If you are a candidate for a total knee replacement and want to feel better, recover faster, and have your replacement last longer, call Memphis Orthopaedic Group at 901-381-4664 to make an appointment with Dr. Jean Simard.
Common Conditions and Pains
Congratulations to Dr. Jean Simard for being the FIRST in Memphis to perform a successful Total Knee Replacement using the Mako Robotic-Arm Assisted Surgery System this morning at St. Francis Hospital-Memphis.
My name is Jay Phillips and I am a Certified Athletic Trainer. I want to talk briefly about neck strength and the possible relationship between neck strength and reducing the risk for concussion in high school sports. As spring football and spring sports arrive I am constantly hearing one question over and over again from coaches, players, and parent’s alike, ‘what else can be done to reduce the risk of concussions?’ Well, there has been research that shows for every one-pound increase in neck strength, odds of concussion decreased by 5%. The research also shows that observing an athlete’s neck size might be a useful tool in screening athletes that just might be at a higher risk of concussions and could possibly be included in early prevention programs. So, if you work with your athlete to increase his or her neck strength and neck size, your efforts should result in a decrease risk of concussion.
Have you even woken up in the morning with stiffness in one of your joints? Do you find yourself noticing clicking, popping, or grinding when you move your joints? What about swelling especially after using the joint? You may be one of several million people in the United States who is affected by osteoarthritis. Osteoarthritis is a process that may affect any joint in the body including the shoulder. Arthritis is known as general “wear and tear” of the cartilage in the joint and generally affects people older than 50. The purpose of the cartilage is to provide a smooth surface so that the bones move with ease. As this cartilage wears away, the ragged surface of the cartilage and then the surface of each bone begins to rub together causing inflammation to occur which leads to pain. Once the process begins there is no cure, but fortunately there are several treatments to help alleviate the associated symptoms.
Today we’ll discuss arthritis of the shoulder, or glenohumeral joint. As demonstrated in the picture below, the shoulder is made of three bones: the scapula, clavicle and the humerus. Shoulder arthritis occurs in the glenoid of the scapula and the head of the humerus.
Symptoms include pain, a grinding sensation with movement, and stiffness. The severity may range from a mild nuisance to debilitating. When discussing your symptoms with your healthcare provider, they may obtain an x-ray of your shoulder. Some of the findings of an arthritic shoulder are demonstrated in the picture below. The x-ray on the left demonstrates a normal healthy shoulder and the one on the right demonstrates an arthritic shoulder. As we compare the two x-rays, we notice that the arthritic shoulder has a loss of the joint space and bone spurs (aka osteophytes).
It is always important to discuss your symptoms with your healthcare provider before beginning any treatment regime. Nonoperative treatments may include suggestions such as over-the-counter non-steroidal anti-inflammatories (NSAIDs), such as Ibuprofen or Aleve, application of heat or ice, home exercises, and steroid injections. For those with advanced arthritis, your healthcare provider may refer you to an orthopedic surgeon for consideration of a total joint replacement.
The following is a link to more information about shoulder arthritis through the American Academy of Orthopaedic Surgeons: http://www.orthoinfo.org/topic.cfm?topic=A00222
-Christopher Pokabla, M.D.
-Lacy D. Johnson, P.A.
Female Athletes at Increased risk for ACL Injury
Over the past decade the speed, power and intensity displayed by female athletes has increased making them 2-10 times more likely to sustain a knee ligament injury such as an anterior cruciate ligament (ACL) injury. More aggressive styles of play has led to an increase in musculoskeletal injuries especially in female athletes who participate in jumping and pivoting sports such as soccer, basketball and volleyball.
Most ACL injuries occur by non-contact mechanisms:
- One-step/stop deceleration
- Cutting movements
- Sudden change in direction
- Landing from a jump with inadequate knee and hip flexion
- Lapse of concentration (resulting from unanticipated change in the direction of play)
There is no easy explanation as to why female athletes are more prone to non-contact ACL injuries. Research shows that female athletes run and cut sharply in a more erect posture than men, and they bend their knees less when landing from a jump. There is also debate on the opinion that another explanation could be the anatomical and hormonal differences between men and women. Another cause is a wider pelvis. Women have a “Q” angle, which makes the thigh bone angle downward more sharply then in men. This alignment makes women’s knees bend more inward when they land which could predispose women to ACL injuries.
Recent studies tells us that the rate of ACL injuries among women can be reduced by following a proper neuromuscular training and conditioning program called Prevent Injury and Enhance Performance (PEP) (http://www.aclprevent.com/pepexercises.pdf) before practices and games. The PEP program consists of a series of 19 warm-up, stretching, strengthening, plyometric, and sports specific agility exercises that can be done in 30 minutes without any specialized equipment.
