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D Magazine: How Collin County’s Healthcare Providers Are Managing Record Population Growth

D Magazine: How Collin County’s Healthcare Providers Are Managing Record Population Growth

by | Apr 13, 2022 | Press Coverage, Sports Medicine

Collin County is the fourth-fastest growing county in the country. Growth can present all sorts of challenges for professionals working in education, healthcare, transportation and every other area of public life.

Philip L. Wilson, M.D., was part of a panel of Collin County leaders, talking about how their organizations met the challenge of keeping people healthy in the midst of a population explosion. 

Read the full article. 

In Strong Hands: Meet the Strength and Conditioning Coaches at Scottish Rite for Children

In Strong Hands: Meet the Strength and Conditioning Coaches at Scottish Rite for Children

by | Mar 4, 2022 | Sports Medicine

Meet the coaches of our Bridge Program. This program is designed to improve movement quality, strength, speed, and other measures in young athletes to simultaneously boost performance while reducing the risk of injury.

Certified Strength and Conditioning Specialists® (CSCS®) are professionals with special training and expertise. Standards set by the National Strength and Conditioning Association (NSCA®) are designed to ensure that these coaches have the proper training and skills to promote safe participation in these activities.

As the Bridge Program coordinator, Matt Schiotz, M.S., CSCS, brings experience as an elite-level sports performance coach with more than 20 years of experience coaching diverse groups of athletes. Schiotz’s coaching journey began with the Kansas City Chiefs before moving to the head strength and conditioning coach role at the University of Southern California. He then returned to the NFL as a strength and conditioning coach for more than a decade.

Schiotz’s most recent coaching role was at Baylor Scott and White Sports Performance Center at The Star in Frisco, where he was also the Director of Performance. He has also worked as a performance coach, providing virtual training sessions using app-based programming and data analysis. Schiotz received his Master of Science in Exercise Physiology from the University of Kansas.

“I am very excited to join the team at Scottish Rite,” Schiotz says. “I believe the continuum from physical therapy to performance training is a model balancing safety and maximum outcomes. Though I have worked with athletes of all ages, my true passion is working with young athletes to help them achieve their sport and performance goals. Seeing them return to a sport or activity they love is my reward, especially as a parent myself. Combined with an athlete’s hard work, I am confident that lessons learned in this program will help each participant optimally develop and be set up for a future of athletic success.”

Justin Haser, M.S., CSCS, is an elite-level sports performance coach with experience working with athletes across all sports. Haser began his coaching career at Ohio University before moving on to the University of Pittsburgh, where he worked with the football team.

Before joining the team at Scottish Rite, he was a sports performance coach at Baylor Scott and White Sports Performance Center at The Star in Frisco. He has coached athletes of all backgrounds, from 8-year-olds to professionals in the NFL and NBA. He led the Return to Play Program, designed to serve athletes as they transitioned out of therapy and back to a full return to their sport.

“I am excited to keep things rolling here at Scottish Rite,” Haser says. “I believe the transition period between finishing physical therapy and returning full time to sport can often be overlooked. Having gone through this process twice myself, I know firsthand the challenges an athlete will face. I played Division I football for Ohio University. During my career, I had a shoulder injury that required two surgeries, the second of which ultimately ended my athletic career. After my career ended, I spoke with my strength coach at the time and explained the situation. He invited me to assist in the weight room for my final year and a half prior to my graduation. Ultimately, this experience showed me what I wanted to do professionally and launched my coaching career. I am looking forward to helping these young athletes by providing guidance and support on their journey back to their field of play!”

Scottish Rite for Children in Frisco is offering training classes for young athletes. Sessions begin the first week of each month. Contact our Therapy Services team at 469-515-7150 or bridgeprogram@tsrh.org to learn more.

Overuse Injuries in Pediatric Female Gymnasts

Overuse Injuries in Pediatric Female Gymnasts

by | Feb 9, 2022 | Sports Medicine

Overuse injuries can come in many forms and remain a concern for athletes of various sports.

Many recognize the risk of overuse injuries in the elbow in baseball players, but did you know gymnasts are at risk for elbow injuries as well? In our pediatric sports medicine practice, we see two unique conditions of overuse in gymnasts’ elbows. These conditions are triggered differently than in a throwing athlete. For gymnasts, these injuries are caused by compression when the arms are repeatedly in a weight-bearing position.

