Common Conditions and Pains

Female Athletes at Increased Risk for ACL Injury

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-Dunaway-e1434650579861

 

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.

It’s Back-to-School Time: Lighten Your Load

 

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.

EXPERT ADVICE
“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
    the center.
  • 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.

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http://newsroom.aaos.org/media-resources/Press-releases/backpack-safety.htm

Sprains, Strains, and Other Soft-Tissue Injuries

Sprains, Strains, and Other Soft-Tissue Injuries

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:

  • sprains
  • strains
  • contusions
  • tendonitis
  • bursitis
  • 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.

Sprains

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.

Sprains and strains are usually treated first with RICE (rest, ice, compression using a bandage, and elevation.)
Strains

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.

Contusions

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.

Tendonitis

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.

Bursitis

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.

Stress Fractures

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.

Good Care

If you are an athlete or a fitness enthusiast, you should pay close attention to your body’s warning signs.

Recreational athletes can help prevent injuries by a brief warm up, then stretching, before exercise.

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.

Last reviewed: July 2007
AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS “Find an Orthopaedist” program on this website

Tips for a Safe Running Program

Tips for a Safe Running Program

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.

Plan for Your 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.
Preparation
  • 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.
Dress Appropriately
  • 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.
Hydration
  • 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.
Sources of some information include: U.S.A. Track and Field Association, Road Runners Club of America, and American Orthopaedic Society for Sports Medicine

Photo copyright ©2010, Getty Images.

 Last reviewed: July 2011
AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS “Find an Orthopaedist” program on this website.

High School Sports Injuries

High School Sports Injuries

Every year, millions of teenagers participate in high school sports. An injury to a high school athlete can be a significant disappointment for the teen, the family, and the coaches. The pressure to play can lead to decisions that may lead to additional injury with long-term effects. High school sports injuries can cause problems that require surgery as an adult, and may lead to arthritis later in life.

When a sports injury occurs, it is important to quickly seek proper treatment. To ensure the best possible recovery, athletes, coaches, and parents must follow safe guidelines for returning to the game.

The Adolescent Athlete

Teenage athletes are injured at about the same rate as professional athletes, but injuries that affect high school athletes are often different from those that affect adult athletes. This is largely because high school athletes are often still growing.

Growth is generally uneven: Bones grow first, which pulls at tight muscles and tendons. This uneven growth pattern makes younger athletes more susceptible to muscle, tendon, and growth plate injuries.

Types of High School Sports Injuries

Injuries among young athletes fall into two basic categories: overuse injuries and acute injuries. Both types include injuries to the soft tissues (muscles and ligaments) and bones.

Acute Injuries

Acute injuries are caused by a sudden trauma. Examples of trauma include collisions with obstacles on the field or between players. Common acute injuries among young athletes include contusions (bruises), sprains (a partial or complete tear of a ligament), strains (a partial or complete tear of a muscle or tendon), and fractures.

A twisting force to the lower leg or foot is a common cause of ankle fractures, as well as ligament injuries (sprains).
Reproduced and modified with permission from The Body Almanac. © American Academy of Orthopaedic Surgeons, 2003.

Overuse Injuries

Not all injuries are caused by a single, sudden twist, fall, or collision. Overuse injuries occur gradually over time, when an athletic activity is repeated so often, parts of the body do not have enough time to heal between playing.

Overuse injuries can affect muscles, ligaments, tendons, bones, and growth plates. For example, overhand pitching in baseball can be associated with injuries to the elbow. Swimming is often associated with injuries to the shoulder. Gymnastics and cheerleading are two common activities associated with injuries to the wrist and elbow.

Stress fractures are another common overuse injury in young athletes. Bone is in a constant state of turnover—a process called remodeling. New bone develops and replaces older bone. If an athlete’s activity is too great, the breakdown of older bone occurs rapidly, and the body cannot make new bone fast enough to replace it. As a result, the bone is weakened and stress fractures can occur—most often in the shinbone and bones of the feet.

