Price Transparency
Back on Beat: Alyson’s Determination to Heal Her Knees

Back on Beat: Alyson’s Determination to Heal Her Knees

by | Jan 16, 2025 | Sports Medicine

Alyson, a 17-year-old of Dallas, TX, has a passion for the fine arts! She has performed in her school’s musical productions, such as “Chicago” and “Mean Girls,” and even sings in the choir. Her most beloved hobby is dancing, but Alyson’s love for dance was threatened at age 9 when she began to feel frequent pain at dance practice.

Prior to visiting Scottish Rite for Children, Alyson was diagnosed with osteochondritis dissecans (OCD) in her knees. OCD causes the bone and cartilage at the joint surface to separate due to a lack of blood supply. It is common in young athletes, and may cause symptoms whensport requires running or jumping frequently. Alyson also has a condition called genu valgum, commonly known as knock-knees.

“I found myself needing frequent breaks from dance class, often icing my knees afterwards,” Alyson says. “In choir, I was often told, ‘Aly, stand with your knees straight.’ I physically could not.”

When Alyson’s paid did not improve, a pediatrician referred her to Scottish Rite for Children Orthopedic and Sports Medicine Center in Frisco. Philip L. Wilson, M.D., assistant chief of staff, director of Sports Medicine and pediatric orthopedic surgeon, met Alyson and her family and recommended surgery as the best course of action to heal Alyson’s knees.   

“My world came to a standstill,” Alyson says. “My afternoons that I previously spent laughing with my friends or learning techniques from my dance teachers were now spent crying and feeling sick to my stomach with the dread of potentially not dancing again.”

Already familiar with Dr. Wilson from a fracture years before, Alyson decided to proceed with surgery. Dr. Wilson performed a double knee surgery, which involved placing plates and screws in both of her knees. The plates stabilized her knees and assisted in helping her knees grow straighter. The road to recovery required Alyson to stop dancing until she was fully healed.

“All of the doctors and nurses were so helpful,” Alyson says. “My determination to return to my sport fueled me through months and the challenging journey of learning how to walk again.”

Once the screws were removed, Alyson began working hard to heal her knees through physical therapy. What began as a painful setback has transformed into a triumphant comeback, and Alyson’s determination has led her to become her school’s drill team captain this year.

“When the ability to not move freely was taken away from me, I realized how much dance shaped me — not just on the stage and field, but in all areas of my life,” Alyson says. “Scottish Rite will always be remembered as an amazing environment for me. Not only were all of my nurses and doctors encouraging, but I also truly felt open to share what I was feeling with them.”

How Spotting Spondylolysis Early Helps Protect Your Child’s Spine

How Spotting Spondylolysis Early Helps Protect Your Child’s Spine

by | Jan 14, 2025 | Scoliosis & Spine, Sports Medicine

Back pain isn’t an adults-only problem. It also affects children, and spondylolysis — a break in a vertebra — is a common cause.

If your child tells you their low back hurts, especially during physical activity, have a medical provider check it out as quickly as possible. If spondylolysis is present, early diagnosis and treatment can prevent a more serious injury to the vertebra called spondylolisthesis. The sooner your child starts treatment, the sooner they can get back to enjoying an active childhood.

 

Spondylolysis vs. Spondylolisthesis: What’s the Difference?

Spondylolysis is a stress fracture that develops in a vertebra, one of a column of bones that protects the spinal cord. Along the spine, pairs of facet joints help stabilize the vertebrae. A thin piece of vertebra called the pars interarticularis links these joints. Spondylolysis affects this bony connector, most commonly in the vertebrae of the lumbar spine (lower spine).

Without treatment, spondylolysis can lead to spondylolisthesis, which is when the pars interarticularis splits. As a result, the vertebra slips out of position, potentially causing pain and nerve damage.

