Sport Safety for Young Athletes

For young athletes, sports activities are more than just play.

Participation can improve physical fitness, coordination, and self-discipline, and help children learn teamwork.

However, children’s bones, muscles, tendons, and ligaments are still growing, making them more susceptible to injury. Growth plates are the areas of developing cartilage at the ends of long bones where bone growth occurs in children. The growth plates are weaker than the nearby ligaments and tendons. A twisted ankle that might result in a sprain in an adult, could result in a more serious growth plate fracture in a young athlete.

There are also significant differences in coordination, strength, and stamina from child to child and between children and adults. Young athletes of the same age can differ greatly in size and physical maturity. Grade school students are less likely to experience severe injuries during athletic activities because they are smaller and slower than older athletes. High school athletes, however, are bigger, faster, stronger, and capable of delivering tremendous forces in contact sports.

Acute sports injuries are caused by a sudden trauma, such as a twist, fall, or collision. Common acute injuries include broken bones, sprains (ligament injuries), strains (muscle and tendon injuries), and cuts or bruises.

Most acute injuries should be evaluated by an orthopedic physician. Prompt first aid treatment should be provided by coaches and parents when the injury occurs. This usually consists of the RICE method: rest, applying ice, wrapping with elastic bandages (compression), and elevating the injured arm, hand, leg, or foot. This usually limits discomfort and reduces healing time. Proper first aid will minimize swelling and help the doctor establish an accurate diagnosis.

Follow these tips to play it safe:
• Always be in proper physical condition to play a sport
• Know and abide by the rules of a sport
• Wear appropriate protective gear
• Know how to correctly use athletic equipment
• Always warm up before playing
• Stay hydrated
• Avoid playing when very tired or in pain

Following a regular conditioning program with exercises designed specifically for their chosen sport can help young athletes avoid injuries.

Coaches and parents are responsible for creating an atmosphere that promotes teamwork and sportsmanship. A young athlete striving to meet the unrealistic expectations of others may ignore warning signs of injury and continue to play with pain. The “win at all costs” attitude of many parents, coaches, professional athletes and peers can lead to injuries. Above all else, youth sports should always be fun.

Avoiding Overuse Injuries

Understanding how to pace yourself while getting fit is key to staying healthy and enjoying physical activity throughout your life.

Overuse injuries can be any type of muscle or joint injury like rotator cuff injury, bursitis, tendonitis, or stress fractures that are caused by repetitive trauma. Overuse injuries are usually caused by biting off more than you can chew, or using bad form when you exercise.

When you take on too much physical activity too quickly, you can hurt yourself. Pushing too hard too soon or simply doing too much of one type of physical activity can strain your body and lead to an overuse injury.

The fear of overuse injuries should not prevent you from exercising. Here are some common sense ways you can avoid overuse injuries:

  • Get a physical before you start exercising. You may have muscular imbalances or medical conditions that can make you predisposed to developing an overuse injury.
  • Consider using a personal trainer. Using the correct technique is crucial to preventing overuse injuries. A good, certified personal trainer can help you begin a new, safe exercise regimen.
  • Use new/well-maintained shoes. When your shoes wear down, you don’t get the proper support, and this can contribute to overuse injuries.
  • Consider the tortoise and the hare. Easing into your new fitness routine/training will help you continue to stay active for years to come. Don’t try to do too much too soon.
  • Warm up, cool down, and stretch. A dynamic stretching warm-up of 5 to 10 minutes and a static stretching routine for 5 to 10 minutes at the end of the hour will do wonders for avoiding injuries. Consider ways to modify activities to fit your present fitness level.
  • Gradually increase your activity level. When changing your activity level or the amount of weight you’re using while strength training, keep it gradual — such as increases of no more than 10 percent each week until you reach your new goal.
  • Try a tri. Done correctly, triathlon training is a perfect balance of running, swimming, cycling, and core strength – a perfect balance to make you really fit and avoid overuse injuries. Even just following a triathlon training program will give you a nice balance of different forms of cardio, strength, and flexibility.

It’s great to set new fitness goals; don’t let overuse injuries sideline you. By working with your orthopedic physician and a personal trainer or physical therapist, easing into activities, and cross training, you can prevent overuse injuries.

What Is Minimally Invasive Surgery?

In 1988, Dr. J. Barry McKernan, after making only a 10mm incision – (equivalent to 0.39 inches, less than half an inch) – inserted a miniature camera into a patient’s abdomen and removed a gall bladder. The patient recovered in days, rather than weeks or months. This was the first laparoscopic cholecystectomy performed in the U.S. and the beginning of the minimally invasive movement in surgery.

Twenty-six years later, minimally invasive procedures have changed the way people think about surgery. Patients who choose innovative minimally invasive procedures over conventional surgery usually have shorter hospital stays and quicker recovery. This means getting back sooner to the things that are important in life.

An orthopedic doctor may recommend minimally invasive surgery for many conditions, including orthopedic injuries and disorders.

