Understanding Bone Marrow Edema

bone marrow edemaBone marrow is a spongy tissue located inside bones that is vital for the production of important constituents of the blood such as white and red blood cells. Microscopic fractures in the internal bone structure lead to bleeding and inflammation within the marrow. These abnormalities are called bone marrow edema or “bone bruising.”

This swelling leads to pain that can feel like a soft-tissue bruise — hence the nickname “bone bruise.” Sometimes bone marrow edema does not have any noticeable symptoms. Other times it results in dysfunction of the bone or joint. Symptoms depend on the underlying causes and severity of the edema.

How Do You Get Bone Marrow Edema?

A common cause is trauma to the area. Trauma caused by acute injury or repetitive overuse wears down tissue over time. Other causes include:

  • Damage to the cartilage surface of the joint due to arthritis
  • Injury to a ligament
  • Synovitis or “joint inflammation”
  • Osteonecrosis, a specific condition that causes interruption of the blood supply to the bone which in turn weakens the bone leading to fractures
  • Bone tumors

How to Detect Bone Marrow Edema

With Magnetic Resonance Imaging (MRI) technology, doctors are now able to produce detailed images of the body’s soft tissues — including bones — using magnetic fields and radio waves. With these images, they can spot abnormalities in the bone tissue indicative of fluid accumulation. Doctors were unable to spot this injury before MRIs, so it was not recognized in the medical community. Long-term effects of bone edema are still being studied.

Treating Bone Marrow Edema

The treatment of bone marrow edema often depends on the underlying causes. The most effective treatment for bone marrow edema caused by trauma is rest and relief from stress.  Most surgeons recommend limiting activity when bone bruising is found, especially if it is near a joint. Other options for treatment include medication, steroid injections, and surgery. A doctor should only suggest surgery if non-surgical treatments consistently fail.

Typically bone bruises heal four to 12 months after the injury. However, 10 to 15 percent of people diagnosed with bone marrow edema still have the injury up to two years after the initial injury. For some people, the conditions of the bone bruising can be indefinitely persistent.

Dr. Stacie Grossfeld has over 10 years of experience detecting and treating bone marrow edema and its related symptoms for patients in the Louisville and Kentuckiana area. If you would like more information on “bone bruising” or think you may be experiencing bone marrow edema, contact Orthopaedic Specialists today at 502-212-2663.

Long Term Correction in Sleep Disturbance is Sustained After Arthroscopic Rotator Cuff Repair

arthroscopic rotator cuff repairThe muscles and tendons that surround and support the shoulder joint in order to reach overhead are called the rotator cuff. Injury to the rotator cuff leads to dull, persistent pain in the shoulder area as well as the neck and even down the arm towards the elbow. Sometimes the area experiences wear and tear with repetitive motions and the injury to the rotator cuff happens gradually over a period. Other times it is the result of a sudden injury like a fall or an intense strain when attempting to lift something heavy. Not all rotator cuff injuries are equal. It’s possible the shoulder pain in the area is simply tendonitis — inflammation or severe irritation in the tendons. A more extreme injury is a partial or full tear that separates the muscles from the bones. In these cases, an orthopedic surgeon may suggest arthroscopic rotator cuff repair as a correction.

What is Arthroscopic Rotator Cuff Repair?

In the case of a full tear from the bone, an orthopedic surgeon may perform arthroscopic rotator cuff repair. Using specialized instruments, the doctor is able to sew the muscles in the rotator cuff back to the shoulder bone. Using anchors and sutures, the surgeon reconnects the tissue in its original location. Remarkably, the surgery only requires a few small incisions around the area in order to be performed. Doctors use small digital cameras held inside the shoulder in order to operate with minimal invasion.

Arthroscopic rotator cuff repair does require general anesthesia prior to surgery. The procedure only takes one to two hours with the possibility of an overnight stay, depending on the pain. Medication is administered to help manage the pain while in recovery. The shoulder should be supported by a sling for four to six weeks post surgery, though full recovery can take up to six months. During this time, the patient should participate in physical therapy to help restore the muscles in the rotator cuff safely.

