Common Cycling Injuries

Article featured on UR Medicine

What Are the Most Common Cycling Injuries and How Can They Be Prevented?

Knee Pain

The knee is the most common site for overuse injuries in cycling. Patellofemoral syndrome (cyclist’s knee), patella and quandriceps tendinitis, medial plica syndrome, and iliotibial band friction syndrome are a few of the more common knee overuse injuries. The first four injuries mentioned involve pain around the kneecap, while the last condition results in outer knee pain. Shoe implants, wedges beneath the shoes, and cleat positions may help prevent some overuse injuries.

Head Injuries

One of the most common injuries suffered by cyclists is a head injury, which can be anything from a cut on the cheek to traumatic brain injury. Wearing a helmet may reduce the risk for head injury by 85 percent. The majority of states have no laws governing the use of helmets while riding a bicycle, but helmets are readily available for purchase and typically low in cost.

Neck/Back Pain

Cyclists most likely experience pain in the neck when they stay in one riding position for too long. An easy way to avoid this pain is by doing shoulder shrugs and neck stretches that help relieve neck tension. Improper form also leads to injuries. If the handlebars are too low, cyclists may have to round their backs, thus putting strain on the neck and back. Tight hamstrings and/or hip flexor muscles can also cause cyclists to round or arch the back, which causes the neck to hyperextend. Stretching these muscles on a regular basis will create flexibility and make it easier to maintain proper form. Changing the grip on the handlebars takes the stress off of over-used muscles and redistributes pressure to different nerves.

Wrist/Forearm Pain or Numbness

Cyclists should ride with their elbows slightly bent (never with their arms locked or straight). When they hit bumps in the road, bent elbows will act as shock absorbers. This is also where changing hand positions will help reduce pain or numbness. Two common wrist overuse injuries, Cyclist’s Palsy and Carpal Tunnel Syndrome, can be prevented by alternating the pressure from the inside to the outsides of the palms and making sure wrists do not drop below the handlebars. In addition, padded gloves and stretching the hands and wrists before riding will help.

Urogenital Problems

One common complaint from male riders who spend a lot of time riding is pudendal neuropathy, a numbness or pain in the genital or rectal area. It is typically caused by compression of the blood supply to the genital region. A wider seat, one with padding, a seat with part of the seat removed, changing the tilt of the seat, or using padded cycling shorts will all help relieve pressure.

Foot Numbness and Tingling

Foot numbness and tingling are common complaints, and shoes that are too tight or narrow are often the cause. In addition, foot numbness can be due to exertional compartment syndrome. This arises from increased pressure in the lower leg and resulting compression of nerves. The diagnosis is made by pressure measurements and is treated with surgical release.

When Should I Seek Care From a Physician?

Any injury that is accompanied by bleeding, severe pain, loss of sensation, or increased weakness should be seen by a physician. Other pain due to overuse or mild injuries can be treated by rest and taking pain relievers such as ibuprofen or acetaminophen. Swelling and pain can also be treated with alternating ice and heat therapy.


New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Common Spring Injuries: Causes & Prevention

Article featured on Atlanta Spine Institute

Common Spring Injuries: Causes & Prevention

The winter is finally behind us. Spring means warmer weather, chirping birds, and unfortunately, injuries. Although we encourage being active in the spring, it’s important to be mindful of common spring injuries and make an effort to prevent them. So what are the most common spring injuries? Keep reading to find out.

Walking and Running

You may walk and run far more in the spring than the winter. This is particularly true if you prefer to exercise outside. When you start to walk or run outside in the spring, take things slowly. Realize that your body needs time to adjust and may have difficulty adapting to the wind and terrain at first. Once you’ve walked or ran for a few weeks, you can pick up the pace and increase the intensity.

Also, wear running shoes that fit you properly and offer good support. By following these tips, you can reduce your risk of injuries like runner’s knee, piriformis syndrome, plantar fasciitis, shin splints, and stress fractures.

Gardening

When you think of gardening, you may picture yourself relaxing outside while growing your favorite plants and produce. The reality, however, is that gardening can be risky and raise your risk of injury, especially if you ignore proper safety precautions. Here’s why: Every time you dig, rake, or weed, you’re engaging in repetitive movements and can face some severe back pain and posture issues.

To lower your chances of gardening injuries, dress in protective clothing, wear gloves, and refrain from sitting on your knees. In addition, don’t be afraid to break every once in a while. There’s no reason to “push yourself” and risk injury just so you can complete your gardening tasks faster. Your health and safety should be your top priority.

Sports

There are a variety of sports you may play once the spring season hits. Golf, baseball, and tennis are a few examples of spring sports that often lead to spring injuries. These sports involve repeatedly moving your shoulders, elbows, and arms. They may cause overuse injuries like wrist fractures, shoulder dislocations, muscle strains, and ankle sprains. To prevent them, stretch and warm up before games and practices, wear proper shoes, use the correct technique, and rest your muscles as much as possible.

Fortunately, most spring injuries can be treated with conservative measures like rest, medication and physical therapy. In some cases, however, surgery may be required. The good news is surgical intervention is almost always effective.


New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Winter Injuries That Can Be Avoided With These Helpful Tips

Article featured on Orthopedic Institute of Pennsylvania
If you’ve experienced an injury or pain while performing a wintertime activity, you are not alone. Personal injury during winter is likely to occur from performing simple activities, especially if you aren’t prepared to prevent an incident. From your back, shoulder and neck to joints and knees, pain and injury in these areas are commonplace during the winter.
The good news? Preventing winter injuries is possible, and you can enjoy the season without unnecessary pain and stiffness. Read on to discover information about winter back injuries, winter shoulder injuries, and — most importantly — health and safety tips to avoid any orthopedic winter injuries.

What Are the Most Common Winter Injuries?

Winter weather conditions bring with them a variety of potential risks for personal injury, as well as injury to others. Some of the most common winter incidents that lead to personal injury include:

  • Falling on ice and snow
  • Experiencing muscle strain from shoveling snow or scraping ice off the car
  • Driving and motor vehicle collisions
  • Accidents while playing winter sports and activities

Not all incidents will cause severe injury, but some winter accidents can be quite serious, especially for certain age groups and for people suffering from previous injuries.

SLIPPING AND FALLING ON ICE AND SNOW

Slipping and falling on ice can be a scary experience. Ice can be difficult to see both at night and during the day. What looks like water pooled on the pavement can actually be a sheet of ice. You could step off the curb and right onto a slippery ice patch. When this happens, severe injury can occur if you fall to the ground. You may be able to recover and only skid briefly, but even if you don’t end up falling, you can wrench your back or experience another kind of injury in your attempt to recover.
Anyone is in danger of injuring themselves by falling or slipping on ice or snow, but seniors are especially at risk. In fact, according to the CDC, falls are the leading cause of injury among older Americans, and winter weather conditions only exacerbate that concern.
There are a variety of potential injuries that can occur from falls on ice, but the most common include the following:

  • Bruises
  • Head or brain injuries, including concussions
  • Ankle strains and twists, and other kinds of muscle sprains and ligament strains
  • Broken bones, most commonly hip and wrist fractures
  • Back injuries, including spinal compression fractures
  • Injuries to the spinal cord

Prevention is always the best method to avoid a slip or fall on icy days, and there are a few things you can try to keep you and your family safer:

  • Wear proper footwear made for icy and snowy conditions.
  • Keep your stride shorter and avoid long steps.
  • Slow things down — try not to rush or run outdoors.
  • Keep de-icer or sand on hand for when things get slippery around your house.
  • In case of injury, always have your cell phone handy.
  • If you need to do outdoor chores, take your time and don’t hurry.

