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CFO & McNeese A WINNING COMBINATION
INmotion
A PUBLICATION FOR
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CONTENTS
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CFO & MCNEESE: A WINNING COMBINATION Coach Brooks Donald Williams with standout MSU players, twins Ashlyn and Caitlyn Baggett from the 2012-2013 season.
COVER 4 Sports Update
FEATURES 6 News For Knees 7 Hip Tips 10 WCCH Honors 11 Joint Points 12 Foot Notes 13 Back Talk 14 Drez Retires
CONTENT 3 News Briefs 8 Bare Bones Facts 15 Patience Puzzles INmotion
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In Motion Magazine, Vol. 3, August 2013 Publication of Center for Orthopaedics CONTACT US:
CENTER FOR ORTHOPAEDICS Lake Charles Sulphur DeRidder 1747 Imperial Blvd. Lake Charles, LA 70605 (337) 721-7236 www.centerforortho.com
About CFO
Center for Orthopaedics, an affiliate of Imperial Health, is the largest musculoskeletal group in Southwest Louisiana and Southeast Texas. The group was founded 19 years ago and has offices in Lake Charles, Sulphur and DeRidder.
[WHAT’S NEW AT CFO] CENTER FOR ORTHOPAEDICS LAUNCHES ORTHO EXPRESS According to a study by Merritt Hawkins and Associates, the average national wait time to see a physician specialist is over 20 days. While the wait time locally is not that long for most specialties, CFO has launched OrthoExpress, a new service to ensure that anyone who has a musculoskeletal injury can be seen by one of their specialists within 24 hours, Monday through Friday. OrthoExpress is designed to provide convenient, responsive access to expert care for sports injuries, broken bones, joint injuries, sudden back or neck pain, work-related injuries and any other musculoskeletal injuries. The service gives patients and referring doctors quick access to specialized care when it’s needed – not weeks after an injury occurs.
DR. NOBLE NAMED LOA PRESIDENT
DR. GREEN WORKS WITH SPECIAL OLYMPIANS
Dr. John Noble was appointed President of the Louisiana Orthopaedic Association, a statewide, professional membership organization comprised of 350 board certified and/or board-eligible orthopaedic surgeons. Dr. Noble has over 17 years of private practice experience, the last 12 of which have been at CFO. He serves as Medical Director for McNeese State University’s Athletic Department and as a Clinical Instructor of Orthopaedics for LSU School of Medicine. He is also actively involved in orthopaedic research projects, including studies relating to new technology for cartilage growth, knee replacement, hip resurfacing and surgical technology. He is a frequent guest instructor and speaker at conferences across the country.
Dr. Tyson Green, foot and ankle specialist, recently screened more than 130 athletes through the Healthy Athletes Fit Feet program held by the Special Olympics Louisiana state games in Hammond. Dr. Green is certified as a Clinical Coordinator by the Special Olympics Training Center in Boston. He supervises the organization’s Fit Feet program, a free podiatric screening for Special Olympics athletes. Fit Feet is conducted in partnership with the International Federation of Podiatrists (FIP) and the American Academy of Podiatric Sports Medicine. At the state games in May, Dr. Green’s wife, son, mother-in-law and brother-inlaw volunteered with him, along with staff from Center for Orthopaedics.
DR. COLLINS HONORED BY WCCH
OUR ATHLETIC TRAINING TEAM IS GROWING
West Calcasieu Cameron Hospital recently presented orthopaedic surgeon Dr. Geoffrey Collins their 2013 Physician of the Quarter Award as part of its ongoing commitment to honor physicians for dedication in their fields and communities. Dr. Collins has served on the medical staff at WCCH for nine years as an orthopaedic surgeon/sports medicine specialist. He is also a team physician for McNeese State University’s Athletic Department.
Three members have been added to the staff of athletic trainers to serve the increasing number of high schools that receive sports medicine services from CFO. Ariel Greene, ATC, LAT, is a graduate of Kinder High School and McNeese State University. She is currently completing coursework to earn a Master of Science degree with a concentration in exercise physiology. She is a certified member of the National Athletic Training Association and the Louisiana Athletic Training Association. Arkansas native Lauren Knight holds an undergraduate degree in athletic training from Central Arkansas University and a Master of Science degree in exercise physiology from McNeese State University. She is a BOC Certified Athletic Trainer and is also licensed by the states of Louisiana and Texas. She was recently employed as a graduate assistant at McNeese State University. Jessica Veillon, ATC, is from Westlake and earned an undergraduate degree in athletic training from McNeese State University. She will graduate with a master’s degree in exercise science from the University of Louisiana-Monroe in December. Jessica is currently working as a graduate assistant, athletic trainer at ULM andINismotion a certified member of the National Association of Athletic Trainers.
DR. POURCIAU PRESENTS AT STATE CONFERENCE Dr. Kalieb Pourciau, a foot and ankle specialist, was a guest speaker at the recent annual Louisiana Podiatric Medical Association’s annual conference held in New Orleans. His presentation covered lower extremity injuries and advances in treatment options.
