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Jammed Finger? Early Treatment Can Improve Outcomes

Jammed Finger? Early Treatment Can Improve Outcomes

by | Dec 4, 2024 | Sports Medicine, Therapy Services

When an injury occurs to a young athlete’s bones, ligaments and muscles in their hand, an evaluation is needed. A properly treated hand injury will most likely heal without complications.

In basketball and volleyball, fingers are at an increased risk of injury due to a variety of causes. Some children may snag their finger on a jersey, or others may hang on the rim or net. When an athlete says they have “jammed” their finger, there is concern for a volar plate injury.

 

What is the volar plate?

The volar plate is a thick ligament, located on the palm side of the finger. It connects two bones in the finger and stabilizes the middle joint of the finger, known as the proximal interphalangeal, which prevents the finger from bending backwards.

 

What is a volar plate injury?

A volar plate injury occurs when the finger is hyperextended or bent backwards, damaging the ligament. It is also commonly known as a sprained or jammed finger.

In some cases, the volar plate can be stretched and torn, pulling off a small piece of bone. This results in a fracture in the area called an avulsion fracture. With severe injuries, the joint may also be dislocated.

 

What are the symptoms in the injured finger?

  • Bruising
  • Immediate pain in the middle joint
  • Swelling of the middle joint
  • Decreased range of motion

 

What is the treatment for a volar plate injury?

Fracture Clinic provider Gerad Montgomery, M.S.N., FNP-C, sees and treats volar plate injuries frequently at Scottish Rite for Children Orthopedics and Sports Medicine Center in Frisco. “Treatment for a volar plate injury depends on the severity and can range from a short period of immobilization to surgery,” Gerad says.

With more than 15 years in providing pediatric orthopedic care, Montgomery has learned to warn families of the risks associated with not properly treating this injury. It’s important for families and young athletes to understand that volar plate injuries can worsen to the point of needing surgery without evaluation or treatment from an expert.

 

When should an athlete return to sports after a volar plate injury?

After a clinical provider has released the athlete to begin exercises, gentle range of motion progressing to strengthening exercises may be recommended. Some athletes may need guided exercise with an occupational therapist. “Before returning to sports, the hand and finger should have full strength and range of motion,” certified hand therapist Lindsey Williams says. “Otherwise, there is a risk of injury to the same or other joints nearby.”

Not sure what to do if your child gets a finger injury? Learn about our Fracture Clinic and Sports Medicine Clinic.

Miles of Motivation: Alice Races Ahead of AMPS

Miles of Motivation: Alice Races Ahead of AMPS

by | Nov 29, 2024 | Psychology, Sports Medicine

12-year-old Alice is racing towards her dreams, confidently managing each day and creating her own path! With a passion for running, she participates in cross country for her school and the Amateur Athletic Union (AAU). After securing fifth place in AAU’s 5K, Alice began experiencing knee pain, which worsened following an injury during P.E. class in 2022. Despite physical therapy and using crutches, her condition didn’t improve. Alice had moments of extreme pain that prevented her from even walking. Unable to find a solution, Alice’s mom, Lindsey, sought help from Scottish Rite for Children in May 2023.

Sports medicine physician Jacob C. Jones, M.D., RMSK diagnosed Alice with amplified musculoskeletal pain syndrome (AMPS). Defined by Psychology fellow Diana Tinsley, Ph.D., AMPS is a chronic pain condition that causes prolonged pain, even though there is no identifiable pain source. “The pain sometimes starts with an injury,” Dr. Tinsley says. “Even though the physical injury heals, the pain persists and can spread throughout the body or even worsen in severity.”

Her condition required a multidisciplinary team of experts in sports medicine, physical therapy and psychology to reintroduce her to her love for running. Lindsey says Dr. Tinsley and physical therapist Ashley Ratliff were key motivators throughout Alice’s care journey. “There were many tears and ‘What if?’ moments during Alice’s treatment,” Lindsey says. “It’s important to truly lean on your care team and follow through with the work they give you to do at home – no matter how hard it may be!”

