Mar05

Tibial Stress Fracture

by theprimusreport on March 5, 2014 at 10:10 pm
Posted In: General

The New Orleans Pelicans say starting point guard Jrue Holiday has undergone surgery for a stress fracture in his right tibia and will miss the rest of the season..

Holiday, a former Eastern Conference All-Star acquired from Philadelphia last summer, has not played because of the shin injury since Jan. 8.

A stress fracture of the lower leg is generally considered an overuse injury. They are sometimes difficult to diagnose due to vague discomfort and generalized pain over the muscles of the lower leg and are often misdiagnosed as shin splints. They come on slowly over time from cumulative trauma to the muscles and bones, often due to overuse. They occurs when muscles become fatigued or overloaded and can not absorb the stress or shock of repeated impacts. Fatigued lower leg muscles transfer that stress to the nearby bone and the result is a small crack or fracture in the bones of the lower leg.

Causes 
Stress fractures are usually caused by  overtraining or overuse. They can also be caused by repeated pounding or impact on a hard surface, such as running of concrete. Increasing the time, type or intensity of exercise too rapidly is another cause of stress fractures to the feet, as is wearing improper footwear.

Women seem to be at greater risk of stress fractures than men. This may be related to a condition called “the female athlete triad,” which is a combination of poor nutrition, eating disorders, and amenorrhea (infrequent menstrual cycle), that predispose women to early osteoporosis   (thinning of the bones). The result of this decreased bone density is an increase in the risk of stress fractures.

High impact sports such as running, gymnastics, basketball, volleyball can increase the risk of stress fractures. In all of these sports, the repetitive stress of the foot strike on a hard surface causes trauma and muscle fatigue. Without the right shoes, good muscle strength or adequate rest between workouts an athlete can develop a stress fracture.

Treating Stress Fractures
The best treatment for a stress fracture is rest. Taking a break from from the routine and doing some low impact exercise for a few weeks (six to eight) can help the bone heal. If rest isn’t taken, chronic problems such as larger, and more persistent stress fractures can develop which may require surgery.

tibialStressFracture

 

Provided by Primus Sports Medicine Staff

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Mar04

Nasal Fractures: What’s Behind That Mask?

by theprimusreport on March 4, 2014 at 11:13 pm
Posted In: Basketball, General, Injuries

“LeBron James Suffers Broken Nose,” the headline that had everyone at the edge of their seats wondering, “what now?”300x300_james_140221

The nose, a centrally located projection on the face, there is no wonder that the nose is the most commonly broken bone of the face. Also called a nasal fracture, a broken nose typically occurs from a direct blow, or upward force, applied to the nose. Immediately after this injury you may notice swelling of the nose, difficulty breathing, black eyes, and, of course, pain.

It is important to consult with a physician after an injury to the nose, as a collection of blood (called a “septal hematoma”) can sometimes form on the nasal septum (divides the two nostrils). You should see a physician right away. If you are seen within one to two weeks, it may be possible to repair your nose immediately. If you wait longer than two weeks (one week for children) you will likely need to wait several months before your nose can be surgically straightened and fixed. If left untreated, a broken nose can leave you with an undesirable appearance as well as permanent difficulty in trying to breathe.

20140227_mta_su5_103-44dae9de18e2f5afc9ca6e35e6384f44Your physician will likely recommend an x-ray to help show that the nose is broken, but it can also discover other facial fractures. If your nose is still in its normal position, rest and being cautious not to bump the nose may be the only treatment. If your nose is not in its normal position it may be repaired, or repositioned, in the physician’s office. In more serious cases surgery is a treatment option. This type of surgery is considered reconstructive plastic surgery, as its goal is to restore your appearance to the way it was prior to injury. After surgery an athlete typically wears a protective facemask during activity. This facemask can be worn indefinitely to help prevent recurrent nasal fractures. When wearing the mask you may return to activity within days after initial injury or surgery. Which mask would you choose?

 

Provided by Primus Sports Medicine Staff

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Mar02

Muscle Imbalances in Distance Running

by theprimusreport on March 2, 2014 at 6:33 pm
Posted In: General

glutes

Distant running requires stamina, strength and strong muscles. The main muscles worked in the leg when running are the hamstrings and calves. However, the gluetal muscles also play a role in running. When the gluteal and hamstring muscles are weak, there is a  risk of serious injury. To minimize this risk,  one must prevent muscle weakness and improve hamstring and gluteal muscles’ flexibility and strength.

