwise there is too much sugar. Wear loose-fitting, light clothing to allow air circulation. Frequently spray or douse your skin with tepid water to allow evaporation. To acclimate to an environment, you should slowly increase activity levels over seven to 10 days. Children and elderly may need 10 to 14 days to acclimate.

Heat stroke can carry a mortality rate approaching 75 percent. Every year, about 200 people die of heat stroke. Often, they are young, healthy athletes with no prior issues. So, if someone is lagging behind, don’t tell them to “just suck it up” and keep going. The main thing is to be smart and be aware.

Concussion – Serious Injury and Serious Talk: “Tips for Observation at Home”

by Tim “Trapper” OConnell MS  LAT
MCHS Divisional Director/Pro Care Orthopedics/CHW Family Med/Occupational Med

First and most important, my thoughts and prayers to all family members associated with a loss or affliction as a result of CTE (chronic traumatic encephalopathy).

We have looked at signs and symptoms observed immediately following a suspected concussion. If injured person is transported to an advanced medical facility, then follow discharge orders. If the injured person is deemed well enough to go home, here are some tips to consider in the hours following a suspected concussion:

  • Increasing headache
  • Nausea or vomiting
  • Difficulty or slurred speech
  • Balance or coordination difficulty
  • Unusual or out of character behavior
  • Changes in level of consciousness
  • Blurred or double vision
  • Disorientation
  • Delayed verbal or motor response
  • Amnesia
  • Stiffness in the neck or weakness in arms or legs
  • Blood or clear fluid from nose or ears
  • Abnormal drowsiness or sleepiness
  • Rest and observation are important. If he/she is able to sleep, continue to observe. If any changes in symptoms or signs are alarming, seek advanced medical care immediately.


Following are some additional tips: 

  • DO NOT take any medication other than what a medical doctor has prescribed.
  • NO physical activity until directed by health care professional.
  • Limit television and cell phone time as well as computer use.



Benefits of Group Exercise

Benefits of Group Exercise
by Andrew Enriquez, Exercise Specialist – Mission Fitness

Think back to when you were a kid and how much you loved going outside to play and how much fun it was just being around friends. Secondly, think back to when we were teenagers and how much we craved to be around a group of friends while hanging out on weekends. Even as adults, we still desire to do things in a group because we enjoy socializing and being a part of something while having fun!

Many things are just made more fun when done in a group rather than by ourselves. Group exercise is a great way to feel young again while being able to socialize and be around others who desire the same thing as you!

Group exercise is typically known as a group of people performing exercises while being led by an instructor. There are many different group exercise formats. You may have tried step classes, core, yoga, spin, muscle pump, toning classes, dance choreographed classes or others. There are a variety of different classes that you can do that may be of interest to you and your friends. You’ll typically find group exercises at a local gym or club and your choice of classes may depend on your schedule, instructor expertise and the type of gym or club you attend.

Group exercise offers a variety of benefits you might miss out on if you choose to work out on your own. Some of the benefits include exposure to a social and fun environment, a safe and effectively designed workout, a consistent exercise schedule, an accountability factor for participating in exercise and a workout that requires no prior exercise knowledge or experience.

Here are a few reasons why you may benefit from group exercise:

  • One of the main reasons many people quit a certain workout program, or stop working out altogether, is because they get bored! With group exercise, you’ll always stay motivated and interested with different instructor styles, workout formats, different props and weights to use and a variety of different music to keep you pumped up. Not to mention that an hour can fly by because you’re having fun and socializing with other while getting a quality workout.
  • Another reason is that many don’t even know where to start once they purchase a gym membership. So attending a group exercise class will take all that stress away because the workouts have already been made for you from the instructor! All you must do is show up with an open mind, a positive attitude and enjoy.
  • Usually, each class is structured with a purpose. Depending on the type of class you take, you may be doing a class that focuses on cardiorespiratory fitness, muscular fitness, stretching, etc. Each class should also have a format that includes warming up, cooling down and stretching. Often, many of us forget to add these components into our own routine which can possibly cause us to get an injury of some sort. With group exercise, it’s all taken care of for you!

Group exercise can be so diverse as it even reaches communities outside of gyms or clubs. You can sometimes find people participating in boot camps or yoga at a park, cyclists along the side of the road and even Tough Mudders or Spartan Races.

Many people just want to be a part of something bigger than themselves. The social aspect of group exercise makes it so much easier for you to build new relationships with people while getting a great workout in at the same time!



