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Everything You Should Know Before Getting Knee Replacement Surgery

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If your goal is to postpone knee replacement surgery as long as possible, there are a number of things you can do to help manage your pain and stay active (via HealthPartners).

As counterintuitive as it may seem, exercising and moving your joints, in spite of the pain, can actually stimulate the flow of fluid around your knees, strengthen the muscles that support your knees, reduce stiffness, and increase flexibility. Stick to low-impact activities such as walking, swimming, strength training, and cycling. Any exercise that strengthens your core, hips, and legs, without damaging your knees any further, should help manage your pain.

Working with a physical therapist to get a personalized exercise plan you can do at home can also have long-term benefits — especially if you’re consistent about doing the exercises on your own. And if you’re even a little overweight, consider losing a few pounds. According to HealthPartners, even losing one pound eliminates four pounds of pressure on your knees, which is pretty impressive.

Cortisone shots and other injections that include hyaluronic acid (HA) help lubricate the inside of the knee and may provide short-term relief — up to about three months — from arthritis pain, says Johns Hopkins Medicine.

As for medications, steer clear of opioids if at all possible; they’re addictive, and aren’t proven to help long-term knee pain. And check with your doctor even before using over-the-counter drugs like ibuprofen and naproxen because they can have side effects.

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Originally Appeared Here

Filed Under: KNEE, Knee Surgery, ORTHO NEWS

Joint Preservation: Restoration Rather Than Replacement

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If you have chronic hip or knee pain, you may think joint replacement surgery is your only treatment option. The good news is — there are less invasive procedures that can help many people relieve their pain and maintain their mobility as they age, says James R. Ross, M.D., an orthopedic surgeon with Baptist Health Orthopedic Care.

“Total joint replacement surgery is generally performed to treat late-stage osteoarthritis after conservative treatments have failed,” explained Dr. Ross. “While joint replacement may be the best choice for some people, innovative joint preservation procedures are helping others, especially younger patients, prolong the life of their hip or knee joint.”

Preserving the Hip Joint

Dr. Ross performs advanced arthroscopic procedures and open hip preservation surgery to resolve bone impingement and repair or reconstruct soft tissues that have been torn or otherwise compromised. Femoroacetabular impingement (FAI), which occurs when the femoral head (ball of the hip) pinches up against the acetabulum (cup of the hip), is just one of the hip conditions he treats. FAI is thought to be a precursor to osteoarthritis because it leads to lesions of the labrum and/or articular cartilage.

Using 3D reconstruction and technologically advanced software for pre-operative planning and guidance during surgery, Dr. Ross precisely repairs damaged tissue and corrects the abnormal shape of the hip joint. This protocol, he says, minimizes complications, pain and the need for a hip replacement later in life.

Preserving the Knee Joint

Similar to the anatomy of the impingement that causes cartilage problems in the hip, mechanical alignment problems in the knee can cause isolated cartilage defects, says Dr. Ross. An osteotomy procedure can halt this uneven deterioration of knee cartilage. The procedure, which is most commonly performed on active people under age 60, involves removing or adding a wedge of bone to the tibia (shinbone) or femur (thighbone) to help shift body weight off the damaged portion of the knee joint and prolong its life span. Osteotomy is often performed in combination with a cartilage restoration procedure to address the gap in cartilage and bony exposure.

Dr. Ross also specializes in cartilage replacement techniques to treat patients who have good bone structure but suffer with cartilage-only defects. Matrix-induced autologous chondrocyte implantation, or MACI, is just one of the innovative techniques Dr. Ross employs to restore cartilage and preserve the knee joint.

Performing Cartilage Restoration

The MACI procedure is comprised of two steps. First, Dr. Ross harvests cartilage cells from the patient’s knee. These cells are sent to a laboratory where, over the course of four to six weeks, they grow into additional cartilage. The second part of the procedure involves implanting the new cartilage back into the patient’s knee, where it will mature and fill in the defect.

“Prevention is the best medicine,” Dr. Ross explained. “Rebuilding the patient’s cartilage will keep the cushion between the bones intact, which can reduce the risk of developing osteoarthritis and requiring joint replacement surgery in the future.”

Assessing Your Options

So how do you know if you are a candidate for a joint preservation procedure? In general, you should see an orthopedic specialist if your joint pain limits your activities and/or you have recurring episodes of the same pain over several weeks or months. Orthopedic surgeons at Baptist Health Orthopedic Care will determine the best treatment methods to reduce your pain, restore your mobility and prolong the life of your hip and knee joints.

Originally Appeared Here

Filed Under: ORTHO NEWS, ortho news - Google

Guideline: Timing Is Everything for RA and Lupus Patients Needing Joint Replacement

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Conventional disease-modifying antirheumatic drugs (DMARDs) may usually be continued in patients with inflammatory arthritis or systemic lupus erythematosus (SLE) undergoing total knee or hip replacement, but the same is not necessarily true for more targeted agents, according to an updated guideline from two medical societies.

Biologic drugs and so-called JAK inhibitors should generally be stopped before arthritis patients have such procedures, and so should biologics such as belimumab (Benlysta) and immunosuppressants in patients with non-severe SLE, according to the guidance from the American College of Rheumatology and the American Association of Hip and Knee Surgeons, with Susan M. Goodman, MD, of the Hospital for Special Surgery in New York City, as lead author.

