Join Team TOCA with Dr. Feng & the Arthritis Foundation for the Walk to Cure Arthritis!

Enjoy the beautiful Arizona weather by joining Team TOCA, Dr. Earl Feng (Orthopedic Surgeon, Arthritis & Total Joint Reconstruction) and the Arthritis Foundation in the Annual Walk for the Cure, Saturday May 5th, 2018 at the Phoenix Zoo! Dr. Feng is not only a TOCA Physician & Surgeon but also serves as a Board Member for the Arthritis Foundation!

At TOCA, each of us has an important role in helping the more than 1.2 million Arizonans living with arthritis including many our patients, our colleagues, and more than 6,000 children in Arizona alone. TOCA is proud to continue our support the 2018 Arizona Walk to Cure Arthritis on May 5th at the Phoenix Zoo. As a sponsor of the Walk to Cure Arthritis, our goal is to help more people with arthritis.

The Arthritis Foundation is the Champion of Yes for patients with arthritis who are being told “no” a lot. No, there isn’t a cure. No, you cannot play sports. No, you cannot pick-up your grandchild.

Here is how you can help!

• Through funding critical research for osteoarthritis to find better treatments and ultimately a cure.
• Giving kids living with arthritis the opportunity to attend Camp Cruz to meet other kids living with arthritis.
• Supporting programs like the Live Yes network for people in our community struggling with pain, connecting them with others with arthritis.
• Getting a patient get back on their feet so they can walk their dog.
• Helping a grandparent alleviate back pain so they can pick up their grandchild.
• Saying “YES” to a patient today!

The event features a three-mile and one-mile course, with arthritis information and activities for the entire family!

Let’s raise funds to find a cure for arthritis, then come together to support each other and walk! Every step counts, every dollar matters!  The Arthritis Foundation’s Walk to Cure Arthritis to help the more than 50 million Americans and 300,000 children with arthritis live better today and to keep the Arthritis Foundation’s promise of finding a cure for tomorrow. Be a Champion of Yes – join our team and raise funds to fight arthritis and find a cure, all while having A LOT OF FUN! If you aren’t able to join the team, we’d appreciate your donation to help reach our goal.

Click here to learn more about this event, join Team TOCA and/or Donate Today! Team TOCA

Event Location:
The Phoenix Zoo
455 N Galvin Pkwy
Phoenix , AZ 85008
Event Schedule:
Event Registration Starts 5/5/2017 6:30 am
Event Registration Ends 5/5/2017 8:00 am
Event Starts 5/5/2017 7:30 am
Event Ends 5/5/2017 10:00 am
Fees:
Walk to Cure Arthritis Registration: No Fees
Event Registration

To Learn more about Dr. Feng and TOCA visit: www.tocamd.com or call 602-277-6211

#Arthritisfoundation #WalktoCureArthritis #Results #Recovery #Relife#TOCAMD #TOCA #ArthritisPhxWalk #PhoenixZoo

Celebrate National PA (Physician Assistant) Week October 6 – 12th!

Each year from October 6-12, we celebrate National PA Week, which recognizes the PA profession and its contributions to the nation’s health.

This week is also an opportunity to raise awareness and visibility of the profession. Before it was a weeklong event, National PA Day was first celebrated on October 6, 1987, in honor of the 20th anniversary of the first graduating class of PAs from the Duke University PA program. October 6th is also the birthday of the profession’s founder, Eugene A. Stead, Jr., MD. Now the profession is 50 years strong!

History of the PA Profession

The PA profession was created to improve and expand healthcare.

In the mid-1960s, physicians and educators recognized there was a shortage of primary care physicians.

To help remedy this, Eugene A. Stead Jr., MD, of the Duke University Medical Center, put together the first class of PAs in 1965. He selected four Navy Hospital Corpsmen who had received considerable medical training during their military service. Stead based the curriculum of the PA program on his knowledge of the fast-track training of doctors during World War II.

The first PA class graduated from the Duke University PA program on Oct. 6, 1967.

The PA concept was lauded early on and gained federal acceptance and backing as early as the 1970s as a creative solution to physician shortages. The medical community helped support the new profession and spurred the setting of accreditation standards, establishment of a national certification process and standardized examination, and development of continuing medical education requirements.

What is a PA? (American Academy of PAs)

What is a PA?

A physician assistant (or PA) is a nationally certified and state-licensed medical professional. There are currently more than 100,000 clinically practicing PA’s in the United States! PA’s practice medicine on health care teams with physicians and other providers. They also prescribe medication in all 50 states.

 

What does a PA do? Well, at the most basic level, a PA is a medical practitioner who works under the supervision of a physician.

Physician assistants (PAs) work closely with doctors and handle duties that range from taking medical histories to setting simple fractures. They are allowed to prescribe medications in some states. Many PAs specialize in a particular area of medicine, such as pediatrics. A master’s degree is required, and all states require that PAs be licensed. Licensing requires passing a multiple-choice exam and completing continuing education courses to keep knowledge current.

Beyond the basic definition, however, the PA profession represents an essential part of the health care infrastructure in a number of important ways.

Physician assistants examine, diagnose and treat patients under the supervision of licensed physician. PAs can prepare casts or splints, suture small wounds and interpret medical tests. According to the American Academy of Physician Assistants (AAPA), these medically-trained professionals can also prescribe medications (www.aapa.org).

Some PAs specialize in a particular area of medicine, such as emergency care or geriatrics, and can assist doctors in advanced medical techniques and procedures. Physician assistants are often the first line of medical care in rural and underserved areas. In some cases, a physician assistant will refer the patient to a medical doctor or make arrangements for transferring the patient to a hospital or clinic.

During this week, TOCA is excited to honor our amazing PAs and to say a big thank you. We appreciate your dedication to patient care, and we recognize the impact that you make in the lives of those patients every day.

To read more about the dedicated Physician Assistant staff at TOCA Click Here

To learn more about TOCA or to schedule an appointment call 602-277-6211

 

#Recovery #Results #Relief #TOCA #TOCAMD #PA #PAWeek #ThankAPA #Patientcare #PhysicianAssistant #PADay #MyOrthoDoc

Protect you and your Children from Injury this Fourth of July Holiday!

Protect you and your Children from Injury this Fourth of July Holiday: Celebrating our Independence with a Boom has been a tradition for many families for years over the July 4th Holiday season. Unfortunately every year thousands of children and adults are needlessly injured by not following basic fireworks safety tips. With the proper respect fireworks deserve, everyone can safely enjoy the show.

