Smashing Through Tennis Injuries

Tennis is a popular pastime, with an estimated 11 million Americans playing the sport. As in many sports, the repetitive motions and overuse of certain joints and muscles can cause injury. Shoulders, elbows, knees and ankles are the usual victims.

A recent report in the March issue of the Journal of the American Academy of Orthopaedic Surgeons (JAAOS) offers tips to help tennis players minimize injury. Tennis elbow is the most common upper body injury, typically resulting from the constant bending motion of the palm down towards the wrist, creating pressure on the elbow. An "overuse" injury such as this might have muscles surrounding the elbow joint with microscopic tendon tears causing inflammation and pain. Tennis elbow is often successfully treated with rest, physical therapy, and proper stretching or use of a brace when playing. If those options do not help with the pain, corticosteriod injections or surgery may be needed.

Sometimes too much upper body strength in players can create an imbalance of weight and force while jumping around the court, causing injury to the lower body. According to the report, up to 67 percent of tennis injuries involve the lower extremities - hips, thighs, legs, ankles, and feet. Common injuries include sprains, strains, fractures, and even broken bones.

To strengthen the lower body and allow it to better bear the weight of aggressive upper body movement, try adding squats and trunk rotations to workouts for better leg and core stability on the court.

Injury Prevention Tips

• Make contact with the ball at the center of one of the racquet's "sweet spots" to minimize weight on the wrist and arm
• Adopt a more relaxed grip reducing the vibration load on the arm and decreasing chances for tennis elbow to develop
• Incorporate exercises to strengthen the lower body, arms and shoulders

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Nanotechnology and ACL Replacements

A torn or ruptured ACL (anterior cruciate ligament) is common, traumatic injury to the knee. More than 250,000 ACL repair surgeries are performed each year nationwide, according to the American Association of Orthopaedic Surgeons.

Recently, a team of medical researchers at the Robert R. McCormick School of Engineering and Applied Science (at Northwestern University) used nanotechnology (the manipulation of matter on an atomic, molecular, and supramolecular scale) to create a synthetic graft for ACL reconstruction. This new method may one day replace some ACL repairs conducted today.

Typical reconstruction involves a bone-patellar tendon-bone graft where a portion of the patellar tendon is cut and used to replace the damaged ACL.

Via nanotechnology, the team combined polyester fibers and calcium nanocrystals, similar to those found in human teeth and bones, to make a more durable and flexible material for the graft. The synthetic fiber was tested on an animal model and successfully adhered to the natural bone once it was attached.

This groundbreaking marriage between an artificial ligament and bone offers potential for improved ACL repairs, and other surgical applications throughout the body.

Long-term evaluation is still needed to determine the effectiveness of synthetic grafts in humans.

Click here to learn more about the study.

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Ask the Doctor - What questions should I ask before total knee replacement surgery?

Question: What questions should I ask before total knee replacement surgery?

Answer:

Before opting for total knee replacement, have a frank discussion with your doctor about what surgery entails and what to expect before and after the procedure. Knee replacement is often necessary when severe arthritis or an injury negatively affects the knee joint causing pain and limited mobility. Some questions to consider include:

1. Are there any nonsurgical treatments to try first? Have you already tried various medications or injections to alleviate pain? Have you attempted physical therapy? If the answer is 'yes', then surgery may be your best option.
   
2. What does the procedure entail? Knee Arthroplasty, or replacement surgery, involves removing the damaged portion of the joint and replacing it with artificial implants, or prosthetics. While under general anesthesia, your doctor will insert the prosthetic via small incisions. There are many options for replacement joint, and your doctor will decide which is best suited to your age, weight, and activity level.
   
3. How long will I stay in the hospital, and what kind of pain will I experience? A typical hospital stay will last two to three days. You will be given medication for your pain as needed, and you may also wear support stockings to control swelling. Patients often describe an aching sensation near the incision as the most uncomfortable pain afterwards.
   
4. When will my physical therapy begin? If there are no complications, your therapy will begin the day after surgery. You will have a walker or crutches to help you get around. Your therapist will show you how to get up and down from lying in bed as well as perform everyday functions such as climbing stairs or getting in and out of cars. Therapy will last for several months in order to regain strength in your knee. Your doctor and therapist will create a specific plan for you with exercises to do at home as well as at a therapy facility.
   
5. How should I prepare my house for when I come home afterwards? Make sure that you have help with you for the first few days back. You don't want to fall and risk further injury. Removing small rugs, cords, and clutter will ensure you have clear walking paths. Arranging to stay on the ground floor of your home, if possible, is also a good idea for a while.
   
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Why Sitting is Bad for Your Health, and What You Can Do About It

Mounting evidence shows that even if you work out regularly, sitting can be bad for your health.

