About Orthopedic Specialists

Orthopedic Specialists of Seattle provides new and advanced procedures including endoscopic carpel tunnel release surgery for carpal tunnel syrome, complex joint restoration procedures, anterior approach hip replacement surgery, and more.

Avoiding and Treating Spring Sports Injuries

Spring arrives on March 20, and with it, the crack of a baseball or softball bat, the sound of a track coach’s whistle and the rough-and-tumble of other outdoor sports in the Pacific Northwest. Spring sports not only herald the return of warmer weather, they are a forerunner of an increase in an athlete’s risk of many sports-related injuries. Doctors at Orthopedic Specialists of Seattle (OSS), who have seen just about every possible sports-related injury, offer tips on how to avoid and treat many sports-related injuries.

Dr. Weil states, “As an orthopedic surgeon specializing in hand surgery, the spring is a busy time for me. I see many sports related injuries in the spring time as people in the northwest come out of winter hibernation. Some of the more common injuries are due to bicycle crashes due to cycling on wet roads and overuse injuries as people ramp up their activities too quickly. The old adage, “slow and steady wins the race”, is true in this case. I look forward to the upcoming triathlon season and will be out in the water, on the bike, and running as well.”

Upper Extremity

In both pro and college baseball players, upper extremity injuries are most common and account for approximately 20 percent of all injuries. Injuries include dislocations, sprains and strains, labral injuries, and rotator cuff injuries. Shoulder problems are usually part of a bigger problem, alignment. By correcting the alignment issues, most shoulder problems can be resolved as long as they haven’t passed the point of no return. Once this happens, surgery is usually the only option to truly fix the problem.

Elbow injuries account for approximately 16 percent of pro and 8 percent of college injuries. These injuries include sprains and strains, contusions, and more severe injuries such as ulnar collateral ligament injuries (Tommy John) and posterior impingement. Elbow sprains and strains are more likely the precursor to an ulnar collateral injury. And just as in the shoulder, by correcting alignment issues, most elbow problems can be resolved as long as they haven’t passed the point of no return.

Baseball Injuries

The 3 main lower extremity injuries in baseball are:

Muscle strains, such as a pulled hamstring or quad,
Ankle sprains, and
Contusions (ie getting hit by a pitch).

Rehab for sprains and strains can involve a short time off from play (if needed) and rehabilitation consisting of regaining range of motion/flexibility, strength, and balance. All of this should be done under the guidance of an athletic trainer or physical therapist.

Hand/wrist

Hand and wrist injuries account for approximately 10 percent of baseball injuries. These can be minor such as contusions to more serious injuries such as fractures and dislocations. The majority of these injuries are from being hit by a pitch or from sliding. Hand and wrist injuries should be evaluated by your athletic trainer who will refer to a sports medicine physician for more severe injuries such as dislocations and fractures. Minor injuries are usually treated with rest, rehabilitation, and taping/bracing if needed.

Track and Field Injuries

Many track and field injuries can be prevented by increasing the level of awareness and knowledge of prevention. Muscle strains and sprains are the most common track and field injuries.

Common track and field injuries include:

Shin splints
Microscopic stress fractures
Compartment syndrome
Tibial stress syndrome
Plantar fasciitis (pain on the bottom of the foot)
Runner’s knee
Chondromalacia
Patellar tendonitis and Osgood-Schlatter disease
Muscle strains to the quadriceps (front of thighs)
Hamstrings (back of thighs)
Hip adductors (groin) and hip flexor (front of hip)
I-T band syndrome
Scrapes and burns from falling
Blisters

OSS doctors offer the following tips for avoiding sports injuries, including baseball and track:

Wear properly fitted shoes – Protective gear is vital, but shoes that fit well are the single most important piece of equipment in just about every sport.
Properly warm-up before engaging in activities – Both youth and adults today seem to believe that they can just ‘flip a switch’ and begin competing. By warming up properly, you gradually lengthen and stretch your muscles, increase your body temperature and blood flow, and alert your body to be prepared for more rigorous physical activity.
Don’t continue to play when you are injured – It’s tempting to try to ‘play through’ an injury, or to go back out on the field before you are ready. That is almost always when greater; often more significant damage is done to an athlete.
Establish a good stretching program to include the gastrocnemius/soleus (calves), hamstrings, quadriceps, hip flexors and hip adductors. Initial stretches should be static (no bounce) and held for at least 30 seconds, then progressed to dynamic stretches such as walking lunges or high stepping.
Hydrate 30 minutes prior to practice/game and drink a combination of water/sports drinks during activities.

If you believe you are suffering from a sports-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.