DR. LOWRY NAMED MEDICAL DIRECTOR FOR TRI PARISH REHABILITATION HOSPITAL Dr. William Lowry, physical medicine and rehabilitation specialist at Center for Orthopaedics, has been named rehabilitation medical director at Tri Parish Rehabilitation Hospital in Rosepine. Dr. Lowry will lead the medical staff and be responsible for overall quality of treatment for the 20-bed hospital. ISSUE 3
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CFO & MCNEESE SPORTS: A WINNING COMBINATION It doesn’t take a team to only win a game - it also takes one to prevent and treat injuries when the game serves up more than a win. That’s why it’s vital that athletes, coaches and sports medicine physicians operate as a well-oiled machine, according to Brooks Donald Williams, championship-winning Head Coach for McNeese Women’s Basketball. The relationship between coach and physician is particularly important because they are the key figures charged with keeping athletes – many of whom are far away from their families – safe and healthy. Williams says it’s not enough for the coach and physician to get along. “We all have to understand and appreciate the functions and roles of our respective jobs, and how these roles play into the well-being of the athletes,” Dr. John Noble Jr., head team physician, agrees. “Obviously, physicians need to understand common injuries, and have a skilled understanding of how to treat them, but they also need to have an understanding of the game, how it’s played, the most common injuries, the medical history of the athletes, the demands of upcoming games and more.” Williams says the relationship the CFO doctors have with the coaching staff and athletes at MSU is “second to none.” Communication plays a critical role. “These doctors do a phenomenal job of relaying information in a timely manner and allowing us, the coaches, to ask questions about the injury and recovery process, which is obviously vital to our program and the team’s success. This gives us the confidence and knowledge to share with the “We’d be very happy athletes and their families.” if we never had to “When the coaching and sports treat an injured medicine staff have open dialogue and good athlete, but sports are communication, the athletes benefit from physical and injuries shared knowledge and understanding,” says will occur. Dr. Noble. Most people think of team physicians as a resource when there is an injury, but their role begins long before the first game takes place. “Our primary goal isINtomotion keep athletes free from injury, so we work very closely with the 4 l
coaching staff and the athletes to ensure that proper conditioning and injury-prevention strategies are in place,” says Dr. Noble. “We’d be very happy if we never had to treat an injured athlete, but sports are physical and injuries will occur. When they do, we’re ready to provide immediate care.” Ashlyn Baggett, back-toback Southland Conference Student Athlete of the Year, got to know the CFO doctors very well during her time as a Cowgirl. “Ash was plagued with several injuries throughout the season, but our team doctors and athletic trainer, Maria White, did a terrific job of caring for her and keeping her safely in the Ashlyn Baggett game,” said Williams. “This Southland Conference Student Athlete of the Year enabled her to lead us to the longest post-season play in Cowgirl basketball history, including a spot in the finals of the Women’s Basketball Invitational.” Another player, Liz Kingham, was injured her entire career as a Cowgirl, but was able to return for the end of her senior season to help guide the team in an amazing season. “Dr. Noble was with Liz every step of the way. Our entire program, as well as Liz and her family, were thrilled that Liz was able to finish out her career with a uniform on,” said Williams. According to Williams, it’s that connection with the coaches and athletes that sets the CFO physician team apart. “These guys have so much passion for McNeese. Their level of commitment to our players and our success on and off the court is a tangible thing, and one that makes a huge difference to our entire organization.” ISSUE 3
CFO AND BEAUREGARD MEMORIAL HOSPITAL TEAM UP FOR SCHOOL ATHLETES IN BEAUREGARD AND VERNON PARISHES The school boards in Beauregard and Vernon Parishes have chosen Center for Orthopaedics (CFO), an affiliate of Imperial Health, and Beauregard Memorial Hospital as their exclusive providers of sports medicine services for high school athletes. CFO will provide athletic trainer coverage for each school’s athletic events and work with the coaches and student trainers on injury prevention and concussion protocols. In addition, Beauregard Parish athletes will have access to sports clinics and a wide variety of assessment and educational opportunities throughout the year. “This partnership with Center for Orthopaedics adds a tremendous depth of sports medicine experience to the services we provide,” says Nathan Tudor,
CEO/Administrator of Beauregard Memorial Hospital. “Our young athletes will now receive the same quality care as McNeese athletes, which will keep them healthier on and off the field.” “We are very excited about expanding our sports medicine service to Beauregard and Vernon Parishes,” says Dr. John Noble Jr., orthopaedic surgeon. “We’re looking forward to working closely with the staff of Beauregard Memorial, as well as the coaches, parents and athletes in the area.” Beauregard Memorial Hospital has been serving the healthcare needs of Beauregard and surrounding parishes for 63 years and is committed to the continual improvement and expansion of healthcare in the interest of better serving the needs of all of our community.
