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Category Archives: Common Problems and Guides

‘Mixin’ It Up’ Does Wonders for Kids in Sports

Kids_SportsFall and winter sports season is upon us! Boys are playing football. Girls are doing their cheer routines at games. Cross-country, field hockey, tennis, and volleyball players are in full swing at high schools across the country. While kids are eager to jump right into these activities, injuries this time of year increase.

Why Do More Sports Injuries Occur in the Fall and Winter?

  • Sudden increases in activity level
  • Unpredictable weather and changes in playing surface. Shifting weather patterns are another factor that contributes to sports injuries in the fall and winter.
  • Muscle fatigue – During the summer months, kids move freely.  Suddenly, when school starts, students are cramped into an uncomfortable school desk for eight hours a day. The hips remain flexed at 90-degrees, and the brain focuses on keeping the hip flexors, hamstrings, and spinal erectors engaged to maintain a sitting position. Unfortunately, these are the opposite muscles the body needs to prevent common sports injuries.

What Are the Most Common Fall and Winter Sports Injuries & How Are They Prevented?

Slowly ramping up activity levels over the course of a few months leading into preseason can minimize the risk significantly. Students should spend at least 10 minutes warming up every practice and devote twice as long to end-of-practice stretches to prevent injuries including:

Kids_FootballMiddle-school-age children come in with growth plate injuries.  A growth plate injury occurs at either end of the leg bone. A damaged growth plate may lead to arthritis, crooked bones, or limbs that do not grow long enough — although these circumstances are rare. More often than not, kids rebound from a growth plate injury without any further consequences.

  • To prevent these injuries, be sure you oversee your child’s strength training to ensure he or she is not lifting too much weight too fast. You also want to see that your child is using the proper form. Playing in extreme cold, certain medications, neurological disorders, metabolic diseases, and genetic factors are believed to all play a role in the development of growth plate injuries as well. It is important to speak with a sports medicine professional to determine whether your child may be at risk for a growth plate injury.

When high school athletes begin to get tired, they get sloppy. Fatigue is the number one factor in ankle sprains.  Teach your child to recognize signs of fatigue so he or she can request a break if the coach doesn’t see it.

Some of these early signals may include some or all of the following symptoms:

  • Inconsistent performance
  • Decreased focus
  • Shortness of breath
  • Muscle twitches
  • Depression or irritability
  • Severe thirst
  • Generalized weakness
  • Nausea
  • Muscle cramps
  • Dizziness
  • Headaches

According to Dr. Downer, “Mix it up, don’t just play one sport. Instead be diverse and try different types of sporting activities throughout the year. Staying active keeps you well-conditioned and less likely to experience an injury.”

If you believe you are suffering from a sports-related injury and need specialized orthopedic care, the orthopedic surgeons at OSS provide excellent treatment options for your injury. Please feel free to contact OSS at (206) 633-8100 to schedule an appointment.

Carving Safety Tips for this Holiday Season

Carving article photoThanksgiving is just around the corner and almost everyone is planning a big feast, strategizing for the family football rematch, watching the Macy’s Day parade and of course, NFL football on TV.  With all these things going on in one day, there is no bigger star than the Thanksgiving turkey as it is paraded from the kitchen into the dining room where someone will be carving the revered bird.  This holiday season, Orthopedic Specialists would like to caution all the carvers out there as they carve the main course and not their hands.

 

People sustain hand injuries during Thanksgiving and the entire holiday season.   When friends and family are watching you as you carve the turkey, you may feel a little overwhelmed, so focus; don’t let your turkey day celebrations go fowl this year because of a hand injury.

 

Follow these easy tips and get your bird on the table in time so guests can start gobbling:

1) Never cut towards yourself. One slip of the knife can cause a horrific injury.  While carving a turkey or cutting a pumpkin your free hand should be placed opposite the side you are carving towards. Don’t place your hand underneath the blade to catch the slice of meat.

2) Keep your cutting area well-lit and dry. Good lighting will help prevent an accidental cut of the finger and making sure your cutting surface is dry will prevent ingredients from slipping while chopping.

3) Keep your knife handles dry. A wet handle can prove slippery and cause your hand to slip down onto the blade resulting in a nasty cut.

