Category Archives: Injuries

5 Facts About Shoulder Injuries

Most people think joint problems are limited to serious athletes or older adults. But when it comes to the shoulder, everyone is at risk.

Between the ages of 18 and 88, almost everyone will experience some kind of shoulder issue, according to Gregory Nicholson, MD, an orthopedic surgeon who specializes in shoulder surgery at Rush University Medical Center.

In fact, shoulders are the most commonly injured joints in the body. The unique and complex anatomy of the shoulder makes it …

1.35 Million Youths a Year Suffer Serious Sports Injuries

Occasional bumps and bruises are expected when kids play sports, but for more than 1.35 million children last year a sports-related injury was severe enough to send them to a hospital emergency department.

Sprains and strains, fractures, contusions, abrasions and concussions top the list of sports-related ER diagnoses for kids ages 6 to 19 — at a cost of more than $935 million each year, according to a report out Tuesday from the non-profit advocacy group Safe Kids Worldwide.

ACL Tears Are on the Rise in Kids

ACL Tears are on the Rise in KidsOnce considered an adult injury, ACL tears are occurring more often in the legs of elementary and middle school-age children, orthopedic specialists report. The increase, which stems in part from better diagnostic tools and a dramatic increase in children playing competitive, organized sports, has created a vexing problem: What is the best way to fix it?

For years, doctors have advised delaying surgery until the bones are finished growing, usually around age 14 for girls and 16 for boys. In the meantime, children were prescribed physical therapy and encouraged to remain active while using a knee brace, with the exception of cutting, pivoting and contact sports.

But postponing surgery hasn’t worked very well, in part because it’s difficult to keep children from further damaging the knee while they wait, In some cases for years. Athletic youngsters often must stop playing sports they love, a loss that can lead to depression and affect a child’s identity and friendships.

The ACL, which connects the thigh bones and shinbones inside the knee joint, is a crucial stabilizer during sports like basketball, football, soccer and lacrosse. Its job is to protect the knee from shifting, rotating and hyperextending as an athlete runs, jumps or lands. An easy way to tear the ligament involves simultaneously decelerating and twisting.

In adults, surgery is not always necessary, especially for those with sedentary lifestyles. Though skiing and soccer might be out, it is possible to walk, run and even play tennis with a fully torn ACL.

Risks are higher for children because it is hard to get them to modify their activity. A study published last year in The American Journal of Sports Medicine found that young athletes who delay surgery five months or more have a higher chance of suffering a secondary knee injury. Waiting can lead to progressive damage to other parts of the knee, including the meniscus and cartilage, multiple studies show.

Though official statistics are scarce, orthopedic specialists estimate that thousands of children and teens are tearing their ACLs each year. Researchers at Children’s Hospital of Philadelphia found a 400 percent increase in youth ACL injuries over the last decade, according to findings presented at the American Academy of Pediatrics 2011 annual meeting. Girls have up to eight times the risk of an ACL tear as boys; though no one knows exactly why.

Dr. Stickney specializes in hip, knee and shoulder surgery in his Kirkland and Redmond locations. If you are experiencing knee issues or have questions about treatment options, contact our office to schedule your next appointment! Watch Dr. Stickney’s video and learn more about orthopedic surgery.

Bad Knees: The Best Exercises to Prevent Further Injury

When people have bad knees, whether they were athletes for several years, received a detrimental injury or have osteoarthritis, it can be a pain – literally. Aside from limiting your daily activity, it can also make staying in shape a lot harder. Consider these exercises to keep active with bad knees.

Common mistakes

best exercises to prevent further injuryWhen people with bad knees exercise, they often make a few mistakes along the way. First off, many people try several different cardio exercises, which is not always a good idea. Only certain knee exercises can help burn calories without putting people in pain. When some do knee exercises, they may bend their knees past the front of their toes. This can aggravate knee joints and make orthopedic problems worse. This is because it puts intense pressure beneath the kneecap, stressing the muscles around it. People sometimes start to perform exercises that their knees cannot handle because they did not ask their doctor first, putting them in danger. Knowing knee strength and capability is crucial before starting any kind of exercise regimen.

Beneficial Knee Exercises

Think about trying out these activities at the gym to get a workout in. Complete these exercises in 10 or more repetitions.