Sleep Disturbance and Arthroscopic Rotator Cuff Repair

It’s very common for people with rotator cuff tear to complain about disturbance in their sleep. The pain is easily triggered when sleeping on one’s side as well as by common, unconscious movements made while sleeping. This pain is so extreme, it often leads to waking.

In a controlled study, the majority of subjects experiencing sleep disturbance before going through arthroscopic rotator cuff repair found that their condition improved over a period of two years. However, those using narcotic medicine for pain relief still experienced sleep disturbance despite having the surgery. To experience long term sleep correction after arthroscopic rotator cuff repair, the patient must work on rehabilitating the area and alternative means of pain relief other than medication.

If you are suffering from shoulder pain possibly due to a torn rotator cuff, contact Dr. Stacie Grossfeld immediately. Dr. Grossfeld is a double board-certified orthopedic surgeon who routinely performs arthroscopic rotator cuff repair for people in the Kentuckiana area. Dr. Grossfeld can be reached at either of her two office locations in Louisville, Kentucky by calling 502-212-2663.

Successful Return to Play After Arthroscopic Shoulder Stabilization VS Non-Operative Management in Contact Athletes With Anterior Shoulder Instability

anterior shoulder instabilityAthletes that participate in contact sports are at a higher risk for conditions like anterior shoulder instability. With overuse or after an injury– such as a dislocated shoulder– the joint stretches and becomes unstable. When the joint capsule is stretched out, it stays that way. This means the shoulder remains unstable and can lead to pain or further injury if not corrected.

There are two ways athletes can correct anterior shoulder instability: non-operative management through maintenance exercises and arthroscopic shoulder stabilization surgery. Here we further explore these two options and their individual benefits and drawbacks.

Anterior Shoulder Instability and Non-Operative Management

Younger athletes can help manage anterior shoulder instability with a combination of exercises that help build muscles that support your joint. In addition to these exercises, athletes should avoid playing contact sports that can undo their work and further de-stabilize the shoulder.

  • Proprioception training – These balance exercises teach your body how to control its positioning of your injured joint.
  • Rhythmic stabilization drills – The purpose of these drills is to re-educate the shoulder muscles on how to react to movement.
  • Scapular muscle strengthening exercises – Building muscle in the scapula can help provide stability when the other overstretched parts of the shoulder cannot.

While non-invasive management mean you don’t have to go under the knife, they also mean giving up contact sport in order to preserve what is left in the shoulder joint. For athletes who wish to return to play, arthroscopic shoulder stabilization may be the answer.

What is Arthroscopic Shoulder Stabilization Surgery?

Arthroscopic shoulder stabilization surgery repairs the overstretched joint by making the capsule and ligaments more tensile. The operation is performed inside the body while the orthopedic surgeon views the operation from a television monitor. The surgeon uses small holes to suture anchors into the shoulder bone. These anchors have stitches attached that the surgeon then passes through surrounding tissues in order to reattach the shoulder labrum and capsule to the socket.

After success arthroscopic shoulder stabilization, contact athletes have a short recovery time before being able to return to play. The athlete helps prevent further injury through further maintenance exercises.

If you are an athlete or non-athlete with anterior shoulder instability, contact Dr. Stacie Grossfeld today. Dr. Grossfeld has over 10 years of experience in arthroscopic shoulder stabilization as well as non-operative management. Call 502-212-2663 to make an appointment today.

Orthopaedic Specialists Now Offering Stem Cell Therapy

Louisville orthopedic surgeon and sports medicine doctor Stacie Grossfeld MD is now offering stem cell therapy to patients in her Louisville, Kentucky office. This cutting edge treatment is used to provide dramatic pain relief for many common medical conditions including osteoarthritis, knee pain, shoulder pain, hip pain, tennis elbow, plantar fasciitis and much more.