Children are most frequently injured by fireworks. Most are under the age of 15. You may think firecrackers or other types of explosive or rocket variety fireworks are most responsible for their injuries. In fact, the biggest risk of injury comes from sparklers. Sparklers account for roughly 16% of all firework related injuries. If you consider children alone, sparklers account for about 1/3 of all injuries and over half of the injuries to children under 5.

In order to prevent children from being injured by sparklers, it is important to consider following some very simple safety tips.

1. Never let children handle, light or play with sparklers without adult supervision.
2. Don’t let your child handle or light more than one sparkler at a time.
3. Don’t pass of a lit sparkler to someone else, have them hold the unlit sparkler while you light it.
4. Don’t hold your child in your arms while you or the child is using sparklers.
5. Keep your distance: its recommended children stay at least 6 feet apart from one another while handling sparklers.
6. Instruct your child to hold the sparkler away from their body keeping them at arm’s length.
7. Avoid waving the sparklers wildly through the air as children frequently lose hold of the sparkler causing injury to themselves or others around them.
8. Wear proper clothing and footwear. Many injuries occur when an burnt out sparkler is dropped on the ground causing foot burns or puncture wounds from stepping on them.
9. Once the sparkler flame goes out, the metal rod should be dropped directly into a bucket of water. The extinguished sparkler and metal rod remain hot for a long time.
10. Keep your fireworks out of the reach of children. Lock them up. Kids are creative and can easily find a source of fire to ignite fireworks, i.e. a lit candle.

Above all, use common sense, pay attention to children, and if alcohol is involved in an adult party with children, designate someone to remain sober and responsible while any and all fireworks are in use. Hopefully these simple tips can help you and your family avoid an unwanted trip to the emergency department, or worse yet, a permanent and disfiguring injury.

The Hand Surgeons at TOCA, as well as the rest of the Physicians and Staff with you and your family health and happiness as we celebrate with pride, our Independence Day.

To learn more or to schedule an appointment call our dedicated TOCA Team at: 602-277-6211!

#Recovery #Results #Relief #4thofJuly #IndependanceDay #FireworkSaftey #InjuryPrevention #4thofJulyInjuryPrevention #TOCA #TOCAMD

(TFC/TFCC) Triangular Fibrocartilage Complex Tear

WHAT IS A TFCC TEAR?
The triangular fibrocartilage complex (TFCC) is a cartilage structure located on the small finger side of the wrist that, cushions and supports the small carpal bones in the wrist. The TFCC keeps the forearm bones (radius and ulna) stable when the hand grasps or the forearm rotates. An injury or tear to the TFCC can cause chronic wrist pain.

There are two types of TFCC tears:
1. Type 1 tears are called traumatic tears. Falling on an outstretched hand and excessive arm rotation are the most common causes.
2. Type 2 TFCC tears are degenerative or chronic. They can occur over time and with age. The degenerative process wears the cartilage down over time. Some inflammatory disorders, such as rheumatoid arthritis or gout, may also contribute to Type 2 TFCC tears.

WHAT ARE THE SYMPTOMS OF A TFCC TEAR?
• Common symptoms of a TFCC tear include:
• Pain, at the base of small finger side of the wrist
• Pain worsens as the wrist is bent from side to side
• Swelling in the wrist
• Painful clicking in the wrist
• Loss of grip strength

WHO IS LIKELY TO GET A TFCC TEAR?
Anyone can get a TCFF tear. It occurs most often in those who fall on an outstretched hand. Athletes are at risk, especially those who use a racquet, bat or club and those who put a lot of pressure on the wrist such as gymnasts. Degenerative tears are more common in people over 50. Medical attention should be sought as soon as possible after an injury to the wrist.
The hand and wrist specialists at TOCA we provide the most advanced treatment options for TFCC tears. Individualized treatment options are developed for each patient to ensure optimal outcomes.

WHAT CA– USES A TFCC TEAR?
TFCC tears are often sustained when a person falls and lands on the hand, bending the wrist backwards. They can also be present in patients with wrist fractures. Degenerative TFCC tears are more common in people over 50. A longer ulna (arm bone on the small finger side of arm) can also contribute to this condition because it puts more pressure on the TFCC.

HOW IS A TFCC TEAR DIAGNOSED?
TFCC tears are diagnosed through careful examination of the wrist. This involves some manipulation to see the extent and location of pain and immobility. An X-ray may be performed to check for fractures and other abnormalities. The most reliable imaging test is an MRI, which allows doctors to inspect the tissue and cartilage to see the extent of the injury. It is important for a patient to see a board certified physician specializing in treating wrist conditions soon after a traumatic injury.

WHAT ARE THE TREATMENTS FOR TFCC TEAR?
Treatment of a TFCC tear depends on stage of severity.
Non-surgical Treatment Options

• Rest
• Ice
• Splint or cast
• Anti-inflammatory medication, such as ibuprofen
• Cortisone injection
• Ultrasound therapy
• Surgical Treatment Options

Surgical Treatment
If no-operative management fails and the TFC tear is still painful, the next step is often a diagnostic arthroscopy. If there’s just a flap of injured tissue causing the problems, but the DRUJ is stable, the flap can be removed arthroscopically. If the TFC is torn, but the DRUJ is stable, the TFC tear can be repaired arthroscopically. If the TFC is torn and the DRUJ is unstable (loose), an open repair is usually the best treatment. The results from these surgeries are usually very good. If a TFC repair is performed, an above-elbow cast will be used for 4 weeks, and then therapy is started.

Often times, the TFC injury is either caused or exacerbated by the ulna being longer than the radius. In these cases, the ulna may have to be shortened to prevent the TFC from re-tearing. The ulnar shortening can be performed at the same time as the TFC repair. Sometimes, if the relative ulnar length is not too bad, a TFC repair is done without ulnar shortening. In these cases, if pain persists the ulnar shortening is then performed as a 2nd surgery.

Ulnar shortenings are traditionally done through a long incision: A small length of bone (usually 2-4 mm) is removed from the middle of the ulna and a plate is put on to stabilize the ulna while it heals. A short-arm cast is worn for 6 weeks and heavy activities are avoided until the bone is healed, which can take 3-4 months. However, a newer technique of ulnar shortening can be performed through a smaller incision, with a quicker healing time. In these cases, after 2 weeks only a removable splint is used. The newer type of ulnar shortening usually heals in 6 weeks. Most, but not all, patients will have this newer option available to them.