Causes

The hamstrings are three muscles located behind the knee and upper thigh. Your gluteal muscles or “buttocks” are located between the top of the hamstrings and your lower back. Weak hamstring and gluteal muscles are caused by low activity or inactivity. Long periods of sitting or standing without movement can cause both the hamstrings and gluteals to tighten, which is a sign of muscle weakness in these areas. If you have been away from distance running for awhile, you’ll have to get your hamstring and glutes back up to speed with stretches and exercises to strengthen and lengthen those muscles.

Disadvantages

Weak hamstrings and glutes affect the gait cycle and the ability to stride while running. One might suffer lower back pain, tightness in the hips and knee pain. Weak hamstrings can also lead to the misalignment of the pelvis, which leads to a stooped spine. Having weak hamstrings can cause the quadriceps located on the upper thigh in front of the leg to overcompensate and become bulky in appearance. Gluteus medius is an abductor of the thigh, and a weak gluteus medius can lead to injuries to the muscles in the thigh. Along with the hamstrings, the gluteal muscles work to stabilize the pelvis. A weak gluteus medius, will cause pelvis tilt more than usual when walking or running, causing you to waddle, or in extreme cases, to limp.

Treatment

Increase hamstring’s flexibility by stretching before a run. Stand with the leg you’re stretching directly in front of the opposite leg. Lean forward with hands on your hips while bending your back knee. If needed, place  hands on  front the thigh for balance. Hold this position for 30 seconds. Improve your gluteal muscles’ flexibility by lying flat on your back and bring one knee up toward your chest. Hold knee to the chest for 15 seconds, then slowly lower the knee. Repeat this four times before switching legs.

Considerations

Before running, warm up the muscles by stretching. If the hamstrings and glutes are weak, this increases the risk of injuries such as strains and tears. Do not stretch to the point of pain. Pain is an indicator that there may be a  tear of the muscle fibers. Stretch to a point that is physically comfortable. When stretching hold your position for 5 to 10 seconds before coming out of the stretch.

Provided by Primus Sports Medicine Staff

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Feb21

Turiaf Out With a Bone Bruise!

by theprimusreport on February 21, 2014 at 3:08 pm
Posted In: Basketball, General, Injuries, Sports
Timberwolves-Ronny Turiaf

Timberwolves-Ronny Turiaf

According to CBSsports.com, Timberwolves center Ronny Turiaf was diagnosed with a bone bruise in his knee and is out indefinitely. Turiaf suffered the injury during Wednesday’s game against the Pacers. A bone bruise, or bone contusion, refers to areas of localized bony tenderness after a traumatic injury, where there is no X-ray evidence of fracture. These painful injuries, while they can persist for several weeks, usually resolve spontaneously with no further consequences.

There are three kinds of bone bruises:untitled

  • Subperiosteal hematoma - A bone has a thin covering called the periosteum, and a direct force can cause an injury with bleeding beneath this covering, resulting in a subperiosteal hematoma.
  • Interosseous bruise - On the other hand, high compressive forces that are repetitively inflicted on a bone can cause bleeding inside the bone where the marrow is located, causing a bone bruise called interosseous bruising. This commonly occurs in the knees and ankles of professional basketball or football players.
  • Subchondral bruise – Finally, there is the subchondral bruise which occurs between a cartilage and the bone beneath it, causing the cartilage to separate from the bone with bleeding in between.

The term bone bruise is also used to describe a group of traumatic bone lesions which are very different from sub-periosteal hematomas. These injuries are usually not visible on X-ray either, however they do show up on magnetic resonance imaging (MRI). They are a feature of certain common sports injuries, such as ACL injuries, patella dislocations, and occult fractures, to name a few.  

 Causes of Bone Bruise

A bone bruise usually results from either a direct and sudden force or from repetitive compressive forces but are not strong enough to break or fracture a bone. There are many ways one can suffer from a bone bruise. Though occult bone lesions may occur wherever there is direct trauma to bone, most knee and ankle sprains are the result of forceful twisting injuries. It is thought that the bruises are caused as adjacent bones are forcefully impacted (“kissing contusions”). In ACL tears, bone bruises are mainly seen in the lateral tibial plateau (outer top edge/surface of tibia) and femoral condyle (lower end of the femur), which is consistent with the valgus (outward force) mechanism of injury.

Symptoms of Bone Bruise

images2Like most types of trauma, a bone bruise is characterized by pain and swelling. However, the pain involved in a bone bruise tends to be more severe and lasts longer than a soft tissue trauma (like in muscles). When a bone bruise is adjacent to a joint, blood and fluids can spread to the joint, causing it to swell. A bone bruise may cause minimal damage to a bone which may be detected with magnetic resonance imaging (MRI) but not by plain x-rays.