CFO INTRODUCES CONCUSSION MANAGEMENT PROGRAM Center for Orthopaedics has implemented a concussion management team designed to educate, prevent and treat concussions among student-athletes. The team was developed in compliance with the 2011 Louisiana Youth Concussion Act and following recommendations from the Louisiana High School Athletic Association. CFO is the sports medicine provider for Cameron and Beauregard Parishes, as well as the team physicians for McNeese State University’s Athletic Department. Although concussions are typically mild and leave no evidence of long-term damage, the extent of the injury with some concussions can have lasting consequences. It is vital that parents, athletes and coaches understand the symptoms of a concussion and the need for early detection and proper treatment. The team is under the medical direction of Dr. Errol Wilder, a family medicine physician with Imperial Health who has specialized training in concussion management, including programs at Penn State University, Inova Health System in Washington D.C. and the Louisiana State University Health Science Center. According to Dr. Wilder, a concussion is characterized by trauma to the brain, caused by either a direct blow to the head or an indirect blow to the body, causing neurological impairments. The resulting functional disturbance to the brain can cause a combination of symptoms that ISSUE 3
includes headaches, nausea, difficulty with concentration, memory loss, irritability, problems with sleep, and fatigue. “Symptoms usually resolve within one to two weeks, but a concussion is a brain injury— and that’s something that should always be taken seriously,” said Dr. Wilder. The concussion management team of certified athletic trainers, registered nurse practitioners and board certified physicians will educate athletes, parents and coaches on the importance of reporting signs and symptoms of concussion to help prevent long-term complications. All participating athletes will be asked to sign agreements to report concussion symptoms. According to Dr. Wilder, “If a concussion is not recognized or is left without appropriate treatment and the athlete gets back in the game too soon, there is a greater risk for long-term injury. CFO’s Sports Injury hotline allows access to a trained professional to address any concerns with an athlete that may have sustained a concussion. Adds Dr. Wilder, “We consider every concussion to be serious and want to educate others to do the same. By taking the proper steps after the initial injury for every concussion, we greatly decrease the risk for long-term problems that could affect a young athlete into adulthood.” For more information or to access the concussion management INmotion team, call (337) 439-7220. l 5
[NEWS FOR KNEES] DR. JOHN NOBLE FIRST IN STATE TO PERFORM INNOVATIVE TREATMENT FOR KNEE ARTHRITIS Lake Charles firefighter Danny Zimmerman was at home splitting firewood when he twisted the wrong way and heard a pop in his knee, followed by searing pain. It didn’t take long for the pain to become intolerable, requiring medical intervention. He saw orthopaedic surgeon Dr. John Noble Jr. who diagnosed arthritis in his knee as the source of his problem. Fortunately, Zimmerman sought treatment early enough to become the first in Louisiana to undergo a new bone-preserving procedure in his knee known as subchondroplasty. This new advance in arthritis treatment involves injecting a cement-like substance into the knee to prevent or delay further deterioration. “It is a reabsorbable calcium phosphate material,” Dr. Noble explains. “Over time the bone will reabsorb it and replace it with a healthy new tissue.” An estimated 27 million Americans suffer from some form of osteoarthritis, a condition that causes breakdown of cartilage and bone in load-bearing joints. Individuals with chronic knee pain associated with early knee arthritis have had few treatment options. “Once cartilage is gone, it cannot be regenerated,” according to Dr. Noble. “Traditional treatments either do not address the underlying cause
of knee pain, or do so at the expense of the entire joint. Advances in early and preventive treatment are crucial to limit further damage and bone loss from knee arthritis and to improve a patient’s quality of life,” says Dr. Noble. “That’s exactly what subchondroplasty does. It allows us to address structural breakdown of bone during the early stages of arthritis and delay progression of the disease, while simultaneously providing pain relief.” During the outpatient procedure, a fiber-optic instrument is used along with fluoroscopic guidance to inject the biologic cement into the bone defect. This cement immediately hardens, stabilizing the bone and reducing irritation in the joint. Dr. Noble says it is ideal for patients 40-75 years of age who experience chronic knee pain due to bone marrow edema, which is a precursor to arthritis. “The best chance to preserve bones is through early intervention,” says Dr. Noble. For Zimmerman, a tiny dot is the only mark left behind from his treatment. “After the surgery, I wore a brace for a about two weeks, then I was up and walking around. I’m now pain-free!”
CYCLING AND KNEE PROBLEMS
The Bureau of Transportation Statistics at the US Department of Transportation estimates that more than 50 million Americans ride bicycles regularly. As more people enjoy the sport, the number of cycling-related musculoskeletal injuries is also rising, with most caused by overuse, according to orthopaedic surgeon Dr. Jonathan Foret. The smallest amount of misalignment can lead to dysfunction, impaired performance, and pain. “Knee injuries are the most common overuse injuries among cyclists,” says Dr. Foret. Pain on the outside of your knee during your pedal stroke may be aggravated by friction on your iliotibial (IT) band—a long, fibrous tendinous sheath located on the outside of your leg, extending from your hip to past your knee. Lowering your seat, stretching, antiinflammatories and ice may help alleviate IT band syndrome. Pain behind your kneecap may be a sign of chondromalacia, a progressive softening of your patellar cartilage (the cushion between your bones). To relieve this pain, pedal easy gears and try raising your seat a little. Strengthening the quadriceps on the inside of your knee by using the leg extension machine in your gym can also help with this problem. If you pedal big gears or don’t warm up properly, you may find yourself limping through a severe case of patellar tendinitis. “Your patellar tendon is soft tissue just below the kneecap,” explains Dr. Foret. Try spinning faster in your small chain ring. Treat by icing the patellar tendon for five minutes, massaging it for five minutes and then repeat. Pain on the back of the medial (inside) of the knees may be caused by friction of three muscles, the sartorius, gracilis and semitendinosus, rubbing together. The best recommendation for this inflammation is rest, ice and lowering your seat. INmotion When evaluating knee pain and cycling-related overuse injuries, Dr. Foret says important considerations include bicycle fit, training distance and intensity, and the individual anatomy. 6 l
