In this edition of our Orthopedic Anatomy Series: Exploring Your Body from the Inside Out, we look at the causes and treatments of common athletic injuries affecting the knee, shoulder, elbow, ankle and other parts of the body.
Our panel of five OrthoCarolina sports medicine specialists partnered with the education experts at Experience Anatomy to discuss these injuries in-depth and answer audience questions in real-time.
Bryan M. Saltzman, MD, is a surgeon specializing in cartilage restoration, knee, shoulder, elbow, and sports medicine at OrthoCarolina's Cartilage Restoration Center, Sports Medicine Center and University office.
James S. Starman, MD, is a surgeon specializing in cartilage restoration, knee, shoulder, elbow, sports medicine and trauma at OrthoCarolina Winston.
In this overview, Dr. Bryan Saltzman, MD, of OrthoCarolina Sports Medicine Center highlights what he sees in his practice when it comes to sports injuries and what your next steps might be moving forward when consulting an orthopedic surgeon.
CASE STUDY – PHYSICAL THERAPY FOR SPORTS INJURIES
Physical therapist Chris Gabriel of OrthoCarolina Sports Training Center highlights a few therapy techniques for the most common sports injuries in the knee and shoulder.
Our panel of sports medicine specialists addressed audience questions during an open Q&A.
Watch the complete Q&A discussion from 29:23 – 1:06:44. Q: What can I do to prevent future knee injuries? Are there are types of vitamins or supplements I can take?
Chris Gabriel - There is not a lot of good evidence of supplements. A good diet and proper food intake are going to mainly prevent injuries. As far as what you can do, there is a lot of injury prevention out there. Most are to prevent ACL injuries, so you can look up the PEP program, sports metrics, Fefa. They focus on sharing materials for the proper warm-up to make sure of our mechanics. Warming up is really really key to minimizing injury.
Q: Have you seen an increase in ACL, Achilles tears and other injuries occurring when the inside ankle bone is low due to overpronation of the ankle? Dak Prescott's latest injury is an example.
Dr. Morgan- Overpronating is common. We see it in runners often. It would be best to go to a proper shoe or foot and ankle specialist to be sure you are getting into the proper foot attire in order to prevent injuries.
Q: Can a rotator cuff tear be healed or strengthened without surgery?
Dr. Saltzman - The ability to deal with a rotator cuff tear without surgery is something that is really lacking with our bodies and our biologies. However, not every tear is the same. Largely speaking, rehabilitation can help the body compensate better with a tear but not always.
Q: Would you recommend stem cell therapy for ligament tears or injuries in general in lieu of extensive surgeries?
Dr. Opalacz - PRP can be great in certain circumstances, especially for tendons. However, they do not replace any surgeries. For example, for an ACL tear, a PRP injection cannot replace an ACL surgery. There are studies that look at whether PRP or stem cells can help enhance the healing process. There are definitely certain benefits to using these, but no, they do not replace actual surgery. They can augment for overuse injuries.
Q: Why do I have muscle cramps and spasms after exercise? Is this an injury risk or warning sign that I'm already injured?
Dr. Starman - There are a lot of different factors that can come from this question. I think a lot depends on the specifics of the person and injury. Having a trial of rest and anti-inflammatories is a great way to start.
Q: What is the difference between a sprain and a strain?
Dr. Saltzman - It’s a little bit more semantics than anything. A strain is going to happen at some degree of injury to a tendon or unit. A sprain is going to be some degree of injury within a ligament.
Q: How long should I rest after a sprain?
Dr. Opalacz - It varies with everyone and the degree of the injury. Typically, I will have a sprain patient rest for two days. Generally, the more you stay off of it, the longer you will have pain symptoms and decreased range of motion. I do like to get people up and moving right away. Like most, we utilize the acronym RICE: Rest, Ice, Compression, & Elevation. All are key components to dealing with a sprain.
Q: How can I treat an overuse injury?
Chris Gabriel - A lot of times our athletes just need rest. It’s a lot harder to do in season, but I try to fully try to educate the kids, parents and coaches to make sure our athletes are getting the rest they need for their bodies. We are starting to get there with pitch counts in baseball, and I think it’s something we are looking at more. We make sure to educate the athletes on best practices on how to rest, having good food intake, etc. Planning rest during the offseason is very crucial.
Q: Am I more at risk of injury in cold weather?
Dr. Morgan - There are some concerns with cold weather. We’ve hit on one of them being the importance of warming up. Some of the basics are there is decreased blood flow in the bloodstream and a decrease in powerful muscle contractions. Warming up and staying warm is very important. Hats and gloves can help. Asthma athletes should use protection over their face as well as have their inhalers. One thing I feel that may be forgotten in the colder months is to be sure to hydrate. Drink plenty of water and fluids. After activity, be sure to get out of the sweaty clothes and change into dry clothes can help. Lastly, making sure the surfaces that we are playing on are free of debris and safe to play on.
Q: At what point should you have an old sports injury looked at after it has been repaired? Should you wait until it hurts every day or is it better to be seen when it bothers you during certain activities?
Dr. Starman - There are some warning signs. These would consist of persistent swelling of the joint and mechanical symptoms like popping or locking of the joints. If you experience these symptoms frequently, it would be recommended to have another evaluation completed.
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For acute orthopedic injuries after scheduled clinic and urgent care hours, please utilize the HURT! App, in partnership with OrthoCarolina, for fast free access to orthopedic advice with a response time of ~4 minutes. Download here.