Alice’s Scottish Rite team worked to create a comprehensive treatment approach that set her transformation into motion. Her goal was to learn how to move through the pain and get back to daily life. Dr. Tinsley provided Alice psychological support through pain management strategies and helped her set manageable goals to work into her day-to-day schedule, such as leaving her crutch at home when doing errands. Soon, Alice went from relying on crutches to walking without assistance altogether. “Her pain had taken over her life,” Dr. Tinsley says. “Pain flares can happen especially when stress increases. We try to put her immense progress into perspective and continue to encourage her.”

Physical therapy for Alice was trickier, as there was no clinical evidence of her injury. However, Ashley’s exercises focused on desensitizing Alice’s knee to decrease the pain signals to her brain and improve Alice’s knee function. Similar to Dr. Tinsley’s approach, Ashley slowly decreased Alice’s use of crutches to help her regain muscle in her knee from not bearing weight on it. “The focus was on making small goals at a time to gradually work to her overall goal of running again,” Ashley says. “This involved a lot of communication between Alice and I to ensure she was being challenged, but also that she had appropriate time to cope and work through new challenges.”

Since Alice was a competitive runner, they alternated between gym sessions and aquatic therapy to improve her pain tolerance for her running return. Alice’s care journey continued at home, with her Scottish Rite care team and family collaborating to decrease her fear of movement. “Alice had such success based on her participation with Dr. Tinsley and being diligent with her physical therapy exercises at home,” Ashley says. “Patients with AMPS need support at home to encourage their progress.” Alice slowly transitioned from running in the pool to the treadmill, eventually running 6 miles without discomfort. Due to her dedication to her passion, Alice made excellent progress and was discharged from physical therapy!

Alice

Inspired by her care, Alice is now encouraging other kids with similar diagnoses. She has published a journal titled “Today is My Day!”, a mindfulness journal dedicated to those who have anxiety or depression. It encourages self-reflection with the goal of taking steps to appreciate life more. Additionally, Alice safely returned to cross country and is continuing to build her strength to achieve her dream of being a professional runner! Her success is a testimony of the support from her Scottish Rite care team and family. “From the smiles we get from the front desk to excellent care, our overall experience has been amazing,” Lindsey says. “Without Scottish Rite, Alice would not be where she is today and doing what she loves!”

Do you have a story? We want to hear it! Share your story with us.

A Parent’s Guide to Contact Sports for Kids

A Parent’s Guide to Contact Sports for Kids

by | Nov 18, 2024 | Sports Medicine

Contact sports can be exciting for young athletes and parents alike. They also introduce an element of danger into the exercise equation. 

Any time a person participates in a physical activity, there’s a risk of injury. However, engaging in contact sports magnifies that risk. If your child participates in this type of athletic activity, following the proper safety precautions is critical.

What’s Considered a Contact Sport?

In a contact sport, players come into physical contact with each other or an object as part of the competition. There’s a risk of contact in nearly all sports, but the risk is higher in some than others. 

In basketball and soccer, for example, children are likely to knock into others athlete as they jockey for the ball. When they’re rebounding, taking a shot or defending on the basketball court, they’re in close contact with others and can accidentally (or otherwise) touch them lightly or with force.

Other sports have an even higher risk of contact. Some sports, such as ice hockey, football and lacrosse, involve techniques that have kids actively running into or making contact with an opponent. Making contact is not incidental in these sports. It is intentional. For that reason, this sports category is sometimes called “collision sports.”

While most contact sports are team sports, some contact is involved in solo activities, such as gymnastics. In that case, an athlete makes contact with the floor or an apparatus rather than a person.

How to Keep Your Child Safe in Contact Sports

To protect your young athlete on the court or field, begin with these basics, which can reduce the risk of sports injuries:

●      Get a sports physical. This specialized medical checkup helps ensure your child is healthy enough to participate in a sports activity. It’s a good idea to have your child have a sports physical before each season, even if their school or team does not require one.

●      Buy the proper protective gear. Every sport has specific equipment, so check with your child’s coaches to see what’s required and recommended. Depending on the sport, this may include a helmet, knee pads, shin guards, padding or a mouthguard.

