Spring is approaching, which comes sports & the rise of ACL injuries

Spring is approaching, which comes sports & the rise of ACL injuries

“The traumatic injuries are something that you can’t avoid in the nature of sports,” said Michael Hughes, Clinic Coordinator and lead Physical Therapist at Agape Physical Therapy of Gates. “A lot of kids will come from the winter and start their spring season, and they don’t have a good strengthening regimen when starting their specific sport. It can lead to some injuries if they don’t have the proper muscle training.”

Orthopedic surgeons at Strong Memorial Hospital are seeing similar trends. According to a hospital spokesperson, orthopedic sports medicine surgeon Mike Maloney, M.D., confirms that he’s seeing the same rate of increase in his practice. We’re told Maloney specializes in treating elite student athletes and says the following factors are causing the alarming increase in this injury:

• The increasing level of intensity in scholastic sports

• More kids specializing in one sport and doing year-round training in that sport

• Lack of emphasis on proper nutrition

• Lack of focus on preventive care – teaching kids how to get conditioned to be strong, and how to move to help prevent injury.

Jeff Bobzin can’t preach it enough to the youth soccer players he coaches in Gates.

“We encourage kids to drink a lot of water, eat right and exercise,” Bobzin said.

Boys between ages 10-14 make up more than half of the reported injuries in the study. Therapists at Agape say its important for parents and kids to map out a training plan to prevent serious body injuries.

Tips for preventing ski injuries

Tips for preventing ski injuries

Ski season is in full swing — but an injury can put you out of commission until next year’s first snowfall. Here’s how to stay safe on the slopes all winter long.

While many people huddle inside during the winter months, away from “bomb cyclones” and blizzards, a select few know that the best way to beat wintry weather is to embrace it — on the ski slopes, that is!

As any seasoned skier will tell you, however, their beloved sport does come with the risk of injury. Fortunately, taking some simple precautions before you hit the slopes can help you stay in peak condition regardless of how many tumbles you take.

We’ve outlined some of the most common injuries that afflict skiers, and what you can do to prevent them.

MCL Injuries

A number of injuries can affect the medial collateral ligament (MCL), but the most common by far is an MCL tears. In skiing, MCL tears most often occur when the skier falls while attempting to slow or stop in a snowplow position, in which the tips of the skis are pointed toward each other. To avoid injury in this position, make sure to always keep your weight balanced. In addition, sticking to runs with which you’re comfortable can reduce the need to enter the snowplow position at all.

ACL Injuries

A variety of falls on the slopes can result in a tear of the anterior cruciante ligament (ACL). It most commonly happens after a forward fall, during which the inner edge of the front of the ski becomes embedded in the snow, trapping the leg in the process. It can also occur when the top of the back of the boot pushes the tibia (the weight-bearing bone in the leg) forward, away from the femur. On other occasions, it arises when the skier leans back on the skis, loses balance, and falls backward. Strengthening the hamstrings, wearing proper bindings, and using shorter skis can all reduce the risk of sustaining an ACL tear.


Like torn ligaments, fractures are most commonly caused by falls while skiing. The wrist and ankles are particularly susceptible to breaks. To help avoid broken bones, always wear adequate protective gear and practice proper techniques for falling. Increasing cardiovascular endurance and developing the surrounding muscles can also be beneficial.

Shoulder Dislocations

Most shoulder dislocations happen when skiers fall, either directly onto the shoulder or onto an outstretched hand or arm. This injury results in heavy, immediate pain, significantly restricts the shoulder’s range of motion, and can leave it misshapen. Since dislocations are caused by sudden trauma, they can be difficult to anticipate, but strengthening the rotator cuff muscles, especially if you have previously dislocated your shoulder, can lower the risk of a dislocation. As with other common skiing injuries, employing proper form will also minimize the possibility of a dislocation.

Spinal Injuries

Aside from protecting the spinal cord, the spine ensures the strength and stability of the back. It is made up of various bony segments called vertebrae separated by pieces of fibrocartilaginous tissue called intervertebral discs, any of which can be injured while skiing. Some ways to avoid spinal injuries include using spine protectors, sticking to trails on which you are comfortable, using proper equipment, and learning the technique for “safe” falls.

While some ski injuries are immediately apparent, others can be more subtle, slowly progressing with time. Fortunately, the talented team of specialists at New York Bone and Joint has extensive experience working in sports medicine and can quickly diagnose and treat any of these common problems. If you think you may have suffered an injury during your latest trip to the mountain, call us today to schedule a consultation, or if the injury has been recent, stop in to our Orthopedic Urgent Care!