Just Three Things – Exercise

Just Three Things – Exercise

by Abby Magness, ACSM, C-EP
Fitness Director for Mission Fitness

  • Cardio
    1. Adults should get 150 minutes of moderate-intensity exercise per week.
    2. This can be 30 to 60 minutes three times a week at moderate intensity or 20 to 60 minutes three times a week at vigorous-intensity.
  • Strength Training/Weight Lifting
    1. Adults should train each major muscle group two or three days each week using a variety of exercises and equipment.
    2. Very light or light intensity is best for older persons or previously sedentary adults starting exercise.
    3. Two to four sets of each exercise will help adults improve strength and power.
    4. For each exercise, eight to twelve repetitions improve strength and power, ten to fifteen repetitions improve strength in middle-age and older persons starting exercise, and fifteen to twenty repetitions improve muscular endurance.
  • Flexibility Training
    1. Adults should do flexibility exercises at least two or three days each week to improve range of motion.
    2. Each stretch should be held for ten to thirty seconds to the point of tightness or slight discomfort.
    3. Repeat each stretch two to four times, accumulating 60 seconds per stretch.
    4. Static, dynamic, ballistic and PNF stretches are all effective. (PNF Stretches are Proprioceptive Neuromuscular Facilitation stretches. This is “a method of stretching muscles to maximize their flexibility that is often performed with a partner or trainer and that involves a series of contractions and relaxations with enforced stretching during the relaxation phase. Definition source: Merriam-Webster)
    5. Flexibility exercise is most effective when the muscle is warm. Try light aerobic activity or a hot bath to warm the muscles before stretching.




Creating a Plan

Creating a Plan

by John Douthitt

General Manager – Mission Fitness at the MCH Center for Health & Wellness 

How many times have you started a new workout program in January only to fall off the exercise wagon by the end of February? It happens to a lot of people when goals are unrealistic or plans aren’t well thought out and organized. Get focused this year and use these tips to create a workout plan that you can stick to through the tough first few weeks.

Create a Weekly Schedule: Long term goals are great, but it is also important to break these down into weekly expectations. Write down a weekly workout plan and schedule it on your calendar like any other appointment or meeting and keep it! When planning your workouts, remember that the Center for Disease Control recommends 150 minutes of cardiovascular exercise per week. Split that into sessions that fit your schedule. You could choose five, thirty minute sessions, or maybe 15 minutes Monday through Thursday and an hour on Saturdays and Sundays.  The choice is yours just pick a plan that works for you. Add in two strength sessions per week and you will be meeting the exercise requirements for a healthy body.

Record Your Exercise: Tracking your workout sessions and progress will increase your motivation to stick to your new schedule. Log your workouts on any number of new apps for your Smartphone or just use good old pen and paper. Either option will hold you accountable and allow you to follow your progress.

Try a Group Exercise Class: Group classes are ideal because there is usually something for everyone and this is a great way to make you friends. The social aspect of working out helps people acclimate to a class, helps you meet new friends and can provide you with an accountability partner. Add a class once or twice a week to cross train and add variety to your program. Plus, on those days when you don’t feel like creating your own workout, you can just show up and follow the guidance of a group fitness instructor.

Increase Intensity Over Time: One of the biggest mistakes many people make in starting up a new exercise program is jumping back into exercise at the level and intensity you were able to maintain years ago. This is a common reason many people do not stick to their plan. Don’t jump on a stationary bike, for example, and go full tilt with a difficult preprogrammed workout, or decide to bench press the same amount of weight you did ten years ago. Doing more than you are ready for might make you throw in the towel. Hop on a treadmill, elliptical trainer or other equipment and work up to the intensity that is right for you. As your strength and endurance improves, you can increase your speed, intensity, duration and resistance and achieve those goals that always seemed unattainable.

Sports Injuries

Sports Injuries – Beware of the Inside Season

by James Ingram, D.O., F.A.O.A.O. – Board Certified in Orthopedic Surgery

It happens quickly, outside sports stop and inside sports start. As a parent/coach/athlete, preventative steps will help reduce pain, injury, lost playing time and money.

The first tip is to continue to hydrate. Yes, your athlete is inside, but loss of body fluid is a set up for dehydration and cramps. This will ultimately be a step in the wrong direction for muscle strains and possible tendon injuries. Drink water before, during and after practice and games.

Great fitting and supportive shoes will prevent the blisters, shin splints and “kneecap” (patellar) bony and tendon inflammation. 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. There are all types of braces, straps and pads. Ask your athletic trainer which is best for your possible condition.

