August 3rd, 2010
The reason for mentioning this injury is it is the same injury Carlos Boozer had at the end of the Jazz season, when he couldn’t play the last game of the season but then miraculously recovered to play a few days later without apparent limitations in the playoffs. The “obliques” are muscles of the abdominal wall that are involved in the twisting motion which is big in baseball. Hitting, throwing, and running the bases all put a demand on these small but important muscles, and any motion that puts stress on the injured muscle can cause a sharp stabbing pain that can be fairly disabling. It can take anywhere from 7-10 days to 4-6 weeks for these injuries to heal and the main treatment is rest from the motions that cause the pain. It is possible to play through the injury if the pain is not too severe, but it will prolong the healing time if it keeps getting “tweaked”. Cabrera’s return will again be a day to day determination based on his functional level, but could be short or long.\
Tags: Cincinnati Reds, Orlando Cabrera
Posted in MLB, Torso Injury | No Comments »
July 29th, 2010
Bay has been diagnosed with a mild concussion from running into the wall Friday. He has had continued to have symptoms since then, and per the discussion yesterday on concussion, has still been able to play. Now, however, he will be held out of the lineup for a few days. I’m not sure what he had in the way of symptoms, but they can generally range from a lightheadedness, dizziness and mild nausea to headaches with exertion. As was discussed yesterday, the symptoms need to be taken seriously and treated appropriately to avoid future problems.
Tags: Jason Bay, New York Mets
Posted in Head Injury, MLB | No Comments »
July 29th, 2010
It has been reported that Strassburg, the prized rookie phenom that throws up to 100MPH, has an inflamed shoulder that was evident when he warmed up for his start on Tuesday. Inflammation of the shoulder is usually a result of too much stress or strain on the tendons of the rotator cuff which is the group of muscles that is heavily involved in the throwing motion. It usually requires rest from the offending activity to allow the tissue to heal and anti-inflammatory medication and ice to speed the process. If not allowed to resolve, it can to develop into a more serious problem, so with a young arm, the Nats will probably be careful about how fast Strassburg returns and also carefully monitor his pitch count to avoid re-injury to the shoulder. Look for them to be very cautious with his arm, because he has a great future, but with as hard as he throws, he will likely be a little more susceptible to overuse problems with his arm.
Tags: Stephen Strassburg, Washington Nationals
Posted in MLB, Shoulder Injury | No Comments »
July 28th, 2010
The NFL has come out with a poster to be posted in every locker room that discusses the importance and long term ramifications of concussions in sport. It represents a change in policy which used to “soft peddle” the potential long term damage that repetitive concussions can have on football players. Recent studies have indicated that repeat brain injury can cause brain damage long term that may not have been totally recognized in the past. Football is obviously one of the highest risk sports for concussion along with rugby and soccer, so it is appropriate that it has received a lot of attention recently. A concussion is a bruise to the brain form a blow or it can occur from a whiplash type of injury where the head gets whipped back and forth. It is like a bruise to any other tissue like muscle, for instance, where there can be damage to the microscopic blood vessels and bleeding in these tissues. Sometimes this can be very dramatic and result in prolonged unconsciousness requiring brain surgery to relieve pressure. Most of the time, the injury is more subtle, resulting in an athlete being dazed or only temporarily unconscious, many times being allowed to continue to play in the game or practice as long as they seem to “be alright”. Another concussion in this state can result in serious consequences. Many athletes have continued to play at a highly functional level after a concussion and then have no memory of the event or the rest of the game they played in. I can recall Steve Young saying he got dinged in a BYU game and couldn’t remember the rest of the game though he played well and they won. The most important sign, to me, that an athlete has had a concussion is amnesia, or lack of memory for exactly what happened when the injury occurred. Many times an athlete will be able to remember everything about the game or even what they had for breakfast that day, but they can’t remember details about what happened when they got hurt. They will often keep asking what happened after they have been told and retold about it. If you are coaching an athlete and aren’t sure if they have a concussion, ask them the details of what happened. If they can’t recount how they got hurt and then what happened immediately after consider them as concussed, and have them cleared by medical personnel before they return to contact. There are testing methods, one of which is the IMPACT testing, that can be done on a computer that indicate whether the brain has recovered from the bruise it sustained with the concussion and if an athlete can safely return to contact activity. A Sports Medicine physician can administer this test if it is available to their clinic. Brain injury, unlike a muscle bruise, is difficult to recover from and can result in permanent deficits if not treated appropriately. It is good to see an organization as prominent as the NFL recognizing the importance of this injury, and hopefully there will be a “trickle down” effect where it is more adequately recognized and treated in our youth.
