Spring Brings Eternal Hope…For Golf

We have all heard the saying Hope Springs Eternal, which is taken to mean that people will continue to hope although it seems unlikely.  Well, we can all hope that Spring will bring eternal health, happiness, and the joy of life back to us after weathering the last several months in quarantine.

It appears as though our elected officials are testing the waters, allowing some access to parks and the great outdoors.  Even the golf courses are open!

That being said, within a short period of time after a delayed golf season being declared, the phone starts to ring with golf injuries.  Be mindful that for the last few months most people have been a combination of lounge lizard and couch-potato…you need to ease into the roll of Tigger and slow your roll to avoid injuries.

Most golf injuries are a result of poor mechanics and overuse. Non-golfers do not understand that you use your entire body to execute a golf swing in a complicated, coordinated movement.  It truly is a sport and not just a hobby.

Most common injuries in golf

  • Back pain
  • Elbow tendonitis
  • Rotator cuff
  • Shoulder pain
  • Knee pain
  • Wrist pain

You may want to play a round of air golf before you hit the course. Similar to air guitar, this is practicing your swing motion without the club in hand.  This will loosen up your joints and muscles to the once familiar swing motion.  Warming up before playing any sport is essential.

Working on your mobility can ward off evil injuries. Stretching and rotating your knees, hips and lower back as well as your neck and shoulders feels wonderful and is a great help. Balance plays a big part in your game and your safety.  Work on your core strength and cross body coordination as well as the oblique muscles needed for your ultimate torso rotation/swing.

Playing a full 18 holes requires a lot of repetitive movements, putting stress on the same muscles, tendons, and joints time after time. To try and avoid injuries:

  • Ease into the 18-hole game with a shorter one at first.
  • Dress for success with proper footwear and appropriate clothing for the weather
  • Don’t forget your sunscreen, sunglasses and a hat
  • Warm up for 10-15 minutes to stretch and increase your range of motion
  • Be mindful of posture- poor posture leads to back, neck and shoulder pain
  • Brace yourself if certain body parts tend to be weak and need support


If you are experiencing pain apply ice/a cold pack for 15-20 minutes at a time to reduce inflammation, every 3 hours if possible. You can use heat when inflammation subsides. Rest it out, take an anti-inflammatory or analgesic if allowed.

If the pain does not diminish within a few days to a week, you might be wise to visit an Orthopedic Specialist to rule out serious or chronic injuries.

Be smart and maintain social distancing and wear your mask as long as it is recommended. The golf course may be open, but life is not quite back to normal yet.


Think well, live well, be well.

Dr. Marshall P. Allegra

879 Poole Avenue, Hazlet New Jersey, 07730
Phone: (732) 888-8388

Dr. Marshall P. Allegra is a board-certified orthopedic surgeon in private practice in Monmouth County for over 25 years. As an experienced diagnostician, Dr. Allegra can expertly determine injuries, and then determine the best treatment options to return you back to your normal life, restoring functionality and range of motion as quickly as possible and avoiding long term implications.

March Madness 2020 Predictions

March Madness is probably one of the largest, most exhilarating, and fun events in all of sports!  Each year at this time, the NCAA Division I men’s basketball tournament, is played, and has been annually since 1939. The inaugural NCAA men’s basketball tournament had just eight teams, increased now to 68 teams. This single-elimination tournament of 68 teams compete in seven rounds for the national championship, resulting in The Final Four.

Before the tournament even begins, there is a long roster of talented players that are out for the season or out indefinitely.  Many of these athletes had the potential of going pro, and the tournament was an opportunity for exposure to professional scouts and career making games. Some injuries are recoverable, allowing the athlete to work back up to full potential.  Some injuries take a career from GO to NO.

The overall rate of injury in a 16-year time span from the 1988–1989 season through 2003–2004 was 9.9 per 1000 athlete-exposures for games.  Athlete-exposures for practices was 4.3 per 1000 during the same time frame.

Roughly 60% of all injuries were to the lower extremity, with ankle ligament sprains being the most common injury and knee internal instabilities being the most common injury. 59% of game-related injuries occurred during the second half of the game, which identifies fatigue as a predisposing factor. A trend of observed increase in physical contact in men’s basketball over the past 2 decades has led to increasing incidence of injuries to the head and face was noted over the 16-year span of the study. You know the issue is real when you have an NCAA Injury Surveillance Program.