Stem cell recruitment therapy is part of a broader trend toward orthobiologic medicine. Orthobiologics are substances found naturally in the human body used to help heal injuries and conditions. Other examples of orthobiologics including: hyaluronic acid injections and platelet rich plasma (PRP) injections.

As a double board certified orthopedic surgeon and sports medicine physician, Dr. Grossfeld explains her interest in offering stem cell recruitment therapy to patients:

“As an orthopedic surgeon and sports medicine physician, I’m very focused on helping my patients heal as quickly and effectively as possible so that they can get back to the activities they enjoy. I’m always learning about the newest treatments available so that I can offer the best that medicine has to offer. Stem cell injections are the latest example of this … a treatment that uses natural bodily substances to offer pain relief through actual healing, rather than just masking pain and injury.”

Stem cell recruitment therapy is a safe and effective treatment to help the body help itself. It’s typically administered during a normal office visit, through a single injection.

Stem Cell Therapy May Help the Following Conditions

Patients have reported improved pain relief and repair for the following conditions:

  • Joint injuries
  • Osteoarthritis
  • Knee pain, shoulder pain, hip pain
  • Pain in the wrists, fingers, ankles and toes
  • Bone fractures that are resistant to healing
  • Soft tissue injuries like plantar fasciitis, tennis elbow, hamstring tears and rotator cuff
  • Spinal injuries causing neck pain, mid and lower back pain, and sacroiliac joint pain

Following a stem cell injection, patients are typically able to return to everyday, non-high impact activities within 24 to 48 hours. (more…)

Need to Know Facts about Platelet Rich Plasma Injections (PRP Injections)

platelet rich plasma injectionsWhat is PRP? 

PRP is short for platelet rich plasma. Platelets are a blood component made up of cytoplasm fragments that help stop bleeding by clotting injuries.

Why are platelets so awesome? 

Platelets are awesome because they contain a multitude of growth factors. By separating out the platelets from the rest of the blood cells, modern medicine allows a high contraction of patients to be injected into the area of the body that is injured. Since Platelet Rich Plasma injections are processed from the patient’s own blood there is virtually no risk of an allergic reaction or rejection.

What kind of growth factors do platelets contain?

Transforming Growth Factor

The transforming growth factor promotes angiogenesis. Angiogenesis is the process that promotes new blood vessels to form. The new blood vessels bring in other healing factors to repair the damaged area of the body. If you can imagine the injured part of a body being like a city that is in need of food to feed the people that live there. More roads need to be built so that more critical food supplies can be delivered to the city. Angiogenesis is the process of building the new roads to bring in supplies. Through angiogensis, more blood vessels grown around the damaged area of the body will allow the area to heal faster.

Platelet Derived Growth Factor

This growth factor attracts macrophages and fibroblasts which are naturally floating around in your blood  Both macrophages and fibroblasts help promote collagen growth and all ligaments, cartilage, and tendons are made up of collagen.

Collagen Stimulating Growth Factor

The collagen stimulating growth factor stimulates granulocytes and macrophage proliferation for the growth of healthy tissues and blood cells.

platelet rich plasma injections

How do Platelet Rich Plasma Injections help heal injuries?

Platelet Rich Plasma injections are generally plasma that has more platelets in it. This is achieved by increasing their concentration through centrifugation. The increased amount of platelets then results in an increased amount of growth factors, as outlined above, which promotes faster healing.

What happens the day of my Platelet Rich Plasma Injections?

  1. A healthcare provider will draw some blood from either your right or left arm . Similar to the amount that gets down for a routine blood test.
  2. The nurse will place the blood into a centrifuge which is located in the exam room. The centrifuge spins the blood at a very fast rate : about 4000 revolutions per minute. Through that spinning process the platelets are separated from the other components of the blood
  3. The PRP is then placed in a syringe and under sterile technique is injected into the area of the body being treated.