4) Keep all cutting utensils sharp. A sharp knife will never need to be forced to cut, chop, carve or slice. A knife too dull to cut properly is still sharp enough to cause an injury.

5) Use an electric knife to ease the carving of the turkey or ham.

6) Use kitchen sheers to tackle the job of cutting bones and joints.

7) Leave meat and pumpkin carving to the adults.  Children have not yet developed the dexterity skills necessary to safely handle sharp utensils.

8) Lastly, should you cut your finger or hand, bleeding from minor cuts will often stop on their own by applying direct pressure to the wound with a clean cloth.

 

Visit an emergency room or a hand surgeon if:

1) Continuous pressure does not stop the bleeding after 15 minutes

2) You notice persistent numbness or tingling in the fingertip

3) You are unsure of your tetanus immunization status

4) You are unable to thoroughly cleanse the wound by rinsing with a mild soap and plenty of clean water

 

Dr. Weil states, “I often see patients whose holiday season has been ruined by an accident in the kitchen.   The most common kitchen injuries that I treat are lacerations.  Lacerations sustained while carving pumpkins, turkeys, and other holiday fare can be quite serious.  These injuries can include cut nerves, arteries and tendons.  These types of injuries require immediate surgical management to restore function.   Treatment can include microscope assisted nerve repairs, artery repairs, and tendon repairs.  If you sustain a laceration where you lose sensation to your finger or hand or are unable to bend your finger please seek medical treatment immediately. “

 

These simple tips will help you enjoy that bird and the rest of your holiday season.  If you would like more information on specialty care of the hand, call Orthopedic Specialists and make an appointment with one of our expert, orthopedic doctors at (206) 633-8100.

 

Preventing Ski Injuries Through Conditioning

Ski_Injury_PreventionA busy ski resort in the United States may see dozens of injuries on the slopes each day. As an orthopedic surgeon, I also see many patients with ski-related injuries throughout the season. Most injuries are the result of poor conditioning, or equipment failure.

The most common injuries amongst downhill skiers are knee sprains, shoulder injuries, head/face injuries and wrist/thumb injuries. The knee is the most commonly injured joint, resulting in about one third of all ski injuries. Injury rates and type vary with uncontrollable factors such as weather and snow conditions. Proper equipment and conditioning, however, are factors that we can control.

Equipment

When skiers examine their equipment, it’s important to make sure that:

-Skis, poles, and boots are in good condition and properly sized for the individual’s weight, size and skill.

-Binding are adjusted and tested prior to each ski season.

-Helmets are properly fitted and checked for damage prior to the ski season.

-Sunglasses, goggles and sunscreen are part of one’s safety equipment.

Conditioning

 

Skiers can increase their safety and performance this winter by starting with a pre-conditioning program that includes four components: endurance, strength, flexibility, and balance. Aerobic fitness is the key to preventing the end of the day injuries (the last run). Cross training, which includes multiple sports and activities in the conditioning regimen, has become popular, especially with a seasonal sport such as skiing. Strength and flexibility focusing on the legs and trunk are vital in injury prevention specific for skiing. Balance training has been shown to be the single most important exercise for preventing ACL tears in women.

 

A typical conditioning program can include:

 

1. Aerobic fitness (5 days/week for at least 30 minutes)

-Running

-Cycling

-Swimming

-Elliptical or stair climber

-Jumping rope

-Treadmill

 

2. Strength (3 days/week, 2 sets of 60 seconds each)

-Leg press

-Wall squats

-Hamstring curls

-Toe raises

-Lateral leg raises

-Sit-ups

3. Flexibility (daily, 2 sets of 60 seconds each)

-Hamstring stretches

-Achilles stretches

-Quad stretches

 

4. Balance Exercises (daily, 2 sets of 60 seconds)

-Standing on one leg, perform mini squats

-Single leg hop, holding for five (5) seconds, repeat

 

In addition to a conditioning program, skiers need to adequately warm up – an activity that is often neglected with skiing. No one would think of running out on the football field or onto the basketball court without warming up first. But with skiing, one typically sits in the car for an hour or more to get to the slopes, and then stands in line for tickets and for the lift, before finally sitting on the chair for several minutes. By the time one has arrived on the top of the hill, he or she is often stiff and cold.

