Healthy + Active | Sports Medicine Edition

Sports Medicine Edition

HEALTHY + ACTIVE summit orthopedics

ACL prevention

injury

WATER vs.

SPORTS DRINKS

FIRST AID TIPS Why see a SPORTS MEDICINE SPECIALIST?

Official Sports Medicine Provider for East Ridge High School, Park High School, Woodbury High School, Concordia University–St. Paul, and University of Northwestern.

CONTENTS

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14 HYDRATION

TREATING INJURIES

SPEEDY RECOVERY

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14

22

ACL RISK

ASCEND PROGRAM

CONCUSSIONS

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SINGLE SPORT: KIDS

ATHLETIC PERFORMANCE

SPORTS MEDICINE BENEFITS

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COMMON INJURIES

ON-THE-GO MEALS

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8 INJURY PREVENTION 10 STEP-BY-STEP RECOVERY 12

45+ ORTHOPEDIC SPECIALISTS

75+ THERAPISTS

900+ EMPLOYEES

25+ ABOUT THIS PUBLICATION

LOCATIONS

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ealthy + active is designed and written by the team of specialists at Summit Orthopedics to provide everyday tips, tools, and expert advice to help you in your journey to live a healthier, more active lifestyle. Each edition has a different focus, such as arthritis, spine, or in this case, sports medicine. We hope you enjoy reading!

ABOUT SUMMIT ORTHOPEDICS

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ummit Orthopedics delivers comprehensive bone, joint, and muscle care to the greater Twin Cities metro area.

Our specialists have the highest levels of subspecialized training in their fields. Summit’s award-winning facilities in Vadnais Heights and Eagan are home to subspecialty clinics, including our walk-in OrthoQUICK™ clinic, imaging, therapy, surgery, recovery care suites, and bracing and orthotics. They are just two of our twelve metro locations dedicated to helping patients live a healthy and active lifestyle.

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healthy + active: sports medicine edition

SPORTS DRINKS VS. WATER SPORTS DRINKS

WATER

»»Can contain the equivalent

»»Generally the preferred

»»Can slow absorption of

»»Prehydration is essential

of 10 teaspoons of sugar

water into the bloodstream

»»Drinks with electrolytes

recommended for events lasting over an hour or when you get muscle cramps

choice for hydration

for sporting events, for marathons, starting 24 to 36 hours before the race

»»Perfect for most activities and youth sports

ACL INJURY RISK & PREVENTION FOR FEMALE ATH LETES

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or those with a daughter who plays soccer or basketball, ACL injuries are a hot topic. We explain what current research tells us about why girls are so prone to this knee injury.

Knee injuries are common among athletes who compete in soccer and basketball. Injury to the anterior cruciate ligament (ACL) has received a lot of attention lately because it is such a high-risk injury among female athletes. In general, girls are nearly three times more susceptible to ACL injuries than boys. For female athletes, the risk of ACL injury is even higher. Girls in competitive sports are four to eight times more likely to tear this ligament, depending on the sport that they play. Bottom line is that female ACL injuries are an area of concern.

UNDERSTANDING ACL ANATOMY AND INJURY The ACL is located deep in the knee joint. It is one of the ligaments connecting the femur (thighbone) to the tibia (shinbone). The ACL functions to stabilize the tibia, keeping it from moving too far in front of the femur in the upper leg and controlling the tibia’s rotation. Typically, this ligament is injured during player actions that cause the knee to bend or rotate excessively, such as landing in the wrong position after a jump. Rough contact or a hit by another player can also cause ligament trauma.

The immediate symptom of ACL injury is knee instability, which has been described as a sensation that the knee is buckling or giving way.

WHY ARE FEMALE ACL INJURIES SO COMMON? Numerous research studies have been conducted to understand why females are more prone to this ligament injury.

Researchers suggest that the following factors may play a role in female ACL injuries:

»»Different knee structures »»Size of the ACL »»Knee alignment with the lower leg »»Skill and conditioning deficits »»Running and jumping technique Although several of these factors may contribute to higher injury risk for female ACL injuries, studies point toward running and jumping techniques as the most significant cause. In response, training programs have been developed to help improve form for running, jumping, and landing during competition. Female athletes who participate in these training programs have significantly reduced their incidence of ACL injury.

