mm

About Charlie Peterson

Charlie Peterson, MD Dr. Peterson is a board-certified orthopedic surgeon whom completed his medical degree from the University of Washington School of Medicine, where he graduated magna cum laude and was involved in several research projects in the orthopedic and internal medicine fields. While there, he was inducted into Alpha Omega Alpha, a prestigious medical school honor society. Dr. Peterson went on to complete orthopedic residency training at the Mayo Clinic, widely regarded as one of the premier orthopedic institutions in the world.

2014 FIFA World Cup Injuries Affecting Field of Players

fifa-world-cup-2014-UnoTelly

Several prominent figures for this year’s World Cup event have been lost to injuries. The list includes:

  • Franck Ribery – France
  • Radamel Falcao – Columbia
  • Marco Reus – Germany
  • Kevin Strootman – Netherlands
  • Luis Montes – Mexico
  • Riccardo Montolivo – Italy
  • Christian Benteke – Belgium
  • Theo Walcot – England
  • Roman Shirikov – Russia

Leg fractures to rolled ankles have plagued this year’s field of players throughout the world. It’s not unusual for injuries to strike before the World Cup, due in part to the increasing demand on players during the club season and the brief turnaround before reporting to national team duty ahead of the sport’s premier competition.

Sepp Blatter, president of FIFA, which puts on the World Cup, blamed “too long a [club] season and always the same players [from the elite clubs] are always in the same competitions. Now they are tired.”

Fatigue is not responsible for all injuries. Muscular ailments occur at all stages of the season, while missteps and reckless tackles are also to blame. Falcao suffered a knee injury in January.

According to U.S. midfielder, Michael Bradley, “There [are] certain things as players you do to try to prevent injuries, to try to stay fit, but at the end of the day, you step on the field, you play, you leave everything out on the field and unfortunately things happen at times.” He goes on to say, “No player ever wants to see anybody else get hurt and have to miss a big game, a big tournament.”

Common soccer injuries include:

  • Lower extremities – Sprains and strains are the most common lower extremity injuries. The severity of these injuries varies. Cartilage tears and anterior cruciate ligament (ACL) sprains in the knee are some of the more common injuries that may require surgery. Other injuries include fractures and contusions from direct blows to the body.
  • Overuse of lower extremities – Shin splints (soreness in the calf), patellar tendonitis (pain in the knee), and Achilles tendonitis (pain in the back of the ankle) are some of the more common soccer overuse conditions. Soccer players are also prone to groin pulls and thigh and calf muscle strains.
  • Upper extremities – Injuries to the upper extremities usually occur from falling on an outstretched arm or from player-to-player contact. These conditions include wrist sprains, wrist fractures, and shoulder dislocations.
  • Head, neck and face injuries – Injuries to the head, neck, and face include cuts and bruises, fractures, neck sprains, and concussions. A concussion is any alteration in an athlete’s mental state due to head trauma and should always be evaluated by a physician. Not all those who experience a concussion lose consciousness.

Treatment options to soccer injuries include:

  • Stop participation immediately until any injury is evaluated and treated properly.
  • Most injuries are minor and can be treated by a short period of rest, ice, and elevation. Contact the physicians at Orthopedic Specialists of Seattle (OSS) to evaluate an injury.
  • Overuse injuries can be treated with a short period of rest, which means that the athlete can continue to perform or practice some activities with modifications.
  • In many cases, pushing through pain can be harmful, especially for stress fractures, knee ligament injuries, and any injury to the head or neck. Contact the physicians at Orthopedic Specialists of Seattle for proper diagnosis and treatment of any injury that does not improve after a few days of rest.
  • Return to play only when clearance is granted by a physician.

Orthopedic Specialists would like to offer the following tips for preventing soccer injuries:

  • Have a pre-season physical examination and follow your doctor’s recommendations
  • Use well-fitting cleats and shin guards — there is some evidence that molded and multi-studded cleats are safer than screw-in cleats
  • Be aware of poor field conditions that can increase injury rates
  • Use properly sized synthetic balls — leather balls that can become waterlogged and heavy are more dangerous, especially when heading
  • Watch out for mobile goals that can fall on players and request fixed goals whenever possible
  • Maintain proper fitness — injury rates are higher in athletes who have not adequately prepared physically.
  • After a period of inactivity, progress gradually back to full-contact soccer through activities such as aerobic conditioning, strength training, and agility training.
  • Avoid overuse injuries — more is not always better! Sports medicine specialists at Orthopedic Specialists of Seattle believe that it is beneficial to take at least one season off each year. Try to avoid the pressure that is now exerted on many young athletes to over-train. Listen to your body and decrease training time and intensity if pain or discomfort develops. This will reduce the risk of injury and help avoid “burn-out”
  • Speak with a sports medicine physician at Orthopedic Specialists of Seattle if you have any concerns about injuries or soccer injury prevention strategies

According to Dr. Peterson, “Two of the challenges the US team will have to face in addition to the “Group of Death” pairings are travel and heat. They will travel over 6000 miles during the preliminaries, and will be playing at least on of their games deep in the Amazon rain forest in the middle of summer! In these situations, it’s very important to work on hydration, proper diet, and sleep. Proper hydration is occurring when one’s urine is fairly clear to clear. Proper diet varies, but usually should include a balance of protein, carbohydrates, and fats. Eat plenty of fruits and vegetables and minimal fried foods and alcohol. Sleep can be tough with airplane travel.

Try to have a standard time to go to bed, and getting at least 8 hours per night is important. If it is hard to fall asleep, natural sleep aids like melatonin can help. Good luck, USA and Sounders players!”

