Watch Out on the Slopes

Skiing is great. Until you have actually ridden a chairlift to the summit of a slope, looked out over the dazzling whiteness, and sped to the earth under your own power, you cannot truly appreciate the allure of the slopes.

But skiing is also dangerous. We know this already: it remains one of the most common culprits for orthopedic injuries in the U.S.. This is particularly true during the high season when more Americans hit the mountain for the very first time – and the mountain hits them back.

That season is now extending, thanks in part to shifting climate patterns which have kept the snowpack high at a number of top slopes across the country this year. More families are finding time to ski than ever before, which means more injuries are appearing late in the spring season.

The best advice for kids and families is also the simplest – exercise caution:

“Because of the high speeds that are traveled, it can go from a mild injury – bruises and sprains – to severe fractures that require surgery or head injuries that lead to bleeding in the brain,” says Dr. Zaslow, in a statement. She said novice skiers and snowboarders are less likely to have mastered the skills needed to avoid obstacles and fall down safely.

I have seen a number of major ski injuries at my San Diego orthopedic surgery offices, and I can tell you that you want to avoid living with that kind of pain. Seek good instruction, stay within your skill level, and reach out to a skilled sports medicine expert if you have any concerns about the way you ski.

Let’s Slash Pediatric Sports Injuries

The numbers are in, and they are suitably grim: three-and-a-half millions kids ages 1-13 are treated for sports injuries every year. Many of these are minor scrapes and bruises, but many are not: far too many kids continue to sustain life-altering injuries to their ligaments, muscles, and brains.

As these numbers permeate the national consciousness, more people have begun stepping up to demand a standardized set of safety protocols that would apply across all the major youth sports. A task force has already begun drafting these very guidelines, and recently published some of the goals they are setting for the project:

The guidelines cover creating emergency action plans for sudden cardiac arrest, catastrophic brain and neck injuries, exertional heat stroke, potentially life threatening medical conditions, environmental issues such as lightning and access to medical services.

Ultimately the guidelines should also cover some of the injuries that I treat every day as a pediatric orthopedist in San Diego: sprains, strains, tears and breaks. Although there are some safety protocols built into various leagues, a definitive set of guidelines that cover broad issues such as sports specialization and mandated rest should be baked into the charter of every kids’ league nationwide.

To protect your kid from lasting sports injuries, visit the best pediatric sports medicine center in San Diego. Start with AOSM.

New Ways To Treat Carpal Tunnel Syndrome

Acupuncture works. This is hardly a controversial statement anymore, as a wide array of rigorous medical testing have supported the efficacy of this ancient treatment.

But until recently, a controversy continued to rage over whether acupuncture worked as a placebo, or as a true therapy. Many people believed that acupuncture worked because people want it to, rather than because it provides any meaningful medical benefit.

Now a new study seems to put this objection to bed. It includes a randomized set of patients with three options – two tiers of acupuncture, and a control that received “sham” acupuncture, i.e. a simulacrum of the real thing. The results:

All three groups found relief from pain, but both of the true acupuncture groups showed measurable physiological improvements in pain centers in the brain and nerves, while sham acupuncture did not produce such changes. Improvement in brain measures predicted greater pain relief three months after the tests, a long-term effect that placebo did not provide.

Consider this one more arrow in the quiver of orthopedic professionals for treating carpal tunnel syndrome. As a San Diego orthopedic surgeon, I am always scouring the literature for new or old ways to offer my patients lasting relief from the pain of a repetitive stress injury. Studies such as this one help me provide better care.

Want to learn more? Contact the carpal tunnel experts at AOSM here today.

Take Two Aspirin and Skype Me in the Morning?

Telemedicine is having a moment. Although the notion of medical treatment from afar has been around since at least the dawn of the telephone, the recent rise of high-quality webcam and phone connections has accelerated the conversation.

Skype, the leader in consumer-grade video conferencing, is leading the pack. As more patients take advantage of video hookups to seek care, more clinicians are getting comfortable with the notion of providing some basic diagnosis and self-care instruction through an online connection.

But does it help?

A recent study pitted Skype support against print materials only, in a cohort of Australian adults with chronic knee pain. The results were clear:

Participants in the group with the video conference calls reported significantly more pain relief and physical function than those in the other group at three months. At nine months, these improvements had been sustained.

The jury is still out on whether Skype support helped because it encouraged better workout and therapy habits, or because the personal touch involved was simply more enriching for patients than working alone. Either way, it’s a clear win for the tele- set.

If you want the best help for knee pain in person, contact the expert knee doctors at AOSM today.


Prevent Repetitive Stress Injuries with Dr. Holland

As one of the premier orthopedic surgeons in San Diego, I put a lot of focus on prevention. Many of my patients are world-class athletes and soldiers, but many more are office workers, teachers, musicians, and parents. These low-impact jobs can nonetheless have a high impact on the joints, tendons, muscles, and bones they use every day.