In general, experts say that there are four ways to reduce the risk of ACL injuries:
- Proper leg muscles strength training and core training
- Proper neuromuscular (balance and speed) training
- Proper coaching on jumping and landing and avoiding any straight knee landing
- Proper footwear that gives optimal traction to allow peak performance in sports with cutting and stopping
Reference: American Academy of Orthopaedic Surgeons
Bob Dunaway, ATC
Bob graduated with a B.S. Degree from Memphis State University in 1988. He became a Certified Athletic Trainer January 1990, and has worked in sports medicine outreach with area high schools and college level athletics since graduation. He served as the Athletic Trainer for world basketball league Memphis Rockers for two seasons & has been with Memphis Orthopaedic Group since 2011. Bob covers St. Mary’s Episcopal School and Southwest Tennessee Community College. He is a Certified Instructor Trainer for the American Heart Association Certified Ergonomic Specialist.
With a bursting school curriculum and more gadgets than before, kids today could be experiencing the effects of a heavy backpack. The American Academy of Orthopaedic Surgeons (AAOS) and the Pediatric Orthopaedic Society of North America (POSNA) urge parents and kids to consider safety first to avoid backpack-related injuries.
According to the Consumer Product Safety Commission (CPSC) more than 24,300 individuals were treated in hospitals and doctors’ offices for injuries related to backpacks in 2012, and more than 9,500 of those injuries were kids 5-18 years old.
“Backpacks are designed to distribute the weight of load among some of the body’s strongest muscles,” said orthopaedic surgeon and AAOS spokesperson Michael Wade Shrader, MD. “But, when worn incorrectly, injuries such as strains, sprains and posture problems can occur. While some of these injuries can be minor, others can have a lasting effect on kids, and follow them into adulthood.”
AAOS and POSNA SAFETY TIPS
AAOS and POSNA recommend the following tips to help eliminate discomfort and reduce the risk of backpack-related injuries.
- Kids should carry no more than 15-20 percent of their body weight.
- Use both shoulder straps to keep the weight of the backpack better distributed and adjust the shoulder straps to keep the load close to the back.
- Remove or organize items if too heavy and pack the heavier things low and towards
- When lifting backpacks, bend at the knees.
- School backpacks are for schoolwork. Carry only those items that are required for the day; if possible, leave books at home or school.
- At home and at school, keep walkways clear of backpacks to avoid tripping.
Parents also can help with backpack-related pain:
- Encourage your child or teenager to tell you about numbness or tingling in the arms or legs which may indicate poor fit or too much weight being carried.
- If the backpack seems too heavy for the child, have them remove some of the books
and carry them in their arms to ease load on the back.
- Purchase a backpack appropriate for the size of your child.
- Watch your child put on or take off the backpack to see if it is a struggle.
- Encourage your child to stop at their locker throughout the day as time permits to drop off heavier books.
When you participate in sports and physical fitness activities, you can injure the soft tissues of your body. Even simple everyday activities can damage these ligaments, tendons, and muscles.
Some of the soft-tissue injuries you are most likely to experience include:
- stress injuries
Any of these can be the result of a single episode, such as a fall, a sudden twist, or a blow to the body. You might also sustain one or more of these injuries because of repeated overuse, such as in ongoing athletic activities. In this case, small amounts of body stress accumulate slowly but steadily. The result can be damage and pain.
Here are some of the injuries you are most likely to experience, along with suggested ways of treating them.
The joints of your body are supported by ligaments. Ligaments are strong bands of connective tissue that connect one bone to another. A sprain is a simple stretch or tear of the ligaments.
The areas of your body that are most vulnerable to sprains are your ankles, knees, and wrists.
A sprained ankle can occur when your foot turns inward. This can put extreme tension on the ligaments of your outer ankle and cause a sprain.
A sprained knee can be the result of a sudden twist.
A wrist sprain most often occurs when you fall on an outstretched hand.
Most mild sprains heal with “R.I.C.E.” (rest, ice, compression, and elevation) and exercise. Moderate sprains may also require a period of bracing. The most severe sprains may require surgery to repair torn ligaments.
Your bones are supported by a combination of muscles and tendons. Tendons connect muscles to bones.
A strain is the result of an injury to either a muscle or a tendon, usually in your foot or leg. The strain may be a simple stretch in your muscle or tendon, or it may be a partial or complete tear in the muscle-and-tendon combination.
The recommended treatment for a strain is the same as for a sprain: rest, ice, compression, and elevation. This should be followed by simple exercises to relieve pain and restore mobility.
For a serious tear, the soft tissues may need to be repaired surgically.
A contusion is a bruise caused by a blow to your muscle, tendon, or ligament. The bruise is caused when blood pools around the injury and discolors the skin.
Most contusions are mild and respond well when you rest, apply ice and compression, and elevate the injured area.
If symptoms persist, medical care should be sought to prevent permanent damage to the soft tissues.
Inflammation is a healing response to injury. It is usually accompanied by swelling, heat, redness, and pain. An inflammation in a tendon or in the covering of the tendon is called tendonitis.