Catastrophic Sports Injuries

Many sports, especially contact sports, have inherent dangers that put young athletes at special risk for severe injuries. Even with rigorous training and proper safety equipment, children are at risk for severe injuries to the head and neck with damage to the brain or spinal cord.

Catastrophic injuries have been reported in a wide range of sports, including ice hockey, wrestling, football, swimming, soccer, pole vaulting, cheerleading, and gymnastics. It is important for coaches, parents, and athletes to be aware of the guidelines and regulations developed for each sport to prevent head and neck injury.

Concussion

Concussions are mild traumatic brain injuries. They are caused by a blow to the head or body that results in the brain moving rapidly back and forth inside the skull.

Although some sports have higher instances of concussion—such as football, ice hockey, and soccer—concussions can happen in any sport or recreational activity.

In 2010, the American Academy of Pediatrics recommended that young athletes with concussions be evaluated and cleared by a doctor before returning to sports. The American Academy of Neurology issued a similar statement, and stressed that doctors who clear athletes for return to sports should be trained in managing and assessing sports concussions.

Growth Plate Injuries

Growth plates are areas of developing cartilage tissue near the ends of long bones. When a child becomes full-grown, the growth plates harden into solid bone.

Because growth plates are the last portion of bones to harden (ossify), they are vulnerable to fracture. Growth plates regulate and help determine the length and shape of adult bone, therefore, injuries to the growth plate can result in disturbances to bone growth and bone deformity.

Growth plate injuries occur most often in contact sports like football or basketball and in high impact sports like gymnastics.

Prompt Medical Attention

Whether an injury is acute or due to overuse, a high school athlete who develops a symptom that persists or that affects his or her athletic performance should be examined by a doctor. Untreated injuries could lead to permanent damage or disability.

Some athletes may downplay their symptoms in order to continue playing. Coaches and parents should be aware of the more common signs of injury, such as pain with activity, changes in form or technique, pain at night, and decreased interest in practice.

Doctor Examination

During the examination, the doctor will ask about how the injury occurred, the symptoms, and will discuss the athlete’s medical history. During the physician examination, the doctor will look for points of tenderness, as well as range of motion.

If necessary, the doctor may recommend imaging tests, such as x-rays or other tests, to evaluate the bones and soft tissues.

Treatment

Treatment will depend upon the severity of the injury, and may include a combination of physical therapy, strengthening exercises, and bracing. More serious injuries may require surgery.

Return to Play

A player’s injury must be completely healed before he or she returns to sports activity.

  • In case of a joint problem, the player must have no pain, no swelling, full range of motion, and normal strength.
  • In case of concussion, the player must have no symptoms at rest or with exercise, and should be cleared by the appropriate medical provider.

Media stories about the early return to competition by professional athletes following injury create the impression that any athlete with proper treatment can return to play at the same ability level, or even better.

It is important for players, parents, and coaches to understand that depending on the type of injury and treatment required, the young athlete may not be able to return to the game at the same level of play—no matter how much effort is put into injury rehabilitation.

Prevention

Many high school sports injuries can be prevented through proper conditioning, training, and equipment.

High school athletes require sport specific training to prevent injury. Many injuries can be prevented with regular conditioning that begins prior to the formal sports season. Injuries often occur when athletes suddenly increase the duration, intensity, or frequency of their activity. Young athletes who are out of shape at the start of the season should gradually increase activity levels and slowly build back up to a higher fitness level.

Using proper technique for the position being played is also key to preventing injury. Proper equipment—from the right shoes to safety gear—is essential. In addition, injuries can be prevented when athletes understand and follow the rules of the game, and display good sportsmanship.