Unfortunately, even with the best preventative measures, accidents happen. Skeletal and muscular issues arise every winter when people fall on ice or snow. If the fall is serious, you may need to call 9-1-1 or go to the ER immediately.
However, some people are unaware that they have a severe injury. This may be because they don’t feel the effects of the fall immediately, or they believe their pain and discomfort will pass with time. Symptoms like pain or swelling should not be ignored, and it’s important to seek the advice of a medical professional to assess your condition.
If you experience an injury on the ice or snow, whether it’s from slipping and falling or from attempting to prevent a fall, make an appointment with a specialist as soon as possible to determine if there is a serious injury. They will also be able to offer an effective treatment plan that meets your individual needs.

SHOVELING SNOW

One of the most loathsome winter jobs is shoveling the driveway and sidewalk. It can take a long time and require a lot of physical exertion. The low temperatures make the task of shoveling snow even more unpleasant. The repetitive actions of twisting and lifting while shoveling can cause severe strain on the body. All it takes is one muscle to be pulled the wrong way for your back, neck or shoulders to seize up.
Snow shoveling can be a potentially risky duty that can cause severe injury. A national study found that over the course of eleven years, there was an average of 11,500 emergency room visits due to snow shoveling injuries. The most common injuries reported were soft tissue injuries mostly to the lower back region. Among the remaining injury reports, lacerations and fractures were also reported, including injuries to the hands, arms and head.

DRIVING AND COLLISIONS

Most of us must continue to work and carry on with our normal, everyday activities even in snowy winter weather conditions. But if you aren’t prepared for winter driving conditions and don’t take the proper safety precautions, you can put yourself and others at risk. A study found that over a period of ten years, there were over 445,000 people injured as a result of weather-related vehicle collisions. The winter weather brings with it all kinds of potentially hazardous road conditions, such as:

  • Wet pavement
  • Sleet and slush
  • Full coverings of snow and ice

FALLING OR COLLIDING DURING WINTER ACTIVITIES

One of the most enjoyable parts of winter is the fun you and your family can have with all kinds of winter activities and sports. From ice hockey and skating to skiing and snowboarding, there are plenty of ways to stay active and have fun in the winter. For kids especially, sledding and tobogganing are some of the best childhood memories of their winter seasons.
These winter activities can be quite risky if you aren’t practicing safety. Falls and collisions in many winter activities can cause several forms of injury. Broken bones and stiff muscles and joints are some of the most frequently reported injuries when it comes to outdoor sports and activities. Running outdoors along the sidewalk or on trails can also pose safety risks if the pavement isn’t salted and the trails aren’t properly cleared.

TYPES OF WINTER INJURIES

These incidents produce various types of injuries, which can range from mild and easily treatable to severe and long-term. Some of the resultant injuries from these winter accidents most commonly include:

  • Head injuries
  • Shoulder injuries
  • Back injuries
  • Neck pain and tension
  • Knee joint pain and soreness
  • Wrist sprains
  • Elbow fractures and dislocation
  • Ankle sprains and strains
  • Hip fracture and soreness

HEAD INJURIES

Head injuries occur during the winter as a result of any number of incidents. Most commonly, falling on ice and hitting your head on the pavement can lead to a potentially serious brain injury. If this occurs, it will need immediate treatment by a physician. A brain injury can be difficult to treat, and often the symptoms won’t be noticed until long after the injury has occurred.
Head injuries can occur during winter activities like tobogganing, snowboarding and skiing, or one can also occur as a result of a motor vehicle collision, which has the potential to lead to serious long-term health consequences.

SHOULDER INJURIES

Shoulder injuries commonly occur when you fall on icy pavement. When your shoulder meets contact with the hard ice-covered pavement, dislocation can occur. This damage to the shoulder joint can be quite severe and leave you suffering from soreness and bruising for a long time afterward.
A torn rotator cuff can happen as the result of repetitive overhead motions from winter sports or shoveling snow. This muscle tear can leave you feeling sore and stiff and may result in a chronic injury as well.

BACK INJURIES

There are plenty of winter incidents and activities that can cause a back injury. The most common injury associated with shoveling snow is to the back, specifically the lower back. Back injuries can also be the result of a serious fall on the icy pavement or on the stairs. Falls during winter sports and activities can also result in a back injury.
Another common way to injure your back during the winter time is by scraping your car’s windshield to remove ice and snow. The bending and leaning motion your body performs while reaching across to scrape the ice can result in pulled and strained back muscles.
Depending on the level of severity, treating a back injury with heat may help to relax sore muscles. An injury that is caused by a fall on ice may damage your spine, so treatment by a physician will be required.

NECK INJURIES

Like back and shoulder injuries, neck injuries can occur due to a number of different winter incidents. The repetitive motion of shoveling snow can certainly lead to stiffness and soreness in the neck muscles. Neck injuries can also happen when scraping snow and ice from your car’s windshield when your muscles become strained from leaning and reaching.
These injuries can usually be treated with a heating pad to relax tense neck muscles. If a neck injury is caused by a fall or a motor vehicle collision, it should be treated at the emergency room.

KNEE PAIN AND STRAIN

High-impact winter sports can be very damaging to your knees over a period of time. This type of injury usually occurs while performing activities and sports such as skiing and snowboarding, where your knees are absorbing the shock of hard landings. Running outdoors on pavement can also cause a similar injury to your knees. The best thing to do with a knee injury is to take it easy until it heals, avoiding any high-impact activities.

WRIST FRACTURES AND STRAINS

A fall on the icy pavement can cause wrist injuries such as fractures and strains. When you take a fall, your natural instinct is to extend your arms and brace your fall with your hands. The impact of the fall on your hands can cause a severe wrist strain or even fracture.
The result can be a serious injury if not treated properly. Your wrist may heal improperly, which could lead to chronic pain later in life.

ELBOW INJURIES

Like wrist injuries, elbow injuries can also arise from a fall on icy pavement. When you extend your arms to brace your fall, not only do your wrists take the impact but your elbows do as well. Your elbow could become dislocated if the impact is so significant that it pops your bone out of position. Otherwise, a more potentially severe injury could be an elbow fracture. This can lead to long-term pain if not treated properly.