If you suffer from chronic pain, tennis elbow, or are in pain and not sure what the cause is, Platelet Rich Plasma injections may bring you relief. You can get more information on this treatment option, or make an appointment, with Dr. Stacie Grossfeld at Orthopaedic Specialists in Louisville, KY. Dr. Grossfeld has over 25 years of experience in orthopedic medicine and offers Platelet Rich Plasma injections for a very affordable price. Get more information on PRP Injections then call 502-212-2663 to make an appointment today.

When To See A Pediatric Orthopedic Surgeon?

pediatric orthopedic surgeonA pediatric orthopedic surgeon is an expert helping children with musculoskeletal issues including problems with bones, joints, back, or muscles. In addition to medical school and an orthopedic surgery residency, pediatric orthopedic surgeons also undergo additional training specifically for pediatrics. They are able to treat children from newborns to teenagers with issues such as limb deformities, spine curvatures, broken bones, infections in the bone or joins, and limping.

3 Common Pediatric Orthopedic Conditions Every Parent Should Know About

According to a Pediatric Orthopedic Surgeon

There are several common conditions in children that a pediatric orthopedic surgeon can help correct early on. Your pediatrician may refer you to see a pediatric orthopedic surgeon if they detect one of these conditions.

Flat Feet

When we’re born, our feet are flat and then they develop arches as we grow. However, for some kids that arch does not fully develop. As they learn to walk, parents may notice that the child’s ankles turn in– a state often characterized as “weak ankles.” Eventually, the lack of arch in the feet can result in foot pain that can make walking uncomfortable.

While arch supports can help reduce pain in the feet, special shoes and inserts can’t affect the development of the arch. Reconstruction surgery can relieve pain and restore function if orthotics do not effectively reduce pain caused by flat feet.

Bowlegs

Also called genu varum, bowlegs are when the legs bend outwards from the knees down in an exaggerated manner. It is an inherited trait common in infants and often corrects itself as a child grows. However, there are two conditions that can lead to persistent bowlegs in children that are toddler age or older: rickets and Blount disease.

Rickets is a condition caused by a lack of the essential vitamins and minerals needed for bone growth. If a child is deficient in calcium and/or vitamin D, the legs cannot develop properly as they grow. This can lead to muscle pain among other problems such as spleen and liver enlargement.

Blount disease causes abnormal growth at the top of the tibia bone which is located by the joints of the knees. Doctors can start to detect Blount disease around the age of 2 and may recommend bracing or surgery to correct it.

Scoliosis

Scoliosis is a condition where the child’s spine curves sideways. If the curves are large enough, the child may need surgery or a brace to help correct it. Most cases of scoliosis develop in early puberty around age 10.

There are many reasons it is important to be aware of these common conditions that often affect infants. The the well being of your children is one reason. However, the most important one is that all of these conditions can be resolved if treated early on.

Dr. Stacie Grossfeld has over 10 years of experience as a orthopedic surgeon including pediatric orthopedics. If you would like more information on common pediatric orthopedic conditions like flat feet, bowlegs, and Scoliosis, contact Orthopaedic Specialists today at 502-212-2663.

Dr. Stacie Grossfeld Receives a Gag Calendar from Metro Specialty Surgery Center Colleagues

Dr. Stacie Grossfeld, of Orthopaedic Specialists in Louisville, KY, was given a very special gift from her colleagues at the Metro Specialty Surgery Center in Jeffersonville, Indiana – a gag calendar. Her colleagues went to great lengths to capture the personality of Dr. Grossfeld by secretly dressing up in her various outfits throughout 2017.

Here are the two masterminds behind this creative venture Jill and Brittney pictured below (left and right respectively).

Talking about creating the calendar, Jill explains, “It was a lot of work – but it was so worth it! Dr. Grossfeld is the only female surgeon at Metro … so she is the only female in a whole team of guys. And we can’t help but notice how GREAT she always looks. She has her own unique sense of style and she always stands out and puts her personality into every outfit she wears. One day we were joking around and we told Dr. Grossfeld that we’d love to try one something she was wearing. She immediately said ‘go ahead’ and so that was the beginning of this great idea!”