Partial Squats – Many people know that regular squats can put bad knees in a lot of pain. However, partial squats can burn calories without aggravating the knee muscles. People begin this exercise similar to regular squats, with their feet hip-width apart. Slowly lower the body, making sure that the toes do not go past the knees. People should only go as low as is comfortable.

Step-Ups – Step-ups can help work the hamstrings, quads and gluteus muscles and strengthen knee muscles if done correctly. People can use an anaerobic step or a step on a staircase for this activity. Step up on one foot, tapping the other at the edge of the stair. Step down and switch. As with partial squats, the knee should not bend over the toes.

Calf Raises – This exercise strengthens the foot, ankle and calf muscles. Stand up with both feet pointed forward. Raise the heels off the ground slowly and then lower them again, making sure to keep the heels in sync. Going slowly makes the workout harder. If people have difficulty staying balanced, they can use a wall or chair for stability.

Hamstring Stretch – This activity helps promote circulation and prevents muscle injuries. People should begin by lying on their back with one leg straight out. Keeping the other leg straight, they should wrap a towel around the foot and pull the leg toward them, making sure that the knee does not lock.

Dr. Stickney specializes in hip, knee and shoulder surgery in his Kirkland and Redmond locations. If you are experiencing knee issues or have questions about your treatment options, contact our office to schedule your next appointment! Watch Dr. Stickney’s video and learn more about orthopedic surgery.

The Throwing Arm of a Baseball Pitcher – Understanding Shoulder Pain

Shoulder pain, particularly related to throwing sports such as baseball, involves the rotator cuff. You may have heard a variety of medical terms related to the shoulder, like rotator cuff tendinitis, rotator cuff tear, or impingement syndrome. But what does this mean  to a baseball athlete?

The first piece of good news is tha shoulder pain, like most other Pitcher at Mound, Throwing the Ballsports-related injuries, rarely requires surgery. Now that we are hopeful that surgery will not likely be required, what can we do to alleviate the shoulder pain and prevent it from coming back?

Before discussing treatments for shoulder pain, a basic understanding of the anatomy of the shoulder may be helpful. The shoulder is a complex joint. There are three bones and two joints that contribute to shoulder function– the humerus, clavicle, and scapula are the bones. The ball and socket joint of the shoulder is between the humerus and the scapula. The acromial clavicular joint between the scapula and clavicle moves with forward elevation of the arm and helps stabilize the shoulder on the chest wall. The shoulder is the most mobile joint in the body and because of this it is easily injured.

Causes of Rotator Cuff Injuries

The shoulder joint is often injured in the throwing sports, such as baseball, because it has a greater range of movement than any other joint in the body. Shoulder muscles and ligaments bare a tremendous amount of stress throughout the throwing motion.

When you raise your arm up above your head, as occurs during the cocking and acceleration phases of the pitching motion, the rotator cuff muscles can be pinched under the acromion, causing irritation and occasionally sharp pain felt on the front or top of the shoulder. This situation is referred to as “shoulder impingement’ or “impingement syndrome”.

Deceleration

 A good throwing technique requires the athlete to use his body weight and the large muscle groups of the legs, back and trunk to generate kinetic energy across the shoulder in the direction of the thrown object. After the ball is released, the retained energy in the throwing arm needs to be dissipated back to the large muscles which then absorb it. Stated more simply, after a ball is thrown, the arm must decelerate. The large muscles of the back and trunk, as well as the triceps and the rotator cuff all assist in deceleration of the arm. A tremendous amount of stress can be placed on the rotator cuff muscles as they assist in decelerating the arm after the ball is released. This is particularly true in pitchers who don’t follow through all the way. By not following through, deceleration must occur abruptly, increasing the amount of stress that is placed on the smaller and more easily injured rotator cuff muscles.

Biomechanics

As stated above, when a pitcher has poor biomechanics, undue stress can be placed on the soft tissue structures of the shoulder. Different biomechanical flaws place stress on different structures. Volumes have been written on the subject. What is important to remember here is that pitchers with poor throwing biomechanics place undue stress on the smaller rotator cuff muscles, compared to the stronger muscles of the back and trunk.  Ensuring that an athlete learns proper throwing technique is a worthy investment in the health of their arm.

 Overuse 

Overuse is the most common source of throwing related injuries. Most importantly, it is avoidable. Paying close attention to pitch counts and giving athletes ample rest is the best way to prevent overuse injuries. It is important that athletes are allowed to come out of a game at the first sign of shoulder discomfort or soreness, even if it is not convenient to the goal of winning the game that day.