Tendonitis is caused by a series of small stresses that repeatedly aggravate the tendon.
Professional baseball players, swimmers, tennis players, and golfers are susceptible to tendonitis in their shoulders and arms.
Soccer and basketball players, runners, and aerobic dancers are prone to tendon inflammation in their legs and feet.
Tendonitis may be treated by rest to eliminate stress, anti-inflammatory medication, steroid injections, splinting, and exercises to correct muscle imbalance and improve flexibility.
Persistent inflammation may cause damage to the tendon, which may necessitate surgical correction.
A bursa is a sac filled with fluid that is located between a bone and a tendon or muscle. A bursa allows the tendon to slide smoothly over the bone.
Repeated small stresses and overuse can cause the bursa in the shoulder, elbow, hip, knee, or ankle to swell. This swelling and irritation is called bursitis.
Many people experience bursitis in association with tendonitis.
Bursitis can usually be relieved by rest and possibly with anti-inflammatory medication. Some orthopaedic surgeons also inject the bursa with additional medication to reduce the inflammation.
When one of your bones is stressed by overuse, tiny breaks in the bone can occur. The injury is termed a stress fracture.
Early symptoms may be pain and swelling in the region of the stress fracture. The bones of the lower leg and foot are particularly prone to stress fractures.
The fracture may not be seen on initial routine X-rays, requiring a bone scan to obtain the diagnosis.
These injuries are treated by rest, activity modification, cast immobilization, and, rarely, by surgery.
If you are an athlete or a fitness enthusiast, you should pay close attention to your body’s warning signs.
Fatigue and pain are usually a signal that you are pressing too hard. Be sure to stretch thoroughly before your work-out, and stop before you are exhausted.
Stress injuries can also result from poor muscle balance, lack of flexibility, or weakness in soft tissues caused by previous injuries. These injuries to the muscle, bone ligaments, and tendons may require a prolonged amount of time to heal, in spite of appropriate care.
Consult your orthopaedic surgeon for treatment of these injuries to the soft tissue and bone. Besides treating the problem, he or she can develop a program of exercise or rehabilitation to restore function.
Although running injuries are quite common, you can reduce your risk for injury. Be sure to follow the proper conditioning and training programs, wear the appropriate apparel and footwear, and be aware of your running environment.
- Run in the shade, if possible, to avoid direct sun. If exposed to the sun, apply at least SPF 15 sunscreen. Wear sunglasses to filter out UVA and UVB rays, and wear a hat with a visor to shade your eyes and face.
- During hot weather, run in the early morning or evening to avoid heat exhaustion. Do not run when pollution levels are high.
- In high altitudes, gradually acclimate yourself to lower oxygen levels by slowly increasing your speed and distance.
- In cool weather, you are less likely to get chilled if you run into the wind when you start running and run with the wind at the finish.
- Do not run at night. If you run at dusk or dawn, wear reflective material. Do not wear a headset or jewelry while running.
- Whenever possible, run on a clear, smooth, resilient, even, and reasonably soft surface. Avoid running on hills, which increases stress on the ankle and foot. When running on a curve, such as a running track, reverse directions halfway through your run so that you have even pressure on both feet during the run.
- Plan a progressive running program to prevent injuries. A five-minute warm-up (which should raise your temperature by one degree) followed by stretching exercises, is essential before starting a run. Following the run, stretching again is important.
- Start your run with your body feeling “a little cool.” Your body temperature will increase when you start running.
- Run with a partner. If alone, carry identification, or write your name, phone number, blood type, and medical information on the inside sole of your running shoe.
- Let others know where you will be running, and stay in familiar areas, away from traffic. If possible, carry a small bag for a cell phone and a whistle or other noisemaker to use in an emergency.
- When selecting a running shoe, look for good shock absorption and construction that will provide stability and cushioning to the foot. Make sure that there is a thumbnail’s width between the end of the longest toe and the end of the shoe. Buy shoes at the end of the day when your foot is the largest.
- Sixty percent of a shoe’s shock absorption is lost after 250 to 500 miles of use, so people who run up to 10 miles per week should consider replacing their shoes every 9 to 12 months.
- Excessive clothing can produce sweating, which causes the body to lose heat rapidly and can increase the risk of hypothermia. Instead, dress in layers. The inner layer should be material that takes perspiration away from the skin (polypropylene, thermal); the middle layer (not necessary for legs) should be for insulation and absorbing moisture (cotton); the outer layer should protect against wind and moisture (nylon).
- To avoid frostbite in cold weather, do not have gaps of bare skin between gloves and jackets, wear a hat, and cover your neck. Petroleum jelly can be used on exposed areas, such as the nose.
- You can lose between six and 12 ounces of fluid for every 20 minutes of running. Drink 10 to 15 ounces of fluid 10 to 15 minutes prior to running and every 20 to 30 minutes along your route. Weigh yourself before and after a run. For every pound lost, drink one pint of fluid.
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