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Preventing Common Golf Injuries

Tips From TOCA’s Orthopedic Experts 

With the Phoenix Management Waste Open in “full swing,” Valley of the Sun residents are certainly luck to enjoy this high-profile golf event right in our own backyard. And, we are fortunate to live in an area where we can get our golf game on year-round! So, preventing common golf injuries should be top-of-mind.

Even though golf is considered a low-impact sport, the repetitive movements of golf can increase the chance of chronic pain or serious injury to the lower back, wrist, shoulder, and elbow. Just ask TOCA orthopedic and sports medicine specialist Dr. Dean Cummings, who treats many golfers, including PGA Tour pros.

“Golf is an incredibly dynamic sport where there are a lot of moving patterns going on during the swing at one time,” says Dr. Cummings. “If there is one thing that’s off — in your shoulder, elbow, wrist or knee, for example — it can ruin the whole swing. When that happens, golfers try to compensate in some way. That can lead to injury down the line.”

TOCA Tips for Preventing Common Golf Injuries

The majority of golf injuries are due to poor mechanics and overuse. For this, reason, TOCA’s orthopedic and sports medicine experts recommend that golfers of all ages and abilities take the following measures in the hopes of preventing common golf injuries:

  • Keep Your Core Strong! Building core strength can help reduce the chance of injury AND improve your golf game.
  • Adequate Warm-Up. Never rush into a round of golf! Spend at least ten to fifteen minutes warming up in a combination “dynamic” and “static” workout (stretches plus movement patterns).
  • Stretch Between Holes. You have time between each hole. Use it wisely by stretching throughout play to stay loose and prevent injury.
  • Get a Grip! Gripping the club incorrectly or too tightly can cause hand and/or wrist pain and injury. Learning proper grip technique can keep you injury-free and enhance your game.
  • Remember to Bend. Bend your knees when picking up balls and heavy clubs to avoid unnecessary back pain.
  • Cool Down. The best time to stretch is just before you leave the course, when your muscles are still warm. Five to ten minutes of post-golf stretching helps increase circulation to joints and tissues and reduces overall stiffness and soreness.

Help ensure that golf remains your lifelong passion and pastime by following the above tips for preventing common golf injuries …  and contact TOCA today if you need help getting back into the swing of golf due to ongoing pain or injury: 602.277.6211.

Stress Fracture Symptoms and Treatment Tips from TOCA’s Orthopedic Experts

“You have a stress fracture” is a diagnosis shared all too often by orthopedic specialists, especially when treating athletes. Athletes are most at risk due to repetitive activity and overuse of their feet and legs. Overuse causes the lower extremities to continually absorb these forces and potentially causing tiny cracks in the bones.

If athletic activity is too frequent, it diminishes the body’s ability to repair and replace bone. And the likelihood of sustaining a stress fracture increases. That’s why runners, dancers, soccer players, and basketball players are particularly vulnerable to stress fractures.

And, according to The Orthopedic Clinic Association (TOCA) orthopedic and sports medicine care expert, Dr. Gerald Yacobucci, MD, “If they are already experiencing consistent pain, the more these athletes train and compete, the more they may be placing themselves at greater risk for injury – and time away – from the sport or activity they enjoy.”

Here’s what Dr. Yacobucci and the TOCA team want ALL athletes, parents, and coaches to know in order to recognize stress fracture symptoms, help prevent stress fractures from occurring, and remain injury-free.

Stress Fracture Symptoms

What are some of the signs of stress fracture to watch out for? Rather than the sharp pain resulting from an acute fracture, stress fractures are typically accompanied by a dull pain that increases gradually. Often, the pain subsides during rest and intensifies during activity. Swelling around the site may be present as well as some tenderness and bruising. As mentioned above, stress fractures can be caused by overuse of lower extremities, common in athletes, but they can also arise from a sudden upsurge in physical activity. Osteoporosis can also increase the chance of a stress fracture.

It’s important to remember that, if dull pain persists, it’s time to seek help from an orthopedic specialist!

Treatment of Stress Fractures

Immediately after injury or stress fracture symptoms occur, patients are encouraged to follow the RICE (Rest, Ice, Compression, Elevation) method. Once you consult with you orthopedic specialist, he/she will examine the “pain point” and X-rays will likely be taken. If the stress fracture is not visible via X-ray, but your doctor still suspects that you have a stress fracture, he/she may recommend that you get an MRI.

