Price Transparency
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.

Bouncing Back From UCL Injury Scarlette Soars Higher Than Ever

Bouncing Back From UCL Injury Scarlette Soars Higher Than Ever

by | Nov 15, 2023 | Sports Medicine

Published in Rite Up, 2023 – Issue 3. 

by Kristi Shewmaker
 
It was a nail-biting week for Scarlette, of Coppell, during the fall semester of her high school senior year. She was waiting for a phone call from the head coach of the gymnastics team at Rutgers®. She hoped the coach would invite her to join the team. Years before, she had set her sights on going to Rutgers and competing there as a gymnast.
 
In competitive gymnastics, recruitment for joining a college team begins around an athlete’s sophomore year of high school. During that time, Scarlette visited the campus, attended gymnastics camps and participated in an official visit to get to know the coaches and student gymnasts. All that was left for her to do was wait for “the call” to let her know if her college dreams were coming true.
 
Born and raised in Oahu, Hawaii, Scarlette started gymnastics when she was 4. “She had tons of energy in preschool,” says Bryan, her father. “She was always hanging from the monkey bars and bouncing around.” Her parents enrolled her in a recreational gymnastics class to burn off energy. “We knew nothing about the sport, apart from what we saw in the Olympics,” Bryan says. But, the coaches picked up on Scarlette’s innate ability, and she excelled quickly. At her first gym, they suggested that she try out for a team. “That was the start of my gymnastics career,” Scarlette says. “I was 6 or 7 years old in my first competition.” And in that early competition, she won. Throughout the years, Scarlette kept winning.

By the age of 14, she rapidly advanced to level 10, the highest level in the USA Gymnastics Development Program. During her first year as a level 10, she made it to the national competition in Indiana, an incredible feat for her age. To ensure that Scarlette and her younger sister, who is also a gymnast, could get exposure and compete in bigger, more prestigious tournaments on the mainland, the family packed up and moved to Texas, specifically for the program at Texas Dreams Gymnastics in Coppell.
 
During her sophomore year, Scarlette tripped as she was running into a tumbling pass and rolled her ankle, landing on her arm. “In Hawaii, we have several hospitals but only one main hospital for children,” Bryan says. “In Texas, we didn’t know where to go, but her coaches and other gymnasts’ parents said, ‘You have to go to Scottish Rite for Children.’” At Scottish Rite for Children Orthopedic and Sports Medicine Center in Frisco, Scarlette learned that she had not only sprained her ankle but also would need care for a more complex injury to her ulnar collateral ligament (UCL) in her left elbow. Assistant Chief of Staff and Director of the Center for Excellence in Sports Medicine Philip L. Wilson, M.D., evaluated Scarlette and consulted with her and her family regarding her individualized treatment options.
 

The UCL is a band of tissue that runs along the inside of the elbow and works to stabilize the elbow joint during overhead movements. Baseball players, gymnasts and, occasionally, quarterbacks sustain this injury. “It has to do with the way you use your elbow, either for weightbearing or throwing,” Dr. Wilson says. Baseball players sustain the injury from repetitive throwing, bringing the elbow back at a certain angle repeatedly, causing stress on the ligament. “For gymnasts, it’s a weightbearing issue,” Dr. Wilson says. “We all have a little bit of an angle in our elbow called valgus. Gymnasts develop more of that angle as they grow due to repetitive weightbearing from a young age.” The force of a gymnast landing on her hands over and over causes repetitive stress on the ligament.

For most people, the treatment plan for a UCL injury is nonoperative with a recommendation of rest and physical therapy (PT). For athletes like baseball players or gymnasts, the plan could include surgery, depending on their injuries and their goals. “When we consulted with Dr. Wilson, part of Scarlette’s treatment plan depended on whether she wanted to stay at the competitive level or just do gymnastics for fun,” Bryan says. The direction she chose would determine the aggressiveness of the treatment.
 
“It is always challenging for the family to make a decision about what to do,” Dr. Wilson says. Ligament reconstruction surgery requires a long commitment to rehabilitation, and often takes a year for the athlete to get back to the competitive level. “An important part of our job is to partner with the family, provide quality counseling time and ensure that they have all of the information they need to make the best decision,” he says.
 
In their initial consultation, Bryan said that it was the first time he heard Scarlette say that she wanted to do gymnastics just to enjoy it. “A few months before my UCL injury, I had been struggling a lot in the gym,” Scarlette says, “and when I got hurt, I was like, ‘Is this a sign? Is this telling me to just be done?’” Bryan explained that Scarlette had hit a plateau in her skillset, which is common for competitive gymnasts, and in her mind, the injury was a setback.
 
Scarlette decided to take the nonoperative route, and Dr. Wilson recommended PT twice a week at Scottish Rite. After seven months, Scarlette was back in the gym when she injured her elbow again. “I was doing a release on the uneven bars, but I missed the bar and landed on my hands and knees,” she says. “The pain shot up my whole arm.”

After the reinjury, Scarlette decided to pursue surgery. “I was getting my skills back, and I think I just needed to take a step back and rest my body,” she says. “I was able to think.” The light at the end of the tunnel, Bryan said, was that she would get a new ligament in her elbow, and she would be much stronger.
 