I AM AGILE. “ Research shows us that when it comes to ACL injury risk among female athletes, how girls jump and land during competition matters.”

— JACK SKENDZEL, M.D.

IMPORTANCE OF INJURY PREVENTION

Replace your warm-up with the following drills:

When it comes to ACL injury, Dr. Jack Skendzel emphasizes how important it is for girls to jump and land properly during competition. Research has shown us how to address and reduce this risk: through carefully designed ACL injury prevention training programs. We identify the training techniques that have been used successfully to reduce ACL injuries, so you can make sure your daughter is getting the preventative coaching she needs to stay safe.

»»Relearning how to land after a jump: With flexed knees

ACL INJURY PREVENTION TRAINING PROGRAMS

»»Footwork training: Learn to move their feet quickly,

Effective preventative training programs—like those taught by our Summit sports medicine professionals— don’t simply build muscle strength. They focus on the comprehensive factors shown to reduce ACL injury risk by encouraging girls to perform training drills that increase balance, power, agility, neuromuscular conditioning, and muscular reaction.

positioned over the feet, and chest positioned over the knees upon landing.

»»Balance exercises: Standing on unstable surfaces, volleying while balanced on a single leg, and performing single-leg vertical jumps.

»»Functional (versus weight) strengthening: Lunges, single-leg squats, and step-ups. softly, with specific purpose, and without a “high knee” technique. Often, an “agility ladder” training tool is used for these drills.

We encourage young athletes to begin these drills four to six weeks before they begin competing. While no program can eliminate all risk of an ACL injury, these training programs have been very successful and are shown to significantly diminish ACL tears.

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IS A SINGLE SPORT GOOD YEAR-ROUND FOR YOUR CHILD?

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laying sports has positive benefits for your child’s physical and social development. But we explain why athletic diversity is safer and more healthful for young athletes than early specialization in a single sport. injury, compared to children who participate in a number of different sports through the year.

Although specialization may seem like a good idea, there are several reasons why children are better served by steering clear of a single sport:

»»During adolescence, children’s bones and muscles are still developing. Playing a single sport can strain certain parts of the body, while other areas of the body are ignored.

This imbalance can lead to overuse injuries.

»»All of us need a recovery period after physical exertion.

This is particularly true for children, who need one to two days off from sports every week. A good rule of thumb for sports participation is that a child’s age should determine the weekly number of hours spent playing sports—an eight-year-old should play sports for no more than eight hours each week.

»»Diversification in sports activities also reduces the possiThere are many excellent reasons to support athletic activities for children between the ages of seven and 18. Athletic activities boost physical development and foster social skills.

Yet research tells us that it’s safer for children to participate in multiple sports than it is for them to join the trend toward early specialization in a single sport.

Researchers found that when young athletes, between seven and 18 years of age, specialize in a single sport, they are one and a half times more likely to be injured, and more than twice as likely to experience a serious overuse

bility that a child will burn out on a single sport and leave sports completely.

Playing a single sport may hone the skills that sport requires, but it doesn’t necessarily develop the motor and anticipatory movement skills that make for a wellrounded athlete.

If your child aspires to an athletic scholarship, the American Medical Society for Sports Medicine reports that diversified sports training during adolescence may be more effective in developing elite athletic skills.

“Despite the common perception, young athletes can be set up for greater success as a multisport athlete than playing a single sport year-round.”

— SCOTT PEPIN, M.D.

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“Playing a single sport can put too much repetitive strain on certain areas of the body.

Meanwhile, other parts of the body are ignored.”

—SARAH LEHNERT, M.D.

TIPS TO PREVENT YOUTH SPORTS INJURIES

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ach parent wants his or her children to enjoy sports safely. These guidelines can help parents prevent some of the most common children’s sports injuries we treat.

There is nothing quite like the pride parents feel watching their child score a game point, execute a crucial pass, and thrive in the teamwork that organized sports teaches. Children’s sports provide wonderful opportunities to develop social skills and establish the active habits that lead to a healthy lifestyle.