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[HIP TIPS]
NEW HIPS GIVE WOMAN NEW LEASE ON LIFE Roxie Buroughs
For Roxie Buroughs, something as simple as putting one foot in front of the other was painful. After suffering with hip problems for years, including a hairline fracture and pins to stabilize both joints, she dealt with continual pain and limited mobility. Then she broke her left hip in 2011. Orthopaedic surgeon Dr. George J. Trappey recommended a total hip replacement with an advanced twist: “The difference is in the approach, thanks to surgical technique advancements and specialized equipment. We use a direct anterior approach for total hip replacement versus the traditional posterior approach.” The technique allows the surgeon to replace the hip joint without detaching any muscles from the pelvis or femur. Traditional hip surgery uses a posterior or anterolateral approach in which the patient lies on their side and the surgeon accesses the hip joint by cutting through skin, tissue and muscle. “With the direct anterior approach, the patient lies on their back on the Hana table, a special table at Women and Children’s Hospital. We make a smaller incision across the front of the hip and accesses the joint by going between the muscles in the leg, rather than cutting through them. Because the muscles and tendons used for walking are not cut with this less-invasive approach, recovery is quicker.” The direct anterior approach reduces the amount of pain, as well as limitations after joint replacement. “Immediately after surgery, most patients are weight-bearing and walking. Patients can expect to remain in the hospital usually no more than two days, with full recovery expected in two to eight weeks.” Buroughs says: “I went home and didn’t even take my pain meds. I was moving around pretty easily right away.” Buroughs was so happy with her new left hip that she decided to have the right one replaced the same way less than a year later. “I feel almost as good as I did before I ever started having hip problems, and for a 69-year-old, that’s pretty amazing. I’m able to do all the things I need to do.”
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WAYS TO BEAT HIP PAIN
The hip is the largest weight-bearing joint in the body, supporting three times the body’s weight with each step. According to orthopaedic surgeon John Noble, Jr., MD, hip pain is becoming more common as baby boomers get older. Hip pain can have many causes, ranging from arthritis or bursitis to strained muscles or tendonitis. “Not all of these are serious, and there are steps you can take on your own to ease pain and keep the muscles and joints of the bone strong.” Dr. Noble offers these suggestions for moving past hip pain: Lose Weight. Getting rid of excess body weight can help to relieve the strain on your hips. Research shows that for every pound you lose, you take two to three pounds of pressure off your hips. Medicate. Take non-prescription anti-inflammatory medications such as ibuprofen. Use ice. Ice is the first line of defense against hip pain. Apply the ice at the site of pain for 15 – 20 minutes, as often as every one to two hours. Do not apply directly to the skin. Use heat. Heat can help relax tight, stiff muscles and improve circulation after an injury. However, do not use heat during the first 48 hours after an injury occurs. After that, alternate heat and ice. Take it easy. Don’t place too many demands on an aching hip. In general, avoid activities that aggravate your pain until you recover. Use support. When you try to avoid bearing weight on your sore hip, you can easily strain muscles and tendons in other areas, so don’t hesitate to use a cane or walker for support and stability. Adjust your movements. If you want your hip to recover, you may need to adjust how you move. For example, when getting out of a car, lift and swing both legs out of the door before standing, and stand with both legs at the same time. By rotating on your rear instead of twisting your pelvis, you will lessen the strain on your hips. Gentle exercise. Water aerobics and yoga are great exercises that will keep your hip limber. Water takes the weight off your hip and allows you to do more without pain than you could on dry land. If you suffer from chronic hip pain, yoga can also enhance flexibility. If pain persists, or worsens, Dr. Noble says you should contact an orthopaedic specialist for further evaluation to determine the exact cause of your pain and an appropriate treatment recommendation. INmotion
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Gliding joints are found between flat bones that are held together by ligaments. Some bones in the wrists and ankles move by gliding against each other.
The pivot joint in the neck allows it to turn from side to side.
Your fingers are moved mainly by the muscles of your forearms which are connected to your fingers by long tendons.
Some of the biggest muscles are found in your back, near the spine. These muscles are responsible for keeping your body upright and give the body the power it needs to lift and push things.
The bones in your body provide a framework for a healthy, active life, but that framework is held together, protected and supported by an intricate network of muscles, tendons and ligaments.
[ALL THE RIGHT CONNECTIONS]
Joints are the place where two bones meet or connect.
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Hinge joints are those in the knee and elbow. They enable movement similar to the way a hinged door moves.
Ellipsoidal joints, such as the one at the base of the index finger, allow bending and extending.
Most humans have about 4,000 tendons, which are cords of elastic tissue that “tie� a muscle to a bone or a muscle to another muscle. A tendon serves to move the bone or structure.
Ligaments are short bands of tough, fibrous connective tissue that connect one bone to another, forming the joint.
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Each step you take requires action from 200 different muscles
The longest tendon stretches near the calf and heel bone. It is called the Achilles tendon.
Your leg muscles enable you to take approximately five million steps each year.
The gluteus maximus is the largest muscle in your body.
Your hands contain 20 different muscles.