Similarly, Brittney explained: “Dr. Grossfeld has this outrageous fashion sense. Whenever she comes to work, we all can’t help but get excited by the different things she puts together and wears. One day we casually mentioned wanting to try something of hers on and she just said ‘sure, go ahead’ … We all love working with her and we also all think she has awesome clothes. When we got the idea to take pictures and make something creative for her, everyone wanted to be a part of it, even many of the guys!”

Somehow everyone managed to keep this effort a complete secret and Dr. Grossfeld was presented with her new calendar a few weeks ago!

Follow along to check out Dr. Grossfeld’s personalized 2018 calendar!

Patty is a scrub tech who just retired and was memorialized in the calendar wearing Dr. Grossfeld’s dress!

(more…)

The Not So Funny Feeling You Get When You Hit Your Funny Bone

prp injectionsUsing PRP Injections to Treat Cubital Tunnel Syndrome

We’ve all been there. Somehow, and often out of nowhere, you hit your elbow in just the right spot to cause severe pain to shoot up and down your arm. This pain occurs whether you barely hit your elbow or when you really smack it against something. Why? The pain you feel when you hit your funny bone is one unlike any other. What causes that not so funny feeling you get when you hit your funny bone? And what do you do if the pain that you feel when you hit your funny bone is intolerable?

When you hit your funny bone, you’re not actually hitting a bone at all. Instead, you’re hitting a nerve. The specific nerve that causes the odd pain associated with hitting your funny bone is your ulnar nerve. It is one of the three central nerves in your arm. The ulnar nerve starts running down your body at the back of your neck and ends in your hand. Like most of the nerves in your body, the ulnar nerve is protected for most of its length. However, there are some vulnerable spots where the ulnar nerve can be bumped and bruised. One of these vulnerable areas where the ulnar nerve is susceptible to compression is in the elbow.

When the ulnar nerve is compressed, it sends shooting, tingling pain and numbness through the arm.

You often feel this pain travel down the forearm before it spreads into the hand and specifically your ring and pinky fingers. This is where the ulnar nerve does most of its work, so the pain follows that path. Often the pain dissipates as quickly as it arises, but what if it didn’t?

The pain of hitting your funny bone is jarring. On the same level as stubbing your toe, when it happens, it seems to be the worst thing in the world. However, for some, that pain never goes away but instead becomes a constant chronic pain. This problem is called cubital tunnel syndrome and arises when the ulnar nerve is continuously compressed.

Signs of Cubital Tunnel Syndrome

Continuous compression of the ulnar nerve can result in cubital tunnel syndrome, but what are the signs? The signs of cubital tunnel syndrome match the symptoms of hitting your funny bone, but last much longer.

The most common signs include:

  • Numbness in the forearm, hand, and fingers that quickly appears and lingers
  • Sudden pain that occurs when the elbow is bent and continues to radiate
  • A tingling sensation that arises and lasts abnormally longer

These symptoms can often lead to even more irritation that results in the numbness being consistent and settling in to the hand and forearm. In severe situations, the numbness can result in muscle weakness that settles in the forearm and hand. This can further lead to some patients developing the “ulnar claw” where the pinky and ring finger curl up in response to extensive numbness.

How to Relieve Pressure on the Ulnar Nerve

There are a few medical approaches to relieving pressure on the ulnar nerve and healing cubital tunnel syndrome. More often than not, splinting the elbow keeps the affected arm straight and relieves pressure on the nerve. Splinting the elbow not only keeps the arm straight, but also prevents patients from making repetitive movements that could further irritate the ulnar nerve.

If splinting and pressure relief does not alleviate the ulnar nerve pressure, anti-inflammatory medications may be prescribed. Surgery is another option for those suffering from chronic pain as a result of cubital tunnel syndrome. However, there are other medical approaches that are not as common but may offer pain relief. One of these, which Dr. Stacie Grossfeld offers in Louisville, KY, are PRP injections.