ANKLE STRAIN

Falls on slippery, icy pavement can also cause ankle injuries. When you struggle to recover your balance after slipping on ice, you can easily roll and twist your ankle. This may end up being a muscle injury whereby the tendon has been strained. Otherwise, a certain type of fracture in the ankle bone can result if more impact has been felt. This type of fracture can be caused not only by a fall on iced-over sidewalks, but also due to winter sports injuries.

HIP FRACTURE

Slips and falls on icy roads and sidewalks can result in many different types of broken bones, fractures and injuries. But one of the more severe injuries occurs when a fall is so hard and sudden that it fractures the hip bone. This can be a very difficult injury to repair, and it can also cause chronic, long-term pain. This injury especially affects seniors who are predisposed to osteoporosis or previous hip injuries. This injury should certainly be treated as an emergency by a physician.

Age Groups and Demographics Most Affected

Certain incidents and their resulting injuries may affect certain age groups more than others. It’s important to apply appropriate safety measures, so everyone can stay safe during the winter.

CHILDREN

Children are susceptible to falls. They can easily fall and injure themselves if they can’t reach handrails or don’t have proper balance. If your child experiences a fall, it’s important to first assess their head for any injuries and then check for elsewhere, like wrists and elbows.
Children especially enjoy their time sledding and tobogganing, which can put them at risk for injury. Be sure to always supervise kids during winter activities and provide them with helmets to protect their heads.

SENIORS

Like children, seniors are also at a higher risk of slipping and falling on icy pavement. Seniors can easily lose their footing and take a fall that can put them in severe danger. Seniors who have suffered in the past from hip injuries could further damage their hips or back. Seniors should be accompanied and helped down driveways and across parking lots to ensure they are stable and have the support to walk safely. Seniors with mobility issues may want to consider motorized scooters during the winter months for extra safety precautions.

ADULTS WITH PREVIOUS MEDICAL CONDITIONS

Adults with previous back, neck and shoulder injuries are also at risk to be severely injured in any of these winter incidents. A slip or a fall can trigger a past injury and can cause further damage. Additionally, adults with a predisposition to osteoporosis are also at higher risk for broken and fractured bones if involved in a collision or a fall.

ACTIVE ADULTS

Adults who remain active throughout the winter months are also at greater risk for injuries if proper safety precautions aren’t followed. Adults who ski and snowboard should be advised that, without the proper equipment, they can be at risk for head injuries as well as neck, shoulder, knee and ankle injuries.
People who run in the winter should be advised to use properly cleared and salted trails and sidewalks, so they don’t risk slipping and falling.

WINTER INJURY PREVENTION TIPS

Though many of these winter accidents can be quite common, they are easy enough to prevent by following specific steps.

  • Thoroughly and regularly salt driveways, sidewalks and stairs
  • Walk carefully across parking lots and provide children and seniors with additional support
  • Stretch before performing any physical exercise
  • Stay hydrated while exercising and shoveling snow
  • Ensure proper footing when shoveling snow or scraping ice off the car
  • Wear a helmet and protective equipment during winter sports
  • Always supervise children playing outdoors in the snow
  • Before shoveling or scraping, make sure to properly stretch

Most businesses and shopping centers take precautions to salt their parking lots and sidewalks once winter hits. Even still, patches may be missed or ice may have formed since the last salting. When rushing into stores and shopping centers, slow down and take your time to carefully walk across the parking lot. Look for areas that have been clearly salted or do not appear wet. Hold onto children and seniors to help stabilize them as you walk across the parking lot or driveway and indoors.
For back injury prevention, it is advised to stretch lightly at first, then move into a deeper stretch. If you are going to be shoveling snow, then it’s important to stay well-hydrated and take frequent breaks so as not to exhaust your body and muscles.
When performing winter sports and activities, be sure to always have the proper protective equipment, like helmets, to prevent head and other serious injuries. If you have access to a gym or can use a treadmill at home, it will prevent any risk of slipping and falling while running outdoors during the winter.
If you choose to run outdoors, go with a buddy and be sure one of you carries a cell phone to call for help in the event of an injury. Familiarize yourself with your running route ahead of time to ensure it’s an area that has been salted and cleared of ice and snow.

WINTER DRIVING SAFETY TIPS

Winter weather can make driving more difficult, which means it can put yourself and others at risk of injury. In order to prevent motor vehicle collisions, follow these winter driving safety tips:

  • Have proper winter-grade tires installed on your car
  • Store an ice scraper in your car
  • Keep windshield washer fluid full
  • Have your vehicle inspected, especially breaks
  • Have a winter safety kit in your trunk, including a high-visibility safety vest, gloves and jumper cables
  • Keep a first aid kit in your car
  • Never drive without a cellphone
  • Limit the time spent driving in the dark

WHAT TO DO IF YOU SUFFER A WINTER INJURY

If you or a family member suffers a winter injury, it’s important to first assess the severity level. Sometimes muscle injuries can be treated with ibuprofen and by applying ice or a heating pad (whichever is more comfortable) or taking a warm bath. However, more severe injuries will need to be treated immediately by a professional. If you suspect broken or fractured bones or a head injury, report it to a physician right away, visit the emergency room or visit your orthopedic injury clinic.


New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.
New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.
Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.
If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

How to Prevent Common Sports Injuries

Article featured on Arkansas Surgical Hospital
Most sports injuries result from either overuse of a joint or damaging a joint through tearing or spraining ligaments or muscles.  Some of the most common sports injuries include torn ACLs, shoulder dislocation, torn rotator cuffs, and sprained ankles.  During the late summer months, emergency departments and orthopedic specialists see a sharp uptick in these injuries.  Sports such as baseball, basketball, volleyball, and tennis contribute to the increase in sports injuries.

Sprains

Sprains or strains are the most common sports injury, with ankle sprains affecting 25,000 people every day.  Any sports activity that requires running, lunging, or shifting on your feet can lead to an ankle sprain, which is the stretching or tearing of ankle ligaments.  A strain is damage to the tendons or muscles.  Both cause swelling, pain, and the need to stop using the ankle for a while.
To minimize your risk of ankle sprains, make sure you stretch and warm up properly before any sports activities.  Stretching helps warm up the ligaments and muscles and makes them more flexible.  More flexibility means less chance of overextending the ligaments and causing damage.

Torn ACL

Knee injuries can be devastating to casual exercisers as well as athletes.  The ACL (anterior cruciate ligament) in the knee is one of the major ligaments controlling joint movement and preventing overextension of the knee.  The ACL connects the upper and lower leg bones.  Most torn ACLs are the result of sudden stopping and starting movements or shifts in direction.  They are common in basketball and other sports that may cause the individual to shift balance quickly.  Jumping and landing, as in volleyball, can also cause a torn ACL.  If you are exercising or participating in a sport and hear or feel a sudden “pop” in your knee, you may have torn your ACL.  A torn ACL will cause severe pain, the inability to put weight on your leg, and swelling.
As with any potential sports injury, the first step in prevention is proper preparation.  Stretching and warming up will help prepare the ligament for exercise.  Stretching after workouts will also help keep the joint from tightening up and becoming injured.
Exercising correctly is also crucial.  Practice landing and jumping properly.  Your knees should be straight for jumping and bend when landing.  Try not to twist your knees when you’re jumping or coming back down, which increases stress on the ACL.  Changing directions should also be practiced so you can do it without twisting the knees.