With severe lupus, however, it’s generally better to keep patients on their regular immunosuppressant regimen as well as belimumab. But for patients with severe SLE taking rituximab (Rituxan), the societies recommend scheduling surgery for the final month of the drug’s dosing cycle when blood levels have bottomed out.

The new guideline replaces an earlier version published in 2017 and takes account of new agents introduced in that time and better understanding of how traditional agents affect patients in the postoperative period, particularly the risk of joint infection.

In explaining the rationale for these guidelines, Goodman and colleagues noted that rheumatic disease patients are at substantially higher risk of periprosthetic infection following joint replacement relative to people without such conditions — by 50% in the case of rheumatoid arthritis. The immunomodulatory drugs that most of these patients take surely contribute to this increased risk.

That creates a management challenge, for simply withholding all the patients’ regular medications raises the likelihood of disease exacerbation. Flares may be less problematic than a deep joint infection, but the latter is relatively rare while flares are common when antirheumatic drugs are withdrawn. Thus, it becomes a question of balancing low risks of a potentially devastating complication against high risks of a lesser but still significantly adverse outcome.

For the update, committees from the two societies reviewed papers published through August 2021 addressing medication use in patients with inflammatory arthritis — rheumatoid arthritis, psoriatic arthritis spondyloarthritis, and juvenile idiopathic arthritis — and SLE undergoing hip and knee replacement.

The major recommendations — all rated as conditional — can be summarized as follows:

  • Inflammatory arthritis and SLE patients may continue usual dosing with conventional DMARDs such as methotrexate, leflunomide, and hydroxychloroquine, as well as apremilast (Otezla) in the case of psoriatic arthritis.
  • Arthritis patients taking biologic drugs including rituximab should stop them prior to surgery, and procedures should be scheduled for around the time the next doses would be due, to obtain some degree of washout.
  • In non-severe lupus, patients should have drugs such as mycophenolate mofetil, azathioprine, cyclosporine, and tacrolimus stopped 1 week before surgery, and usual doses of belimumab and rituximab should be delayed.
  • In severe lupus, conventional DMARDs as well as anifrolumab (Saphnelo) and voclosporin (Lupkynis) — both first approved in 2021 — should be continued at usual doses. Belimumab and rituximab can also be continued, but as mentioned above, surgery should be scheduled for late in the latter’s dosing cycle.
  • No changes in corticosteroid medications are generally needed.
  • In all cases where regular medications were stopped, they may be restarted when surgical wounds have started to heal and no signs of infection or other complications are evident.

As with any guideline, Goodman and colleagues emphasized that these are not intended as hard-and-fast rules and clinicians should engage in shared decision-making with patients to take account of their particular preferences and circumstances. “One patient representative on the current Voting Panel noted the anxiety that patients experience around changes to their medication regimens and urged clinicians to be cognizant of this important issue,” the authors wrote.

Goodman and colleagues also acknowledged significant gaps in the available evidence and called for new research, including prospective randomized trials, to “provide clearer answers” to questions about use of conventional DMARDs, for which such evidence is often lacking. “Perioperative management of biologics also needs more definitive study,” they added.

Notably, the guideline update did not address other issues related to joint replacement, such as risk of venous thromboembolism and other cardiovascular events.

  • John Gever was Managing Editor from 2014 to 2021; he is now a regular contributor.

Disclosures

Guideline development was supported by the American College of Rheumatology and the American Association of Hip and Knee Surgeons.

Goodman and many other co-authors reported relationships with pharmaceutical and medical device companies.

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Originally Appeared Here

Filed Under: ORTHO NEWS, ortho news - Google

Sports Injury Rehabilitation Techniques for Athletes

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Injuries are an extremely prevalent outcome, both in recreational and competitive sports alike. While there are injury prevention protocols that can and should be implemented, injuries, both mild and severe, are never out of the realm of possibility.

Because of the inevitability of injury in sports, rehabilitation programs are necessary for an athlete’s regimen. Not only do rehabilitation techniques aid in the general recovery and healing of injuries, but they also promote improved stability, movement mechanics, and range of motion after full recovery has been achieved.

A rehabilitation program combines the functions of physiotherapy, sports physiology, orthopedic surgery, and pharmacology. These programs are crucial for allowing an athlete to return to peak form and begin participating in sport again. The organization of rehabilitation protocols depends on several factors, including the type and severity of injury and the athlete’s health status and activity level.

Without a proper rehabilitation program, injuries can worsen, damage can become more severe, and secondary injuries can occur as a result. That’s why it’s imperative that you consult with a trusted, reliable, and experienced medical professional for the proper evaluation, diagnosis, recommendation, and treatment recommendation that’s most suitable for your situation.

The following will be a general discussion about sport-related injury rehabilitation, its goals and objectives, and specific techniques for effective healing and complete recovery of a given injury.

Common Sports-Related Injuries

Common injury types amongst athletes are those related to joints and surrounding areas. Joints are extremely vulnerable and susceptible to injury due to their role in movement and skeletal support.

Because of its responsibility for movement, range of motion, and stability, joints are typically the first area of the body to be impacted by injury when placed in compromised positions or under stressful environments.

