HEALTH ON TIME Ortho - Fall 2016

ortho HEALTH ON TIME

FALL 2016

Getting Back in the Game

DON’T GET SIDELINED

BY SPORTS INJURIES

FIRST AID FOR SPORTS INJURIES

WHETHER ONE IS A DAILY JOGGER, weekend sports leaguer, or occasional golfer, skater or dancer, there is a chance of injury to muscles, ligaments, tendons or joints. Fortunately, sports medicine professionals specialize in the diagnosis and treatment of problems that can crop up in active individuals.

As a specialty, sports medicine draws on the skills and talents of health care professionals in many different disciplines, including orthopaedists, nurses, physical therapists and others, who help people to maintain or improve their physical performance. And when activity leads to injury, the sports medicine team can help an individual return to an active lifestyle.

Form follows function

A quick anatomy lesson can help you to understand how your body works or is affected by injury. We know about bones and muscles, but we do not often think about the connective tissues that hold those parts together and keep joints moving smoothly. Tendons attach muscles to bones, bones are connected to one another by ligaments, and joints are protected by capsules of cartilage and lubricated by a thick gel-like substance called synovial fluid. Disruptions in the system can cause pain, swelling or loss of function.

Over time, the repetitive motion involved in activities such as running and biking can lead to overuse injuries in the muscles and joints, causing chronic pain and discomfort. Even non-athletes can be sidelined by carpal tunnel syndrome or plantar fasciitis (pain in the heel), which also result from prolonged stress or repetitive motion. The good news is that most repetitive injuries can be treated effectively, allowing a quick return to an active lifestyle.

Other injuries that can be treated by orthopaedic sports medicine specialists range from mild to severe. More severe injuries are frequently caused by trauma generated by sudden force, such as a collision or fall, resulting in sprains, strains, fractures or dislocations.

IF YOU SUSTAIN AN INJURY while exercising or competing, you can follow these steps to help minimize pain — and prevent further injury — until you can follow up with a health care professional. An easy way to remember the steps is by using the acronym “R.I.C.E.”

Rest

Stop or limit sports activities and any activities of daily living that aggravate the injury site.

Ice

An ice pack will help to limit swelling, and the chill can lessen the perception of pain. Remove the ice pack after 20 minutes to prevent frostbite. Repeat ice pack application four to six times a day for two to three days.

Compression

Use wraps such as elastic bandages, tape, splints or air casts to immobilize the damaged tissues and keep swelling to a minimum.

Elevation

Use a pillow to support the affected limb above the level of the heart, if possible; this will also help to reduce swelling.

KEEPING YOU IN THE GAME To learn more about our services, visit augustahealth.org/play.

Certified athletic trainers provide expert care on-field and off IF YOU’VE BEEN TO a high school sports event, then you’ve probably seen the athletic trainers (ATs) from Augusta University Sports Medicine on the court, field or race route.

ATs are licensed and trained to evaluate and diagnose, as well as treat and rehabilitate all injuries in athletes. ATs are often an athlete’s main source of health care, and they primarily focus on prevention, recognition, treatment and rehabilitation of athletic injuries. They’re also experts on concussions and

work on other issues that result from or affect an athlete’s performance and health.

In addition to on-field injury evaluation, diagnosis and first aid, ATs provide an array of support services for athletes, including: • Preseason physicals and screenings • Concussion education programs • Heat injury prevention • Injury treatment and rehabilitation • Education and counseling The athletic trainers also run a fall sports injury program where they treat nonemergent injuries for school athletes and other active individuals on Saturday mornings at Augusta University Medical Clinic at West Wheeler.

ATs function in various settings, including athletics and performing arts, as well as industrial and tactical settings, such as military, law enforcement, and fire and rescue.

ATs at Augusta University Sports Medicine

work during athletic events for local high school and college teams and assist team physicians.

While they are usually out in the community at practices, home games or away games, they also see patients in the West Wheeler clinic. As such, they are integral to what Augusta University Orthopaedics and Sports Medicine offers to the region.

To learn more about our fall sports injury program, visit augustahealth.org/fallsports.

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Augusta University 1120 15th St. Augusta, GA 30912

NONPROFIT U.S. POSTAGE PAID AUGUSTA UNIVERSITY

BONES AND JOINTS UND It’s All Fun and Games Until Someone Gets Hurt GET THE HELP YOU NEED TO STAY IN THE GAME INJURIES AFFECT PERFORMANCE not only in one’s preferred sport or exercise program, but they also disrupt daily activities at home and work. Pain from injury can even affect sleep patterns, so getting proper treatment is important for one’s overall well-being.