In summary, TFC tears are very common. Fortunately, there is effective treatment for them. All of the surgeries discussed here are performed as outpatient procedures (you go home the same day), and newer techniques are available that allow patients to return to activities quicker, with fewer problems.

At TOCA (The Orthopedic Clinic Association) we have some of Arizona’s most experienced physicians who treat triangular fibrocartilage complex injuries, in addition to other hand and wrist injuries, degenerative diseases and many other orthopedic needs.

To schedule an appointment contact our dedicated TOCA Team at 602-277-6211! You can also learn more about our Orthopedic Hand & Wrists Specialists here on our TOCA website.

 

#Recovery #Results #Relief #Handpain #painfree #TFC #handsurgery

Cast Away: Fishing Safety & Boating in Arizona

Cast Away: Fishing Safety & Boating in Arizona! Arizona is blessed with diverse fishing opportunities, from the large reservoirs to the trout lakes in the mountains, and plenty of low-elevation fishing holes in between. Go out and catch a memory!

Recreational fishing (especially angling) is one of the most popular activities in the world, but as with other sports, it’s not without its risks. Most anglers are careful to avoid the obvious and most dramatic of fishing dangers (dehydration, hooking a finger, boat motor fires, accidental drowning, etc.). However, if you want to keep yourself in top fishing shape, you also have to protect yourself from more mundane fishing hazards – overuse injuries.

As the name states, overuse injuries are caused by too many uninterrupted repetitions of an action. The body parts involved become fatigued to the point of injury; this effect is intensified if the repeated action requires awkward or unnatural movements, such as is sometimes seen in bowling or pitching a baseball. Overuse injuries are notoriously stubborn to cure – but then again, it’s often those with the injuries that are stubborn. Because you must treat an overuse injury with rest (which means taking a sometimes lengthy break from the beloved activity that cause the injury in the first place), many people make the mistake of returning to activity before their injury is fully healed, creating a vicious cycle that can be difficult to break.

Angling provides the perfect conditions for an overuse injury thanks to the repetitive movements of casting coupled with the bad body mechanics that are common to so many people. As is often said, prevention is the best medicine. With a few simple tweaks, you can help stop overuse injuries from ruining your fishing trips.

Although it might sound silly, you should prepare in advance of a fishing trip the way you would for other athletic events. Keeping yourself in good physical condition will give you the endurance you need for long fishing sessions, and you will be less plagued by the aches and pains that can make your trip less enjoyable. Besides eating a balanced diet and exercising regularly, you should include stretching and strengthening exercises specifically geared for the muscles you will use during angling – your abdominals, back, and upper body.
Because fishing trips are often all-day affairs, it’s important to change up your activity. Alternate sitting and standing – but do both with good posture – to avoid unnecessary stress on your back and feet. Switch your grip and casting style throughout the day so no one motion or position is repeated excessively (and as an added bonus, this will help you master a diversity of fishing styles). And perhaps most important of all, take breaks to rest, even if you don’t feel tired. Remember that most people don’t realize they are developing an overuse injury until it’s too late.

Lastly, be realistic about your abilities. Seek coaching to fix any bad body mechanics you may have during casting. Shooting heads and sinking weights put extra strain on the wrists, elbows, and shoulders of anglers who aren’t adept at their use, so avoid them for all but short periods of time if you fall into this category. In addition, using heavy or long rods, longer lines, and fishing for heavy fish should all be engaged in sparingly unless you are expert enough to do so correctly.

Fishing memories can last a lifetime, so don’t let an overuse injury keep you from enjoying the water with your friends and family.
You throw a hook into the water, you sit and wait for a bite or you reel back in. Fishing is a great pastime, but in order for it to be truly enjoyable, you must be safe. Keep these important guidelines and tips in mind for a safe fishing experience.Image result for arizona fishing

1. Get physically prepared.
You don’t necessarily need to be in top physical shape to catch a fish, but you do need to be able to navigate in and out of a boat or possibly across rocks to your favorite fishing spot. Since regular physical activity is essential for your family’s health, make sure you stick to a daily fitness routine leading up to fishing season. Consider visiting the local pool to brush up on your swimming strokes in the case you fall out of the boat or into the water from the shore.

2. Check your fishing gear.
Fishing lines get old and tangled, fishing poles get worn, and lures can break. Open up your tackle box and discard broken fishing tackle. Restring your pole if the line looks ragged and replace your reel or pole if showing signs of damage. The last thing you want to do is cast out and hook someone or yourself due to faulty fishing gear. If you are going out on a boat, do a boat safety check and make sure your life vests are in good condition.

3. Dress up for the occasion.
Sturdy, protective footwear is especially important when fishing. It can keep you from cutting your foot on obstacles in the water or on shore, keep your feet warm, and prevent slipping. Wear clothing according to the weather conditions, choosing attire that will keep you cool in the heat and warm in the cold. Wear sunscreen regardless of temperature and consider a hat that shades your ears and face. Be sure you and the kids don those life vests if you are on the water. Life jackets are also important if you are wading in deep waters that have strong currents. Even if you are an excellent swimmer, a life jacket can help keep you safe in the event that you fall and hit your head.

4. Pack a first aid kit.
Image result for first aid kitWhile you are hoping for the big catch, you may fall and sustain a cut, get bit by insects, or get a hook in the hand. A first aid kit can come to the rescue for many injuries.
For scrapes and cuts, rinse the wound with clean water (this doesn’t mean pond water) and stop the bleeding by compressing with a clean cloth. Apply an antibiotic cream and cover with a bandage. Try to keep the area dry, changing bandage as needed.

For insect bites and stings, clean area with water, apply a cold compress if available, apply antibiotic cream, and take acetominophen or ibuprofen for pain. Be sure to remove ticks and stingers, if present, before treating. To avoid bites and stings, apply an insect repellent before you start fishing.

When it comes to fishing hooks, if the hook is embedded in the head or face, in a joint, or near an artery, seek medical help immediately. If the hook is embedded in the finger or elsewhere in the skin, clean area with soapy water. Tie a long piece of fishing line to the rounded part of the hook. Push the hook shank parallel with the skin and give the fishing line a firm, sharp yank. The hook should come right out of the entry point. Wash the area again and apply an antiobiotic ointment and bandage to keep it clean and dry.
Note: Be sure your family is current on your tetanus vaccinations.