WEST CALCASIEU CAMERON HOSPITAL RECEIVES BLUE DISTINCTION CENTER+ DESIGNATION, TWO GRADE “A” PATIENT SAFETY AWARDS Improving health outcomes is every hospital’s mission, but one local hospital has changed its healthcare delivery model, and people are noticing. Early this year, Blue Cross and Blue Shield of Louisiana named West Calcasieu Cameron Hospital (WCCH) as a Blue Distinction Center+ in Knee and Hip Replacement. The Blue Distinction Centers for Specialty Care® program is a national designation awarded by Blue Cross and Blue Shield companies to medical facilities that have demonstrated expertise in delivering quality specialty care. Since 2006, consumers, medical providers and employers have relied on the Blue Distinction program to identify hospitals delivering quality care. The selection criteria used to evaluate facilities were developed with input from the medical community and include general quality and safety metrics plus program specific metrics. According to WCCH Chief Executive Officer Janie Frugé, such a notable recognition demonstrates the hospital’s commitment to quality Janie Frugé WCCHcCEO are, and efficiency. “An accomplishment like this is the result of teamwork all the way from our Board of Commissioners to our physicians to our staff members. It speaks to who we are and what we’ve been able to accomplish by working together,” she said. “The field of orthopaedics has grown increasingly more sophisticated in its level of treatment. It’s important that patients know where to turn for quality care and demonstrated expertise,” said Dr. Geoffrey Collins. “WCCH has proven their commitment to making advances in care available in Southwest Louisiana. Designations like these distinguish institutions that offer the highest level of health care, and for us and our patients, that knowledge is invaluable.” Research confirms that the newly designated Blue Distinction Centers+ demonstrate better quality and improved outcomes for patients, with lower rates of complications and readmissions than their peers. “This distinction is supported by solid data and achievements. It is not an accomplishment that is takenIN lightly—it motion shows that West Calcasieu Cameron places a genuine focus on high standards of care. This applies not just to the level of skill provided 10 l
to its patients, but the level of cost efficiency,” Dr. David Carmouche, chief medical officer at Blue Cross and Blue Shield of Louisiana. “The expanded emphasis on both quality and cost efficiency takes the program to a new level. As for our network facilities that have been named Centers of Blue Distinction, we are proud of their commitment. We are eager to continue working with these top providers to give our mutual customers access to quality, affordable healthcare.” Blue Distinction Centers+ also are more than 20 percent more costefficient. The program provides consumers with tools to help them make better informed healthcare decisions. These results will also enable employers, working with their local Blue Plan, to tailor benefits to meet their individual quality and cost objectives. In May, the Leapfrog Group recognized West Calcasieu Cameron Hospital with an “A” Hospital Safety Score based on the hospital’s overall capacity to keep patients safe from infections, injuries, and medical and medication errors. It is the first and only hospital safety rating to be peer-reviewed in the Journal of Patient Safety (April 2013). “As the only hospital in Calcasieu Parish to receive an ‘A’ grade for the second time since November of last year, this accomplishment speaks volumes about the care we deliver. Our team is continuously looking at ways to improve, and while we have received the highest score once again, we still know that we can be better. Patient safety is our top priority,” says Fruge. “Earning the top ‘grade’ on the Hospital Safety Score demonstrates WCCH’s ongoing commitment to excellence in patient care – a commitment we appreciate on behalf of our patients,” said Dr. John Noble Jr. “We congratulate West Calcasieu Cameron Hospital for its achievements and are proud to be a part of their medical staff.” To see West Calcasieu Cameron Hospital’s scores as they compare nationally and locally, visit the Hospital Safety Score website at www.hospitalsafetyscore. org, which provides information on how the public can protect themselves and loved ones during a hospital stay. Local hospitals’ scores are also available on the free mobile app, available through the website.
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[JOINT POINTS] BREAK THE CYCLE OF REPETITIVE STRESS INJURIES We’re all taught that practice makes perfect, and that repetition leads to success. While that may be true, it’s also true that repetition can lead to overuse injuries when it comes to certain types of activities. Orthopaedic surgeon Dr. Steven Hale explains that overuse injuries, also called repetitive stress injuries, are more subtle than an acute, traumatic injury and usually occur over time. Those most at risk for overuse injuries engage in activities that include repetition, high force, direct pressure, vibration, awkward joint positions and/or prolonged, constrained posture.
USE THESE COMMON-SENSE Dr. Hale says if your sport, occupation or hobby involves two or more of these risk RULES TO PREVENT OVERUSE factors, you’re at greater risk of developing an overuse injury. “Basically, every tissue has INJURIES IF YOU ARE INVOLVED IN its breaking point, and if enough of these factors are combined, then pain and injury may HIGH-RISK ACTIVITIES: result.” • Take frequent breaks. Overuse injuries are most often seen in athletes, and have led to several commonly used • Stretch the muscles you use before and after the specific terms: tennis elbow, shin splints, swimmer’s shoulder, little league elbow, tennis elbow, activity or job you are performing. Achilles tendonitis and jumper’s knee.” • Listen to your body. Pain is your body’s way of telling Work-related overuse injuries are also common. These, such as carpal tunnel syndrome, you that something isn’t right. If something hurts, stop. are usually associated with repetitive hand movements, but Dr. Hale says any part of the • Use good posture and proper technique. body can be affected. Overuse injuries do not always require medical attention. Dr. Hale says most symptoms can be managed with self-care measures, such as rest, ice or heat packs, and over-the-counter anti-inflammatory medications. You should see your doctor if you experience pain associated with the activity for two consecutive days or longer, or if the problem is occurring with increasing frequency. The diagnosis of overuse injuries can usually be made after a thorough history and physical examination. In some instances, x-rays or additional tests may be needed. Treatment depends on the specific diagnosis, but prevention is always preferable, Dr. Hale says.
