Think Spring, Think Injury Avoidance

At this time of year, many individual can’t wait to leap into spring, getting back to the gym to drop some winter weight, or onto the golf course or other playing field. Proceed with caution! Sports injuries can be caused by poor training practices, improper gear and not warming up or stretching enough. People often get hurt because they are not in shape and take on too much, too soon.

The most common sports injuries are:

  • Achilles tendon injuries
  • ACL tears
  • Dislocations
  • Fractures
  • Knee injuries
  • Pain along the shin bone
  • Rotator cuff injuries
  • Sprains and strains
  • Stress fractures
  • Swollen muscles
  • Tennis elbow

If you do get injured, stop. Continuing to play or exercise can cause more harm. Treatment often begins with the RICE (Rest, Ice, Compression, and Elevation) method to relieve pain, reduce swelling, and speed healing. Other possible treatments include pain relievers, keeping the injured area from moving, rehabilitation, and sometimes surgery.

It’s important to know when to look further than your medicine cabinet to treat sports injuries. An orthopedic surgeon is a medical doctor or doctor of osteopathy with extensive training in keeping your bones, joints, ligaments, muscles, tendons, cartilage and spine in good working order. Together, all of these parts of our bodies make up our musculoskeletal system.

Orthopaedic surgeons have the greatest knowledge of and experience with the wide range of conditions and treatment options available in musculoskeletal care, many of which do not involve surgery. However, if surgery is the best option for recovery, an orthopedic surgeon is the best trained to provide that surgical treatment.

Orthopaedic surgeons use the most effective and efficient diagnostic tools and our experience in musculoskeletal treatment to determine the best care for our patients.

Initial treatment of an injury following the basic RICE formula may be all you need, but if your injury does not heal on its own and continues to be painful, swollen or stiff, you may need surgery.

Depending upon the type of injury, your age and other factors, your orthopedic surgeon may recommend minimally invasive surgery such as arthroscopy following by physical therapy to help you resume your normal activities. In other cases, more traditional surgical repair may be recommended by your orthopedic surgeon.

Sometimes preventing common sports injuries is beyond our control, but many times sports injuries are preventable. Working out regularly will help you to enjoy your sports activities safely and you’ll garner extra health benefits as well. If you feel your sports injury isn’t healing on its own, consult an experienced orthopedic surgeon to help you get well and back into the game as soon as possible.

Ask The Expert

Dr. Marshall Allegra has a private practice in Hazlet and has affiliations with Riverview Medical Center, Bayshore  Community Hospital, Shrewsbury Surgical Center, and Metropolitan Surgical Institute. Dr.Allegra has been in  continuous private practice in Monmouth County since 1988. His education and training includes Undergraduate  Education at Bucknell University, Medical UAG/RWJ at Jersey Shore Medical Center and Surgical and Orthopaedic training at UMDNJ Newark.Dr.Allegra is a Fellow,American Academy of Orthopaedic Surgeons and a Diplomate on the American Board of Orthopaedic Surgeons.

Dr. Allegra, being in practice for over 20 years youmay have seen many cases where a patient is a candidate for either arthroscopic or joint replacement surgery. Can you tell our readers what criteria dictate one or the other?

Surgical treatment of arthritic joints has evolved over the 23 years I have practiced in Monmouth County. The emergence of arthroscopy in the late 1970s offered hope for less invasive care of joint pain. Orthopedic surgeons later realized that arthroscopy had limited use in the treatment of severe arthritis, and with the improvement of joint replacements, arthroscopy was relegated to a secondary role in these cases. Arthroscopy is best suited for younger, active patients with limited arthritic involvement of joints. The goal in arthroscopy in these patients is to delay eventual joint replacement surgery. Total joint replacements are best suited for those patients over 60 years of age who are not obese. These are not intended for extremely active patients, like runners, as such activity will increase the rate of wear of the implants. While these guidelines are not absolute criteria, we have witnessed an increase in patients that are heavier, younger, and more active that require joint replacements. Older patients have become more active as well, and life expectancy has been extended. Newer techniques, including minimally invasive replacements, limited joint replacement (less than total joint replacements) and arthroscopy-assisted joint replacements are emerging. These techniques are used with greater frequency today.

On a similar note, when is a partial joint replacement (minimally invasive) procedure appropriate?

In general, partial joint replacement refers mainly to the knee, which is divided into three compartments. Patients will often present with one or two of the three compartments affected. The procedure replaces only the diseased areas of the joint, leaving the healthy joint spaces and ligaments intact. The advantage is that recovery is quicker and usually more activity is allowed for the patient. Typically, it is offered to the younger (less than 65), more active patient with limited arthritis. It can also be performed in an outpatient setting, utilizing regional anesthesia, and allowing for a same day return to home.

Can you also comment on the differing surgery’s recovery period and what a potential candidate would need to be aware of for the respective surgeries?

Total Joint replacements of the hip and knee typically require a hospital stay of 2 to 4 days, with most patients spending some time in a rehabilitation facility, usually 3 to 7 days after discharge from the hospital. Partial knee replacement and total shoulder joint replacement are typically performed in an outpatient surgical center setting or as an overnight stay in a hospital. Total joint replacement patients require longer periods of recovery before returning to work, usually (but not always) 2 to 3months,whereas partial joint replacement patients recover in about one half that time.

For the procedures that you personally specialize in, can you comment on the mobility after and the length of time these surgeries can provide a normal lifestyle?

In general, the total joint replacement offers predictable, lasting relief of painful, arthritic joints. The typical patient treated this way can expect pain relief and the ability to walk without a cane or crutches within the first 3 to 4weeks, and will experience continued improvement up to 12 to 18 months post operatively. Patients often report that the joint has a more natural feel 1 to 2 years post operatively. Good to excellent outcomes are in the 95% range. The typical modern hip and knee replacement can be expected to last 20 to 25 years within a 95% probability. These are best suited for an older population, but at times the indication for surgery is extended to much younger patients. Mobility is usually excellent, but this should not lead people to believe they can place unreasonable demands on the implants, such as distance running. Partial joint replacement offers less invasive surgery, more rapid recovery and generally more mobility. These procedures should be viewed as a stop-gap measure in many younger, more active patients who will eventually require revision to total joint replacements when they are older. The use of smaller incisions in hip and knee replacement surgery has resulted in less blood loss and faster recovery. The typical hip replacement in my practice can be performed through a 4 to 5 inch incision. Partial replacements of the knee use even smaller incisions.