Avoiding Spring Gardening Injuries

Spring weather in the Pacific Northwest is beautiful and although we still have rain showers, it is the best time for gardening and getting in some spring cleaning.  If you are like some of us here at OSS, gardening is a popular hobby.  Over time however, it can take a toll on your body.  Creating a dream garden requires repetitive bending, kneeling, reaching, and twisting that may result in putting an extensive amount of strain on your muscles and joints.

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According to Dr. Scott Ruhlman, “Spring time is a great time to get outside and do yard work. In this case the old adage rings true, that an ounce of prevention is much more than a pound of cure. Use the proper tools and body positioning when gardening. I am not only a hand surgeon but an avid gardener too.”

Raking, digging and planting may present injuries and OSS would like to share some helpful tips to keep you pain-free while you garden:

  • Sunscreen – Fair-weather skin tends to burn faster and in the Pacific Northwest when we see the sun peek out from the clouds, we rush to catch some of those sunshine rays.  Use sunscreen with SPF and wear a wide brimmed hat.
  • Light Stretching and Walk – Before you take on your dream garden, do some light stretching so that your muscles can warm up and take a short walk to get your blood flowing.
  • Spread out your Workload – If your  garden took a toll over the winter months, pace yourself and spread out the work; this gives you the opportunity to see your garden progress and prevents you from injury by doing all the work at once.
  • Kneeling vs. Bending – Place less strain on your back by avoiding bending; kneel instead.  Wear kneepads and use a cushioned mat to comfort your knees while working on the ground.
  • Keep Moving – Long periods of time in one position will put stress on your muscles and joints; so keep moving so that you avoid overworking specific areas of your body
  • Lift Cautiously – Lift with your legs and not your back when carrying heavy loads and remember to hold objects close to your body when lifting.

If you believe you are suffering from a gardening-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 or consultation with Dr. Ruhlman.

Knee Injuries on the Job

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Driving down Interstate 5 through the Pacific Northwest, you see a lot of logging trucks pass you by.

Loggers and truck drivers do a lot of heavy lifting and/or climbing, but so do other professions, like nurses, construction workers, doctors or even chefs who walk long distances while lifting items they may need on the job.

You may not think of these jobs as a place where a knee injury might occur, but in fact, occasionally injure a person.

A knee injury might not be apparent at first, but over time, may become swollen and painful. The knee injury now becomes an impediment, and you are unable to lift things because your stance is unstable.

Think about the last time you wobbled a little because your knee gave out and developed a nagging pain soon after. Did you do anything to alleviate the pain you felt in your knee?

Common Knee Injuries

Meniscus Injuries: Meniscus tears can cause intense pain and instability in the knee depending on the severity of the tear. Clients with tears to the meniscus describe a sensation of their knee “giving out” or “coming out from under them” while walking or climbing stairs.

The knee will most likely swell in order to protect itself, which can be intensely painful and can limit movement. Although physical therapy, anti-inflammatory medication and cortisone injections can help reduce symptoms, an orthopedic doctor will often recommend arthroscopic surgery to repair the tear.

Ligament Injuries: Injuries to the cruciate ligaments – such as the anterior cruciate ligament (ACL), medial collateral ligament (MCL) and posterior cruciate ligament (PCL) – are sometimes referred to as sprains, but they can be much more complicated than simple muscle strains. These injuries can require months of treatment to recover, and some cruciate ligament injuries — e.g., anterior cruciate ligament (ACL) tears – may require reconstructive surgery.

Chondromalacia: Chondromalacia is a disorder caused by softening of the articular cartilage of the kneecap. It can be caused by traumatic injury or overuse or repetitive motion on the job. Signs and symptoms of chondromalacia include dull, achy pain in the front of the knee, increased pain when walking up or down stairs, pain in the knee when kneeling or squatting, knee pain after sitting for long periods of time, a grating or grinding sensation when you extend your knee and knee stiffness.

To diagnose the problem, an OSS physician may require you to attempt simple knee exercises or recommend X-rays or other imaging tests such as an MRI or CT scan. Treatment options include rest, pain relievers or physical therapy. In rare cases, arthroscopic or realignment surgery may be options.

According to Dr. Watt, “Knee problems and injuries may be job-related or not. Sometimes it is obvious and sometimes not obvious and this may be part of the initial evaluation. I have extensive experience on all types of knee problems and injuries and would love to help anyone with a knee problem to try and regain a healthy knee.”

Dr. Watt is a board-certified orthopedic surgeon here at OSS who works with patients dealing with a wide range of orthopedic issues. Dr. Watt carefully weighs conservative and aggressive methods of treatment to devise a plan tailored to the specific needs of the individual. This personalized approach creates excellent outcomes, with patients working as close partners in the treatment process.

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:

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.

2014 Sochi Olympic Injuries

sochi-injuries-sick-300x199The 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.

Sochi-Closing-Ceremony-300x225According 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