As we celebrate our children’s victories, we also want their participation in organized sports to be safe and healthful. Any child can suffer an injury on the field, but we want to help parents to prevent some of the most common sports injuries that are both predictable and preventable.

The following guidelines can help you provide a sports experience for your child that is both rewarding and safe:

»»Make a preseason physical examination part of your routine. When your child is in good physical condition, the risk of injury drops. It is also a good idea to discourage children from competing when they are very tired or in pain.

»»Choose well-organized sports run by certified athletic trainers. Look for programs that actively demonstrate a commitment to injury prevention.

Coaches and staff should include certified athletic trainers with proven first aid and CPR skills. Confirm that rules about safe equipment use are enforced, and that the organization has a plan for responding to emergencies.

»»Supply your child with proper safety-certified gear. Helmets, guards, and sport-specific athletic shoes are designed for your child’s protection. Don’t allow your child to use a hand-me-down helmet unless it fits properly and has been recertified for safety.

»»Confirm that warm-ups and cool-downs are part of your child’s sports routine.

Warm-up exercises make muscles and other soft tissues warmer and more flexible. Some training exercises are designed to prevent or reduce the incidence of injuries such as ACL damage and concussion. Cool-down routines loosen muscles that tighten during competition.

»»Encourage your child to stay hydrated while playing. Children are particularly susceptible to heat-related illnesses, which can be very dangerous.

»»Make sure your child uses sunscreen. Sunburn can sneak up on a child. Sun protection helps to safeguard your child against damaging his or her skin now, and reduces the risk of the skin cancers that can occur later in life.

»»Learn the safety rules for your child’s specific sports. Safety rules are developed to anticipate and prevent injury. Encourage your child to respect and follow the rules of the game.

We can’t protect our children from every risk, but following these guidelines can reduce your child’s risk of common sports injuries. A little precaution and prevention will help keep youngsters in the game, developing the confidence and fitness that will help them reach their personal summits for a lifetime.

“Any child can suffer an injury on the field, but we want to help parents to prevent some of the most common sports injuries that are both predictable and preventable.”

— JAMES GANNON, M.D. summit orthopedics

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STEP-BY-STEP PLAN TO INJURY RECOVERY

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uffering an injury is no fun, but understanding what to expect during the recovery process can help. We walk you through the steps from injury to full recovery.

Injury is frustrating, whether you hurt yourself on the playing field or running track, in a misstep as you go about your daily routine, or as the result of a fall. We can’t turn back the clock to prevent damage that’s been done, but we can walk you through the stages of recovery, so that you’ll know what to expect and what you can do to maximize your recovery.

Rehabilitation from an injury follows a series of steps from the time of injury until you can resume all of the activities that you love. Of course, your entire recovery process should be designed and monitored by your physician and physical therapist.

Follow the steps from injury to recovery:

»»The acute phase of injury: In the immediate aftermath of an injury, your focus is on minimizing swelling. Follow the RICE formula for recovery: Rest, Ice, Compression, and Elevation, and limit your activities. If your injury is severe, your treatment at this stage may involve surgery, bracing, or casting.

»»Maintain overall condition: While your injury is healing, your physician and therapist will work with you to identify ways for you to safely stay fit. A runner with an injury may switch to running in water. A patient in a cast may exercise healthy muscles through strength training. Don’t delay exercise until you are healed—you’ll be further ahead if you stay in shape during the healing process.

»»Regain range of motion and strength in your injured limb or joint: For most injuries, gentle range of motion exercises can begin almost immediately after injury. Your physician and therapist will create a plan for you and monitor your progress.

»»Functional drills: Once your strength has returned to normal in your injured limb or joint, you will start doing specific exercises focused on balance and agility to help you reclaim any coordination that you may have lost as a result of the injury. If you have a lower extremity injury,

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expect to be doing some brisk walking, rope jumping, hopping, or light jogging. If your injury is in an upper extremity, you’ll start doing some light throwing. You may feel terrific at this stage, but you are probably only about 75 percent recovered, so it’s important to take it slow.

»»Sport-specific movement exercises: You’ll be started on movement patterns specific to your sport only after you have progressed with range of motion, strength, endurance, and agility, and are tolerating functional drills. Your therapist will monitor your progress to ensure that you don’t reinjure yourself, and may have you wear protective tape or supports during this stage.