PRP, or Platelet Rich Plasma, injections are used to help a wide variety of conditions such as tennis elbow, achilles tendonitis, and osteoarthritis. While PRP injections are most often used to relieve joint pain they can also help with cubital tunnel syndrome, as well.

PRP injections are injections of plasma – the liquid part of your blood – with more platelets injected into it. The platelets in our blood promote healing. PRP injections have a higher concentration of platelets which help fight inflammation and pain. PRP injections are known to treat chronic pain, chronic injuries, and can even help with pain management post surgery.

Chronic pain of any form should not be tolerated. Chronic pain, such as cubital tunnel syndrome, that affects the functionality of your hands and the comfort of your day-to-day life should be treated immediately. If splinting isn’t working and pain medication isn’t helping, consider speaking to your medical provider about PRP injections. They can help to alleviate the pain and allow you to return to your normal day-to-day life.

Dr. Stacie Grossfeld has over 25 years of experience as an orthopedic surgeon with a specialty in sports medicine. She is one of the only doctors in the Louisville, KY area to offer PRP injections at an affordable price regardless of insurance and medical coverage. If you are suffering from chronic pain due to a compressed ulnar nerve or other injury, call Orthopaedic Specialists at 502-212-2663 today to schedule an appointment.

A Personal Surgical Journey: An Interview with Orthopedic Surgeon Dr. Stacie Grossfeld

elbow injuryDr Grossfeld is a sports medicine orthopedic surgeon who is an avid tennis player. She unfortunately tore a tendon in her elbow that is commonly injured in tennis players and needed to under go surgery for the condition. What makes this story unique is she actually performs the elbow injury surgery she underwent on a regular basis. She also treats a wide variety of athletes from elite juniors, pro-athletes, and weekend warriors. Does Dr. Grossfeld practice what she preaches? How was it for her to be on the other side of the table as a patient instead of as the surgeon? Did she learn any lessons through this experience?

Tell me a little bit about your passion for tennis and your injuries.

Dr. Grossfeld: I started playing tennis late in life at age 34. Prior to that I had been a competitive cyclist and cross country ski racer. So, tennis was a totally new sport for me that used an entirely different skill set. I jumped into it with both feet and started out by joining a local USTA team and competing at a 3.5 USTA level. The third year I played my team made it to the semifinals of the National USTA 3.5 tournament held in San Diego, California. The next year I got bumped up to a 4.0 level and then to a 4.5 level. At this level most of the women have played tennis in college, but I had only been playing for 5 years.

I wanted to get better, so I increased the amount of days I was playing to 4-5 times a week and started playing 5.0 gals.

As a general rule – if you are a 5.0 player you have played Division I tennis in college. The 5.0 girls can hit the ball so hard and with such speed and power, it’s amazing. At this time I had been playing competitive tennis for over 15 years, but then my elbow injury occurred.

The 5.0 girls just hit the ball so hard that it was too hard for my elbow and my common extensor tendon tore. Having treated this elbow injury for over 25 years i knew exactly when I tore it during a match. I knew that it was a big and bad deal. So, I did the exact opposite of what I knew was right… I put on a really tight elbow brace and tried to finish out the season. I got to the point where when I hit the ball a little off center I thought I would cry or get sick to my stomach.

Not only could I not play tennis because of the intense pain. I was also having pain performing surgery. I decided I needed to cross the aisle, so to speak, and become a patient. It was hard. I had never been seriously injured before.

The MRI of my right elbow revealed what I suspected and a surgery was scheduled. This was not as easy as it sounds because I have a busy surgical schedule and patients were scheduled for me to do their surgery. Details were worked out and I was put on the OR schedule.

