The Five Seasons tennis pros demonstrate some of the common mistakes made by recreational players that can lead to injury. They discuss the importance of footwork and balance as essential elements of putting the player into position to hit the ball properly. Additionally they emphasize the importance of the connection of the right and left sides of the body in producing smooth effortless strokes.

In the YouTube video about common tennis injuries, we explain the basic care of acute minor injuries following the R.I.C.E. (Rest, Ice, Compression and Elevation) treatment formula. Injuries which don’t resolve in a few days with the basic care may require the attention of a sports medicine physician.
 
Youth tennis is another important topic. I encourage parents to teach your children tennis at a young age because it’s one of the safer sports for them to play. In addition, there are long-term health benefits for children who start playing at a young age and continue playing as an adult. We discuss those positives and other benefits in the third YouTube video.
 
Visit our YouTube channel to watch the videos and tell us what you think in the comments section.

http://www.youtube.com/user/MethodistsSports?feature=watch

 To read Dr. Sallay’s “Healthy Tennis” articles in Midwest Tennis magazine

http://www.methodistsports.com/physicians/peter_sallay/documents/Dr.SallayTennis_Articles.pdf

After the successful surgery, her son, Nick, motivated his mother in a unique way by recording videos of her exercise routines. This way, she could easily remember them and could visually chart her progress. With the help a physical therapist, Marion recovered ahead of schedule and she said the total knee replacement surgery gave her a new beginning in life.
 
Many of our patients at Methodist Sports Medicine / The Orthopedic Specialists need their family and friends to help them through the rehabilitation process, and I was impressed with Nick’s method of using video. Nick edited multiple recordings into a short movie trailer that he premiered at their family holiday party in 2011. He passed it along to our staff and he wants to share it with you.
 
Nick said he titled the video “Mom’s Road to London 2012”as a metaphor of her hard work and inspirational triumph.
 

VIDEO: Mom’sRoadtoLondon2012

Only three physicians in the state of Indiana belong to the ACL Study Group. John McCarroll, M.D., and I have the privilege to represent Methodist Sports Medicine / The Orthopedic Specialists and collaborate with doctors from around the world.

The ACL Study Group was organized 25 years ago by John Faegin, M.D., and a small group of orthopedic surgeons with a common interest in the anterior cruciate ligament. Now, John Bergfeld M.D., organizes this large international study group that meets every two years to exchange information in an informal and friendly atmosphere. About 40 percent of the attendees are from the United States, 40 percent come from Europe and 20 percent travel from Asia, New Zealand and Australia.

The presentations deal with the past, present and future of ACL injuries and treatment. These are some of the topics I am looking forward to hearing:

• Returning to sports after ACL reconstruction at the high school and collegiate football level.
• Is it possible to prevent ACL injuries among adolescents?
• ACL reconstruction to decrease the advancement of arthritis.

I am excited to see what improvements and innovations have been developed since our last meeting that will help our patients at Methodist Sports Medicine / The Orthopedic Specialists.

As I hinted at earlier, runners are often affected by shin splints, but aerobic dancers and individuals in the military also are at risk. These individuals can reduce their risk of experiencing shin splints by gradually making changes to their workout routine or increasing their workout routine overtime. Changes in an exercise regimen by running longer distances or on hills, or increasing the frequency of how much an individual exercises each week can all lead to shin splints. Individuals with flat feet also have an increased chance of suffering shin splints because they are forced to place a significant amount of stress on their lower leg muscles while exercising. 

If you do suffer from shin splints the best course of treatment is rest. You will need to take several weeks off and utilize low-impact activities or conditioning as a substitute, such as stretching exercises or yoga. Depending on the severity of your shin splints, I also might recommend anti-inflammatory medication or the use of cold packs and mild compression to decrease the swelling and pain.

After resting for a few weeks, it will be okay for you to hit the gym or field again – just take it slowly. Warm up and stretch adequately before and after exercising. Gradually increase your training, and if your shins start to bother you again, stop immediately. Rest for another few days, use a cold pack and then return to your exercise schedule even more slowly.

If rest does not effectively treat you’re your symptoms, you should consult an orthopedic specialist. It’s important to keep in mind that other more serious conditions can mimic shin splints. Only a doctor can determine the cause of prolonged shin pain, some of which may include:
• A stress fracture – If shin splints do not heal overtime with rest, an MRI might be recommended to help determine if you have suffered a stress fracture of the tibia bone.

• Tendonitis – An inflamed tendon, known as tendonitis is a result of overusing a joint or not stretching properly before activity. This can cause pain very similar to what you’d feel if you suffered shin splints. A doctor may use an MRI to help diagnose the presence of tendonitis.