Shoulder Dislocation

A dislocated shoulder has a wide range of symptoms, including deformity of the joints, severe pain, swelling and bruising, instability or locking of the joint.  There may also be weakness, burning, or numbness in the neck or arm.  Some people may experience shoulder spasms that increase the pain.  Unfortunately, there is a 7 in 10 chance of a repeat shoulder dislocation after the first one.  For this reason, it’s imperative to learn ways to prevent it in the first place and minimize the chance of recurrence.
For tennis players and others who rely on their shoulder joint, warm-up and stretching are a good idea, but they should also take the time to strengthen the shoulder joint, so it’s less likely to become dislocated.  Exercises can be as simple as pushing out against a wall with your arm; elbow flexed as though shaking hands with someone.  Repeat this up to 20 times, holding for 5 seconds each time.  Then push the arm and shoulder inward, pressing the bent hand into the opposite palm, repeating 20 times for 5 seconds each time.  Resistance band exercises can also strengthen the shoulder joint, as can working with lightweight dumbbells.
Many shoulder dislocations are the result of falling and catching yourself improperly.  If you do fall, resist the urge to catch yourself with your hands, as this frequently leads to a shoulder dislocation or broken arm bone.  Keep your arms bent close to your body, spinning so that you land on your buttocks or side.  Wearing protective gear on your shoulders can also help prevent repeat injuries.

Torn Rotator Cuff

Fraying or the tearing of rotator tendons in the shoulder is known as a torn rotator cuff.  While physically active people are most susceptible to a torn rotator cuff, you can also sustain a torn rotator cuff even if you are sedentary.  The pain of a torn rotator cuff may be sudden and severe or begin as a nagging pain when using the shoulder for routine activities such as shaking hands, lifting things, putting on clothing, or reaching behind the body.  Severe pain at night due to swelling may interfere with sleep.
Exercise focusing on strengthening the small cluster of muscles in the rotator cuff.  Combine activities that strengthen the entire shoulder area with some exercises specifically for the rotator cuff.  Lower resistance with multiple repetitions is best for strengthening the area.  Keeping the movements small and controlled will also help.

The Takeaway

Increased activity and participation in sports are good for your health, and changes in the weather makes it more enjoyable.  To make sure you can continue to enjoy your activities, the crucial elements are proper warm-up, exercises to strengthen your joints, and knowing how to move correctly to minimize the possibility of injury.  Working on balance and stability is also helpful.  Yoga, tai-chi, and other activities that focus on slow stretching and enhanced, safe movement can help reduce injuries.  Knowing your limits is also essential.  If you haven’t played basketball for a few years, a rigorous game the first time out isn’t a good idea.  You need to relearn how to move safely and make sure your muscles and ligaments are properly toned and warmed up every time you play.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.
New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.
Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.
If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

7 Health Benefits of Swimming

Article featured on verywellfit, Medically reviewed by Vanessa Nzeh, MD

Swimming is the fourth most popular form of exercise in the United States with over 27 million people participating over the age of six.

But there are also many barriers to participating in swimming. For instance, many people don’t learn to swim until later in life and some may experience discomfort or even fear of the water because it’s an unfamiliar environment.

Despite those hurdles, swimming provides a range of unique health benefits. Some people describe the sensation of immersing themselves in water as transformative or healing—and many enjoy the antigravity aspect of floating. There are also many documented health benefits associated with swimming that may inspire you to develop your own program of pool or open water exercise.

Health Benefits of Swimming

Participation in any physical activity—especially on a regular basis—can provide a wide range of health benefits. Regular exercise improves heart health, can help you reach and maintain a healthy weight, reduces your risk of type 2 diabetes and metabolic syndrome, and may even reduce the risk of certain cancers. Exercise can also help you experience sharper thinking, learning, and judgment skills as you age, reduce your risk of depression, and can even promote better sleep. And just a single bout of exercise can provide immediate benefits, including reduced short-term feelings of anxiety.

The water environment and the fact that swimming involves the entire body give it a few unique advantages over other popular activities such as walking, running, or cycling.

Researchers have investigated the many ways participation in different types of swimming can affect the body. It is important to note, however, that just like any physical activity, there are significant differences between participation levels.

For example, lifelong competitive swimmers may experience different health benefits than those who swim for fun just a few times per month. These are some of the findings regarding the health benefits of swimming.

May Improve Body Composition

Swimming may help you to reduce body fat. A small study published in the Journal of Exercise Rehabilitation found that middle-aged women who swam regularly (60-minute sessions, three times per week for 12 weeks) showed an average drop in body fat of almost 3% while a control group (women who did not swim) showed no significant change. The swimmers also showed improved flexibility, cardiovascular endurance, and improved blood lipids.

However, another study examined changes in body composition in younger women who participated in a 12-week swim program. The study involved 34 women in their early 20s who were assigned to a swimming group or a non-swimming (sedentary) group. The swimming group participated in three 60-minute swim sessions per week for 12 weeks.

At the conclusion of the study, researchers found that the swimming group did experience a decrease in hip circumference but did not show significant changes to body composition as compared to the non-swimming group.

Lastly, in 2015 researchers evaluated the psychological, social, and physical health states of competitive swimmers engaged in long-term training. The study took place during four days of the French master championships in 2011. All swimmers selected for the event were invited to take part in the study, but only 490 participated.

May Lower Blood Pressure

A handful of studies have suggested that swimming may help lower blood pressure. One study involved women who had been diagnosed with mild hypertension. Researchers evaluated the effects of different swimming protocols on their blood pressure.

For the study, 62 women were randomly assigned to participate in high-intensity swimming (6–10 repetitions of 30-second all-out effort interspersed by 2 minutes of recovery), moderate swimming (one hour at moderate intensity), or a control group (no training or lifestyle changes).

After 15 weeks, researchers saw no changes in the control group. But both the high intensity and moderate swimming groups saw a decrease in systolic blood pressure. Both groups also decreased resting heart rate and body fat.

Several other studies have also found associations between swimming for exercise and lower blood pressure, especially in people with hypertension.

Reduced Risk of Musculoskeletal Injury

Exercise physiologists have noted that many popular sports and leisure activities require a certain level of technique and can involve impact with the ground leading to bruises, contusions, bone fractures, and more serious injuries. This can make the high risk of injury a point of weakness for many traditional sports and athletic activities.

However, in at least one published review, researchers point out that the probability of these types of injuries taking place in a low-impact swimming environment is minimized given the fact that weight is reduced through the use of the water’s buoyancy.

Fewer Respiratory Infections

If cold weather swimming appeals to you, participation in this extreme sport may help you to avoid upper respiratory tract infections and gain other health benefits.

