Monthly Archives: December 2015

DID YOU SAY SPORTS INFECTIONS?

December 28, 2015

MRSA

Most athletes expect injuries and not an infection to be the thing that would most likely make them miss some time. Viral, fungal, and bacterial infections can not only take a person out of the game, but can be serious enough to require hospitalization. Recent outbreaks of Staph infections at schools and even ones affecting professional teams (e.g. Tampa Bay Buccaneers) have shed light on the issue, but many athletes are still unaware of the potential for infection in locker rooms, outdoor sporting activities, and even among family. Here are some commons infections that can afflict athletes.

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Staph Infections

Perhaps the most dreaded and serious of them all are the Staph bacterial infections. Most recently, there has been a surge in community-acquired MRSA infections (a resistant strain) that often affects those with poor hygiene, who live in crowded situations, and have had recent trauma to the skin. They are particularly common in wrestlers, football players, and anywhere there is shared use of contaminated equipment. A recent study showed that there was a 22% prevalence of Staph in locker room whirlpools in college training rooms. It will often present as a red, painful bump but can also develop into abscesses and further soft-tissue infection. Prevention is key with frequent hand washing being the most important prophylaxis. How it presents determines how it is treated. Fluid collections should be drained and all patients should be placed on antibiotics that target the resistant form. Returning to play, per various groups’ guidelines, should only be considered after treatment for 72 hours, no new lesions for 48 hours, and no drainage being present.

Infectious Mononucleosis (IM)

Also known as “kissing disease”, IM is a common viral infection that affects teenagers and young adults, and is often caused from sharing water bottles. Patients will experience a sore throat, body aches/pains, fatigue, fevers, and possibly a rash, and it may take upwards of a month for symptoms to present themselves after one is exposed. The most concerning feature associated with IM is spleen enlargement. When an athlete’s spleen is enlarged, especially contact athletes, this puts them at risk for having the spleen rupture, and, while although rare, can be potentially fatal. IM symptoms usually disappear after 3-4 weeks but may take longer till an athlete is ready to return to sports. Controversy exists with regards to when a contact athlete with IM is safe to return to sports, but most studies show that is probably safe after 4-6 weeks for them to return to play.

Fungal Infections

Caused by direct skin-to-skin contact, fungal infections are quite prevalent and can affect all parts of the body. “Athlete’s foot”, “jock itch”, “ringworm” all fall into this category. While they don’t usually cause too much in the way of significant health issues, they can cause athletes to miss quite of bit of practice and competition time. Most commonly, treatment is in the form of topical creams/ointments, but for more serious cases oral treatment may be needed. Current guidelines recommend 72 hours of topical treatment for non-scalp infections and having a protective dressing over all lesions for return to play.

Summary

While infections are an often overlooked cause of athletes and patients missing time from their sports or activities, they can be just as frustrating as an injury with regards to time off, treatment, and recovery. Sarasota Orthopedic Associates is driven to helping get their patients back in the game, no matter the cause.

Trevor Born, MD – Dr Born is a Sports Medicine physician at Sarasota Orthopedic Associates specializing in upper and lower extremity conditions. SOA has three convenience locations in Sarasota, Lakewood Ranch, and Venice and offers same day appointments when needed.

This entry was posted in on December 28, 2015 by sarasotaAdmin.

TENNIS ANYONE?

December 22, 2015

tennis racket and ball

Tennis is one of the more popular sports on the Gulf Coast of Florida. Year round competition at all levels can unfortunately lead to various “overuse” injuries, and some athletes may even sustain acute traumatic injuries which may force them to miss time. An overview of common injuries as well as ways of preventing and treating them may help to keep a tennis player on the court.

Tennis Elbow

Perhaps the most dreaded of all the overuse conditions is “Tennis Elbow,” or lateral epicondylitis. A degenerative process affecting the tendons on the lateral aspect of the elbow, which help to bend the wrist backwards, it is commonly seen in tennis players given that these muscles help resist impact when the racquet strikes the ball. Combined with their importance in gripping the handle, these muscles/tendons are prone to overuse if not properly prepared. Strengthening, a regular warm-up routine, and paying attention to grip size can help minimize the risk of developing the condition. Treatment often includes rest, therapy, braces, medications, and injections. While most cases improve with these conservative measures, occasionally surgery is needed.

