Five Ways to Prevent Tearing Your ACL While Downhill Alpine Skiing

Posted February 25, 2019 by Orthopaedic Specialists

1. Warm up properly.

If you are a black diamond skier, warm up on some blue runs. If you were a blue level skier, warm up on some green runs.

2. Be aware of your surroundings.

While nothing is better than skiing with your air pods in your ears listening to your favorite Alpine ski playlist, listening to your surroundings is very important. When you’re on the chairlift for example, and the lady sitting next to you is nervously asking your husband how to get off the chairlift…that is a conversation you want to hear. Because when you’re getting off the chairlift, you want to make sure you are no where near her as you exit.

3. Make sure your equipment is properly fitted.

Check that your bindings are not too tight for your ski boots based on your ski ability. If you wipe out, you want to make sure your skis pop off your boots. A ski that does not detach can catch in the snow and tear your ACL.

4. Listen to your body.

When your legs are tired, you’re done for the day. I know everybody wants 10,000 vertical feet of skiing before 10 AM and 30,000 vertical feet of skiing before 3 PM, but if at 2 o’clock your legs are tired, end your day. It’s very important that you’re not skiing with tired legs.

5. Make sure you’ve worked on strengthening your hamstrings in the gym.

Your hamstrings protect your ACL. So hit the hamstring curl machine prior to heading out west or jumping on that chairlift. Also, when you’re riding a bike, make sure you are clipping into your petals and pulling back during the up stroke of your pedal stroke on the bike because that will strengthen your hamstrings.

The top image is a normal ACL(a happy skier’s knee) and the bottom image is a torn ACL (a sad skier’s knee).

How to Properly Train For Long Distance Running

Posted February 21, 2019 by Orthopaedic Specialists

As spring approaches so too does running season here in the Ville! Saturday the 23rd is the Anthem 5K Fitness Classic, followed by the Rodes City Run 10K on March 9th, the Papa Johns 10 Miler March 23rd and the Mini Marathon and Marathon run of April 27th.

Whether you’re gearing up for the Louisville Triple Crown of Running or the Kentucky Derby Festival Marathon, properly training will go a long way in helping you reach your goals and stay injury free no matter your level of ability. As Dr. Stacie Grossfeld has many years of experience treating common running injuries and helping runners continue to enjoy the sport they love, here are a few tips on preparing yourself for the long road ahead!

Make sure you have the right running shoes.

Wearing the right shoes for your foot can help prevent common running injuries such as shin splints, stress fractures and sprains. It is recommended that you are fitted with running shoes at a store that is familiar with runners so you can have a gait analysis performed.

Build up the right amount of endurance.

If preparing for a long distance run you’ll need to log the appropriate amount of mileage well before race day. It is commonly encouraged that runners complete at least 1 long run a week during their training in order to build up their endurance.

Incorporate recovery days.

While discipline and dedication are positive attributes in athletic training, it’s important not to over train. The number one reason for stress fractures is too much training too quickly. That being said, take 1 or 2 days off a week and if you must keep moving, consider a low impact exercise such as yoga, walking or swimming.

Warm up, stretch, and then mix it up.

Before you do the real deal, go a light run or get on a bicycle in order to get your blood pumping. You’ll know you’re ready once you start to break into a sweat.
Stretching helps the body recover and should be saved for after your muscles are warm.
On your off days, mix it up with some cross-training exercises. Strength training reduces the risk of injury, so think of it as sharpening the tools in your tool box.

Log quality runs.

If you don’t push yourself to run a little faster every time, it’s likely you won’t be able to even complete the mileage. Doing so will help you keep a better pace come race day. Just be sure to leave at least 10% in the tank.

Listen to your body.

If you start to have aches and pains in certain areas of your body and the pain is getting worse, do not try to run through them. This is a sign that something is wrong and you should consult a medical professional.

Hydrate and then hydrate a little more.

Hydrating during or after a run is key, but so is hydrating before. You’ll also want to make sure you’re maintaining enough caloric intake to keep up with your energy expenditure. If you are doing a lot of long distance running, you may want to keep a food log to make sure that you are taking in enough calories and nutrients to keep up. The second most common reason for stress fractures is lack of proper caloric intake.

If you have any medical conditions such as hypertension or coronary artery disease, you should check with your primary care physician for medical clearance before starting a running program of any kind.

If you or a loved one are experiencing an injury due to running, make an appointment with the Orthopaedic Specialists by calling us at 502-212-2663 or using the contact form online. Dr. Stacie Grossfeld is a trained orthopedic surgeon who is double board-certified in orthopedic surgery and sports medicine.

What does a ballerina’s foot look like on an X-ray?

Posted February 15, 2019 by Orthopaedic Specialists

What does a ballerina’s foot look like on an X-ray when they are on their toes? The top image is you and me walking. The bottom left image is a ballerina en pointe. The most common injury among dancers are foot problems. I see metatarsal stress fractures, bunion deformities, flexor hallus longus tendinitis, and other foot related issues. Looking at this image can give you a reason why….

What is a Meniscus?

