Functional Testing: Why is it Important for Athletes Returning to Sports?

Functional Testing: Why is it Important for Athletes Returning to Sports?

by | Feb 6, 2019 | Sports Medicine


There are many factors to consider before releasing a young athlete back to sports after an injury. Our sports physical therapists and sports medicine physicians continually review and discuss the latest evidence on risk factors for injuries in young and growing athletes. Most of these studies evaluate the risk of injury after an anterior cruciate ligament (ACL) reconstruction and consistently state that as many as 1 in 4 will re-tear the same or have a new injury to the opposite ACL when returning to sports.

Our pediatric sports medicine clinical and research staff often discuss how we know when it is safe to allow an athlete to go back to sports. Here are a few examples of the questions that come up in these conversations:

  • How old is the patient?
  • Has the actual tissue had time to heal since the procedure?
  • Does the athlete plan to play a sport or position that puts them at greater risk?
  • Is the athlete mentally ready and confident to get back in the game?
  • Is it the beginning of the season or does the athlete have several months before competition season?
  • Has the athlete regained full strength and mobility since the injury?
  • Has the rest from the recovery caused the non-injured leg to become weak?
  • Can the athlete safely perform the necessary movements required in the sport(s)?

We continue to study these questions, and many others, to help us make the best decisions for our athletes. Since many of these questions are based on an athlete’s physical strength and ability to move, movement analysis is a critical component of this process. Our movement analysis testing, also known as the functional testing protocol, takes into consideration many aspects of movement to identify who is most at risk of being injured again. The results can be simplified into pass or fail. However, the tests identify specific areas for the athlete to improve before retesting.

Our goals are to get athletes back to sports, keep them in sports and prevent injuries in the future. With tools like these, we can make recommendations based on objective findings. We can also demonstrate to athletes and families, who may be at risk for re-injury, exercises to strengthen areas of weakness.

Learn more about our research in pediatric sports medicine.

Meet the team and check out the state-of-the-art sports therapy gym in Frisco.

What is Sports Physical Therapy?

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Share Your Story: Why I Volunteer

Share Your Story: Why I Volunteer

by | Feb 5, 2019 | Spotlight

Meet Luann and Andrew, a mom who is a hospital volunteer and a patient who was treated in our Neurology department. Learn more about their journey below.Blog written by Luann, of Dallas. Our son, Andrew, was always very active and loved playing soccer and basketball. He was usually the fastest runner on the soccer field and could shoot three-point shots from half court. When he turned 10, I noticed he couldn’t run like he used to, and as hard as he tried, he just couldn’t keep up with his teammates.

I took him to his pediatrician and she could not find anything physically wrong. His left foot started
to turn in so we thought maybe he just needed ankle braces, so we gave that a try. That didn’t help, so we began a seven-year search for answers. We saw 13 different doctors – from podiatrists, to an orthopedic specialist and even a neurologist, but we were still left without answers. In the meantime, Andrew was growing and his ability to walk was becoming more and more difficult. He had pretty much given up the idea of ever playing sports again.  Attending high school was even a struggle for him. In the morning, he was strong and could walk, but by the end of the school day he was physically spent. I would pick him up from school and take him home, where he would have dinner and then literally crawl to his bedroom to go to bed, only to face the same struggle the next day. It would just break my heart to see him not being able to attend football games or go to movies with his friends. He had pretty much given up the idea of attending homecoming or walking across the stage at his high school graduation.

After seven years, 13 doctors, countless doctor visits, MRI’s, CT Scans, X-rays, braces, and exercises, we were referred to Texas Scottish Rite Hospital for Children. We initially met with Dr. Sucato in August of Andrew’s senior year of high school. Dr. Sucato thought it would be best if we saw Dr. Delgado, a neurologist at the hospital. I thought this would be a waste of time since we had already seen two other neurologists, but I reluctantly agreed.

We saw Dr. Delgado that October and that is when our miracle began.

I remember sitting in the exam room with a stack of X-rays, MRI reports, CT scans and other medical records. In walked Dr. Delgado and through my tears I began to tell him all of Andrew’s physical challenges for the past several years. I will never forget that day – he looked at us and said we were going to find out what was going on! He was the first doctor who had told us that. He closely studied Andrew walking, which was so hard for me to watch. Andrew underwent a few different tests and on January 29, 2010 was admitted to the hospital for a spinal tap. 