5. Stay aware of your fellow fishers.
Keep distance between you and your fellow fishers to avoid hook or pole injuries when casting. Safety glasses are a good idea for kids to protect their eyes, especially as they hone their fishing skills. In addition, always know where your family members are and don’t let your kids fish alone. Employ the buddy system.
New anglers. Should always learn how to cast overhead first. This cast teaches the proper technique and is safer than side casts.

6. Never go fishing alone. Always fish with someone else and, ideally, with two other people. If one person is injured or in danger, a second person can stay with them while the third person seeks help. This is especially important when rock fishing. Let somebody know the location of your fishing trip, who you are going with and an approximate time you will be back.

7. Weather and fishing
Staying aware of weather conditions is an important part of fishing safety. Make sure you have the most up-to-date local weather information available and be prepared for sudden changes. For coastal locations, take particular note of unexpected tide and swell conditions.

Additional Fishing and Boating Safety Tips: 
• No drinking or using drugs while driving a boat.
• Abide by boat speeds and wake zone laws.
• Stay alert of debris, stumps, boulders when boating.
• Stay off of the water if there are lightning storms.
• Use your boat lights at night.
• Keep an extra fully-charged battery on board.
• Use caution with hooks, like baiting, knot tying, rigging.
• Don’t fish in unrestricted zones.
• Be sure you keep your area organized and clean.
• Carry maps of the areas you will be at.
• Bring a cell phone.
• Stay hydrated.

Arizona fishing and boating trips can range from a day of casting for trophy largemouth bass to fly-fishing for brown trout on Woods Canyon Lake. In order to experience the best fishing in Arizona, check for updates to fishing regulations, read local fishing reports, and find the best spot.

These 11 Amazing Spots In Arizona Are Perfect To Go Fishing
Image result for arizona fishing• Big Lake
• Cluff Ranch Ponds
• Dead Horse Lake
• Dogtown Lake
• Lake Pleasant
• Lake Powell
• Oak Creek
• Peña Blanca Lake
• Riggs Flat Lake
• Saguaro Lake
• Tonto Creek

 

 

If you experience an injury during your summer activities the Team at TOCA is here to help! Learn more about our Orthopedic Surgeons, Sports Medicine Physicians and Physical Therapy Team. To schedule an appointment call 602-277-6211!

Read more about summer time outdoors in Arizona: Arizona Hiking Tips: Take a Hike. Do it Right.     10 Common Summer Injuries  Men’s Summer Health & Common Sports Injuries

#Results #Recovery #Relief #family #summer #fishingfun #fishingsafety #TOCA #TOCAMD #AZFishing

Men’s Summer Health & Common Sports Injuries

The summer is a great time to build up your fitness program, enjoy fresh fruits and vegetables, take a vacation, and have fun. It’s also a time to pay attention to your health and safety. Below are tips to help you stay safe and healthy this summer and all year long.

Sprains, strains, tendonitis, and even broken bones are all consequences of living an active and athletic lifestyle. Luckily, with the right knowledge and preparation, many injuries can be diminished or entirely prevented.

There are two classes of injuries: traumatic and cumulative. Traumatic injuries are those accidents that happen in sport or daily life, such as rolling your ankle on a trail run or crashing your bike on the morning commute. Cumulative injuries relate to tissue damage that occurs over time as a result of repetitive strain. These types of injuries creep up and may be a function of poor posture, faulty movement patterns, or improper training.

 

The Seven Most Common Sports Injuries

What weekend warriors need to know about preventing and treating the seven most common sports injuries!

After a sedentary work week, end-zone catches and 36-hole weekends can take their toll in common sports injuries. The seven most common sports injuries are:

  1. Ankle sprain
  2. Groin pull
  3. Hamstring strain
  4. Shin splints
  5. Knee injury: ACL tear
  6. Knee injury: Patellofemoral syndrome — injury resulting from the repetitive movement of your kneecap against your thigh bone
  7. Tennis elbow (epicondylitis)

To see how to prevent and treat these common sports injuries — and to learn when it’s time to look further than your medicine cabinet to treat sports injuries— read on.

The most common sports injuries are strains and sprains

Sprains are injuries to ligaments, the tough bands connecting bones in a joint. Suddenly stretching ligaments past their limits deforms or tears them. Strains are injuries to muscle fibers or tendons, which anchor muscles to bones. Strains are called “pulled muscles” for a reason: Over-stretching or overusing a muscle causes tears in the muscle fibers or tendons.

“Think of ligaments and muscle-tendon units like springs,” says William Roberts, MD, sports medicine physician at the University of Minnesota and spokesman for the American College of Sports Medicine. “The tissue lengthens with stress and returns to its normal length — unless it is pulled too far out of its normal range.”

Preventing the most common sports injuries

Sometimes preventing common sports injuries is beyond our control, but many times sports injuries are preventable. “Some injuries,” Roberts says, “we bring on ourselves because we’re not conditioned for the activity.” His advice: “Work out daily and get double benefit — enjoy your weekend activities and garner the health benefits.”

Every workout should start with a gentle warm-up to prevent common sports injuries, says Margot Putukian, MD, director of athletic medicine at Princeton University. “Getting warmed up increases blood flow to the muscles, gets you more flexible, and could decrease injuries,” she adds.

Overuse injuries are common and preventable, according to Putukian. “Don’t come out and hit the ball for an hour after not playing for a while,” she says. Whether it’s hiking, running, or team sports, do some “pre-participation training” first by lightly working the relevant muscle groups in the weeks before the activity.

And learn to recognize when you’ve already left it all on the field. Stop when you are fatigued. Muscle fatigue takes away all your protective mechanisms and really increases your risk of all injuries. You can always come out to play again next weekend — if you don’t get injured today.

Treating the most common sports injuries

Usually, common sports injuries are mild or moderate — there’s some damage, but everything is still in place. You can treat them at home using the PRICE therapy method described later in this article. But you should expect that some common sports injuries may take months to heal, even with good treatment. If a sprain or strain is severe, however, the entire muscle, tendon, or ligament is torn away, and surgery may be needed.

Here are some specific tips for treating each of the most common sports injuries:

1. Ankle sprain

What it is: Most athletes have experienced a sprained ankle, which typically occurs when the foot turns inward. This turning stretches or tears the ligaments on the outside of the ankle, which are relatively weak.