Also called “winter swimming” or “ice swimming,” the sport involves swimming in cold to ice-cold water, most often in water below 5 °C (41 degrees Fahrenheit). Ice swimming used to be practiced only by extreme athletes, but has grown in popularity and now recreational swimmers compete regularly in both local and international events.

Scientists who published a 2020 study in the International Journal of Environmental Research and Public Health reviewed studies related to ice swimming. They found that regular participation was associated with improvements in hematological and endocrine function (including decreased blood pressure, decreased triglycerides, and better insulin sensitivity), fewer upper respiratory tract infections, relief from mood disorders, and a general sense of well-being.

The researchers note, however, that only experienced swimmers in good health should participate in the sport. They state that “there is a risk of death in unfamiliar people, either due to the initial neurogenic cold shock response or due to a progressive decrease in swimming efficiency or hypothermia.”

If cold weather swimming sounds too extreme, you may still be able to gain better respiratory health with traditional pool swimming. A 2016 study published in the International Journal of Yoga compared the health effects of swimming to yoga.

Also, swimmers who participated in the 2015 study at the French Masters had greater peak expiratory flow values which suggested improved lung function.

Improved Health Perception

In 2015, a group of researchers investigated how different levels of participation in swimming might affect the health perception of middle-aged women. In their report, the study authors write that health perception is important in the way we manage our overall health because our behavior and choices are based on what we perceive about health in the first place.

They note that this relationship is important now more than ever as stress levels and fatigue are on the rise in many areas.

In the 2015 study involving participants of the French Masters, researchers measured the swimmer’s health perceptions. All of the female swimmers and the older age groups of male swimmers reported significantly higher values when it came to perceptions of vitality as compared to reference values. All of the swimmers who participated in that study also indicated significantly lower scores for the perception of bodily pain.

More Swimming Benefits

Many people who swim describe benefits that are not likely to be reported in clinical studies. In fact, according to U.S. Masters Swimming (USMS), Olympic swimmer Janet Evans once described swimming as the “ultimate all-in-one fitness package” because it improves your physical, mental, and emotional well-being.

These benefits are not groundbreaking news to Marty Munson, a marathon swimmer who has swum around many islands including Key West and Manhattan. Munson is a USMS-certified swim coach, a certified Adult Learn to Swim instructor, and is a USA Triathlon Level 1 coach.

In her experience coaching both new and experienced swimmers, she has seen that the sport can be transformative. She outlines a few keys areas where change is likely to occur.

Elevated Sense of Achievement

“So many people come to the pool feeling that swimming is impossible for them,” says Munson. She adds that people are often sure they can’t learn to swim and see they see the water as “other” or “scary.” Part of this may be due to the fact that breathing in the water is different than breathing on land. But after learning a few basics, “new swimmers learn to luxuriate in it, work with it, and move through it,” she says “And they always amaze themselves when they do.”

For swimmers who have some limited experience in the water, there are also benefits. By refining basic skills, beginning-level swimmers can become proficient in the water. Simple tweaks can make the difference between struggling in the water and being frustrated, and gliding through it, and having fun.

Improved Self-Reliance

When people who are just learning to swim finally get the hang of it, they gain so much more than technique, says Munson. “Swimming isn’t just about moving your arms, legs, and core, and getting to the other side of the pool.”

Instead, she describes a process that involves learning to rely on your own strength and abilities. “A big part of swimming is about learning to not fight with the water,” she says. “That kind of acceptance and surrender, used at the right moments, is a powerful skill both in the pool and out.”

Munson says this sense of self-reliance often carries over into other areas of life. “It’s an amazing feeling to know that you can jump into any body of water and manage it just fine,” she says.

Tips to Get Started

If the benefits of swimming have inspired you to dive in and start your own program, Munson has a few suggestions to help you get started.

Reframe Fears About Breathing

People are often afraid of thinking about the fact that you can’t breathe when your head is under the water. But Munson explains that you do breathe under water. You just breathe out when your face is in and breathe in when your head is above the surface. So, it’s not that you can’t breathe under the water. Instead, you breathe differently underwater.

“Many people think they should hold their breath under the water. When you do that, you’re actually creating a feeling of panic. But if you breathe out underwater and breathe in when you bring your head up or turn your head to the side you’ll be able to create the same in-out rhythm that you have on land.”

To adjust to the new breathing pattern Munson suggests that you practice blowing bubbles under the water before you try swimming. Put your face in the water and make a lot of big bubbles, breathe in when you come up. Practicing this pattern will help you to establish a comfortable breathing rhythm.

Be Patient

Many times people have bad previous experiences with water and a qualified instructor can help you get past them. And remember to be patient and kind to yourself as you learn to swim. “Don’t let people force you into deeper water than you’re ready for,” she says. “But also don’t convince yourself that you can’t make it to the next level.”

Learn to Tread Water

Treading water teaches you to keep your head above water regardless of water depth. “When people learn this skill, they get a huge jump in confidence in the water,” says Munson. It helps new swimmers pause and support themselves when they get uncomfortable. Lastly, Munson suggests that practice is important. You don’t have to spend a long time in the pool each session, just a few minutes on a regular basis can make a difference.

“I can always tell when swimmers in my weekly classes have been in the pool in between sessions,” she says. “It doesn’t take long to develop skills, but you do have to get in the pool to do it.”


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.
New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.
Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.
If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

3 Common Golf Injuries: How to Avoid the “Rough”

Article from Brigham Health Hub, written by Elizabeth G. Matzkin, MD

Golf is a lifetime sport – people of all ages and activity levels can participate. It is a great way to get outside and stay active, especially if you choose to walk the course. On average, a golfer playing 18 holes on foot will walk anywhere from three to six miles. Injuries are common at all levels of play, from first-time golfers to professionals. Before you take your first swing of the season, be sure to check out the tips below on signs, symptoms, and prevention of common golf injuries.

1. Rotator Cuff Tendinitis

What is it?

The rotator cuff is a group of important muscles and tendons in your shoulder. Rotator cuff tendinitis is caused by inflammation of these tendons, leading to pain and decreased function. Rotator cuff tendinitis is commonly associated with overuse. Signs and symptoms include pain with overhead movements or repetitive motions of the shoulder.

How can I prevent this?

Rotator cuff tendinitis can be caused by overuse or improper technique during your swing, putting too much stress on the shoulder. Consult a golf instructor for suggestions on improving swing technique. You should always stretch out your shoulders and warm up with a few exercises before you start swinging for the day.

How is it treated?

If your doctor suspects you have rotator cuff tendinitis, they may prescribe rest, ice, and an anti-inflammatory medication. Your doctor also may recommend physical therapy to help maximize shoulder strength and function. If you have a flare-up of significant pain that limits motion, sometimes your doctor may recommend a corticosteroid injection to decrease acute inflammation.

2. Golfer’s Elbow

What is it?