●      Be sure your child learns the correct technique. Many sports injuries in contact sports occur because somebody incorrectly performed a move. Emphasize that your child should use proper form and follow the rules of the sport.

●      Mix things up. Overuse injuries are common among athletes, particularly young athletes who are still growing and developing. Encourage your child to participate in multiple sports or physical activities that use different parts of the body, which will lower the risk of overusing a specific muscle or joint. Overuse injuries can reduce your child’s range of motion and limit their ability to play at their best.

In addition to these tips, talk with the coaches or even the athletic trainer about other steps you can take to keep your child safe while playing contact sports. There is some risk, but you can also do many things to mitigate that risk.

The Scottish Rite for Children sports medicine team is committed to keeping kids healthy and in the game. Call 469-515-7100 to schedule an appointment with one of our sports medicine specialists.

Emily Claire’s Transformation: A Pain-Free Knee and a New Life Path

Emily Claire’s Transformation: A Pain-Free Knee and a New Life Path

by | Nov 7, 2024 | Sports Medicine, Therapy Services

Cover story previously published in Rite Up, 2024 – Issue 3.

by Kristi Shewmaker

Emily Claire, of Plano, spends most of her time raising two pigs — Dolly and Kenny, named after Dolly Parton and Kenny Rogers. Like the country legends, Dolly and Kenny are not related. Every morning and evening, the 17-year-old drives to the barn to take care of them where they show their affection for her in different ways. “Dolly gets the zoomies,” Emily Claire says. “She’ll run laps in her pen, but Kenny just sits there with puppy dog eyes looking at me. He also likes to cuddle. Dolly, not so much, but Kenny will lay across my lap.”

Emily Claire is president of the FFA Plano chapter and secretary of Area V’s District VII for the state of Texas, which is part of the National FFA Organization, historically known as Future Farmers of America. She recently attended the Texas FFA State Convention in Houston. “It’s a lot more than just showing animals or being a farmer,” she says. Through FFA, she has engaged in leadership and career development events that will serve her throughout her senior year of high school and beyond.

Dr. Henry B. Ellis

As a young teen, Emily Claire had her heart set on playing softball. She played for school and select teams and had dreamed of playing at the collegiate level. But, she started experiencing pain in her knee, leading to multiple incidents of partial dislocation. The first time, she was crossing the street. “My kneecap slipped out, and I fell to the ground, literally in the middle of the street,” she says. “It was embarrassing.” The second time, she fell at softball practice, but each time, her kneecap went back into place. Then, in the fall of 2021 during her freshman year of high school, her kneecap fully dislocated at catcher practice. “I was in my squat throwing down to second base, and I popped up to throw, and my kneecap just locked out,” she says. “I couldn’t move it. I didn’t know what was happening, and I was freaking out.”

TREATING KNEECAP INSTABILITY
An established patient at Scottish Rite for Children Orthopedic and Sports Medicine Center in Frisco, Emily Claire was initially treated with a brace and a specific exercise program. Unfortunately, she experienced increasing episodes of instability in her kneecap, or patella. Recurrent episodes of patellar instability often require surgery. Henry B. Ellis, M.D. — pediatric sports medicine surgeon, sports medicine fellowship director and medical director of clinical research — performed medial patellofemoral ligament (MPFL) reconstruction surgery on Emily Claire’s left knee.

“MPFL reconstruction is common for us in pediatric sports and those that take care of kids because kneecap instability is very common in kids,” Dr. Ellis says. “In our practice at Scottish Rite, it is one of the most common conditions that we treat.”

When Emily Claire’s kneecap dislocated, it tore an important ligament that holds the patella in place. In surgery, Dr. Ellis replaced the torn ligament with a new one to give her kneecap stability. However, patellofemoral instability is complicated. Sometimes, it requires more than simply replacing a ligament. At the end of the femur, or thigh bone, is a groove called the trochlear groove. The patella fits into this groove, and when the knee bends or straightens, the patella slides up and down in the groove. Emily Claire’s kneecap was not aligned in the groove because of the position of her tibial tubercle, the bony bump on the upper part of the shin where the patellar tendon attaches. “Her kneecap was living off to the side,” Dr. Ellis says. To mitigate this problem, he performed a procedure to shift Emily Claire’s tibial tubercle, which aligned her kneecap in the groove and ensured that it would track and glide correctly.

