Price Transparency
Supporting the Mental Aspects of Recovery after an ACL Reconstruction

Supporting the Mental Aspects of Recovery after an ACL Reconstruction

by | Jan 9, 2024 | Sports Medicine

Anterior cruciate ligament injuries (ACL) continue to be a problem in youth sports such as basketball and soccer. Many athletes and families are very aware of the lengthy physical aspect of returning to sport after an ACL injury and surgery. Some are surprised by the mental challenges and demands that come along with an injury. Patients, like Johanna, are supported by our multi-disciplinary team from the moment they walk into our sports medicine clinic.

Watch Johanna tell her story.

Physical therapist Rushi Patel says, “a lot of times people talk about the physical aspect of an ACL initial injury but you could argue the mental aspect is just as hard.”

Upon arrival, our team begins assessing a new patient from the “inside out.” We ask questions about how the athlete was injured, what level of competition they want to return to and what challenges they are facing physically and mentally in addition to the injury. These help us decide who needs to be involved in the athlete’s care from day one. Here are three tools we implement in our care of young athletes:

  • Certified child life specialists assist children and teens in understanding diagnoses and medical procedures, this helps to keep anticipation and fear under control.
  • Psychologists are available to consult when our clinic team or responses to screening questionnaires suggest an athlete may need more individualized guidance on pain management, coping with the injury and fears related to returning to sports.
  • Many of our patients receive stress management and pain management skill instructions to help them navigate day to day moments and the progression of rehabilitation. Download PDF.

Every team member, from nurse to physical therapist is focused on caring for kids and teens all day, every day. We use age- and developmentally appropriate strategies when we talk to kids, formulate treatment plans and create our educational materials.

Johanna says, “Scottish Rite has been like no other care I’ve gotten at a medical facility I truly feel loved and cared for and not just seen as a number or a patient with an issue to get resolved but they truly care about who I am what my goals are and ultimately what I want to accomplish in life.”

Check out how you can help us learn to prevent ACL injuries.

What to Expect If Your Child Has a Stress Fracture

What to Expect If Your Child Has a Stress Fracture

by | Jan 8, 2024 | Sports Medicine

If you have a young athlete in the family, you probably know that bumps and bruises are part of the game. A more severe injury, like a stress fracture, however, can be worrisome for any parent. Being informed about the nature of stress fractures and how to help your child heal can ease your mind.

What Causes Stress Fractures in Kids?

A stress fracture, sometimes called a hairline fracture, is a tiny crack in a bone caused by physical stress. This type of injury often occurs when a specific muscle or joint is overused or strained, known as an overuse injury.

Stress fractures commonly occur when a child performs the same movements over and over again, for example, running, jumping or throwing a ball.

Telltale Signs of a Stress Fracture 

Stress fractures develop over time, and one of the first signs you may notice is your child frequently complaining of pain after playing or practicing their sport. 

Your child may experience other symptoms, including:

●      Pain during exercise that doesn’t always go away with rest

●      Redness

●      Swelling

●      Tenderness

Swelling or bruising may develop around the bone in the early stages of the injury when it’s considered a “bone stress reaction.” As the injury worsens, it develops into a stress fracture, causing a crack or tiny break in the bone.

Stress Fractures Commonly Seen in Kids

Stress fractures are most common in the weight-bearing bones in the legs and feet, including the tibia bone (shinbone). However, young athletes can experience stress fractures in many other parts of the body. 

Gymnasts, for example, can develop stress fractures in the wrist, while softball and baseball pitchers may experience stress fractures in the arms or shoulders. Stress fractures affecting the lower extremities are common in nearly all sports since most activities place stress on the legs and feet. Rarely, stress fractures can develop in the spine or ribs.

How Are Stress Fractures in Kids Diagnosed and Treated?

If your child has symptoms of a stress fracture, check in with a medical provider. A sports medicine specialist can help determine the cause of your child’s discomfort and provide a treatment plan.

To diagnose an injury, the provider will first gather your child’s medical history and then conduct a physical examination, focusing on the area of discomfort. If the provider suspects a stress fracture, he or she may order imaging tests, such as an X-ray, CT scan or MRI, to confirm a diagnosis.

The primary treatment for a stress fracture is rest. Because the injury is most often the result of overuse of a bone and the surrounding muscles, taking the stress and strain off that part of the body is essential. Your child should take a break from activity, and if the injury is in the lower body, your child may also need to wear a boot or use crutches to take weight off the injured bone.

