Preventing Concussions in High School Athletes

August 4th, 2014 Comments off

high school football team scrimmage practice

Photo By: K.M. Klemencic

The rate of concussions in high school athletes more than doubled between 2005 and 2012, according to a new study published in The American Journal of Sports Medicine.

That increase isn’t necessarily due to the fact that more student athletes are being injured, but is likely due to an increase in awareness and education about concussions.

“I believe what is explaining the increase is the increased awareness, not that sports are more dangerous,” said lead researcher Dr. Joseph Rosenthal, an assistant professor of physical medicine and rehabilitation at Ohio State University. “It’s just that the concussions are being recognized more, which is good news.”

The education about concussions isn’t simply about awareness and detection, but also about prevention.

“Concussion prevention comes down to a few different things,” said Dr. Vernon Williams of the Kerlan-Jobe Center for Sports Neurology. “From sport-specific technique to wearing proper equipment and strengthening the neck, there are a number of steps athletes, parents, and coaches can take to help prevent the occurrence of a sports concussion.”

Dr. Williams offers these tips for concussion prevention in the student athlete:

• Avoid collisions — Collision sports like football, wrestling, and have some of the highest concussion rates in young athletes. Teaching athletes proper technique to avoid collisions with the head can help reduce the likelihood of concussions in these sports. Tackling technique, keeping the head up, not leading with the head and other technique-related education is important for student athletes.

• Wear properly fitting headgear — A properly fitting helmet worn in the right position can also help prevent concussions. There is even some emerging data from the University of West Virginia that suggests some helmet types and brands better protect against consussions than others.

• Focus on strengthening the neck — Athletes who have strong necks have some protective benefit because a strong neck stabilizes the head and spine better, is less prone to forces of impact, and therefore less prone to concussions. Isometric neck strengthening, particularly in football, soccer, and other collisions sports can help reduce an athlete’s risk of concussion for both boys and girls.

• Stay hydrated — Hydration is often overlooked when it comes to concussions, but it is another important factor to consider. Dehydration causes significant changes in mental function and reaction time, thus putting an athlete at a greater risk of injury or concussion. Even minimal dehydration can increase an athlete’s concussion risk.

• Train the brain — Training the brain to improve vision, balance, reaction time, and speed of mental processing allows an athlete to better protect him or herself, therefore reducing risk of concussion.

In addition to these tips, Dr. Williams stresses the importance of removing an athlete suspected of suffering a concussion from play immediately and not allowing the athlete to return to play until the brain is healed. Second concussions most often occur within 10 days of the first concussion. When an athlete is returned to play too soon, he or she is at increased vulnerability of suffering a second concussion because the brain hasn’t regained its function and speed of mental processing.

Click here to watch a discussion on concussions in sports with Dr. Vernon Williams, Director of the Kerlan-Jobe Center for Sports Neurology and Pain Medicine.

To learn more about concussions, including sports concussions, prevention, treatment and symptoms of concussions, visit the Centers for Disease Control page on Traumatic Brain Injury.



Pitching Rehab: Is the Interval Throwing Progression Really Best?

July 22nd, 2014 Comments off

pitcher throwing baseball

As a pitcher rehabs from an elbow or shoulder injury that required surgical intervention, he must complete a multiphase rehabilitation program known as the interval throwing progression as he works his way back to the mound.

The interval throwing progression has been part of baseball rehabilitation and conditioning for decades, but little was known about the upper extremity loads an athlete is subjected to during this progression.

“Much of what is done in baseball rehab is done simply because we’ve always done it this way,” said Karen Mohr, PT, Director of the Kerlan-Jobe Orthopaedic Foundation. “There’s not always a lot of science behind it.”

Researchers at Kerlan-Jobe wanted to take a look at whether or not this throwing progression is the most effective and efficient method of pitching rehab. Sports medicine doctors and physical therapists at Kerlan-Jobe evaluated the loads on the shoulder and elbow during the interval throwing progression and published their results in the report Biomechanical Comparison of the Interval Throwing Program and Baseball Pitching. Read more…

Kinesio Tape: Can this trendy tape benefit athletes?