 

Who’s at Risk for Stress Fractures of the Spine

Repeatedly overstretching the spine stresses the vertebrae, which are especially vulnerable to stress fractures during childhood because they’re still growing. Your child may have a higher risk of spondylolysis and spondylolisthesis if they participate in sports or activities that involve frequently leaning back and moving the lumbar spine, including:

  • Ballet
  • Football
  • Golf
  • Gymnastics
  • Soccer
  • Volleyball
  • Cheerleading
  • Weightlifting
  • Wrestling

 

When Back Pain Is a Red Flag

Sometimes, stress fractures of the vertebrae develop silently, without causing symptoms. In other cases, however, these bone breaks provide clues to their presence. Back pain is the main one.

Spondylolysis in a lumbar vertebra can cause low back pain that feels like a muscle strain. Your child’s discomfort may get worse with activity and improve with rest. Other symptoms of spondylolysis include pain in the legs and buttocks, which may be a sign the pain has spread from the back. Spasms from the stress fracture can cause your child’s hamstrings to tighten.

 

Diagnosing and Treating Spondylolysis

If you notice symptoms of spondylolysis, take your child to their primary care provider, who will ask about medical history and sports participation. The medical provider will also perform a physical exam to look for signs of a stress fracture in the low back and legs. He or she may press on your child’s back to identify tender areas or ask your child to bend backward to see if the movement causes discomfort.

Imaging tests, such as X-rays and CT scans, can show stress fractures in the vertebrae and help your child’s medical provider confirm a spondylolysis diagnosis. MRI scans can show whether a stress fracture has led to tissue damage.

Your child’s primary care provider may refer you to a pediatric orthopedic specialist for further evaluation and treatment. If found early, spondylolysis usually heals with nonsurgical treatment.

Your child may need to take a temporary break from sports that put repetitive stress on the low back to give the fracture time to heal. To help the process, they may need to wear a back brace to limit the spine’s movement.

While the injury heals, your child may take over-the-counter pain-relieving medications to stay comfortable. Working with a physical therapist can also help reduce pain and improve strength and flexibility in the lumbar spine.

Surgery isn’t usually necessary. However, if spondylolysis leads to severe spondylolisthesis, spinal fusion may be the most appropriate treatment. During this operation, a surgeon connects two damaged vertebrae using a bone graft so the vertebrae heal into a single, stable bone.

 

How to Reduce Your Child’s Risk of Spondylolysis

You can help protect your child’s spine and keep him or her on the field or court by encouraging simple steps to reduce the risk of spondylolysis, including:

  • Build strength in the middle. Encourage your child to strengthen his or her core to help support the lower back.
  • Focus on one sport at a time to prevent overuse injuries. Don’t let your child play more than one sport that increases the risk of a spinal stress fracture per season.
  • Play it smart. Ensure your child uses the proper equipment and technique for his or her sport.
  • Rest up. Your child should take at least one day off from practice or training each week.
  • Eat a balanced diet. Maintain a healthy diet with adequate calcium and protein intake. Vitamin D supplementation is especially necessary for those missing key nutrients in their diet.

 

Need an expert who can treat your child’s low back pain? Schedule an appointment with a pediatric orthopedic specialist at Scottish Rite for Children.

Can You Sleep With a Concussion? A Common Question, Answered

Can You Sleep With a Concussion? A Common Question, Answered

by | Jan 13, 2025 | Sports Medicine

A concussion is a type of traumatic brain injury, and if your child has experienced one, there are many ways you can support their recovery process. One of the most important ways you can help is by ensuring your child gets plenty of rest. For many years, it was thought that sleeping with a concussion was unsafe. Current evidence encourages parents to promote and protect rest, as it helps the child’s brain recover.

“We now know that it is safe to sleep after a child has been medically diagnosed with a concussion by a medical provider,”pediatric sports medicine physician Jane S. Chung, M.D., says. “Unless your child’s provider says otherwise, let your child sleep without interruption.”