Common sports injuries

It helps to know what terms for some sports injuries mean. A sprain refers to a stretch or tear in a ligament or joint capsule, while a strain is a pulling, twisting or overextension of a muscle or tendon. Sometimes a health care professional might describe a problem as “tendinitis” or “bursitis”; the suffix “-itis” indicates that a certain body part is inflamed or swollen.

Treatments DEPENDING ON THE SEVERITY of an overuse or sports injury, sports medicine professionals have an array of treatments to offer. The patient may be given a course of exercises or braces that can be managed at home. Medications for pain relief can include over-the-counter analgesics or prescription painkillers.

Inflammation that does not respond to oral anti-inflammatories may require steroid injections to help soft tissues heal.

More serious or prolonged problems might require invasive procedures. These can range from arthroscopic surgery — a minimally invasive procedure to repair damaged tissues around a joint that has a high success rate and short recovery period — to open surgery for more complex issues.

Arthroscope

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Tend iceps

Patella (knee cap)

Quadr

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Articular Cartilage & Ligament

Tibia (shinbone)

ula

Meniscus

Fi b

Surgical Instruments

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Femur (thighbone)

During arthroscopic surgery, two or more instruments are inserted into the joint through small incisions. The surgeon views the damaged tissue through the arthroscope and uses the slim surgical tool to make repairs.

FRACTURES OR BREAKS CAN OCCUR in just about any bone.

In most cases there will be significant pain, and the affected limb might look misaligned. Bone breaks are a medical emergency and require a visit to the emergency department for X-rays, diagnosis and immobilization.

Be proactive about your health! Visit us online at augustahealth.org/ortho, or call 706-721-2741.

ER STRESS Wrist sprain — This injury is most frequently caused by an unexpected fall (common among skateboarders) but can occur as the result of wrenching (as with a hockey stick or ski pole).

Tennis elbow — Inflammation of the tendon on the outside of the elbow is caused by repetitive flexing and bending of the wrist and results in burning pain and weak grip strength.

Rotator cuff strain — This overuse injury can occur in sports with repetitive overhead arm movement, as is done by baseball pitchers or swimmers, causing inflammation of the muscles and tendons of the front or back of the shoulder.

Wrists, Elbows and Shoulders

Subluxation of the shoulder — Also known as shoulder instability, this overuse injury is caused by repeated stretching and tearing of the shoulder ligaments, which results in looseness and allows the top of the arm bone to slip out of place (although not to the extent of a full shoulder dislocation).

TRAVEL BALL SURVIVAL KIT IF YOU OR A LOVED ONE regularly travels some distance for competitions, be sure to have a bag regularly stocked with the following items: First-aid kit that includes: ■ ACE wraps — two double-length, 6 inches and 4 inches wide ■ Assortment of bandages ■ Gauze pads and skin-friendly tape ■ Antibiotic ointment ■ Sunscreen ■ Empty bags for making ice bags (several) ■ Ice packs (2–4)

isposable gloves D Water to avoid getting dehydrated (iced down) ■ Sports drinks to hydrate (iced down) ■ Healthy snacks, including trail mix or protein bars ■ Chocolate milk as a recovery drink, because it contains the right amount of carbohydrates, protein and fat ■ ■

Drink Up

DEHYDRATION OCCURS when you use or lose more fluids than you take in. Watch out for these signs of dehydration: ry, sticky mouth D Extreme thirst ■ Sleepiness or tiredness in children; irritability and confusion in adults ■ ■

ecreased or no D urination, and any urination produced is darker than normal ■ Few or no tears when crying ■

■

Constipation

■ Headache, dizziness ■

or lightheadedness apid breathing R and heartbeat

If you suspect dehydration, call 911 right away.

Lower Legs and Knees

Sprains of one or more ligaments of the knee — anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL) — stretching or tearing the ACL can occur after a sudden change in direction, while a blow to the outside of the knee is a frequent cause of damage to the MCL. Torn knee cartilage — The meniscus is a thick pad of cartilage that acts as a shock absorber between the thigh and shin bones; a torn meniscus often happens in contact sports, but can happen to anyone.

Feet and Ankles

Ankle sprain — torn lateral ligaments of the ankle — is common in sports with rapid directional change.