BEING A BABY BOOMER DOESN’T HAVE TO BE A PAIN The generation of peace and love has evolved into the generation of aches and pains. Baby Boomers — people born between the years 1946 and 1964 — are getting older. In 2011, the first of the baby boom generation reached what used to be known as retirement age. And for the next 18 years, boomers will be turning 65 at a rate of about 8,000 a day. As a group, they’re living nearly twice as long as previous generations, and for the most part, are remaining much more active. However, this generation is less resigned to simply accept injury and pain as an inevitable part of aging, and, according to orthopaedic surgeon Dr. Geoffrey Collins, they don’t have to. Dr. Collins says the original source of pain is typically just the natural wear and tear that occurs to joints over time. “As you get older, your joints start to show the signs of years of use, just like anything else.” He explains that Boomers often unknowingly make their problem worse by cutting back on their activities when they experience joint pain. This results in a loss of muscle strength, decreased range of motion, reduced circulation to the area, and stiffness. “So the next time they need to exert that part of their body, they experience more pain and stiffness due to inactivity. Pretty soon, that knee or back is painful any time they move. It’s a vicious cycle that can quickly lead to an extreme reduction in activity and chronic pain.” The good news is that Baby Boomers do not have to live with the pain. “We have an arsenal of nonsurgical interventions that can often eliminate – or at least delay – the need for surgery for joint pain,” says Dr. Collins. The first step is a comprehensive physical exam to assess functional status. “The treatment is determined based an each individual’s unique situation – their pain level and functional capacity,” says Dr. Collins. “Conservative treatment options are always our first choice, but if the problem reaches a point where surgery is needed, there are many new minimally invasive advances that can help us help patients regain the active lifestyle they enjoy.” ISSUE 3
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[FOOT NOTES]
DIABETICS:
STAY ON YOUR TOES WHEN SHOPPING FOR SHOES Foot problems are a well-known risk associated with diabetes. The disease can cause reduced blood flow to the feet, depriving them of oxygen and nutrients. This makes it more difficult for blisters, sores, and cuts to heal. Diabetic nerve damage called peripheral neuropathy can cause numbness in your feet. “When you can’t feel cuts and blisters, you’re more likely to get sores and infections,” explains Dr. Tyson Green, foot and ankle specialist. “If you don’t notice or treat these sores, they can become deeply infected. This is what typically leads lead to amputation.” Many potential problems can be avoided by wearing the right shoes. “If your disease is well-controlled, you may not need what people commonly call ‘diabetic’ shoes. You can just focus on getting a good shoe with a good fit, and checking your feet regularly for any problems. But if you have uncontrolled blood glucose levels or a history of foot complications, therapeutic shoes are recommended. For high-risk patients, protective shoes and orthotic inserts provide a frontline for preventing foot ulcers. This is why we make those available in our office, along with the services of a certified diabetic shoe fitter.” Therapeutic shoes must meet certain requirements to qualify for Medicare Part B coverage. According to Dr. Green, these shoes have to have extra depth, be able to accommodate custom inserts, and must have protective features that diabetic shoes need, like a protective toe and heel. Whether choosing regular or diabetic shoes, the main thing to look for is a good fit. The distance between your longest toe and the tip of your shoe should be one-half your thumb’s width, Dr. Green said. Other things to look for: good toe space; wide foot bed to allow for swelling; breathable material; insole cushioning; adjustable closures; seamless interiors; closed design; hard outsoles; and low heels. Also, look for socks made of synthetic fibers and try shopping toward the end of the day. Feet can swell throughout the day and you don’t want to try on shoes that will become too small as the hours pass. For more information about footwear and orthotic products for diabetics, call CFO, 721-7245 or visit www.centerforortho.com.
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FOOT FACTS FOR MEN
Men may not force their feet into pointy-toed high heels, but that doesn’t mean they’re walking on Easy Street. Men face some of the same foot concerns as women do, along with some additional risks, according to Dr. Kalieb Pourciau, foot and ankle specialist. “Many common male occupations require men to be on their feet, supporting their weight for hours at a time. Your feet take a pounding when you run, get twisted when you play basketball, are put at risk when you do yard work, and get crammed into ill-fitting or worn-out shoes on a regular basis. But men tend to ignore foot and ankle problems until they have an injury or develop pain that limits their normal activities.”