Scarlette underwent surgery the summer before her junior year. Wearing a brace, she started range of motion exercises and began PT within the first week. Over many months, her therapy goals included regaining mobility of her joint and then progressing toward strengthening, endurance and power production. At six months, she went back to the gym while continuing PT, and at eight months, she resumed training but not at full skill level. Finally, the summer before her senior year, she was given the all clear to train without restriction and to fully return to gymnastics that fall.

 

“I learned a lot about myself during my recovery,” Scarlette says. “I had to build my way back up. The basics I received to get my skills back really helped my confidence and my performance. I trusted my care team, their process and everything they did.”

 

“I have massive respect for the program at Scottish Rite,” Bryan says. “Dr. Wilson gave Scarlette the option to do what she wanted to do. He didn’t go right to surgery. The professionalism of him to offer PT first, that he even took that into consideration, is a big deal. For any parent considering a facility for their child’s orthopedic needs, it’s a no-brainer. There’s no reason to go anywhere else.”
 
In the 2023 gymnastics season, Scarlette finally got to compete in all four events — vault, uneven bars, balance beam and floor exercise. “After all that she had been through, it was enlightening to see her compete,” Bryan says. “Her demeanor changed. She was driven and confident, not too deep in thought. She just went out there and did her thing, and let it be in the judges’ hands.”
 
After more than a year and a half of injuries, surgery and recovery, Scarlette said that waiting to hear from Rutgers felt like forever. But, the phone finally rang. She was officially offered a position on the team. And, her answer was, of course, yes!

“I’m excited for a whole new chapter,” Scarlette says. “I get to experience college life as a student athlete and compete on a much bigger stage. I can’t wait to experience that whole new world!”

Read the full issue.

Three Areas Of Focus To Stay Fueled Through Busy Sports Seasons

Three Areas Of Focus To Stay Fueled Through Busy Sports Seasons

by | Oct 17, 2023 | Sports Medicine

Parents of student-athletes are familiar with the long days of practices before school, hours of schoolwork and games in the evening. Our sports dietitian, Taylor Morrison, M.S., R.D.N., CSSD, L.D., shares everything parents of busy young athletes need to know about fueling well, eating enough and staying hydrated to support their stacked schedules.

When trying to ensure your athlete is getting enough fuel and enough nutrition for sports and school, start by focusing on three key things:

  1. Maintain energy levels with meals and snacks that provide both quick and sustained energy.
  2. Stay hydrated.
  3. Recover well.

Maintaining Energy Levels
It’s important that young athletes keep their brains and muscles well-fueled throughout the day, starting when they get up in the morning. This is crucial so they not only perform their best in school but also so that they show up for sport practices energized with plenty of fuel in the tank to use for their sport. When athletes show up to practices with depleted energy stores, they run the risk of dizziness and fatigue in the short-term and decreased strength and overall performance long-term.

To know what foods to choose in their fueling strategy, it’s important that they have a basic understanding of the macronutrients, including carbohydrates, protein and fat:

  • Carbohydrates are the best and quickest source of fuel for the brain and muscles. This macronutrient can be used for energy in a young athlete in anywhere between 15 and 60 minutes after consumption, depending on the specific food they choose. These should be included in all meals and snacks throughout the day and can be a great snack 15 to 60 minutes before a practice. Foods high in carbohydrates include grains, such as bread or granola, and starches, such as potatoes or rice.
  • Protein is important for building and maintaining muscle and for injury recovery. It takes a little longer for the body to use protein for energy, so it is best left out of the pre-practice snack unless the athlete has a good 90 minutes or more before start time. It is, however, an important part of meals and the athlete’s recovery snacks. Foods high in protein include meats, such as beef, chicken, turkey, fish and seafood and eggs, and dairy products, such as milk or yogurt.
  • Fat is another important energy source for young athletes. These foods can also help fight inflammation and are crucial for the body to absorb certain vitamins (specifically A, D, E and K). However, it takes the body the longest to digest fat, so it should be kept out of the pre-practice snack and saved for the post-event meal or for meals and snacks that are a few hours away. Foods high in fat include certain cuts of meat, cheese, avocados, nuts and eggs.

For more information on how to incorporate meals and snacks around a busy training session, refer to our Tournament Nutrition guide.

Staying Hydrated
Athletes should understand the importance of drinking water and fluids throughout the day, starting when they wake up in the morning. Drinking 24 ounces from a water bottle 10 minutes before warmup will not make up for the fact that the athlete forgot to drink any water earlier that day. It will likely just leave him or her uncomfortable during the event and needing to take a bathroom break.
When asked what is best to drink, water should be the go-to drink of choice. If an athlete has trouble drinking fluids during the day, remember that foods can help hydrate as well. Sports drinks are best for when an athlete has been practicing for an hour or more or it is a very hot and humid environment.  There are a few other instances where a sports drink is helpful, and these special situations include:

  • The athlete has trouble eating solids before or during an event due to nerves.
  • The athlete is a salty sweater.
  • The athlete struggles with muscle cramping during events.