 

It’s important for skiers to remember to warm up and stretch before starting down the hill. Often an easy, predictable run is a good idea before heading to the more challenging terrain. The few minutes spent warming up will be well worthwhile in injury prevention.

More about Knee Injuries

 

Every ski season, I treat many knee injuries. In the 1970′s, ankle injuries were more common, resulting from soft, leather boots. The development of stiffer boots has transferred much of the force to the knee.

 

The most common knee injury from skiing is the MCL (medial collateral ligament) injury. It often results from catching an edge or having the skis diverge, so that the foot is forced away from the body. This creates a distraction force on the inside of the knee. Fortunately, the MCL has a good blood supply, and can be treated non-operatively, with a period of bracing for 4-8 weeks, depending on the severity of the injury.

 

ACL (anterior cruciate ligament) injuries are also common skiing injuries. They are thought to occur from the forces created by the long lever arm of the ski that are transmitted to the knee ligaments. Commonly, the ACL is injured with a hyperextension mechanism. In expert skiers, we see ACL injuries when saving a backwards fall by a strong quadriceps contraction, pulling the tibia (lower leg) forward with enough force to rupture the ACL. Recent boot and binding technology has reduced the rate of ACL injuries. In young, active individuals, the ACL injuries often require surgical reconstruction. Success rates from surgery are excellent, but require aggressive rehabilitation and six months of recovery time before one can return to skiing or other twisting or pivoting sports.

 

No one wants to go down the path of surgery and recovery. But too many people wait to think about preparing for skiing until half way through the season, when snow has already accumulated and they are on their way to the top of the mountain. Many times, this is too late. Although injury is a risk we all take when participating in any sport, a conscientious approach to skiing – including equipment inspection and conditioning – will minimize the occurrence. Not only will these precautions reduce injury rate, but they will also enhance performance, decrease fatigue, and ultimately, increase one’s enjoyment of the sport.

 

If you believe you are suffering from a knee-related injury and need specialized orthopedic care, the surgeons at Orthopedic Specialists of Seattle provide excellent treatment options available for you.  Please feel free to contact OSS at (206) 633-8100 to schedule an appointment.

 

 

Jack-O-Lantern Carving Safety Tips

Every October, carved pumpkins peer out from porches and doorsteps in the United States and other parts of the world. Gourd-like orange fruits inscribed with ghoulish faces and illuminated by candles are a sure sign that Halloween and the holiday season is upon us. The practice of decorating “jack-o’-lanterns” – the name comes from an Irish folktale about a man named Stingy Jack – originated in Ireland, where large turnips and potatoes served as an early canvas. Irish immigrants brought the tradition to America, home of the pumpkin, and it became an integral part of Halloween festivities. Click Here and find pumpkin carving safety tips for you and your loved ones!

pumpkin-carving

Backpack Safety for Back to School

It’s back to school season it’s time to clean out those backpacks to make room for the new school year!  Sure, you may have some items that should have been thrown out from the previous school year, but now, you need to make room for those new books and supplies to get you through the next school year.

Did you know that according to the Consumer Product Safety Commission, injuries from heavy backpacks result in more than 7,000 emergency room visits per year.  Sprains, strains, and “overuse” injuries were among the top complaints.
backpackOSS would like to offer some basic safety tips for you:

- Your backpack should weigh only 15% – 20% of your total weight
- Backpack straps should be wide and padded
- Make sure the backpack has two shoulder straps
- The backpack should have a padded back
- Adjust the bottom of a full backpack and make sure it is not more than four inches below your waistline.
- Consider using a rolling backpack, an air backpack or a light-weight backpack
- Periodically check the contents and weight of your backpack; you may be amazed at the amount of unneeded items you are carrying

Prevent injury when using a backpack, do the following:

- Use both shoulder straps to keep the weight of the backpack better distributed
- Tighten the straps to keep the load closer to the back
- Organize items and pack heavier things low and towards the center
- Remove items if the backpack is too heavy and only carry items necessary for the day
- Lift properly by bending at the knees when picking up a backpack

Here’s a great tip from Dr. Shapiro, “Take the time to lift your kids backpack. What could they leave behind to lighten their heavy load?”

