The anterior cruciate ligament (ACL) is a ligament on the inside of the knee joint that connects the tibia to the femur. The function of the ACL is to prevent the tibia from shifting forward on the femur. ACL injuries are common during sports activities. Often, tears result from a non-contact twisting injury. Sports such as soccer and football are especially high risk. Female athletes are three to four times more likely to suffer an ACL injury than males. Unfortunately, the ACL rarely heals on it's own. Because the healing potential of the ACL is low, repair of the damaged ligament is often not possible. In older individuals, a torn ACL can sometimes be treated non-surgically. In young, active patients surgery is typically recommended to reconstruct the injured ACL. This can be done arthroscopically as an outpatient in most cases. The most common options to reconstruct the ACL are the middle third of the patellar tendon, the hamstring tendons, or a cadaver tendon. All of the reconstruction options have pluses and minuses, and this is something your surgeon can discuss. Potential complications of surgery include knee stiffness, infection, DVT, and retear of the new ACL. Fortunately, retear of the ACL is not common, occurring approximately 5-10 percent of cases. After surgery, patients are typically in a brace for several weeks. Physical therapy starts several days after surgery and will likely continue for several months. Typical time to return to sports activities is six to eight months.
A concussion is a type of traumatic brain injury caused by a bump, jolt, blow, or hit to the body that causes the brain to move rapidly back and forth in the skull. The sudden movement causes chemical changes in the brain, sometimes stretching and damaging brain cells.
Though concussions are usually not life-threatening, the effects can be serious. Signs and symptoms generally show up soon after the injury and include the following signs; appears dazed and confused, forgets instruction or play, unsure of game, positions, or opponent, moves slowly, loses consciousness, mood or personality changes. Symptoms the athlete may report include headache, nausea, vomiting, balance problems, dizziness, blurred vision, sensitivity to light or noise, confusion, difficulty concentrating, "not feeling right".
It is important for an athlete to be removed from the game, practice, or activity immediately and not return if signs or symptoms of a concussion are present. It is also important to have an experienced physician evaluate the athlete and monitor them in the weeks following the injury and guide the return to activity. If you need to have someone evaluated for a possible concussion, Ortho Urgent Care Sports Medicine at our office is open Monday through Thursday 8am to 8pm and Friday from 8am to 5pm.
Most concussions are not life-threatening, but there are times when a concussion requires immediate and urgent evaluation. If the following danger signs or symptoms are present, please take your child to the emergency room or call 9-1-1.
One pupil larger than the other, drowsiness or inability to wake up, headache that gets worse or dose not go away, slurred speech, weakness, numbness, decreased coordination, repeated vomiting or nausea, convulsions or seizures, unusual behavior, increased confusion, restlessness, agitation, loss of consciousness (passed out/knocked out).
Our Sports Medicine physicians have expertise in managing concussions, including utilizing SCAT5 and ImPACT testing and making return to play decisions in collaboration with parents and athletic trainers.
A fracture is a break in the bone that typically occur after a trauma, such as a fall, hit, accident, or injury. It may cause significant pain, swelling and deformity to the limb. The break can be stable or unstable depending on the severity of the break and how the bones have moved. X-rays are used to identify broken bones and check the alignment. Some fractures require surgery to realign the bones, other times the bones can be adjusted without surgery. Casts are typically used for 4-12 weeks depending on the location.
If the bone breaks in such a way that bone fragments stick out through the skin, or a wound penetrates down to the broken bone, the fracture is called an "open" fracture. This type of fracture is particularly serious because once the skin is broken, infection in both the wound and the bone can occur and should be treated immediately.
Our Ortho Urgent Care Sports Medicine physicians are partners with Orthopaedic Surgeon and Physical Medicine and Rehabilitation physicians and can direct you to the right care quickly.
A stress fracture is an overuse injury. It occurs when muscles become fatigued and are unable to absorb added shock. Eventually, the fatigued muscle transfers the overload of stress to the bone causing a tiny crack called a stress fracture. At times, the bone can become irritated but not actually crack, which is a stress reaction. These tend to occur in the lower extremity bones that are weight bearing. They are more common in athletes performing repetitive activities, like running.