»»Return to play: Before you re-engage with your sport, or your normal activities, your physician and therapist want you to be healed to the point where it is very low risk of additional harm.

In this final phase, as you resume your activities, give special attention to adequate warm-up prior to your activity, and icing afterward, as appropriate.

Our sports medicine teams monitor advances in medicine that will help athletes back to a 100 percent recovery as quickly as possible, without sacrificing safety.

“Only after successfully navigating several sport-specific tests, under the observation of a physician and/or physical therapist, are athletes ready to return to sport.”

— ERIC KHETIA, M.D.

When you commit to these steps, and have them monitored by your medical team, you’ll be on your way to a healthy and safe recovery.

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R I TREATING YOUR CHILD’S SPORTS INJURY REST »»Refrain from using the injured limb for at least 48 hours.

»»Consider crutches to keep weight

off the injured leg—or a sling if you hurt your arm.

»»Encourage your child to listen to his or her body. If an activity or movement is causing soreness or pain, it’s time to modify or stop.

»»Medications like nonsteroidal anti-

inflammatory drugs (NSAIDs) such as ibuprofen are also an option.

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ICE »»Cold treatments at the injured area will ease pain and swelling. Ice is typically used for the first 48 to 72 hours following an injury.

»»Apply a crushed ice pack or a bag

of frozen peas for 15 to 20 minutes at a time. Repeat icing four to eight times a day.

»»Protect the skin at the injury site by

wrapping the ice or peas in a towel.

»»Never let your child sleep with ice on an injury.

C E Y

oung athletes should be able to enjoy a safe, happy game experience—but not every sports-related injury can be prevented. Our tips explain how to care for minor injuries, and how to recognize when you need professional medical care.

COMPRESSION

ELEVATION

»»For ankle, knee, or wrist injuries,

»»To reduce swelling, raise the

»»Begin applying wrap below the

»»Prop an injured leg or arm up on

»»Monitor the exposed digits; if your

»»Keep it elevated as much as possible,

consider a compression sock or an elastic wrap to reduce swelling. injured area and wrap upward, leaving fingers or toes exposed. child feels numbness or temperature change—or if you see discoloration— loosen the wrap.

injured limb above the level of your child’s heart. pillows for support, and to keep your child comfortable.

not just when ice is being applied.

»»Remove the wrap before your child goes to sleep.

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SUMMIT’S ASCEND Rehabilitating Neuro

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nee, hip, and ankle surgery can take a toll on leg strength and balance. Summit’s ASCEND program is designed to help athletes reclaim the neuromuscular balance they need to compete safely.

HIGHER-LEVEL RECONDITIONING Recovery after a lower extremity injury takes time. During the first three months following a surgical repair, patients focus on resuming the activities of daily life—but athletes need a higher level of conditioning before they can safely return to competitive sports.

Summit’s ASCEND program is designed to provide the more intensive conditioning athletes need. One focus of the ASCEND program is identifying and correcting neuromuscular imbalances.

NEUROMUSCULAR IMBALANCES “An imbalance occurs when people just don’t have enough proximal strength,” explains ASCEND physical therapist Jenny Blade. Proximal refers to muscles that are situated

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closest to the body’s midline. “These imbalances put extra stress on lower joints. In some cases, we’ll see knees collapse inward. Or, when quads are dominant, athletes land with their knees farther forward instead of sitting their hips back. This puts additional stress on joints and can lead to another injury.”

“Muscle imbalance can have a significant impact on the stability of a joint.”

— PETER PARTEN, M.D.

TYPES OF NEUROMUSCULAR IMBALANCE Neuromuscular imbalances can present in a number of different ways. Neuromuscular imbalance refers to muscle groups within the body that tend to be weaker or tighter.

Physical therapist Kyle Hall reviews some of the imbalances that the ASCEND program is designed to address.

PROGRAM: muscular Imbalances

“Targeted strengthening and conditioning exercises can help counteract risks associated with muscle imbalances.”

— KIRK SCOFIELD, M.D.

»» Ligament Dominance: “We see this when patients move in a way that does not allow their muscles to absorb force,” she explains. “Instead, they are putting increased stress on the joint ligaments.”