Softball Pitchers’ Windmill Delivery Can Cause Injury

Softball pitching subjects the biceps to high forces and torques when the player’s arm swings around to release the ball. Published in the March 2009 issue of the American Journal of Sports Medicine, the study of the “windmill” pitching motion appears to explain the high incidence of anterior shoulder pain observed in female softball players.

In the study, seven women — three collegiate and four professional pitchers — underwent motion analysis and surface electromyography to evaluate the muscle firing pattern of their biceps in the course of a windmill pitch. Electromyography detects electrical potential generated by muscle cells when they contract.

The researchers found that even though the upper arm movement in both baseball and fast-pitch softball gives the ball about the same velocity, the muscle force during the windmill pitch was much higher, according to the press release.

Moreover, the maximum force, or maximum contraction, occurred not when the arm was cocked, as in baseball’s overhand pitching, but when the arm circled around from the 9 o’clock position (i.e. almost fully extended back) to the 6 o’clock position (i.e. perpendicular with the ground), completing the windmill motion with the release the ball.

In one case, a pitcher had ruptured her tendon during play, which implicated the long head of the biceps tendon as the source of stress. Female softball pitchers are prone to overuse injury not only because of windmill pitching dynamics, but also because they pitch so many games.

Common Softball Injuries

Common injuries in softball players include tendonitis, rotator cuff and tendon strain, and ulnar nerve damage, but there are also plaguing lower body injuries that affect softball pitchers. So what is the source of injury? In simplest terms, the hips provide the platform for the scapula, and the scapula is the platform for the shoulder. If there is dysfunction in that system, this leads to injury. If a pitcher complains of shoulder pain, the shoulder may not be at fault for the pain, but rather faulty mechanics in the lower body.

Many times, softball pitchers experience upper body injuries that may be a result of faulty lower body mechanics. Force is produced in the ground, transfers through the legs and torso, and finishes in the upper body. If something along those lines isn’t functioning properly, injury will present itself.

Anterior shoulder pain is one of the most common complaints among windmill pitchers. A typical overhand pitch sees around 108 degrees of motion, whereas the windmill pitch has around 360 degrees of motion; which is an increase in the eccentric action of the biceps.

Strength and conditioning for softball pitchers takes on a significant meaning because all of the energy is transferred from the ground up to the hand (the final point of contact with the ball) and pitch from a flat surface vs. baseball players who pitch off of a mound; this means that a softball pitcher would need to train in ground reaction-force, emphasizing gluteal exercises. Strong glutes will provide a strong base for the pelvis, then transferring energy through the core to the upper body.

When considering training regimens for windmill softball pitchers, much of the conditioning should focus on strengthening the lower extremity and lumbopelvic-hip complex. The lower extremities and lumbopelvic-hip musculature can often be addressed in the same exercises. Ideally, the lumbopelvic-hip complex should be addressed first in the training cycle in order to maintain a base of stability throughout all the conditioning exercises.

Dr. Shapiro states, “Warming up prior to the game and using the proper technique while playing will reduce the opportunity for injury; however, if you are experiencing pain this may be from overuse or an acute injury. It is best to seek medical attention and be evaluated by an Orthopedic and Sports Medicine Specialist.”

If you believe you are suffering from a softball-related injury and need specialized orthopedic care, Orthopedic Specialists of Seattle provide excellent treatment options available for you.

Rules to Get Fit for Runners

As we thaw from this winter’s frost, our bodies will need to acclimate to warmer weather once again.

The warmth of spring is upon us, and once again it’s time to start gearing up for a refreshing change to the winter routines that have kept us cooped up with muscles creaking.

Even if you managed to remain active through trips to the gym; the prospect of getting outside and in the sun offers a range of new exercises that require preparation and training.

Prone to Injury

You may ask, “if I have maintained my exercises, why would I need any extra preparation?” The answer is that it’s specifically at the start of these new exercises that your body is most prone to injury.

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 its outdoor equivalent, from biking in the park to soccer on the grass.

Getting Back into Shape

The following are three important steps you should take to ensure that getting back into shape leaves you free from injury while offering the most beneficial takeaway of getting back into shape for spring.

Take a moment to set a goal. Setting a goal helps propel yourself towards a specific aim, a simple enough idea which cannot be understated in its power to focus yourself on a reasonable achievement.
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.
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 provide excellent treatment options available for you.

2014 Sochi Olympic Injuries

The 2014 Sochi Olympics has had a fair share of injuries, none more so than the extreme sports that were added to the winter games as a way to attract a younger audience to watch and show interest in the Games.