For example, the sport of football, in which athletes attempt to tackle other athletes, leads to impact on joints from any direction, and the impact is often applied to a joint in a compromised position.

Of the most common sports-related injuries, the shoulders, knees, and ankles are some of the most vulnerable regions of the body.

The following are some of the most common injury types in sporting events that often require some level of rehabilitation:

  • Sprains (Ankle Sprain, Knee Sprain, Wrist Sprain)
  • Strains
  • Tears (Rotator Cuff Tear, ACL Tear, Achilles Tendon Rupture)
  • Fractures (Ankle Fracture, Patellar Fracture)
  • Dislocations (Shoulder Dislocation)
  • Separations (AC Joint Separation)
  • Depending on the injury type and severity level, a specific rehabilitation protocol will be required.

While a sprain, for example, will likely only require at-home self-care and over-the-counter anti-inflammatory medication, tears and fractures will often require more complex surgical procedures, physical therapy, stronger pain medication, and regular monitoring of progress by a physician to reach the same end-goal of complete restoration and recovery.

A Step-By-Step Guide Towards Rehabilitation

No matter the injury or severity level, the rehabilitation process requires a multidisciplinary approach. The following is an example of a step-by-step guide for rehabilitation that athletes and sports medicine specialists will often follow to achieve the best outcomes.

  • Step 1: Diagnosis
  • Step 2: Attend to Inflammation
  • Step 3: Promote Primary Healing (Rehabilitation Exercise, Pain Management)
  • Step 4: Improve Fitness (Sport Specific Training & General Conditioning)
  • Step 5: Control Physical Stressors & Prevent Re-Injury

Throughout the duration of the rehabilitation process, it’s encouraged to focus on the quality of activity rather than quantity. Just as overtraining can cause initial injury, it can also result in poor recovery and an unsatisfactory rehabilitation outcome.

Goals of Rehabilitation

The primary aim of injury rehabilitation is an imminent return to sport in peak form and a focus on preventing re-injury.

The best methodology in rehabilitation uses goal identification and the creation of a roadmap to that goal. Along the way, the athlete will need encouragement and motivation since they can always be at risk of becoming discouraged. The rehabilitation process can be quite draining, both physically and mentally, for the athlete. Therefore, a constant positive focus on achieving the goal and reaching the destination is critical for success.

 

The following are the primary goals of an effective rehabilitation program:

  • Regaining Stability After Injury
  • Regaining Normal Movement After Injury
  • Restoring Function & Performance to Pre-Injury Levels
  • Encouraging Safe Return to Sport
  • Minimizing Risks of Re-Injury

Once all of these goals and objectives have been met, the rehabilitation process is all but complete. It’s now the physician’s job to monitor progress frequently and ensure the athlete follows preventative measures. The athlete must play their part by actively following the recommendations outlined by their physician to ensure a safe return to sport with the new target of health and longevity.

Final Thoughts

All severely injured athletes, as well as non-athletes, can benefit from rehabilitation programs. In fact, according to the World Health Organization, it’s estimated that 2.4 billion individuals globally live with an injury or health condition that could benefit from rehabilitation. This number will certainly increase in the years to come.

Rehabilitation markedly assists in recovery and healing, and it reduces time away from athletic participation. The process focuses on retraining of proper movement mechanics and encourages the overall health and well-being of the athlete, both mentally and physically.

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Originally Appeared Here

Filed Under: Athletic Health News, ORTHO NEWS

Exercising in Extreme Conditions

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While extremely hot and cold temperatures aren’t particularly a barrier to entry when it comes to sport and physical activity, extreme conditions can trigger negative consequences if the participant isn’t diligent and prepared.

If physiological homeostasis and internal body temperature cannot be maintained, whether in a hot or cold environment, conditional injuries, side effects, and diminished performance are the likely result.

Since it’s important to try to maintain physical activity throughout the year, it’s critical for any athlete to be aware of the conditions in which they perform. An athlete must be prepared for performing in less than ideal conditions.

The following will be a discussion of the potential harm that the environment can have on the physical well-being of an athlete. Moreover, we’ll discuss preventative measures that must be taken in order to remain healthy, active, and injury-free, no matter the weather conditions.

Outlook on Exercise in Extreme Conditions

Exercising in extreme conditions, whether hot or cold, places added stress on the body. Without implementing preventative measures to combat such stress, the risk of injury increases dramatically.

When exercising in extreme cold, the body transports its blood supply to the skin and away from the muscles in order to maintain internal temperatures. As a result, the heart rate increases, and less oxygen is delivered to the muscles, which leads to an increased risk of muscular injury. In addition, the athlete’s level of hydration decreases, and muscle cramping can easily result.

On the contrary, when exercising in extreme heat, perspiration levels are affected. As a result, the internal body temperature rises, and the athlete is at higher risk of heat-related conditions like heat stroke.

A lack of understanding of the effects of extreme changes in the environment on the body can cause the athlete that has not prepared to be at risk of severe injury.

The following are several of the most common potential outcomes of unsafe exercise in extreme conditions, both hot and cold:

  • Heat Exhaustion
  • Heat Stroke
  • Hypothermia & Frostbite
  • Muscle Cramps
  • Muscle Strain
  • Tears and Ruptures

The majority of the outcomes mentioned above typically come with warning signs in the form of symptoms. Upon the occurrence of symptoms, the athlete should halt activity and rest and subsequently seek immediate medical attention.