»» Quadriceps Dominance: When an athlete’s quadriceps muscles are strong, they may rely too much on those quadriceps muscles in the front of the thigh without using their hip, hamstring, and gluteus muscles.

»» Leg Dominance: “Many people have a preferred plant, kick, or drive leg,” says Kyle. “That preference can lead to asymmetries in muscle recruitment, strength, and flexibility from one leg to the other. Interestingly, female athletes tend to be more one-leg dominant than males.”

»» Trunk Dominance: “Trunk dominance is also referred to as core dysfunction,” Kyle explains. “We see it when patients don’t properly sense the position of their trunk in space and in relation to their legs and body. This creates increased stress to the joints. Core dysfunction is more common in ages where we experience increased growth periods; during these growth periods, we are relearning how to position our body in relation to our trunk. When an injury interrupts this stage of growth, a patient may need some support to learn proper positioning.”

“Correcting imbalances is one advantage of the ASCEND program,” Kyle says. “When all of your muscles engage properly to share the impact of high-intensity performance, you’ll play with more strength and with less risk of a reinjury.”

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REACH HIGH. “When you are starting a new exercise program, I recommend to slowly and gradually build into it and learn along the way. I would not go it alone if you don’t have to.”

— AMY BEACOM, M.D.

MORE THAN PRACTICE: What It Takes to Excel in Sports Performance

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ports are more competitive than ever, and athletes and parents are constantly searching for the competitive edge. Max Lipset, high school soccer coach and owner of The Power House, shares what makes some athletes readier than others to perform their best on game day.

“In any sport, I believe the difference is in an athlete’s well-roundedness, their ability not to excel in just one area but be skilled in all domains of fitness — strength, speed, agility, power, endurance, stamina, coordination, flexibility, accuracy, and balance,” says Max. “Intentional strength and conditioning programs are the key to playing your best and staying injury-free.”

Check out how to achieve optimal performance year-round.

STRENGTH TRAINING Why It’s Important: Playing sports rarely creates adequate strength required for optimal performance. Strength training helps reduce injury, build resilience to physical stresses from sports, stabilize joints, and increase bone density.

Types of Activities: Uses a variety of tools to develop well-rounded athletes. It builds foundational and power movements, and proper functional strength.

How Often: »» Off-season: 6 to 12 weeks, 3 to 4 days a week »» In-season: 1 to 2 times a week

SPEED AGILITY QUICKNESS (SAQ) Why It’s Important: The ability to accelerate, decelerate, change direction, and control the body in space at variable speeds defines success in almost every sport. Formal SAQ instruction helps athletes become more explosive while optimizing brain signal efficiency and motor skills.

Types of Activities: Sharpens athletes’ reaction times and challenges neuromuscular responses. Contains short, intense drills that teach proper running and sprint mechanics and plyometrics, and emphasizes core stability.

How Often: »» Off-season: 3 days a week for sports with cutting and change of direction »» Other sports: 1 to 2 days a week

CARDIORESPIRATORY ENDURANCE Why It’s Important: Cardiovascular fitness is the ability of the heart and lungs to efficiently fuel the body during output. Training for improved cardio fitness requires effective training across multiple energy systems and should be balanced between a focus on endurance and stamina.

Types of Activities: Sport-specific intervals, circuit training, and longer distance efforts can improve fitness and recovery times during off-season. Using various tests, like VO2 max, gauges the efficiency of an athlete’s cardiovascular endurance.

How Often: In-season: Matched to demands of the sport

MOBILITY AND RANGE OF MOTION Why It’s Important: Mobility is the ability to move freely through full range of motion. Missing range of motion in a particular joint eventually causes a problem. Developing these areas makes athletes more dynamic and fluid, and increases athleticism.

Types of Activities: Uses targeted mobility, corrective exercise and other activities. A Functional Movement Screen assesses athletes in sport-specific movements and identifies areas of tightness or instability.

How Often: Off-season: Correct mobility problems and assess range of motion to reduce injury risk

CUSTOM PERFORMANCE SOLUTIONS Whether you are seeking the latest in performance training and injury prevention or looking for the next step after physical therapy, the partnership between Summit and The Power House has the services to guide you to the next level of competition and fitness.