In rare cases, bones that don’t heal after a long period may require surgery to heal correctly.

Prevention 101

To reduce the risk of a stress fracture, have your child avoid repetitive movements as much as possible. Also, encourage cross-training. Having your young athlete do activities that require different muscles and movements not only limits stress on a single joint, but it can also strengthen other muscles and improve their performance in their primary sport.

You can also help your child prevent stress fractures by having them prioritize rest between games and practices, using proper sport-specific equipment and eating a balanced diet rich in vitamin D and calcium. Finally, teach your child never to play through pain.

Think your child may have a stress fracture? Call 469-515-7100 to schedule an appointment with one of Scottish Rite for Children’s sports medicine specialists.

Sports Medicine Year in Review

Sports Medicine Year in Review

by | Jan 8, 2024 | Sports Medicine

Scottish Rite for Children Orthopedic and Sports Medicine Center has had an exciting year! We celebrated our fifth birthday in the beautiful facility where we serve children with a variety of pediatric orthopedic needs requiring all levels of care from observation to complex reconstructive surgery. Our mission is often described having three elements, clinical care, teaching and research. Together, they provide a rich experience for patients and trainees and help to define pediatric orthopedics across the world.

Here are a few updates from the Sports Medicine team.

CLINICAL CARE
In the sports medicine clinic, we see more than 16,000 visits each year, and that number continues to grow. Recognized again for excellence in patient experience, our team focuses on educating the patients and families and providing outstanding care so that patients have the outcome they desire. Our work to integrate screening for psychological and nutritional needs help our patients succeed in their rehabilitation and return to sport efforts.

TEACHING
Pediatric sports medicine is a relatively new subspecialty in pediatric orthopedics. In fact, only a handful of organizations have an ACGME-accredited* fellowship program focused on this area. We are very excited to share that we are currently in the process of selecting our first fellow to join our team in 2024. This year-long training program offers a sports medicine surgeon the opportunity to train alongside our experts in the clinic, on the sidelines and in the operating room. In the past year, we had 13 orthopedic residents rotate through our clinic to learn about care and research in pediatric sports medicine.

RESEARCH
This year, our team published more than 20 articles in prestigious medical journals. Many authored by our medical staff and trainees and others were collaboration with peers in the Pediatric Research in Sports Medicine (PRiSM) Society. Here are findings that are being presented at national and international conferences and have the potential to change sports medicine in the areas of diagnostics, clinical care, return-to-sport decision making and injury prevention.

The Sports Medicine team is presenting results from more than 25 projects at a national meeting for the PRiSM Society in January. This work is made possible by our patients, national grants, generous donors and many student trainees learning about pediatric orthopedics and sports medicine.
Learn how healthy athletes can volunteer for a study or you can donate.
 
* The Accreditation Council for Graduate Medical Education (ACGME) is the accrediting body for graduate medical education. They hold programs to standards that prepare physicians in nearly 200 specialties.

What’s in an ACL Injury Prevention Program?

What’s in an ACL Injury Prevention Program?

by | Jan 2, 2024 | Sports Medicine

In a study conducted by members of Scottish Rite for Children’s sports medicine research team, we have found that one in five parents are not aware of injury prevention programs that can reduce the risk of anterior cruciate ligament (ACL) injuries. This is alarming because studies show that these injuries can take an athlete out of sports for at least nine to 12 months and increase the risk of a second injury and knee problems as an adult. Many say they would participate in these programs if they knew how. Here are three elements of day-to-day training that align with sport-related injury prevention and can be implemented individually or as a team.

    1. Wake Up Your Brain and Muscle Connection

    This step is called muscle activation and is focused on waking up small but very important muscles that maintain core stability during activity. From planks to squats, controlled movements that engage specific abdominal, spinal, shoulder and hip muscles are a key to a safe start for practice or competition. This step is rooted in principles of neuromuscular coordination, and with repetition, it is believed to improve stability and reduce injury risk during activities.

    1. Warm Up Your Muscles

    Now that your brain and muscles are talking, you need to get the blood flowing into those muscles and move them through their full range of motion. Athletes are familiar with dynamic warm-up exercises like soldier walks and knee hugs, and learning ways to maximize these exercises can help improve the effectiveness and reduce the time needed for the warm-up. Make sure you’re warm before you take off at full speed or make large movements with force like jumping, throwing a long distance or kicking a ball.