Nonsurgical treatment options for stress fractures include keeping weight off of the area (perhaps wearing a boot or using crutches), and modified activity for a period of up to 8 weeks. In some, more severe, cases, surgery may be necessary to allow the stress fracture to heal properly. This typically entails using a pin, screw, or plate to “fasten” the bones together in order to promote healing. The key to recovery is to allow ample time for rest, healing, and rehabilitation. Taking time off ensures that you can eventually get back to the activities you enjoy safely and without placing yourself at risk for additional injury.

Stress Fracture Prevention

According to Dr. Yacobucci, “One of the most important pieces of advice I share with patients, especially athletes, is to monitor and be mindful of your activity and pain level. If you find that you’re consistently experiencing pain during training or workouts, then it’s time to listen to your body’s signals. Refrain from activity until you seek further treatment from an orthopedic expert.”

Additional stress fracture prevention tips from Dr. Yacobucci and TOCA experts include:

  • Wearing footwear with good support.
  • Strength training and cross-training to avoid overuse of certain muscle sets and strain on bones.
  • Good nutrition, including plenty of calcium and Vitamin D for optimal bone strength.
  • And good common sense. Listen to your body’s signals and seek help if pain persists after adequate rest.

To schedule a consult with Dr. Yacobucci, or one of TOCA’s knowledgeable and highly trained orthopedics specialists, please contact us at 602.277.6211.

Dr. Blazuk and colleagues study the Validity of Indirect Ultrasound Findings…

Title: Validy of Indirect Ultrasound Findings in Acute Anterior Cruciate Ligament Ruptures

Ken Mautner, MD, Walter I. Sussman, DO, Katie Nanos, MD, Joseph Blazuk, MD, Carmen Brigham, ATC, Emily Sarros, ATC

Objectives: Ultrasound (US) is increasingly being used as an extension of the physical examination on the sidelines, in training rooms, and in clinics. Anterior cruciate ligament (ACL) injury in sport is common, but the literature on US findings after acute ACL rupture is limited. Three indirect US findings of ACL rupture have been described, and this study assessed the validity of these indirect signs.

American Institute of Ultrasound in Medicine /  J Ultrasound Med 2018; 9999:1-8 / 0278-4297

Click here for full article!

 

Dr. Lederman and colleagues discuss the outcome of a subscapularis peel repair with a stem-based repair after total shoulder arthroplasty

Title: Healing and functional outcome of a subscapularis peel repair with a stem-based repair after total shoulder arthroplasty

Reuben Gobezie MD, Patrick Denard MD, Yousef Shishani MD, Anthony Romeo MD, Evan S. Lederman MD

Background

The purpose of this study was to evaluate functional outcome and healing of a subscapularis peel with a stem-based repair after total shoulder arthroplasty (TSA). The hypothesis was that the repair would lead to subscapularis healing in the majority of cases.

Full article: https://doi.org/10.1016/j.jse.2017.02.013

Journal of Shoulder and Elbow Surgery

Volume 26, Issue 9, September 2017, Pages 1603-1608

Dr. Lederman, Dr. Lund and former fellows have described a new class of labral tears in the shoulder*

Title: The Glenoid Labral Articular Teardrop Lesion: A Chondrolabral Injury With Distinct Magnetic Resonance Imaging Findings

Evan S. Lederman MD, Stephen Flores MD, Christopher Stevens MD, Damien Richardson MD, Pamela Lund MD

*Identification of this lesion of MRI can help in diagnosis and treatment of labral tears.

Purpose

Evaluation and description of a pathognomonic lesion identified on magnetic resonance imaging (MRI) of a chondrolabral injury of the glenohumeral joint.

Methods

Patients were prospectively identified at the time of MRI by a characteristic teardrop appearance of a pedicled displaced chondrolabral flap in the axillary recess on coronal imaging and retrospectively reviewed.

Full article: https://doi.org/10.1016/j.arthro.2017.08.236

Arthroscopy: The Journal of Arthroscopic & Related Surgery

Volume 34, Issue 2, February 2018, Pages 407-411

 

Dr. Lederman and colleagues review how bone can react differently to shoulder replacements and document the potential benefit and safety of short stem shoulder implants

Title: Proximal Stress is Decreased with a Short Stem Compared to a Traditional Length Stem In Total Shoulder Arthroplasty

Patrick J. Denard MD, Matthew P Noyes MD, J B Walker, MD, Yousef Shishani, MD, Reuben Gobezie MD, Anthony A Romeo, MD, Evan S. Lederman, MD

Background

This study compared the outcome and radiographic humeral adaptations after placement of a traditional-length (TL) or short-stem (SS) humeral component during total shoulder arthroplasty (TSA). The hypothesis was there would be no difference in outcome or radiographic adaptations.