• Chronic exertional compartment syndrome – This is a very unusual condition that causes nerve compression and pain, most often in the front of the lower leg. It occurs due to excessive muscle swelling during activity that puts pressure on these blood vessels and nerves, and results in pain, swelling, weakness and possibly loss of muscle coordination. In many cases compartment syndrome is treated with surgery to release the fascia and allow more room in the compartment.

One of the best ways to avoid shin splints is exercising smartly. However, if you start experiencing shin pain, consult your orthopedic specialist so he can accurately assess your condition.

More than 8 million student athletes participate in fall sports and many of them will be sidelined before the end of the season due to a sports-related injury.  In fact, according to the American Academy of Orthopedic Surgeons, nearly 1.8 million student athletes will be injured this year.

Heat exhaustion, sprains and strains, and acute injuries are commonly seen in athletes returning to fall sports. After a long summer, kids are less physically prepared to hit the playing field, which can lead to an increase in injuries. A pre-season physical, wearing properly-fitting equipment and recognizing pain early can prevent some of these injuries.

Following are some of the most common injuries faced by athletes that participate in the fall’s most popular sports, including football, basketball and wrestling:

Football
More than 920,000 student athletes are treated for football-related injuries each year – the most of any fall sport. The most common football-related injuries include:
• Strains and sprains: These are the most common injuries in football and usually affect the ankle, knee or wrist. Signs of this type of injury include pain, swelling, bruising and limited ability to move the affected muscle or joint.
• Fractures: Fractures to the wrist, arm and leg account for more than one quarter of all serious football injuries. Bruises, swelling, localized pain and the inability to move the affected area, are all signs of a fracture.
• ACL tears: Indications of a possible ACL tear include hearing a “pop,” instability of the knee, immediate pain and swelling.
• Concussions: If a player experiences a significant “blow” to the head it can be very serious. They should seek immediate medical treatment if they have a headache, nausea or confusion. Loss of consciousness is also possible.

Wrestling
According to the American Academy of Pediatrics, wrestling ranks fourth in participation but second in the rate of injuries suffered by athletes. In addition to concussions, the most common wrestling-related injuries include:
• Prepatellar Bursitis: Also known as “housekeeper’s knee,” key symptoms include swelling and pain on the top of the kneecap along with limited movement.
• Rotator cuff tendonitis: The wear and tear on the shoulder during wrestling can cause tendonitis, which is an inflammation within the shoulder joint. This can cause pain with movement of the arm, trouble sleeping due to pressure on the shoulder and weakness of the arm when reaching overhead.

Basketball
Each year, more than 481,000 basketball-related injuries are treated, according to the U.S. Consumer Product Safety Commission. Some of the most common basketball injuries seen are:
• Jammed fingers: Blunt impact to the tips of fingers can cause the joints in the fingers to jam, causing pain, bruising and swelling.
• Ankle sprains: Pay attention to tenderness, pain and swelling around the ankle. These symptoms, along with the loss of movement of the ankle, can indicate an ankle sprain.
• Plantar Fasciitis: A sharp pain in the heel of the foot, especially in the morning, is a common symptom of this injury.

As with any time of year, athletes that participate in fall sports must make sure their bodies are properly conditioned before hitting the playing field. If they do experience discomfort or an injury they should seek help from their onsite medical staff and follow up medical care from an experienced orthopedic surgeon.

More than 49 million Americans, young and old, will take to the roads on a bike each month. Whether it’s pedaling in the park or competing in a marathon, cycling does come with risks. In fact, more than 567,000 cycling-related injuries occur each year, according to the American Academy of Orthopaedic Surgeons.
Cycling is a great low-impact way to stay in shape but due to its repetitive nature, joint injuries and muscle pain are a common occurrence. If a person experiences pain around their knee cap, swelling or prolonged muscle inflammation they should consult an orthopedic surgeon.  However, prior to that there are measures that can be taken to avoid an injury.
If you enjoy an occasional bike ride or are an avid cyclist, it’s important to follow these tips to help avoid knee-related injuries:
• Take precautionary measures – It is important that your bike’s seat and handle bars fit your height.  If your bike is not properly adjusted, it could place unnecessary pressure on your knee joints. Too high of a seat can cause pain in the back of the knee, while a seat that is too low or too far forward can cause pain in the front of the knee. Also, make sure your foot and cleat alignment is correct. Pain on the inside or outside of the knee can be caused by improper foot position on the pedal.

• Wear appropriate gear – Head injuries are one of the number one reasons for emergency room visits. Wearing a helmet while riding a bike is one safety precaution that should never be overlooked. In fact, it’s estimated that wearing a helmet can reduce head injuries 85 to 88 percent. Cyclists should also consider wearing knee and elbow pads to reduce the risk of injuries to those areas if they experience a fall.