Symptoms of Extreme Temperature-Related Conditions

Ignoring signs and symptoms of a heat-related or cold-related injury or illness is a bad decision by the athlete. By avoiding these warning signs, symptoms could worsen, ultimately resulting in a severe injury with potential long-term damage.

The following are the most common symptoms associated with exercising in extremely hot conditions:

  • Dizziness & Nausea
  • Headache
  • Extreme Thirst
  • Abnormally Elevated Heart Rate
  • Trouble Breathing

The following are the most common symptoms associated with exercising in extremely cold conditions:

  • Loss of Mobility
  • Thirst
  • Tightness, Stiffness, & Soreness
  • Trouble Breathing
  • Intense Shivering
  • Loss of Sensation/Numbness
  • May Trigger Symptoms of Asthma or other Related Conditions

Upon the identification of any or all of these symptoms, stop exercise immediately, seek hydration, and aim to bring your core body temperature back to homeostasis. Next, it’s important to closely monitor your breathing and heart rate, seek help, and involve a medical professional.

Prevention of Heat and Cold Injuries

Luckily, there are several strategies that can be implemented and executed in order to prevent heat or cold injuries from occurring. Not only will the following preventative measures reduce your risk of injury, but they are also good to maintain your overall health.

The following are the most effective preventative measures to combat extreme conditions:

  • Understand Your Tolerance to Hot and Cold
  • Acclimate Yourself to Such Conditions
  • Be Humble Towards Your Fitness Level (Don’t Exert Yourself)
  • Maintain Adequate Hydration
  • Dress Appropriately and Be Prepared to Add or Eliminate Layers
  • Stretch, Warm-Up, and Cool Down
  • Improve Aerobic Capacity

Heat-related and cold-related injuries and illnesses can be prevented with careful planning and preparation. For example, wearing light reflective clothing when it is very hot outside can be helpful. The athlete should make every attempt to control what they are able to control.

Exercise shouldn’t have to be put on pause because of an external factor like the weather. Instead, athletes need to learn how to make the necessary adjustments to maintain safety, prevent injury, and allow for optimum performance.

Final Thoughts

Extreme conditions, such as heat or cold, can trigger negative consequences for the unprepared athlete. So, it’s best that all athletes gain an understanding of the potential risks of such conditions.

Implementing appropriate preventative measures will reduce the risk of injury and allow continued participation in sporting activity.

The good news is that exercise can be performed safely under extreme hot or cold, but athletes must learn to adapt to these conditions appropriately.

Originally Appeared Here

Filed Under: Athletic Health News, ORTHO NEWS

Aerobic And Resistance Training in Sports Medicine

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The benefits of aerobic and resistance training in both recreational and competitive athletes are well documented. Sports programs and athletes have embraced these techniques as pillars of improved sporting abilities and good health maintenance.

A properly curated and executed training regimen that aligns properly with an athletes goals and objectives will definitely increase strength and power while also improving performance. Such a program also has been shown to reduce musculoskeletal injuries, decrease the severity of injury occurrences, and improve the general health of bones, muscle tissue, and other connective tissue.

The physical changes that occur during aerobic and resistance training improve the protection against injury for those who participate in such intensive sport and activity.

A discussion of the role that aerobic and resistance training plays in a sports medicine context follows. More specifically, we’ll dive a little deeper into a broad overview of each training methodology, outline their respective benefits, and even summarize potential risk factors associated.

What is Aerobic Training?

Otherwise referred to as “cardio”, or cardiovascular exercise, aerobic training is a training methodology that requires the use of oxygen in order to meet and maintain energy demands. Examples of aerobic training include lower intensity, steady-state activities such as endurance walking, running, biking, swimming, and sports such as basketball, soccer, hockey, and track & field.

Aerobic exercise is extremely effective and efficient at improving heart rate, blood pressure, and cholesterol levels, boosting bone density, strength, mobility, and reducing the risk of injury, disease, and other health-related conditions. Aerobic fitness also improves the body’s ability to absorb oxygen and delay fatigue. All of these positive results can be attributed to the increased blood flow that occurs with aerobic training.

What is Resistance Training?

Resistance training is a training methodology that involves strength exercises via machines, bodyweight, free weights, resistance bands, and any other modality that applies resistance to a given movement.

The intention of resistance training is to improve one’s ability to carry load and exert force; however, research suggests that resistance training accomplishes much more than that, especially in the context of sports medicine, performance training, and physical rehab. In addition, muscles that are accustomed to receiving regular resistance training will often grow in size and become resistant to fatigue during exercise.

Benefits of Aerobic & Resistance Training

The benefits of aerobic and resistance training in a sports medicine context are vast, not to mention its benefits to the general public unrelated to sport. Maintaining a program of both can yield surprising results for an athlete, especially in these modern times where the level of competition has increased substantially. By incorporating cardio into your workout regimen, you’re giving your body time to recover after an intense weight session or long run with weights.