REHABILITATING BODY, MIND AND SPIRIT
MPFL surgery stabilized and corrected Emily Claire’s kneecap. What came next would change the direction of her life. Her knee injury and rehabilitation served as a catalyst that led her to discover her dream career. Throughout her care journey, she received treatment from Dr. Ellis and a multidisciplinary team, including physician assistant Ben Johnson, registered nurse Tammy Norris, physical therapist Katie Sloma, child life specialists, psychologists and athletic trainers, among others.

After surgery, Emily Claire met physical therapist Katie Sloma for a physical therapy evaluation. “I remember talking to Katie and asking her questions,” Emily Claire says. “I was really curious about her job.” For weeks, Emily Claire was on crutches, wore a brace and could not bear weight on her leg. “I got a really good tan line at the softball field with stripes going across my leg,” she says. “It was very humbling having two different size quads.”

Katie worked with Emily Claire on quad strengthening, range of motion and mobility through manual therapeutic exercises and aquatic therapy.

“Emily Claire always came in with a smile and ready to work,” Katie says. “She was curious about the process and liked to remain informed, which was cool for us to see.”

For several months, Emily Claire could not play softball. Then, slowly, she was reintroduced to the game part time, but ultimately, her team broke up during her sophomore year. “I was like, ‘OK, I don’t know what I’m supposed to do now,’” she says. She recalls trying out for other teams, but her knee had not fully recovered. “I wasn’t getting called back,” she says. “It was like nobody wanted me, and that was really degrading, and I was like, ‘Am I even supposed to play softball anymore?’”

Things began to change in 2023 when Emily Claire attended the FFA Collin County show. “Everybody there was just so nice and comforting. It felt like a place that I belonged,” she says. “So, I went home and cried about it a lot, and I was like, ‘I just don’t think softball’s for me.’”

OPTIMIZING CARE THROUGH EXPERT TEAMWORK
Emily Claire continued to gain strength and increase athletic conditioning by working with athletic trainers while participating in Scottish Rite’s Bridge Program.
“In our care of any youth athlete, one of the biggest advantages that we have at Scottish Rite is the ability to work together,” Dr. Ellis says. “When someone presents a problem, we offer solutions, but we do it not just as a physician to patient, but as Scottish Rite as a whole.”

Physician assistant Ben Johnson agrees. “The care we provide is a team-based approach with all team members focused on a singular goal of getting patients like Emily Claire back to doing what they love to do without limitations,” he says. The exceptional dynamic of Scottish Rite’s continuum of care results in optimal outcomes for patients. “The key to Emily Claire’s success is the fact that she had an opportunity to work with our team together,” Dr. Ellis says.

Emily Claire liked the team she worked with so much she decided to join it. Over the summer, she interned at the Frisco campus’ Movement Science Lab, processing data for a neurocognitive research study. “I have received so much at Scottish Rite — and not just care,” she says. “Everybody here is so kind and loving, and they want to help you not just get better and achieve your goals, but they’re willing to help you learn.”

Emily Claire’s time at Scottish Rite has inspired her to become a physical therapist. “Instead of something that I had to go to, physical therapy became something that I looked forward to,” she says. “Everyone was there for me.” Katie shares that Emily Claire’s interest in the field of physical therapy was rewarding to her as a provider. “It shows that her time at Scottish Rite made a positive impact on her even when things got hard,” Katie says.

Upon reflection, Emily Claire explains that her care journey also changed her mental health. “It showed me that I was more unhappy than I was happy playing softball, and that softball wasn’t for me,” she says. “I thought I was going to let so many people down
if I didn’t play, but it opened my eyes and showed me that I like doing FFA a lot more.”