A factor to consider when choosing drinks and electrolyte packets is the age and stage of development the athlete is in. Before puberty, an athlete regulates body temperature differently than an adult, relying less on sweat to cool the body and, therefore, losing less electrolytes. An 8-year-old basketball player will likely not need the electrolyte replacement that a 17-year-old basketball player will need.

For more support in helping your young athlete hydrate, check out our Hydration for Young Athletes handout.

Recovering Well
Just because the game or practice is over does not mean athletes should forget about nutrition. This is especially true when the athlete is in back-to-back events or has a quick turnaround time between games. This could mean multiple games in a day, or it could look like a game ending in the evening and the next game early in the morning. During these small windows, the recovery fuel counts.

The three key components of a great recovery snack are:

  1. Carbohydrates

Carbohydrates replenish depleted energy stores in the muscle, which then prevents the body from breaking down protein (muscle) for fuel moving forward.

  1. Protein

Protein that the athlete eats helps to rebuild and repair the muscle that is naturally broken down a little with exercise. It will also help maintain the athlete’s strength.

  1. Fluid

 
Fluid will rehydrate the body to keep energy levels up and prevent dehydration.
For more info on recovery snacks, check out our handout, blog post or the below video!

For more sports nutrition information, visit www.scottishriteforchildren.com/nutrition.

Strength and Conditioning Training: It Is Not Just About Getting Strong

by | Oct 10, 2023 | Therapy Services

What is strength and conditioning?
Strength and conditioning may better be referred to as “physical preparation.” An athlete needs to be physically capable of accomplishing the goals set by the coach to compete in the game. Benefits of strength training go beyond just getting an athlete bigger, stronger and faster. Proper training improves an athlete’s resiliency and confidence in their performance as well. Though preventing injuries may not be directly related to movement and strength training, there are studies that suggest that overuse injuries may be reduced by as much as one-half with appropriate training.

Medical Professionals Programs like this are available on-demand for a limited time Browse Now. A blue and green advertisement for medical professionals

Ideally, an athlete participating in a strength and conditioning program is:

  • At a developmentally appropriate level.
  • At a physically appropriate level.
  • Receiving proper instruction and supervision.
  • In a setting with equipment that is appropriate for both the athlete and the sport.

KEISER YOUTH TRAINING CLASSES KE 0000000 D 10 10 45 St PB 48KG. A group of young boys squatting in a gym

What is training age?
An athlete’s training age may vary across skills or activity. The “training age” is typically much lower than the chronological age. A soccer player may have started playing soccer at age 4 but didn’t start resistance training until age 12. Therefore, that athlete should not begin a strength and condition program at the level of an athlete with five years of resistance training who may be lifting weights and using other forms of resistance.

How should goals be set for a young athlete?
The goals of the program should also be individualized and progress should be tracked. Measures for strength, power, endurance and speed are commonly used. More importantly, an assessment of movement quality should be integrated in the progression. Proper form in fundamental movements should always precede increased resistance or other challenging elements of an exercise.

Younger athletes should learn that “bulking up” is not an appropriate goal for them. These changes will not occur until developmental stages where hormones are present to create those visual changes. What is more likely to occur with movement and strength training in this population are neurological changes that lead to improved neuromuscular control, which is believed to reduce the risk of knee and ankle injuries common in young athletes.

What happens after an injury?
After proper diagnosis, a transition to a supervised strength and conditioning program is ideal only after treatment and rehabilitation for a musculoskeletal injury. An athlete often completes formal physical or occupational therapy before they are ready to return to sport. Therefore, a continued progression of sport-related and other activities help the athlete to complete recovery and prepare for realistic sport environments. Complex movements and distractions that are common during competitions can be integrated into training sessions where variables are controlled.
People squatting in front of a matrix squat rack | HEME 10 45 S 17 18 13 14 15 ᏣᏃ Ec A Ec 16 16 MATRIX 18 14 10 SCOTTISH RITE FOR CHILDREN PORTS MEDICINE Jasirs 处

In a recent program for medical professionals, strength and conditioning coach Justin Haser, M.S., CSCS, and physical therapist Daniel Stokes, P.T., D.P.T., CSCS., explained how strength and conditioning is integrated in the continuum of care for healthy and injured athletes. Watch now on YouTube.

Coaching Kids: Top Tips for Coaches

Coaching Kids: Top Tips for Coaches

by | Sep 5, 2023 | Sports Medicine

Here are simple tips to integrate into coaching messages for kids. Building a solid foundation of good habits will help them well-beyond this youth sports season.

  • Teach athletes to eat a healthy snack with carbs before games and practices.
  • Encourage athletes to drink water before, during and after practice and games.
  • Respond quickly to complaints of pain and encourage an evaluation by a pediatric sports medicine specialist.
  • Learn how to lead your team through a dynamic warm-up and save stretching for after games and practices.
  • Most of all, keep it fun!

As a participant in the University of North Texas Athlete Transition Program, Tyree Eady, B.S., M.S., volunteered at Scottish Rite for Children in the Movement Science Lab on the Frisco campus. He is passionate about changing the future for young athletes through research and using his platform as a professional athlete

Learn more about sport-related injury prevention.