Shoulder Injuries

The shoulder, like the elbow, is also predisposed to overuse injuries in tennis players. The serve is a complex motion that not only requires a balance of muscle coordination around the shoulder, but good core and lower extremity flexibility and strength to minimize risk of injury. The rotator cuff muscles can often become fatigued or weak, which can throw off the balance, and irritate surrounding tissues. The tendons and surrounding bursa can become inflamed, which may affect one even off the court. Again, conservative treatment is often all that is needed, not only focusing on the shoulder, but providing a total body program to minimize the stress on the shoulder during strokes. If symptoms persist, then further imaging and possible surgery may be needed, especially if a rotator cuff tear is present.

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Lower Extremity Injuries

The legs are just as important as one’s arms on the tennis court. Rapid changes of direction, sudden stopping and acceleration, and jumping are often needed during a match. Muscle strains, knee and ankle sprains, and stress injuries can occur during these movements. Strains, such as “pulling” a hamstring or calf muscle, can often be prevented by adequate stretching prior to playing. An awkward step or twisting episode may result in a sprain. Ankle sprains almost always improve with conservative measures, but recurrent sprains may result in continued instability and require surgery. Knee sprain treatment depends on what is injured. While certain ligament and tendon issues around the knee can heal with non-operative treatment, meniscal and ACL tears often need surgery, but this is determined on a patient-to-patient basis.  Quickly increasing the amount of tennis one is playing may predispose them to a stress fracture, either in the lower leg or foot. These require rest and off-loading of the limb, possibly with the assistance of crutches. Lastly, proper footwear is vital to the health of the lower extremities and minimizing the risks of these conditions.

Summary

Understanding the spectrum of conditions that can affect tennis players is often a good first step into learning ways to avoid them. Every patient/athlete is unique and working with them through their condition in a customized approach will best enable them to get back in the game.

Trevor Born, MD  is a Sports Medicine Physician at Sarasota Orthopedic Associates treating upper and lower extremities with non-surgical treatment as well as minimally invasive options. Click HERE for more information.

 

This entry was posted in on December 22, 2015 by sarasotaAdmin.

SHOULD MY CHILD PLAY THE SAME SPORT ALL YEAR LONG?

December 16, 2015

sports blog lento

Ahhh!!! Florida, with its beautiful warm sunny days and virtually endless opportunities for sporting events, is a hotbed for the development of youth sports.  Here in the Sarasota/Bradenton area, there are numerous opportunities for the young athlete to participate in sports year round.  Too often, however, young athletes are playing only one sport all year long without the potential for rest or recovery.

Unfortunately, sports medicine specialists now understand that this is not a healthy strategy. In fact, young athletes who play or perform a single sport greater than eight months out of the year are at a significantly increased risk of experiencing an injury compared to the other youths who participate in different sports.  In a recent sports medicine article, youth athletes who focus on a specific specialization of sport program are twice as likely to get injured compared to their friends who participated in self-directed unstructured free play.

There are a few theories as to why this may occur. Playing only one sport may overload developing structures causing overuse injuries.  Additionally, proper development of other diverse muscle skills which occur during regular free play or from participating in array of different sports may not occur when a child only plays one sport.

Based on these theories, it is recommended that young athletes be given time away from their specific sport so that they can participate in free unstructured play with their peers.  Parents and educators should provide opportunities for free play as well so that our young athletes can improve their motor development in general during the growing years which can reduce injury rates and encourage life-long activity free of injury.

Paul H. Lento, MDDr Lento is Fellowship Trained and Triple Board Certified in Physical Medicine.  He is a nationally recognized Sports Physician having served as team physician for major sporting events such as Winter Olympics and major city marathons. Locally he is team physician for Lakewood Ranch High and Booker High Schools. He holds the distinction being named a Castle Connelly Top Doc and sees patients at Sarasota Orthopedic Associates.  Learn more HERE.