The MRI will show bone bruises as localized abnormalities in the subchondral bone (which is just beneath the joint-lining cartilage) and marrow, because of the increased water content of the injured area. The best MRI images of bone bruises are produced from Short T1 Inversion Recovery [STIR] sequences.

Treatments for Bone Bruise

How quickly a bone bruise heals will clearly depend on the severity of the initial injury, as well as the level of activity during the healing phase. As bone bruising in the knee is so often associated with ligamentous and meniscal damage, it is difficult to attribute clinical symptoms to bruising alone. For this reason MRI is the best way of demonstrating healing.

After a traumatic injury, it is best to rule out a fracture by consulting a doctor who may request tests to be done. When a bone bruise is diagnosed with an MRI, one should rest the involved bone or joint and avoid any type of stress that could impede the healing process.

Immediately after injury, apply an icepack over the injured area to prevent excessive swelling and pain. You may also take anti-inflammatory medications to reduce severe inflammation and pain, which can last for more than a few weeks to a month.

Avoid placing more stress on the bruised bone area to allow adequate healing. A bone bruise heals more slowly than a soft tissue damage. To support and protect a bone near a joint from further trauma, it is advisable to wear a brace.

If you are a smoker, we advise against using tobacco or nicotine, which can delay the healing process, since they constrict blood vessels, thus reducing blood flow to the area.

Provided by Primus Sports Medicine Staff

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Feb18

Jammed! Common Finger Injuries in Basketball

by theprimusreport on February 18, 2014 at 1:24 pm
Posted In: Basketball, General, Injuries, Sports

untitled1 During basketball season you may think that knee injuries are the most common amongst athletes. However, there is one injury that a large majority of players have had but did not hit the headlines on Sports Center. One of the most common basketball is a “jammed” finger. Typically, a “jammed” finger occurs from a blunt impact or forced motion to the proximal interphalangeal joint (AKA the PIP joint) of the fingers. An example of this impact is when a player attempts to catch a pass and the basketball collides with the tip of the finger. There are varying degrees of this injury. Depending on how severe the impact is, there can be stress of the ligaments at the PIP joint. In the more serious cases you want to rule out a fracture or dislocation of the finger. Although the finger may look a bit deformed after suffering a “jammed” finger, there is a chance that it is just a simple jam rather than a more serious injury.

Symptoms of a “jammed” finger include swelling, loss of range of motion (ROM), pain, and tenderness to touch. While this injury is common on the basketball court, it can also occur while untitledplaying baseball, or even falling while riding a bike. Depending on the severity of the injury, the healing process can take from two to eight weeks.

Treatment in most cases includes RICES (rest, ice, compression, elevation, stabilization) therapy which involves the following steps: resting the injured finger/hand; icing the finger 15 minutes every hour for the first 48 hours; compressing the finger with a splint to keep it from bending (this is also stabilization); and elevating the finger above chest level. After 48 hours, switch over from ice to heat.untitled3

If symptoms persist or worsen, or if full ROM does not return in a matter of days, be sure to consult with an orthopedic physician. At your visit you will likely take X-ray to rule out a finger fracture, and may be prescribed anti-inflammatory medications to help reduce swelling. Your orthopedic surgeon may also have an athletic trainer or physical therapist create a customized stretching and strengthening home exercise program during the rehabilitation stage. Formal therapy may be required in more severe cases.

In some cases a “jammed” finger can result in a Mallet Finger. Mallet Finger is another common injury in basketball players, but can also occur in baseball and football. Mallet Finger can be the result of the extensor tendon, which straightens the tip of the finger, being torn from its attachment on the bone, or from a small fracture in the bone. Usually the fingertip will be very sensitive, painful, and swollen. Along with pain, you may not be able to fully extend the tip of the finger. This is a more serious injury and requires a visit to your orthopedic surgeon. If left untreated, Mallet Finger can cause irreparable loss or motion to the fingertip (a droop at the tip) and a cosmetic deformity. Fortunately, functional problems are rare. In some extreme cases of Mallet Finger, doctors may recommend surgery to correct the deformity. These cases are rare and usually surgery is only needed if there is a large fracture of the bone in association with the injury.

As with most other injuries, early detection and treatment can lead to a full recovery. Physicians will usually recommend the use of ice to reduce the swelling and pain at the fingertip. In addition, like with a “jammed” finger, a small splint is typically used to enable the finger to heal fully straight. The splint may have to be worn for up to six weeks. No worries, you will still have full function of your hand, this splint only covers a portion of the finger. If you remove the splint too early, you may jeopardize the healing that has occurred and the finger could return to a bent position.

Although this injury may not seem very devastating, and may not have you out of your sport for very long, you must care for your fingers and hands as they are very important to daily activity.

Provided By Primus Sports Medicine Staff

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