Recently published in The Journal of Bone and Joint Surgery, this study from our team described the different aspects between the following elbow conditions induced by repeated activity in a group of 58 competitive gymnasts seen in our practice.

What is capitellar osteochondritis dissecans (OCD)?
A rare, painful developmental bone and cartilage injury to the capitellum on the elbow end of the humerus, the upper arm bone.

What is a radial head stress fracture?
An even less common bone injury to the radial head, the elbow end of a forearm bone, caused by repeated compressive forces in the elbow.

“Even though these are rare conditions, we see them enough that we were able to look at a large group seen over five years in our practice,” study author Chuck W. Wyatt, M.S., CPNP, says,  Comparing multiple details of the images and characteristics of the gymnasts, including activity levels, the study found several key findings.

  • Both injuries present at a young age, 11.6 years on average in this group.
  • Radial head stress fracture may be more likely in a more acute (sudden) manner.
  • Likelihood of returning to competition seemed likelier with higher level of training and competition at the time of diagnosis.
  • Having capitellar OCD on both elbows was associated with the lowest rate of return. One in three returned to same or similar level of competition.

In our sports medicine practice, we will use this information to counsel gymnasts who present with these conditions and more importantly, continue to study and educate the gymnastics community about early recognition, treatment and prevention. “This population has so many unique characteristics to consider when it comes to injuries,” assistant chief of staff and lead author Philip L. Wilson, M.D., says. “We look forward to continuing to study to understand how growing and intense training affect their bones and long-term health, particularly in the elbow.”

This study, “Elbow Overuse Injuries in Pediatric Female Gymnastic Athletes” was published in a highly rated, peer-reviewed journal, The Journal of Bone and Joint Surgery. Authors include Scottish Rite for Children Sports Medicine medical staff and former research coordinators who have gone on to pursue post-graduate degrees in the field.

Read the full article here.

Learn more about Osteochondritis Dissecans (OCD) in the Elbow.

Study of Patient-reported Outcomes of Legg-Calvé-Perthes Leads to Greater Mental Health Awareness for Healing Children

Study of Patient-reported Outcomes of Legg-Calvé-Perthes Leads to Greater Mental Health Awareness for Healing Children

by | Jan 6, 2022 | Sports Medicine

A new study of Legg-Calvé-Perthes disease on patients’ mental health at Scottish Rite for Children led to helpful insights for pediatric orthopedic care for the condition and an award for UTSouthwestern medical student Angel Valencia.

Training with Harry Kim, M.D., M.S., the director of the Center for Excellence in Hip, Valencia was awarded the PROMIS® Health Organization Trainee Poster Award for his work analyzing data from PROMIS® Health Organization’s patient-reported outcomes measurement information system (PROMIS®), which allows patients to evaluate and monitor their physical, mental and social health.

TEXAS SCOTTISH BITE HOSPITAL. A man with glasses and a bow tie is wearing a white coat that says texas scottish rite hospital

Kim is a founding member and Chair of the International Perthes Study Group (IPSG), a group of more than 50 pediatric orthopedic surgeons and researchers from 16 different countries dedicated to improving the care of patients with Perthes disease. “Although there are still uncertainties with the condition, we have made significant strides in advancing the clinical research and treatment,” says Kim.

The study shed light on patients’ quality of life following Legg-Calvé-Perthes disease, one of the most common childhood hip disorders that can result in significant hip deformity and early-onset osteoarthritis. These findings will allow clinicians to identify at-risk patients who would most benefit from mental health resources before developing significant depressive symptoms or anxiety. This study also shows the need for further work in identifying other risk factors for adverse mental health outcomes and evaluating current practices of psychological support.

In a healthy hip joint, the ball of the joint, or the round femoral head of the femur, fits perfectly into the round socket of the pelvis. Perthes disease interrupts the flow of blood to the femoral head causing all or part of it to die. When osteonecrosis, or bone death, occurs, it results in the ball breaking or deforming under pressure from normal rigorous childhood activities. Patients generally heal without surgical intervention, but the process can be slow. If the femoral head remains misshapen, long-term issues like pain and stiffness can arise.

