Heads Up Michigan!
Youth sports concussion education and awareness are essential to ensuring the overall health of our student-athletes. Oakwood Healthcare has been involved in promoting the education/awareness initiative for over a year, joining collaborative forces with several key organizations to do so.
Today, there is legislation being introduced in both the House and Senate to make it mandatory that an athlete see a physician following a concussion and before returning to participation – this is a good thing. 35 other states have already passed into law similar legislation.
We Specialize In You is more than a tag line – our communities, our student-athletes and their families matter.
A special thank you goes to Barbara Semakula, MD for leading the charge!
Last fall, a high school football sophomore learned that seconds count with a sports injury. During a varsity football game, the athlete sustained a knee injury and had to leave the game. He was evaluated onsite immediately by a physician and certified athletic trainer, thanks to an outreach sports medicine program offered through Oakwood Healthcare System. March is National Athletic Training Month and having an emergency plan for first aid is one of the National Athletic Trainers Association’s recommendations for injury prevention.
The injured athlete was given crutches and scheduled to see an orthopedic physician the following Monday, where x-rays confirmed that he had chipped a bone under his knee cap.
Arthroscopic surgery was scheduled for the following day. Arthroscopic surgery involves a lighted probe with a microscopic magnifying lens that is inserted into a large joint through a tiny incision. The image is displayed on a monitor to help direct the orthopedic surgeon to the exact site of an injury. The football player completed rehabilitation in three and a half weeks and played in the final game of the season.
Oakwood Sports Medicine benefits over 1,500 student-athletes each year. The program was developed several years ago in conjunction with Lawrence Morawa, MD, an orthopedic surgeon at Oakwood.
“I’ve been involved with this program for 25 years,” said Dr Morawa. “The athletic training program has worked very well. Our goal is to determine the extent of an injury right away.”
Oakwood athletic trainers begin their work early in August with the fall sports teams through the middle of June when school lets out. They spend several hours each day attending practices, evaluating injuries, performing rehab for those that need it and also attending home events.
“We assess the severity of the condition to determine the specifics of the injury,” said Jeff Kline, ATC and director of Oakwood Sports Medicine. “Through the evaluation process we can determine if it is an injury where an athlete can return to play or if they need further examination by a physician, or in the event of severe or life-threatening conditions, treatment in the emergency department. We are concerned with the quick and safe return of the athlete after an injury.”
According to Kline, there are several benefits to having an allied healthcare professional onsite at the high schools.
“The coaches defer to the athletic trainer for injury assessment and parents have an advocate looking after their kids. We are an access point to gain quality health care.”
Soft tissue injuries in athletics are common and occur with greater frequency as the level of competition increases (youth>>high school). Sprains, strains and contusions are the most common injuries seen across all sports, regardless of level of participation.
A sprain denotes an injury to a ligament; a strain refers to a muscle injury and a contusion is better defined due to the way it happens (mechanism of injury), which is by direct contact with another player, the ground, equipment or other object and can affect muscles, bones and ligaments.
Contusions are the second most common injury in athletics, behind strains. Nearly all athletes will sustain a contusion (bruise) while involved in athletics. Contact and collision sports will produce several contusions in every practice or event, every day. For this piece, we are talking only about contusions to the area below the knee and above the ankle, typically from being hit by a puck or another skater.
Contusions occur when there is direct impact to the body, crushing muscle fibers and blood vessels below the skin’s surface. Contusions cause swelling and pain in the affected area and can also result in loss of range of motion in the surrounding area. When the connective tissue or blood vessels are impacted, they can tear and leak blood and fluid – this is the primary source of the swelling. Depending on the extent of tissue damage, there may be a blueish discoloration at the site of impact.
Most contusions are minor and heal quickly. It is important to have a proper evaluation by an athletic trainer or physician before returning to play as more severe contusions may require further evaluation and treatment.
The goal should be to control pain, inflammation and bleeding by following the (P). R.I.C.E. principal:
P – protect the injured site from further impact by using a high density foam or gel padding. If necessary, remove the athlete from practice or game.
I – apply an ice pack for no more than 20 minutes. Repeat application every 2 hours.
C – using a compression wrap or bandage, wrap the affected area.