What you can do: With an ankle sprain, it’s important to exercise to prevent loss of flexibility and strength — and re-injury. You can ask your doctor or physical therapist to help you know what kinds of exercise you should do.

When to see a doctor: It’s important to note where the sprain has occurred. A ‘high ankle sprain’ is slower to heal and should probably be seen by a doctor to make sure the bones in the lower leg did not separate. One way to recognize a high ankle sprain is that this sprain usually causes tenderness above the ankle.

2. Groin pull

What it is: Pushing off in a side-to-side motion causes strain of the inner thigh muscles, or groin. Hockey, soccer, football, and baseball are common sports with groin injuries.

What you can do: Compression, ice, and rest will heal most groin injuries. Returning to full activity too quickly can aggravate a groin pull or turn it into a long-term problem.

When to see a doctor: Any groin pull that has significant swelling should be seen early by a physician.

3. Hamstring strain

What it is: Three muscles in the back of the thigh form the hamstring. The hamstring can be over-stretched by movements such as hurdling — kicking the leg out sharply when running. Falling forward while waterskiing is another common cause of hamstring strains.

What you can do: Hamstring injuries are slow to heal because of the constant stress applied to the injured tissue from walking. Complete healing can take six to 12 months. Re-injuries are common because it’s hard for many guys to stay inactive for that long.

4. Shin splints

What they are: Pains down the front of the lower legs are commonly called “shin splints.” They are most often brought on by running — especially when starting a more strenuous training program like long runs on paved roads.

What you can do: Rest, ice, and over-the-counter pain medicine are the mainstays of treatment.

When to see a doctor: The pain of shin splints is rarely an actual stress fracture — a small break in the shin bone. But you should see your doctor if the pain persists, even with rest. Stress fractures require prolonged rest, commonly a month or more to heal.

5. Knee injury: ACL tear

What it is: The anterior cruciate ligament (ACL) holds the leg bone to the knee. Sudden “cuts” or stops or getting hit from the side can strain or tear the ACL. A complete tear can make the dreaded “pop” sound.

When to see a doctor: Always, if you suspect an ACL injury. ACL tears are potentially the most severe of the common sports injuries. “A completely torn ACL will usually require surgery in individuals who wish to remain physically active.

6: Knee injury: Patellofemoral syndrome

What it is: Patellofemoral syndrome can result from the repetitive movement of your kneecap (patella) against your thigh bone (femur), which can damage the tissue under the kneecap. Running, volleyball, and basketball commonly set it off. One knee or both can be affected.

What you can do: Patience is key. Patellofemoral pain can take up to six weeks to clear up. It’s important to continue low-impact exercise during this time. Working out the quadriceps can also relieve pain.

7. Tennis elbow (epicondylitis)

What it is: Repetitive use of the elbow — for example, during golf or tennis swings — can irritate or make tiny tears in the elbow’s tendons. Epicondylitis is most common in 30- to 60-year-olds and usually involves the outside of the elbow.

What you can do: Epicondylitis can usually be cleared up by staying off the tennis court or golf course until the pain improves.

The PRICE principle for treating common sports injuries

The U.S. Marines say that “pain is weakness leaving your body.” Most of the rest of us would add, “OK, but can’t we hurry it up a little?” The answer is yes. Using the PRICE method to treat any common sports injury will help get you back in the game sooner.

First, it’s important to know that swelling is a normal response to these injuries. Excessive swelling, though, can reduce range of motion and interfere with healing. You can limit swelling and start healing faster after common sports injuries by using the PRICE principle:

  • P — protect from further injury
    For more severe injuries, protect the injured area with a splint, pad, or crutch.
  • R — restrict activity
    Restricting activity will prevent worsening of the injury.
  • I — apply ice
    Apply ice immediately after a common sports injury. “Ice is the miracle drug” for sports injuries, says Putukian. “It’s an anti-inflammatory, without many side effects.” Use ice for 20 minutes every one to two hours for the first 48 hours after the injury. Don’t use heat during this time — it encourages swelling and inflammation.
  • C — apply compression
    Compression with an elastic bandage will help reduce swelling.
  • E — elevate the injured area
    Elevating the injured area above the heart will also reduce swelling.

Over-the-counter pain relievers usually relieve the pain of common sports injuries to a tolerable level. If they don’t, it’s probably time to see a doctor.

When to get medical attention for common sports injuries

We know you’re tough — but you also need to be smart. If you suspect a serious injury or if you have any of these signs, see a doctor:

  • Deformities in the joint or bone — it looks “crooked,” or moves abnormally
  • You cannot bear weight or can’t use the limb without it “giving way”
  • Excessive swelling
  • Changes in skin color beyond mild bruising
  • It’s not getting any better after a few days of PRICE therapy

 

If you are injured the Team of Orthopedic Physicians here at TOCA are here to help! To learn more or schedule an appointment call: 602-277-6211.

 

#Results #Recovery #Relief #Injuryprevention #Menshealth #ShowUsYourBlue #SportsMedicine #SportsInjury #TOCA #TOCAMD

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome

Carpal tunnel syndrome is a condition that causes numbness, tingling and other symptoms in the hand and arm. Carpal tunnel syndrome is caused by a compressed nerve in the carpal tunnel, a narrow passageway on the palm side of your wrist.

The anatomy of your wrist, health problems and possibly repetitive hand motions can contribute to carpal tunnel syndrome.

Proper treatment usually relieves the tingling and numbness and restores wrist and hand function. Many people get better if they rest their wrist and wear a splint. Some people need surgery.

Symptoms

Carpal tunnel syndrome symptoms usually start gradually. The first symptoms often include numbness or tingling in your thumb, index and middle fingers that comes and goes.

Carpal tunnel syndrome may also cause discomfort in your wrist and the palm of your hand. Common carpal tunnel syndrome symptoms include:

  • Tingling or numbness. You may experience tingling and numbness in your fingers or hand. Usually the thumb and index, middle or ring fingers are affected, but not your little finger. Sometimes there is a sensation like an electric shock in these fingers.

The sensation may travel from your wrist up your arm. These symptoms often occur while holding a steering wheel, phone or newspaper. The sensation may wake you from sleep.

Many people “shake out” their hands to try to relieve their symptoms. The numb feeling may become constant over time.

  • You may experience weakness in your hand and a tendency to drop objects. This may be due to the numbness in your hand or weakness of the thumb’s pinching muscles, which are also controlled by the median nerve.

