Injury Prevention and Treatment of Orthopaedic Conditions by a Sports Medicine Surgeon

From concussions to ankle sprains, from hip labral tears to knee instability, from a broken elbow to severe arthritis of the shoulder in need of a joint replacement- our Orthopaedic Specialists treat them all.

Although these types of injuries are common in athletes, they can also occur in car accidents, during altercations, when taking part in recreational activities, and even at the workplace. Sometime these conditions are the result of wear and tear over time due to chronic (over-)use, aging, or both.

The Orthopaedic Sports Medicine Surgeons have completed extensive training and are highly skilled at various treatment methods ranging from office procedures or outpatient minimally invasive surgery with little downtime, to very complex surgeries to restore function, improve pain and prevent future disability. Orthopaedic Sports Medicine surgeons are here to help you and your loved ones get back on your feet.

Since Orthopaedic Sports Medicine surgeons treat such a wide variety of injuries in multiple parts of the body, in patients of all ages, treatment by these specialists does not just entail surgery. A large number of conditions can be managed with conservative treatment such as rest, ice, elevation, compression, dedicated home exercises, physical therapy, and injury prevention programs.

For some conditions, a small office procedure can quickly resolve the symptoms, such as a cortisone injection to fight pain and inflammation; a gel injection with hyaluronic acid -the key nutrient for cartilage- to nourish and lubricate the joint surfaces and combat arthritis symptoms and worsening degeneration.

Sometimes, an injection or series of injections using a ‘biologic’ may be recommended by your doctor. Examples of biologic injections are platelet-rich plasma (PRP) where your own blood is used, and ‘stem cell injections’ where the bone marrow from your pelvis or hip bone (BMAC) is used to make a highly concentrated volume of the body's most potent cells involved in the natural healing process. These cells are then injected at the site of your injury to allow your body to heal quickly and efficiently.

Your orthopaedic sports medicine surgeon may use an ultrasound machine in the office to perform certain injection procedures. You may know what an ultrasound is from its most common use: monitoring the growth and development of unborn babies during pregnancy. This imaging modality is useful for real-time diagnosis in the office setting and can evaluate structures dynamically. For example, while the patient demonstrates a motion that causes pain, whereas an MRI is only static, in one position, and is not available in the office. The use of ultrasound-guidance during injection procedures ensures the injection is placed at the exact site of the injury and improves patient safety and reduces complications.

If your condition does require surgery, orthopaedic sports medicine surgeons are highly skilled in arthroscopic procedures. Arthroscopy means that your joint is visualized using a tiny camera, projecting the inside of your joint onto a computer screen. This requires only a very small, less than a ¼ inch incision, and allows for a very detailed and often complete evaluation.

Joints that are very often treated with arthroscopic procedures are the shoulder, elbow, wrist, hip, knee, and ankle. Another benefit is that by using one to three additional similarly-sized small incisions, your surgeon can often times fix the issue during this same surgery.

Because of the smaller incisions, this technique results in less pain, allows a faster return to work, school, and sports activities, with a very low risk of complications, and you can return home the same day after most of these procedures.

However, most Orthopaedic Sports Medicine Surgeons are also well versed in a variety of bigger open surgeries, if this is indicated to treat your issue and to maintain an active lifestyle. Examples are shoulder replacements done for arthritis and for rotator cuff tears that are not able to be repaired. Another example is its use for cartilage injuries as well as reconstruction of various ligaments and procedures to restore injuries cartilage. Open procedures require a longer surgical time, sometimes even a short stay in the hospital, and it may take several months of physical therapy after surgery to see the final outcome. However, those surgeries were designed to improve long-term outcome and quality of life by reducing pain and dysfunction. It also prevents long-term disability and allows you to remain independent and keep doing the things you love.

Our team of experienced, well-trained, and highly-skilled Orthopaedic Specialists at the Sequoia Institute for Surgical Services Inc. see and treat almost all conditions within Orthopaedics.

We have a team of board-certified and board-eligible surgeons as well as experienced nurse practitioners with extensive knowledge in various Orthopedic Subspecialties. We have a dedicated fellowship-trained, board-certified Orthopaedic Sports Medicine surgeon who sees patients at all three of our office locations to ensure you do not have to travel far or wait long to be seen. We also have specialists in the field of Hand Surgery, Shoulder and Elbow Surgery, Knee and Hip Surgery & Joint Replacement Surgery.

We accept all major insurances, including worker's compensation, Medicare and Medi-Cal plans, and see patients of all ages. Our dedicated team of medical providers and their caring ancillary and support staff will treat you like family. We welcome you and/or your family to come see us for your orthopaedic needs at one of our three convenient office locations in the Valley: Porterville, Reedley, or Visalia. We have excellent long-standing relationships with all major hospital systems in the area such as Kaweah Health System and Adventist Health System and perform surgical procedures at various locations throughout the Valley.

