Seattle Seahawks Injury Status

Football season is moving right along and our beloved Seattle Seahawks are 6-3 overall; ranking 10th in offense and 3rd in defense. There are several injuries on this season’s roster, including:

Seattle Seahawks Injuries

Coach Pete Carroll has cleared some of these players to return to the field but others are questionable for the rest of the NFL season. Of note, Zach Miller had undergone surgery and is on the injury reserve list and is not playing while Marcus Burley’s hamstring injury has sidelined him from playing for a questionable amount of time.

“With such devastating injuries to the squad up and down the line up, it reiterates the importance of preparation to prevent injury,” states Dr. Ruhlman.

The treatment protocol for football injuries varies and can range from basic RICE (rest, ice, compression, elevation) to surgery, with several options in between.

For all of these injuries, RICE can be improved with active cold and compression therapies to help speed up the healing process for injuries.

Cold compression therapy can also be used after surgery to help speed up the recovery process.


OSS hopes that all these players recover from their injuries and wish the Seattle Seahawks a great rest-of-the-season.

If you believe you are suffering from a sports-related injury and need specialized orthopedic care, the orthopedic surgeons at OSS provide excellent treatment options for your injury.

Avocados vs. UFC Fighter… and the Winner is?

avocado-cut-3aWho knew you would have to watch your back, or should we say hand, when making the family’s homemade guacamole? Avocados; they look innocent enough, but did you know that avocados are the cause of hundreds of hand injuries a year?

Take for example, UFC Tri Star Welterweight contender, Rory MacDonald.  He gave himself a deep cut in his left hand while cutting an avocado at home, prompting a trip to the emergency room and making him worry he’d have to drop out of his UFC 170 fight against Demian Maia.  Fortunately for MacDonald, he received stitches for his hand injury.

The danger is hidden inside the avocado. Avocados have a soft creamy skin, easily sliceable, but inside, the pit also needs to be removed carefully. Often times, this is done by stabbing the end of a knife onto the pit and twisting it off. If not done properly, the knife can glance off the pit and cut your hand. 

You can also injure yourself when slicing the inside of the avocado while it rests in the palm of your hand; the pressure may be too great and accidentally, you slice right through the peel and your palm along with it, hitting an artery, nerve or tendon in the process.

Slicing an artery, nerve or tendon can be serious. It is possible to have a partial injury to a tendon and still move the hand normally, but there is a risk that the tendon could rupture completely. According to Dr. Ruhlman, “Knife injuries from cutting an avocado are among the most common injuries I see, and unfortunately, often cause an injury that needs surgical repair.  Hopefully, awareness of this common injury might prevent a rate of such a devastating injury.”  By using the proper tools and technique, injury can easily be prevented.  If you do cut yourself it might mean surgery and possible months of therapy.

OSS has several providers specializing in hand injuries.  If you are suffering from a hand-related injury, contact OSS to schedule an appointment with one of our physicians at (206) 633-8100.

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.


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.

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.

Dr. Ruhlman Featured in Swedish Ballard

This is Swedish Ballard’s third post in a four-part series to encourage and inspire Ballard residents and the surrounding communities to be healthy while leading active lifestyles in 2014.  Below, posted in its entirety, is the article from Swedish Ballard’s web site; posted 1/29/14.

By Scott Ruhlman, MD
Orthopedic Surgeon

Looking to be more active in 2014? Have you been waiting all year to enjoy winter sports such as skiing or snowboarding?

There are a few common injuries that often get my patients down when they are on the go. Below are a few tips and tricks to help you prevent these common injuries and determine the best treatment options should you need it.

The most common injuries in the wrist and ankle are sprains and fractures. Throwing, twisting, weight-bearing, and impact can put you at risk for a wrist injury. Ankle sprains and fractures are typically caused by making a fast, shifting movement with your foot planted on the ground.

In most cases, I recommend the RICE approach: rest for around 48 hours; ice the injured area to reduce swelling (use a pack wrapped in a towel); compress with an elastic ACE wrap; and elevate the injury above heart level.

However, if you experience these symptoms, contact your provider for further evaluation.

  • Pain at the time of injury
  • Swelling
  • Bruising or discoloration
  • Difficulty moving the wrist or ankle
  • A “popping” or tearing sensation during the trauma
  • Warmth and tenderness of the skin

More serious injuries will likely be treated with a splint, boot or cast. The healing process can take up to six weeks. Surgery may also be required.

ACL Tears
The ACL, or anterior cruciate ligament, is one of the major ligaments in your knee that helps with stabilization when turning or planting. ACL injuries take place during cutting or pivoting movements. The hallmark of a torn ACL is a distinct popping noise and your knee may give out. The affected knee will begin to swell and become stiff between 2-12 hours after the injury. People often experience pain or tenderness, and discomfort while standing or walking.

Treatment for ACL injuries depend on the severity of the tear, as well as your age and activity level. Non-surgical treatment such as physical therapy or using a brace may be sufficient. Other individuals will need reconstructive surgery. In all cases, it is important to consult with your provider as soon as possible if you suspect a problem.

Rotator Cuff Tears
The rotator cuff is a group of four small muscles and tendons in the shoulder that provide stability to the shoulder and mobility to the arm. A torn rotator cuff can happen in two ways. An acute tear happens suddenly, such as when you fall on an outstretched hand or lift a heavy object. Tears can also happen slowly over time. As we age, the tendons of the rotator cuff become weaker and gradually fray.

Symptoms of a rotator cuff tear include pain with movement of the shoulder and tenderness to touch. Inability to lift even household objects out to the side or overhead is also typical. Another indicator is a prior history of shoulder tendonitis or bursitis as this would point to excessive stress on the rotator cuff over time.

Treatment can be conservative for some tears, including physical therapy to improve shoulder mobility and progressively strengthen the cuff muscles. However, the majority of tears will likely require surgery to restore shoulder function.

Meniscus Tears
The meniscus helps to absorb shock, as well as stabilize the knee joint. A lot of your body weight is distributed through the meniscus when you move, especially when performing athletic activity. Meniscus tears are caused by twisting and compression that can occur with such activities as running or jumping.

If you have a meniscus tear, you may hear a popping sound or feel a tear or rip in the knee. Swelling generally occurs within a few minutes to a couple of hours and your knee might feel like it is out of place. In less acute injuries, swelling may not occur. Your knee might feel like it’s catching during movement, or like it’s “out of place”. If you suspect you may have a meniscus tear, make an appointment with your provider right away.

Initial treatment of a meniscal tear is typically nonsurgical, and may include RICE (rest, ice, compression and elevation). If the tear doesn’t heal, you may need surgery.

While the majority of these sports injuries are due to circumstance and pre-existing injuries, there are precautions that you can take to help prevent them from happening to you:

  • Maintaining a lifestyle involving consistent exercise
  • Warming up and stretching prior to rigorous activities
  • Cooling down and slowly relaxing after exercise.

Dr. Scott Ruhlman practices orthopedic surgery at Orthopedic Specialists of Seattle, and has extensive experience with sports medicine. If you have any questions regarding your shoulder pain or function, please feel free to contact Dr. Ruhlman’s office at (206) 784-8833.