Concussion Symptoms: Diagnosis and Treatment in Athletes

Concussion Definition

A concussion is a type of injury to the brain that results from some sort of trauma to the head. This type of injury usually results in temporary symptoms, however, there are sometimes lasting effects impacting memory and concentration. Whether the trauma results from a contact sport like hockey, soccer or football; a car accident; or a fall, the symptoms can have a significant impact on your daily life

Symptoms:

Depending on the severity of the concussion, there are a number of symptoms that can occur. In addition, there can be a delayed onset in some symptoms, making it tricky to diagnose. Some of the most common symptoms of a concussion can include:

  • Headache
  • Loss of consciousness
  • Ringing in the ear or ears
  • Nausea
  • Vomiting
  • Feeling drowsy or fatigued
  • Feeling dizzy
  • Experiencing blurred or double vision
  • Confusion
  • Memory loss
  • Feeling disoriented
  • Sensitivity to light and noise
  • Disrupted sleep patterns
  • Slurred speech
  • “Feeling “dazed” or “seeing stars”
  • Feeling in a “fog” or “underwater”

Individuals with a concussion could experience one or more of the above symptoms. In addition, some of the symptoms may be delayed. Therefore, it is very important to monitor a person that has suffered a head trauma to recognize any new or worsening symptoms and to seek diagnosis and treatment if necessary.

Athletes in Contact Sports

Certain types of contact sports could put athletes at a higher risk for concussion. The highest incidence of concussion in sports occurs in football, soccer, hockey, basketball and rugby. Further, athletes that have experienced a concussion are more likely to sustain additional concussions.

Treatment and Steps to Recovery

  1. Rest and avoid risk for additional head trauma.
  2. Return to light activity first as symptoms leave.
  3. Resume moderate activity when symptoms are mostly gone.
  4. Return to regular activity when all symptoms are gone and do not return with physical activity.

 

 

 

 

 

Knee Replacement Recovery: What to Expect

Is a Knee Replacement Right For You?

If you are contemplating a knee replacement, there are likely several factors you are considering in deciding on this type of surgery. You are probably thinking about the procedure itself, the risks, benefits and recovery process. Experiencing chronic pain in the knee and limited range of motion can impact your quality of life and ability to do daily activities. Climbing stairs, getting up from a seated position and even walking can be extremely difficult for someone with arthritis in the knee, a worn out joint or certain knee injuries. For this reason, knee replacement can seem like a great option.

What is a Knee Replacement?

During a knee replacement, an orthopaedic surgeon will make an incision above the knee, replacing damaged bone and cartilage with metal and/or plastic parts. This procedure is fairly common and will typically last for about 15 to 20 years. Patients that undergo a knee replacement can often benefit from an improved quality of life, significant decrease in pain and improved mobility.

What to Expect During Recovery

If you are contemplating a knee replacement, there are a number of considerations to keep in mind. Once you understand the procedure, you will want to know what to expect in the days, weeks and months after the surgery. The average recovery time for this procedure is six months, however, returning to rigorous physical activity can take up to twelve months for some patients. Age, weight and overall health are factors that can impact recovery timelines. For the first several weeks, you may need assistance walking including the use of a walker or crutches.

One of the risks associated with knee replacement surgery is a developing a blood clot. To help avoid this complication, it is best to try to get up and walk soon after surgery, using assistance or crutches. Wearing compression socks and taking blood thinners after surgery can also decrease the likelihood of a blood clot.

Physical therapy will be a key component of recovery after surgery. This will begin immediately after surgery but the duration and frequency of physical therapy can vary widely from one person to another. Some people will need up to four months of physical therapy while others will not need therapy beyond six or eight weeks.

If you are considering a knee replacement, it is important to discuss the risks and benefits with your orthopaedic surgeon. Making a list of questions prior to meeting with your doctor is a great way to assure you get all of the information you need to make an informed decision.

 

Knee Injuries: Common Orthopaedic Signs and Symptoms

Knee Injuries

Knee Injuries are some of the most common orthopaedic injuries. The knee is a complex joint that supports the entire body and takes on a lot of daily stress. No matter your activity level, weight or age, your knees are susceptible to injury.

Types of Knee Injuries

Some of the most common types of knee injuries include fractures, dislocations, sprains and tears. Ligaments, tendons and the meniscus are components of the knee that can easily sustain an injury. If experiencing knee pain or instability, it is important to get the appropriate diagnosis in order to determine the right course of treatment.