Because many young athletes are focusing on just one sport and are training year-round, doctors are seeing an increase in overuse injuries. The American Academy of Orthopaedic Surgeons has partnered with STOP Sports Injuries to help educate parents, coaches, and athletes about how to prevent overuse injuries. Specific tips to prevent overuse injuries include:

  • Limit the number of teams in which your child is playing in one season. Athletes who play on more than one team are especially at risk for overuse injuries.
  • Do not allow your child to play one sport year-round—taking regular breaks and playing other sports is essential to skill development and injury prevention.
Last reviewed: August 2012
Reviewed by members of POSNA (Pediatric Orthopaedic Society of North America)

The Pediatric Orthopaedic Society of North America (POSNA) is a group of board eligible/board certified orthopaedic surgeons who have specialized training in the care of children’s musculoskeletal health. One of our goals is to continue to be the authoritative source for patients and families on children’s orthopaedic conditions. Our Public Education and Media Relations Committee works with the AAOS to develop, review, and update the pediatric topics within OrthoInfo, so we ensure that patients, families and other healthcare professionals have the latest information and practice guidelines at the click of a link.
AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS “Find an Orthopaedist” program on this website.

Bicycle Safety

Bicycle Safety

Cycling is a good form of exercise, so it is not surprising that more than 80 million people in the United States have taken up bicycling for fun and as a mode of transportation.

According to the Consumer Product Safety Commission (CPSC), more than 1.4 million cycling injuries were reported in 2012.

Common Bicycle Injuries

In 2010, bruises and minor cuts were the leading types of injuries involving bicycles, followed by fractures, muscle strains, and sprains. However, serious injuries, including death, do occur. Some of the most common cycling injuries that orthopaedic surgeons treat include broken collar bones and wrists.

Tips for Preventing Injuries

To minimize your risk of injury while riding a bicycle:

  • Wear a helmet. Wearing a bike helmet reduces the risk of serious head and brain injury by 85%. Always wear a helmet approved by the American National Standards Institute (ANSI).
    • Make sure it fits snugly but comfortably, and does not obstruct your vision.
    • It should have a chin strap and buckles that stay securely fastened.
    • Studies have shown that wearing a bicycle helmet can reduce head injuries.
  • Follow the rules of the road. Familiarize yourself with all of the bicycle rules of the road in your city or state. Ride in the direction of traffic. Follow traffic signs and lights. Signal your turns or your intentions so that drivers can anticipate your actions. If you are riding with others, ride single file.
  • Ride defensively. Understand that drivers often do not see cyclists, so you must be fully aware of your surroundings and ready to act to avoid a collision. Intersections are especially dangerous because drivers making turns are not looking for cyclists. Be careful when riding next to parked cars to avoid being hit by an opening door.
  • Choose bike routes wisely. Avoid riding on high traffic roads. The most direct route to your destination is often not the safest because more vehicles will also take that route. Select streets with fewer and slower cars.

    Whenever possible, choose streets with designated bicycle lanes. If there is not a bicycle lane, ride on the right shoulder of the road.

    Choose wide streets. When a street lane is too narrow for a vehicle and bicycle to safely ride side-by-side, or if there are several parked cars on the street, you will need to join traffic and ride toward the center of the road. If this causes traffic behind you to jam, or if cars are switching lanes trying to pass you, it is safest to find a different, quieter street.