This entry was posted in on December 16, 2015 by sarasotaAdmin.

YOU’RE GOING TO STICK A CAMERA IN WHERE? The Basics of Ankle Arthroscopy

December 8, 2015

foot pain 1

You have probably heard of, or know someone who has had, a knee or shoulder arthroscopy or “scope.” What you may not know is that we can also perform arthroscopy of the ankle. This can be a quite useful procedure for some common ailments of the ankle. This is frequently performed as an outpatient procedure with a few small incisions.

During ankle arthroscopy a small incision about ¼” long is made over the front of the ankle. This small incision allows us to place the camera into the ankle joint and see the cartilage covering the tibia, talus and fibula (the bones that make up the ankle joint). We then make a second 1 /4“ incision that allow us to insert a second tool such as a probe or motorized shaver that we can use to assess and clean up damaged tissue. Being able to visualize the ankle joint from the inside out allows us to treat some conditions with much smaller incisions than would be possible otherwise.

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We commonly clean up damaged cartilage or inflammation of the lining of the joint through the ankle scope. We can also perform procedures such as micro-fracture or grafting which can help stimulate healing of damaged cartilage. Recently, we have been using ankle arthroscopy to prepare the ankle joint for fusion by scraping out any remaining cartilage. This has been incredibly helpful because it allows us to perform an ankle fusion procedure through 4 or 5 small incisions instead of 1 or 2 quite large incisions. This has resulted in lower levels of pain and fewer issues with wound healing.

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If you have been having problems with your ankle, whether it is new or quite old, come see me at Sarasota Orthopedic Associates. We have many options both surgical and nonsurgical for getting you back on your feet… back to work… back in the game… back to life.

For an appointment with Dr. Eric James, orthopedic foot and ankle surgeon, call 941-951-2663.

For more detailed information on foot and ankle arthroscopy, check out this excellent article at the American Orthopedic Foot and Ankle Society website.

http://www.aofas.org/footcaremd/treatments/Pages/Ankle-Arthroscopy.aspx

happy foot

This entry was posted in on December 8, 2015 by sarasotaAdmin.

OFF BALANCE? IT’S MORE SERIOUS THAN YOU THINK

December 1, 2015

balance high wire

Studies have shown that 40% of us will have a balance issue at some point in our lives. Some of these issues will be the catalyst for us to see our physician. A balance disorder is a condition making one feel unsteady or dizzy. Any number of things may cause a balance disorder including:

  • Ear infection
  • Head injury
  • Medication
  • Low blood pressure
  • Eye/Vision problems
  • Arthritis
  • Inner ear condition
  • Brain disorder
  • Weak muscles or bones
  • Aging

Proper balance is important to daily living.  A good sense of balance helps us bend over without falling, rise from a chair without tumbling, turn without tipping over, and walk without stumbling. Balance is critical to maintain our independence and enjoy our daily life. Good balance functions as a result of many systems in our body working in harmony. The eyes, ears (vestibular system), and sense of surroundings, when working properly together, help us to stay upright. These tell the brain how to work with our musculoskeletal system and maintain balance.

The CDC (Center for Disease Control) says one-third of adults over 65 fall each year and among those even older, falls are the leading cause of injury related deaths. As we age, our sense of balance can deteriorate, however, there are some simple things we can do to slow the process.

balance with chair

  • Keep moving. One of our physicians’ favorite phrase is “motion is lotion”. Exercise is, indeed, our best defense against many conditions.
  • Build balance. Try standing on one leg for 30 seconds, increasing your time each day. Stay close to a counter or table for support.
  • Biking helps bone density and strengthens your muscles to help avoid falls.
  • Proper stretching of your calves will build strength and stability in legs and feet.
  • If you’re able, plank exercises help build your core.

With any exercise program or even increasing your daily activity, it’s advisable to consult your physician first and discuss any limitations you might have. At Sarasota Orthopedic Associates, we take care of your bones, joints, tendons, and muscles. Click HERE to learn more about us.

This entry was posted in on December 1, 2015 by sarasotaAdmin.