E – always elevate the injured area to a level higher than the heart. This will aid in fluid reabsorbtion and promote healing.
Continue to follow the PRICE principals for the first 48-72 hours following injury. Once it is safe to return to play, continued protection of the injured site may be necessary.
In hockey, following a lower leg contusion, the worst scenario when returning to the ice is to be struck in the injured area again…and again. If the shin pads do not adequately provide protection, then the use of a high density foam or gel padding is necessary. If the shin pads adequately cover the affected area but the pressure from wearing the pads is uncomfortable, apply a doughnut type pad to the area underneath the pads.
This year’s Oakwood University: Joint Class 101 has been a great initiative and successful. Oakwood looks to continue Joint Class into 2012.
Tonight is the last Joint Class of 2011. If you would still like to attend, call 543.WELL or register at www.oakwood.org
Thank you for your support and we look forward to seeing you in 2012!
Ankle sprains are the most common musculoskeletal injury seen by primary care physicians. Female basketball players are at a higher risk than other sports and overall, football, soccer and basketball have a higher incidence of injury. Approximately 85% of all ankle sprains affect the lateral aspect, or the outside ankle ligaments; the remaining 10% and 5% are syndesmotic injuries and medial injuries respectively.
WHAT TO DO?
Here are 4 simple steps to take if you have injured your ankle:
1. REST – Cease activity for the rest of that day – unless you have immediate access to qualified sports medicine professionals (like an athletic trainer or sports medicine physician), making those return-to-play decisions on your own is not advisable.
2. ICE – Apply ice bag or frozen vegetables to the injured area every 2 hours for 20 minutes at a time. Continue to use ice application for the first 24-48 hours. As an alternative, you can immerse the foot/ankle into cold water 12.7ºC (55ºF) for no more than 8-10 minutes every 2 hours.
3. COMPRESSION – Use a compression or ACE wrap, not only around the ankle itself, but start from the toes and wrap up past the ankle to about boot-top high.
4. ELEVATION – Elevate the injured leg/ankle above the level of your heart.
During the initial, most painful period of time following an ankle injury, consider the use of crutches. This will provide adequate “rest” of the injured part – similar to using a shoulder sling or wrist brace – and for the student-athlete, make it much easier to get around the school or campus.
If you have gross deformity (not caused by edema or swelling), specific bone tenderness (Ottawa Rules) or the inability to bear weight immediately after the injury occurred, seek treatment from your doctor’s office. Most ankle sprains (some studies indicate ~85%) do not require an x-ray.
Early, gentle range of motion exercise can usually begin the first day following the injury. Examples include ankle pumps (moving the ankle as if you were pushing on the gas pedal) and drawing the alphabet in small letters with the big toe. Repetitions should be performed in the most pain-free range available.
A guided progression to more advanced exercises and ultimately preparing for a return to sporting activities follows once range of motion improves, a reduction in swelling is observed and you are able to walk normally without crutches.
To find a Oakwood Sports Medicine specialist, visit www.oawkood.org/physicians.
Oakwood neurosurgeon Kenneth Casey, MD will join top experts from around the country to teach high school coaches and athletic directors how to prevent deaths and serious injuries among high school, college and professional athletes.
Dr. Casey will present Concussions Occur in the Classroom, on the Playground and in the Game on June 19 in Grand Rapids.
New research shows even low-level shocks to the head can cause concussions
The number of concussions being diagnosed in the U.S. is rising, in part because doctors and qualified healthcare providers are better able to recognize the symptoms. The public and the media are also more aware of the issue after several high-profile athletes have been sidelined by concussions or had their sports careers ended.
Dr. Casey has been involved in concussion-related healthcare at the national level. He has a special interest in creating an injury registry around youth athletics – using raw injury data from the Oakwood Sports Medicine efforts. No such database exists in Michigan.
Neurocognitive Concussion Testing
Neurocognitive testing is now available through Oakwood’s Sports Medicine program.
Neurocognitive testing is used to find out about a person’s thinking abilities and to determine whether these problems are improving or getting worse. For sports-related concussions, this test is administered via computer and helps the physicians, psychologists, athletic trainers and other licensed healthcare professionals to assist them in determining an athlete’s ability to return to play after suffering a concussion.