Treatment and Prevention

Reduce Inflammation – Using the RICE method: 1) Rest; 2) Ice; 3) Compression; and 4) Elevation

Myofascial Release – When muscle tissue is injured, scar is formed. Scar formation (also called myofascial adhesion) is the body’s way of patching an injured area. The problem with scar is that it is tough and fibrous, whereas healthy muscle is supple and elastic, like a rubber band. Myofascial Release Technique is used to break up scar formation and restore the muscle’s elasticity, or rubberband-like characteristics. Once the rotator cuff muscles are painfree and myofascial adhesions are broken, therapeutic exercises are essential to a complete recovery. It should also be noted that myofascial release technique can increase throwing velocity by optimizing the elasticity of the throwing muscles.

Stretching and Strengthening Exercise – Stretching and strengthening of the rotator cuff is crucial to completing shoulder rehab and remaining pain free. A few simple rotator cuff exercises will strengthen the muscles, resulting in injury resistance and optimal performance. You’ll notice that college and major league pitchers perform rotator cuff exercises on a regular basis, even when they are not injured. This speaks volumes to the importance of a healthy rotator cuff in pitchers, as well as other athletes whose sport involves repetitive stress on the shoulder.

If you are shoulder pain due to a sports injury, please call me at 425-823-400 or email me at ProOrthoAppointment@proliancesurgeons.com to schedule an appointment.

Common Weightlifting Injuries

Weight lifting is a sport as well as part of someone’s exercise regimen.  Experienced weight lifters rarely suffer serious injuries but newcomers to the sport or exercise are more prone to musculoskeletal injuries.

 

Distal biceps rupture:

This is a rupture of the biceps tendon that attaches the biceps muscle in the arm to a bone of the upper forearm. A weightlifter can rupture this tendon at the elbow with a sudden force that extends the elbow while trying to contract the biceps. Performing a biceps curl and then losing control of the weight is an example. Surgery to reattach the tendon is usually needed. Choosing a weight that a person can lift and control can help prevent a distal biceps rupture.

 

Labral tear:

The labrum is a cartilage bumper in the shoulder that surrounds the glenoid (socket). With repetitive compression of the labrum or possibly an acute motion that injures the shoulder, the weightlifter can feel discomfort or a clicking sensation deep within the shoulder. An orthopedic surgeon can perform a physical exam and tests that suggest a labral tear. An MRI with contrast injected (MR arthrogram) can demonstrate a tear. Surgery is often required to treat a shoulder labral tear if it limits activity. Proper technique and having shoulder pain evaluated early if it is not improving can be helpful.

 

Shouldering impingement:

This is more of a cause of chronic shoulder pain in a weightlifter rather than an acute injury. Avoiding exercises that cause pain can help the problem. Working with a physical therapist to improve shoulder mechanics and strengthen the muscles around the shoulder can often speed recovery. Seeing an orthopedic surgeon or a physical therapist when this problem develops and starting a treatment program can often accelerate return to overhead lifting.

 

Lower back muscle strain:

A strain of the muscles of the lumbar spine can occur from using improper technique with exercises or picking up or putting down weights awkwardly. Fortunately most don’t require more aggressive treatment than rest and activity modification. Proper lifting technique is key.

 

Quadriceps or hamstring muscle strain:

Acute strains of the quadriceps and hamstring muscles from squats, leg presses, lunges and other lower extremity exercises can occur. Most heal without surgery and require only rest and short-term exercise modification. Proper exercise techniques and choosing an appropriate amount of weight can help prevent injuries.

 

 

Patellar or quadriceps tendonitis:

These are also more chronic issues with the tendons around the knee than acute injuries. Pain in the tendons above or below the kneecap with lower extremity exercises can develop and worsen over time. Often short-term avoidance of exercises that reproduce the pain, anti-inflammatory medication, and ice can resolve the problem.

 

Many of the injuries listed above can be prevented by using proper technique. Often simply rest and short-term activity modification can prevent a minor pain from turning into a more serious injury.

 

If any musculoskeletal pain continues to limit your ability to work out the way you want, consider visiting Dr. Stickney to learn and understand possible treatments by calling 425-823-400 to schedule an appointment or email him at ProOrthoAppointment@proliancesurgeons.com.