Whether it’s implemented as a performance enhancement, preventative protocol, or injury rehabilitation program, aerobic and resistance training is incredibly advantageous for athletes of all kinds. Yet, it’s essential that such a program is curated, executed, and monitored correctly and under professional supervision.

The following are several beneficial functions that aerobic and resistance training play:

  • Promotes Muscle Growth & Strength
  • Reverses Muscle Loss
  • Increases Athletic Performance
  • Boosts Explosiveness & Power
  • Promotes Mobility & Flexibility
  • Improves Heart Health
  • Enhances Cardiovascular Ability
  • Reduces Body Fat
  • Increases Bone Density
  • Reduces Risk of Health Conditions (Diabetes, Hypertension, Cancers, Osteoporosis)
  • Improves Health Indicators (blood pressure, resting heart rate, metabolism)
  • Boosts Well-Being
  • Injury Prevention

While not all of these benefits are related to sports medicine and athletics, it’s worth noting to emphasize its role and importance for general health, longevity, performance, and other health and fitness factors.

Several of these benefits indirectly correlate to sports and athletics, such as well-being and motivation in association with performance and the reduction of risk for various health conditions associated with physical injury and capability.

Nevertheless, a well-planned and properly monitored aerobic or resistance training regimen can help prevent sports-related injuries and improve overall performance.

Potential Risks Associated with Aerobic & Resistance Training

The risks associated with aerobic and resistance training primarily pertain to youth athletes; however, other injuries can be classified as accidental, even in the most elite of athletes.

Some issues that can lead to undesirable aerobic and resistance training results include poor, unqualified instruction, inefficient technique, inappropriate training loads, and overtraining. These issues are problematic with any competitive sport, whether weightlifting, sprinting, track & field, gymnastics, or football. Such bad technique or training can lead to soft tissue injuries, lower back pain, and growth plate injuries, among others.

Final Thoughts

The evidence supporting aerobic and resistance training benefits on physical health, injury reduction, sports performance, and other sports medicine modalities is clear.

While other preventative protocols are effective in sports medicine and injury reduction, aerobic and resistance training implemented in the correct environments are beneficial both for the recreational participant and competitive athlete alike.

However, it’s important not only to receive medical clearance prior to engaging in such activity but to find a professional who specializes in supervising effective rehabilitation and strength programs.

Originally Appeared Here

Filed Under: Athletic Health News, ORTHO NEWS

The Most Effective Injury Prevention Protocols

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Sports activity is the number one cause of injury in adolescents and young adults. This alone underlines the importance of an effective injury prevention plan, yet, further emphasis is likely needed.

Injuries will undoubtedly have the potential to affect the mental mindset of the athlete. In addition, they also can majorly affect a person’s long-term health and well-being, not to mention the potential implications on the healthcare system, economic environment, and other routine relationships depending on the severity and long-term outlook of rehabilitation.

The importance of having an effective injury prevention protocol, especially as a competitive athlete, is undeniable.

What follows will be a discussion of injury prevention. We’ll begin by outlining what an injury prevention protocol is and how to develop one. We’ll then touch on the most common causes of sports injuries and why a preventative plan is relevant. Lastly, we’ll share the details of some of the most effective injury prevention protocols that you can begin to implement into your physical health regimen.

What is an Injury Prevention Protocol?

An injury prevention protocol is a proactive plan that helps athletes avoid both major and minor injuries and minimize the risk of injury. Fewer overall injuries are the ultimate goal of such a program.

Injury prevention involves a modification of risk factors and focusing on external factors that are within one’s control. For example, an improved diet, increased hydration, and improved sleep may reduce the risk of injury.

Injury protocols are most effective when used in conjunction with individualized strength and conditioning programs. However, it’s also important to know that the use of an injury prevention protocol is based on the athlete’s functional capability, compliance, and attitude toward change. An injury prevention protocol can be implemented in both the short term (hours or days) and long term (weeks or months).

Flexibility is important in injury prevention programs because athletes will not necessarily follow all recommendations, for example, if they feel uncomfortable trying something new or if they don’t believe that a particular strategy actually works.

Injury prevention programs must eventually adapt to the athlete.

Understanding what injuries are most common in your given sport and learning how those injuries are most commonly caused is, at its most basic, how you begin to develop an actionable injury prevention protocol.

The most common sports injuries are:

  • Strains
  • Sprains
  • Fractures
  • Dislocations & Separations
  • Ligament Tears
  • Tendon Ruptures
  • Tendonitis
  • Concussions

The most common causes of sports injuries include:

  • Poor Technique or Form
  • Being in Poor Physical Health (inflexible, tight, stiff, overweight, immobile)
  • Lack of Muscular Strength
  • Lack of Stretching (no warm-up or cool down during activity)
  • Wearing Improper Gear or Lack of Protective Gear
  • Impact & Collision
  • Accidental Fall

While athletes can create and implement a preventative plan on their own, it’s likely more beneficial to consult with a doctor or specialized physician to get their recommendations and take advantage of their professional supervision and monitoring capabilities.

Effective Injury Prevention Protocols

From a medical standpoint, developing and implementing an effective injury prevention protocol requires a multifaceted approach.

Not only do you need to analyze the data surrounding a given injury, but you also need to understand the population and demographic you’re dealing with, the available resources, and the most effective plan to achieve the goal of prevention.