When to see a doctor

See your doctor if you have persistent signs and symptoms suggestive of carpal tunnel syndrome that interfere with your normal activities and sleep patterns. Permanent nerve and muscle damage can occur without treatment.

Causes

Carpal tunnel syndrome is caused by pressure on the median nerve.

The median nerve runs from your forearm through a passageway in your wrist (carpal tunnel) to your hand. It provides sensation to the palm side of your thumb and fingers, except the little finger. It also provides nerve signals to move the muscles around the base of your thumb (motor function).

Anything that squeezes or irritates the median nerve in the carpal tunnel space may lead to carpal tunnel syndrome. A wrist fracture can narrow the carpal tunnel and irritate the nerve, as can the swelling and inflammation resulting from rheumatoid arthritis.

There is no single cause in many cases. It may be that a combination of risk factors contributes to the development of the condition.

Risk factors

A number of factors have been associated with carpal tunnel syndrome. Although they may not directly cause carpal tunnel syndrome, they may increase your chances of developing or aggravating median nerve damage. These include:

  • Anatomic factors.A wrist fracture or dislocation, or arthritis that deforms the small bones in the wrist, can alter the space within the carpal tunnel and put pressure on the median nerve.

People with smaller carpal tunnels may be more likely to have carpal tunnel syndrome.

Diagnosis

Your doctor may ask you questions and conduct one or more of the following tests to determine whether you have carpal tunnel syndrome:

  • History of symptoms. Your doctor will review the pattern of your symptoms. For example, because the median nerve doesn’t provide sensation to your little finger, symptoms in that finger may indicate a problem other than carpal tunnel syndrome.

Carpal tunnel syndrome symptoms usually occur include while holding a phone or a newspaper, gripping a steering wheel, or waking up during the night.

  • Physical examination. Your doctor will conduct a physical examination. He or she will test the feeling in your fingers and the strength of the muscles in your hand.

Bending the wrist, tapping on the nerve or simply pressing on the nerve can trigger symptoms in many people.

  • X-ray. Some doctors recommend an X-ray of the affected wrist to exclude other causes of wrist pain, such as arthritis or a fracture.
  • Electromyogram. This test measures the tiny electrical discharges produced in muscles. During this test, your doctor inserts a thin-needle electrode into specific muscles to evaluate the electrical activity when muscles contract and rest. This test can identify muscle damage and also may rule out other conditions.
  • Nerve conduction study. In a variation of electromyography, two electrodes are taped to your skin. A small shock is passed through the median nerve to see if electrical impulses are slowed in the carpal tunnel. This test may be used to diagnose your condition and rule out other conditions.
  • Gender. Carpal tunnel syndrome is generally more common in women. This may be because the carpal tunnel area is relatively smaller in women than in men.Women who have carpal tunnel syndrome may also have smaller carpal tunnels than women who don’t have the condition.
  • Nerve-damaging conditions. Some chronic illnesses, such as diabetes, increase your risk of nerve damage, including damage to your median nerve.
  • Inflammatory conditions. Illnesses that are characterized by inflammation, such as rheumatoid arthritis, can affect the lining around the tendons in your wrist and put pressure on your median nerve.
  • Alterations in the balance of body fluids. Fluid retention may increase the pressure within your carpal tunnel, irritating the median nerve. This is common during pregnancy and menopause. Carpal tunnel syndrome associated with pregnancy generally resolves on its own after pregnancy.
  • Other medical conditions. Certain conditions, such as menopause, obesity, thyroid disorders and kidney failure, may increase your chances of carpal tunnel syndrome.
  • Workplace factors. It’s possible that working with vibrating tools or on an assembly line that requires prolonged or repetitive flexing of the wrist may create harmful pressure on the median nerve or worsen existing nerve damage.

However, the scientific evidence is conflicting and these factors haven’t been established as direct causes of carpal tunnel syndrome.

Several studies have evaluated whether there is an association between computer use and carpal tunnel syndrome. However, there has not been enough quality and consistent evidence to support extensive computer use as a risk factor for carpal tunnel syndrome, although it may cause a different form of hand pain.

Treatment

Treat carpal tunnel syndrome as early as possible after symptoms start.

Take more frequent breaks to rest your hands. Avoiding activities that worsen symptoms and applying cold packs to reduce swelling also may help.

Other treatment options include wrist splinting, medications and surgery. Splinting and other conservative treatments are more likely to help if you’ve had only mild to moderate symptoms for less than 10 months.

Nonsurgical therapy

If the condition is diagnosed early, nonsurgical methods may help improve carpal tunnel syndrome, including:

  • Wrist splinting. A splint that holds your wrist still while you sleep can help relieve nighttime symptoms of tingling and numbness. Nighttime splinting may be a good option if you’re pregnant.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs, such as ibuprofen (Advil, Motrin IB, others), may help relieve pain from carpal tunnel syndrome in the short term.

There isn’t evidence, however, that these drugs improve carpal tunnel syndrome.

  • Your doctor may inject your carpal tunnel with a corticosteroid such as cortisone to relieve pain. Sometimes your doctor uses an ultrasound to guide these injections.

Corticosteroids decrease inflammation and swelling, which relieves pressure on the median nerve. Oral corticosteroids aren’t considered as effective as corticosteroid injections for treating carpal tunnel syndrome.

If carpal tunnel syndrome is caused by rheumatoid arthritis or another inflammatory arthritis, then treating the arthritis may reduce symptoms of carpal tunnel syndrome. However, this is unproved.

Surgery

Carpal tunnel release

Surgery may be appropriate if your symptoms are severe or don’t respond to other treatments.

The goal of carpal tunnel surgery is to relieve pressure by cutting the ligament pressing on the median nerve.

The surgery may be performed with two different techniques:

  • Endoscopic surgeryYour surgeon uses a telescope-like device with a tiny camera attached to it (endoscope) to see inside your carpal tunnel. Your surgeon cuts the ligament through one or two small incisions in your hand or wrist.

Endoscopic surgery may result in less pain than does open surgery in the first few days or weeks after surgery.

  • Open surgery. Your surgeon makes an incision in the palm of your hand over the carpal tunnel and cuts through the ligament to free the nerve.

