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

5 Common Hockey Injuries

Hockey photo

The regular NHL season is well underway and the Seattle Thunderbirds are respectively improving their stats with their recent win over the Vancouver Giants at ShoWare Center.

In the regular season as well as the off season, players experience a variety of sports-related injuries as a result. Ice hockey is a contact sport where the players and the puck move at high speeds, so when players run into each other or objects, great force is used. This is why hockey is considered a collision sport. Injuries are fairly common, but efforts can be made to avoid them with training and proper equipment. Listed below are five common injuries that can occur while playing hockey.

AC Joint Injury

The acromioclavicular joint, or AC joint, is one of the joints in the shoulder responsible for motion and stability. The ligaments that hold the AC joint together can be torn through sudden impact to the shoulder, which can cause separation to occur in the AC joint. This sudden impact can happen in hockey when players skating at high speeds collide with one another or into a rigid surface. Swelling, bruising, pain, and motion range loss are all symptoms of AC joint separation. There may also be visible bumps on the shoulder if the bones separate.

Shoulder Dislocation

Shoulder dislocation generally refers to a dislocation in the glenohumeral joint in the shoulder. This happens when the top of the humerus, or upper arm bone, is forced out of the glenoid, the socket in the shoulder joint it usually nestles in. If a player falls or receives a heavy blow or sudden impact on the shoulder, it can cause dislocation if the upper arm is forced to move in an abnormal way. Symptoms of shoulder dislocation include pain, weakness, and mobility issues. The arm may also appear to hang incorrectly off the shoulder.

Muscle Strain

Muscle strain occurs when a muscle is pushed past its limit. This can happen if a player’s muscle is suddenly presented with a heavy load or stretched beyond its normal ability. If a player’s muscles are tight but not warmed up or not conditioned well, tearing or straining is a risk. Symptoms of a muscle tear include pain at rest or when the muscle is used, and weakness or inability to use the muscle.

Meniscus Injury

The meniscus is a C-shaped piece of cartilage in the knee. There are two menisci in each knee joint, and if they are torn they can affect stability in the knee. This tearing can happen if the cartilage is worn down or through the quick movements and stress put on the knees by ice skating. Symptoms vary depending on how and where the meniscus is torn, but symptoms can include pain, instability or feeling the knee “giving,” stiffness, swelling, and an impaired range of motion. Sliding, popping, or locking may occur if the tear is left untreated because loose fragments from the meniscus tear will drift into the joint.

Gamekeeper’s Thumb

The ulnar collateral ligament, or UCL, connects the bones at the base of the thumb, which prevents the thumb from moving too far from the hand. When an acute sprain or tear of the UCL occurs, it is called a UCL injury. When the injury is chronic and develops over time from repeated UCL stretching, it’s called gamekeeper’s thumb. UCL injuries are commonly caused by injury or trauma in which the thumb is bent away from the hand at the MCP joint. This can happen in sports hockey, or in any situation in which a fall is landed on an outstretched hand.

This injury might also be sustained when a person is gripping something that is suddenly moving, like a hockey stick during a fall. Swelling, pain, and tenderness on the ulnar side of the thumb are all symptoms of UCL injury. You may also have difficulty pinching and gripping with the thumb, and you may have limitations in your range of movement. In severe cases, a bump under the skin, called a Stener lesion, may form due to the ends of the torn ligament being held apart by a nearby tendon.

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

Volleyball Injuries Caused by Repetitive Motion

Karch Kiraly, Misty Mae Traenor, Logan Tom, Kerri Walsh and Steve Timmons dominated the sport of volleyball both on the court and in the sand. It’s no surprise that over their years as either and Olympic gold medalist or a top professional athlete, they have had their share of injuries over the years. From shoulder injuries to foot and ankle injuries, these athletes have battled the pain and recovered through extensive orthopedic protocols and treatments.

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