Not a college athlete in your home? According to a study of high school basketball players by the National Athletic Trainers’ Association (NATA):

  • Twenty-two percent of all male basketball players sustained at least one time-loss injury each year.
  • Approximately 42% of the injuries were to the ankle/foot, far outnumbering other injured body categories such as hip/thigh (11%) and knee (9%).
  • Sprains were the most common type of injury (43%).
  • General trauma was the second most common type of injury (22%).
  • Sixty percent of the injuries occurred during practice.
  • Fifty-nine percent of game-related injuries occurred during the second half of the game.

Injury Prevention Tips

  • Wear athletic shoes that fit securely, are non-skid and have high tops for ankle support.
  • Warm up and stretch before each session.  This will increase deep muscle temperatures giving increased flexibility
  • Use proper technique and follow the rules (they were not made to be broken).
  • Use a mouth guard, ankle braces, safety glasses, elbow, and knee pads to prevent injuries when falling and coming into contact with other players.
  • Do not wear jewelry or other accessories.
  • Play on a clean, dry, safe surface.
  • If you are injured, take the time to rest it out before you return to sports.

If an injury occurs, remember the R.I.C.E. method

  • Rest the injured area.
  • Ice the injured area for 20 minutes every 2 hours.
  • Apply a Compression wrap to reduce swelling.
  • Elevate the injured area to a level above the heart.

Our prediction is March Madness will inspire young and old alike to play basketball with gusto.  Enjoy the game, take precautions to avoid injuries.  If you get injured and you do not improve within a few days, seek medical advice or treatment.

Dr. Marshall Allegra spends time speaking with each patient at his office in Hazlet to understand their unique condition. With over 25 years of experience as an Orthopedic Surgeon, Dr. Allegra is an expert at diagnosing pain and prescribing the most appropriate non-surgical interventions before surgery is recommended.

High Speed, High Impact: A Risky Combo for Young Football Players

Injuries are an inevitable risk in athletics and football is no exception. Young football players have almost twice as many injuries as athletes in other sports, with more than 500,000 high school and college football injuries treated each year. One of the reasons for this elevated risk is that football is a high-speed, high-impact sport.

Tackling, blocking and other physical interactions between players can result in a number of common orthopedic injuries.

Another reason orthopedic injuries are so frequent in football is because the nature of the game requires players to pivot and change direction, increasing the likelihood of injuries to the joints and other tissues. Sudden bursts of speed can cause muscle damage if the player is not warmed up and in condition. Overuse injuries are also common, especially for quarterbacks.

These factors combine to make football a relatively high-risk sport. The most common musculoskeletal injuries in football include:

ACL injuries – The anterior cruciate ligament in the knee can become damaged or torn when a player is impacted from the front or rear. A torn ACL can often occur as a result of non-contact injuries.

MCL injuries – Injuries to the medial cruciate ligament in the knee is also very common because it occurs when the knee is impacted from the side.

Torn meniscus – When a player rotates their body while a foot stays planted, the knee can twist, causing the meniscus to tear.

Ankle sprains and strains – Ankles are susceptible to soft tissue damage when pivoting, changing direction, or when too much pressure is put on the ankle joint.

Muscle contusions – A strong impact to a large muscle, usually in the thigh, can cause a contusion. This is basically a large, deep bruise that can impair muscle function.

Torn hamstring – Bursts of speed can cause the hamstrings to tear if the player is not conditioned or properly warmed up.

Shoulder tendinitis – Frequent throwing can cause overuse injuries like shoulder tendinitis from repetitive motions.

Shoulder separation or dislocation – A direct blow below the shoulder can cause a separation of the acromioclavicular joint while a dislocation occurs when the head of the humerus detaches from the scapula.

Getting Back into The Game

Treatment for these football injuries can range from basic RICE (rest, ice, compression, elevation) to surgery, with several options in between.

Athletic trainers are a key component to keeping players healthy. Parents should help to maintain optimal performance condition by ensuring their young athlete is well rested, receives the proper nourishment, and maintains good condition all year long.

Still, injuries do happen. Be sure to see a board-certified orthopedic physician at the first signs of an overuse injury -soreness, swelling, tingling or discomfort – or when an accident occurs on the field. A thorough diagnosis and fast treatment will accelerate recovery and return to play for your young athlete.