Once you’ve identified the goals and objectives of the prevention protocol, it’s now time to develop the plan and take action. By choosing the most effective protocols discussed below, the athlete will have the best chance to reduce the risk of injury and, at best, prevent it altogether.

Below are the most effective injury prevention protocols for athletes:

  • Consistent Strength Training Program
  • Structured Stretching Regimen (Warmup, Cooldown)
  • Foam Rolling
  • Proprioceptive Training Program (Balance, Coordination, Agility, Plyometrics, Functional Movement)
  • Physical Therapy
  • Manual Therapy
  • Ensure Proper Technique
  • Utilizing Protective Equipment
  • Avoid Overtraining
  • Proper Rest
  • Contrast Therapy

It’s important to note that multiple different protocols can be used for any given injury because of so many multitudes of injury types and severity levels.

The good news is that most injury prevention protocols require a similar strategy. By taking a holistic approach to self-care, being proactive with implementation, and remaining consistent with the protocol elements, you give yourself the best chance at success.

Additionally, a sports medicine physician’s specialized input for suitable recommendations, guidance, and supervision is extremely beneficial.

Final Thoughts

As always, the best medicine is prevention. At its most basic, the easiest yet most effective way to prevent sports-related injuries is to stretch, warm up consistently, and cool down.

Recovery is a pillar of sports performance and sports medicine, and without it, injuries are almost guaranteed to occur.

By taking the necessary steps outlined in this article, focusing on stretching, hydration and nutrition, proper technique, and the elimination of overtraining, you give yourself the best chance at reducing the risk of injury.

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Originally Appeared Here

Filed Under: Athletic Health News, ORTHO NEWS

Sports Ultrasound Use

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Ultrasonography is a diagnostic and evaluation modality that has been used in medicine since the mid-1900s, although the physics of ultrasound were initially considered in the late 1800s. In recent years, ultrasound use has become more popular for sports medicine and surgical procedures, among other functions.

Unlike MRI’s and X-Rays, ultrasounds have the unique ability to provide a safer, more comfortable environment for the patient, free of radiation, while still providing effective and useful information to the operator and physician in charge.

While the sophistication and development of ultrasound technology continues to grow rapidly, there are still restraints, limitations, and disadvantages of this interventional modality.

In what follows, we’ll be discussing what a sports ultrasound is, why and how it’s used in a medical context, and its advantages & disadvantages, among other things.

What is a Sports Ultrasound?

A sports ultrasound, or more specifically a musculoskeletal ultrasound, is a non-invasive imaging and evaluation tool that uses sound waves to identify specific body regions and aid in the diagnosis of an injury or condition.

Ultrasound use, in general, is wide-ranging, with applications in medical fields such as obstetrics, general surgery, gynecology, orthopedics, and urology.

In the context of sports medicine, ultrasounds are of primary benefit when it comes to sport-related injuries such as ligament or tendon tears, dislocations, tendonitis, fractures, sprains, and ruptures because of its ability to effectively scan structures with high accuracy and resolution.

This makes it an incredibly effective tool for evaluating injuries of the ankle, hip, leg, and shoulder.

The prevalence of ultrasound use in sports medicine has grown in recent years due to the many obvious benefits for the athlete and its potential to reduce healthcare costs drastically.

As mentioned, however, this innovative technology does come with some limitations. The following information will discuss ultrasound use and its advantages and disadvantages.

Sports Ultrasound Uses

Ultrasound in the context of sports medicine is a diagnostic technology that is especially beneficial due to its ability to evaluate musculoskeletal structures non-invasively.

Ultrasound has been used by physicians to examine fluid surrounding structures that may indicate tendonitis, for example. It can also be used to evaluate range of motion functionality and evaluate possible bone fractures.

Outside of its diagnostic utilization, ultrasounds can also be an effective visualization tool during certain medical procedures, such as proper localization of injection sites for medications such as steroids. This improved visualization is much safer for the patient and more accurately treats the condition.

It can also be utilized in joint aspiration, which can help diagnose a joint condition as well as relieve pain and pressure in a joint.

Advantages of Sports Ultrasound (US)

Ultrasound meets all of the necessary requirements of utility in the healthcare industry, and more specifically, in sports medicine.

Not only is it cost-effective for the user and physician, but its resourcefulness, portability, safety, and high-resolution imagery make it a superior medical tool in many contexts, sports medicine included.

While ultrasonography is still underutilized, many are becoming more and more aware of its specific benefits.

Below are the Several Benefits of Using a Sports Ultrasound [5]:

  • It’s non-invasive
  • Provides real-time assessment data
  • Readily available
  • Equipment portability
  • Safe in health-compromised patients
  • Use is repeatable for monitoring
  • Relatively cost-efficient
  • Offers high-quality resolution imagery of examination
  • Free from ionizing radiation
  • Interactive

The advantages of a sports ultrasound far outweigh its few disadvantages.

It’s important to realize the safety that ultrasound provides versus ionizing radiation. Anytime that radiation can be avoided, it is much more healthy for the injured athlete.

Ultrasound operators should not only have a keen understanding of how to use it, but they should also be aware of its limitations. For example, while an ultrasound is effective for examining and diagnosing certain injuries and conditions, it doesn’t adequately assess deeper-rooted injuries, such as fractures of bones.