  • Avoid distracted cycling. Do not listen to music with head phones, talk on your phone, text, or do anything else that can obstruct your hearing and/or vision while riding.
  • Take extra precautions while bicycling at night. Wear bright fluorescent colors and make sure to have rear reflectors. Both a working tail light and headlight should be visible from 500 feet away.
  • No drugs or alcohol. Never ride a bicycle while under the influence of drugs or alcohol.
  • Never underestimate road conditions. Be cautious of uneven or slippery surfaces.
  • Maintain your bicycle. Check your bicycle’s mechanical components on a regular basis (brakes, tires, gears, etc.), just like you would for a car. If your bike is not in good condition, do not ride it.
  • Adjust your bicycle to fit. Make certain the bicycle is the proper size for the rider. Appropriately sized frames, handlebar and seat heights will improve your ability to control the bike, and reduce the risk for overuse injuries. If you ride regularly, consider a professional fit from a bike shop.
  • Dress appropriately. Avoid loose clothing and wear appropriate footwear. Never wear flip flops. Wear padded gloves. Use appropriately padded cycling shorts for longer rides. If you commute on your bike, carry your belongings in a proper bag with close fitting straps. Wear sunscreen, when appropriate.
  • Pace yourself: Cycling can be vigorous exercise. Make sure you are fit enough to participate before you start pedaling. In addition, make sure you understand how to use the gear systems on your bike to help control your physical exertion level. See your doctor before you begin any exercise program.
  • Change riding positions. Slight variations in your position can reduce stress on pressure points on your body and avoid overstressing muscles.
  • Hydrate. Be sure to carry water and food on longer rides. Drink a full water bottle each hour you spend on the bike.
  • Supervise younger riders at all times. It is recommended that younger children ride only in enclosed areas.
Last reviewed: June 2013
AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS “Find an Orthopaedist” program on this website.

Getting the Most Out of Your Doctor’s Visit

Getting the Most Out of Your Doctor’s Visit

Your visit with an orthopaedic surgeon is an important meeting that can be most effective if you plan ahead.

Research shows that patients who are more involved with their care get better results.

The following checklist will help you become more active in your healthcare and get the most out of each office visit.

Before You Go
  • Find out the basics about the office.
    Where is it? What time should you arrive? If you’re going to drive, where can you park? Do you need to bring your insurance card or a medical referral?
  • Assemble your records.
    Compile medical documents and records to take to the doctor�s office. These may include:

    • Relevant medical records from other doctors
    • Results and copies of x-rays and other imaging studies
    • Results from any lab tests
  • Make written lists.
    • All the medications your regularly take, including herbs, vitamin supplements and over-the-counter medications you are taking
    • Your medical history, such as prior treatments for heart or thyroid problems
    • Past surgeries, even those not related to your current problem
    • All allergies (rash, hives, swelling) or unexpected reactions (nausea, drowsiness) to medications
    • Any medical problems that run in your family
    • Your concerns about your condition (pains, loss of mobility or function)
  • Bring a friend.
    Consider asking a friend or family member to accompany you to help you ask questions and remember all of the information your doctor provides. If you need a translator, ask another adult to come with you; do not rely on a child to translate.
  • Dress appropriately.
    For spine and many problems involving the arms and legs, you may be asked to undress. Wear loose clothing that is easy to take off and put on.
At the Doctor’s Office
  • Arrive early.
    You will need time to complete any required forms or tests before meeting with your doctor.
  • Be honest and complete in talking with your doctor.
    Share your point of view and do not hold back information that you think may be unimportant or embarrassing, such as incontinence or memory loss.
  • Stick to the point.
    It might be fun to share news about the children, but keep it short to get the most out of your time with the doctor.
  • Take notes and ask questions.
    Take notes on what the doctor tells you and ask questions if you do not understand a medical term, the reason for the doctor’s recommendations, or the instructions for taking medication.
  • Ask what to expect from your treatment.
    Find out what effect it will have on your daily activities, and what you can do to prevent further disability.
  • Ask for more information to take with you.
    Ask your doctor for handouts or brochures that you and your family members can review at home. Your doctor may refer you to a website for more information.
  • Talk to the other members of the healthcare team.
    Physician assistants, nurses, or therapists (speech, physical or occupational) can also address any questions or concerns.
When You Get Home
  • Review the materials the doctor gave you.
    If you cannot remember something, or if you do not understand your notes, call the office and speak to a member of your healthcare team.
  • Follow the doctor’s instructions.
    Take the full course of medication and make sure you follow the prescribed diet or exercise routine. Remember, you are a part of your healthcare team, too.
  • Keep your doctor informed.
    Follow up with your doctor on test results, adverse reactions to medication, or any complications or worsening of your condition.

http://orthoinfo.aaos.org/topic.cfm?topic=A00561