Active Keeping you...
Keeping you... … is a quarterly newsletter from West Tennessee Bone & Joint Clinic. The clinic’s ten physicians specialize in sports medicine and orthopedic problems. For copies of the newsletter, contact Adam Kelley, Marketing Director, at 731.661.9825.
In this issue: True or False? What do you know about baseball injuries? Meet our doctors: They see patients in your communities Overuse injuries caused by repetition • Prevention tips • Age-appropriate pitching charts
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Sports Medicine • Orthopedic Excellence
ACL surgery, rehab put Middle School athlete back in the game
She doesn’t like sitting on the sidelines. “I’m really ready to play,” Martin said. “I miss pain. my team. I really just She knew right away she was hurt, but it was an want to get back.” important game against Bradford Middle School. She Martin and wanted to stay in. her mom met “It just popped,” said 14-year-old Martin. “It kind with Dr. of scared me. I tried to run on it. I never thought that Pearce, who I would get hurt to the point I couldn’t play.” specializes in She didn’t know it at the time, but Martin tore her sports medianterior cruciate ligament (ACL). It’s a common but cine and ortraumatic injury that will sideline an athlete for thopedic months. surgery, as well as Martin and her mother, Kimberly Manning, went arthroscopy and joint to West Tennessee Bone & Joint Clinic shortly after replacement and reconstruction. He performed surthe injury to get an official diagnosis from Dr. David gery to repair Martin’s knee on December 22, and Pearce. An X-ray was negative, but an MRI proved then she began the long road to recovery. what they had suspected. Despite her daughter’ s tough situation, Manning The ACL was torn. Martin was out for the season. said the clinic has made her daughter “That’s not anything a parent feel comfortable and strong. wants to hear,” Manning said. “Everybody there has been great,” The ACL is one of the knee’s Manning said. “Dr. Pearce has been four major ligaments. It attaches to awesome.” the femur and the tibia, and helps Martin visits the clinic three times keep the knee stable, preventing it a week for physical therapy. Manfrom bending in the wrong direcning expects Martin to continue the tion. You can’t play sports with a rehab until July or even August. And, torn ACL. maybe her daughter will be back on The news was difficult for Marthe field in September. tin. She plays basketball in the winMartin said she feels good about ter and softball in the spring, her prognosis, and she expects to be summer and fall. back on the field as soon as she can. And, she’s good. She said the doctors and therapists at At 5 feet 9 inches, she’s a standIn softball, Kaitlyn Martin is a West Tennessee Bone & Joint Clinic out on the middle school basketball power hitter and pitcher. have helped her tremendously. court, earning MVP honors in the “They’ve been great,” Martin said. “If you feel bad, Gibson County Athletic Conference her sevenththey’re there to support you. They’re like a new team grade year. In softball, she’s a power hitter and a away from my team.” pitcher who was named MVP of the USGF World Series in the 12U division. Continued, Page 3…
aitlyn Martin, an eighth grader at Medina Middle School, was midway through her basketball season when her knee exploded with
731.661.9825 n 888.661.9825 n www.wtbjc.com
Meet our doctors: They see patients in Dr. Lowell Stonecipher
Dr. Kelly Pucek
Sees patients at Main Clinic only 24 Physicians Drive, Jackson Dr. Stonecipher, board certified in orthopedic surgery, started the West Tennessee Bone & Joint Clinic in 1973. His medical degree is from Tulane University School of Medicine, New Orleans. His residency was at Greenville, South Carolina, General Hospital. Dr. Stonecipher specializes in general orthopedic surgery, spine surgery, arthroscopy and joint replacement. He was the first physician in Jackson to do endoscopic surgery to relieve carpal tunnel pain.
See patients in Selmer every two weeks McNairy Hospital Outpatient Dept. 705 E. Poplar Ave. Dr. Pucek’s medical degree is from the University of Arkansas in Little Rock. His internship and residency were with UT at Erlanger Medical Center in Chattanooga. He received special training in trauma and is board certified in orthopedic surgery. Dr. Pucek specializes in general orthopedic surgery, joint replacement, arthroscopy and trauma surgery.
Dr. Harold M. “Trey” Antwine III
Dr. Michael Cobb Sees patients in Brownsville every two weeks Haywood Park Community Hospital 2545 N. Washington Ave. Dr. Cobb earned his medical degree at UT Health Science Center in Memphis. His internship and residency were at the City of Memphis Hospital; his residency in orthopedic surgery was at the Campbell Clinic in Memphis. He is board certified in orthopedic surgery. Dr. Cobb specializes in general orthopedic surgery, arthroscopy, sports medicine and joint replacement and reconstruction.