We are honored to have the trust of our patients and feel blessed to have the opportunity to take care of them and their loved ones. It is our number one goal to take care of our patients and place your needs first. So, if you suffered an injury or have been told you have an Orthopaedic condition that potentially needs surgery, we invite you to call and schedule a consultation. Early diagnosis and treatment are crucial in maintaining long-term joint health & function, and maintain good quality of life.

But of course, preventing injury is always better than treating it. Therefore, our Orthopaedic Specialists would like to leave you with the following 5 tips to prevent injury and live an active, healthy, and happy life!

• Tip 1. At least 30 minutes of cardio activity a day and 30 minutes of strength training 3 times a week will maintain the overall health of your body as you age. Did you know that this process already starts at just 30 years of age? Regular exercise does not only have beneficial effects on your heart and lungs, but it helps to reduce weakening of the bone (osteoporosis) and muscles (atrophy) that occurs as we age. An added bonus is that a nice brisk 30-minute walk every day will clear your mind also has been proven to have a positive impact on your mood, affect and even memory! Need motivation? Join a class at the local gym, ask a friend or coworker(s) to join too, start a weight race at your job, or make it a family event so you can all be healthy together.

• Tip 2. Stretching is the most important way to prevent even the most painful (overuse) injuries, so do not forget to incorporate stretching into your workout routine. Always stretch after warming up the muscles with heat or light exercise, there is very little to gain when the muscle is cold. We all get stiffer as we age, so you have to increase the time and frequency with which you stretch as you age if you want to remain active and not wear out your joints prematurely due to the increased forces on your cartilage from stiffness and tightness of the muscles exerting increased pressure. Everybody has a different level of flexibility, but on average you should for 10-20 minutes, 1 day a week for every decade you are old. Add a day to this if you know you are stiffer than most other people you know, play a strength or contact sports, or frequently suffer from overuse type injuries. All of these are caused by muscles that are strong but too tight and pull across joints, on adjacent bone or are tightly spanned over a bursal sack and can lead to tendinitis, bursitis and arthritis, all of which are painful and keep most patient away from the beloved hobbies, unable to work.

• Tip 3. Nutrition and hydration are key! You muscle is 80% water and your cartilage 90%, if you are dehydrated when performing strenuous activity, your muscles are more likely to get strains and start cramping and the waste products of muscle breaking down can even lead to a lasting damaging effect on your kidneys and other vital organ systems. Nutrition, hydration, personal protective equipment. Drink plenty of water, especially when temperatures are high. Sports drinks contain electrolytes, which you can lose when you sweat. However, much less so that you lose water, so unless you work out for more than an hour at a high intensity, it is not necessary to consume these drinks. Read the label if you do buy any, because a lot of them are meant for endurance sports and therefor are loaded with carbohydrates (i.e., this means they are pure sugar), high is calories, and drinking just one of those drinks can undo your entire work out when it comes to burning calories. If you are working out to lose some weight, remember calories in – calories out = how much weight you will lose. So, if you eat a 500-calorie bagel and walk for 30 minutes on the treadmill burning 200 calories, you will still gain weight, despite your good efforts.

• Tip 4. Wear protective equipment where possible. Depending on the sports and the level at which you participate, protective equipment may be required, such as helmets and shoulder pads for football, and a helmet and eye protection for ice hockey. However, even when this is not mandated by the sport, protecting yourself from harm in any way possible never hurts. If you have a knee that has suffered some injuries in the past and swells every time you work out, be proactive and wear a knee sleeve. Just remember to put it on before the knee swells because although over-the-counter knee sleeves can prevent swelling from occurring/ reduce the amount of swelling that occurs, they are not powerful enough to make the swelling disappear once it is already there and you are trying to continue to play. Not only does simple compression at one joint help avoid/ limit swelling, but it also provides more feedback to your brain making you much more aware of that joint and less likely to re-injure it. But be aware that it does demonstrate a potential weakness to the opposing team (I.e., your Achilles heel, either literally or figuratively). So, you may want to ensure it is not so easily visible and perhaps hidden under clothing.

• Tip 5 If you get injured, do the following immediately to minimize the effects of the injury and shorten the recovery time: rest the injured extremity, and avoid putting pressure on it or moving it if it hurts to do so. Apply ice to the location of the pain, be careful to do this only for 20 minutes at a time, and never put the ice directly on your skin to avoid frostbite. Wrap the injured part to prevent swelling by compression and also elevate to prevent and reduce swelling. Elevate means the injured body part has to be higher than your heart; otherwise, the blood will rush down to the injury and it will hurt and swell much more. If you have no medical problems or allergies that do not allow you to take over-the-counter medication for pain and inflammations (NSAID family, example ibuprofen, naproxen)

If the pain and swelling are not getting better after two days and/ or you are unable to return to your normal activity level gradually, or are unable to bear weight or feel instability, you should be seen and evaluated.

Your primary doctor or the local emergency room can perform an initial evaluation and even perform x-rays and refer you to one of our specialists for a consultation. Of course, we hope you and your loved ones will never get hurt, but if you do, we are here to help! You can schedule an appointment by calling the office, or you can book an appointment with us online.