    Physical therapist Jessica Penshorn has put together a great easy to follow program for basketball players that combines mobility, activation and dynamic warm-up. Watch the short video, or read a summary of the program and download a handout here.

    1. Wind-down

    After the training or competition session is over, abruptly stopping can leave muscles confused and angry. Post-activity recovery strategies like foam rolling, contrast baths and gentle stretching can reduce the onset of muscle soreness and setting the body up for a quick turnaround to activity the next day.
    Email bridgeprogram@tsrh.org to sign up for our Athlete Development program for group training sessions that use all of these strategies to build solid foundations and strength, power and speed for high performance.

    If you want to learn more about injury prevention programs for your young athlete, check out these resources:

    *Sparagana, P., Selee, B., Ellis, H., Ellington, M., Beck, J., Carsen, S., Crepeau, A., Cruz, A., Heyworth, B., Mayer, S., Niu, E., Patel, N., Pennock, A., VandenBerg, C., Vanderhave, K., Williams, B., & Stinson, Z. (2023). Parental Awareness and Attitudes Towards ACL Injury Prevention Programs in Youth Athletes: Original Research. Journal of the Pediatric Orthopaedic Society of North America, 5(4).

    Is Your Young Athlete Having Orthopedic Surgery? Five Suggestions to Prepare your Pantry for Recovery

    Is Your Young Athlete Having Orthopedic Surgery? Five Suggestions to Prepare your Pantry for Recovery

    by | Dec 11, 2023 | Sports Medicine

    Following surgery, the body experiences increased energy demands due to inflammation and tissue healing. Some patients may eat less due to reduced activity, an increased need for sleep and the use of medications. Not eating enough, when nutrition needs are highest, can prolong recovery time and cause muscle loss.

    For young athletes planning to return to sports, the demands can go beyond the early phase of surgery recovery. After knee surgeries to reconstruct ligaments, such as the anterior cruciate ligament (ACL) or after extensive activity restrictions for healing of osteochondritis dissecans (OCD), these nutrition tips should be used throughout physical therapy and return to sports training. These phases can last months and have high energy demands.

    Certified sports dietitian Taylor Morrison, M.S., R.D.N., CSSD, L.D., says, “Athletes have unique needs when there are healthy, but these needs change and continue to be unique as they are recovering from significant surgeries.” Morrison cares for young athletes in Scottish Rite’s sports medicine clinic and teaches principles of healing and muscle recovery that can help an athlete well beyond their care.

    Morrison offers these nutrition guidelines to help preserve and promote muscle health and support recovery in all phases:

    Eat regular meals and snacks to maintain energy levels and promote wound healing immediately after surgery. Eat a meal or a snack every three to four hours and around physical therapy sessions.

    Include quality protein to help with tissue repair and wound healing. Include foods rich in leucine, an amino acid that helps build and repair muscle, such as chicken, milk, yogurt, eggs and cheese, at each meal and some snacks and especially after physical therapy sessions.

    Include quality carbohydrates to provide energy. Carbs keeps protein available for healing and fiber, which can help with normal digestive function. Carbohydrates with fiber include whole grains, fruits and starchy vegetables. Other carbohydrates include milk and yogurt.

    Include healthy fats that are high in omega 3s to fight long-term inflammation. Healthy fats with Omega 3s include salmon and tuna. Other healthy fats include avocado, nuts, seeds, peanut butter, almond butter and vegetable oil.

    Include a bedtime snack that contains casein to support muscle protein synthesis throughout the night. Casein is a slow-to-digest protein found in milk, yogurt and cottage cheese.
    When you head to the store to stock up on recovery-friendly foods to have on hand, take this list with you for ideas.

    • Eggs
    • Greek yogurt
    • Protein bars
    • Peanut Butter, Almond Butter, SunButter®
    • Starkist® Tuna packs + crackers
    • String Cheese
    • Balanced nutritional supplements such as Boost®, Pediasure®, Carnation Breakfast Essentials®, Kate Farms® or Orgain®

    Nutrition after surgery is important for all patients to preserve muscle and provide the increased energy and nutrients the body needs to heal. Some patients will need a specific nutrition plan due to additional medical conditions. If you would like help with an after-surgery nutrition plan, ask your care team about a certified sports dietitian consult.

