The O&P Edge: Bracing the Curve

The O&P Edge: Bracing the Curve

Scoliosis is one of the most common conditions our experts treat, and it presents in many forms – from the common to the complex. Depending on the child and the severity of their curve, the plan for treatment can vary. Bracing is a treatment option for patients whose curve is smaller to moderate. At Scottish Rite, our in-house Orthotics department creates custom braces – making sure it fits the child just right.
 
Orthotics clinical coordinator, Kara Davis, CPO/L, FAAOP, spoke with The O&P Edge, discussing the effectiveness of bracing as a treatment for adolescent idiopathic scoliosis.
 
Read the full article.

Get to Know our Staff: Maria Anderson, Dental

Get to Know our Staff: Maria Anderson, Dental

What is your role at Scottish Rite for Children?  
Dental Clinic Manager

What do you do on a daily basis? 
I manage outpatient services and surgical procedures performed by the Dental department staff and residents. 

Is there a special referral process for patients to be seen in our Dental clinic?
In order to be seen in the Dental clinic, one must be a Scottish Rite patient and internally referred by their primary service or provider. We do not see patients outside of the organization or walk-ins.

What path did you take to get here or what led you to Scottish Rite? How long have you worked here?
I have always enjoyed working with individuals with special needs. I first rotated through the Scottish Rite for Children Dental clinic as a hygiene student. I started my career as a dental assistant in 1994 and joined Scottish Rite in 2000. I have been the clinic manager since 2006. 

What do you enjoy most about Scottish Rite for Children?
The variety of responsibilities and the continual professional growth. I also enjoy being able to collaborate with the other specialty services in the management and care of our patients.
 
What’s your favorite place to eat around here?
I love Mexican food—Uncle Julio’s or Ojeda’s

What’s something—big or small—that you’re really good at?
Golfing, gardening and playing “chicken foot” with my family.

Do you have a pet? What’s he/she like?
I have a mixed dachshund and Chihuahua dog, Jagger. He loves spending time with his family and acts like our child, since I no longer have kids at home. 

Is there something that has made you smile recently?
Birth of my first grandchild, Hannah Grace who was born on October 19, 2020

Stress Fractures: How Nutrition Plays a Role

Stress Fractures: How Nutrition Plays a Role

Many athletes with injuries seem to have overlapping nutritional concerns. In particular, gymnasts, dancers, soccer players, cross country runners and track & field athletes are being treated for stress fractures. For some, it’s a second or third stress fracture within a year. These reoccurring stress fractures often are a sign of under-fueling in the young athlete. This is when they are not consuming the optimal caloric intake for the energy they are burning with exercise and sport.

A handful of the female athletes also report that in the midst of their intense training and competition schedule they have stopped having regular periods. This is a concern for young females. Loss of the menstrual cycle is a sign that the athlete has an energy deficit where she expends more calories than she is eating and drinking. This can lead to hormonal, growth and development complications that can be long-lasting and needs to be addressed as soon as possible. Not only does this have general health implications, but it can set the athlete up for overuse related injuries, decreased performance and even time loss from sports.

Female Athlete Triad
Though they rarely occur together, these inter-related conditions: 1) low energy availability, 2) bone loss and 3) menstrual irregularities are called female athlete triad. Low energy availability, or not having enough calories to carry out the demands of the athlete’s sport is the main cause of this. Here are common questions addressed in a nutrition consultation for a young athlete experiencing these and other medical conditions:

  • Are they skipping any meals?
  • Are they getting 3 out of the 5 food groups at each meal?
  • How much water/fluid are they drinking?
  • Are they getting adequate calcium and vitamin D for their age?
  • Are they getting enough protein for their weight, sport and age?
  • Are they spacing this protein out adequately throughout the day?
  • Do they appear to be getting adequate calories for their growth and sports needs?

Customized Plan
Nutrition counseling is an important role in recovery and injury prevention, especially when athletes have had injuries that are linked to energy deficiencies. Young athletes should learn to fuel their bodies for sports and activities so that they are performing at their best and avoid preventable injuries.

  • Identifying fueling ways to increase calories or other nutrients needed.
  • Discussing pre- and post-exercise snack and meal planning.
  • Planning ways to optimize fluid intake.
  • Providing education on specific topics based on the athlete’s needs and goals. This might include supplements, hydration or specific nutritional deficiencies.

Print the PDF

Find more resources on sports nutrition for young athletes.

Fueling for Home Runs: Nutrition Tips for Young Baseball Players

Fueling for Home Runs: Nutrition Tips for Young Baseball Players

While baseball may not be considered an endurance sport or immediately thought of as a power sport, it still demands a level of energy and strength for successful catches, pitches, hits and runs. Additionally, baseball requires concentration, fine motor skills and coordination for sometimes hours on end. For these reasons, nutrition is very important for the young baseball player. Being adequately fueled and well hydrated prior to game time will give the young baseball player sustained energy, strength and focus for top health and performance. 