My goals was to be back on the tennis court in 3 months.

elbow injuryAfter 2 weeks, my incision had healed and I started performing surgeries again while trying to avoid any forceful use of my arm. Well that situation did not turn out so well. In the middle of a rotator cuff repair I felt my tendon re-tear. The follow-up MRI revealed that the second tendon tear was much worse than the first.

A revision surgery was scheduled and this time I planned on being out of the operating room for 2 months. The next two months I followed my personal professional post operative instructions to the T. Going to PT twice a week as well as wearing my elbow and wrist brace.

What was kind of humorous was I had just performed this exact same surgery on one of my patients a week before my surgery. When I saw her in the office, we chatted about the elbow injury recovery process together. Not sure how many times that happens to a surgeon!

After 2 months I started back in the operating room and was super careful about everything knowing this was the last chance I had to get my common extensor tendon to heal.

I was in the gym/YMCA on a spin bike six days a week while recovering. Riding was easy on the elbow, and a great way to maintain my cardio fitness. It also helped to improve blood flow to the elbow and promote healing in my elbow injury. I also started back to a low weight and high rep lifting program. The lifting program was focused around strengthening all the muscles in the shoulder and core to protect the elbow. This is something I have been telling my patients for years on a daily basis.

For me, goal number one was to get back to doing surgery pain free. Goal number two was to be able to perform my normal activities of daily living pain free. Tennis was not a priority

Everything was going well and about 6 months later I returned to my first tennis clinic with a group of players that were a couple levels lower than my previously held level. The thought was that they would hit the ball with less force and it would allow me to ease back into the sport . Almost immediately I started having a new weird pain in my wrist.

I did a self examination of my painful wrist, a series of X-rays and a wrist MRI. Good grief I headed back on the operating room schedule to fix a torn wrist ligament (TFCC) and have my ulna bone shortened. During surgery a stainless steel plate and 8 screws were placed in my forearm .

That surgery went fine and recovery was great. I followed the same advice that I give my patients after surgery and I did fine.

After a year later and lots of weight lifting, tons of cardio, and zero pain I picked up my tennis racket while cleaning out a closet. Dang that racket felt good in my hand! It was like I was shaking hands with a long lost friend. And then a thought crept into my mind …

elbow injuryMaybe if I just started playing on softer surfaces, such as clay, in a non-competitive situation and strictly doubles then I may be able to play tennis again for fun. I thought this would work and it did! I started to play one day a week, with easy practice, no lessons, no pressure, for fun and waited to see how my elbow injury would do. It did fine.

I then slowly bumped playing up to twice a week, every other week, and didn’t play during the winter months with the same results!

After two years post surgery for my elbow injury I decided to play competitively as a doubles player in an outdoor summer league that wasn’t as competitive as the USTA league. That went well for two seasons. I was in the “super chill” tennis program. Doubles on clay, playing only 6 months of the year and only playing twice a week max with lots of time in the gym for cardio/ strength. This routine was helping me to avoid further tennis injuries to my elbow or wrist.

Then an interesting thing happened at the end of this summer’s doubles league.

I ended up playing a doubles match against a gal and her mom. The daughter had played D-1 college and then played on the satellite circuit with pro players. This gal was amazing to say the least . During the match I was able to trade ground strokes with her, we would get into some rally’s with hard hitting ground strokes and my elbow wouldn’t hurt. I was hitting forehands and backhands with this really good player with no pain and hitting like I had done before my injury.

It was at this time that the thought crept back into my mind that I might be able to play singles again at the same level I had played prior to being injured.

I started working out with my prior 4.5 USTA team. But with a total different mind set. No solo lessons, only hit once a week and keep cross training. Last week I stepped onto the court and played my first 4.5 singles USTA match in almost 3 years. I had a blast and winning was just icing on the cake.

What advice can you give your patients from your elbow injury experience?