Huddle Up About Back-To-School Sports Safety

For many kids, back to school means back to sports. Youth sports are a valuable experience, filled with challenges, competition and fun.  Being part of a team fosters feelings of belonging, inspires collaborative play and strategy, and can be an excellent form of exercise.

Still, parents often worry about the risk of injury their children face on playing fields. Even if your child returns to school in optimal condition after a summer spent building up body, flexibility and speed, too many kids still get stuck on the sidelines with injuries, some of which are preventable.

The Centers for Disease Control and Prevention says more than 2.6 million children are treated in the emergency department each year for sports- and recreation-related injuries.

Common injuries young athletes face are often related to the skeletal and muscular systems of the body. The American Academy of Orthopaedic Surgeons stresses that children’s bones, muscles, tendons, and ligaments are still growing, making them more susceptible to injury. Fortunately, many youth-sport injuries can be prevented. Continue reading “Huddle Up About Back-To-School Sports Safety”

Sports Medicine Specialists See Tommy John Surgery On The Rise Among Youth Baseball Players

So-called Tommy John surgery, a surgical repair for injured elbows, has saved the careers of many a major-league pitcher. While this may seem like an extreme treatment for a high school athlete, a recent study in the American Journal of Sports Medicine has found teenage pitchers now undergo more of the procedures than any other group. These results highlight the risk of overuse injuries in this age group, according to orthopedic specialists.

The study found that athletes ages 15 to 19 account for 56.8 percent of the ulnar collateral ligament (UCL) reconstruction procedures, commonly known as Tommy John surgery after the pitcher who won more than half the victories in his 26 years in the major leagues after becoming the first person to undergo the procedure.

Damage to the UCL, a band of tissue in the elbow that binds the upper and lower arm bones together, is typically an overuse injury caused by throwing at extreme intensity and frequency.

Sports have become so competitive that young athletes are often playing for nine or more months every year on school teams, travel teams and in multiple leagues, tournaments, showcases, camps, indoor ball and other programs. Playing when fatigued, and when a player’s physical condition and technique may not be the best increase the risk of developing an overuse injury.

A Growing Concern

The study shows both the incidence and regional demographic of Tommy John surgery in the United States. Interestingly, Tommy John surgery is most often performed in the second quarter of the year – during the traditional high school baseball season – and performed most often in the South than in any other region in the United States, echoing earlier research that showed that Major League players who grew up in the South are more likely to have Tommy John surgery as well. However, indoor baseball and travel teams is now extending the baseball season here on the East Coast, as well.

Prevention Beats Repair

The American Sports Medicine Institute has issued recommendations in its “Position Statement for Youth Baseball Pitchers” that include, limiting pitching to no more than 100 innings per year, taking a break from overhead throwing for an optimal four months per year, and plenty of vigilance about rest and proper technique.

Major League Baseball has launched its own “Pitch Smart” initiative, which includes guidelines for coaches, young players and parents, to avoid overuse injuries.

Players experiencing a UCL injury may experience:

  • Pain when using the arm in an overhead position
  • Soreness on the inside edge of the elbow
  • Minor swelling along the inside of the arm
  • Possibly numbness or tingling in the arm
  • Instability at the elbow joint, feeling like the arm may “give out” when moved through the motion related to your sport

Diagnosing & Treating a UCL Injury

Consult a sports medicine specialist or orthopedic physician at the early signs of these symptoms. Your doctor will conduct a thorough physical examination and order an MRI to assess the degree of the UCL injury.

There are three classifications of a UCL injury of the elbow:

  • A first-degree sprain occurs when the ligament is strained without it becoming stretched
  • A second-degree sprain occurs when the ligament is partially torn
  • A third-degree sprain occurs when the ligament is torn or ruptured

An ulnar collateral ligament tear results in an elbow that loses function altogether. Consulting an experienced sports medicine or orthopedic consultant at the earliest stage of injury can help alleviate further damage.

Ice, rest, anti-inflammatory medication and physical therapy, as well as the use of a cast or splint, will often help to resolve a mild UCL injury.

Surgery may be required for more acute tears and ruptures, using a minimally invasive, arthroscopic surgical approach where the ulnar collateral ligament is reconstructed using a soft tissue graft.


Teen sports are great: They promote teamwork, jump-start a lifelong exercise habit, and provide an antidote to obesity. But teen athletes can also get hurt, which means they—and their parents and coaches—should be vigilant about prevention.

