May19

Carter-Williams Rookie of the Year Has Shoulder Surgery

by theprimusreport on May 19, 2014 at 10:44 pm
Posted In: General

Just days after winning the Rookie of the Year award, the Philadelphia 76ers announced guard Micheal Carter-Williams had undergone surgery on his right shoulder. Carter-Williams underwent the surgery to repair the labrum in his right shoulder. The surgery was considered a success.

NBA: Philadelphia 76ers at Atlanta Hawks

A SLAP tear is a specific kind of injury to the shoulder. To help make your shoulder more stable, there is a ring of firm tissue, called the labrum , around your shoulder socket. The labrum helps keep your arm bone in the shoulder socket.SLAP stands for “superior labrum, anterior to posterior”—in other words, “the top part of the labrum, from the front to the back.” It refers to the part of the labrum that is injured, or torn.

labrum

Symptoms of a SLAP tear may include popping, clicking, or catching in the shoulder.  Some people have pain with movement of the arm over the head or throw a ball, or feeling of weakness or instability in the shoulder.  Aching pain is common. People often have a hard time describing or pointing to exactly where the pain is.

A SLAP tear can be hard to identify, because there are so many other things that can cause  shoulder pain and because SLAP tears are not common. Ways to diagnose a SLAP tear include physical examination,  and with MRI often with dye injected into shoulde

The first step in treatment is to see whether pain medicine and rehabilitation can take care of the problem. NSAID which are anti-inflammatory medicines, may help the pain. Rehabilitation may include exercises to strengthen the rotator cuff muscles and to gently stretch the back of the shoulder.  For many people, surgery is the only thing that helps. With  arthroscopic surgery the injury is evaluate and repaired.

With nearly six months to go until the start of the 2014 season, Carter-Williams should have plenty of time to get back to full strength.

Primus Sports Medicine Staff- OB

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May17

Ibaka’s Season Ends with Calf Injury

by theprimusreport on May 17, 2014 at 10:36 pm
Posted In: General

indexThe Oklahoma City Thunder suffer a huge deficit in the remainder of the playoffs with losing one of their star players, Serge Ibaka. Ibaka is expected to miss the rest of the playoffs due to a calf injury he suffered during the playoff game against the Los Angeles Clippers,. An MRI later revealed a grade 2 strain of his planataris muscle.

251323403041045-141957BF5770096BAF0The plantaris muscle is a thin, small muscle the runs along the gastrocnemuis muscle (major calf muscle). This muscle is very active when plantarflexing (point toes downward) the foot with the knee fully extended. As with most muscles, tendons, or ligaments, when the plantaris muscle is injured it is identified with 3 levels of severity:

  • Grade I- minor trauma or “sprain.”
  • Grade II- more severe trauma or “partial tear.”
  • Grade III- severe trauma or “complete tear.”

Signs and symptoms include local swelling in the calf and pain limiting full dorsiflexion (pulling ankle upward-toes toward nose). Even with a grade 3 tear, or rupture, the treatment is non-operative. Rehabilitation can take between 1 and 2 months and can be broken up into 3 phases.

Phase 1- This phase (one week) is designed to prevent further damage, control pain, swelling and inflammation.

Phase 2- Beginning during week 2, this phase initiates some exercise to restore soft tissue mobility. These exercises include stretching and plafaf8429b07af2b3a8fe12d970a07a11a_crop_northntar flexion exercise in a seated position. Once these are tolerated well, exercises are progressed to full weight bearing (standing). All exercises should be initially performed in a slow and controlled manner.

Phase 3- Goals for this final phase consist of increasing calf muscle strength and endurance, in preparation for the return to sport program. The return to sport program can be initiated at the beginning of the fourth week if the athlete demonstrates appropriate healing.

The Oklahoma City Thunder will take on the San Antonio Spurs Monday for game 1 of Western Conference Final, as Serge Ibaka is working to recover.

 

 

Provided by the Primus Sports Medicine Staff

AS

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May16

Marlins Pitcher Jose Fernandez Has Surgery Today!

by theprimusreport on May 16, 2014 at 3:16 pm
Posted In: General

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Marlins pitcher Jose Fernandez was diagnosed with a tear of his ulnar collateral ligament earlier this week, and underwent “Tommy John” surgery this morning.  Although this is considered a season-ending injury, sources say that Fernandez’s elbow is “pristine,” making it more likely that he will return to the same level. Dr. Neal ElAttrache performed his surgery. untitled

Tommy John surgery repairs an injured elbow ligament. It’s most commonly done on college and pro athletes, especially baseball pitchers. But it’s sometimes done on younger people as well. The surgery is named after former Los Angeles Dodgers pitcher Tommy John. In 1974, he underwent the first surgery of this type. Tommy John surgery is also called UCL reconstruction. UCL is short for ulnar collateral ligament.

Here’s what Fernandez has to look forward to following surgery, and throughout the 12-18 month recovery.

For the first week, the arm is kept in a hard brace, completely immobile. The athlete can then start very gentle exercises, and by about two weeks after the surgery it’s usually possible to restart everyday tasks like eating and combing his hair.  The average wait is around four months for any kind of pitching activity, though it can be anywhere from three to six, depending on the patient’s recovery. It is crucial not to rush the process. While the arm may feel great, there is a definite risk or re-injury should the new tendon/ligament be over-taxed, especially early on in recovery. As with any arm injury, the distance and velocity of the throwing is gradually increased, up until the pitcher is once again throwing off a mound. Here’s a typical time table:

0-7 Days: Splint is worn, squeeze a soft ball.