Discuss the risks and benefits of each technique with your surgeon before surgery. Surgery risks may include:

  • Incomplete release of the ligament
  • Wound infections
  • Scar formation
  • Nerve or vascular injuries

During the healing process after the surgery, the ligament tissues gradually grow back together while allowing more room for the nerve. This internal healing process typically takes several months, but the skin heals in a few weeks.

Alternative Medicine

Integrate alternative therapies into your treatment plan to help you cope with carpal tunnel syndrome. You may have to experiment to find a treatment that works for you. Always check with your doctor before trying any complementary or alternative treatment.

  • Yoga. Yoga postures designed for strengthening, stretching and balancing the upper body and joints may help reduce pain and improve grip strength.
  • Hand therapy. Early research suggests that certain physical and occupational hand therapy techniques may reduce symptoms of carpal tunnel syndrome.
  • Ultrasound therapyHigh-intensity ultrasound can be used to raise the temperature of a targeted area of body tissue to reduce pain and promote healing. Research shows inconsistent results with this therapy, but a course of ultrasound therapy over several weeks may help reduce symptoms.

If you are experiencing hand or wrist pain, the specialized Orthopedic Physicians at TOCA are here to help. To learn more call 602-277-6211 or visit our website at: www.tocamd.com

#Recovery #Results #Relief #carpaltunnel #handpain #wristpaint #TOCA #TOCAMD #Handtherapy #orthopedicphysician #handpain #wristpain

 

10 Common Summer Injuries

10 Common Summer Injuries – Summer is a season full of beautiful weather, vacations, sports, and other enjoyable outdoor activities. Unfortunately, summer also means an increase in injuries. There are many ways to prevent the injuries that are most common during the summer months, as you and your family enjoy the warm weather. Here you can find helpful tips and facts to help you have a safe and injury-free summer.

1. BICYCLE INJURIES: Wearing a helmet will reduce the chance of a head injury by 85 percent, according to the Bicycle Helmet Safety Institute. The use of a bicycle helmet also seriously reduces the chance that a bike accident, which often involves a motor vehicle, will be fatal for the cyclist

2. BASEBALL AND SOFTBALL INJURIES: Since baseball is a non-contact sport, injuries happen with unintentional contact, according to the American Academy of Orthopedic Surgeons. Warming up and stretching can help prevent common strains and sprains. Coaches are also advised to become very familiar with the conditions of their field, and to be prepared for emergency situations with an on-hand first aid kit along with a medical response plan.

3. PLAYGROUND INJURIES: Studies indicate that roughly 7 out of 10 playground injuries happen because of a fall or an equipment failure. Pediatricians are acutely aware of such hazards.

* Ground cover is important. Stay away from concrete and grass. The best ground covering is rubber or wood chips. Also, look for rusty nails or broken equipment.

* Remember to apply sunscreen regularly while enjoying an outdoor playground.

4. ATV, MOPED AND MINI BIKE INJURIES: The U.S. Consumer Product Safety Commission advises against using ATVs on paved roads, allowing children under the age of 16 to ride adult ATVs, or riding an ATV as a passenger. Additionally, that government agency urges ATV enthusiasts to always wear helmets and protective gear.

5. SOCCER INJURIES: Proper conditioning, stretching, warmups and cool-downs are key to preventing many of these injuries including the severe sprains, torn cartilage and damaged anterior cruciate ligaments (ACLs).

6. SWIMMING INJURIES: When spending time at a pool, lake or shoreline with family and friends, designate brief shifts in which an adult is always serving as a “water watcher.”

Here are some other swimming safety tips:

* Never dive into shallow water.

* Jump into lakes, rivers or the sea feet-first, particularly in dark waters, where you can’t see what’s below.

* Stop swimming during inclement weather.

* Try to avoid crowded swimming spots where it’s hard to monitor your group.

* Avoid wearing headphones at the pool or beach, so you can hear any developing trouble.

7. TRAMPOLINE INJURIES: On average orthopedic physicians see one to three patients each week with a trampoline injury. Sprains and fractures are the most common among them but bruises, bumps and bloody noses are also a concern. Here are some of this doctor’s trampoline safety recommendations:

* Allow only one person on a trampoline at any given time.

* Use a trampoline net to minimize falls.

* Make sure the trampoline is situated on a relatively soft surface such as a lawn.

* Make sure the trampoline is secure.

* Keep the trampoline well-maintained. Any damage to the supporting bars or mats present a fresh safety danger.

* Untrained tumblers should avoid somersaults and other “high-risk maneuvers.”

8. VOLLEYBALL INJURIES: Staying fit during the off-season is the best way for regular players to avoid injury during games. Recreational players should remember to stretch and warm up before a game, wear sunscreen and stay hydrated.

9. AM– USEMENT PARK, STATE FAIR AND CARNIVAL RIDE INJURIES: The following are the top ride safety tips from the International Association of Amusement Parks and Attractions (IAAPA).

* Mind the posted height, weight and health restrictions on each ride.

* Read any posted safety rules for each ride. Responsible parks also have attendants who remind riders about safety rules at the start of each ride.

* Never dangle your hands or feet outside of a ride.

* Always stay in your seat during a ride.

* Always use the straps, belts, crossbars and any other ride safety equipment.

* Make sure your possessions are secure.

10. WATER SPORTS INJURIES: Many of these injuries can be prevented with preseason conditioning and a purposeful warm up before your exercise.

Although doctors regularly treat cuts, strains, sprains and orthopedic injuries from such water sports as jet-skiing and wakeboarding, they also caution against dehydration, which outdoor enthusiasts may forget about while frolicking in or near water.

The team members at TOCA and our Physicians are here to help! To learn more about TOCA and our physicians visit more of our webpages here on: www.tocamd.com or call 602-277-6211!

#Recovery #Results #Relief #TOCAMD #SummerFun #InjuryPrevention#PlaySmart #PlaySafe #SummerSaftey

Dr. Cummings and Vito Berlingeri talk Golf, injuries and recovery in the latest addition of the AZ Golf Insider!

Dr. Cummings and Vito Berlingeri talk Golf, injuries and recovery in the latest addition of the AZ Golf Insider. Check out the full artical by clicking here: http://staging.yudu.com/…/…/45vcVtT1Y15VmxzM/html/index.html

“When I went into his office, Dr. Cummings greeted me like he had known me for 30 years”, said Berlingeri. “He told me with surgery and physical rehab, I would be back to hitting golf balls within seven weeks.”

That’s exactly what happened, with Berlingeri able to play 18 holes just three months after surgery.