Sports injuries fall into two categories. Acute injuries, like a sprained ankle or torn ACL, occur suddenly, after a missed step or a midfield collision. Overuse injuries are caused over time by repetitive motion. Overuse injuries used to be fairly rare among teens and kids but increasingly, orthopedic specialists see teens with overuse injuries that used to plague mostly collegiate or pro athletes.

These injuries include damaged ulnar collateral ligament in the elbow (common in baseball pitchers, it can be fixed with so-called Tommy John reconstruction surgery), or osteochondritis dissecans, an overuse problem most commonly found in the knee that can result in loose bone or cartilage fragments in the joint.

One culprit: America’s youth sports culture. Immersion in high school teams, private club teams, traveling teams and sports summer camps mean more injuries. Many kids now specialize early and pursue a single sport through adolescence, rather than switching sports with the season. When young athletes do that, they lose the benefit of cross-training. Focusing on all-around athleticism keeps the body balanced and less vulnerable to injury.


There are ways to protect against both overuse and acute injuries. Proper conditioning is crucial. Young athletes new to sports should start by getting in good overall shape—including working on aerobic fitness, strength, and flexibility.

Start by being active for 30 to 60 minutes most days of the week, for at least six to eight weeks, before they get into sports. If not, it’s an absolute setup for injury. On the other hand, serious teen athletes may need to build more recovery time into their schedule, training hard on some days, but going easier and working on recovery and technique on alternate days.

Technique is important. Many young pitchers, for example, improperly rely on their arms for power rather than their trunk and legs. Done correctly, both strength training and working on the core muscles of the back and abdomen may prevent injury and boost performance. Sports-specific warm-up programs can also help.

When an injury does occur, its severity can be lessened by rest, prompt treatment and physical therapy. The incorrect reaction is to discourage teens from participating in sports. The risk of injury is far outweighed by the benefits of physical activity.


Sports participation promotes the physical and emotional well-being of children, and also encourages a lifelong habit of exercise. Although the benefits of athletic activity are significant, too much activity can lead to injury.

In recent years, orthopedic physicians have begun to see young athletes with significant increase in overuse injuries. In most cases, these are sports related.

Overuse injuries occur gradually over time, when an athletic activity is repeated so often that some areas of the body do not have enough time to recover between playing. For example, overhand pitching in baseball can result in injuries to the elbow, and swimming is often associated with injuries of the shoulder.

Because young athletes are still growing, they are at greater risk of injury than adults. The consequences of overdoing a sport can include injuries that impair growth and may lead to long-term health problems.


When a young athlete repeatedly complains of pain, a period of rest from the sport is necessary. If pain persists, it is important to seek proper medical treatment. To ensure the best possible recovery, athletes, coaches and parents must follow safe guidelines to plan a return to the game.

Overuse injuries occur in a wide range of sports, from baseball and basketball to track, soccer and gymnastics. Some of these injuries are unique to a certain sport, such as throwing injuries of the elbow and shoulder that are prevalent in baseball players. The most common overuse injuries involve the knee and foot.

Overuse injuries can affect muscles, ligaments, tendons, bones and growth plates. In children, these structures are still growing, and the growth is generally uneven. Bones grow first, which pull at tight muscles and tendons. This uneven growth pattern makes young athletes more susceptible to muscle, tendon and growth plate injuries.

Growth plates are those areas of developing cartilage where bone growth occurs in children. The growth plates are weaker than the nearby ligaments and tendons. Repetitive stress can lead to injury of the growth plate and disrupt normal growth of the bone.

Concerned your young athlete may be developing an overuse injury? Make time to talk with a board certified orthopedic physician who specializes in the care of young athletes.


Everyone agrees that team sports are terrific for children. They teach sportsmanship, cooperation, and how to have fun on the playing field.

Your child may be a budding soccer player or a seasoned high school athlete. Regardless of where he/she falls on the youth sports continuum, there are steps all parents should take to keep their youngster safe and happy.

According to the Centers for Disease Control, high school athletes account for an estimated two million injuries, 500,000 doctor visits and 30,000 hospitalizations each year. Not only are youth athletes injuring themselves playing sports more often, but the types of injuries and the magnitude of injuries that we are seeing have changed – for the worse.

More youth athletes are suffering from injuries that previously would have only been seen in professional level athletes. Overuse and serious acute injuries are becoming more common. As the intensity and demands of youth sports continue to rise, young athletes are more vulnerable than ever to these types of injuries.