1-4 Weeks: Discontinue splint; sling worn for one more week; gradually achieve full range of motion.

1-2 Months: Full range of motion at elbow, wrist, forearm, shoulder; lightweights for forearm exercises.

2-3 Months: Continue lower body conditioning program; continue exercises for upper extremities, including rotator cuff.

3-4 Months: Easy tossing (no wind-up), 25-30 throws building up to 70.

4-5 Months: Continue throwing program with easy wind-up, 20-50 feet, 10-40 throws.

5-6 Months: Throwing program extends to 60 feet at half-speed.

6-7 Months: Gradually increase distance to 150 feet.

7-8 Months: Progress to a mound at half- to three-quarters speed, using proper body mechanics (stay on top of the ball, keep elbow up, throw over the top, follow through with the arm and trunk).

9-10 Months: Simulate game situations.

10-12 Months: Begin normal routine and make appropriate rehab starts.

After 10-12 months the recovery is not fully complete. It will often take another year for a pitcher to become completely comfortable with his new arm.  Most major league pitchers return from ulnar collateral ligament reconstruction by the second season after surgery.

Provided by Primus Sports Medicine Staff

 AS

 

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May14

Mo Williams is Questionable for NBA Playoffs Game 5

by theprimusreport on May 14, 2014 at 1:19 pm
Posted In: General

The Trail Blazers did not have their leading bench scorer for  Game 4 of their Western Conference semifinal series against San Antonio.  Mo Williams originally injured his left groin in Game 6 against Houston, then re-aggravated it in Game 2 against the Spurs.  He is questionable for Game 5 tonight. Mo williams

A groin pull is an injury to the muscles of the inner thigh. The groin muscles, called the adductor muscle group, consists of six muscles that span the distance from the inner pelvis to the inner part of the femur (thigh bone). These muscles pull the legs together, and also help with other movements of the hip joint. The adductor muscles are important to many types of athletes including sprinters, swimmers, soccer players, and football players.

A groin pull is an injury to the adductor muscles called a muscle strain.  When a muscle is strained, the muscle is stretched too far. Less severe strains pull the muscle beyond their normal excursion. More severe strains tear the muscle fibers, and can even cause a complete tear of the muscle. Most commonly, groin pulls are minor tears of some muscle fibers, but the bulk of the muscle tissue remains intact.

groin

 Groin pulls are usually graded as follows:

  • Grade I Groin Strain: Mild discomfort, often no disability. Usually does not limit activity.
  • Grade II Groin Strain: Moderate discomfort, can limit ability to perform activities such as running and jumping. May have moderate swelling and bruising associated.
  • Grade III Groin Strain: Severe injury that can cause pain with walking. Often patients complain of muscle spasm, swelling, and significant bruising.

The injury appears to be related to factors including hip muscle strength, preseason conditioning, and previous injury. Because of this, proper conditioning is of utmost importance to prevent the occurrence of a groin strain injury. Athletes  should incorporate adductor strengthening,  pelvic stabilization, and core strengthening into their workouts to prevent the occurrence of a pulled groin.

The initial management of an adductor injury should include protection, rest, ice, compression, and elevation (PRICE). Painful activities should be avoided. The use of crutches during the first few days may be indicated to relieve pain.

The athlete  should not be advanced to quickly back to his/her sport, as the injury may become a chronic condition. Acute strains easily can become chronic strains if proper time is not allowed for healing. Chronic strains are much more difficult to manage. Surgery is indicated in acute strains only when there is rupture and in select chronic strains that are refractory to conservative treatment.

Provided by the Primus Sports Medicine Staff-OB

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May05

Jermaine O’Neal End of Season Injury

by theprimusreport on May 5, 2014 at 12:17 pm
Posted In: General

WARRIORS VS. CLIPPERS GAME 6During Thursday’s game against the Clippers, Warriors center Jermaine O’Neal had to leave the game after suffering an injury to his right knee. Later, sources revealed that O’Neal suffered a bone bruise of his right knee. Although results of his MRI have not been revealed, according to ESPN, O’Neal said, “Anything short of an MCL, PCL or ACL tear, I’m going to play on it.” He played a total of 3 minutes during Game 7 against the LA Clippers on Saturday.jermaine-o-neal-knee

It appears that O’Neal’s right knee hyperextended while his foot was planted. While it has been revealed that O’Neal suffered a bone bruise of his patella (kneecap), with a hyperextension mechanism an injury to the ACL can also be of concern, especially if there is an associated “pop” sound and/or sensation in the knee. There are 3 levels of severity with ACL injuries.

Grade I- minor trauma or “sprain.”

Grade II- more severe trauma or “partial tear.”

Grade III- severe trauma or “complete tear.”

Amongst athletes a grade III tear almost always results in surgery to reconstruct the ACL. Grade I and II ACL injuries may not require surgery, but rather an extensive rehabilitation program. The main focus of ACL rehab, whether Grade I or Grade III, will be to regain range of motion, reduce swelling, retain muscle size and strength, and maintain cardiovascular fitness. Although O’Neal has been contemplating retirement after 17 seasons in the NBA, ending with a knee injury is not the ideal situation. Check out “The MRI Report” link for more information about what O’Neal’s MRI might tell us once it has been revealed.

 

Provided by the Primus Sports Medicine Staff-AS

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