We are coming up on International Repetitive Stress Injury Awareness Day, a worldwide event designed to focus attention on these slow-moving but deeply damaging injuries. The event raises awareness for injuries of the neck, back, hands, elbows, shoulders, and wrists. Basically any body part that can be hurt by overuse in an unnatural or stressful position.

The most basic and important thing you can do to prevent RSIs is to create better working conditions: proper posture and support for office drones, and better lifting and gripping protocols for manual laborers. Also, rest:

Prevention of RSIs should focus on eliminating repetitive work through job design which may involve mechanizing certain tasks. In addition, jobs should be structured so that workers can rotate between different tasks, using different muscles groups.

The San Diego Orthopedic Surgery Center offers superior treatment for RSIs and their precursors. Better help is just a phone call away. Call us and prevent a life-altering repetitive stress injury today.

This Old Rotator Cuff

Rotator cuff problems are all around us. More than two million patients are treated each year for these injuries, a significant percentage of which are gradual rather than traumatic in origin.

The simple fact is that the human shoulder can give way on its own, without a lot of help.

When the four muscles that comprise the rotator cuff start to tear, the pain and mobility issues can become chronic. This injury can be caused by repetitive movements, poor conditioning, even sleeping in the wrong position. But it is uncommon among young people, and more common in their older counterparts:

The blood flow to the rotator cuff diminishes as people age, leaving it susceptible to injury and tearing. . . .Studies show that as a patient’s age increases into the late 60s and 70s, the reliability of a tendon healing declines.

It’s something to watch for, even if it’s not something that you can reliably prevent. Exercise and stretching certainly help, and trying a varied and healthful diet never hurts either. But if you want to hit the slopes or the gym on a daily basis, and you are over 50, be aware that cool-down time and plenty of rest are more important than ever as you age.

For the best rotator cuff surgery and treatment in San Diego, contact Dr. William Holland today.

Good News for Stem Cell Treatment on Elbows

One of the perennial questions faced by professional baseball pitchers is how long they will be able to do what they do. Pitching is extremely traumatic on the joints and ligaments of the shoulder and elbow, a fact which has led to many calls for limiting the pitch count of younger players.

But once a player is in the big leagues, he doesn’t have the luxury of sitting a few games out when he’s tired. Pros face all the same health issues as younger athletes, and the consequences can be punishing. When joints give out entirely, pitchers have traditionally been faced with two prospects: Tommy John surgery, or retirement.

But platelet rich plasma (PRP) may represent a Third Way, one which extends careers without extending time in recovery. As the Los Angeles Angels’ Garrett Richards recently discovered, the bounce-back can be astoundingly swift:

Instead of electing to undergo standard Tommy John surgery, Richards decided to try to heal his injury by getting an injection of stem cells directly into his elbow. . . . Gross, but it apparently worked. Passan reports Richards is feeling great and throwing 98 mph at spring training. Richards is clearly pleased with the tentatively positive outcome: “Science, bro. I’m a believer now,” Richards told Passan.

This isn’t the same response that everyone will have, of course. But it is an encouraging sign for this still-novel procedure, one that could soon be a common treatment for elbow pain that helps athletes young and old heal faster and play longer.

Got Knee Pain? You Might Be Able To Skip the MRI

Magnetic Resonance Imaging (MRI) is one of the most powerful tools that we orthopedic surgeons have in our repertoire. Because MRIs offer a more granular image of the body’s internal structures, including blood flow and soft tissues, it is the preferred diagnostic tool for most orthopedic cases.

But x-rays are making a comeback. Far older and more limited than MRIs, x-rays nonetheless offer valuable information to orthopedists and other specialists, at a fraction of the cost. Sometimes that information suffices for diagnosis and treatment of knee pain, rendering the MRI redundant at best:

While magnetic resonance imaging (MRI) is widely used by doctors to diagnose problems like torn knee ligaments and cartilage, a study in the September 2016 issue of the Journal of the American Academy of Orthopaedic Surgeons found that a simple x-ray may be a better diagnostic tool as it helps reduce time and cost.

The full study addresses the question of how often an MRI provides actionable information beyond what an x-ray has revealed; the answer is, not much. In many cases an x-ray can suffice on its own, saving patients a needless hassle while expediting the treatment of their knee pain.

The San Diego Orthopedic Surgery Center at AOSM boasts state of the art technologies for diagnosing and treating the most stubborn cases of knee pain in San Diego. To set up your own appointment with the best knee doctors in Southern California, call today.

Gentle Stretches for Treating Knee Pain

Although knee pain can have many causes, one of its universal issues is that treatment can be even more painful than the underlying problem.

Most people who have engaged in vigorous physical therapy for knee pain due to a torn ACL, MCL, or meniscus, know the particular agony of exercising a joint that is already inflamed. Yet these patients find themselves in a Catch-22, because doing nothing can cause the joint to stiffen up and heal improperly.

The Today Show recently published a video that could help. It covers the basic of some very gentle knee stretches that you can do at home, without unnecessary exertion or extended cool-down routines:

The American Orthopedic Sports Medicine Center (AOSM) offers the most modern and minimally painful therapy for chronic knee pain in the San Diego area. Please contact the offices today for an appointment.