Medial epicondylitis, also known as golfer’s elbow, is caused by inflammation of the tendons and muscles on the inside of the elbow. Golfer’s elbow is a common overuse injury, caused by repetitive motions. Signs and symptoms of golfer’s elbow include persistent pain on the inside of the elbow and pain during movements of the wrist, such as turning a doorknob or shaking hands.

How can I prevent this?

Golfer’s elbow can be caused by improper swing technique that puts additional stress on the tendons of the inside of the elbow. Ask a golf instructor to recommend techniques that minimize stress on the elbow during a swing. In addition, make sure you are using golf clubs that are the right fit for your size and strength.

How is it treated?

If your doctor suspects you have golfer’s elbow, they will likely prescribe rest, ice, non-steroidal anti-inflammatory medication, and physical therapy to strengthen your elbow muscles and tendons. Your doctor also may prescribe a wrist brace or forearm band to help reduce pain with movements of the wrist.

3. Knee Pain

What is it?

A golf swing requires rotation of the knee as you turn your hips and shoulders to follow through. This movement can cause or aggravate a torn meniscus, a cartilage structure in the knee that helps absorb the impact of walking and rotation during a swing. For older golfers, this movement also can exacerbate pre-existing arthritis.

How do I prevent it?

Weakness in the thigh muscles, like the hip flexors, quadriceps, and hamstrings, puts additional pressure on the knee joint when walking and especially during a golf swing. Specific exercises that target these muscle groups will maximize your strength and help to take pressure off of the knee joint, decreasing pain during golf or other daily activities. Proper swing technique is also important to minimize the rotational forces on the knee.

How is it treated?

If your doctor suspects you have arthritis or a tear in the meniscus, they may recommend ice, non-steroidal anti-inflammatory medication, and physical therapy to increase the strength of your thigh muscles. By maximizing strength and decreasing swelling, you can get back to a pain-free golf swing. However, if you have persistent pain and severe limitations in your activities, your doctor may recommend a corticosteroid injection or further intervention.

Golf is a great way to exercise and stay active for many people. Unfortunately, injuries can occur at any age or level of play. Be on the lookout for these common injuries and be sure to stretch and warm up your arm and leg muscles before you hit the course. If you have persistent pain from golfing, be sure to consult your doctor for a proper diagnosis and treatment plan.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.
New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.
Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.
If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Causes of foot pain all runners need to know

Causes of foot pain all runners need to know

Article Featured on OSMS

A total ankle replacement, also called total ankle arthroplasty, is a surgical treatment option for patients suffering from ankle pain, typically due to arthritis or injury. If this pain is impacting a patient’s quality of life or keeping them from walking comfortably, they might benefit from a total ankle arthroplasty. While lesser known than a total hip, knee or shoulder replacement, total ankle replacements are gaining popularity.

Read more

5 Expert Tips for Preventing Winter Sports Accidents

5 Expert Tips for Preventing Winter Sports Accidents

BY KAYLA MCKISKI | Article Featured on US News

Hitting the slopes or the skating rink as the winter of 2020 winds down? Don’t let an accident or injury spoil your fun.

“Winter sports and recreational activities have great health and cardiovascular benefits,” said Dr. Joseph Bosco, vice president of the American Academy of Orthopaedic Surgeons (AAOS). “However, it’s important not to underestimate the risks that cold weather can bring.”

He noted that hospitals and health care clinics see a surge of bone and joint injuries during the winter months and many could be prevented with the right preparation.

Sprains, strains, dislocations, fractures and more traumatic injuries can happen to anyone. Here, Bosco and the AAOS offer suggestions on how to protect yourself:

  • Be prepared: Before you tackle a winter sport, make sure your muscles are warmed up and in good condition. Cold muscles, tendons and ligaments are more prone to injury. Make sure to have water and other supplies on standby.
  • Wear appropriate gear: Well-fitting protective equipment like goggles, helmets, gloves and padding is crucial. Your clothes should be layered, light, loose and wind-resistant. Footwear should be warm, provide ankle support and keep your feet dry.
  • Follow the rules: If you’re unsure of the rules of your sport, it’s time to take a lesson with a qualified instructor, especially with sports like skiing and snowboarding. Knowing how to fall correctly and safely can drastically reduce your risk of injury.
  • Keep an eye on the weather: Warnings about storms and extremely low temperatures are red flags. If you’re experiencing hypothermia or frostbite, seek immediate shelter and medical attention.
  • Use common sense: Always have a buddy when participating in an outdoor sport or activity. If you feel pain or fatigue, don’t push yourself and stop the activity.

“Don’t let winter sports injuries freeze your fun,” Bosco said in an AAOS news release. “By keeping in good physical condition, staying alert and stopping when you’re tired or in pain, you can enjoy the best of winter and reduce your risk of injury.”


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Shoulder Injuries in the Throwing Athlete

Shoulder Injuries in the Throwing Athlete

Article Featured on AAOS

Overhand throwing places extremely high stresses on the shoulder, specifically to the anatomy that keeps the shoulder stable. In throwing athletes, these high stresses are repeated many times and can lead to a wide range of overuse injuries.

Although throwing injuries in the shoulder most commonly occur in baseball pitchers, they can be seen in any athlete who participates in sports that require repetitive overhand motions, such as volleyball, tennis, and some track and field events.

Anatomy of the Shoulder

Your shoulder is a ball-and-socket joint made up of three bones: your upper arm bone (humerus), your shoulder blade (scapula), and your collarbone (clavicle).

The head of your upper arm bone fits into a rounded socket in your shoulder blade. This socket is called the glenoid. Surrounding the outside edge of the glenoid is a rim of strong, fibrous tissue called the labrum. The labrum helps to deepen the socket and stabilize the shoulder joint. It also serves as an attachment point for many of the ligaments of the shoulder, as well as one of the tendons from the biceps muscle in the arm.

Strong connective tissue, called the shoulder capsule, is the ligament system of the shoulder and keeps the head of the upper arm bone centered in the glenoid socket. This tissue covers the shoulder joint and attaches the upper end of the arm bone to the shoulder blade.

The bones of the shoulder

The bones of the shoulder. Reproduced with permission from J Bernstein, ed: Musculoskeletal Medicine. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2003.

The ligaments of the shoulder

The ligaments of the shoulder. Reproduced with permission from J Bernstein, ed: Musculoskeletal Medicine. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2003.

Your shoulder also relies on strong tendons and muscles to keep your shoulder stable. Some of these muscles are called the rotator cuff. The rotator cuff is made up of four muscles that come together as tendons to form a covering or cuff of tissue around the head of the humerus.

The biceps muscle in the upper arm has two tendons that attach it to the shoulder blade. The long head attaches to the top of the shoulder socket (glenoid). The short head attaches to a bump on the shoulder blade called the coracoid process. These attachments help to center the humeral head in the glenoid socket.

rotator cuff anatomy

This illustration shows the biceps tendons and the four muscles and their tendons that form the rotator cuff and stabilize the shoulder joint. Reproduced and adapted with permission from The Body Almanac. (c) American Academy of Orthopaedic Surgeons, 2003.