A stress fracture typically is painful with activity and improves with rest. It is identified based on physical exam, history, and x-rays. It sometimes requires further imaging, including MRI or a bone scan to diagnose.
Treatment includes rest from the triggering activity, usually for about 6-8 weeks depending on the location of the stress fracture. There are some bones that are more difficult to heal and can cause long term problems if not treated with adequate rest.
Prevention is key, especially in high risk sports. Be sure to increase activity incrementally, especially at the beginning of the season. Incorporate crosstraining activities like biking, elliptical, and swimming. Maintain a healthy diet with adequate vitamin D and calcium. Use appropriate footwear, especially good running shoes that fit your foot type. If you develop pain, take a few days of rest and if the symptoms are not improving, see your sports medicine provider.
Ortho Urgent Care Sports Medicine at our office is open Monday through Thursday 8am to 8pm and Friday from 8am to 5pm.
Growth plates are found in the long bones of the body—the bones that are longer than they are wide. Most long bones in the body have at least two growth plates, including one at each end. Growth plates are located between the widened part of the shaft of the bone (the metaphysis) and the end of the bone (the epiphysis). The long bones of the body do not grow from the center outward. Instead, growth occurs at each end of the bone around the growth plate. When a child is fully grown, the growth plates harden into solid bone. During stages of growth, the growth plates are the "weakest link" and can become injured more easily.
The growth plates can be injured traumatically and have breaks through them. These will be diagnosed with x-rays and examination. The treatment depends on the location and severity of the fracture, but usually involves immobilization with a cast for a period of time.
Growth plates are also susceptible to overuse injuries. Tendons attach near many of the growth plates and can pull on the growth plates during periods of growth and can cause pain. This is common at the tibial tuberosity in the front of the knee, called Osgood Schlatter's, the back of the heel, called Sever's, and many other locations in the upper and lower extremities.
There are many possible causes of back pain in active individuals, including muscle imbalances, postural issues, stress fracture, slipped vertebrae, facet joint pain, or disc herniation. In younger athletes, is is more unusual to have back pain and this should be evaluated by a physician to rule out other causes.
Arthritis is a condition that causes joint inflammation, swelling, and pain. The condition occurs when the lubricating cartilage in the joint wears away, leaving irregular cartilage and bone to rub against bone causing pain. This condition is common in people over the age of 50, but can start at younger ages. Several diseases can result in arthritis, but trauma and rheumatoid disease are the most common causes in the ankle.
Knee conditions or injuries that affect your ability to exercise or participate in sports:
Foot and ankle conditions or injuries that affect your ability to exercise or participate in sports:
Shoulder and arm conditions or injuries that affect your ability to exercise or participate in sports:
Platelet rich plasma, usually referred to as "PRP", is an injection of your own blood into an affected tendon or joint that promotes natural growth factors to heal the area. This is a cutting edge non-invasive treatment option that can be effective for many common conditions. It creates long term healing by promoting naturally occurring growth factors to the area and stimulate the healing process.
PRP is a concentration of platelets and growth factors that are created from a small amount of your own blood. The blood is spun in a machine that separates the platelets and concentrates them to about 5 times the normal amount, which promote healing and contain growth factors.
Your health care provider will draw a small amount of blood from your arm. The blood is then placed in a centrifuge and rapidly spun to separate and concentrate the platelets and growth factors from the other blood cells. The platelet rich layer is then injected into the tendon or joint.
Speak with one of our doctors today and ask if this treatment may be an option for you. It is not currently covered by insurance and is paid for out of pocket.
TenJet is a non-surgical intervention that targets and treats the source of chronic tendon pain or tendinosis. It uses a specifically engineered needle that "powerwashes" the area, removing debris and scar tissue, while leaving the healthy tissue unharmed. It also promotes recruitment of healing growth factors to the area. It is a procedure performed in the surgery center with light sedation in approximately 15 minutes.
Frequent areas of tendon pain that can be addressed with TenJet include rotator cuff or shoulder pain, golfer or tennis elbow (medial or lateral epicondylitis), patellar tendon (knee), Achilles tendon, and plantar fasciitis. The TenJet procedure is covered by most insurance providers and performed at the outpatient surgery center.