Full article: https://doi.org/10.1016/j.jse.2017.06.042

The Journal of Shoulder and Elbow Surgery

Volume 27, Issue 1, January 2018, Pages 53-58

Dr. Josh Vella – 5th Annual World Congress in Orthopedics-2018

Dr. Josh C. Vella, TOCA Hand and Upper Extremity Surgeon, is honored to carry the distinction of becoming an international lecturer at the 5th Annual World Congress in Orthopedics-2018 in Milan, Italy.

He was one of a few distinguished international lecturers who discussed various new treatment options with the theme of this years conference “Breaking Barriers in Orthopedic Research”.

Photo: Dr. Josh C. Vella (center), Dr Michael Boland (right) of The Hand Institute, University of Auckland, New Zealand and Dr  Scott Fried (left) in collaboration with Thomas Jefferson University Hand Center in Philadelphia.

Dr. Lederman was a recent invited lecturer at the American Academy of Orthopedic Surgeons Annual Meeting 2018

 

Complex Shoulder Arthroplasty: Primary and Revision, Anatomic and Reverse, Three-Dimensional Planning – When and How? A case-based, comprehensive review of shoulder arthroplasty.

Moderator: Asheesh Bedi, MD: Panelists: Evan Lederman, Anthony Romeo, Gilles Walch, JP Warner, Brad Parsons, john Tokish, David Dines, Josh Dines, Michael Freehill, Xinning Li

New Orleans, LA – AAOS 2018 – American Academy of Orthopedic Surgeons (AAOS) 2018 Annual meeting at the Ernest Morial Convention Center ,Tuesday March 6, 2018. With over 30,000 attendees, the conference is the preeminent meeting on musculoskeletal education to orthopaedic surgeons and allied health professionals in the world.

Dr. Padley has a long tradition of providing care for sports teams.

Dr. Padley returned to the Dominican Republic in April with the Cincinnati Reds for the annual opening of their Dominican complex. The trip included evaluations of 40+ Dominican athletes hoping to advance their way up the Cincinnati Reds baseball system. This marks the beginning of the baseball season for the Dominican teams. Most major league baseball teams have affiliates in the Dominican in search of that next great player! Dr. Padley is an orthopedic consultant and provider to the Cincinnati Reds for major league baseball spring training and throughout the year for their minor league and rookie league teams. In additional to this health care relationship, he is also a consultant to Japanese professional baseball for the Saitama Seibu Lions. With his expertise in hip disorders and injuries, Ballet Arizona benefits from his service as a consultant. He was a team physician for the WNBA’s Phoenix Mercury for four years including the 2014 championship season. Dr. Padley proudly serves as the team physician for Benedictine University in Mesa as well as Millennium and Verrado High Schools in Goodyear.

For more information on Dr. Padley, Click HERE

 

Congratulations to Dr. Evan Lederman for his recent publication!

Title: The Evolution of the Superior Capsular Reconstruction Technique

Alan M. Hirahara, MD, FRCSC; Evan S. Lederman, MD; Wyatt J. Andersen, ATC; and Kyle Yamashiro, PT, DPT, CSCS

Introduction

Irreparable, massive rotator cuff tears can result in unacceptable functional deficits in patients. When the supraspinatus tears and retracts medially, the superior capsule is also disrupted, and superior constraint is lost. With no superior restraint to the humerus, the humeral head migrates superiorly, causing a decrease in the acromial-humeral distance. [1-4]

Biomechanical analysis has shown that a defect in the superior capsule results in a minimum 200% greater glenohumeral superior translation and subacromial peak contact pressure compared with an intact capsule. [3] The malposition of the humeral head leads to functional abnormalities and pseudoparalysis.

Numerous proposed treatments for massive rotator cuff tears – including debridement and tenotomy, tendon transfers, and reverse total shoulder arthroplasty – have yielded mixed results and high complication rates. [5-12] In particular, reverse shoulder arthroplasty can result in humeral or glenoid fractures, persistent anterior or posterior instabilities, loosening of the glenoid or humeral cemented components, dislocations, and infection. [5-7]

The superior capsular reconstruction (SCR) was described by Hanada et al [13] in 1993 and by Mihata et al [1] in 2013 as an alternative procedure to increase function and decrease pain by restoring the restraint mechanisms in the shoulder. Using a graft to recreate the superior capsule, the humeral head is centered in the glenoid, allowing the larger muscles (ie, deltoid, latissimus dorsi, and pectoralis major) to function appropriately. Mihata et al [3,4] have found that the SCR reduces glenohumeral superior translation and subacromial contact force.

Full article link below.

ICJR.net  March 2018