In addition to the ligaments and rotator cuff, muscles in the upper back play an important role in keeping the shoulder stable. These muscles include the trapezius, levator scapulae, rhomboids, and serratus anterior, and they are referred to as the scapular stabilizers. They control the scapula and clavicle bones — called the shoulder girdle — which functions as the foundation for the shoulder joint.

Muscles in the upper back

Muscles in the upper back help to keep the shoulder stable, particularly during overhead motions, like throwing. (Note: this illustration has been drawn in such a way to show the many layers of muscle in the back.) Reproduced with permission from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010.

Cause

When athletes throw repeatedly at high speed, significant stresses are placed on the anatomical structures that keep the humeral head centered in the glenoid socket.

baseball pitching phases

The phases of pitching a baseball. Reproduced and adapted with permission from Poss R (ed): Orthopaedic Knowledge Update 3. Rosemont, IL. American Academy of Orthopaedic Surgeons, 1990, pp 293-302.

Of the five phases that make up the pitching motion, the late cocking and follow-through phases place the greatest forces on the shoulder.

  • Late-cocking phase. In order to generate maximum pitch speed, the thrower must bring the arm and hand up and behind the body during the late cocking phase. This arm position of extreme external rotation helps the thrower put speed on the ball, however, it also forces the head of the humerus forward which places significant stress on the ligaments in the front of the shoulder. Over time, the ligaments loosen, resulting in greater external rotation and greater pitching speed, but less shoulder stability.
  • Follow-through phase. During acceleration, the arm rapidly rotates internally. Once the ball is released, follow-through begins and the ligaments and rotator cuff tendons at the back of the shoulder must handle significant stresses to decelerate the arm and control the humeral head.

When one structure — such as the ligament system — becomes weakened due to repetitive stresses, other structures must handle the overload. As a result, a wide range of shoulder injuries can occur in the throwing athlete.

The rotator cuff and labrum are the shoulder structures most vulnerable to throwing injuries.

Common Throwing Injuries In the Shoulder

SLAP Tears (Superior Labrum Anterior to Posterior)

In a SLAP injury, the top (superior) part of the labrum is injured. This top area is also where the long head of the biceps tendon attaches to the labrum. A SLAP tear occurs both in front (anterior) and in back (posterior) of this attachment point.

Typical symptoms are a catching or locking sensation, and pain with certain shoulder movements. Pain deep within the shoulder or with certain arm positions is also common.

shoulder labrum and SLAP tear

(Left) The labrum helps to deepen the shoulder socket.

(Right) This cross-section view of the shoulder socket shows a typical SLAP tear.

Bicep Tendinitis and Tendon Tears

Repetitive throwing can inflame and irritate the upper biceps tendon. This is called biceps tendinitis. Pain in the front of the shoulder and weakness are common symptoms of biceps tendinitis.

Occasionally, the damage to the tendon caused by tendinitis can result in a tear. A torn biceps tendon may cause a sudden, sharp pain in the upper arm. Some people will hear a popping or snapping noise when the tendon tears.

biceps tendinitis

(Left) The biceps tendon helps to keep the head of the humerus centered in the glenoid socket. (Right) Tendinitis causes the tendon to become red and swollen.

Rotator Cuff Tendinitis and Tears

When a muscle or tendon is overworked, it can become inflamed. The rotator cuff is frequently irritated in throwers, resulting in tendinitis.

Early symptoms include pain that radiates from the front of the shoulder to the side of the arm. Pain may be present during throwing, other activities, and at rest. As the problem progresses, pain may occur at night, and the athlete may experience a loss of strength and motion.

Rotator cuff tears often begin by fraying. As the damage worsens, the tendon can tear. When one or more of the rotator cuff tendons is torn, the tendon no longer fully attaches to the head of the humerus. Most tears in throwing athletes occur in the supraspinatus tendon.

rotator cuff tear

Rotator cuff tendon tears in throwers most often occur within the tendon. In some cases, the tendon can tear away from where it attaches to the humerus.

Problems with the rotator cuff often lead to shoulder bursitis. There is a lubricating sac called a bursa between the rotator cuff and the bone on top of your shoulder (acromion). The bursa allows the rotator cuff tendons to glide freely when you move your arm. When the rotator cuff tendons are injured or damaged, this bursa can also become inflamed and painful.

Internal Impingement

During the cocking phase of an overhand throw, the rotator cuff tendons at the back of the shoulder can get pinched between the humeral head and the glenoid. This is called internal impingement and may result in a partial tearing of the rotator cuff tendon. Internal impingement may also damage the labrum, causing part of it to peel off from the glenoid.

Internal impingement may be due to some looseness in the structures at the front of the joint, as well as tightness in the back of the shoulder.

The muscles and tendons of the rotator cuff

The muscles and tendons of the rotator cuff. Reproduced with permission from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010.

shoulder impingement

This illustration shows the infraspinatus tendon caught between the humeral head and the glenoid. Reproduced with permission from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010.

Instability

Shoulder instability occurs when the head of the humerus slips out of the shoulder socket (dislocation). When the shoulder is loose and moves out of place repeatedly, it is called chronic shoulder instability.

In throwers, instability develops gradually over years from repetitive throwing that stretches the ligaments and creates increased laxity (looseness). If the rotator cuff structures are not able to control the laxity, then the shoulder will slip slightly off-center (subluxation) during the throwing motion.

Pain and loss of throwing velocity will be the initial symptoms, rather than a sensation of the shoulder “slipping out of place.” Occasionally, the thrower may feel the arm “go dead.” A common term for instability many years ago was “dead arm syndrome.”

Glenohumeral Internal Rotation Deficit (GIRD)

As mentioned above, the extreme external rotation required to throw at high speeds typically causes the ligaments at the front of the shoulder to stretch and loosen. A natural and common result is that the soft tissues in the back of the shoulder tighten, leading to loss of internal rotation.

This loss of internal rotation puts throwers at greater risk for labral and rotator cuff tears.

Scapular Rotation Dysfunction (SICK Scapula)

abnormal positioning of the scapula

This photograph shows abnormal positioning of the scapula on the right side. Reproduced with permission from Kibler B, Sciascia A, Wilkes T: Scapular Dyskinesis and Its Relation to Shoulder Injury. J Am Acad Orthop Surg 2012; 20:364-372.

Proper movement and rotation of the scapula over the chest wall is important during the throwing motion. The scapula (shoulder blade) connects to only one other bone: the clavicle. As a result, the scapula relies on several muscles in the upper back to keep it in position to support healthy shoulder movement.

During throwing, repetitive use of scapular muscles creates changes in the muscles that affect the position of the scapula and increase the risk of shoulder injury.

Scapular rotation dysfunction is characterized by drooping of the affected shoulder. The most common symptom is pain at the front of the shoulder, near the collarbone.

In many throwing athletes with SICK scapula, the chest muscles tighten in response to changes in the upper back muscles. Lifting weights and chest strengthening exercises can aggravate this condition.