July 20th, 2014 Comments off

WhAthlete wearing kinesio therapeutic  tapeen nineteen-year-old Nick Kyrgios defeated Rafael Nadal at Wimbledon, tennis fans were talking about more than his impressive talent on the tennis court; social media was abuzz about the “tattoo” on his forearm.  However, what fans thought was a long strip of tribal body art extending from his right wrist up into his sleeve was actually elastic therapeutic tape, also known as “kinesio tape.”

Athletes in a variety of professional sports, including tennis, golf, World Cup soccer players and Olympic athletes, have recently been seen sporting the tape.  In her “ice bucket challenge” video, Michelle Wie is seen with bright blue tape crisscrossing her left leg. But does this trendy tape have any real therapeutic value?

The tape is used to provide muscle and joint support for athletes without restricting movement.  But since the last time we reported on kinesio tape, there is still no real scientific evidence that the tape provides any benefit to athletes.  Those who tout the benefits of the tape claim that it works by lifting the skin, reducing pressue and relieving pain and swelling.  However, other scientists suggest that the tape has little more than a placebo effect for the athletes who use it.

Read more about kinesio tape here.


Summer Sports: Wakeboarding & ACL Injury

June 30th, 2014 Comments off

Wakeboarding is a relatively new sport, invented in 1985 by San Diego surfer Tony Finn. Over the last three decades, the sport has evolved from a recreational experiment into a competitive water sport that combines techniques used in water skiing, snowboarding and surfing.

Because the sport is so new, there is little research on the types of common wakeboarding injuries. However, the extreme stunts performed in wakeboarding put athletes at a high risk of a lower extremity injury. In fact, one 2012 study published in the journal Sports Health: A Multidisciplinary Approach identifies knee injuries as some of the most prevalent among wakeboarding, even ranking wakeboarding among some of the most dangerous sports for the knees.

In the study, researchers from Emory University in Atlanta and the Center for Sports Medicine and Orthopaedics in Chattanooga surveyed professional and amateur wakeboarders seeking information on history of ACL knee injuries. Of the survey respondents, 42 percent said they had suffered an ACL tear while wakeboarding.

The prevalence of ACL tears found in the study ranks among the highest injury in sports. According to the research, the primary mechanism of injury involves axial compression when landing a jump or stunt.

An ACL knee injury typically requires surgical reconstruction and months of rehab following the injury. While some ACL injuries may be treated with non-surgical methods such as physical therapy, an ACL injury often requires one of several surgical options to successfully restore knee strength and stability.

Kerlan-Jobe Fellow Works with ASU Wake Devils Wakeboarding Team

Last month, Ossur sponsored Dr. Tim Bert, Kerlan-Jobesports medicine fellow who now works in Arizona to accompany the Arizona State University Wake Devils wakeboarding team to the National Wakeboarding Championships in Las Vegas as full-time medical staff. Dr. Bert and other staff worked with the athletes to prepare them for competition in an effort to reduce the athlete’s risk of injury.

Wake Devils Welcome OSSUR/CTI from Wake Devils on Vimeo.

Dr. Daniel Kharrazi: Team physician to the LA Sparks

June 27th, 2014 Comments off

LA SparksOn June 21, 1997 the Los Angeles Sparks and the New York Liberty tipped off the first WNBA game in Los Angeles. Sparks Guard Penny Toler scored the league’s first basket. Kerlan-Jobe Orthopedic Surgeon and sports medicine specialist, Daniel Kharrazi, M.D., has been with the LA Sparks all the way.

When he first started covering the Sparks as team physician, Dr. Kharrazi was a Sports Medicine Fellow at Kerlan-Jobe. He worked alongside Kerlan-Jobe physician Stephen Lombardo, M.D., who now serves as team physician for the Los Angeles Lakers. Doctors Lombardo and Kharrazi work together to provide sports medicine care to both teams.

As team physician, Dr. Kharrazi helps to identify and diagnose injuries, stays up-to-date on players’ progress throughout physical therapy and assesses their ability to return to the game. Although he does not travel with the team, Dr. Kharrazi covers all home games played in LA.

Dr. Daniel Kharrazi, Kerlan-Jobe Orthopaedic Clinic

Dr. Daniel Kharrazi, Kerlan-Jobe Orthopaedic Clinic

Player education is the most important part of his job as team physician, says Dr. Kharrazi. Keeping players educated about their injuries and treatments available to get them back on the court as soon as possible is his main goal. The team’s Physical Therapists work with players to rehab from injuries and educate them about injury prevention.