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COMMON YOUTH SPORTS INJURIES

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very year, more than 2 million children are treated in hospital emergency rooms for sports-related injuries. Awareness is the first step in prevention, so we review the most common childhood sports injuries.

“Beginning a new season or sport, especially when you aren’t as well-conditioned, is when we see many injuries.”

— BRENT WARNER, M.D.

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Whether your child is the high school quarterback, a member of the track team, or the first member of the family to grab a helmet when it’s time for a weekend biking excursion, encouraging pleasure in sports at a young age builds valuable healthy habits. The benefits of an active life far outweigh the obesity and diabetes risks of a sedentary lifestyle spent in front of a television or computer.

Yet, as parents ourselves, we know that an active lifestyle also has a downside. The CDC reports that more than 2.6 million children up to 19 years of age are treated in hospital emergency rooms for sports- and recreation-related injuries. Sports injuries in children run the gamut from minor scrapes and bruises to serious brain and spinal cord injuries.

Taking steps to prevent sports injuries begins with awareness. The following list reviews the most common sports-related injuries treated in children:

healthy + active: sports medicine edition

SPRAINS AND STRAINS Ankle sprains are the most common athletic injury. Sprains occur when a ligament connecting two or more bones in a joint becomes damaged. Strains are also common and involve damage to a muscle or tendon.

HEAT-RELATED ILLNESSES GROWTH PLATE INJURIES Growth plates are areas of developing tissues at the end of the long bones in growing children and adolescents. As the tissue growth becomes complete, growth plates are replaced by solid bone. These injuries require medical treatment from an orthopedic doctor who specializes in bone injuries. Your child’s growth plates are located at the ends of these bones:

Heat illness is always dangerous. Children are particularly at risk because they perspire less than adults, and their core body temperature will be higher before sweating is triggered. Heat illnesses include dehydration, heat exhaustion, and heat stroke.

»»The long metatarsal bones and phalanges in the hand and fingers

»»The radius and ulna bones in the forearm »»The femur in the upper leg »»The tibia and fibula in the lower leg »»The metatarsals and phalanges in the foot

REPETITIVE MOTION INJURIES When bones, muscles, and tendons are subjected to repeated stress from overuse, children are at risk for stress fractures, tendinitis, and inflammation.

Although injuries can happen to anyone—from a child to a seasoned athlete—there are preventative measures that parents can take to minimize injury risks. Understanding the risks is the first step in supporting a safe environment for your children’s sports activities. We want your family to enjoy the health and social benefits of sports now—and establish a foundation for healthy activity over a lifetime.

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TIPS TO A SPEEDY RECOVERY S

ports season is fleeting in Minnesota— unless you compete on skis or skates. We have some guidelines to shorten your stay on the sidelines.

When you play sports, you want to be in the thick of the action—not sidelined with an injury. One of the goals of the sports medicine team at Summit is to try to get our athletes safely back on the field as soon as possible. Still, we realize that when athletes resume a sport too quickly, before they are adequately healed and recovered, it puts them at risk for reinjury and the chance of extended downtime.

A successful recovery from a sports injury requires the right treatment game plan. With early diagnosis, treatment, and appropriate rehabilitation, you can often safely accelerate your recovery.

»»Maintain good physical condition: Research shows that athletes who are in excellent physical condition not only prevent injuries—they also tend to suffer less severe injuries and recover quickly.

“The best results are from patients who commit to the hard work of therapy.”

— ANGELA VOIGHT, M.D.

»»Seek out prompt treatment: When you seek medical help sooner rather than later for an injury, you lessen the acuteness of the physical damage. Early treatment means less swelling, stiffness, and loss of muscle tone.

»»Commit to your rehabilitation program: Once your injury has been diagnosed, you will probably work with a physical therapist to strengthen injured tissues and correct gait patterns or other physical habits that may have contributed to your injury. Your therapist will work with you once or twice a week—but you will be responsible to maintain your exercise program every day, whether you are with your therapist or not. The more committed and dedicated you are to your therapy program, the better—and faster—your recovery will be.