If you believe you are suffering from a backpack-related injury and need specialized orthopedic care, Orthopedic Specialists of Seattle provide excellent treatment options available for you.  Please feel free to contact OSS at (206) 633-8100 to schedule an appointment.

 

 

Common Swimming Injury – Swimmer’s Shoulder

Swimmers shoulderSwimming is a sport in which there is a great diversity among participants. There are both recreational and competitive swimmers, ranging in age from preschool through college. Although the lack of impact in swimming makes it a perfect choice for avoiding lower-body injuries, the intense involvement of upper-body muscles makes overuse injuries a real possibility.

The most common swimming-related injury is swimmer’s shoulder, shoulder pain usually caused by rotator cuff tendonitis. Many cases of swimmer’s shoulder can be successfully treated through physical therapy. For competitive athletes, rotator cuff surgery may be recommended if shoulder pain continues after 6 months of guided rest and rehabilitation.

Signs and Symptoms of Swimmer’s Shoulder

• Shoulder pain while swimming freestyle
• A forward shoulder slouch while seated
• Underdeveloped posterior shoulder musculature
• A mild winging on the affected side’s left scapula
• Tenderness in the acromioclavicular joint and coracoid process in the impingement area
• Tenderness in the affected side’s bicep tendon and supraspinatus tendon
• A full range of motion in all planes
• Strength is slightly decreased in the supraspinatus and infraspinatus
• Full strength in the internal rotators, arm extensors, and flexors
• Moderate posterior and anterior laxity in both shoulders
• A bilateral sulcus sign
• Impingement and adduction-compression tests on the affected side were positive
• An apprehension test on the affected side was negative

Swimming Safety and Injury Prevention

According to Dr. Franklin, “Proper warm up, stretching, technique and conditioning are crucial in preventing tendonitis and overuse injuries in swimmers.”

• Learning proper technique goes a long way toward preventing injuries; if you’re just starting out, schedule some sessions with a swimming coach.
• Remember to warm up and stretch before every swim, giving particular attention to your shoulders.
• A strength-training program can help build up the muscles around the shoulder and upper back; ask a physical therapist or personal trainer if you need help creating a routine.

If you believe you are suffering from swimmer’s shoulder or swimming-related injury and need specialized orthopedic care, the orthopedic surgeons at OSS provide excellent treatment options for your injury. Please feel free to contact OSS at (206) 633-8100 to schedule an appointment.

Hand Rejuvenation – New Trend with Women and Plastic Surgery

June is the quintessential month for weddings.  The phrase “June Bride” is in our vernacular, conjuring up images of a beautiful bride, a handsome groom, family and a spectacular and exotic honeymoon.

 

Before the wedding takes place however, there is the all-important engagement photo shoot and for that, women throughout the country are acting on a new trend – plastic surgery for their hands, also known as hand rejuvenation or “handlifts” to show-off their beautiful diamond ring.

 

This new trend is rooted in today’s social media practice called the “selfie”.  Newly engaged women are excited to show off the ring on their finger and post it in social media outlets like Facebook and Instagram.  “Selfies” have made society more self conscious of their appearance including their hands.  “Handlifts” have gone up 40% since the rise of social media.

 

According to Dr. Weil, “Next to our faces the hands are the most recognizable and exposed parts of the body.  The hands are often forgotten when it comes to rejuvenation procedures. However, they are one of the first areas which are noticed by others, especially when there are years between the appearance of your face and hands. Just like our faces, our hands will show the signs of aging. In some cases our hands may even make us look older than we are. As we age our hands lose fat– along with collagen– which decreases the elasticity and leads to thinning of our skin. This can cause the skin to become loose and wrinkled and cause the veins and tendons of our hands to become more prominent. Today, however, Dermal Fillers (Juvederm, Restylane, Perlane, Radiesse, etc.) have become an excellent option for restoring the volume and smoothness that our youthful hands once had.”