• Follow the rules of the road – It is important to follow the rules of the road when out on the street. Bike on even, dry surfaces and ride in the direction of traffic. Avoid biking at night, but if you do, wear reflectors. Also, stay alert and pay attention to your surroundings to avoid falls or collisions.

• Strengthen and stretch your muscles – As with any sport, stretching before a bike ride gets your muscles warmed up and ready for a more rigorous workout. Stretching not only prepares your muscles for a more efficient ride, but it creates flexibility and decreases the risk of a pulled muscle or injury. By strengthening the muscle around the knee joint through strength training, a knee injury is less likely.

• Rest your body and knees – Overuse injuries to the knee can be caused by riding too hard, too many miles or too long without giving your knees a rest. Lack of rest can lead to serious knee damage. When first starting out, bike at a low resistance to get use to road riding. Also use a gear that allows you to pedal quickly, approximately 70-100 strokes per minute. Since there can be increased tension when the quadriceps meet the knee cap during a ride, make sure to strengthen the muscles around the knee to reduce injury.

If you do experience an injury, it’s important to have it evaluated by an orthopedic specialist. Unchecked knee pain could be something more serious, such as a fracture, torn ligament or torn cartilage. Only a qualified orthopedic surgeon can determine the extent of an injury.

Participation in summer sports is a great way to stay physically fit, but it also increases the chance of injury – particularly to a person’s knees. In fact, according to the American Academy of Orthopedic Surgeons, more than 19 million visits a year are made to physician’s offices due to knee injuries.
Mark Ritter, M.D., an orthopedic surgeon with Methodist Sports Medicine/The Orthopedic Specialists, sees an increase in sports-related knee injuries during the summer months. “I see many patients who come in with knee injuries that could possibly have been avoided by using a few preventative measures,” says Dr. Ritter. “It’s important that athletes have a thorough medical evaluation and properly condition their body before participating in a marathon or a competitive sport. Doing so will diminish their chance of experiencing a sports-related injury.”
Dr. Ritter offers some other tips on ways to avoid common sports-related knee injuries:
• Warm up and cool down – It is important to stretch before and after any physical activity, especially a game. Your muscles need to be warmed up before any rigorous exercise as cold muscles are more prone to injury. There are stretches for legs and knees that you can perform. One easy exercise is to lie prone (face down) and grab the ankle of the leg, which helps stretch the front of the knee.

• Condition and strengthen muscles –Strengthening your overall core will also increase stability. Consistent exercise ensures your body is preparing muscles for more strenuous play. By working the quadriceps and hamstrings, your knee will be supported. Also, yoga is a good way to increase flexibility and create a strong core.

• Don’t “play through” an injury – Make sure to stop playing when you feel pain and to tell trainers and doctors all the symptoms of the pain. Playing through the pain could make the injury worse. Pay attention to your body’s signals and rest when you experience fatigue.

• Recognize pain, swelling and stiffness – If you recognize any pain, swelling or stiffness, stop playing and let your knee rest. These could be symptoms of tendonitis or bursitis – common injuries in soccer and sports that require running or where the knee could be overused. The pain could also indicate an injury known as Runner’s Knee or a torn cartilage.

• Pay attention to your surroundings – By doing this, you are less likely to receive a direct blow to the knee or fall. Twisting a knee during a fall or a blow to the knee can result in a few common injuries. A torn anterior cruciate ligament (ACL) is the most common injured ligament in the knee and occurs when the knee is twisted too far or in an odd way. Knowing where other players are on the field or court can reduce your risk of falling and incurring a knee injury.

• Use knee bracing and correct footwear – Wearing a knee brace can help stabilize and support the knee. Also, make sure to wear the proper shoes for the sport and replace them as they become worn out.

• Get a physical exam – Before starting any recreational or organized sport, it is important to get a physical exam. This allows your doctor to identify any problem areas in your muscles and joints. It also makes sure you’re in the right condition for the sport.

In most cases, it is best to rest the knee until the pain subsides and the injury heals. Don’t go back to sports too quickly or you could reinjure the knee. If you have severe pain, feel or hear a popping of the knee or have serious swelling, it is important to see an orthopedic specialist. Pain and swelling for more than 48 hours can indicate a more serious injury. Most knee injuries can be treated without surgery, though in more severe cases, surgery may be needed. For more information on how to stay safe during summer sports and activities, visit www.mykneehurts.info.

From baseball to soccer to football, everyday millions of children and young adults participate in sports activities. These activities teach children team work and improve their physical fitness, coordination and self-discipline.  It also increases their chance of experiencing sports-related injuries such as concussions, sprains, fractures, muscle tears, and back and neck injuries. However, there are measures that can be taken to help prevent these types of injuries, such as:
• Undergoing medical exams prior to the sport’s season, which should include concussion screenings and physical evaluations;
• Using proper protective gear, such as shin guards for soccer and helmets for football and baseball;
• Staying hydrated and always warming up before practice or a game;
• Never playing through pain or an injury.