Here's what happens to your body internally when you sit for long periods of time:

• Muscles and joints become stiff and tight
• Blood flow to the heart shows decreasing circulation
• Insulin production drops leading to lack of energy
• Hunger cravings set in causing unnecessary and/or unhealthy snacking

Externally, you may notice the effects of too much sitting in someone's weak posture or rounded shoulders and slightly bowed head- mimicking their form at a desk. This hunched position can even distress the lungs, limiting their ability to properly expand and take in air when breathing.

Is there anything you can do to offset these long hours spent in a chair?

A recent Indiana University study compared people who sat for three hours straight with others who got up and walked around for five minutes each hour. The constant sitters' circulation fell by half, while the walkers' circulation did not drop at all.

The important takeaway is that even small bits of activity interspersed with sitting are highly beneficial. For every hour that you sit, aim to take a break for at least five minutes and do the following: 

• Run an errand in your building or office
• Climb up and down a flight of stairs 
• Flex your calves
• Do neck rolls and shoulder stretches
• Challenge a colleague to have a "walking meeting"

Also, consider sitting on an exercise ball while at your desk or even raising your desk to standing level so that your legs have more room to move. 

This article was adapted from Men's Journal. 

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Join Our Free Seminar on Intuitive Eating

Do you ever eat out of pure boredom or because you're reacting to a situation? On Thursday, March 26, Texas Orthopedics will host a free talk about Intuitive Eating at our Northwest Austin location at 470 Seton Center Parkway, Suite 200 from 5:15-6:30pm. The talk will discuss the difference between physical and emotional feelings surrounding eating habits.

What is Intuitive Eating?

Eating healthy is a mantra that many of us try to live. Yet, often we claim there are obstacles in our way. Time, stress, convenience are just a few reasons.

The theory behind intuitive eating is to approach healthy eating with full consciousness of your mind and body. Becoming attuned to our body's natural hunger signals will help us make wiser food decisions.

Next Thursday, March 26th, nutrition counselor, Anne Wilfong, RDN, LD, will give a presentation on the 10 guiding principles behind intuitive eating. These include:

1. Reject the Diet Mentality
2. Honor Your Hunger
3. Make Peace with Food
4. Challenge the Food Police
5. Respect Your Fullness
6. Discover the Satisfaction Factor
7. Honor Your Feelings Without Using Food
8. Respect Your Body
9. Exercise
10. Honor Your Health
    

Register today! For additional details call 512-439-1100.

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Two Rules To Protect Your Little Leagurers Pitching Arm

Springtime is here, which also kicks off the start of American's favorite pastime, baseball season. Everyone from pro organizations to the pint-sized Little Leagues are winding up their pitchers and sending them to the mound.

Pitchers are known to suffer from overuse injuries to their elbows and shoulders. The constant repetitive motion of throwing over and over can wear down these joints and cause painful inflammation.

Little League baseball is protecting young pitchers from injury by strictly enforcing pitch count rules. First adopted in 2007, additional rules were added in 2010 and 2014 to reinforce best practice. The guidance defines the number of pitches a young player should throw in a game and how much rest he must take between pitching appearances.

The pitch count rules are proving successful so far. A 2011 study commissioned by Little League showed a reduction in risk of shoulder injuries by 50 percent in players ages 8 to 13.

2 Rules to Prevent Injury

#1 Keep Track of Pitches: Designating an official scorekeeper to track pitch counts. That person is also responsible for notifying the umpire-in-chief when a player has reached his pitch limit and/or provide current pitch counts for any player upon request. Youngest players (7-8 years) are allowed up to 50 pitches per day, while the older ones (17-18 years) can pitch up to 105 per day.

#2 Rest!: Mandatory rest periods foster proper muscle and joint recovery between pitching. The days of rest are dictated by the player's age and the number of pitches per day (within the pitch count guidelines). A player fulfill the 'days off' before being eligible to pitch again.

The recent 2014 amendment addressed Regulation VI Note 3, stating that in the event the first inning was not completed, all records even pitching records, are to be disregarded.

Complete pitch count rules available at the Umpire Resource Center: 2014 Little League Rule Changes.
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Rodeo and Sports Medicine

Rodeo Austin kicks off soon, March 14-28, at the Travis County Expo Center. While many fans enjoy the food, entertainment, rides, and award-winning livestock - the main attraction is undoubtedly the rough stock events - barebacks, bronco, and bull riding. 

Like football, basketball, or hockey, rodeo riding is a tough sport requiring a great deal of skill and athleticism. Professional rodeo riders, or cowboys, must train like any other athlete. These men and women need strong core muscles as well as superior upper body strength to balance atop a large and aggressive animal, or strategically rope something (such as a calf) moving swiftly alongside them. Strong hips and knee joints are also necessary to help hang on tight!

Simple exercises such as arm and shoulder, or hip and leg extensions with a resistance band, as well as squats to strengthen thigh and leg muscles, might be typical of a rider's workout.Stretching to loosen the neck and spine before and after an event is also important. 