Disadvantages of Sports Ultrasound (US)

The disadvantages of ultrasound should be considered; however, these can be managed well in most sports medicine programs. The primary disadvantage of the ultrasound is its user-dependency.

These are some of the Disadvantages of Using a Sports Ultrasound [6]:

  • Highly user-dependent
  • Requires a lengthy training period for the operator
  • Inability to examine deeper structures of the body
  • May be ineffective in obese or overweight patients

Regardless of these few disadvantages, ultrasounds are an extremely beneficial tool for the healthcare system. With the ability to evaluate tendinopathies, rotator cuff pathology, and other soft-tissue conditions, ultrasound is an invaluable modality in sports medicine.

Final Thoughts

Sports ultrasound is cost-efficient for both the user and the patient, and it provides extremely useful information in an extremely high-quality format. More importantly, it’s safe, readily available, fast, and portable.

Luckily, sports ultrasound use is growing and will continue to be a helpful benefit to the field of sports medicine.

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Filed Under: Athletic Health News, ORTHO NEWS

Injections for the Athlete

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There are several categories of injections for athletes, each with its purpose and benefits. Athletes may benefit from certain types of medical injections, and those will be discussed.

Generally, there are three particular reasons an athlete might require an injection. These are to combat pain, reduce inflammation, and aid in surgical procedures. Injections can also be used in a rehabilitation program for injury maintenance.

In the following, we’ll discuss some of the details about injections used to treat athletes. In addition, we’ll distinguish several types of injections and their uses and benefits.

Types of Injections

Athletes often require injections for some type of treatment. With so many different injuries and problems with pain, certain injections can help pave the way for an athlete to return to the sport they love.

The most common athlete-related injuries requiring injection include bursitis, tendonitis, carpal tunnel syndrome, muscular injuries such as strains and contusions, and more severe injuries such as tendon or ligament tears or ruptures.

Below are the three most common injections that athletes receive for various treatments:

  • Corticosteroid Injection
  • Local Anesthetic
  • Ketorolac (non-steroidal anti-inflammatory pain killer)

Corticosteroid Injection

A staple in history for the treatment of muscular trauma and inflammatory injuries in athletes, corticosteroids have been known to many as the superior option of treatment.

Its reputation in the medical literature is profound, such that it has been the most consistent symptomatic relief of pain for so many people with minimal bad side effects.

Corticosteroids do have some potential risks and side effects, and complications, especially when intramuscularly injected. Nevertheless, corticosteroids are a common injective treatment used on athletes regularly, and they have been shown through comprehensive research and systematic reviews to be extremely beneficial both in the short-term and long term.

Corticosteroid injections may also have the benefit of decreasing the overall need for additional steroid use in the future by the athlete.

Local Anesthetic

The use of local anesthetic is highly beneficial for the immediate relief of pain, whether caused by injury or other inflammatory conditions. It also plays a significant role during surgical procedures both at the pre-surgical stage and the postsurgical recovery. More and more surgeons have adopted the use of local anesthetic at the area of surgical incisions at the conclusion of the operation. This significantly improves immediate postoperative pain control.

Like any type of injection to the body, local anesthetic can cause potential adverse reactions such as an allergic reaction. This possibility must be closely monitored post-injection, such that treatment can be administered in the event of an allergic reaction.

Interestingly, in some sports federations, local anesthesia for the sole purpose of pain relief has been banned due to its apparent performance-enhancing benefits.

Ketorolac (Toradol)

Ketorolac, or Toradol, is one of the most common pharmaceutical drugs used in medicine. When injected intramuscularly, Toradol acts as an extremely effective pain reliever without causing the undesirable side effects of some more potent pain medications.

While Toradol has been used regularly for pain control over the years, its uses are still somewhat controversial in certain settings due to its potential ineffectiveness and side effects on certain patients. Toradol can be especially harmful to the kidney in patients who already have kidney damage or have a higher risk of developing kidney damage.

Potential Side Effects

The risks of the most commonly used injections in athletes are generally low, but it’s best to be aware of what these potential effects are.

The following are some of the side effects and complications that can occur when injecting an athlete with a medication such as a steroidal or non-steroidal therapeutic drug:

  • Infection
  • Allergic Reaction
  • Further Weakening of the Tendon Resulting in Rupture
  • Increase in Pain Rather Than a Decrease
  • Muscle Atrophy & Weight Gain
  • Vascular Injury and Bleeding
  • Nerve Damage
  • Breast Tissue Development in Men
  • Infertility
  • Acne
  • Elevated Blood Pressure
  • Syncope (passing out)

These are only some of the potential side effects of injections. In addition, many of these side effects are specific to the type of injection that the athlete receives, as well as the overall health of the athlete at the time of injection. It’s important to understand that not all athletes will be good candidates for medication injections, such as steroids. Therefore, it’s essential that the administration of any injection should be overseen by a medical professional.

Yet, while any medication poses potential risks, the most commonly used injections that have been discussed have been shown to be very safe. It’s best to discuss these issues with your medical doctor to understand these potential side effects better and know your risk.

Final Thoughts

Medical injections used for athletes in sports medicine have proven to be extremely useful. Following particular protocols and safe methodology helps the athlete to be able to continue their sport in the face of obstacles such as pain.