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»»Cultivate a positive attitude: Your can-do mindset will help you stick to your rehabilitation exercises even on the days when you aren’t feeling very motivated. The stronger you are when you return to your sport, the lower the chance of reinjury. An upbeat perspective will help you stick to the exercises you need to do in order to rebuild strength in injured tissues.

When you suffer a sports injury, excellent sports medicine care is a necessary, but not a sufficient, component of a speedy and successful recovery. The injured athletes who partner with their medical teams and take responsibility for their recovery are most likely to return to play faster— and safely.

WHAT LEVEL OF ACTIVITY IS SAFE AFTER CONCUSSION? H

igh school athletes suffer thousands of sportsrelated concussions every year, and research has shown that the consequences of repeated concussions can be serious. The rules of athletic competition have been adjusted to help prevent these injuries, and to recognize and treat them earlier when they do occur.

“Our medical understanding of concussion has come a long way in the last few decades,” says Dr. Jack Skendzel, one of Summit’s sports medicine physicians.

“We know that you don’t have to be knocked out to suffer a concussion. Any blow to the head can cause a concussion. The symptoms are physical and mental, and in some cases, may not show up until a few hours after the injury. It’s important for parents to be alert for

“Parents play an essential role in watching for concussions and promptly seeking care if something seems off.”

— PETER DALY, M.D.

symptoms like trouble concentrating, fatigue, dizziness, headache, or forgetfulness.”

Rules are now in place to evaluate potential sports-related concussions immediately, and guidelines established to sideline players with concussion symptoms until the player can be evaluated and properly treated.

A PARTNERSHIP FOR ADVANCED CONCUSSION CARE Summit Orthopedics has partnered with HealthEast Concussion Clinic at Bethesda Hospital to provide treatment for concussion by experts including physicians, neuropsychologists, and therapists.

This team provides:

»» Diagnosis »» Information about recovery »» Help returning to daily activities, work, and sports

»» Consultation with providers involved in your care

»» Communication with schools and employers, if needed

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BENEFITS OF SEEING A SPORTS MEDICINE SPECIALIST

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ports medicine specialist Dr. Jeffrey Furmanek explains the advantages of treatment provided by physicians with specialized training in sports medicine—and how their expertise can benefit you whether or not you are an athlete.

If you have an injury that isn’t improving and is interfering with your daily activities, medical care is in order. Should you make an appointment with your family practice doctor or a sports medicine specialist? We offer guidance about the roles of the family practice doctor and sports medicine specialist to help you make the best choice for your care.

“Although either a general practitioner or a specialist can manage patients with rest, ice, and nonsteroidal

“When you consult with a sports medicine specialist, you benefit from their additional training in injury prevention, strength training and conditioning, and healthy lifestyle promotion.”

— BRENNAN BOETTCHER, D.O.

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anti-inflammatories, once an MRI becomes necessary, it’s time to see a specialist,” says Dr. Furmanek, a sports medicine specialist with Summit Orthopedics. “We have the depth of expertise to determine the next best appropriate step for that injury. Is it a partial tear or a full tear? Is it a torn cartilage, ligament, or tendon? Not all tears necessarily need surgery. It is the specialist’s job to discern the most appropriate treatment based on the specifics of the patient’s diagnosis.

“Anyone familiar with Malcolm Gladwell’s book Outliers knows about the 10,000-hour rule,” he continues.

“According to Gladwell’s research, it takes 10,000 hours of focused experience in a certain area to develop technical expertise. When you consult an orthopedic specialist, you are working with a physician who has concentrated expertise in treating your injury. This level of expertise isn’t necessary for a minor injury that is going to heal within a week or two. But when the problem is more serious, a specialist’s care ensures that you’ll get the most experienced and informed treatment.

“Another advantage of seeing a specialist in a subspecialty practice like Summit Orthopedics is that we have

subspecialists in every area of orthopedics. If a patient sees me with an injury that’s outside of my own expertise, I can expedite a referral within our practice to make sure that patient gets the very best care without delay.

surgery. Your specialist will work with you to make sure you are taking appropriate steps that are comfortable for you, and will monitor your progress to make sure you don’t put your injured limb or joint at risk. If a tailored nonsurgical treatment plan fails, you and your specialist can consider your surgical options.