Recently, Emily Claire received the news that she was accepted to her college of choice, Tarleton State University, where she will pursue a degree in kinesiology. Upon graduation, she plans to attend physical therapy school. But for now, she is enjoying her senior year, beginning this fall, when she shows her superstars, Dolly and Kenny, at the State Fair of Texas.

Read the full issue.

How to Help Your Kids Prevent Football Injuries

How to Help Your Kids Prevent Football Injuries

by | Aug 27, 2024 | Sports Medicine

Even as awareness of concussions and other problems has grown, football remains the most popular sport for adolescent boys. While participation has dropped, Texas still has the most high school football players of any state – totaling more than 170,000. That’s almost double the number of players in California, which has the second largest population of players. It’s no surprise that the sport remains so popular in a state known for “Friday Night Lights.” Yet while rule changes have modified risks, football injuries are still common. Scottish Rite for Children has advice to help your kids avoid some of these common sport injury problems.

Common Injuries in Football

Football has the highest injury rate among school sports. Most youth sports injuries are muscle, joint or bone injuries including:

Other common injuries in football are concussions and heat-related injuries, such as dehydration and exertional heat stroke.

Protective Equipment Is Key

Tackle football players wear pads for a reason. If your child is playing on a team that does not have the resources of a varsity-level squad, make sure they practice with the correct gear including:

  • Properly fitting helmet approved by the National Operating Committee on Standards for Athletic Equipment
  • Leg (thigh and knee) pads
  • Mouthguards
  • Cleats that are the correct size and fit
  • Shoulder pads
  • Protective cups

Some players may also wrap their wrists, ankles or knees with tape or bracing. Protective braces (i.e. knee brace or ankle brace) may decrease the risk of injury in some athletes. However, custom outer knee braces have not yet been proven to lower injury outcomes.

Practice Makes (Almost) Perfect

Proper training may also reduce injury risk. While your child’s coach determines what happens at practices, you can help your child learn ways to reduce the risk of football injuries all year long by:

  • Encouraging moderate off-season conditioning. Staying in shape throughout the year with cardiovascular exercise and strength training is great for your child’s health overall and may reduce the risk of injuries when they head back to the field.
  • Getting a physical. A pre-season assessment by your child’s pediatrician or sports medicine specialist can ensure that your child is healthy enough to play and raise any areas of opportunity for addressing musculoskeletal complaints before training begins.
  • Promoting hydration. Not only does proper hydration help prevent heat-related injuries, it’s also important for peak performance and maintaining a proper tackling technique. 

Encouraging your child to play different sports during the offseason can also help prevent overuse injuries while keeping them active and conditioned. Playing multiple sports has been shown to be associated with improved performance and reduced injury risk.

What About Concussions?

Whether your kids are linemen or quarterbacks, concussions are a risk during games and practice. Although some full contact drills have been banned from youth practice to reduce concussion risk, 63% of concussions in high school football players do happen from tackling, even during practice. Helmets do not prevent concussions, regardless if they are the best rated helmets on the market. Delaying tackling until the age of 14 is advised by some, however, there are ways to make the sport safer for young athletes. If your child is playing tackle football, make sure the coaches:

  • Limit tackling during practice.
  • Teach safe tackling tactics.
  • Remove the child from play immediately whenever a concussion is suspected.
  • Always follow established return to play guidelines after a concussion.
  • Have a doctor and/or athletic trainer on the sidelines to evaluate players during games after a possible concussion.

Talk to the Coaches

Coaches are an important part of football injury prevention. Before signing your child up for a league, ask the coaching staff questions to ensure injury prevention is part of their philosophy such as:

  • Do you encourage injured players to keep playing or take time off to recover?
  • If my child has a possible concussion, what is the protocol at the time of the injury and when it is time to return to play?
  • Does your child have their own water available?
  • How do you teach sportsmanship and fair play?
  • What type of tackles and drills do you run during practice?
  • Will practice be rescheduled or held indoors if the weather is extremely hot or severe storms are expected?

Only you can decide if a coach’s temperament and attitude toward the game is the right fit for your child — or if football is even a good option for your family. But with a proactive coaching staff, a supportive home and your sports medicine team at Scottish Rite, you can help limit the risk of a sports injury in football for your child.