Certified sports dietitian, Taylor Morrison, M.S., R.D., CSSD, L.D., says, “Young baseball players tend to be very focused on skills practice and miss the opportunity to improve their game by properly fueling and hydrating.” She encourages parents to support young athletes by learning sport-specific tips and providing appropriate food choices to help the athlete meet nutrition goals. 

Tips for Supporting Your Young Athlete
Here are five things you can do for your baseball player to ensure sustained energy, focus and coordination on the field.

1. Emphasize the importance of good hydration each day, every day. Make sure your athlete is drinking water during and after a game as well. 
2. Provide a balanced meal three to four hours before the game. This meal should consist of:

  • Quality carbohydrates such as whole grain bread, pasta, rice, oatmeal, fresh fruit, starchy vegetables, low-fat dairy.
  • Lean protein such as chicken or turkey breast, fish, lean ground beef, low-fat dairy.
  • Healthy fat such as nuts or nut butters, olive oil, avocados, seeds (including chia & flax seeds).
    • Example: Turkey sandwich on whole wheat bread with lettuce, tomato and avocado + fresh fruit cup + glass of low-fat milk.

3. Offer a snack one to two hours before the game.

  • A pre-game snack should focus on easily-digested carbohydrates. Limit protein, fat and fiber, which take longer for the body to digest and may affect performance during the game.
  • Examples: Fresh fruit, dried fruit, pretzels, applesauce, low-fiber cereal, low-fiber granola bar, white bread or white pasta.
  • For those athletes who experience pre-game jitters and stomach discomfort, a liquid source of carbohydrates like a small serving of a sports drink may be tolerated better right before a game.

4. A sports drink may supply the athlete with additional easy-to-digest carbohydrates if energy levels start to dip during a game.

5. Don’t forget recovery. A good recovery meal contains carbohydrates, protein, healthy fat and fluid. Together, these nutrients replenish depleted energy stores (carbohydrates), repair muscle, help fight inflammation and rehydrate the body.

Learn more about nutrition and hydration for young athletes.

Hip Injuries in Young Athletes

Hip Injuries in Young Athletes

Pediatric orthopedic surgeon and associate director of clinical research, Henry B. Ellis, M.D., presented this as part of Coffee, Kids and Sports Medicine education series.

Watch the full lecture
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Ellis provided a detailed discussion of the history and physical exam of young athletes with hip complaints to distinguish between common and less common hip conditions. Young athletes require a different approach than an adult athlete. Numerous conditions present more often, or only, in a younger patient compared to an adult. These include slipped capital femoral epiphysis (SCFE), adolescent hip dysplasia, epiphyseal dysplasia, apophysitis, stress fractures and more.

The ball and socket joint allows motion in all planes. For some young athletes, the soft tissue is particularly flexible which can increase the risk for injuries. A review of the anterior-posterior (AP) pelvis X-ray in a growing child provides an excellent overview of the pertinent anatomy in the growing pelvis and hips. There are physes, growth centers, that are present early and active through adolescence. Pelvis and hip growth centers include:

  • Acetabular physis (triradiate cartilage)
  • Proximal femoral physis
  • Greater trochanter apophysis
  • Ischial tuberosity
  • Anterior superior iliac spine

Five Key Tips for Evaluating the Youth Athlete’s Hip

  • History can help focus the exam.
  • Always examine both sides.
  • Adequately expose the area of interest while maintaining modesty.
  • Look beyond the hip.
  • Consider chaperone or an assistant in the room with hip exam.

Ellis says his detailed hip exam will last about 15-20 minutes. To provide an overview, he demonstrated a “three-minute hip exam” before he provided a detailed explanation of each step discussing associated conditions with each step.

Tests for recognizing signs of concerning conditions: 

  • Passive hip flexion that causes obligate (automatic) external rotation is indicative of SCFE and requires a prompt referral to minimize sequelae.
  • Dial test/passive circumduction with the hip joint relaxed. The provocation of pain indicates intra-articular problems such as synovitis or infection.
  • Hip flexion (90+ degrees) with adduction and internal rotation that causes pain is a sensitive screening tool for labral pathology.
  • Hip apprehension sign is positive when hip abduction and external rotation in side-lying causes apprehension and indicates a need for additional assessment for hip dysplasia.

In conclusion, Ellis provided some take-home messages for the audience.

  • A good clinical exam will often lead you to the diagnosis.
  • AP and frog pelvis X-ray is appropriate to evaluate for hip problems.
  • 80% of hip injuries are soft tissue strains that can be treated with rest, early range of motion and gradual return to sports when pain improves.
  • Some hip conditions require a MR arthrogram, so avoid an MRI of the hip until evaluated by a specialist, unless a stress fracture or other concerning diagnosis is suspected.

Ellis never disappoints an audience. As the first event after a break from our livestream events, we received these wonderful comments from attendees:

  • “So great to be here again!”
  • “Thank you for a well put together and thorough presentation. Also, I appreciate the handouts.”

Check out our latest on-demand lectures available for medical professionals.