  • Meniscus tears are often the result of a twisting, pivoting or a cutting motion. This is a common sports injury but can also result from arthritis or a fluke motion while trying to get up from a seated position.
  • Knee fractures typically occur from a motor vehicle accident or falling from a significant height. Types of knee fractures include patellar fractures, distal femur fractures and proximal tibia fractures.
  • Tendon tears involving the patellar tendon or the quadriceps tendon are common in people who play sports that involve running and jumping. Direct force to the front of the knee can also result in a tear of one of the knee tendons.
  • Knee dislocations occur when bones of the knee are forced out of place. These injuries can result from sports related contact, a fall, or a motor vehicle accident.
  • Anterior cruciate ligament injuries most often occur while playing a sport such as soccer, football or basketball. The injury typically results from landing incorrectly or changing direction rapidly.
  • Posterior cruciate ligament injuries occur frequently from trauma to the front of the knee, while the knee is bent. This type of injury is common in motor vehicle accidents and sports.
  • Medial collateral ligament injuries are typically contact injuries that are caused by a direct blow to the outside of the knee.
  • Lateral collateral ligament injuries are less common as they result from a blow to the inside of the knee, pushing it outwards.

Symptoms and Treatment

With such a variety of injuries that can occur in the knee, it is clear that proper evaluation and diagnosis are key in finding the correct treatment. If you are suffering from knee pain that doesn’t subside or worsens over time, it is important to be evaluated by an orthopaedic surgeon. Swelling as well as  inability to bend or straighten the knee are also signs that you may have one of the above injuries. Some injuries will require surgery but others may heal on their own or with physical therapy.

Overuse Injuries: Prevention for Youth Athletes

Overuse Injuries in Athletes

Orthopaedic surgeons have seen an increase in the occurrence of overuse injuries in children over the past several years. This shift has been associated primarily with youth athletes.  The trend to specialize in a single sport at a young age has certainly contributed to the rise in overuse injuries in this population.

Overuse injuries occur when an individual uses the same muscle groups and applies stress on specific areas of the body repeatedly. The pressure to compete can push athletes to overtrain. In addition, without an appropriate amount of rest in between, the likelihood of injury increases even more.

Some of the most common overuse injuries involve the knee and the foot. The lower body tends to take on the most impact. In addition, shoulder and elbow joints suffer from repetitive motion in certain sports. Muscles, ligaments, tendons, growth plates and bones are at higher risk in children as their bodies are still growing.

Common Overuse Injuries

  • Stress Fractures result from repetitive force commonly in weight bearing bones of the leg and foot.
  • Shin Splints, also known as medial tibial stress syndrome, cause pain and discomfort on the front part of the lower leg.
  • Runner’s Knee is typically experienced as pain felt between the knee cap and thigh bone.
  • Iliotibial Band Syndrome is commonly found in runners, weightlifters and cyclists. This lateral pain can be frustrating for athletes as it can be slow to heal.
  • Achilles Tendonitis is an injury that causes an acute pain in the back of the ankle.
  • Plantar Fasciitis is a very common injury of the feet that is caused by inflammation of the soft tissue in the bottom of the foot.

Injury Prevention

If you have a youth athlete, one of the best ways to help avoid overuse injuries is by diversifying their sports participation. Avoiding specialization at an early age can decrease the likelihood of these types of injuries. Another way to help prevent injury is increasing rest time to allow growing bodies to recover in between games and practices. Pushing hydration and a healthy diet is another great way to help prevent injury. Consult an orthopaedic surgeon if you think your child is suffering from an overuse injury.

Elbow Pain: When to see an Orthopaedic Surgeon

Elbow Pain

Elbow pain can feel like an inconvenience when it begins to interfere with your daily activities. Often time will ease the discomfort. However, elbow pain can be more serious than just a nagging distraction. So how do you know when to see an orthopaedic surgeon for an assessment and when to trust that time and rest will be enough?

Causes

The elbow is a complex joint made up of bones, cartilage, nerves and ligaments. Elbow pain can be caused by a number of different things. Overuse is one of the most common causes of  this type of injury. Doing a repetitive motion such as throwing, lifting or swinging can produce wear and tear on the joint, resulting in pain.

In addition to overuse injuries, other reasons for experiencing pain in your elbow joint include, arthritis, a strain or sprain of the joint, a fracture, a dislocated elbow or trapped nerves. All of these issues can produce pain but the severity can vary significantly. Just as there are many different causes for this type of pain, there are different methods of treatment depending on the diagnosis.

When to See an Orthopaedic Surgeon

If your pain is keeping you from performing daily activities, it is possible that the injury needs medical attention. Trying to care for your elbow pain at home with rest, ice, compression and elevation (R.I.C.E.) can often times be enough. However, when the pain does not subside with these approaches, it is likely necessary to see an orthopaedic surgeon. If you are experiencing severe pain, swelling and bruising or are unable to fully extend and/or bend your elbow, it would be beneficial to get in to see a doctor. If your pain increases over time, an orthopaedic surgeon could help determine the best treatment plan. When in doubt, it is always wise to rule out anything serious by making a trip to see your doctor.