 

Dr. Weil’s dermal filler of choice for hand rejuvenation is Juvederm Ultra XC. Juvederm Ultra XC works by restoring the volume of hyaluronic acid in your skin, helping to reduce wrinkles and smooth out folds. Hyaluronic Acid (HA) is a naturally occurring sugar found in the human body. Hyaluronic acid creates volume in the skin by delivering nutrients and by holding in water, making sure the skin stays hydrated. Its function is very similar to that of a sponge–it soaks up and absorbs water–which in this case creates volume in the skin of your hands. Dr Weil goes on to say, “Think of hyaluronic acid as the body’s internal moisturizer!”

 

Hand1Youthful hands have a fullness of the skin and subcutaneous tissues. The skin is soft and without wrinkles except for the natural lines seen over the finger joints and knuckles. Veins may be visible, but not obvious.

 

 

 

 

Hand2 Loss of skin thickness and volume in the tissues underneath the skin make the veins easily noticeable and unattractive. Pigment changes and dark spots occur as a result of sun exposure. The thin skin becomes wrinkled and has far less elasticity.

 

 

 

 

Hand3 Hand rejuvenation with dermal fillers is an affordable, non-invasive way to treat volume loss and thinning of the skin that occurs with aging. Using dermal fillers to restore the volume and smooth away wrinkles of the hands is a procedure with little discomfort and no downtime.

 

If you would like more information about hand rejuvenation, call Orthopedic Specialists of Seattle (206) 633-8100 to schedule an appointment with Dr. Weil.

Summer Running

 

As runners, think about the varied terrain and urban obstacles of jogging outdoors versus the treadmill’s regularity; now apply that same comparison to every gym exercise and the variables of their outdoor equivalents, from biking in the park to soccer on the grass.

 

Here are three important steps you should take to ensure that getting back into running leaves you free from injury this summer:

 

1)  Take a moment to set a goal. Setting a goal helps propel yourself towards a specific aim, a simple enough idea which cannot be overstated in its power to focus yourself on a reasonable achievement.
2)  Renew one of your new year’s resolutions or challenge yourself to meet or beat a pace that you haven’t quite kept up with over the past few years.
3)  More importantly, set up a log book to keep track of your times and achievements. Having a physical record of where you started with a means to your ends is paramount to meeting your goal.

Speaking of physical reminders, the change in season is the perfect opportunity to change your sneakers! Most dedicated running stores offer in-depth analyses of your feet and gait to make sure that you get the proper equipment. Think about marking your shoes with the date of purchase so you can keep tabs on when you got them so that you don’t keep using them after their time is up.

Dr. Mark Reed states, “With so many different running styles gaining popularity; selecting the shoe that fits your style is important. A properly fitted shoe will help protect against injury and may also enhance performance. “

You should also set up an appointment with your OSS physician to go over all the requisites, making sure to get the OK for the goals you’ve set for yourself before the start of new routines.

The simple act of updating your equipment and evaluating your physiology are powerful motivators for getting back in shape and keeping you injury-free.

If you believe you are suffering from a running-related injury and need specialized orthopedic care, Orthopedic Specialists of Seattle provides excellent treatment options available for you.  Please feel free to contact OSS at (206) 633-8100 to schedule an appointment.

Are you a Desk Jockey? How are your Joints?

desk jockey

The orthopedic surgeons at OSS and the physical therapists at Seattle Orthopedic Center (SOC) see a fair amount of orthopedic injuries from all walks of life ranging from body-related complaints – some from accidents, some from surgery and some from extreme sports.  And yet, some of the most common injuries come from sitting at your desk all day.  Commonly dubbed a “Desk Jockey” means that most of your days is spent sitting at your desk, on the phone, pushing paper, and using your computer, laptop or tablet.

 

When compared to more physical occupations, a Desk Jockey wouldn’t seem like someone experiencing a joint injury but more like a paper cut or stapler accident.  All the work you do on your computer, there are several ways to incur both a neck and shoulder injury caused by repetitive motion.  All the mouse click you make in a day, improper monitor positioning, chair height and keyboard position may cause neck and shoulder pain that can become acute, causing a severe amount of fatigue.  Although most of these injuries may not become chronic in nature, for some, the shoulder pain and neck pain persists.