What Is a Cortisone Shot?

What Is a Cortisone Shot?

Cortisone shots can potentially provide long-lasting relief from pain and inflammation in the joints.

Many injections can greatly reduce pain and inflammation caused by musculoskeletal injuries or chronic conditions such as arthritis, significantly shortening recovery timelines and providing lasting relief. One shot we particularly recommend to patients entails an injection of cortisone into a damaged joint. We’ll tell you what you need to know about this tried-and-true treatment for pain and inflammation in the joints.

What Is a Cortisone Shot?

A cortisone shot is an injection composed of a corticosteroid medication and a local anesthetic. Used to relieve pain and inflammation, it’s most commonly injected into a joint, often in the shoulder, hip, or knee. These shots are often one option in a comprehensive treatment plan for chronic inflammatory conditions such as arthritis, tendinitis, or rotator cuff impingements or tears.

How Long Does a Cortisone Shot Last?

A cortisone shot’s effectiveness depends on the severity of the patient’s condition. In most cases, pain and inflammation will marginally increase for about 48 hours following the injection, and will decrease precipitously thereafter. In some cases, a single injection can provide relief for as long as several months.

Generally, cortisone shots should only be given two times per joint per year. Repeated cortisone injections can damage the cartilage in the joint.

What Are the Side Effects of a Cortisone Shot?

Cortisone shots are typically safe in moderation, but since they infrequently lead to serious complications, they should be taken under a doctor’s supervision. Be sure to let your doctor know if you suffer from diabetes or other any other conditions affecting your blood sugar levels, as well as any medications that you are currently taking.

Most cortisone shots have some minor side effects, including a temporary uptick in pain and inflammation in and around the joint, and a thinning and lightening of the skin around the site of the injection. In some cases, however, they can result in a sudden spike in blood sugar if you’re diabetic and have poorly controlled blood sugar levels. .

What If the Cortisone Shot Doesn’t Work?

Cortisone shots provide a source of temporary relief from inflammation and pain. They will not solve the underlying problem, and pain may gradually return as the shot’s effectiveness subsides. As a result, cortisone shots should be administered as part of a more comprehensive treatment plan that may include physical therapy or surgery.

Fortunately, our team of orthopedic specialists at Comprehensive Orthopaedics has several years of experience in treating joint problems. Regardless of your specific condition, we’ll work with you to develop a personalized treatment plan that provides lasting relief from your symptoms.

Obesity to Blame for Epidemic of Knee Dislocations, Complications

Obesity to Blame for Epidemic of Knee Dislocations, Complications

Need another reason to keep your weight under control?

Excess weight can cause dislocation of your knee and may even lead to a complication that results in amputation of your leg.

A new study attributes a surge in dislocated knees to the U.S. obesity epidemic.

“Obesity greatly increases the complications and costs of care,” said study lead author Dr. Joey Johnson, an orthopedic trauma fellow at Brown University’s Warren Alpert Medical School.

“As the rate of obesity increases, the rate of knee dislocations increases. The total number of patients who are obese is increasing, so we are seeing more of these problems,” Johnson explained.

Knee dislocations result from multiple torn ligaments. Vehicle crashes or contact sports, such as football, are common causes.

For the study, the researchers analyzed more than 19,000 knee dislocations nationwide between 2000 and 2012. Over that time, people who were obese or severely obese represented a growing share of knee dislocation patients — 19 percent in 2012, up from 8 percent in 2000.

Obesity is also linked to more severe knee dislocations, longer hospital stays and higher treatment costs, according to the study published recently in the Journal of Orthopaedic Trauma.

And the chances that a knee dislocation would also injure the main artery behind the joint and down the leg were twice as high for obese patients than for those whose weight was normal, the findings showed. This severe complication of knee dislocation — known as a vascular injury — can lead to leg amputation if not treated, the study authors said.

Patients with a vascular injury averaged 15 days in the hospital, compared with about one week for other patients. Their average hospitalization costs were just over $131,000 and $60,000, respectively.

The study authors said doctors should be especially watchful for vascular injury in obese patients whose knees are dislocated.

“That subset of obese patients who come in with complaint of knee pain need to be carefully evaluated so as not to miss a potentially catastrophic vascular injury,” said study co-author Dr. Christopher Born, a professor of orthopedics at Brown.

Reducing obesity rates could help reverse the growing number of knee dislocations, the researchers suggested.

More information

The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases has more on knee problems.