More than 20 million Americans have had minimally invasive surgery, and time has proven it to be as effective as conventional surgery. When you have minimally invasive surgery, you’re likely to lose less blood and have less postoperative pain, fewer and smaller scars, and a reduced risk of infection than you would following conventional, or “open” surgery.

Minimally invasive laparoscopic surgery uses state-of-the-art technology to reduce damage to human tissue when performing surgery. For example, in most procedures, a surgeon makes several small incisions and inserts thin tubes called trocars. Carbon dioxide gas may be used to inflate the area, creating a space between the internal organs and the skin. Then the miniature camera (usually a laparoscope or endoscope) is placed through one of the trocars so the surgical team can view the procedure as a magnified image on video monitors in the operating room. Specialized instruments are placed through the other trocars to perform the procedures.

There are some advanced minimally invasive surgical procedures that can be performed almost exclusively through a single point of entry – meaning only one small incision. This is called single site laparoscopy, and is another approach to performing traditional laparoscopic surgery using the same tools. Orthopedic surgeons often perform single site laparoscopy to repair conditions of the hip and knee. These kinds of procedures are not for everyone, and only your doctor can determine if a minimally invasive surgery is right for you.

Understanding Minimally Invasive Knee Surgery

Arthroscopy is a common surgical procedure in which a joint (arthro-) is viewed (-scopy) using a small camera. Arthroscopy gives doctors a clear view of the inside of the knee. This helps them diagnose and treat knee problems.

Technical advances have led to high-definition monitors and high-resolution cameras. These and other improvements have made arthroscopy a very effective tool for treating knee problems. According to the American Orthopaedic Society for Sports Medicine, more than 4 million knee arthroscopies are performed worldwide each year.

Arthroscopy is done through small incisions. During the procedure, an orthopedic surgeon inserts the arthroscope (a small camera instrument about the size of a pencil) into your knee joint. The arthroscope sends the image to a television monitor. On the monitor, your surgeon can see the structures of the knee in great detail. Your surgeon can use arthroscopy to feel, repair or remove damaged tissue.

Almost all arthroscopic knee surgery is done on an outpatient basis. Arthroscopy can be performed under local (numbs just your knee), regional (numbs below the waist), or general anesthesia (puts you to sleep). The anesthesiologist will help you decide which method would be best for you. If you have local or regional anesthesia, you may be able to watch the procedure on a television monitor.

The orthopedic surgeon will make a few small incisions in your knee. A sterile solution will be used to fill the knee joint and rinse away any cloudy fluid. This helps your orthopedic surgeon see your knee clearly and in great detail.

Your surgeon’s first task is to properly diagnose your problem. Your surgeon will insert the arthroscope and use the image projected on the screen to guide it. If surgical treatment is needed, your surgeon will insert tiny instruments through another small incision.

Arthroscopy for the knee is most commonly used for:

  • Removal or repair of torn meniscal cartilage
  • Reconstruction of a torn anterior cruciate ligament
  • Trimming of torn pieces of articular cartilage
  • Removal of loose fragments of bone or cartilage
  • Removal of inflamed synovial tissue

Recovery from knee arthroscopy is much faster than recovery from traditional open knee surgery. Keep your leg elevated as much as possible for the first few days after surgery. Apply ice to relieve swelling and pain. Your surgeon will see you in a few days to check your progress, review the surgical findings, and begin your postoperative treatment program.

Your doctor will prescribe pain medication to help relieve discomfort and may also recommend medication such as aspirin to lessen the risk of blood clots.

You should exercise your knee regularly for several weeks after surgery. This will restore motion and strengthen the muscles of your leg and knee. A formal physical therapy program may improve your final outcome.

Unless you have had a ligament reconstruction, you should be able to return to most physical activities after 6 to 8 weeks, or sometimes sooner. Higher impact activities may need to be avoided for a longer time. If your job involves heavy work, it may be longer before you can return to your job. Discuss when you can safely return to work with your doctor.

You will need to talk with your doctor before returning to intense physical activities. The final outcome of your surgery will likely be determined by the degree of damage to your knee.

Partial Joint Reconstruction Is an Option for Knee, Hip and Shoulder Pain

Joints refer to the areas on our body where two or more bones meet. While we have different kinds of joints, the ones more commonly used and more easily damaged are the weight-bearing joints, such as the hips and knees. Less commonly, non-weight bearing joints, such as the shoulder, are damaged. Through overuse and aging, these joints may become weak and painful. Joint disorders such as arthritis cause pain and limit our daily activities.

Reconstructive partial joint replacement, or hemi-arthroplasty, offers relief for many people through safe and minimally invasive procedures when performed by a skilled orthopedic surgeon. Many people who have ongoing pain or loss of function in a joint may be a candidate for partial joint replacement surgery.