Yoga and Orthopaedic Injury Prevention

Practicing Yoga

Yoga has many proven benefits. From mental to physical, you can improve many aspects of life no matter your age or ability level. If you already incorporate yoga into your weekly routine, you likely experience the many benefits this exercise has to offer. But did you know how important this practice be for injury prevention?

Benefits

It is no surprise that exercise can help with overall health and emotional wellbeing. But certain types of exercise have specific benefits that supplement fitness routines like weight training, running, swimming and cycling. Whether you are an athlete or an individual with a low level of physical activity, yoga can offer many advantages.

  • Stretching techniques can ease lower back pain and improve mobility
  • Increased flexibility can help avoid injuries such as strains and overuse injuries
  • Increased muscle tone and core strength can help reduce back pain and injury
  • Improved balance which can prevent falls

Injury Prevention

Orthopaedic injuries can range in severity from a slight sprain to a complex fracture. Some of these injuries are unavoidable but others can be prevented with a little proactive exercise. Many of the benefits of yoga directly impact your body in ways that help prevent injury. Slow movements and stretching combined with deep breathing can warm up your muscles. Incorporating this routine into your daily life, even if for a brief duration of time, can help prevent injury.

An increase in your overall flexibility is important in injury prevention. Along with improved flexibility comes an increase in range of motion. These two benefits go hand-in-hand when it comes to preventing orthopaedic injury as they allow your body to better move in unexpected ways. This is especially important when it comes to preventing falls.

By building muscle through yoga, your are providing your body more stability. A regular routine of yoga will help you improve functional strength by moving numerous muscles and joints at the same time. In addition, yoga helps to strengthen your connective tissues like ligaments and tendons, helping to prevent the likelihood of strains and sprains.

Improving overall balance by focusing on core strength, yoga can decrease the possibility of injury from a slip or fall. This becomes increasingly important and people age.

Starting a Yoga Routine

As with any other type of exercise program, it is always recommended that you consult your doctor first. There is a wide variety of types of yoga and finding the right one for you is essential.

Spondylosis: Stress Fractures of the Spine in Contact Sports

Spondylosis

Stress Fractures are a common occurrence in competitive athletes. Spondylosis is a specific type of stress fracture that can develop in the vertebrae of the spine. Typically, this injury will occur in the lumbar area of the spine. This injury can cause a great deal of lower back pain. While spondylosis can develop for no reason in about 5% of youth, it is commonly associated with repeated stress on the lower back.

Causes

There can be a variety of reasons for developing spondylosis, sidelining the individual for quite some time. Trauma to the lumbar spine from a fall, a hit in a contact sport, or overuse are some of the most common causes for this type of stress fracture. What may develop as a very small fracture can continue to worsen as the athlete attempts to play through the pain. Additional trauma to the fracture can lead to further injury.

Symptoms

Spondylosis is a condition that can be tricky to identify. Because some of the symptoms can mimic other issues, it can be easy to put off seeking and evaluation and waiting for conditions to improve. The following are often symptoms of spondylosis:

  • Lower back pain that may mimic a muscle strain
  • Pain the the buttocks area
  • Pain the the thigh region
  • Tenderness or stiffness in the lower back
  • A sensation of unexplained tightness in the hamstrings

Treatment for Spondylosis

Spondylosis can be diagnosed with the use of x-ray, MRI or a CT scan. Once Spondylosis has been diagnosed, it is important to follow the directions of a physician such as an orthopaedic surgeon fellowship trained in spine. The most challenging part of the treatment is having patience and letting the fracture heal. This can be difficult for young, competitive athletes. The following treatment strategies are often effective in healing spondylosis without surgical intervention:

  • Rest/time off from sports
  • Physical therapy
  • Core exercises approved by a certified trainer or physical therapist
  • Training to increase flexibility
  • Over the counter medications to aid in pain relief and swelling

If your adolescent is suffering from lower back pain that is interfering with daily activities or participating in sports, it could be beneficial to see an orthopaedic surgeon to assess for any issues with the spine. If a stress fracture is the culprit, it is important to know as soon as possible to avoid any further damage.

Bone Bruises and Fractures: Diagnosis and Treatment

Bone Bruises Vs. Fractures

Orthopaedic trauma can occur in many ways. Bone bruises and fractures are two very common types of injuries that can cause significant pain and restrict activity. However, treatment for these two injuries can look very different.

From an unexpected fall to a forceful impact during a sport, there are endless ways to sustain a substantial bone injury. Bone bruises and fractures are common injuries that can cause pain, swelling and limited range of motion. With many similarities in symptoms, it may be tricky to determine how serious the injury is. Getting a proper diagnosis after suffering an orthopaedic injury is key to getting on the road to recovery.