Don’t skimp on equipment. While there is no reason not to buy second-hand sports equipment, make sure it meets current safety standards.

All sports equipment should fitcorrectly. Have your child try it on before you buy it and make sure it fits and is properly fastened. Encourage your child to take it off and put it back on in the store so that he/she knows exactly how to do it.

Don’t buy second-hand athletic shoes. These should be well cushioned and custom fitted to the child’s feet. Make sure you get the right type of shoe for the sport.

Be vigilant about insisting your child wearhis/her equipment.


If the coach has outlined a training schedule, make sure the young athlete adheres to it. Don’t let him/she overdo — Coach knows best.

Parents should review training plans to make sure that the coach follows safety procedures. If you have questions, speak to the coach.

Stretching is important before and after a workout. Children and teenagers feel invulnerable and often skip this crucial step.

Make sure your child drinks plenty of water before, during, and after training and practices. This may sound obvious when it is still warm outdoors but should not be ignored when the weather cools down.


In addition to pre-participation physicals, there are some simple steps that youth athletes, as well as their parents and coaches, can take to help minimize sports injuries. Most common overuse injuries result from the sudden increase of activity in intensity and/or duration. Cross-training and fitness training during the off-season help the body become acclimated to vigorous athletic activity which can effectually minimize the stress on the body at the start of a season.

Once an athlete is engaged in competitive play, careful stretching and cool-down should be a regular part of the game-day routine. With every sport, correct form and technique should be taught, encouraged and reiterated to youth athletes. Proper hitting form and techniques, core strength and body positioning will help reduce the likelihood of an overuse or traumatic injury. Coaches and parents should make sure that their athletes are properly fitted with uniforms, pads and helmets. Athletes should speak regularly with a certified athletic trainer or sports medicine physician if they or their parents have any concerns about injuries or injury prevention before beginning any fitness program.

Sports injuries are an increasing concern with youth sports in this country. But by educating our youth and their families we can all help to make this season a safe and fun one.


Most sports injuries among young athletes are sprains and strains. Fractures account for only about five percent of injuries, experts report.

Regardless of this, any injury should be treated seriously. Consult an orthopedic physician and do not let your child “play through” an injury. Make sure the injury is completely healed before your child heads back to the playing field.

Team sports, whether they are organized by the school, your town’s recreation department, or a parents’ co-op, are great fun for all children from about age six on. With a little help from their parents, kids can complete a safe and successful season!

Winter Sports Injury Prevention pt.2

More than 440,000 people were treated at hospitals, doctor’s offices, and emergency rooms for winter sports-related injuries in 2010, according to the US Consumer Product Safety Commission.

  • 144,000 injuries from snow skiing
  • 148,000 injuries from snowboarding
  • 58,500 injuries from ice skating
  • 91,000 injuries from sledding and tobogganing

Common winter sports injuries include sprains, strains, dislocations, and fractures. Many of these injuries happen at the end of the day, when people overexert themselves to finish that one last run before the day’s end. A majority of these injuries can easily be prevented if participants prepare for their sport by keeping in good physical condition, staying alert, and stopping when they are tired or in pain.

There are many things you can do to help prevent injury during favorite winter activities.

  • Never participate alone in a winter sport.
  • Keep in shape and condition muscles before participating in winter activities.
  • Warm up thoroughly before playing or participating. Cold muscles, tendons, and ligaments are vulnerable to injury.
  • Wear appropriate protective gear, including goggles, helmets, gloves and padding.
  • Check that equipment is working properly prior to use.
  • Wear several layers of light, loose and water- and wind-resistant clothing for warmth and protection. Layering allows you to accommodate your body’s constantly changing temperature. Wear proper footwear that provides warmth and dryness, as well as ample ankle support.
  • Know and follow all rules of the sport in which you are participating.
  • Take a lesson (or several) from a qualified instructor, especially in sports like skiing and snowboarding. Learning how to fall correctly and safely can reduce the risk of injury.
  • Pay attention to warnings about upcoming storms and severe drops in temperature to ensure safety.
  • Seek shelter and medical attention immediately if you, or anyone with you, is experiencing hypothermia or frostbite. Make sure everyone is aware of proper procedures for getting help, if injuries occur.
  • Drink plenty of water before, during, and after activities.
  • Avoid participating in sports when you are in pain or exhausted.