As with all sports, injuries occur even with the most experienced professionals. Fractures, dislocations, sprains/strains, ligament tears, and skin abrasions are common.

A more severe injury might be a spinal cord injury or concussion. According to historical data from the NCBI (National Center for Biotechnology Information), head and neck trauma typcially accounts for 10-29% of reported rodeo injuries, with concussion incidence rates of 3.4 per 1000 competitive exposures.

Professional associations for rodeo cowboys now encourage riders to consistently sport proper headgear and other protective equipment (helmets, braces, cervical collars, mouthpieces, and special vests) while urging sufficient recovery time following serious injuries like concussions - such as practiced in the NFL and NHL.

Many rodeos these days are equipped with onside medical care for riders needing urgent attention. These custom-made mobile facilities house first-aid supplies, and often x-ray and ultrasound machines to quickly diagnose treatment. 

Cheers For Area Athletic Trainers

Athletic trainers are sometimes referred to as the "unsung heroes" in sports. They work as hard as any athlete or coach, attend every practice and game, and almost never get any recognition or applause following a big win.

As March is National Athletic Training Month, Texas Orthopedics salutes the staff and student trainers at all the Austin-area schools.

Texas Orthopedics supports and works closely with many of the area high schools including: Austin High School, Bowie High School, St. Andrews Episcopal School, Westwood High School, McNeil High School, Cedar Park High School, and Vandegrift High School.

The official role of an athletic trainer is to assist the medical professionals who specialize in the prevention of emergency care, diagnosis, treatment, and rehabilitation of sports-related injuries.

Unofficially, their jobs may involve assisting players by taping or bandaging minor bumps and bruises, administering heat or ice therapy, or helping to stretch before and after a game. Trainers are often in the locker room or on the field long before and after a game. They shed their own blood, sweat, and tears right alongside the athletes they care for. 

Certified athletic trainers have earned degrees from accredited athletic training curriculum. Essential subject areas include injury/illness prevention, first aid and emergency care, assessment of injury/illness, human anatomy and physiology, therapeutic modalities, and nutrition. According to the National Athletic Trainers' Association, more than 70 percent of certified athletic trainers hold at least a master's degree.

Many specialists at Texas Orthopedics have personal experience both playing and coaching a variety of sports, and we are thrilled to honor the trainers dedicated to our local student athletes.

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Dr. Schultz on KVUE: Hip Procedure Enables Patient to Climb Mt. Kilimanjaro

The hip resurfacing procedure at Texas Orthopedics has not only enabled local pastor and Cedar Park resident John Short to resume his active lifestyle, it has improved his mobility so much, he set his sights on climbing Mt. Kilimanjaro, the highest free-standing mountain in the world, in an effort to help stop human trafficking.

John Short and Dr. Randall Schultz were recently interviewed by KVUE news about the innovative procedure and the impact it's had on his life.

"Resurfacing means we are literally just putting a new surface on top of the ball which has lost its cartilage coating," Dr. Schultz explained to KVUE.

Short completed the climb to help raise funds and awareness about human trafficking.

"It's representative of a woman, a girl or young lady to actually climb out of her situation," said Short.

For more information about Operation Freedom Climb, click here.

To view the entire KVUE story, click here.

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Salt and Soft Drinks... And Other Foods that Make Bones Brittle

Food rich in calcium and vitamin D are necessary for bone strength and helpful in warding off painful conditions such as osteoporosis. Examples of these key foods include milk, yogurt, canned fish, and dark leafy greens. On the flip side, there are specific foods that can rob your body of calcium and diminish healthy bone density.

Here's what to look out for in your diet to best benefit your bones (via WebMD):

1. Excess salt can lead to calcium loss and weaken bones. It pops up most commonly in processed and fast foods, but is also found in breads, cereals, and canned and frozen goods. Check labels and recipes for sodium content, and use it sparingly.
2. Soft drinks, and other carbonated beverages, contain phosphoric acid which draws calcium from bones and increases its excretion in urine. Beverage options that are better choices include calcium and vitamin D-fortified juices, plain or chocolate milk, or flavored waters.
3. While caffeine is widely believed to have some health benefits, it is also proven to deplete calcium from bones. Although tea has caffeine, it is considered less harmful than coffee, and contains plant compounds that may even protect bones. If trying to curb your caffeine intake, start by mixing half regular with half-decaf drinks, and adjust gradually.
4. Soy products, such as edamame, tofu and tempeh, contain plant compounds that may inhibit calcium absorption. Practice moderation when consuming soy protein, and balance it out iwth a calcium supplement. 

Avoiding these foods, and adopting a diet full of calcium-rich dairy, whole grains, fruits, vegetables, and lean proteins, is the best way to strengthen bone density and boost bone health. And check with your doctor about taking a daily supplement. 

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