Sees patients in Lexington every week Family Physicians of Lexington, 250 Boswell St. Dr. Antwine, board certified in orthopedic surgery, graduated from Tulane University School of Medicine. His internship and residency were at Greenville Memorial Hospital and Shriner’s Hospital for Crippled Children in Greenville, South Carolina. He has a subspecialty certificate in orthopedic sports medicine. He specializes in orthopedic surgery, sports medicine, arthroscopy and joint replacement and reconstruction.
Dr. David Johnson
Dr. David Pearce
Sees patients in Parsons monthly Decatur County Hospital, Outpatient Dept. 969 Tennessee Ave. S Dr. Johnson earned his medical degree at the UT Health Science Center, Memphis. His internship was at Methodist Hospital; his residencies were at Methodist Hospital and the Campbell Clinic, all in Memphis. He is board certified in orthopedic surgery. Dr. Johnson specializes in general orthopedic surgery, sports medicine, arthroscopy and joint replacement and reconstruction.
Sees patients in Union City every week Doctor’s Clinic of Union City 1020 E. Reelfoot Dr. Pearce, a graduate of Georgetown University School of Medicine, completed his residency at the Medical College of Virginia in Richmond and then had a fellowship in sports medicine at Thomas Jefferson University in Philadelphia. Dr. Pearce, who is board certified in orthopedic surgery, specializes in sports medicine, general orthopedic surgery, joint replacement and reconstruction and arthroscopy.
For an appointment at a satellite clinic, call 888.661.9825
How much do you know about baseball injuries? rue or False? Knee injuries are the most common injuries in baseball. False: Shoulder and elbow injuries are the most common Little League injuries, particularly among pitchers.
rue or False? Shoulder and elbow injuries usually occur in youth baseball due to poorly conditioned throwing arms and poor throwing/pitching mechanics. True: Generally, muscles of the shoulder are underdeveloped and then become
overused, resulting in increased strain placed upon both the shoulder and the elbow. rue or False? If a young athlete is throwing too hard, too much and without rest, a serious elbow or shoulder injury may be on the horizon. True!
rue or False? A young athlete should begin throwing breaking pitches at a young age in order to master the technique
before playing high school baseball. False: Introduction of breaking pitches to a young pitcher’s repertoire too early can actually result in permanent damage of immature soft tissue structures, as well as growing parts of the bone (growth plate). Growth plates are the areas of developing cartilage where bone growth occurs in children. The growth plates are weaker than the surrounding ligaments and tendons, making them more susceptible to injury. By Marty Grooms, OTR/L
Dr. Jason Hutchison Sees patients in Dyersburg every week Med-South Clinic, 1700 Woodlawn Dr. Hutchison earned his medical degree at UT Health Science Center in Memphis. His internship was at Methodist Hospital and his residency was at the Campbell Clinic, both in Memphis. Board certified, he specializes in general orthopedic surgery, sports medicine, arthroscopy and joint replacement and reconstruction.
Dr. Adam Smith Sees patients in Bolivar every two weeks Bolivar General Hospital, 650 Nuckolls Dr. Smith earned his medical degree from the University of Kentucky College of Medicine. His internship and residency were at Wake Forest University Baptist Medical Center in North Carolina. He did a fellowship at Mayo Clinic, Rochester, Minnesota. Dr. Smith is board certified in orthopedic surgery. He specializes in shoulder and elbow reconstruction and has a strong interest in hip arthroscopy.
Dr. Doug Haltom Sees patients in Ripley every week Ripley Medical Clinic, 202 Tucker Avenue Dr. Haltom earned his medical degree at UT Health Science Center in Memphis. His internship was at UT at Chattanooga and his residency was at the University of Missouri-Columbia. He did a fellowship at the Indiana University/Methodist Sports Medicine Center. He is board certified in orthopedic surgery.
Dr. John Everett Sees patients in Dyersburg every two weeks Med-South Clinic, 1700 Woodlawn Ave Practicing at West Tennessee Bone & Joint Clinic since 1978, Dr. Everett received his medical degree from UT Health Science Center in Memphis. His intership was at Parkland Hospital, Dallas, and his residencies were at Methodist Hospital and the Campbell Clinic in Memphis. He has a special interest in osteoporosis and sees patients with the condition every other Monday at the main clinic in Jackson.