First Steps to Recovery After a Concussion

If your child has a head injury and displays symptoms of a concussion, immediately remove them from activities that put them at risk for a repeat head injury, such as athletic practices or games. You should take your child to see a provider with experience in concussion management. In addition to concussion testing, these providers are experienced at evaluating brain function and the consequences of the injury.

Signs of a concussion observed by others can include:

    • Appearing dazed or stunned
    • Confusion
    • Forgetting plays
    • Being unsure of game, score or opponent
    • Exhibiting unsteadiness
    • Moving clumsily
    • Answering questions slowly
    • Losing consciousness (getting knocked out)
    • Memory loss
    • Being more sleepy or tired than usual
    • Seeming sad, nervous or anxious
    • Being irritable, easily frustrated or upset
    • Having problems with academic performance
    • Slow to get up after a fall, collision or blow to the head
    • Clutching the head after an injury
    • Sleep problems

     

    Concussion symptoms felt by the athlete can include:

    • Headaches
    • Concentration or memory problems
    • Nausea
    • Balance problems or dizziness
    • Double or blurred vision
    • Feelings of being “in a fog” or slowed down
    • Sensitivity to light or noise
    • Confusion
    • Just “not feeling right” or “feeling down”

     

    A concussion evaluation includes a variety of physical exams, tests and computerized neurocognitive testing, as needed. If your child is diagnosed with a concussion, their provider will give you advice about what your child can and can’t do in the days immediately following the injury. Most importantly, your child should avoid activities, practices and games that increase their risk for a repeat head injury until cleared by their medical provider.

    Your child’s doctor will work with you to determine when your child can progressively return to school, practices and games. Returning to activities too early can cause worsening symptoms and delayed recovery.

     

    How Much Sleep Your Child Needs

    Your child’s doctor will encourage you to make sure sleep is part of the recovery plan. “Sleep plays an important role in a child’s growth and development,” Dr. Chung says. “Following a concussion, sleep is even more important to allow brain healing and recovery. We encourage at least 9 to 10 hours of sleep every night during concussion recovery in our teenage patients.”

    As your child recovers, take the steps to help them get good-quality sleep. You can improve your child’s sleep habits with these tips:

    • Help them create a wind-down routine. Your child should avoid energy drinks and caffeine, especially close to bedtime. If your child has a hard time falling asleep, develop a sleep routine that helps prepare your child to sleep. They can try taking a warm bath or shower, you can read them a story or help them find other relaxing activities to signal their brain and body that it’s time for bed.
    • Create a sleep-friendly environment. Your child’s bedroom should be quiet and comfortable. If the room gets lots of sunlight, you can use blackout curtains and keep the room cooler.
    • Stick to a sleep schedule. You should ensure your child goes to bed and wakes up around the same time every day. Avoid long naps during the day. They may take brief short naps during the day, no more than 30 minutes, if needed. However, we encourage kids to go to bed earlier if they are feeling tired, rather than taking prolonged naps during the day, as it can negatively affect their circadian rhythm.
    • Turn off electronics. Computers, televisions and other screens produce a blue light that can keep kids awake. Your child should avoid electronics at least one to two hours before bedtime.

    In addition to ensuring good-quality sleep, keep an eye out for sleep problems. In research conducted at Scottish Rite for Children with patients who had a sport-related concussion, experts learned poor sleep quality can be associated with prolonged concussion recovery and delayed return to sport compared to those athletes who had good sleep quality.

     

    Talk with your provider if your child experiences:

    • Difficulty sleeping at night. Frequent naps can make it hard for your child to sleep at night.
    • Lack of improvement in symptoms. A normal concussion resolves within two to four weeks.

    Another study published in the Journal of Clinical Sleep Medicine by our sports medicine team suggests that after a concussion, sleep quality may be affected.

     

    Does your child need help recovering from a concussion? Call 469-515-7100 to schedule an appointment with a sports medicine specialist at Scottish Rite for Children Orthopedic and Sports Medicine Center. 

