Bike Safety Awareness

Bike Safety Awareness

No matter where you live, biking is a great way to get outdoors and be active. Whether it’s for pleasure, to exercise or for commuting purposes, biking has numerous physical and mental benefits — the key is to do it safely.

“Biking is a low-impact resistance exercise that is great for building muscles, improving coordination and increasing mobility, but just like any physical activity, biking comes with risks. Bruises and minor cuts are usually the leading types of injuries involving bicycles, followed by fractures, concussions, muscle strains and sprains. You can significantly lower that risk by taking safety precautions and following the rules of the road,” said Amy L. McIntosh, M.D., FAAOS, orthopedic surgeon, and spokesperson for the American Academy of Orthopaedic Surgeons (AAOS).

May is National Bicycle Safety Awareness Month, which serves as a reminder of the importance of bicycle safety all year long. The AAOS shares the following information about bicycle injury prevention and strategies for how you and your family can stay safe.

Common bicycle injuries
There were more than 325,000 preventable bike-related injuries in the U.S. in 2020, according to the National Safety Council (NSC). Bruises and minor cuts are usually the leading types of injuries involving bicycles, followed by fractures, muscle strains and sprains. However, serious injuries, including death, do occur. According to the NSC, there were nearly 1,260 preventable bicycle-related deaths in 2020.

Helmet safety
No matter what your age or level of experience, you should wear a helmet every time you bike. Cuts, bruises and even broken bones will heal, but damage to your brain can be permanent. Even a low-speed fall can result in serious head injury.

When choosing a helmet, make sure it is:

  • Snug — It should not slide from side-to-side or front-to-back.
  • Level — It should be square on top of your head, covering the top of the forehead. It should not tilt in any direction.
  • Stable — The chin strap keeps the helmet from rocking in any direction. Chin straps should be replaced if any part of the buckle breaks. Otherwise, a helmet may fly off in an accident.

Road safety rules
When biking, it’s important to be aware of your surroundings and follow the rules of the road. Start by familiarizing yourself with the bicycle rules of the road in your city or state, and do not ride if you are looking at your phone or mobile device. Pull over to the side to change your music, check your map or answer a call. Ride in the direction of traffic and always follow traffic signs and lights. Signal your turns or your intentions so that drivers can anticipate your actions, and if you are riding with others, ride in single file.

“Staying alert and aware of your surroundings — even when traffic appears light — can help bicyclists to prevent musculoskeletal injuries,” added Dr. McIntosh.


Choose bike routes wisely

Avoid riding on high-traffic roads and instead select streets with fewer and slower cars. Whenever possible, choose streets with designated bicycle lanes. If there is not a bicycle lane, ride on the right shoulder of the road. When a street lane is too narrow for a vehicle and bicycle to safely ride side by side, or if there are several parked cars on the street, you will need to join traffic and ride toward the center of the road.

Pace yourself and prevent injuries
Cycling can be vigorous exercise, so make sure you are fit enough to participate before you start pedaling. Make sure you understand how to use the gears on your bike to help control your physical exertion level. Additionally, change riding positions periodically to reduce stress on pressure points and avoid overstressing muscles. Finally, stay hydrated by bringing water, especially on longer rides.

Supervise young riders
Whether it’s their first ride or they’ve been cycling for a few years, younger riders benefit from someone watching and advising them. Younger children or people just learning to ride should only do so away from moving vehicles and traffic. New riders may need reminders to avoid distracted cycling.

Visit the AAOS Newsroom to learn more about bike safety, injury prevention and find musculoskeletal facts and figures.

Get to Know our Staff: Sarah Dronzek, Registered Nurse

Get to Know our Staff: Sarah Dronzek, Registered Nurse

Scottish Rite for Children attended the 2023 D Magazine Excellence in Nursing Awards, where Scottish Rite registered nurse Sarah Dronzek received an award in the Direct Care category. She and so many other nurses help make Scottish Rite a wonderful place to be for our patients and families. Learn more about Sarah:

How long have you worked at Scottish Rite? How long have you been a nurse?
I was a nurse extern here at Scottish Rite in the summer of 2014. I worked at Children’s Medical Center once I graduated from nursing school, but I came back to Scottish Rite as quickly as I could in September of 2016. I have been a nurse for eight years now.

What area do you work in?
I recently transferred from the inpatient unit to the surgery department. I now work in the Post-Anesthesia Care Unit (PACU).

What do some of your daily tasks look like?
As a PACU nurse, I take care of patients immediately post surgery. I closely monitor their vital signs, levels of consciousness, surgical sites and surgical lines and drains. I help treat pain and manage any adverse effects my patients might develop from surgery and/or anesthesia

What is your favorite thing about being a nurse at Scottish Rite?
I love our patient population and the ability to witness the amazing work our talented physicians perform to help give our kids back their childhood. Scottish Rite is such a wonderful organization, and it feels more like a second family than a workplace.