When injections are performed by medical professionals in the organization of a well-designed sports program, the best outcomes for athletes can be achieved.

It’s also important to understand the safety and concerns of injections and their application in your respective sport.

Originally Appeared Here

Filed Under: Athletic Health News, ORTHO NEWS

The Most Common Gymnastics-Related Injuries

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Gymnastics is an extremely difficult sport that involves excessive body strength and power, extreme precision and skill, and complex routines that drastically increase the risk of injury.

The sport itself is known as one of the highest-risk sports in the National Collegiate Athletic Association (NCAA) when it comes to injury, in large part due to the extreme stresses that occur during a given maneuver or maneuvers.

As a result of the nature of the sport, more injuries are certainly more common than others, though both upper body and lower extremity injuries are prevalent.

In what follows, we’ll be discussing the most common gymnastics injuries, the likely causes of each, as well as preventative tips and recommendations. Because of the nature of the sport, not all injuries can be prevented; however, certain proactive steps should be taken to reduce the risk of injury.

Most Common Gymnastics Injuries

Gymnastics has one of the highest rates of injury for any sport, especially for females. In fact, an average of 100,000 women, both young and old, report a gymnastic-related injury annually.

While a certain level of skill, strength, and preparation is required of gymnastics, no amount of preparation can prevent all potential risk of injury. With the rigorous efforts and complex movements involved, injuries will inevitably occur, both minor and severe.

There’s a multitude of causes of gymnastics-related injuries; however, the most common injuries result from weight-bearing stresses and traumatic impact. Other causes include overtraining and lack of recovery.

The following are the most common Gymnastics injuries:

  • Traumatic Knee Injuries (i.e., ACL Tear)
  • Achilles Tendon Rupture
  • Ankle Fractures
  • Labral Tears
  • Sprains & Strains

Other notable injuries include shoulder dislocations and elbow separations, lower-back strain, burns and blisters, and herniated discs.

Many strategies can be implemented to help prevent such injuries. While these are not full-proof, they certainly drastically decrease the risk.

ACL Tear

Traumatic knee injuries such as an ACL tear are unfortunately prevalent in gymnastics, especially at the elite levels. The ACL, in particular, is a knee stabilizing ligament that provides necessary function to the joint.

An injured or torn ACL can sideline an athlete for many months and requires immediate surgery followed by a rigorous and thoughtful rehabilitation program.

Achilles Tendon Injury

The Achilles tendon is the largest tendon in the body, and it attaches the calf to the heel. Its primary function is to allow lower extremity movement via the leg and foot. As you can imagine, the consequences of injuring the Achilles tendon are severe and sometimes can be career-ending for the gymnastic athlete.

An Achilles tendon tear requires immediate surgery and months of rehabilitation. It most commonly occurs due to the overuse and constant stress and strain placed on the tendon during competition.

Ankle Fracture

The ankle incurs constant impact and is often subject to stress fractures, which can sometimes be called “hairline” fractures. These can be quite painful and can take a long time to heal. Ankle fractures typically occur during the landing of a complex gymnastic maneuver.

Labral Tear

A Labral tear is one of the most common upper extremity injuries in gymnastics. While any gymnast can experience a labral tear, they’re most common in ring and bar specialists.

In short, a labral tear is an injury to the labrum, which is the cartilage attached to the shoulder socket that ensures proper stability of the joint.

Sprains & Strains

Though less severe, sprains and strains are extremely common in gymnastics and several other sports and can develop into more severe injuries if not proactively managed.

Because of the complexities of movement, copious amounts of training, and general physical demands involved in gymnastics, sprains and strains can occur at a moment’s notice.

The most common sprains and strains in gymnastics occur in the fingers, hand, wrist, ankles, and legs. The good news is that gymnasts can be very successful in preventing these types of minor injuries.

Injury Prevention Tips for Gymnasts

Injury prevention is the standard to achieve in this sport. While all injuries can’t be prevented, the effort to prevent as many injuries as possible is key to improving longevity within the sport. Unfortunately, many unpredictable accidents do occur in this sport.

By prioritizing physical health, you provide your bones, muscles, joints, ligaments, and tendons with the most substantial environment to perform yet remain uninjured.

Prioritizing physical health requires proactive actions, consistent exercise implementation, and rehabilitative strategies before an injury occurs. The following are the most common and effective preventative measures for gymnasts to reduce the risk of injury:

  • Stretching
  • Hydration
  • Avoiding overtraining
  • Follow rehabilitation protocols (i.e., physical therapy)
  • Ensure proper techniques
  • Avoid loose clothing and wear proper gymnast attire
  • Wear protective gear during training (i.e., hand grips, chalk, heel pads, wrist wraps, braces)
  • Rest and recover
  • Use spotters
  • Ensure the basic equipment safe and intact

Final Thoughts

Gymnastic injuries often don’t require surgery, but they usually require some medical attention. When injuries occur, no matter the severity, it’s important to seek treatment immediately.

Ignoring symptoms prolongs healing, increases suffering, and can result in more significant problems down the road.

Following preventive techniques can greatly reduce the risk of injury.

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Filed Under: Athletic Health News, ORTHO NEWS

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