The most common injuries seen in basketball include knee and shoulder injuries. ACL, meniscal and cartilage knee injuries are common. Depending on the type of injury, most players with knee injuries can expect to be out of the game anywhere from six weeks for a torn meniscus or cartilage injury to six months for an ACL knee injury.

In his decision to specialize in sports medicine, Dr. Kharrazi says it is the young, athletic players who recover quickly that are his biggest inspiration.

“Professional athletes are incredibly motivated,” says Dr. Kharrazi. “They are unique specimens that can rehabilitate from an injury much faster than a normal person and they are really motivated to return to the game. Watching players rebound from an injury is really rewarding.”



Official Statement by Dr. Ralph Gambardella on the passing of Kerlan-Jobe CEO Woody Runner

June 24th, 2014 Comments off

Woody RunnerIt is with a heavy heart that we share with you the tragic and sudden loss of our dear friend and Chief Executive Administrator Woody Runner. We are deeply saddened by his passing and ask that you join us in sending your thoughts and prayers to his family, friends and loved ones during this most difficult time. Woody was a beloved husband, father and grandfather who was admired as much for his generosity and compassion as he was for his leadership and dedication to enhancing Kerlan-Jobe’s legacy. He will be sorely missed.


Ralph A. Gambardella, M.D.
President and CEO
Kerlan-Jobe Orthopaedic Clinic

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Benefits and Risks of Yoga

June 9th, 2014 Comments off
men and women doing yoga

Photo by daveynin, Flickr Creative Commons

Many people of all ages and athletic ability turn to yoga for relaxation, exercise and even relief of joint and muscle pain. While there are many benefits of yoga, when not practiced carefully and correctly, yoga stretches can also pose the risk of serious muscle injuries.

Benefits of Yoga

According to the American Academy of Orthopaedic Surgeons (AAOS), the “rewards of basic yoga outweigh the potential physical risks, as long as you take caution and perform the exercises in moderation, according to your individual flexibility level. These rewards include improved strength, balance, and flexibility, as well as improved sense of well-being. Yoga may also be beneficial for certain bone and joint problems like carpal tunnel syndrome, tennis elbow, and arthritis.”

In addition to improved strength, balance and flexibility, research also suggests benefits of yoga may include:

• Reduce risk of heart disease
• Ease headaches and migraines
• Promote a healthy weight
• Provide relief from chronic back and neck pain
• Improve sleep
• Lower blood pressure
• Reduce stress

Risks of Yoga

Although yoga offers a number of benefits and can be used to rehab from sports injuries, it also comes with some risks of injury if proper precautions when practicing yoga are not taken. According to AAOS, common yoga injuries include “repetitive strain to and overstretching of the neck, shoulders, spine, legs and knees.”

Here are a few things you can do to prevent injuring yourself while practicing yoga:

• Talk to your doctor before starting yoga.
• Only work with a qualified yoga instructor and discuss any known injuries or illness with your instructor prior to the start of the class.
• Start slowly and establish a good foundation in the basics of yoga before moving on to advanced poses.
• Warm up before a yoga session as cold muscles, tendons and ligaments are more prone to injury.
• Don’t hesitate to ask questions if you are unsure of a yoga pose or movement.
• Know your limits and listen to your body. Do not attempt poses or movements that are beyond your level of experience or comfort. If you experience any pain, stop and take a break. Consult with your physician if pain persists.
• Stay hydrated, especially when participating in hot yoga.

Sprained Thumb: Treatment, Recovery and Prevention

May 28th, 2014 Comments off
thumbs up

Credit: Sarah Reid, Flickr Creative Commons

Washington Nationals’ left fielder, Bryce Harper was sidelined until July following a ligament sprain in his left thumb that will require surgery. Harper’s surgery is the same type of surgery Los Angeles Angels slugger Josh Hamilton underwent earlier this spring.

Kerlan-Jobe orthopaedic surgeon, Dr. Steven Shin recently spoke with Bleacher Report about Harper’s thumb injury and explained the surgery and prognosis for patients undergoing this type of procedure.