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FOOT CONDITIONS MOST LIKELY TO AFFECT MEN: GOUT. A disorder that results from the build-up of uric acid in tissues or joints and typically affects the joint of the big toe. Symptoms typically include pain, inflammation, and swelling. HEEL PAIN. Can result from any number of factors, such as stress fracture, tendinitis, arthritis, nerve irritation, degenerative arthritis or “heel spur syndrome.” ANKLE SPRAIN. Participating in sports is one way men sprain their ankle, but even daily activities such as walking on an uneven surface or slipping on a wet driveway can produce the painful stretching or tearing of the ankle ligament. ACHILLES TENDON PROBLEMS. Often caused by a sudden increase of repetitive activities, especially in those who don’t exercise regularly. The risk of these problems is also higher for men whose work puts stress on their ankles and feet. HALLUX RIGIDUS. Characterized by painful stiffening of the big toe joint following overuse. At highest risk: those who frequently stoop or squat, and golfers. ATHLETE’S FOOT. Caused by fungi that thrive in warm, moist environments, involves a red, scaly, itchy and sometimes painful rash, with peeling and cracking between the toes. It can spread to your toenails, heels, palms, underarms, and groin and is contagious. According to Dr. Pourciau, the bottom line for healthy feet is for men to pay attention to foot pain or any other changes in your feet. “Foot pain is not normal, and most foot and ankle conditions are easier to treat when diagnosed early.” ISSUE 3
[BACK TALK] PROTECT YOUNG BACKS FROM BACKPACKS
According to the U.S. Consumer Product Safety Commission, more than 7,000 children are injured each year due to overloaded backpacks. Research indicates that many school-going youth carry far more than the recommended weight (10 percent or less of their body weight) in backpacks, which puts them at increased risk for back strain and injury. Studies show that up to 25 percent of young students are carrying backpacks weighing more than 20 percent of their bodyweight on a daily basis. This is equivalent to an adult carrying a small refrigerator, and is far too much weight for a child to support. When a backpack is too heavy, a child hyperextends or arches their back or leans the head and trunk forward to compensate for the weight of the bag. “This stresses the muscles in the neck and back, increasing the risk of fatigue and injury,” says Dr. Craig Morton, physical medicine and rehabilitation specialist. He says using only one strap causes asymmetry of the spine and affects the spine’s natural shock absorption abilities. When purchasing a backpack, parents should choose one that has two wide, padded straps that go over the shoulders and a waist belt to distribute weight more evenly across the body. The width should not be greater than the child’s torso. Dr. Morton offers these additional recommendations for backpack use: • Multiple compartments to help distribute the weight of the load. • Use both shoulder straps. • If the backpack is too heavy, remove some books and carry them cradled in the arms or against the stomach. • Adjust the straps so the backpack sits on the hips and pelvic area, not at the top or at the buttocks. • Arrange the heaviest items close to the back. • If your child already has back problems, ask the school to issue a second set of books that can stay at home.
STRAIGHTENING OUT BACK PAIN MYTHS It might be a dull ache, a persistent throb, or a painful wrench, but sooner or later, most people – eight out of 10 – will experience back pain. It’s the most common cause of restricted activity among people under age 45, and the second most common reason for doctor visits, following only colds and flu. Almost as common as back pain, are misconceptions about its causes and treatment. Here are some of the most common back pain myths, and the actual facts, from the CFO back pain specialists. STAYING IN BED WILL RELIEVE THE PAIN. You can rest for one to two days for an acute injury or strain, but anymore can cause the muscles to weaken and slow your recovery. If you are going to rest in bed, make sure you get up and walk a few minutes every hour to keep your muscles strong. ONLY OVERWEIGHT PEOPLE GET BACK PAIN. Anyone can suffer from back pain. Other risk factors for back pain are smoking, old age, stress and depression. BACK PAIN IS ALWAYS CAUSED BY AN INJURY. Disc degeneration, injuries, diseases, infections, depression, pregnancy and even inherited conditions can cause back pain. ISSUE 3
BACK SURGERY IS THE BEST MEDICAL OPTION. Multiple studies have found that 90 percent of patients with low back pain will see their symptoms fade on their own within one to three months. When treatment is required, the first course of treatment for patients with low back pain should be non-invasive. EXERCISE IS BAD FOR YOUR BACK. Regular exercise prevents back pain, and for those suffering an acute injury resulting in lower back pain, doctors may recommend an exercise program that begins with gentle exercises and gradually increases in intensity. LIFTING HEAVY OBJECTS HURTS YOUR BACK. It’s not necessarily how much you lift, it’s how you lift. Squat close to the object with your back straight and head up. Stand, using your legs to lift the load. Do not twist or bend your body while lifting. ALWAYS SIT UP STRAIGHT TO PREVENT BACK PAIN. While slouching is bad for your back, sitting up too straight too still for too long can also put a strain on the back. Try standing for part of INmotion the day, while on the phone or while reading work materials. l 13
CFO DOCTORS
Dr. James D. Perry Orthopaedic Surgeon
Dr. John W. Noble Jr. Orthopaedic Surgeon
Dr. Geoffrey J. Collins Orthopaedic Surgeon
A LEGACY OF MEDICAL EXCELLENCE After a career that spans 50 years, orthopaedic surgeon and sports medicine specialist Dr.
Dr. Steven S. Hale Orthopaedic Surgeon
David Drez Jr. has announced his retirement. Dr. Drez started on his career path at an early age. The only child of David Drez Sr., a general practice physician in DeQuincy, and Hester Bingham Drez, a registered nurse, he
Dr. George “J.” Trappey IV Orthopaedic Surgeon
always knew he would be a doctor. His interest in orthopedics and sports medicine began in high school, where he played football for coaches Jack Doland and Johnny Buck. After earning his medical degree from Tulane University, he went on to complete a general surgical and orthopedic residency at Charity Hospital in New Orleans. He returned
Dr. Jonathan L. Foret Orthopaedic Surgeon
to Southwest Louisiana in 1971 to begin private practice, and soon established a reputation as one of the country’s leading knee, shoulder and sports medicine specialists. Throughout his career, Dr. Drez was involved in medical research leading to many “firsts” in treatment advances for his patients. He has published a large body of research that focuses
Dr. Craig G. Morton Physical Medicine and Rehabilitation Specialist
primarily on athletic injuries and their prevention and treatment options. Dr. Drez is coauthor of Orthopedic Sports Medicine, the highly acclaimed guidebook for sports medicine physicians, physical therapists and athletic trainers, and was co-editor of Operative Techniques in Sports Medicine, as well as a multitude of journal articles.