Kaitlyn Martin Continued from front cover… Martin is expected to make a full recovery. And when she returns to sports, she won’t be playing for Medina Middle School anymore. It will be a new challenge with a new team, but Martin can’t wait to get back in the game. “High school is a totally new competition that I feel I’m ready for,” Martin said. And she will be ready — thanks to West Tennessee Bone & Joint Clinic.
Little League shoulder describes an injury to the growth plate in the shoulder. This occurs from repetitive microtrauma from overhead activities, such as throwing. X-rays, above, often show widening of the growth plate.
Overuse injuries Prevention tips
Recommended veruse injuries, especially those Average Age related to the shoulder and ulnar for Various Pitches collateral ligament in the elbow, are Pitch Age preventable. Fastball 8 Here are some tips to keep you Slider 16 healthy and in the game… Change-up 10 n Warm up properly with stretching, Forkball 16 running and easy, gradual throwing. Curveball 14 n Rotate playing other positions beKnuckleball 15 sides pitcher. Screwball 17 n Concentrate on age-appropriate pitching. Master the fastball first Source: James R. Andrews, M.D., and Glenn S. Fleisig, Ph.D. and the change-up second, before considering breaking pitches. (See box, top right.) Maximum Pitch Counts n Adhere to pitch count guidelines. Age Pitches/Game (See box, at right.) 7-8 50 n Don’t pitch with elbow or shoul9-10 75 der pain; see a doctor if the pain 11-12 85 persists. 13-16 95 n Don’t pitch on consecutive days. 17-18 105 n Don’t play year-round. Source: Little League Baseball n Never use a radar gun. n CommuniRest Periods Required cate reguNo. of Pitches for ages... Required larly about 14 & Under 15-18 No. of Rest Days how your 66+ 76+ 4 days arm is feel51-65 61-75 3 days ing and if 36-50 46-60 2 days there is 21-35 31-45 1 day pain. 1-20 1-30 None n Avoid pitchSource: Little League Baseball ing on multiple teams with overlapping seasons. n Emphasize control, accuracy and good mechanics. n Speak with a sports medicine professional or athletic trainer if you have concerns about baseball injuries or injury prevention strategies. These sports tips provide general information only and are not a substitute for your own good judgment or consultation with a physician. Information is provided through the website, www.STOPSportsinjuries.org.
Overuse injuries caused by repetition
s we move into By Doug Haltom, M.D. spring and then summer, baseball is back. Sports requiring repetitive overhead motion, such as baseball, can lead to shoulder and elbow overuse injuries, especially in children and adolescents. Unique to children and adolescents are their developing physes, or growth plates. These areas are inherently weak and are therefore susceptible to overuse injuries. Growth plates are the areas of bone that contribute to the growth of that particular bone.These areas are weaker than the tendons and ligaments that attach to them, making them more susceptible to overuse injuries. The proximal (upper) part of the humerus at the shoulder and the medial (inside) part of the elbow are the most common areas for these types of injuries in adolescents. Little League shoulder is the term used for this type of injury to the growth plate in the shoulder. This occurs from repetitive microtrauma from overhead activities, such as throwing. Patients complain of shoulder pain, made worse with throwing. A recent increase in the amount of throwing often precedes the symptoms. Patients usually have tenderness of the shoulder and weakness of the shoulder muscles. X-rays often show widening of the growth plate. (See image, inside.) Likewise, Little League elbow is a term
used to describe an overuse injury to the inside part of the elbow’s growth plate and its surrounding structures. This area does see significant tension during a portion of the throwing motion. (See picture, below.) Patients complain of elbow pain, decreased throwing velocity, and decreased throwing distance. X-rays can be normal or can show several distinctive growth plate abnormalities around that part of the growth plate. Treatment for both of these conditions is rest. The initial period of rest and avoidance of throwing is usually four to eight weeks, followed by stretching, strengthening and a throwing progression. Athletes usually return to their pre-injury level of play, and long-term consequences are rare. Proper throwing mechanics and careful attention to pitch counts (specific for age) are very important in preventing these overuse injuries. See inside for a chart on pitch counts for each age and information on how to prevent these injuries.
Keeping You Active
The physicians and staff at West Tennessee Bone & Joint Clinic, P.C. specialize in comprehensive orthopedic care. They diagnose and treat diseases and injuries of the bone, muscles, tendons, nerves and ligaments in adults and children.
Jackson • Brownsville • Selmer • Lexington • Parsons • Dyersburg • Union City • Bolivar • Ripley
24 Physicians Drive, Jackson