-Russ Toronto, M.D.
Posted in Head Injury, NFL | No Comments »
July 27th, 2010
The NFL has come out with a new flyer for players on concussion as reported by the AP and ESPNews. Tomorrow I’ll discuss the subject-what the players are being advised and helping coaches of young athletes and parents know what to make of the current recommendations for their young athletes.
-Russ Toronto, M.D.
Posted in Head Injury | No Comments »
July 27th, 2010
The L.A. Times reported that Kobe Bryant had arthroscopic knee surgery for “removal of loose bodies” in the knee that was giving him problems during the season. He had his knee drained during the season as reported by the press, and this is the third surgical procedure on that (the right) knee. It was scoped in 2003 and 2006 also. While it was termed a success and not a particularly difficult procedure, the fact that the knee has had 3 procedures would imply that there is some ‘wear and tear’ going on in that knee. In general, loose bodies in a knee are from cartilage that lines the bones in the joint and come from a sluffing off of some of that cartilage from the continual rubbing that goes on from running and jumping in sports. It also occurs in the elbows of professional baseball players from the ‘wear and tear’ of throwing. While it can’t be stated specifically for Bryant’s case unless you are the one looking at his knee, the implication in general is that knee that has had multiple procedures has some issues with cartilage wear, which is kind of like the tread on a tire getting thinner. No one can predict what might happen but the likelihood is that the days the knee has to have a lot of impact on it are numbered and that it will probably cause more problems in the future.
Tags: Kobe Bryant, LA Lakers
Posted in Knee Injury, NBA | No Comments »
March 26th, 2010
Achilles Strain/Tear/Calf Strain
This injury is common in athletes doing explosive acceleration and deceleration sports of which basketball is a prime example. The calf muscle is the second strongest in the body and originates behind the knee then goes down the back of the leg and turns into the Achilles Tendon. Strains or tears in either the muscle or the tendon can be mild or severe, and the tendon can even be a complete tear (Kalin Lucas). If the injury is in the calf muscle, milder strains can be resolved with rest from running and jumping, some therapy (ice and heat), a lift in the shoe and maintaining conditioning with biking or some other non-impact activity until an individual can hop on it with no pain. That is usually 10-14 days for a mild strain, 2-4 weeks for a moderate strain and 4-6 weeks for a severe muscle strain. Kirilenko, Bynum, and Pavlovic seem to have varying degrees of this injury. The difficulty is knowing when to return to play because while it can feel normal to jog and run easy, it may not be ready to jump and move at an NBA level so athletes may have a set back and take another week to heal which seems to be the case with Kirilenko (I don’t know any specifics). While MRI’s might substantiate the injury they really aren’t necessary to evaluate or treat the injury, but in pro-athletes they seem to be done, anyway, because they have unlimited resources (this is an editorial comment).
Achilles strains and tears are lower down from the calf muscle in one of the strongest tendons in the body. In medical terms, a strain is the same thing as a tear and means disruption of the fibers of the tendon which is similar to a rope. Milder strains or tears can be treated like the muscle strain or tear (see above). More severe or complete strains/tears are most often dealt with surgically in the competitive athlete. Once surgery is done to repair the torn tendon the athlete will be on crutches and in a boot for 6-8 weeks then rehabbing for another 2-6 months to regain full strength. Even then, there is often a slight strength loss compared to normal. It is often more difficult to completely recover from than ACL surgery.
With appropriate care and rehab in the weekend athlete, strains of the calf muscle or Achilles Tendon can heal and resumption of sporting activity should be able to be resumed.
Posted in Leg Injury | No Comments »