How does it feel to be recognized for the care you provide?
Words will never be able to describe how deeply honored I am to have received this award. It truly means the world to me, and it validates the dedication and hard work that I’ve put into my career as a nurse. I am astounded by the amount of support that I have received throughout the process of receiving this award, and I cannot thank my nominator enough for nominating me!

Less Common Sports Continue to Grow in Popularity

Less Common Sports Continue to Grow in Popularity

About two-thirds of kids who come to see us for sport-related injuries play at least one of these five popular sports: soccer, football, basketball, baseball and volleyball. However, young athletes sustain injuries in many other sports and activities.

Download the PDF

The goal of the program is to inform health care professionals who work with young athletes about current concepts and the latest evidence on sport-specific injuries, providing care, returning to sports and preventing injuries. In part two of this program, Jacob C. Jones, M.D., RMSK, provided epidemiology, common injury patterns and recommendations for preventing injuries in softball, tennis, martial arts, rugby, fencing and track & field. This program was presented as a part of a monthly series for medical professionals called Coffee, Kids and Sports Medicine.

Pediatric sports medicine research has been supporting multisport athletes for various reasons including, but not limited to, the benefits that come from the varied skill development and training patterns and demands. Physical literacy is a term that describes how comfortable an individual is with various physical skills. With this in mind, we encourage kids and athletes to test out different sports and activities at varying levels of competitions. Injury risk can be managed in all activities, and knowing what injuries occur in which sports will help with that.

Softball
Softball injuries occur most commonly in the shoulder of pitchers. Much like baseball, repetitive motion, particularly on the growing joint and bones can cause an overuse injury. Because of the style of pitching, the adolescent elbow in softball is at a much lower risk of injury compared to baseball where the elbow accounts for half of injuries in pitchers. The mechanism of shoulder injury is also different in softball, and therefore, it is not diagnosed as Little Leaguer’s shoulder, which is commonly diagnosed in young baseball pitchers. Additionally, the softball pitcher experiences pain much earlier in the season, typically within the first six weeks. Other common injuries among high school softball players include ankle sprains and concussions.

Advice from an Expert – Softball
Katie Holehouse, P.T., D.P.T., CSCS, played softball as a child and earned a scholarship to play at George Mason University. One of her first jobs was as an assistant softball coach in a high school. She has three tips to avoid softball overuse injuries.

  1. Young athletes should take breaks from softball throughout the year.
  2. An appropriate warm-up should include total body movements of all joints – not just the arm.
  3. Strength and conditioning of upper and lower body during off-season can decrease injury risk.

Tennis
Tennis is a combination of quick movements and direction changes with the feet and repetitive, forceful movements with the arm(s). Since the game is not timed, fatigue also contributes to performance and injury risk in tennis.

Repetitive external rotation in shoulder and overextension in spine are the most common causes of injuries. The knee is another joint that is often injured in young tennis players. Joints like the elbow and knee in skeletally immature players will present with conditions that are very different from adults in this sport. For example, tennis elbow, a condition affecting the tendons around the elbow, is much less likely young tennis players than other conditions.

Advice from an Expert – Tennis
Orthopedic surgeon and avid tennis player, John E. Arvesen, M.D., is a three-time Texas High School State Champion and two-time Big 12 Champion at Baylor University. Arvesen offers these tips for preventing injuries in young tennis players:

  1. Dynamic warm-up is key for injury prevention.
  2. Many injuries come from faulty mechanics.
  3. “Throwers Ten” is a good supplement to the serve.
  4. Remember good hydration, especially in the summer.

Martial Arts
All of the different forms of martial arts help young athletes build strength, improve balance and increase flexibility. Additionally, they contribute to improvements in cognitive function, self-esteem, self-respect and self-awareness.
The varying styles contribute to differences in injury risk across the different forms. Some like tae kwon do and grappling may have a higher risk of contact injuries from engaging and striking with the hands, body and feet. In competitions, the head and pelvis are most frequently injured. Contusions and bloody noses are the most common injuries. Weapons may increase the risk of injuries. Meditative forms of martial arts, such as tai chi, have lower risk of contact injuries and offer safety in slow, controlled movement patterns.

Advice from the Experts – Nose Bleeds
Our athletic trainer team boasts more than 50 years of experience in sideline care of young athletes. Their top tip for managing epistaxis (a bloody nose) in martial arts and other sports is “Don’t tilt the head back!” This may lead to swallowing or vomiting of blood. Have gloves, gauze and Vaseline® on hand when the risk for this injury is high. Cutting tampons or purchasing commercially available cotton nose plugs help to slow the hemorrhage.

