Memphis Orthopaedic Group

Concussions

In the past few years, we have seen the media bring the subject of concussions into the spotlight. One movie in particular, “Concussion” starring Will Smith highlighted the potential long-term effects of repetitive brain trauma in NFL players. The Center for Disease Control estimates that 1.6 to 3.8 million people in the United States will suffer a sports-related mild traumatic brain injury this year, which we can all agree is a significant number. This raises several questions with athletes, parents, coaches, and athletic trainers. How do we know if an athlete has sustained a concussion? How should they be treated? When can they return to their daily activities, school, and sports? How are they prevented?

Concussions have several different definitions ranging from “complete loss of consciousness” to “getting your bell rung”. In the 2016 Journal of the American Academy of Orthopaedic Surgeons article Concussions in Sports: What Orthopaedic Surgeons Need to Know? it was stated “The Concussion in Sport Group formally defined concussion as a complex pathophysiological process affecting the brain, induced by biomechanical forces.” What does this mean? Essentially, after the brain sustains an injury whether direct or indirect, the chemicals produced in the brain go into overdrive leading to symptoms such as confusion, headaches, irritability, nausea, vomiting, depression, or dizziness. Why don’t we just order a CT or MRI to determine if a concussion is present? A great question! The answer is that these tests are typically normal in a concussed patient and do not help us with diagnosis. This is why it is important for players, parents, coaches, and athletic trainers to know the symptoms. The severity of the symptoms can range from person to person. This in turn can make it difficult to determine if an athlete has sustained a concussion, but once the symptoms are recognized it is essential for them to be removed from the sport until cleared by a medical provider.  Your family physician, a sports medicine physician, or a neurologist are doctors that can treat patients with concussions. If a player returns to sports too soon or before being cleared by a doctor, it may prolong or even worsen their symptoms.

Once we have determined an athlete is concussed, how should they be treated? The answer always incorporates REST in the treatment plan! Both mental and physical rest may be necessary until patients are symptom free. We all know what physical rest is, but what is meant by mental rest? This includes limiting television, video games, and occasionally reading until symptoms resolve. Both players and parents of young athletes must be educated on the importance of being symptom free prior to return to play. While concussions may not be 100% avoidable, prevention is still an important factor. Making sure players have proper equipment and understand safe techniques for their sport can potentially aid in the prevention of concussions.

The following is a link to more information about concussions through the American Academy of Orthopaedic Surgeons: http://orthoinfo.aaos.org/topic.cfm?topic=A00574

-Christopher Pokabla, M.D.

-Lacy D. Johnson, P.A.

Treatment Options for Rotator Cuff Tears

What are the treatment options for rotator cuff tears?  First and foremost, what is the rotator cuff?  It’s a group of four tendons all of which come from muscles that originate on the scapula or shoulder blade.  The tendons then attach to the “ball” of the shoulder joint forming about 1/2 of a shirt sleeve cuff from the front to the back of the “ball”.  The two middle tendons on the top of the ball are the one’s usually torn.  If you’re under forty years of age you probably don’t have a rotator cuff tear, i.e., the older you are the more likely the diagnosis. The under forty crowd most likely has rotator cuff tendinitis or, if injured, a shoulder separation, dislocation, or labral tear.   Middle-aged patients(forty to sixty years old roughly) tend to tear the rotator cuff after injuries whereas degenerative tears are more likely the older one gets. On the job rotator cuff tears are quite common.  

 Treatment options are conservative or nonsurgical, and surgical.  I treat most of my younger very active patients with surgery simply because they rarely respond to injections and physical therapy.  Surgery has a high success rate generally especially in healthy nonsmoking patients and many of these patients can resume normal activities and work several months after the repair. Rotator cuff surgery is easier and more likely to be successful if I can do the repair less than six months after symptoms begin.   Repeat surgery is required in less than 10% of patients. 

 Older patients have a much better chance of responding to injections, physical therapy, home exercises, activity modification, and “wait and see” treatment.  

 Hope this helps.  Thanks for your time.

Mark Harriman, M.D. 

Low Impact Exercise

As we age past 40, our bodies lose muscle mass and bone density. So it is certainly wise to exercise in order to maintain as much muscle mass and bone density as possible.

That being said it’s important to listen to your body. In our 20’s and 30’s, the mantra for exercise is “no pain, no gain.”

I would suggest that after 40 you should listen to your body. If a certain exercise hurts, you may want to modify, decrease reps or even discontinue it altogether.

Safe low impact exercises include biking, ellipticals, rowing machines, yoga, Pilates and pretty much anything in a pool.

So try to implement some of these into your regular routine!

-Kenneth Grinspun, M.D

Memphis Orthopaedic Group Health Expo and Sports Physicals Event May 10th!

MOG Release 2 19 14 FINAL

FOR IMMEDIATE RELEASE

April 1, 2014

Contact: Michelle Hodges, Marketing Director

Phone: 901.240.0056

Memphis Orthopaedic Group  Health and Injury Prevention Expo and Sports Physicals

To Benefit Middle and High School Tipton and Lauderdale County Students

MEMPHIS, Tennessee–Memphis Orthopedic Group (MOG), a Division of MSK Group, P.C.  will host the first annual Health and Injury Prevention Expo on Saturday, May 10, 2014 from 8:30 am to 5:00 pm at Brighton High School located at 8045 Hwy 51 S, Brighton, TN. The event is being sponsored by Depuy Synthes Mitek Sports Medicine, *a leader in orthopaedic sports medicine and a part of the DePuy Synthes Companies of Johnson & Johnson, as well as Safe Kids Worldwide, and Methodist North Hospital. Medical specialists will be on-site to provide sports physicals and educate participants about common over-training injuries, proper stretching and injury prevention techniques, nutrition, hydration, concussions, recognizing cyber bullying and other health topics.

Students, family members and friends are invited to participate in a day of fun and learning at the expo featuring, food, entertainment, giveaways and educational breakout sessions. A hospitality room will be available for coaches, school administration and city officials. MOG is providing the sports physical service free of charge. Participating schools may choose to charge a fee, which the school can use for its own fundraising purposes. All proceeds will go directly to the schools to the benefit of their students.

“We’re thrilled to be able to provide this service to the schools and community. Sports participation offers a host of benefits, including teaching young people team-building skills, weight management, and social skills development. We anticipate the participation of eight to nine schools, and look to have anywhere from 800 to 1,000 students and their families join us for the sports physicals and associated activities, ” said Michelle Hodges, MOG Marketing Director.

Commenting on the event, Dan Hein, MSK Group, P.C., Chief Operating Officer “It is important to us as an organization to give back to the community and the schools, and this event is the perfect venue to do just that.”

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About Memphis Orthopedic Group:

Memphis Orthopedic Group has served the Greater Memphis area since 1942 and has five offices throughout the area. Walk-in access is available during the day, evenings and Saturdays. For more information on Memphis Orthopedic Group, please call 901.381.4664 or visit memphisorthogroup.com.

*DePuy Synthes Mitek Sports Medicine is a division of DePuy Orthopaedics, Inc.

Patient Testimonial — Dr. Manugian

I would like to thank Dr. Manugian and his staff for the excellent service I received during my visit in August. I came there unable to walk on my right foot.  After seeing another doctor, I came to MOG for a second opinion. Dr. Manugian took an assessment of my foot and did an excellent job in treating me.

 

The staff was courteous while maintaining their professionalism. I am doing well and would gladly recommend anyone to Dr. Manugian.

 

Thank you again for the treatment.

 

Charlotte R. Harris