If you believe you are suffering from a soccer-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.

MCL Tears and Repairs By Dr. Charlie Peterson, MD

MCL Tears and Repairs

The medial collateral ligament (MCL), located on the inside portion of the knee, is one of the more common sporting injuries to the lower extremity. It is usually an “acute” injury, meaning that it happens suddenly due to trauma. In sports, the athlete may take a sudden blow to the outside of the knee, creating excessive tensile force to the MCL, such as being tackled in football. This injury also occurs commonly in sports where the ankle is immobilized such as hockey and downhill skiing, where the ankle is stabilized in a skate or boot. This immobilization leaves the knee to absorb the full impact of a collision or fall and increases the risk of knee injury.

Functional Anatomy

The skeletal anatomy of the knee consists of three bones. The thigh bone, medically termed the femur connects with the shin bone, called the tibia. In the front of the knee is the knee cap, or the patella. Holding these bones together are the four major knee ligaments. Two are located deep within the joint and are called cruciate ligaments. They prevent excessive forward and backward motion, as well as rotation. The remaining two are the collateral ligaments, and are located on the sides of the knee. Their job is to prevent lateral, or sideways, motion of the knee. The MCL is located on the inside of the knee joint and prevents the knee from collapsing inward. In addition to the bones and ligaments, the knee has two cartilage pads called the medial meniscus and lateral meniscus. These pads act as shock absorbers within the knee.

Types of MCL Injury

Tears to the MCL are usually a result of direct trauma, either from a blow to the outside of the knee, such as with a football tackle, or a fall that pushes the lower leg sideways. Partial tears will cause varying degrees of instability within the knee, and are often treated successfully with conservative interventions including bracing and physical therapy to strengthen the surrounding musculature. Complete tears may cause significant instability in the knee, especially if in combination with other ligament injuries such as the ACL.

If isolated, even high-grade MCL tears can still often be treated with bracing alone. However, such tears often occur in conjunction with other structures such as the medial meniscus or the anterior cruciate ligament (ACL). The medial meniscus has a direct connection to the MCL, making it particularly susceptible to injury during an acute MCL sprain. Should this be the case, surgical intervention may be required to restore full function due to the degree of instability caused by multiple injuries.

Non-operative Treatment

MCL tears are most often treated successfully without surgery. With significant tears there may be an initial degree if instability following injury. A hinged knee brace may be prescribed to limit control of this aberrant movement. As the ligament heals, your orthopedic surgeon may refer you to physical therapy to strengthen the leg musculature surrounding the knee, and also to restore normal movement patterns that may have been disrupted following injury and immobilization. Patients are able to perform most of their normal daily activities during this process, with the possible exception of high intensity athletics, and generally have very good outcomes following four to eight weeks of rehabilitation.

Surgical Treatment

In cases where non-operative treatment has failed or in some multiple ligament injuries, the surgeon will recommend repair or reconstruction surgery. This means that the damaged MCL will be repaired with sutures if possible. If that is not possible, then a new ligament can be fashioned from a soft-tissue “graft,” a piece of tendon taken from either the patient or a cadaver. A small incision is made to gain access to the area, and the repair made, or the tendon graft is anchored in place with surgical screws.

Following surgery, there will be a period of immobilization, followed by physical therapy. The duration and intensity of the rehabilitation process is dependent on the type of MCL repair or reconstruction, and the other injuries present. In most cases, patients can return to full function including athletics at the conclusion of treatment.

Gel-One Injections for Arthritis Treatment

Patients, who have been suffering from chronic arthritis throughout their lives, have a new treatment option worth investigating. The new treatment is one Dr. Peterson is proud to be offering to his patients. Patients, that could not find relief before, may find relief with Gel-One. Zimmer Corporation, the company that developed Gel-One, created a brand new single use injection that is unlike the older ones on the market. This product has no false injections into the knee.

Out with the Old – Hyaluronic Acid Injection Therapy

The current treatment method, when used in patients who have had their arthritis for over a decade, has only around a 50 percent chance of actually relieving the pain of arthritis of the knee for an extended period of time. Those who find success with it have relief that lasts approximately 6 months, on average.

A second aspect of the current method of treatment is that even if the hyaluronic acid injection is successful in providing relief, some methods of therapy require a patient undergo multiple injections weekly, typically three to five per week depending on the severity of the arthritic pain.

In with the New – Gel -One

The Gel-One product by the Zimmer Corporation is not the first single-use injection treatment to be offered on the market. The previously used injection often provided an amount to be injected that was not sufficient to properly reduce pain and inflammation in the knee, producing what is affectionately called a pseudosepsis (fake infection). The Zimmer Corporation has worked hard to counter this first injection option by working to produce one that is much more effective while being processed in a way that still allows for delivery in a single use injection system.

Gel-One however has been clinically tested in a controlled study group to confirm that it does not produce a pseudosepsis effect.  The study consisted of 379 randomized patients, which 248 of them receiving the Gel-One formula. The patients were compared to the control at the thirteenth week beyond the baseline and demonstrated a greater amount of pain relief, averaging out at approximately 40% reduced amount of pain.

Also in this study there were no unexpected side effects observed, lending to the confidence our clinic has in this product as a new therapy option for those with chronic arthritic pain.

Gel-One and Our Clinic

Dr. Peterson offers Gel-One to his patients, and early results seem promising. He is continuing to use other forms of hyaluronic acid for those patients who have done well with them, and prefer not to switch.

If you would like to discuss your arthritis treatment options and find out if Gel-One is  right for you, make an appointment with Dr. Peterson at Orthopedic Specialists of Seattle. OSS is a comprehensive orthopedic practice.