Dr. Furmanek points out, “Being a sports medicine physician and surgeon means being specifically trained in the treatment of musculoskeletal injuries. Although many of “A specialist is going to be more familiar with all the these injuries are linked to athletic activity, conditions like different types of surgery available,” he continues. “He ankle sprains and knee injuries can affect anyone—not or she has more experience with which surgery best just athletes.” addresses the specific problem, and is trained to respect the lifestyle objectives that the patient wants to protect.”

Sports medicine physicians offer expertise in the treatment of a variety of musculoskeletal problems.

As a sports medicine surgeon, Dr. Furmanek performs about 450 shoulder and knee surgeries every year. Like Some of the most common injuries they treat include: his fellow specialists, he follows developing advances in his »»Acute injuries: These are injuries that occur as the result area and can educate patients about all available treatment of a sudden impact or fall, such as ankle sprains, muscle risks and benefits. strains, knee and shoulder injuries, and bone fractures.

“I am also going to factor my patient’s life-specific activi»» Overuse injuries: These problems develop over time ties into consideration,” says Dr. Furmanek. “We call this when a repetitive motion causes stress on bone or tissue ‘directing our care.’ I want to know how your symptoms that results in gradual damage. Tendinitis and stress are affecting your life. Are you a runner? If an injury only fractures are examples of overuse injuries. hurts when you run, runners who want to get back on the trails will probably be more interested in surgical options to “Your specialist becomes your partner in managing your reduce pain and improve function. For non-runners, surinjury,” explains Dr. Furmanek. “There are nuances to gical options may have a much lower priority. Our tailored each individual diagnosis. One person may respond best to care means that we work with you to create a personalized physical therapy. Another patient may prefer a longer regtreatment plan with your objectives in mind.” imen of conservative treatment options before considering

EXCEL.

SMART OPTIONS FOR ON-THE-GO MEALS

S

ometimes, there’s simply no time for thoughtful meal preparation. Dietitian Kayley Gamm offers options that provide good nutrition without slowing you down.

“You don’t need to sacrifice good nutrition for a quick meal.”

— KAYLEY GAMM, R.D., L.D.

THREE PLACES TO FIND HEALTHY ON-THE-GO MEALS “Limited time to eat doesn’t have to mean a meal with limited nutritional benefit,” says Kayley. “In this day and age, it is really easy to throw together a quick and nutritious meal on the go. There have been many times when I have had to opt for convenience rather than planning ahead. When you know where to look, it’s easier than you think to make healthy choices while on the move.”

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encourage clients to skip fried foods, opting for a plain burger and a side salad instead. Another great option is a 6-inch sub sandwich.

Whole-grain bread will boost up the fiber, keeping you full longer.

Turkey or chicken provide great lean protein, and if avocado is an option, you’ve got an excellent healthy fat in the mix. Don’t forget to load up on veggies! Vegetables are a nutritional boost that should be included with every meal.

Think of portions when dining out: “Dining out is a challenge for many people,” says Kayley. “But you can usually find healthy options on a menu. Fish and lean meat entrees with vegetables are great.

Often times, restaurants portions are more than double the standard serving size. Order off the appetizer menu or share a dish to keep the portions under control.”

Find on-the-go meals at the gas station: “There are actually some really great food choices at a gas station or convenience store,” Kayley chuckles. “You’ll find hard-boiled eggs, Greek yogurt, fruit, sandwiches or wraps and protein shakes. A hard-boiled egg, a piece of string cheese, and a PRACTICE HEALTHY EATING HABITS WHEN piece of fruit make a great breakfast on the go. CHOOSING ON-THE-GO MEALS A sandwich or a protein shake can be a quick “When you are busy, be aware of your hunger. You don’t want to lunch while on the road.” be starving when you sit down to a meal. Also think about balance Don’t compromise nutrition when eating fast food: when you order a meal. When eating on the run, use the equation: “Sometimes when you are traveling, fast food is the whole-grain + lean protein + vegetable = balanced meal. Choosing most convenient option,” Kayley acknowledges. “I convenience or quick foods doesn’t mean that you have to give up on nutrition.” healthy + active: sports medicine edition

Talent wins games, but teamwork wins championships. —Michael Jordan

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