Dr. Grossfeld: Its important to listen to your doctor and ask lots of questions. My arm wasn’t going to be the same, but I had to figure out a way to return to tennis. I decided to get there by working around my elbow. Your surgeon understands your injury better than anyone especially if there is surgery involved. They understand the quality of the tissue being repaired which is really important and plays a role in how fast a recovery can occur if a full recovery can occur.

Does being a patient make you a better doctor?

Dr. Grossfeld: I think most doctors are compassionate which is the reason we became doctors and empathy is so important as a physician. Being in the shoes as a patient reinforces what I do as a doctor. The experience also confirmed how important the whole healing process is from start to finish.

Why is rehab so important?

Dr. Grossfeld: It is critical to make sure the range of motion and strength is restored to the area that has been injured. Some people can do this without the guidance of a physical therapist and some people /surgeries require a PT to help with recovery. I also talk to my patients about the team approach; the surgeon, the patient and PT . We are all a team to get them better and we get have our special role that is critical.

What was the most important part of your return to play after an elbow injury?

Dr. Grossfeld: Understanding what my limitations are and being realistic about them.

Dr. Grossfeld has over 10 years of experience as an orthopedic surgeon and experience as a patient, as well. If you have injured your elbow, wrist, or shoulder while playing sports or in some other way, contact her today. Call 502-212-2663 to make an appointment with an orthopedic surgeon who has been voted as  one of the Top Ten Orthopedic Doctors in Louisville, KY and has received a Patient’s Choice Award as a top rated doctor from http://www.vitals.com/

Shoulder Pain? 10 Signs of a Shoulder Overuse Injury

shoulder overuse injuryAs far as joints go, the shoulder is very closely fitted into its socket. Because of its close fit, the archway between bones and ligaments in the shoulder are prone to inflammation, especially if the shoulder is overused. In extreme cases, as a response to the inflammation the body may develop scar tissue or calcific deposits that require removal. In less extreme instances, the person may develop shoulder bursitis (when the bursa becomes inflamed and painful) or tendinitis (when the tendons or surrounding tissue become inflamed, swollen, and tender).

Shoulder bursitis and tendinitis are overuse injuries that often affect athletes that use their arms in repeated overhead motions. For instance, baseball players, football quarterbacks, tennis players, and swimmers often suffer from shoulder overuse injury. The pain typically occurs at the tip of the shoulder and can run down the deltoid muscle into the upper arm. Other causes of shoulder pain include:

  • Bone spur – Extra bone tissue in the shoulder rubs against a tendon, nerve, or other bone, causing loss of movement and pain.
  • Impingement syndrome – A shoulder muscle, tendon, and busar sac rub against the shoulder blade. Impingement syndrome often develops in conjunction with tendinitis. It can also result from poor posture.
  • Tear (both partial and full-thickness) – Gradual weakening of the shoulder tendons lead to micro tears that eventually develop into full-thickness tears.

Below are 10 signs that your shoulder pain is the result of a shoulder overuse injury like bursitis or tendinitis.

  1. The shoulder pain is persistent and occurs even when the arm is not in use.
  2. The pain feels more like a lasting, dull ache rather than a sharp pain.
  3. The pain occurs as a gradual onset.
  4. You don’t have history of a direct injury to the shoulder area.
  5. You experience stiffness or aching after or during competition or training.
  6. There is tenderness at one point in the shoulder.
  7. You are missing training sessions due to the severity of the pain in your shoulder.
  8. There is visible swelling in the shoulder area.
  9. The amount of time for the pain to dissipate increases.
  10. Loss of motion in the shoulder.

Your shoulders and shoulder joints are important parts of your body and should be monitored with care. If you feel that you may be at risk of overusing your shoulders and developing a shoulder overuse injury, reevaluate your day-to-day activity. A shoulder overuse injury can often be prevented with rest, rehabilitation, and a new approach to activity.

Dr. Stacie Grossfeld has over 10 years of experience as an orthopedic surgeon including various types of shoulder surgery. If you would like more information on shoulder overuse injury and recovery, contact Orthopaedic Specialists today at 502-212-2663.