 

OSS offers these tips while working at your desk to help alleviate neck and shoulder pain:

  • Simple Ergonomics – Set up your workstation so that your keyboard, mouse, monitor, and chair are in the optimal position for your body.
  • Move – Take breaks; stop working for a moment, get up and move.  Change positions into your day to help relieve the tension and reduce strain in your neck, back, shoulders, hips and knees.
  • Stretch - If you spend several hours a day typing, there are common finger and wrist muscles that get used over and over again. This repetitive motion can cause strain and lead to repetitive stress injuries.
  • Sleep - A good night’s rest is a great chance to give your back and neck some support and relief for as long as you’re lucky enough to remain horizontal. Sleep also plays an important restorative role in healing injuries and keeping the body healthy.

 

According to Nicole Marble, PT, “As physical and occupational therapists, we help patients achieve structural balance through education, therapeutic exercise, neuromuscular re-education, and manual therapies that mobilize soft tissues and joints. This will decrease pain and maximize function whether our patients sit for prolonged periods or participate in high level sports and activities. Here at SOC/OSS our physical therapists are able to offer personalized care with 45-minute one-on-one treatment sessions. We also work closely with the orthopedic surgeons to create and maintain a physical therapy program that is designed to get you back to what you love. “

 

If you are suffering from joint pain and injury, contact OSS to schedule an appointment with one of our physicians at (206) 633-8100.

 

Shoulder Dislocation and Treatment

safeshoulderdraw

Here in the Pacific Northwest outdoor activities are a way of life.  From lumberjacks to the most experienced kayaker, healthy joints are important to perform various tasks and activities that involved upper body strength involving our shoulders.  The shoulder is the most mobile joint in the human body. To accomplish this, the shoulder requires a balance of stability and strength.

Shoulder dislocation is a fairly common injury sustained by people of all age ranges. It is generally a sudden onset type of injury, which is caused by trauma to the shoulder region. There are many causes of this type of injury, from athletics to falling from a ladder. Most dislocations occur as the arm is outstretched to the side or overhead in conjunction with a force pushing the arm backward.

Dislocated shoulder signs and symptoms may include:

  • A visibly deformed or out of place shoulder
  • Swelling or discoloration (bruising)
  • Intense pain
  • Inability to move the joint

Shoulder dislocation may also cause numbness, weakness or tingling near the injury such as in your neck or down your arm. The muscles in your shoulder may be in spasm from the disruption, often increasing the intensity of your pain.

When the shoulder dislocates, the ligaments in the front of the shoulder tear causing pain and at least some loss of function in the affected arm. Although the ligaments may heal, the result is a shoulder that has even more laxity and instability than prior to the injury. Many athletes and active individuals will experience multiple occurrences of dislocation after the first event due to the increasingly unstable shoulder. Successive dislocations, because of the increased amount of instability in the joint, often take significantly less force to occur. Whereas the first dislocation is usually the result of a traumatic force upon the shoulder, subsequent dislocations could result from ordinary, athletic or heavy use of the arm.

A common condition that may exist with shoulder dislocation is a SLAP tear, which is a tear to a structure in the shoulder known as the glenoid labrum. The labrum is a cartilage rim, similar to an O-ring, which covers the outside edge of the shoulder socket. This acts to deepen the socket and give the shoulder some extra stability. But under the extreme force of a shoulder dislocation, the labrum can be torn from the bone, creating a painful injury with reduced motion and strength of the arm.

Labral tears often produce a clicking or popping with shoulder motion, along with apprehension in the overhead ranges. Because these cartilaginous structures do not have a great blood supply, they often do not heal on their own and may require surgical intervention to re-attach the labrum to the bone.

According to Dr. Shapiro, “A consistent strengthening program is often the key to shoulder stability.”  There are many treatment options available for these types of shoulder injuries.   Some are non-surgical such as physical therapy, while more extensive injuries may require surgical repair. Joel Shapiro, MD, specializes in surgical and non-surgical treatment of shoulder injuries at Orthopedic Specialists of Seattle and uses the latest technologies and research studies to aid in the diagnostic process and treatment of your injury.

 

A good physical therapy program can help protect against instability.  While this cannot help everyone, a diligent therapy program is always the first step. After evaluating your shoulder, a customized therapy program will be created.

If you believe you are suffering from a shoulder injury, Orthopedic Specialists of Seattle is here to help.  Please feel free to contact OSS at (206) 633-8100 to schedule an appointment with Dr. Shapiro.