Rugby
Some sources suggest rugby is the ninth most popular sport in the world. The rules for youth differ from those of adults. Rugby injuries most commonly occur during a match with more than three-quarters of injuries occur during tackling. Proper tackling form is key to help avoid injury. Rugby injuries affect teenage girls most often. The style of play puts the head at the greatest risk of injury and football-like helmets are not used. The lack of protective equipment also contributes to joint and bone injuries, such as fractures, in the clavicles, hands and extremities.

Advice from an Expert – Head to the Hip
Fracture clinic nurse practitioner Ray Kleposki, M.S.N., CPNP, a former rugby player and currently a youth rugby coach, has 20 years of experience in the sport. His advice is to learn proper tackling form, which differs from football — head to the side hip. He advises that learning and following the rules prevents both injuries and penalties.

Rib injuries may not be common in youth sports, but the consequences of misdiagnosis and treatment can be high. Rib fractures are less common in kids compared to adults; however, kids with rib fractures have higher rates of hemothorax/pneumothorax, spleen and liver injury.
Rib injuries with these signs and symptoms warrant further medical evaluation:

  • Cardiac involvement
  • Abdominal injury
  • Trouble breathing, painful breathing and/or coughing
  • Dysphagia
  • Hoarse voice

Fencing
Fencing is a combat sport that is growing in popularity that involves sword fighting. With proper training and equipment, young athletes safely participate in fencing which has three different disciplines:

  • Foil
  • Epée
  • Saber

A competitive fencer typically focuses on one of these disciplines. Each discipline has different weapons, targets and rules. Saber athletes have the highest injury rate with injuries in the knee, thigh and ankle. Anecdotally this occurs more in the lead leg. Other injuries common to other sports may also occur including acute sprains and strains and chronic complaints in the leg are consistent with patellofemoral syndrome. Unique to fencing, puncture injuries are generally prevented with proper equipment.

Track & Field
The variety of events in track & field expose athletes to acute and chronic, or overuse, injuries. The array of injury patterns differs based on the demands of the event. Running, sprinting, jumping, throwing and combination of these requires each event to be considered separately when it comes to injury incidence and risk.

A recent study evaluated youth hurdlers and found the most commonly injured body parts were the ankle, knee and wrist. The injury types that most often cause a hurdler to present to an emergency department are fractures, joint sprains and contusions.

Learn more in an article “Age and Sex Comparisons in Pediatric Track and Field Hurdle Injuries Seen in Emergency Departments of the U.S. Sports,“ recently published in Sports, an international peer-reviewed journal. This article is a review of data from a registry called the National Electronic Injury Surveillance System. Dr. Jones and his peers in the Pediatric Research in Sports Medicine Society studied this information to describe a population that had not been done before. This kind of work helps providers in caring for and helping to prevent injuries in specific populations.

Share Your Story: Meet Marley

Share Your Story: Meet Marley

Meet Marley, a patient who is seen by our team of scoliosis and spine experts. She also appears in some of our new advertisements! Learn more about her journey below.

Blog written by Marley.

I first learned that I might have scoliosis when I was at my 7-year-old annual checkup with my pediatrician. I didn’t think that I had any symptoms, but when the doctor checked my back, they told my parents I had a curve. My pediatrician referred us to Scottish Rite because they are the experts in helping kids who have scoliosis! 

When we got to the Frisco location, I recognized the crayon logo from going to a park by the Dallas hospital. I’ve now been a patient at Scottish Rite for four years, and I see Dr. Ramo for my scoliosis treatment. On my first appointment, we learned that my curve was large for my age, since I hadn’t had my growth spurt yet. Dr. Ramo told us that as I grew, the curve might get worse, and I could end up having to have surgery. I started wearing a brace, and over the past four years, my curve has actually decreased, and I will most likely not need surgery if I continue on this path!

Dr. Ramo makes me feel like he knows me as a person and not just a patient. He always asks me about how I’m doing in the different sports I play, and he remembers things about my hobbies and interests. I also really enjoy talking to Kelsey, who makes my brace and works on it when I grow. Whenever she has to make me a new brace, she lets me pick out my design. The last time I had to get a new brace, she even helped track down the special pattern I wanted for my brace. 

My favorite thing about Scottish Rite are the volunteers. They are always at the front entrance, and I feel comfortable when they welcome me. I love when they give me stickers, books or popcorn. My entire experience has been great because everyone cares about me and wants to help me improve.

Favorite dessert?
Sugar cookies and vanilla ice cream with rainbow sprinkles. 