OSS admires all the Olympians competing for the Gold as well as glory for their respective country; and as the final week rounds out this year’s Winter Olympics, we want to wish all the athletes who were involved in some kind of injury, a speedy recovery.

According to Dr. Charlie Peterson, “These events demonstrate that even at the elite level of competition, injuries are part of the game for all athletes. It re-emphasizes the need for maximum fitness and proper techniques and equipment to minimize the chance of injury, as well as the timely treatment of injuries when they occur.”

Here is a rundown of athletes and their injuries:

Ski-cross racer Maria Komissarova of Russia broke her spine during a practice run at the Extreme Park and is being treated in Munich after undergoing surgery in Krasnaya Polyana, the nearest town to the venue.
Canadian skier Yuki Tsubota suffered a mild concussion and a fractured cheekbone in a Feb. 11 crash during the women’s slopestyle event, where athletes soar and slide over obstacles before launching themselves off progressively larger jumps. The 20-year-old landed short and was taken off the course on a stretcher. She has returned home to see if she needs surgery.
During the women’s snowboard cross event on Feb. 16, Jacqueline Hernandez of the U.S. was carried off after she banged her head, as was Norway’s Helene Olafsen with a knee injury.
Islanders star John Tavares is out for the season after suffering a left knee injury in Team Canada’s win over Latvia on February 18.
Bode Miller owns a U.S.-record six Olympic Alpine medals, including a bronze in the super-G from last weekend that made him the oldest ski racer to win a Winter Games medal. He said Wednesday, February 18 that his knee bothered him after that race, and it’s been swollen during the Sochi Olympics.
Heidi Kloser of Vail injures right knee in crash, out of Sochi Olympic moguls

March Madness – Preventing Basketball Injuries

The 2014 NCAA Men’s Basketball tournament starts on March 18, 2014 and OSS congratulates all the teams who have made it to the tournament. March Madness is a frenetic tournament of college teams on their quest to be the best.

Getting to this tournament has been long and sometimes with injury, but we hope that they have performed all the necessary conditioning so that they can compete with the best.

Basketball is a fast, moving sport and sometimes, injuries can occur. Common basketball injuries include:

Ankle Sprains

Treatment for an ankle sprain involves rest, ice, compression, and elevation (RICE). The need for X-rays and evaluation by an OSS physician is determined on a case-by- case basis and depends on the severity and location of pain. Pain and swelling over the bone itself may need further evaluation. An injury to the ankle could represent a simple sprain or could be the result of an injury to the growth plates located around the ankle and should be evaluated by a physician.

Jammed Fingers

Jammed fingers occur when the ball contacts the end of the finger and causes significant swelling of a single joint. Application of ice and buddy taping the finger to the adjacent finger may provide some relief and allow the athlete to return to play. If pain and swelling persist, evaluation by a physician or athletic trainer is recommended and an x-ray of the finger may be needed.

According to Dr. Scott Ruhlman, “It is often difficult to distinguish a devastating finger injury versus a simple sprain based on swelling alone. An x-ray is key to guide ideal treatment.”

Knee Injuries

Basketball requires extensive stop and go and cutting maneuvers which can put the ligaments and menisci of the knee at risk. Injury to the medial collateral ligament is most common following a blow to the outside of the knee and can often be treated with ice, bracing and a gradual return to activity.

Deep Thigh Bruising

Treatment includes rest, ice, compression, and elevation. Commercially available girdles with thigh pads are now available for protection.

Foot Fractures

Stress fractures can occur from a rapid increase in activity level or training or from overtraining. Stress fractures in basketball most commonly occur in the foot and lower leg (tibia). Once diagnosed, a period of immobilization and non-weight bearing is recommended. Return to play is permitted once the fracture has completely healed and the athlete is pain free.

Prevention of Basketball Injuries

Have a pre-season physical examination and follow your doctor’s recommendations for basketball injury prevention
Hydrate adequately – waiting until you are thirsty is often too late to hydrate properly
Pay attention to environmental recommendations, especially in relation to excessively hot and humid weather, to help avoid heat illness
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 basketball through activities such as aerobic conditioning, strength training, and agility training.
Avoid overuse injuries – more is not always better. Many sports medicine specialists 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.”
Talk with your coach, an OSS physician and/or athletic trainer about an ACL injury prevention program and incorporating the training principles into team warm-ups.
The athlete should return to play only when clearance is granted by a health care professional.

Dr. Jonathan Franklin reminds everyone that “Conditioning and flexibility are key as they reduce the risk of injury during the season. Preparing your body for a game ahead of time will pay off with more success during the season.”

If you believe you are suffering from a basketball-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.