Doctor Examination

Medical History and Physical Examination

The medical history portion of the initial doctor visit includes discussion about your general medical health, symptoms and when they first began, and the nature and frequency of athletic participation

During the physicial examination, your doctor will check the range of motion, strength, and stability of your shoulder. He or she may perform specific tests by placing your arm in different positions to reproduce your symptoms.

The results of these tests help the doctor decide if additional testing or imaging of the shoulder is necessary.

Imaging Tests

Your doctor may order tests to confirm your diagnosis and identify any associated problems.

X-rays. This imaging test creates clear pictures of dense structures, like bone. X-rays will show any problems within the bones of your shoulder, such as arthritis or fractures.

Magnetic resonance imaging (MRI). This imaging study shows better images of soft tissues. It may help your doctor identify injuries to the labrum, ligaments, and tendons surrounding your shoulder joint.

Computed tomography (CT) scan. This test combines x-rays with computer technology to produce a very detailed view of the bones in the shoulder area.

Ultrasound. Real time images of muscles, tendons, ligaments, joints, and soft tissues can be produced using ultrasound. This test is typically used to diagnose rotator cuff tears in individuals who are not able to have MRI scans.

Treatment

Left untreated, throwing injuries in the shoulder can become complicated conditions.

Nonsurgical Treatment

In many cases, the initial treatment for a throwing injury in the shoulder is nonsurgical. Treatment options may include:

  • Activity modification. Your doctor may first recommend simply changing your daily routine and avoiding activities that cause symptoms.
  • Ice. Applying icepacks to the shoulder can reduce any swelling.
  • Anti-inflammatory medication. Drugs like ibuprofen and naproxen can relieve pain and inflammation. They can also be provided in prescription-strength form.
  • Physical therapy. In order to improve the range of motion in your shoulder and strengthen the muscles that support the joint, your doctor may recommend specific exercises. Physical therapy can focus on muscles and ligament tightness in the back of the shoulder and help to strengthen the structures in the front of the shoulder. This can relieve some stress on any injured structures, such as the labrum or rotator cuff tendon.
  • Change of position. Throwing mechanics can be evaluated in order to correct body positioning that puts excessive stress on injured shoulder structures. Although a change of position or even a change in sport can eliminate repetitive stresses on the shoulder and provide lasting relief, this is often undesirable, especially in high level athletes.
  • Cortisone injection— If rest, medications, and physical therapy do not relieve your pain, an injection of a local anesthetic and a cortisone preparation may be helpful. Cortisone is a very effective anti-inflammatory medicine. Injecting it into the bursa beneath the acromion can provide long-term pain relief for tears or other structural damage.

cortisone injection in shoulder

A cortisone injection may relieve painful symptoms. Reproduced with permission from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010.
Your doctor may recommend surgery based on your history, physical examination, and imaging studies, or if your symptoms are not relieved by nonsurgical treatment.The type of surgery performed will depend on several factors, such as your injury, age, and anatomy. Your orthopaedic surgeon will discuss with you the best procedure to meet your individual health needs.

Arthroscopy. Most throwing injuries can be treated with arthroscopic surgery. During arthroscopy, the surgeon inserts a small camera, called an arthroscope, into the shoulder joint. The camera displays pictures on a television screen, and the surgeon uses these images to guide miniature surgical instruments.

Because the arthroscope and surgical instruments are thin, the surgeon can use very small incisions (cuts), rather than the larger incision needed for standard, open surgery.

During arthroscopy, your doctor can repair damage to soft tissues, such as the labrum, ligaments, or rotator cuff.

shoulder arthroscopy

During arthroscopy, your surgeon inserts the arthroscope and small instruments into your shoulder joint.

Open surgery. A traditional open surgical incision (several centimeters long) is often required if the injury is large or complex.

Rehabilitation. After surgery, the repair needs to be protected while the injury heals. To keep your arm from moving, you will most likely use a sling for for a short period of time. How long you require a sling depends upon the severity of your injury.

As soon as your comfort allows, your doctor may remove the sling to begin a physical therapy program.

In general, a therapy program focuses first on flexibility. Gentle stretches will improve your range of motion and prevent stiffness in your shoulder. As healing progresses, exercises to strengthen the shoulder muscles and the rotator cuff will gradually be added to your program. This typically occurs 4 to 6 weeks after surgery.

Your doctor will discuss with you when it is safe to return to sports activity. If your goal is to return to overhead sports activities, your doctor or physical therapist will direct a therapy program that includes a gradual return to throwing.

It typically takes 2 to 4 months to achieve complete relief of pain, but it may take up to a year to return to your sports activities.

Prevention

In recent years, there has been a great deal of attention on preventing throwing injuries of the shoulder.

Proper conditioning, technique, and recovery time can help to prevent throwing injuries. Throwers should strive to maintain good shoulder girdle function with proper stretches and upper back and torso strengthening.

In the case of younger athletes, pitching guidelines regarding number of pitches per game and week, as well as type of pitches thrown, have been developed to protect children from injury.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Hip Pointers in Contact Sports

Hip Pointers in Contact Sports

Article Featured on Nationwide Children’s Hospital

Hip Pointers

Bumps and falls are all a part of everyday life as an athlete, and can often result in bruising and injury. The majority of these types of injuries are seen in contact sports. The term “hip pointer” is often used as a catch all phrase for any injury resulting in pain to the front of the hip. However, this is not always the case.

What is a Hip Pointer?

A hip pointer is bruising caused by a fall or a direct blow to the iliac crest, or front and top of the pelvis. This bruising is not always visible and may actually occur deep below the skin. Bruising may also occur in the abdominal muscles which attach to the pelvis. Most often hip pointers are seen in contact sports such as football and soccer. Hip pointers are extremely painful and may be aggravated by walking, running, laughing, coughing, or deep breathing.

Treatment

Hip pointers are treated immediately with rest and ice. Resting the injured hip from extremely painful movements will help to reduce swelling and speed the healing process. It may take 1 to 2 weeks before the injured hip is pain free with movement. During this time the athlete should be allowed to stretch the hip in all directions to avoid stiffness. The rule here is to stretch in the pain free range. Any pain will only slow the healing process and delay their return to sport.

It is important to consult your physician if your pain last more than two weeks or worsens overtime. This may be a sign of a more severe injury. Ice should be applied directly to the hip for 30 minutes of every 1-2 hours for the first 72 hours. A regimen of gentle stretching for 20-30 seconds can help to loosen the muscles around the injured hip and reduce pain. For more information on strains please see the article “The Sprains and Strains of Sporting Injuries” located on the Nationwide Children’s Hospital website.

Prevention

Hip pointers can be prevented by wearing appropriate protective equipment. For example, football and hockey wear protective hip pads to help prevent this injury. In other sports where padding is not worn, such as soccer, certain skills and techniques can be taught to avoid this injury. Padding can also be worn to prevent further injury to the hip.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.