Hips and knees, the largest joints on the human body, bear a tremendous toll over the years from wear and tear, chronic disease such as arthritis, and traumatic injury. When joints are damaged, the resulting pain can disrupt sleep, reduce mobility, and affect all aspects of daily life.

If you suffer from hip or knee pain, rest assured you are far from being alone. Each year six million Americans seek medical help for painful knees. This translates into 2.5 percent of the U.S. population seeking orthopedic specialists for relief of knee pain. It’s estimated that about 32 million Americans visit their physician for some form of arthritis. Non-surgical intervention is the first line of treatment, with medications, therapy and injections. Surgery is reserved for those patients who do not respond to more conservative measures.

Thankfully, partial knee reconstruction and partial hip reconstruction have become very reliable procedures as orthopedic surgeons continue to revise and improve upon these minimally-invasive techniques. And, most of today’s artificial joints can be expected to last at least 15 years, and some longer than 20 years.

Partial knee reconstruction may be possible for patients with damage to one part of the joint. The knee has three distinct compartments, which can be treated separately. Doctors refer to this limited reconstruction as a unicompartmental knee replacement. In a partial or unicompartmental knee replacement, only the diseased parts of the knee are removed and replaced; the healthy portions are left untouched. Successful partial knee replacements can delay or eliminate the need for a total knee replacement. They also allow a greater range of movement than standard total knee replacements, and they are often performed as an outpatient procedure returning the patient home on the same day.

Partial hip reconstruction is an alternative to total hip replacement, and is usually reserved for the elderly patient with a particular type of hip fracture.

Although partial shoulder joint reconstruction is less common than partial knee or partial hip replacement, it is successful in relieving joint pain and is usually used to treat osteoarthritis, and is commonly performed on an outpatient basis.

The benefits of partial joint reconstruction surgery include smaller incisions, a shorter hospital stay, less bleeding, reduced risk of infection and other complications, and faster recovery and rehabilitation.

When searching for the right orthopedic surgeon, ask friends and family for referrals and always consult an orthopedic surgeon with extensive experience performing the reconstruction your condition requires.

Knee Microfracture Surgery

Knee Microfracture Surgery
Microfracture surgery of the knee is an articular cartilage repair surgical technique that works by creating tiny fractures in the underlying bone. This causes new cartilage to develop from a so-called super-clot.

Microfracture surgery has gained popularity in sports in recent years; numerous professional athletes including members of the NBA (most notably Andrew Bogut, Anfernee Hardaway, Jason Kidd, Greg Oden, Allan Houston, Kenyon Martin, Tracy McGrady, Chris Webber and Amar’e Stoudemire, MLB (Jeff Clement), Matt Kemp, Derek Holland, NFL and NHL players have undergone the procedure.

The microfracture procedure uses the body’s own healing abilities and provides an enriched environment for tissue regeneration of chondral defects, which are damaged areas of articular cartilage of the knee. The surgery is quick – typically lasting between 30–90 minutes – minimally invasive, and can have a significantly shorter recovery time than an arthroplasty (knee replacement).

The Surgical Procedure: Microfracture
The microfracture procedure is done arthroscopically. An orthopedic surgeon visually assesses the defect and performs the procedure using special instruments that are inserted through three small incisions on the knee.

After assessing the cartilage damage, any unstable cartilage is removed from the exposed bone. The surrounding rim of remaining articular cartilage is also checked for loose or marginally attached cartilage. This loose cartilage is also removed so that there is a stable edge of cartilage surrounding the defect. This process of thoroughly cleaning and preparing the defect results in optimum surgical outcomes.

Multiple holes, or microfractures, are then made in the exposed bone about 3 to 4mm apart. Bone marrow cells and blood from the holes combine to form a “super clot” that completely covers the damaged area. This marrow-rich clot is the basis for the new tissue formation.

The microfracture technique produces a rough bone surface that the clot adheres to more easily. This clot eventually matures into firm repair tissue that becomes smooth and durable. Since this maturing process is gradual, it usually takes two to six months after the procedure for the patient to experience improvement in the pain and function of the knee. Improvement is likely to continue for about 2 to 3 years.

Following rehabilitation and physical therapy, which begin immediately after the microfracture procedure, most patients return to normal activities after 6 to 8 weeks. Athletes can resume sports that involve pivoting, cutting, and jumping approximately 4 to 6 months after a microfracture procedure.

What are the signs and symptoms of an articular cartilage injury that may be treated with the microfracture technique?

  • Intermittent swelling – Loose fragments floating in the knee can cause swelling to occur.
  • Pain – Pain with prolonged walking or climbing stairs.
  • Giving way – The knee may occasionally buckle or give way when weight is placed upon it.
  • Locking or catching – Loose, floating pieces of cartilage may catch in the joint as it bends, causing the knee to lock or have limited motion.
  • Noise – The knee may make noise (called crepitus) during motion, especially if the cartilage on the back of the kneecap is damaged. This noise is often described as “snap, crackle, and pop”.