    Lifetime Sports: Starting Good Habits for Young Athletes

    Lifetime Sports: Starting Good Habits for Young Athletes

    by | Jan 8, 2025 | Sports Medicine

    Assistant Chief of Staff and pediatric orthopedic surgeon Philip L. Wilson, M.D., is dedicated to changing the game for young athletes. Research shows that children who specialize in a sport before the age of 14 are more likely to burn out, quit sports or experience long-term health issues.

    Knowing how important physical activity is for wellness into adulthood, Wilson shares his expertise on lifetime sports. Read the following for how coaches and parents can keep young athletes engaged by diversifying their activities.

    Download this as a PDF.

    WHAT IS A LIFETIME SPORT?

    A lifetime sport is an activity or sport that is enjoyable throughout your life. You can do these activities with a variety of people without being dependent on a team. It fits within any lifestyle, and you’re not forced to schedule around it.

     

    HOW IS IT DIFFERENT FROM CROSS-TRAINING?

    It depends on what is motivating you. If you’re focused on cross-training to get better for your primary sport, you may not stick with the activity for a long time. If you’re participating in a wide variety of activities to promote general health and well-being, I think you’re more likely to continue.

     

    WHAT ARE SOME EXAMPLES OF LIFETIME SPORTS?

    Hiking, tennis, golf, swimming, jogging, walking, pickleball and bicycling

     

    WHAT CAN PARENTS DO TO ENCOURAGE THESE ACTIVITIES?
    • Leave time in the schedule for physical activities.
    • Ask your kids what they would like to do.
    • Lead by example. Show them that being active is a way of life.

     

    WHAT COULD MOTIVATE KIDS TO BECOME LIFETIME ATHLETES?

    You should create a variety of opportunities for them to develop an interest in being active. I think of activities like taking a walk in a nature preserve, taking advantage of your city’s jogging trails, trying out different playgrounds or checking out the local climbing gym. The options are endless when combining activities and the outdoors.

     

    WHY IS THIS IMPORTANT?

    In my career, I’ve seen some athletes continue in their primary sport for a long time. I’ve also seen many give up for one reason or another. It’s a tough transition, going from being a dedicated athlete to “real life” activities. I believe that those who are well-rounded and have learned the long-term values of sport and fitness will be healthy adults. They will understand the values of maintaining an active lifestyle

     

    Learn more about Scottish Rite for Children’s Bridge Program, designed to help young athletes optimize performance and reduce injury risk. 

    Expanding Young Athletes’ Potential Beyond the Court

    Expanding Young Athletes’ Potential Beyond the Court

    by | Dec 16, 2024 | Events, Sports Medicine

    Picture courtesy from the Dallas Mavericks. 

    Division Director of the Movement Science Laboratory Sophia Ulman, Ph.D. inspires the next generation of athletes to explore the wide range of opportunities in sports beyond the court.

    The Dallas Mavericks organization hosted their annual Mavs Academy Fall Classic in November in Frisco, Texas. The tournament united 80 boys’ and girls’ varsity teams across Texas to compete at various Frisco ISD schools throughout two weekends. Scottish Rite for Children’s athletic trainers handled injuries on the sidelines, ranging from minor abrasions to significant joint injuries, like ACL tears.

    While the teams showed off their high-quality skills on the court, Ulman represented Scottish Rite’s sports medicine team in the tournament’s off-court, educational enrichment. In a panel discussion, Ulman expanded young athletes’ perspectives of careers in sports through her own journey. Starting as a competitive basketball player herself, she acknowledged that she was like many young athletes — imagining a career that allowed her to stay connected to sports. Ulman shared how her career path evolved with her internship at Duke University’s Michael W. Krzyzewski Human Performance Laboratory (K-Lab). Since then, Ulman has conducted innovative research on lower extremity injuries,  as well as a variety of risk factors including movement quality, nutrition, sleep and early sport specialization in Scottish Rite’s state-of-the-art Movement Science Laboratory.

    “I get to be around young athletes every day, and the work I get to do has the potential to impact thousands more,” Ulman says. “I can’t imagine a better place to be.”