Associated with TOCA since 2001, Dr. Cummings estimates that up to 40% of the patients he sees play golf, including numerous PGA Tour professionals. No matter the skill level, he encourages all golfers to take injury prevention measures, especially keeping your core strong.

“Your body only has so much time before wear and tear happens. I’ve recommended other golfer friends with injuries go to Dr. Cummings at TOCA ever since.” (said Vito Berlingeri)

Getting an accurate diagnosis and then a plan is critical to the process, Berlingeri and his physician (Dr. Dean Cummings) agreed.

“You have to spend at least 10-15 minutes warming up in what I call a combination dynamic and static workout. That’s doing some stretches plus some movement patterns. I also recommend stretching while you’re playing.”

“At TOCA we provide an excellent assessment while looking at the whole body and not just an individual body part,” Dr. Cummings said. “We also make sure that each patient is treated with conservative therapeutic management first, and then surgery if needed. I think we have doctors in our group who are phenomenally gifted, but the good thing is they know when to operate, which is very important.”

Dr. P. Dean Cummings is an Orthopedic Surgeon & Sports Medicine Physician and Surgeon at TOCA.

To learn more about Dr. Cummings and TOCA or to schedule an appointment visit: www.tocamd.com or call 602-277-6211!

#Results #Recovery #Relife #Golf #AZGolf #AZGolfInsider #AGA#BunkertoBunker #TOCA #TOCAMD 

March 2017 is Cheerleading Safety Month!

March 2017 is Cheerleading Safety Month! Safety is a big concern in all sports and cheerleading is no exception. Because it combines both stunting and gymnastics, there are many opportunities for accidents if the proper precautions aren’t taken. While we often think of them as being nothing more than entertainment on the sidelines, cheerleaders serve a vital role, and the stunts they pull are demanding both mentally and physically. Cheerleading Safety Month comes each year to raise awareness that safety is vital to the health and performance of our team’s biggest supporters.

Basic Cheer Safety:
* Remove all jewelry
* Wear athletic shoes
* Keep your hair tied back
* Always have supervision
* Practice on safe surfaces such as mats and padded floors
* Have an emergency plan

In order to stay out of harm’s way and still perform spectacular stunts, there are a few basic guidelines that must be followed:
* Get proper instruction
* Always use a spotter
* Follow proper progression
* Practice proper technique
* Don’t push it
* Focus
* Warm up
* Communicate
* Don’t ignore injuries
* Stay in shape

Of course, cheerleading safety should be practiced any time cheerleading is being performed, but March – Cheerleading Safety Month – provides the perfect opportunity to shine the spotlight on cheerleading safety.

March often marks the winding down of basketball season and with it most school cheerleading will also come to an end. Soon, tryouts for the next season will take place, giving coaches the opportunity to implement their safety programs for a new team.

There are four groups directly responsible for the safety of the cheerleader – the administration, the coaches, the cheerleaders themselves, and the cheerleaders’ parents. Each can use this month to focus on cheerleading safety and enhance safety in their programs.

Administrators, are you involved in your cheer program? Make sure you have selected a qualified coach to supervise the team and give them sufficient support. At a minimum, the coach should complete the American Association of Cheerleading Coaches and Administrators safety course. Coaches should also take advantage of any other training available, such as training provided by the National Federation of State High School Associations or the US All Star Federation. They should be encouraged to attend camps, clinics and coaching conferences in order to further their knowledge of skill techniques. As an administrator, you should make sure your program has adequate practice facilities and matting and that the coach is following the safety rules.

Coaches, are you fully aware of your responsibilities with regard to safety? You should make sure your cheerleaders are using proper skill progressions. Don’t pressure your cheerleaders to try skills they are not ready to attempt. You or someone at practice, such as a coach’s assistant, should be CPR certified and trained in basic first aid. Make sure that you are following recognized safety rules and practices (AACCA, NFHS or USASF) outlined for your program. Develop and practice an emergency plan in the event a serious injury occurs.

Cheerleaders, you too have a responsibility for your own safety. If you feel scared about a particular stunt or tumbling skill, voice your concerns to your coach or parent. Take stunting very seriously, and stay focused on the skill and your part in it until it is safely completed. Practice good health and fitness habits so you can perform to the best of your ability. Remember, others are relying on you to be at your best during every performance.

Parents, use your voice! Know the safety rules, and If you find that standard practices aren’t being employed, bring it to the attention of the coach. If that doesn’t resolve the matter, do not hesitate to take your concerns to the administration. Ultimately, if you feel that your child’s safety is being compromised, take the difficult step of removing them from the program.

Cheerleading can be a safe and healthy activity when it is properly supervised. Let’s use this month of awareness to make sure we are all doing our part!

History of Cheerleading Safety Month
As the basketball season winds down to a close, Cheerleading tryout season often starts, and a bunch of intrepid new group comes to pick up the pom-pom and start down the demanding path of becoming a cheerleader. With the Administrators, Coaches, the Cheerleaders Parents, and Cheerleaders all working together, an education on how to perform at their very best while being safe in their efforts can be passed on and absorbed.
Cheerleading has been around for a long time, since the late 1800’s in fact, and believe it or not back then it was an all-male sport. From 1877-1923, it was the men that led the cheers, that helped to support their team, and in 1898 the idea of organized teams entered the scene. It wasn’t until 1923 that there women actually entered the field of cheerleading, and it took until 1940 for them to actually be recognized in things like student pamphlets and newspapers.
In 1987 the American Association of Cheerleading Coaches & Administrators was formed, and it wasn’t long after that that the important of safety education among Cheerleaders and those who trained them became obvious. This was the first seeds of National Cheerleading Safety Month coming to pass.

How To Celebrate Cheerleading Safety Month
There are a number of great ways to celebrate Cheerleading Safety Month, starting with being an active advocate for safety in your local cheerleading squad. This is a special opportunity for parents and administrators, a chance to make certain that your children or team is observing all the necessary safety practices to ensure they have a great, and safe, time.
You can also make contact with the National Cheer Safety Foundation to register as an official Cheer Safety Ambassador with their organization. This allows you to report injuries in cheerleading, build an emergency plan, and generally be a great asset to your team, your children, and their safety.

 

For more information on orthopedic sports medicine call 602-277-6211!

#cheersafe#Results#Recovery#Relief#Gameon#Sportsmedicine#Injuryprevention