Favorite color?
My favorite color is metallic gold because it’s sparkly and shiny.

Favorite book?
My favorite book is The Vanderbeekers of 141st Street. 

What do you want to be when you grow up?
When I grow up, I want to be a marine biologist because I love the water, I love science and I love animals.

Do you have a favorite hobby/sport/interest? 
My favorite sports are swimming and kung fu. I also love to play the piano. 

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

Four Tips to Prevent Injuries in Youth Lacrosse

Four Tips to Prevent Injuries in Youth Lacrosse

Lacrosse is one of the oldest sports in North America and is also one of the fastest growing sports in the United States. In 2021, there were more than 40,000 collegiate and more than 450,000 youth lacrosse players. Boys’ and girls’ lacrosse follow different rules and require different equipment, which may impact the types of injuries seen in these young athletes.

“Lacrosse is an intense and demanding sport,” orthopedic surgeon John E. Arvesen, M.D., says. “Athletes who are prepared can dramatically reduce the risk of injury.” Coaches and parents can use these tips to guide young athletes in the right direction.

FOUR WAYS TO REDUCE INJURY RISK IN LACROSSE

Wear proper equipment. Protective gear that meets standards and fits correctly will provide the most benefit. Poor-fitting equipment may not offer the same protection or support.

Perform a dynamic warm-up. This involves continuous movement to raise the body’s core temperature in preparation for training or competition. Perform this before each practice or game to increase elasticity in the muscles, tendons and ligaments around the joints.

Learn and implement effective hydration strategies. Mild dehydration can worsen performance. Ideally, players should drink water every 15 to 20 minutes. Add a sports drink during intense activities lasting longer than one hour or in very hot environments to replace electrolytes lost through sweat.

Plan for rest and cross-training. Early sport specialization increases an athlete’s risk of injury and inhibits their athletic development. Focusing on one sport at an early age may lead to movement imbalances, an increased risk of injury and overtraining. A one- or two-month break between seasons and a day or two of rest each week in-season is recommended.

Some injuries in lacrosse are more difficult to prevent, such as those that occur from sticks, collisions and falls. Non-contact injuries are considered to be more preventable. As a sports physical therapist and youth lacrosse parent and coach, Michael Losito teaches young athletes the importance of learning fundamental movements to prepare their bodies for non-contact injuries. “When an athlete has control over the trunk and lower extremities, he or she can produce more power, which may help to protect the joints from minor and serious injuries,” Losito says.

Common Injuries in Lacrosse

Despite efforts to reduce the risk of injury, some accidents are going to happen. Make sure you recognize and respond to injuries promptly. Many conditions can be treated with rest and a short round of rehabilitation if they are recognized early.

SPORT-RELATED CONCUSSIONS
Concussions in girls’ lacrosse players are often the result of stick contact, or a blow with a stick to the head. Boys’ lacrosse has a higher risk for concussion due to player-to-player contact. An athlete with any concussion symptoms, including change in behavior, thinking or performance after a collision or a blow to the head, neck or body, should be removed from play immediately and not return to play the same day. A medical professional with experience managing concussions should determine when it is safe to return to play.

KNEE AND ANKLE INJURIES
Sudden changes in direction, stopping and jumping can place a lot of stress on the knee.  This can stretch and tear ligaments, such as the anterior cruciate ligament (ACL) and medial collateral ligament (MCL). A swollen knee is a sign of a joint injury that needs to be evaluated.

In lacrosse, sudden direction changes, stepping on another player’s foot or landing from a jump can result in an ankle injury. Ankle sprains and injuries to the growth plate are common in growing athletes and should be evaluated to optimize treatment and return to sport.

BACK AND CHEST INJURIES
Player-to-player collisions or falls may cause back injuries. Powerful and repetitive rotation while running, cradling, shooting and passing is more likely to cause activity-related pain in lacrosse. Overuse injuries, such as stress fractures (spondylolysis), are also common in young athletes. Persistent back pain from overuse injuries needs to be evaluated by a medical professional. The equipment and high-speed movements in lacrosse increase the risk of a rare injury from a direct blow to the chest from the ball, a stick or player collisions. The condition, called commotio cordis, can be life-threatening. Chest protectors may reduce the impact and risk of this injury.

ARM INJURIES
The design of lacrosse protective gear allows the arm to move freely but leaves the shoulder open to injury. Clavicle (collar bone) fractures and ligament injuries, or “separated shoulders,” may occur. A change in the appearance of the shoulder, pain, swelling or limited motion after a collision or fall should be evaluated.
Body checks, stick checks and slashing may cause hand and wrist injuries. Soft tissue injuries such as ligament sprains may heal with rest and ice. Others may need a brace or other treatment.

Download the PDF.