SOURCE: Brown University, news release, Nov. 3, 2017

Sports Injuries: Kneecap (Patellar) Dislocation

Sports Injuries: Kneecap (Patellar) Dislocation

Athletes in high impact sports or sports that require a lot of running and jumping are prone to knee injuries.  kneecap dislocations most often happen as a result of trauma, such as when a football player is tackled, or a soccer players falls hard on his knees.

The kneecap, or patella, is referred to as dislocated when it slips out of the groove in the femur (thigh bone) that is naturally sits in. Some patients recover from a dislocation and never experience the condition again. For other patients, however, the patella will chronically dislocate until it is repaired through surgery.

You’ll know you’ve dislocated your knee cap if you feel these symptoms following an incident:

  • Severe pain at the knee
  • Redness and swelling
  • Deformity
  • Difficulty moving the knee at all

While many patients can overcome a patellar dislocation with a physical therapy regimen, severe cases will require surgery.

If the surrounding cartilage and bone are not severely damaged, five to six weeks of rehabilitation should be sufficient.   This includes strengthening exercises designed to rebuild the muscles surrounding the patella, which also will in-turn restore the range of motion that should be enough to recover from the injury.

If surgery is required, an orthopedic knee specialist will reset the kneecap and perform a short arthroscopic procedure to remove any dislodged pieces of bone, and smooth down any damaged cartilage. As with most sports injuries, surgery will also require 6 to 8 weeks of rehabilitation for proper healing.

Dr. Main and Dr. Pick-Jacobs treat athletes with mild to severe patella issues routinely. Dr. Main is an expert in arthroscopic surgery to repair the knee following even the most severe cases of kneecap dislocation.

Do Your Knees Crackle and Pop?

Do Your Knees Crackle and Pop?

Knees that “pop,” “click” or “crackle” may sometimes be headed toward arthritis in the near future, a new study suggests.

It’s common for the knees to get a little noisy on occasion, and hearing a “crack” during your yoga class is probably not something to worry about, experts say.

But in the new study, middle-aged and older adults who said their knees often crackled were more likely to develop arthritis symptoms in the next year.

Of those who complained their knees were “always” noisy, 11 percent developed knee arthritis symptoms within a year. That compared with 4.5 percent of people who said their knees “never” popped or cracked.

Everyone else fell into the middle. Of people who said their knees “sometimes” or “often” made noise, roughly 8 percent developed knee arthritis symptoms in the next year.

Doctors have a term for those joint noises: crepitus.

Patients commonly complain of it, said Dr. Grace Lo, the lead researcher on the study. She’s an assistant professor at Baylor College of Medicine in Houston.

But until now, it hasn’t been clear whether crepitus can predict symptomatic knee arthritis. That means people not only have evidence of cartilage breakdown on X-rays, but also suffer symptoms from it — namely, frequent pain and stiffness.

“Our study suggests crepitus is not completely benign,” Lo said. “It’s a sign that something is going on in the knee joint.”

Dr. Joseph Bosco, an orthopedic surgeon who wasn’t involved in the study, agreed that frequent crepitus should be checked out.

“A lot of people’s knees ‘snap’ and ‘pop,'” said Bosco, a professor at NYU Langone Medical Center in New York City. “Do they need to run out for knee replacements? No.”

But, he added, “if you experience crepitus regularly, get an evaluation.”

The findings, published May 4 in the journal Arthritis Care & Research, come with some caveats.

The nearly 3,500 study participants were at increased risk of developing knee arthritis symptoms to begin with, Lo explained.

The participants ranged in age from 45 to 79. Some were at risk of knee arthritis simply because of old age, while others had risk factors such as obesity or a history of a significant knee injury.

So it’s not clear, Lo said, whether the findings would translate to — for example — a 35-year-old whose knees crack when she runs.

Plus, even though the study participants were initially free of knee arthritis symptoms, some did have signs of arthritis damage on an X-ray.

And it was in that group where crepitus was a red flag: People who “often” or “always” had noisy knees were nearly three times more likely to develop knee arthritis symptoms as those who “never” had crepitus.

According to Lo, the findings could be useful in everyday medical practice. “If patients are complaining of frequent cracking or popping in the knees,” she said, “get an X-ray.”

If that turns up signs of arthritic damage, Lo said, then the risk of progressing to symptoms in the near future is probably significant.

Unfortunately, there is no magic pill that can stop arthritis in progress. But, Lo said, for patients who are heavy, weight loss can help.

Some, she added, might benefit from strengthening the muscles that support the knees.