If an athlete does experience an injury it is important that it is not ignored or taken lightly.
Sports-related injuries in children are of great concern because their bones, muscles, tendons and ligaments are still growing. To avoid long-term damage, young athletes should seek immediate care for any minor or serious injury.

Following are several signs to help determine if immediate care is needed:
• Inability to play following a sudden injury;
• Decreased ability to play due to a chronic or long-term complication following an injury;
• Visible deformity of the athlete’s arms or legs;
• Severe pain from a sudden injury, which may prevent the use of an arm or leg.

Sometimes, sports-related injuries occur after office hours or on the weekends.  If and when this happens I recommend that my patients visit the emergency room or an orthopedic walk-in clinic like the one we have at Methodist Sports Medicine / The Orthopedic Specialists. One of our fellowship-trained orthopedic surgeons is available to treat patients with sudden or recent sports or active lifestyle-related injuries.  Patients can visit our Avon or Greenwood locations Monday through Friday from 8 a.m. to 10 a.m., or our Carmel location Monday through Saturday from 8 a.m. to 10 a.m. For more information, please visit www.methodistsports.com or call 317-817-1200.

By Barb Berggoetz

Winter is upon us, and with that comes snow, ice and winter sports.

“Winter can be a great time to get involved in some fun sports, but if you are one of the millions of people who will take to the ice and snow this season, pay attention to your body and prepare yourself for the sport,” said Dr. Mark Ritter, an orthopedic surgeon at Methodist Sports Medicine/The Orthopedic Specialists.

According to the American Academy of Orthopedic Surgeons, snowboarding is the leading cause of winter sports injuries, affecting nearly 150,000 people. Next is skiing and snowmobiling.

For more information on how to stay safe during winter sports and activities, visit www.mykneehurts .info, www.mybackhurts.info, or www.methodistsports.com.

Here are some of Ritter’s tips:

1. Warm up and cool down: Stretch for about 30 seconds or more and do some light exercise for three to five minutes to warm up your muscles. This helps blood to flow to your back muscles and prepares your body for activity. A cool down afterward reduces cramping and tightening.

2. Gear up properly: It is important to wear the correct footwear, protective gear and layers to keep warm. Not only is proper gear important, but staying warm is essential to prevent frostbite and keep muscles flexible.

3. Don’t imitate stunts: Don’t try any stunts you see on TV. Those are practiced moves that can cause untrained athletes to injure themselves.

4. Never practice alone: Because extreme sports are just that, extreme, you should never practice alone in case of an injury.

5. Use good technique: Remember not to twist or jerk your body in a way that is uncomfortable. It’s wise to take lessons from a trained professional to prevent back strain or injury.

Unfortunately, there are several common misconceptions associated with knee replacement surgery.  The most common is the belief that the procedure will allow you to become a super athlete or do more than you could before you developed a knee injury or arthritis. I can tell you that this won’t occur. However, for those individuals that choose to undergo knee replacement surgery, 90 percent will experience a dramatic reduction of knee pain and a significant improvement in their ability to perform common everyday physical activities.

To improve upon your recovery results, your orthopedic surgeon will advise you to avoid certain activities such as lifting heavy objects, jogging or participating in high-impact sports – for the rest of your life.  He may also ask you to adhere to following guidelines:

• Follow your surgeon’s and physical therapist’s instructions carefully.  Doing so will improve your long term recovery.

• Keep up with your exercises. By closely following the directions of your physical therapist, the better your chances are for a successful recovery.

• Engage in lower stress activities. Try activities such as golfing, hiking, walking or swimming. These activities place less stress on your knees.

• Manage your pain as directed.  Be sure to take pain medications as prescribed by your doctor.  If the medication is not relieving your pain, speak with your doctor about other pain management options.

• Control swelling. Place ice cubes in a sealable plastic bag, wrap it in a towel and place it on your knee.  By reducing the swelling, you will help to reduce pain and improve circulation and range of motion.

• Rest.  It’s important to get plenty of sleep to help your knee heal.  You will want to minimize keeping the leg down (standing or sitting) too long during the first few weeks as it will cause increased swelling in the knee during this healing process.  When sitting try to keep the leg propped up.   

Following your surgery, you should conduct a yearly check up with your orthopedic surgeon.  Your surgeon will monitor for wear and tear, and other potential future complications. Remember, excessive activity or weight may accelerate the normal wear of your knee replacement, and cause it to loosen and become painful. With appropriate activity modification, a patient’s knee replacement could last for many years and hopefully for life!