Explanation of the injury

A sprained thumb is an injury to the primary ligament in the thumb, the ulnar collateral ligament. This type of injury is common in falls. When you fall, it’s natural to catch yourself by extending your arm and hand. How you land can stretch your hand, resulting in a strain or sprain. In this type of injury, the ulnar collateral ligament may be partially or completely torn. Read more…

Impingement Syndrome: What You Need to Know

May 26th, 2014 Comments off

In this video from ATLXTV on Common Sports Injuries, Dr. Neal ElAttrache of the Kerlan-Jobe Orthopaedic Clinic discusses Impingement Syndrome, a common sports injury for overhead athletes.

Dr. Neal ElAttrache is a Sports Medicine Surgeon and member of the KJOC board of directors. Dr. ElAttrache is the team physician for the LA Dodgers and an orthopedic consultant for the Anaheim Ducks, St. Louis Rams, LA Lakers, LA Kings, and the PGA Tour. Suffice it to say, Dr. ElAttrache knows his stuff. Among Dr. ElAttrache’s numerous accomplishments:
• Listed among 2006-2001 “Best Doctors in America”
• Named a “Super Surgeon” –Baseball Prospectus
• Selected 2011 “Super Doctor of Southern California” –
• Voted a 2010 “Super Doctor” — Los Angeles Magazine

Dr. Podesta to Serve As Team Physician for LA’s New Arena Football Team

April 16th, 2014 Comments off
Dr. Luga Podesta at the Honda Center in Anaheim where the LA KISS play.

Dr. Luga Podesta at the Honda Center in Anaheim where the LA KISS play.

Many of our doctors serve as team physicians for a variety of professional, collegiate and high school sports teams. Luga Podesta, M.D. is one of those. Specializing in non-surgical sports medicine, Dr. Podesta has served as a Team Physician for the LA Dodgers, LA Avengers Arena Football team, and the LA Riptide professional lacrosse team, among others.

This season, Dr. Podesta is joining the LA KISS arena football team as team physician. While there are differences from sport to sport, Dr. Podesta says there are also many similarities from sport to sport when working as a Team Physician.

“Our job is to make sure our athletes aren’t returning to play with an injury that could lead to a permanent  or catastrophic injury,” he says.

Specific challenges faced by the Team Physician for an arena football team are much the same as faced by the physician working with an NFL team. “Football is a collision sport; players will get hurt and they will play with injuries,” says Dr. Podesta. “It’s a matter of figuring out what injuries are safe for them to play with, and which injuries are not safe to continue play.”

A 2008 study published by Dr. Podestain the American Journal of Sports Medicine,Injury Patterns in Professional Arena Football,found similar injury patterns in both the field and arena game. The primary difference between injuries in arena football and the NFL is that more arena football players suffer stress fractures and fractures in the foot due to the harder playing surface.

Dr. Podesta and Dr. Banffy examine an LA KISS player.

Dr. Podesta and Dr. Banffy examine an LA KISS player.

The pressure is on for physicians working with collision sports like football, hockey and lacrosse teams compared to sports like baseball, Dr. Podesta explains. “In football, the physician can actually have an impact on the game. For example, in baseball, if a player comes out of the game with an injury, they’re usually done for the outcome of the game,” he says. “Whereas in football, lacrosse and hockey, there’s a lot the physician can do to treat the players on the sidelines and get them back into the game. That’s where the team physician really becomes valuable to the team.”

To prepare for the season and potential injuries, physicians practice different routines for different injury scenarios, such as on field management of spinal injuries. To diagnose and treat injuries for the LA KISS, Dr. Podesta and other physicians working with the team, including two other Kerlan-Jobe sports medicine specialists, Michael Banffy, M.D. and Vernon Williams, M.D., will use musculoskeletal ultrasound to diagnose soft-tissue injuries on the field. They will also have x-ray technology available at the stadium to aid in diagnosing skeletal injuries and computer based neurocognitive tests to help diagnose concussion.

Though they are well prepared, Dr. Podesta hopes this first season with the LA KISS will be a quiet one as far as injuries go. “You really hope you’re more of an observer than a participant,” he says. “You prepare for all scenarios, including back injuries and concussions, but hope you never have to treat serious injuries.