A young boy in a hospital bed with a red bandage on his hand

A week later, we received the call that changed our lives.

My husband Earl, Andrew and I went back to the clinic and nervously waited in the exam room, praying for an answer. I had prepared myself for the worst. Dr. Delgado walks in and said he knows what is going on with Andrew – I could hardly believe we were hearing those words! Andrew has Dopa-Responsive Dystonia, a rare neurological disorder that is easily treated. His brain doesn’t produce enough of the chemical dopamine, so he takes a medicine that is often used to treat Parkinson patients.   We were beyond excited for a diagnosis, but I was not going to get my hopes up until I saw positive results!  Andrew took his first pill that Friday and within 24 hours he was able to walk, stand and run like he had been able to eight years ago. He went to school that next Monday and his baseball coach called me to find out what had happened – no one could believe the miraculous change in Andrew!

A man wearing a shirt that says hunger is hugging a woman

Andrew was able to play in the last baseball game of his senior year and the The Dallas Morning News was there to capture it all.  Andrew’s friends and family filled the stands, cheering him on. He got up to bat, got a hit and was able to run the bases – something we all thought we would never be able to see him do again. I cheered and cried at the same time! He was then able to attend the high school homecoming dance, his classmates voted him “Raider of the Year” and he proudly walked across the stage at his graduation. 

I still tear up thinking of this journey and how Dr. Delgado and Scottish Rite Hospital gave my son his life back.  Andrew went on to graduate from the University of North Texas and has moved to Los Angeles, California, where he is truly enjoying life. My heart is so proud and full to see him have the confidence to go out on his own. For so many years, he felt he had to hide in the background due to his physical limitations.  He didn’t want anyone to see him and was laughed at for his physical shortcomings. 

He is an amazing young man. When he went to bed at night, he knew he would have to wake up and face the same challenges again that next day. He never complained, was always smiling and was a true testimony to everyone he ran into. I am one proud mom!

Because of everything Dr. Delgado did for my son, I decided I wanted to give back to the hospital. On February 22, 2011, I began volunteering at the hospital. I volunteer Tuesday evenings, at special events and I serve on the Volunteer Executive Committee. My biggest honor is to volunteer in Dr. Delgado’s Neurology Clinic. I love being able to greet his patients, assure them that they are in an amazing place and are seeing the best doctor in the world.

A basketball player is jumping in the air to dunk the ball

It is my absolute pleasure to brag on Scottish Rite Hospital and to share Andrew’s Story and give other families hope.

When Andrew is home for a visit, he always tries to stop by the hospital and visit with Dr. Delgado and his staff – I love seeing the big grins on each of their faces! Thank you to Dr. Delgado and his amazing team, who we now consider family, for giving my son his life back.

DO YOU HAVE A STORY? WE WANT TO HEAR IT! SHARE YOUR STORY WITH US.

#SRHaccess Facebook LIVE Recap: Overgrowth Related Syndromes

#SRHaccess Facebook LIVE Recap: Overgrowth Related Syndromes

by | Jan 30, 2019 | Hand Conditions

On this week’s #SRHaccess Facebook LIVE, Director of the Center for Excellence in Hand Scott Oishi, M.D., joined us to discuss the hospital’s expertise in caring for children diagnosed with overgrowth related syndromes. Below is a recap of the conversation.

Watch the live segment.

Common overgrowth conditions:

  • Macrodactyly – abnormally large fingers and toes caused by an overgrowth of soft tissue and bone.
  • An overgrowth related syndrome can affect the upper and lower extremities, as well as muscles throughout the body.
  • The overgrowth can have vascular anomalies – an impact to the veins and lymphatic system.
  • In the hand, the thumb, index and middle fingers are the most common extremities affected. Those fingers are along the same nerve distribution area.

Fast facts about overgrowth related syndromes:

  • Every presentation is different.
  • Severe cases where an extremity (arm or leg) is significantly bigger than the other, it is possible for it to be detected on an ultrasound.
  • Once a child is born and taken to an orthopedic specialist, the diagnosis can be clear from the physical presentation.