Learn the facts
To learn the facts about concussions, services offered or schedule a visit with an Oakwood Sports Medicine specialist visit oakwood.org.
Do you have shoulder, hip or knee pain? If so, Oakwood’s Joint Class 101 may be the first step to living with less pain and more mobility.
Jeff Kline is Oakwood’s director of sports medicine and he’ll give us an overview of Joint Class 101, which is part of Oakwood’s Ortho University. Listen to Jeff Kline talk about Oakwood’s Ortho University.
Fred Goethe didn’t know what to do.
For about three weeks, the 63-year-old Canton resident had been bothered by nagging pain in his hip that made it difficult to sleep and get around as well as he used to. Goethe decided he needed to find out what caused the ache as well as what to do about it and, after a little research, found himself in the first Joint 101 class sponsored by Oakwood Healthcare. He said he’s glad he did.
“It was very educational,” he said. “I was really impressed with it.”
One part, lecture, one part question-and-answer period and one part informal evaluation, Joint Class 101 brings orthopedic specialists, family doctors and physical therapists to small groups of people concerned about lingering pain in their hips, knees or shoulders. The free class allows time for the physicians to talk about issues and potential treatments, along with time for audience members to ask specific questions. They break up into small groups so attendees have some individual time with the doctors, too. Mary Zatina, senior vice president of government relations, corporate planning and communications for OHI, said the goal is to inform, not recruit.
“People make better health care decisions when they are equipped with information. Our physicians know a great deal about the anatomy of the human body, the causes of joint pain and the many options for addressing joint pain. Through Joint Class 101, a panel of physicians and therapists will share their extensive knowledge in simple terms that everyone can understand,” she said.
“Joint pain can be a serious quality of life issue and we want everyone to know exactly what their options are so they can resume active lives without the pain,” she added.
There are a wide variety of treatment options available, anything from injections to over-the-counter medicine to physical therapy or major or minor surgery. Sometimes, changing shoes is all that’s necessary to alleviate a chronic pain, according to Karen Weaver, MD, a family doctor who was a member of the initial panel of experts.
A 46-year-old attendee who leads an active lifestyle wanted to find out the best way to eliminate the arthritis that impacted both his knees. He was concerned about the stigma associated with total joint replacement—as well as how well the replacements would hold up. Dr. Eric Silberg, an orthopedic specialist and surgeon had this advice: don’t let age be a factor in considering things like knee replacement or physical therapy.
“I always tell people that I would happily trade active years in their 40s for active years in their 70s or 80s,” said Silberg. “Even professional athletes work with physical therapists—and they couldn’t be more active.
“Age is not a factor—it’s your health and spirit,” he added. “It’s really about quality of life and if you want a better quality of life.”
The Joint 101 classes are free and will take place every two weeks, either at the Oakwood Hospital & Medical Center (OHMC) in Dearborn or at the Oakwood Southshore Medical Center (OSMC) in Trenton. They will feature a moderator along with primary care physicians, surgeons or physical medication and rehabilitation (PM&R) physicians talking about a variety of joint-related issues as well as a question and answer period. Attendees can expect plenty of information in language that is easy to understand.
The next class is from 6-7:30 p.m. on April 21 at the OSMC in Trenton. The next Dearborn class is from 6-7:30 p.m. on April 28 at OHMC. For more information or to register, call (800) 543-WELL or visit www.oakwood.org.
The Oakwood Sports Medicine program is designed for anyone who is physically active. Whether you’re a senior maintaining an active lifestyle, a weekend warrior, or a sports enthusiast or experience athlete, your individual needs are as diverse as the activities you pursue. When you suffer an injury, it can disrupt your daily routine and the activities that keep you fit.
Oakwood Sports Medicine has been providing outreach services to the communities we serve since 1986. The importance of having access to a certified athletic trainer is immeasureable.
Our team is comprised of orthopedic and sports medicine physicians, physiatrists, family physicians, pediatricians and athletic trainers. Our interdisciplinary approach to care includes:
- Injury evaluation
- Patient education
- Timely evaluation and management of orthopedic conditions
- Progressive rehabilitation of injuries
As an organization, Oakwood has always worked toward improving the health of the communities we serve.