A serious consideration for all court sports is the continued emphasis on “core strength”. Doing “core” work with a balance of abdominal/back structures will maintain great control of the hips and pelvis. Keeping in mind that this is the most powerful muscle group for jumping, running, change of direction and stopping. A well maintained “core” will also assist in diminishing the pelvic drop that has been documented in jump-stop moves that are associated with anterior cruciate ligament (ACL) tears/injuries of the knee. The female athlete is more prone to ACL injury than male, due to many documented studies. Most research has moved the training phase of athletes into detailed attention of the muscle balance of the thigh, (quadriceps in the front and hamstrings in the back). As an athlete, coach and parent, more knowledge and conditioning will be a rewarding insurance to a long productive season.

If you have questions or concerns about an injury. Please don’t hesitate to call our office at 432-640-6446.

Hope you had Happy Holidays and Best of Luck for all Seasons.

James Ingram, D.O., F.A.O.A.O., Board Certified in Orthopedic Surgery, specializes in treating immediate and chronic orthopedic conditions. Dr. Ingram also works to incorporate prevention as a model to live by for all of his patients. Dr. Ingram specializes in:

  • Joint Replacement – Shoulder, Hip, and Knee
  • Arthroscopy of shoulder and knee
  • Sports Medicine

ProCare Orthopedics
519 North Lincoln Avenue
Odessa, Texas 79761
Office Hours: Monday – Friday: 8:00 am – 5:00 pm
Call (432) 640-6446 for more information

The Benefits of Exercise on Diabetes

The Benefits of Exercise on Diabetes

by John Douthitt

General Manager – Mission Fitness* at the MCH Center for Health & Wellness

Regular activity is a key component of managing diabetes. When you are active, your cells become more sensitive to insulin allowing them to work more efficiently. Your cells also remove glucose from the blood using a mechanism totally separate from insulin during exercise.

Besides lowering one’s blood glucose and thus improving their A1C score, regular physical activity can help your body manage many health conditions. Some of the benefits of regular physical activity are the following:

  • Lowers blood glucose levels.
  • Lowers blood pressure and cholesterol.
  • Lowers one’s risk for heart disease and stroke.
  • Burns calories to assist in maintaining a healthy body weight.
  • Increase in energy throughout the day.
  • Improved sleep.
  • Stress reduction.
  • Improves circulation and cardiovascular output.
  • Strengthens muscle and bones.
  • Keeps your joints flexible.
  • Can improve balance thus reducing the likelihood of falls.
  • Improve one’s quality of life.

*Mission Fitness, the most advanced health and fitness complex in the Permian Basin, incorporates state-of-the-art facilities with the most cutting-edge training equipment available today. Whether you are training as part of a medical treatment plan, or just want to stay in the best physical condition you can, Mission Fitness is perfect for you. If you would like a tour of Mission Fitness, please visit the facility located on Hwy. 191 at Faudree Rd. (8050 E. Hwy 191) in Odessa, TX. For more information, call 432-640-6400.

Five for Five

“Five for Five—Five Exercises to complete in Five Minutes”

by Abby Magness, ACSM-HFS – Fitness Director at Mission Fitness

Nowadays we all feel so rushed for time! We have work to finish up, kids to take to practice and laundry that needs to be folded. How are you supposed to fit a workout in between all of that? Here are five exercises that are effective and can be done anywhere with no equipment! Try doing each of these exercises for one minute each before moving to the next exercise. Complete this circuit 3-4 times, depending on how you are feeling.

       1. Bodyweight Squats

Make sure you are driving all of your weight through your heels and keeping your knees behind your toes as you sit your glutes back towards your heels.


2. Push Ups

Keep your shoulders and hips in one line as you drop your chest to the floor. Bend your elbows to 90 degrees and press back up. Too hard on your toes? No problem! Drop to your knees and focus on keeping that solid alignment as you bend into your elbows.


       3. Plank with Alternating Shoulder Taps

Make sure to keep your hips level and your bellybutton pulled into your spine. Stacked joints are always stronger so make sure to keep your shoulders directly over your wrists.


       4. Walking Lunges

Bending both legs into a 90 degree angle, keep your weight driving into your front heel. Step together and repeat on the opposite side.


       5. Tricep Dips off of a bench or chair

Find a chair or bench and place your palms behind you with your fingers facing towards you (as shown below). Bend your elbows and then extend by contracting your triceps and pressing into a straight arm press. Repeat.