Monday, March 31, 2014

Eickhoff's Extras: New In the News



A new study demonstrated that young athletes who are highly specialized in one sport and undergo intense training are at significantly higher risk of severe injury.  It is thought that a developmentally immature body cannot handle the physical stress of specialized, intense training. 

Some of the study findings included:
  • “Young athletes were more likely to be injured if they spent more than twice as much time playing organized sports as they spent in unorganized free play – for example, playing 11 hours of organized soccer each week, and only 5 hours of free play such as pickup games.
  • Athletes who suffered serious injuries spent an average of 21 hours per week in total physical activity (organized sports, gym and unorganized free play), including 13 hours in organized sports. By comparison, athletes who were not injured participated in less activity – 17.6 hours per week in total physical activity, including only 9.4 hours in organized sports.”
The author of the research offers the following tips to reduce the risk of injuries in young adults:

-“Do not spend more hours per week than your age playing sports. (Younger children are developmentally immature and may be less able to tolerate physical stress.)
-Do not spend more than twice as much time playing organized sports as you spend in gym and unorganized play.
-Do not specialize in one sport before late adolescence.
-Do not play sports competitively year-round. Take a break from competition for one to three months each year (not necessarily consecutively).
 -Take at least one day off per week from training in sports.”


Jennifer Eickhoff, FNP-BC, MSN, ATC, LAT

Disclaimer:
There is a fine line between blogging and giving medical advice. The content of this blog is for informational purposes only and should not be construed as medical advice.  Nothing contained in this blog is intended to replace the medical advice of a trained, licensed physician.
In all matters relating to your health, you are urged to consult a physician. You can contact Advanced Bone & Joint to set up a formal consultation appointment with Dr. W. Anthony Frisella, Dr. Dane Glueck, Dr. Brandon Larkin, Dr. Anthony Lombardo, Dr. John McAllister, II, Dr. Brian Meek, Dr. Paul Spezia, Jennifer Eickhoff, FNP-BC, or Matt Pliske, PA-C

Monday, March 24, 2014

Eickhoff's Extras: New In the News



A new study showed that patients with knee pain who took glucosamine for six months had no difference in pain, function, or changes in their knee structure on MRI follow up.  Currently more than 1 in 10 adults use glucosamine and in 2010 sales were over 2 billion dollars.    Right now there is no medication to decrease or reverse the damage to cartilage.  Save your hard earned money and focus on diet and exercise to help with arthritis pain.  Talk with your provider to see if injections, therapy, or bracing  would be a good choice for you. 

Jennifer Eickhoff, FNP-BC, MSN, ATC, LAT
Kwoh C, et al "The joints on glucosamine study: the effect of oral glucosamine on joint structure, a randomized trial" Arthritis Rheum 2014; DOI: 10.1002/art.38314.ed 2013 Dec 26; 369:2515 

Disclaimer:
There is a fine line between blogging and giving medical advice. The content of this blog is for informational purposes only and should not be construed as medical advice.  Nothing contained in this blog is intended to replace the medical advice of a trained, licensed physician.
In all matters relating to your health, you are urged to consult a physician. You can contact Advanced Bone & Joint to set up a formal consultation appointment with Dr. W. Anthony Frisella, Dr. Dane Glueck, Dr. Brandon Larkin, Dr. Anthony Lombardo, Dr. John McAllister, II, Dr. Brian Meek, Dr. Paul Spezia, Jennifer Eickhoff, FNP-BC, or Matt Pliske, PA-C

Monday, March 17, 2014

Eickhoff’s Extras: New in the News



Swedish researches are looking into a blood test to confirm concussions, and also predict if the symptoms will
be persistent.  The research shows that the protein total tau in the blood becomes elevated and can be seen on blood work even after one hour of experiencing a concussion.

While this research is still a long way before it is incorporated into clinical practice, it is interesting to see and may be the future for concussion care

Jennifer Eickhoff, FNP-BC, MSN, ATC, LAT


Monday, March 10, 2014

Eickhoff’s Extras: New in the News



Patients with meniscal tears and no arthritis in the knee may not need surgery.  New research shows that with time and physical therapy, many patients with non traumatic meniscal tears do get better without surgery. 

Jennifer Eickhoff, FNP-BC, MSN, ATC, LAT

Sihvonen R et al. Arthroscopic partial menisectomy verses sham surgery for a degenerative meniscal tear. N Engl J Med 2013 Dec 26; 369:2515

Monday, March 3, 2014

from the Doctor's Desk: So my knee cap has moved... Doctor, what do I do now?



Patellar dislocation (kneecap) tends to happen in a younger patient with a plantar flexed foot in a rotation maneuver to the upper thigh.  For instance, someone golfing with the lead leg can hit a long drive, torquing his upper extremity, and the patella can sublux, which means partially slide out, or completely slide out, dislocate laterally.  This can also happen with slips and falls and is certainly not the privilege of young athletic individuals. 

 
What are the symptoms?
 
1.     Pain and deformity of the patella. 
2.     Weakness of the leg.
3.     Difficulty in flexing the leg with it dislocated.
4.     Inability to bear weight.
5.     Swelling and instability.

Treatment:  Relocation of the patella is paramount and then placement into a knee immobilizer is what normally would take place in the emergency room setting.  Followup with an orthopedist is the norm. 
 
Things that I look for with a patellar dislocation.  You will have swelling and we sometimes will take the blood that is in the knee joint out for pain control.  MRIs are commonly obtained along with plain films.  These are to determine if there is persistent subluxation of the patella or if there are fragments of cartilage and bone that have been knocked off.
 
Not all patellar dislocations need to be treated surgically; however, if there is bony damage that is noted, then arthroscopy and perhaps even open repair of the torn ligament would be recommended.  Acute patellar dislocations that are treated non-operatively that re-dislocate are an operative candidate in my view.
 
There are certain congenital abnormalities that predispose some patients to patellar dislocation such as a shallow trochlear groove or ligamentous laxity.  These are treated differently.

The Essential Lesion:  The medial patellofemoral ligament has now become the mainstay
for treatment in patellar dislocations.  Acutely one can attempt to repair this; however, there are times that if it is stretched out, then we need to replace with a tendon.  This tendon is normally a hamstring autograft or allograft.  This would be harvested at the time of surgery and secured into the patella and the femur, giving us a static checkrein.  Rehab is remarkably fast for this debilitating injury with surgery of this type.

If you have this problem and would like to know more, the Academy of Orthopedic Surgery website can be accessed or you can make an appointment to see sports medicine physician, Dr. Paul M. Spezia.

Paul M. Spezia,D.O.

Disclaimer:
There is a fine line between blogging and giving medical advice. The content of this blog is for informational purposes only and should not be construed as medical advice.  Nothing contained in this blog is intended to replace the medical advice of a trained, licensed physician.
In all matters relating to your health, you are urged to consult a physician. You can contact Advanced Bone & Joint to set up a formal consultation appointment with Dr. W. Anthony Frisella, Dr. Dane Glueck, Dr. Brandon Larkin, Dr. Anthony Lombardo, Dr. John McAllister, II, Dr. Brian Meek, Dr. Paul Spezia, Jennifer Eickhoff, FNP-BC, or Matt Pliske, PA-C