Want more advice on preventing or treating football injuries for your child? Call 469-515-7100 to schedule an appointment with one of our sports medicine specialists at Scottish Rite for Children Orthopedic and Sports Medicine Center.

Do Kids Need Sports Drinks to Stay Hydrated?

Do Kids Need Sports Drinks to Stay Hydrated?

by | Aug 23, 2024 | Sports Medicine

Do Kids Need Sports Drinks to Stay Hydrated?

When your kids are out of school for the summer, you want them to have plenty to do. Day camps, sports leagues and time at the swimming pool are all great ways to keep your kids active (and off their screens). However, if your kids are outdoors in the summer heat, it’s important to ensure they stay hydrated. While sports drinks replace electrolytes lost during physical activity, they may not be the best choice for most children’s hydration. In most instances, water may be just what the doctor ordered.

Why Hydration Matters

The amount of water that makes up the body is usually within the 45-75% range. Getting enough water each day is important for your body to function properly. Drinking water regulates your body temperature, helps with digestion and brain function, and can also help prevent cavities if the water is fluoridated.

We lose water through the course of normal activities, such as breathing, urinating and sweating. During the hotter summer temperatures, drinking fluids helps keep your body from overheating by replenishing what you lose from sweating.

How Much Water Does a Child Need?

Your child’s ideal daily water intake varies depending on their age and activity level. If you’re worried your child isn’t drinking enough plain water, remember they are also getting water in other beverages, such as fruit juice and milk, and in fresh fruits and vegetables at meals.

More About Sports Drinks

Sports drinks do have some benefits. Electrolyte replacement can also be beneficial when your child is sick. However, for kids engaged in normal levels of activity, additional fluid from sports drinks may not be necessary.

Most sports drinks contain high levels of added sugar, which are beneficial for long duration games and activities where food cannot be consumed. Kids and teens not participating in these types of activities likely don’t benefit from a sports drink if they consume water with regular meals and snacks.

Sports drinks and electrolyte replacement drinks can also have high levels of sodium. In short, sports drinks are not the healthiest option for your child to consume on a daily basis, nor are they considered a requirement for adequate rehydration in children and teenagers.

Download this guide on hydration drinks from our Certified Sports Dietitian

Hydration Drinks – Choose Wisely (English)
Hydration Drinks – Choose Wisely (Spanish)

If Your Child Is Picky About Beverages

If your child only likes certain drinks or would always reach for sugary soda if given the chance, you can try different strategies to boost hydration while limiting sugar. Try these tips for staying hydrated:

  • Encourage fruit intake. Most fruits have high water content. Serving fresh fruit, such as watermelon or oranges, at meals and for snacks can improve hydration.
  • Flavor their water. Put fresh fruit or herbs in water to add flavor without calories or sugar. You can also freeze fruit in ice cube trays and toss it in fresh water to cool it down. 
  • Make reusable water bottles special. Have your child decorate water bottles with stickers. Personalized bottles are more fun to use and show off.
  • Pop in some popsicles. Pour fruit puree or a blend of low-fat or sugar-free yogurt and fruit into popsicle molds for a refreshing treat.

Signs of Heat Illness

Hydration is particularly important when exercising in hot and/or humid environments. These can increase the need for replacing carbohydrates and electrolytes with sports drinks. Proper planning and hydration can reduce the risk of consequences from dehydration. A sign of dehydration is being thirsty.

Recognizing the signs and symptoms of heat illness and responding quickly is critical to your child’s health.

  • Weakness
  • Vomiting
  • Excessive thirst
  • Headache
  • Fatigue
  • Sweating
  • Nausea
  • Light-headedness

Preventing heat illness is important for young athletes. You should call your pediatrician or seek emergency care if your child is lethargic, has a high temperature, is vomiting or complains of abdominal pain.

Find more tips for hydration and nutrition from our Certified Sports Dietitian on our sports nutrition page.

Need more advice on keeping active kids healthy? Call 469-515-7100 to schedule an appointment with a Scottish Rite for Children Sports Medicine specialist.