    Ulman’s perspective broadens young athletes’ views of sports, specifically through showing how it is possible to contribute to the game through STEM-specific careers. Panelists alongside Ulman included Mechelle Lewis Freeman — USA Track and Field Olympian, Olympic coach, CEO/Founder of TrackGirlz and partner with Ulman in Scottish Rite’s FAST clinics — and Dallas Mavericks legend Rolando Blackman, among others.

    “I love talking to the kids because so many of them think that if they don’t go professional, that’s it with sports,” Ulman says. “Being able to share with them that it’s not just being a professional athlete, it’s not just production or being a broadcaster, but there are a lot of STEM-specific jobs as well.”

    The Mavs Academy Fall Classic reinforces the relationship between young athletes’ physical performance, well-being and opportunities as they continue to develop. By having a sports medicine expert like Ulman, there is a touch of Scottish Rite’s principles of keeping children active and healthy well into adulthood.

    “Over the years in our collaboration with the Mavs Academy, we have had the privilege of educating hundreds of young athletes and have engaged families in our injury prevention research,” says Ulman. “With a solid commitment to our mission of giving children back their childhood, we are dedicated to defining injury prevention standards and using evidence-based information in our care and in our community education so we can truly change the game for young athletes.”

     

     

    Does Your Child Feel Like Their Shoulder Is Loose? Shoulder Popping Can Be a Sign of Shoulder Instability

    Does Your Child Feel Like Their Shoulder Is Loose? Shoulder Popping Can Be a Sign of Shoulder Instability

    by | Dec 10, 2024 | Sports Medicine

    Crunching and popping are the sounds your child should make when eating carrots, celery and the occasional potato chip. They are not the sounds you want to hear when they move their arms and shoulders, but all sounds may not be bad. Shoulder popping can be a sign of shoulder instability, which is a condition that can affect kids and adolescents.

    “Often times, kids will wait too long to receive treatment after a shoulder relocation,” sports medicine orthopedic surgeon John A. Arvesen, M.D., says. “In fact, the shoulder is one of the most mobile joints in the body. The more your shoulder dislocates, the most likely you will have additional injuries to the cartilage and labrum.”

     

    What Causes Shoulder Instability?

    The humeral head is a ball at the top of the upper arm bone. This ball rests in a shallow socket of the shoulder blade, which is called the glenoid. The glenoid is surrounded by soft tissue called the labrum, which deepens the socket side of the joint.

    When the tendons and ligaments of the shoulder fail to securely hold the ball in the socket, the shoulder joint can feel loose. An injury to the labrum can result in a tear known as a Bankart lesion. Damage to the labrum makes it easier for the ball to slip out of the socket.

    Slipping or instability of these conditions can range from a minor annoyance with slight discomfort and popping sounds to a painful shoulder dislocation that needs immediate attention.

    Shoulder injuries, such as instability, occur most commonly in kids who play sports. The bones and joints of young athletes are not fully mature. Due to the stress that sports can put on the body, injuries are bound to happen. Some kids have naturally loose ligaments, making them even more prone to shoulder instability.

    Other factors that can raise the risk of shoulder instability include having a previous subluxation or complete shoulder dislocation, hypermobility in the joint, and playing specific sports that put the shoulder in at-risk positions. High-impact sports, such as football, gymnastics and volleyball, increase the potential for shoulder instability.

     

    What to Watch and Listen For in the Shoulder

    Common symptoms of shoulder instability include the shoulder feel loose or feeling like it may slide or slip when bringing it over your child’s head. Certain motions or arm positions can aggravate the pain, and your child may describe the shoulder as feeling loose or unstable. Other symptoms that signal shoulder instability include:

    • Experiencing weakness in the shoulder
    • Having a sensation that the shoulder is slipping or popping out of the joint
    • Limited range of motion with daily activities or sports
    • Numbness and tingling in the arm

     

    The Seriousness of Shoulder Dislocation

    When the humeral head comes all the way out of the shallow socket of the glenoid, shoulder dislocation occurs.