Bone Bruises

Bones bruises, also known as bone contusions, are similar to bruises of other tissue in your body. When the area suffers a trauma, the small blood vessels of your bone tissue are damaged. This damage isn’t enough to show up on an x-ray, it is more of a “micro-fracture.”

Symptoms of Bone Bruises

  • Pain, sensitive to touch of the injured area
  • Bruising to the skin
  • Swelling
  • Stiffness of the joint
  • Palpable lump under the skin
  • Joint inflammation

Treatment for Bone Bruises

  • Rest the injured body part
  • Ice the injury periodically throughout the day
  • Elevate the impacted area above heart level to assist with decreasing the swelling
  • Take a medication such as acetaminophen to reduce swelling and pain

Fractures

When a fracture to the bone occurs, a visible crack in the bone will appear on the x-ray. This makes the diagnoses of a fracture a bit more straightforward. Symptoms of fractures are very similar to those of a bone bruise. Pain, swelling, tenderness of impacted area can all accompany a fractured bone. The best way to determine whether or not a fracture has occurred is to consult with an orthopaedic surgeon immediately. In some cases fractures can be treated with a cast however, in some cases, surgery is required. Determining the diagnosis quickly is the best bet for getting the appropriate treatment plan as soon as possible.

Shoulder Pain and Injury Illustration - © Agility Orthopedics

Shoulder Pain: When to See and Orthopaedic Surgeon

Living With Shoulder Pain

Are you living with chronic shoulder pain? Have you been avoiding meeting with a physician in fears that your pain might be something more serious? It is common to put off seeking treatment in hopes that pain will subside on its own. But how can you determine the difference between temporary pain and and an issue that requires medical intervention?

Signs You Should Consult an Orthopaedic Surgeon:

  • Your pain is accompanied by swelling or redness
  • Your shoulder joint is tender to the touch
  • Your shoulder joint appears to be deformed or abnormal
  • You are unable to move your arm away from your body
  • Your pain increases over time
  • Your pain has lasted more than a few weeks
  • Your pain prevents you from doing daily activities or disrupts your sleep
  • Methods of self care such as rest, ice and use of pain relievers do not decrease pain

*If shoulder pain occurs in addition to tightness in the chest or labored breathing, you could be experiencing a heart attack. Call 911 immediately.

Causes of Shoulder Pain

If you are experiencing pain in your shoulder, you may or may not know the source of the discomfort. If you have experienced an acute injury, you have a better understanding of the source of your pain. However, shoulder pain can often develop slowly over time leaving the sufferer with a lot of questions about the source and solution of the problem. There are a number of reasons for sustained pain in your shoulder joint.

  • Bursitis
  • Rotator cuff injury or tear
  • Damage to your labrum, joint lining or ligaments resulting in shoulder instability
  • Frozen shoulder (adhesions in the shoulder joint resulting from underuse)
  • Arthritis
  • Broken collar bone
  • Brachial plexus injury

If you are trying to determine whether or not to consult an orthopaedic surgeon for your pain, know it is often better to air on the side of caution. Be sure to prepare for your appointment by considering the right questions to ask.

 

Cortisone Injection: Risks and Benefits

Cortisone Injection

Are you suffering from pain and swelling in your tendons, muscles, bursa or joints? You might be seeking a treatment option that can alleviate the pain quickly without an invasive procedure. If so, a cortisone injection may be one of the options you are considering.

What is a cortisone injection? A cortisone injection, often referred to as a steroid injection, is a shot of medicine used to target a specific part of the body to reduce inflammation and pain. This intervention can offer fast-acting relief to muscles, joints or tendons. The side effects of this type of treatment a generally mild however, it is beneficial to weight the risk to benefit ratio before deciding if this is the best option for you.

Benefits of a Cortisone Injection

  • Intervention provides fast-acting results ranging from a few hours to a few days for noticeable relief.
  • Patients often report experiencing minimal discomfort.
  • Often covered by insurance
  • Can be administered in your orthopaedic surgeon’s office

Risks/Side Effects

  • Pain around the injection site
  • Bruising around the injection site
  • Temporary facial flushing
  • Nerve damage
  • Joint infection
  • Temporary elevated blood pressure

Consultation

So how do you determine if getting a cortisone injection is the best treatment option for you? Consulting with an orthopaedic surgeon about your treatment options is the best way to make a decision. Prior to your consultation, prepare a list of questions to help gather the best information. Some helpful questions may include:

  • What is your success rate with an injection for my particular injury/orthopaedic issue?
  • How much downtime should I expect after receiving the injection?
  • Is there anything I need to do in preparation for this procedure?
  • Will this procedure be covered by my health insurance?
  • How long can I expected to wait for the injection to begin working?
  • What is the duration for the results to last?
  • Are there any particular side effects I could expect knowing my medical history?