    To learn more from Morrison, visit the sports nutrition page on our website.

    Shouldering an Injury: What AC Joint Separation Recovery Looks Like

    Shouldering an Injury: What AC Joint Separation Recovery Looks Like

    by | Dec 6, 2023 | Sports Medicine

    Young athletes can experience many shoulder injuries while playing sports, one of which being AC joint separation. Sometimes called shoulder separation, this injury affects the acromioclavicular joint, which rests where a part of the shoulder blade called the acromion connects to the clavicle, or collarbone.

    If your child recently sustained an AC joint separation, you both are likely wondering how long it will take to recover and get back in the game. Athletes can usually return to sports and physical activities after 12 weeks. However, each child’s experience with AC joint separation is different. Your child’s recovery will depend on several factors, including how severe the injury is and the treatment your child receives. 

    Understanding AC Joint Separation 

    To understand the recovery process, it helps to understand what an AC joint separation is and how it impacts your child’s activities. 

    AC joint separation typically occurs when your child experiences a strong blow to the shoulder during a game or falls on his or her arm. The impact can strain or tear the ligaments attached to the underside of the clavicle — the AC and coracoclavicular (CC) ligaments — separating the collarbone and shoulder blade (scapula). Your child may have intense pain, swelling, bruising and limited range of motion in the shoulder and arm. Your child may also develop a bump above his or her shoulder.

    Sports medicine specialists categorize AC joint injuries into several types, including: 

    ·       Type I injuries: These injuries are generally mild. The AC ligament is sprained, and the CC ligament is still intact.

    ·       Type II injuries: These occur with a complete tear to the AC ligament, a sprain in the CC ligament and slight separation between the clavicle and acromion.

    ·       Type III injuries: Both the AC and CC ligaments are torn, and the separation between the clavicle and acromion is more pronounced.

    ·       Type IV, V and VI injuries: These involve tears in the AC and CC ligaments, and the clavicle is pushed further into the shoulder and neck.

    Recovering From AC Joint Separation With R&R

    An AC joint separation can often heal naturally using nonsurgical treatments, such as rest and temporary activity restrictions. Your child’s sports medicine specialist may recommend:

    ·       Cold packs to reduce pain and swelling 

    ·       Immobilizing your child’s arm with a sling for resting the shoulder as it heals 

    ·       Medication for pain relief 

    Kids can often heal without surgery, even with severe AC joint injuries. Your child’s provider may start with conservative remedies before moving to surgery. 

    Surgery for AC Joint Separation 

    Surgery is generally used only with more severe AC joint injuries, and it may help if your athlete continues to experience pain despite nonsurgical treatment. Surgery can also help address bumps (deformities) that form after AC separation. 

    Surgical procedures involve removing a small portion of the collarbone to prevent it from rubbing against the acromion. Minimally invasive or open reconstructive surgery on the AC and CC ligaments may allow your child’s surgeon to reattach them to the collarbone. These procedures may involve plates or other materials to hold the ligaments in place. 

    Children who have nonsurgical treatments typically regain shoulder function within six weeks, while those who have surgery will have a longer recovery. Your child may need rehabilitation before returning to sports. Surgical recovery can take about six months.

    Many children recover well from AC joint separation, and very few have complications.  

    AC Joint Separation or Clavicle Fracture?

    Although older children and teenagers can experience AC joint separation, a more common shoulder injury in children is clavicle fracture.

    Like AC joint separation, a clavicle fracture can occur after a hard fall or an impact from an accident. The two injuries cause similar symptoms, as well, including:

    ·       A bump near the break

    ·       A drooping shoulder

    ·       Pain, swelling or bruising around the collarbone

    ·       Pain that occurs when your child tries to move the shoulder or arm and that causes them to not use the arm as much as they normally might

    Your child’s provider may recommend imaging to determine whether your child broke a bone or experienced an AC joint separation. Fortunately, clavicle fractures, like AC joint separation, can often be treated without surgery.

    Whether your child has AC joint separation or a clavicle fracture, it’s essential to follow the provider’s recovery instructions and ensure your child fully recovers before getting back to the field or playground. 

    At Scottish Rite for Children Orthopedic and Sports Medicine Center, pediatric orthopedic surgeons, physical therapists, athletic trainers, psychologists and other sports medicine specialists work collaboratively to develop personalized treatment plans for each young athlete. Call 469-515-7100 to learn about our sports medicine program.