Valencia retrospectively analyzed 62 patients aged 11 years or older in the healed stage of Perthes disease who reported on their physical mobility, pain interference, fatigue, anxiety, depressive symptoms and peer relationships at the time of their visit. The results showed a significant correlation between the degree of femoral head deformity and patient-reported mental health. As patients’ mobility decreased, their fatigue, pain interference, anxiety and depressive symptoms increased. “This study highlighted the wealth of knowledge that patients can impart on clinicians to improve their care with the use of patient-reported outcome measures,” Valencia says. “By utilizing these measures and addressing patient psychosocial needs in their treatment, clinicians will have a greater perspective to provide patient care at a more comprehensive level.”

Interestingly, the study did not show a considerable correlation between femoral head deformity and peer relationships. “This is likely due to the variability of social support systems and interests of patients,” Valencia says. “For example, a severely deformed femoral head in a child who likes to engage in many sports activities with their friends may respond differently than a child who enjoys socializing with computer-related activities that do not require as much movement and loading on the hips.”

Valencia is proud of this achievement and the work he and the researchers at Scottish Rite for Children are doing. “I cannot overstate what an honor it has been working with Dr. Kim and the rest of the Perthes team at Scottish Rite, and I look forward to continuing our research in Perthes patient-reported outcome measures,” he says.

Spondylolysis: A Common Cause of Back Pain in Young Athletes

Spondylolysis: A Common Cause of Back Pain in Young Athletes

by | Dec 29, 2021 | Sports Medicine

Back pain is a common complaint in young athletes. Most often, it is caused by an overuse injury related to repetitive extension-based motions. Muscles may become fatigued and sore, and some may progress to injury to the structures of the spine itself. Stress placed on the vertebrae (the bones in the spine) due to repetitive movements related to sport participation can lead to a bone stress injury or stress fracture. This condition is called spondylolysis.

Sports medicine physician Jane S. Chung, M.D., says, “Athletes and parents should be aware of the symptoms of spondylolysis, as this is one of the most common causes of low back pain in adolescent athletes that we see in pediatric sports medicine.”

What sports are most likely to cause spondylolysis? 
Spondylolysis is often associated with sports that require repetitive back extension (arching of the back, or bending backwards), such as tumbling during gymnastics or cheer, blocking as a football lineman, dancing or serving in volleyball or tennis. Our experience has been that spondylolysis can occur in any sport, including baseball, soccer and others that are not thought of as involving excessive back extension.

Is this a condition diagnosed in children only?
There are different types of spondylolysis that occur in all ages, but it is more commonly diagnosed in adolescent athletes because of the extreme demands of physical activities and sports.

What symptoms are reported with this condition?
Back pain and stiffness during and after activity are most common.

How is it diagnosed?
A thorough history and physical exam will often provide information that raises the possibility of spondylolysis. The diagnosis is usually confirmed with imaging. Sometimes, if there is a complete fracture or crack in the bone, this can be seen on X-rays. More often, an MRI is helpful to identify stress injuries that may not be visible on X-rays.

What is the treatment for this condition?
Shane M. Miller, M.D., sports medicine physician, says, “With increased demands placed on young athletes including year-round sport participation and specializing in one sport, we are diagnosing this condition more frequently. When identified and treated early, athletes tend to miss less time from their sport, and have a greater success rate of returning to sports and continuing to play at a high level.”

Initial treatment often requires resting from any activity that causes or increases the pain, such as sports, running and lifting weights. In some cases, a brace is recommended to help with pain.

Physical therapy may also be recommended to help improve flexibility and core strength. Muscle imbalance caused by tight hamstrings and weak stomach muscles can be improved with appropriate exercises. Stronger muscles support the spine and help decrease the stress placed on the bones and discs.

Is surgery needed?
It is unlikely that surgery would be needed unless the spondylolysis progresses to a more severe condition called spondylolisthesis. Even with this progression, rest and bracing are often successful. Surgery may be necessary in cases if the non-surgical treatments do not work.

With increasing trends of single sport specialization and the pressure of performing year-round, this is a common injury we treat in our young athletes. Chung and Miller encourage athletes and parents to not ignore these symptoms and to seek further evaluation by a pediatric sports medicine specialist if they are concerned. Early detection and treatment lead to a greater chance of returning to same level of sport.

Learn more