Posted February 14, 2019 by Orthopaedic Specialists

A meniscus is a structure located in your knee joint that functions as a shock absorber. You have two of them in each knee and they are prone to tearing. When the meniscus is torn, it produces a sharp stabbing pain and sometimes it will cause your knee to click or even lock. Many times swelling is associated with a meniscal tear.

The treatment for a meniscal tear is a knee arthroscopy. That is the procedure where I go in and remove the torn part of the meniscus. On occasion the meniscal tear can actually be repaired or sutured back together but that is only rare. The reason why the meniscal tears are typically not repaired is because the meniscus does not have a good blood supply. So if I place sutures in the meniscus it would just not heal. There is a part of the meniscus that is very vascular and has a good blood supply. If the tear occurs in that area then the meniscus can be repaired versus just removing the part that is torn.

The meniscus has shock absorbing qualities but once it is torn, the area where the tear is located no longer provides any shock absorbency. The only thing the torn meniscus provides is pain.

Do I Have Scoliosis?

Posted February 14, 2019 by Orthopaedic Specialists

Often when a patient comes in with back pain, they ask the question, “Do I have scoliosis?”

Scoliosis is a curvature and a rotational deformity of the spine. By definition, the curvature of the spine should be at least 10°.

There are 2 Types of Scoliosis:

1. Adolescent Onset Scoliosis

The standard case of scoliosis usually occurs during a growth spurt right before puberty. However, it is possible that the condition may not be caught until adulthood when the symptoms become more problematic. While the cause of adolescent onset scoliosis can be attributed to birth defects, a spinal injury, muscular dystrophy, or cerebral palsy, the cause of most pediatric cases is unknown. It has also been determined that scoliosis can be genetically related.

Treatment is based on the age of onset and the degree of the curve. This can range from simple observation and bracing, to complex invasive surgery. If caught early on, the issue can most likely be resolved. Uneven shoulders, hips or waist are signs of scoliosis.

2. Adult Onset Scoliosis

Also known as degenerative scoliosis, this form of the condition typically affects those 50 or older. Adult onset scoliosis can slowly occur over time with age. In fact, it is normal to experience a form of degeneration when it comes to facet joints and intervertebral discs. As we age, this kind of deterioration is also known to cause osteoarthritis as well as degenerative disc disease.

According to a recent study, “at least 60% of the population over age 60 has at least mild degenerative scoliosis.” While adult onset scoliosis is fairly common, in some cases it may be accelerated, resulting in severe symptoms.

Symptoms include a dull back ache and sciatica like sharp shooting pains originating in the lower back or buttock, usually on one side. This can make it difficult to move or walk. Treatment options are often nonsurgical and involve physical therapy, medication, as well as avoiding overly strenuous activities.

If you or a loved one is experiencing back pain, make an appointment with the Orthopaedic Specialists by calling us at 502-212-2663 or using the contact form online. Dr. Stacie Grossfeld is a trained orthopedic surgeon who is double board-certified in orthopedic surgery and sports medicine.

Discovering an Occult Fracture

Posted February 13, 2019 by Orthopaedic Specialists

The top left x-ray of the elbow is normal. The top right x-ray of the elbow has an occult fracture of the radial head. An occult fracture is when you cannot see the break on an x-ray. How did I know the radial head bone was broken if I couldn’t see the fracture line on the x-ray????

Answer: the bottom image has the positive “fat pad sign.” This anterior and posterior fat pad sign is circled in red. The soft tissue shadow located on the front and back of the elbow bone indicates that there is blood in the elbow joint. The fat pad which normally sits adjacent to the bone is not seen on a normal x-ray.

When there is bleeding in the joint it elevates the fat pad and it looks like a sail on a sail boat. The most common cause for a sail sign is an occult fracture of the radial head. This patient was also very tender to palpation over the radial head which matched the x-ray. Thanks Carina Curnow Burns ,M.D. and Becky Fuller Olds , N.P. for the great referral and the perfect textbook radiographic image!

What is Scoliosis?

Posted February 12, 2019 by Orthopaedic Specialists

Do I have scoliosis? This is a question I get asked fairly often when people come in with back pain.
Scoliosis is when you have a curvature and a rotational deformity of your spine. By definition the curvature of the spine should be at least 10°.

You can develop it as a child with the etiology (most commonly genetically related) or as an adult secondary to arthritis. Treatment is based on the age of onset and the degree of the curve. It can range from simple observation, bracing, to complex invasive surgery.

The image with the blue S curve is a patient with scoliosis and the image with the straight green line shows a normal spine.

Facts about Achilles Tendon Ruptures

Posted February 11, 2019 by Orthopaedic Specialists

Lateral Patellar Compression Syndrome

Posted February 8, 2019 by Orthopaedic Specialists

This is a condition where your kneecap is tilted and compresses on the femoral groove abnormally. Imaged below is a picture of a kneecap joint with lateral patellar compression syndrome. You can see where on the right side the bones are touching each other and on the left side there’s a big open space. There should be an even space on both sides.

This picture shows how the kneecap looks after I have performed a lateral release. This should give the patient almost immediate pain relief. This is a diagnosis sometimes difficult to figure out because there is not a great imaging modality to document. Many times it is more of a dynamic problem and cannot be statically imaged.

Having a Great Week with Genevieve Jacobs, M.D.