The Achilles tendon can become inflamed or torn, often as the result of stress during high acceleration.

To learn more about Augusta University Sports Medicine, visit augustahealth.org/play.

DON’T LET A THROWING INJURY THROW YOU OUT OF THE GAME

Q&A

ASK THE EXPERTS ABOUT IMPORTANT HEALTH ISSUES

ARE THERE GENDER DIFFERENCES IN POTENTIAL SPORTS INJURIES? While exercise has many health benefits, women who train to the point of missed periods risk long-term problems. Lower estrogen levels can lead to bone loss and early osteoporosis. Athletes need to take in enough calcium and vitamin D to strengthen bones and avoid decreased athletic performance and potential injury.

IS STRETCHING VALUABLE? Some studies show that stretching can help range of motion, flexibility and blood flow to muscles. The best approach is to: ■ Stretch after warming up muscles for at least five to 10 minutes — or wait until after your main workout.

■ Concentrate on major muscles in the calves, thighs, hips, lower back and shoulders, and hold stretches for 30 seconds or longer.

■ Aim for symmetry. Match stretches on right and left sides, even if one side feels like it needs more.

HEALTHY NEWS BONE DENSITY VS. SCREEN TIME A study of nearly 700 adolescents in Norway showed a relationship between longer time spent with computers and television (versus time spent exercising) and lower bone mass density (BMD) in teen boys.

The study, reported in BMJ Open, also showed that the lower BMD persisted for two years. Lower bone density at this age could signal future risk for fracture as these are the prime years for completing skeletal scaffolding. Girls in the same age range with higher “screen time” actually had higher BMD; further research is needed to determine if girls’ estrogen levels play a protective role.

CONCUSSION IN SPORTS Better information about traumatic brain injury in nonprofessional and school sports is helping players, coaches and parents look for signs of concussion.

Concussion is caused by the brain rocking against the inside of the skull because of a blow, collision or fall, and can occur in any high-speed sport, including baseball, basketball or soccer. The concussed person might not lose consciousness but can show signs of confusion, headache, nausea, poor coordination, or changes in mood or sleep patterns. If these occur at any time up to two weeks after a head injury, seek professional medical help. The greatest brain damage comes after repeated concussions, so do not resume practice or play until a medical professional gives the all-clear.

However, doing so moves the top of the arm bone forward, which places stress on the connective tissue in the front of the shoulder. Over time, the connective tissue loosens, which helps the thrower rotate his or her shoulder even farther away from the midline of the body and throw the ball faster — but, as the connective tissue loosens, the thrower has less shoulder stability.

“It’s difficult to predict who will have problems,” says Dr. Mark Fulcher, director of hand and upper extremity surgery at Augusta University Orthopaedics. “Though we do know that kids who throw all year long — summer and school time — will experience more injuries.”

Dr. Lynn Crosby, director of shoulder surgery at Augusta University Orthopaedics, has advice for fending off throwing injuries.

“It’s important to stretch and strengthen under the supervision of an experienced athletic trainer in the preseason to prevent throwing problems,” he said.

Augusta University Orthopaedics is here to help you stay in the game. Look no further than the area’s only health center with fellowship-trained specialists in each orthopaedic subspecialty.

Monte Hunter, MD Chair of Orthopaedics and Director of Sports Medicine Board-certified in orthopaedic surgery and fellowship trained in primary care sports medicine and orthopaedic sports medicine

Lynn Crosby, MD Director of Shoulder Surgery

Board-certified in orthopaedic surgery and fellowship trained in shoulder surgery

Mark Fulcher, MD Director of Hand and Upper Extremity Surgery

Board-certified and fellowship trained in hand surgery

Drs. Hunter, Crosby and Fulcher each have more than 20 years of experience in their respective specialties.

If you think that you or a loved one is experiencing a throwing injury, call 706-721-2741, or visit us online at augustahealth.org/ortho.

Copyright © 2016 GLC, Skokie, IL 60077 U.S.A. This publication is not meant to replace professional medical advice or service. Personal health problems should be brought to the attention of appropriate medical professionals.

THROWING IS A COMPLEX MOTION that requires a stable foundation starting with the legs and rotation of the pelvis. The shoulder has to be stable to produce power, and the outer head of the bicep is key in stabilizing the head of your upper arm bone.

Rotating the shoulder away from the midline of the body helps the thrower throw the ball faster.