    If the shoulder is dislocated and does not immediately go back into place, your child may need emergency care right away. If the arm returns to its normal position and function, it’s best to follow up with a pediatric orthopedic surgeon. This condition is likely to happen again once it occurs the first time. If shoulder dislocations continue to occur, it can cause more serious damage inside the joint.

     

    Treatment for Shoulder Instability

    Diagnosing shoulder instability usually starts with a physical exam. This examination includes range of motion, strength testing and other special tests in the shoulder, such as apprehension sign, relocation test and load and shift tests, to confirm the diagnosis.

    The treatment method is determined by the type of shoulder instability – anterior or posterior shoulder instability. Anterior shoulder instability is when a shoulder pops out of a place towards the front, and posterior shoulder instability is when the shoulder dislocates in the back. Arvesen and a team of researchers discovered children with anterior shoulder instability have more problems with their shoulder being unstable, while children with posterior instability usually experience more pain. This reveals that anterior shoulder instability injuries require more intensive treatment and rehabilitation.

    Researchers at Scottish Rite for Children also found atypical injury patterns occur mostly in younger patients. Imaging, such as an X-ray or magnetic resonance imaging (MRI), may be recommended to get a closer look at the tissues inside the shoulder joint and to rule out specific conditions. In this population, changes to the surface of the glenoid bone or a Hill-Sachs lesion on the humeral head may be noted after a first or repeat instability incidents, these findings may influence the decision to have surgery.

    Pain medications, including anti-inflammatory drugs such as ibuprofen, combined with rest and cold packs can help reduce pain and swelling. A sling may be recommended to help immobilize and support your child’s arm and shoulder as they heal. Additionally, a personalized physical therapy program may be recommended to help strengthen the muscles that control and stabilize the shoulder joint and the shoulder blade, known as the scapula.

     

    Will Your Child Need Surgery?

    Many patients have significant improvement in their shoulder symptoms after getting proper rest and performing a home exercise program or formal physical therapy. However, if instability continues to be a problem after trying nonoperative treatments, surgery may be recommended. Surgical treatments, such as Latarjet procedure, are frequently performed arthroscopically.

    The goal of any treatment is to return your child to an active life as quickly and safely as possible, and this applies to surgery as well. Returning to sports with pain or too soon after a surgery may lead to long term problems

    Every kid recovers differently. The pediatric orthopedic surgeon will work with you to determine when to let your child resume full activity. Regaining full range-of-motion, strength and improving the overall stability of the joint are the main goals of recovery.

     

    Keeping Kids Moving: Protecting Shoulders from Injury

    Kids are meant to move. Shoulder instability and pain can get in the way of moving at full speed. There are steps you can take to prevent shoulder instability and dislocation.

    An exercise program can increase the strength and control of the muscles responsible for creating stability at the shoulder joint to provide the support the shoulders need to stay strong and in place. Stability in the shoulder and mobility in the upper back are necessary for activities that require extreme shoulder motion, such as throwing a baseball or hitting a volleyball.

    Dr. Arvesen and Scottish Rite physical therapist Katie Sloma, P.T., D.P.T., CSCS, are collaborating to develop a return to play protocol. This will guide decision making for upper extremity athletes who have injured their shoulders or who are recovering from shoulder surgery. They have presented their initial recommendations at a national meeting for pediatric research in sports medicine and are currently testing the protocol in a research study with our movement science lab team.

    Shoulder instability can slow your child down, but it doesn’t have to bring them to a full stop. Kids are resilient and heal quickly. The sports medicine experts at Scottish Rite for Children can help your young athlete get back to the games they love to play — on the field, in the pool or simply in your own backyard. 

    Think shoulder instability may be affecting your child or teen? Request an appointment today by calling Scottish Rite for Children Orthopedic and Sports Medicine Center 469-515-7100.