Dr. William J. Lowry Jr. Physical Medicine and Rehabilitation Specialist
In addition to his clinical contributions, Dr. Drez is well-recognized as an educator, playing a key role in training hundreds of orthopaedic specialists across the country. He is a clinical professor of orthopaedics at LSU School of Medicine in New Orleans and a clinical assistant professor of orthopedic surgery at Baylor College of Medicine in Houston.
Dr. Tyson E. Green Foot and Ankle Surgeon
In recognition of his contributions to the education of orthopedists, the “Dr. David Drez Chair in Orthopedic Sports Medicine” was dedicated at LSU in New Orleans in 2006. Dr. Drez served as head team physician at McNeese State University for 37 years and was inducted into the McNeese State University Hall of Fame and the Louisiana Athletic Trainers
Dr. J. Kalieb Pourciau Foot and Ankle Surgeon
Association Hall of Honors. In further appreciation of the countless hours he donated to McNeese, the rehabilitation area of the university’s Sports Medicine Center was also named the “David Drez, Jr., MD Rehabilitation Facility.” Dr. Drez was one of the five founding members of Center for Orthopaedics in 1994,
INmotion Dr. Andrew L. Foret Hand and Wrist Surgeon
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setting a standard for hard work, ethics, and a dedication to his patients that has guided the group for nearly 20 years. ISSUE 3
[PATIENCE PUZZLES]
Name:_______________
Date:_______________
No Bones About It
NO BONES ABOUT IT Locate and circle the names of bones found in the word find to the right.
KKI COAUGJ NT S UVUJ RBKZ B Q WH B Q F T J Q T P X A V U V G I V R R Q F Y V C F I P A I E MMJ V J C I E L CI VAL CE T XQAE QJ RYBQ L E A B I L T Z E G WN F F C N E H WO WU H N E V O L V T D C L U H WU T M J RXF S E GL NRI S OVOARJ P DV MS N J V A O Q B U S C L A T N O R F N KF P DP ORL I HUCYUAOL L I P U C R Y U T E D H MF Y V U R I S U K I M WC V Q C A V V U Y X S D D X L V F V Q T U Q MR S N Z N B I E D T E A U Y N Q D J A E E I F V R A A G I A I MN MS UOCXUCUXF E CL NKP I I P UK WX M E Z M D K I T S U A O J D B R E M I O S MC T MD B S G P L A O D E I T L I N Y T J R S T U N C A A B R MS U T K P R U MI K L A L S C C H U U I V Z E O C S G Q F P C F A Z I S P H Z B K WG D O S A WD E A B P A D K C C R Z X P S F
FRONTAL MANDIBLE SCAPULA CLAVICLE STERNUM HUMERUS RADIUS ULNA PHALANGES COCCYX FEMUR PATELLA TIBIA FIBULA
FRONTAL MANDIBLE SCAPULA CLAVICLE STERNUM HUMERUS NAME RADIUS THAT DOC ULNA PHALANGES COCCYX FEMUR PATELLA TIBIA FIBULA
Use the clues below to complete the crossword puzzle.
ACROSS CLUES 3. This doctor serves as head team physician for McNeese’s Athletic Department. 4. Which doctor was motivated to become a doctor by an orthopaedic surgeon in his hometown of New Iberia? 6. Which doctor is a native of Metairie? 8. Y ou’re not seeing double. There are two doctors with this last name at CFO. They are brothers. 9. Which doctor has been known to tear it up on the dance floor locally? http://www.softschools.com/ DOWN CLUES 1. This doctor served as president of his high school’s Key Club. 2. This CFO doctor was voted “Best All Around” at Catholic High School of Pointe Coupee and is a wellknown face on the local cook-off circuit. 5. This CFO physician is the reigning king of Krewe des Amis and was Mr. McNeese in 1998. 7. This CFO doctor is a graduate of St. Louis Catholic High School and was a team captain of the McNeese baseball team.
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INmotion
l 15
THE WAIT IS
OVER
It’s about time. Getting the treatment you need as quickly as possible is your top priority when you or a loved one has a musculoskeletal injury.
OrthoExpress at Center for Orthopaedics offers a 24-hour appointment guarantee,* Monday through Friday. OrthoExpress puts you on the fast track to getting the care you need. We guarantee that you’ll be seen by one of our specialists within 24 hours. After all, taking care of bones and joints is what we do best, giving you the added reassurance of being within arm’s reach of the diagnostic and treatment resources of the region’s largest musculoskeletal group. INmotion
* with insurance approval 16 l
Come see us for:
Sports Injuries Broken Bones Sprains & Strains Knee Injuries Hip Injuries Foot & Ankle Injuries Shoulder Injuries Elbow Injuries Sudden Back or Neck Pain Hand & Wrist Injuries Work-Related Injuries
at Center for Orthopaedics (337) 721-7236 LAKE CHARLES l 1747 Imperial Blvd.
www.centerforortho.com
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