Once diagnosed:

  • The hospital’s hand team will counsel the family.
  • As of now, research does not show any genetic cause to an overgrowth syndrome. It is also not related to anything the mother did or did not do while pregnant.
  • A blood/tissue sample may be taken from the affected extremity to be sent off for genetic testing to see if there is a mutation in the DNA.
  • Nothing is done immediately with an infant and the hand experts will observe the patient as they grow.
  • If a child is born with an extremely enlarged limb and have rapid overgrowth within their first year of life, a treatment plan will be put in place sooner rather than later.
  • In mild cases, the child will be observed until their limb is the size of the same sex parent. From there, the doctor will decide whether intervention is needed, such as surgery.

Learn more about the common hand conditions our experts treat.

An Injury Not to Ignore: Hand & Finger Fractures in Young Athletes

An Injury Not to Ignore: Hand & Finger Fractures in Young Athletes

by | Jan 29, 2019 | Fractures

Believe it or not, hand and finger injuries in kids, especially young athletes are very common. In fact, almost 20 percent of the injuries we see in the Fracture Clinic are hand related injuries. For children, these injuries can occur in a number of ways. For athletes, some of the more common mechanisms we see are from a finger getting struck by a ball, a hand getting stepped on or a finger getting caught in a jersey. While most injuries to the hand or fingers will get better with some time, rest and immobilization, others may require more extensive care or even a surgery to correct alignment or restore function. As the parent of a young athlete, it is important to know when to seek medical treatment.

Recognizing a hand injury in a child is not always easy and may require the attention from an expert who specializes in caring for patients whose bones are still developing. Sometimes, X-rays can appear normal and exam findings can be subtle making it easy to miss or ignore injuries to the hand. If rest is not healing the injury, it is important to know the signs and symptoms where being evaluated by a pediatric specialist is necessary.

Some general “redflags” with finger injuries include:

  • Hearing or feeling a “pop” or “crack” at the time of the injury.
  • Seeing significant swelling immediately after the injury occurs.
  • Noticing differences compared to the same finger on the other hand. Seeing bleeding or drainage at or around the nailbed.
  • Inability to move, straighten or bend the finger or a joint more than two days after the injury.

Gerad Montgomery, M.S.N., FNP-C, tells us that most pediatric hand and finger injuries can be managed with immobilization in a cast or splint. However, when there is significant displacement of fracture, injuries to ligaments and tendons or damage to the nailbed, surgery may be needed.

Advice for parents of young athletes

  • Teach proper techniques with catching, hitting or throwing a ball.
  • Discourage grabbing a shirt or jersey in fast-moving games like football or tag.
  • Encourage athletes to be aware of surroundings during team sports.

  • Insist that athletes wear proper protective sports equipment when appropriate.
  • Never ignore an injury to the hand or fingers. Though it may be tempting to “push through the pain” and keep playing, these injuries can have serious consequences if they are overlooked. Don’t wait to have it evaluated by a medical professional.

Learn more about fracture care at Scottish Rite for Children in Frisco.

Symbrachydactyly: Did You Know?

Symbrachydactyly: Did You Know?

by | Jan 28, 2019 | Hand Conditions

Our Center for Excellence in Hand cares for the common to the complex of upper extremity disorders. Depending on the patient and their hand difference, our experts put together an individualized treatment plan to help the child have the most function as possible.

One of the common hand conditions seen at the hospital is symbrachydactyly. Although the literal definition of this term is “short, webbed fingers,” many different presentations can be seen.

Here are the top things to know about the condition:

  • Symbrachydactyly occurs when an arm or hand does not develop completely while the child is in the womb. Depending on the case, it is possible for the child to be missing joints, fingers or an entire hand. A child could have small finger remnants called “nubbins.”
  • Children with the condition are generally healthy.
  • The direct cause of this condition is unknown and a genetic etiology is not thought to be present.
  • It does not cause any pain to the child.
  • Our team works with each patient to help them function independently and participate in normal activities.

Learn more about the common hand disorders our experts treat.