ACL Reconstruction

When you tear your anterior cruciate ligament (ACL), and undergo surgery, you cannot “repair” the ligament tear. You have to reconstruct the ligament. Reconstruction means you have to take some other ligament or tendon in the patient’s body and turn it into an ACL.

There are many options. I commonly use two of the hamstring tendons that attach near the knee joint.
The hamstring tendons will reform as a scar tissue type tendon, hamstring strength returns back to normal, and the neuro function to the hamstring tendons returns back to normal within one year. So as surgeons we steal from Peter to feed Paul, but eventually we get back to Peter, so to speak…

Pictured below are the hamstrings after I have harvested them from the patient. The second image reveals the new ACL that I I have constructed in the operating room. After the surgery the athlete will be back to their game within five months.

  

 

What is the difference between osteoarthritis and osteoporosis?

This is a commonly asked question and tends to be confusing to many of my patients.

Osteoarthritis is the breakdown of the cartilage that covers the ends of each long bone. Think of each long bone in your body as having a hat over each end. The hat is the cartilage. As the hat material wears out, the end of the bone becomes exposed. Osteoarthritis is the process where the cartilage is wearing down, similar to the hat material. Eventually the bone becomes exposed and that is extremely painful.

Osteoporosis is a condition where your bones become thin. It has nothing to do with cartilage. It has everything to do with the fact that your bone goes from being a very strong structure to a very thin fragile structure. That occurs in women as we lose estrogen and in men as testosterone levels go down as they age. In women, this can typically occur after age 60 and in men typically after age 75.

Osteoporosis is a silent condition because it doesn’t cause any pain until the bone become so fragile it breaks. Osteoarthritis is a process that occurs over time and typically there is pain associated with the joint where osteoarthritis is occurring. There are cases where people will have the arthritic process occurring for years and be completely asymptomatic until they reach the end stage where there is no cartilage left in the joint.

What is a Heel Spur?

A heel spur is bone spur (osteophyte) that comes off the bottom part of your calcaneus (the heel bone). A bone spur occurs because of plantar fasciitis. Plantar fasciitis is a chronic inflammation of the plantar fascia that runs from the bottom part of your calcaneus to your toes. With chronic inflammation, the plantar fascia will ossify at the origin site: please see the x-ray below, the red circle reveals a bone spur.

Treatment for a bone spur involves treatment for the underlying plantar fasciitis. Surgically removing the bone spur does not correct the problem. The bone spur will return if the plantar fasciitis is not treated. Plantar fasciitis is treated with physical therapy, stretching, anti-inflammatory medications, shoewear modifications, a night splint, Cortizone injections, PRP injections and stem cell injections.

10 Ways To Prevent Running Injuries From Dr. Stacie Grossfeld

While every runner will likely experience an injury at some point, it’s still beneficial to do everything you can to prevent them from happening in the first place. What better way to do your due diligence than to take the doctor’s advice?

Here are 10 Ways To Prevent Running Injuries from Dr. Stacie Grossfeld herself:

1. Do not increase your mileage more than 10 percent per week.

Gradually preparing your body to take on more will allow it to handle the stress more evenly on your joints as well as build endurance.

2. Warm up to warm up. Do a light run or some type of exercise until you have a light sweat, then stretch. Stretching cold muscles is a bad idea.

Warming up before you stretch helps increase the blood flow to your muscles, making them more flexible and mobile.

3. Replace your shoes before they are worn out.

Running on shoes that are past their prime means you’re likely missing out on shock absorption, cushioning and stability. All of these characteristics are valuable because they help to reduce the amount of stress and impact on your joints.

4. Try to change up running surfaces to change the load and force on your legs.

Each surface you run on poses a unique challenge to your muscles, by it up you reduce the chance of an overuse injury and increase your ability to tackle new terrains.

5. Cross train on your days off.

Routinely engaging in another sport or activity can help your body’s joints recover and allow you to strengthen other areas in need.

6. Track your mileage, surface and workout type to review in case an injury occurs.

Keeping tally of how long you run for and whether these runs tend to be on hard or soft surfaces will allow you to better pinpoint the cause of any future injury.

7. Listen to your body. You may have a training plan but your body might need a modification.

While it’s good to set goals and challenge yourself, don’t be afraid to listen to your body and make changes to your training plan that will keep you from injuring yourself.

8. Do not let injuries linger if they are not improving.

If you are struggling with a running injury, make sure you seek the right medical attention and treatment plan for you. Ignoring injuries or running through them can sometimes increase the magnitude of the problem.

9. Stay hydrated.

Drinking enough water is essential to preventing heat exhaustion and dehydration; illnesses that can leave you feeling fuzzy and put you in serious harms way.

10. Seek the advice of professionals if you are new to the sport.

If you’re interested in becoming an avid runner, ask those whose are experts in the field for training tips. Why not start off on the right foot?

To get more information on injury prevention and learn about innovative treatment options, continue reading our blog. Dr. Stacie Grossfeld is a trained orthopedic surgeon who is double board-certified in orthopedic surgery and sports medicine. To make an appointment with the Orthopaedic Specialists, call us at 502-212-2663 or use the contact form online.

Understanding & Treating A Torn ACL

Our ACL (anterior cruciate ligament) is the major ligament in our knee that provides stability. It helps keep our knee together and controls the back and forth motion of the knee. A torn ACL is common among young athletes who repeatedly twist, turn, and participate in stop and go movements associated with soccer, football, basketball and hockey. The ACL can be torn as a result of any of these activities including taking a hard hit from the side, resulting in the knee joint to become over extended. 

This is what it looks like inside of the knee.The image with the red arrows reveals a normal ACL while the image with the green and blue dotted lines and arrow show a torn, blown out ACL.

Tearing your ACL not only makes your knee unstable, it can also mean another part of the knee is injured as well. An ACL injury is most often signaled by a popping noise, severe and constant pain, as well as some loss of motion.

A physical examination is needed to diagnose such an injury, though an X-ray or MRI may also provide a clearer picture. In order to repair the ligament, surgery is required. The only way to mend a torn ligament is to reconstruct it. Most orthopaedic surgeons do this by using a tissue graft as scaffolding for a new ligament to grow on. Part of the hamstring tendon or the central part of the patellar tendon are often used as an autograft in these cases.

Because regrowing a ligament takes time, it is generally a 6 month recovery period before one can resume their normal activities. Older, inactive patients may not require surgery and simple methods such as bracing, physical therapy, as well as icing and elevation can help reduce the swelling and pain.

While an ACL surgery requires a long road of recovery and rehabilitation, it is worth the process in order to regain the full function of your knee. If not treated properly, chronic pain, arthritis and the limited use of your knee can hinder your lifestyle. 

If you have sustained an ACL injury, or you have any questions about ACL injuries and the reconstruction surgery, call Dr. Grossfeld’s office at 502-212-2663 for more information. 

Centre College’s Student Intern Sean Gilpatrick

We recently had the pleasure of having Sean Gilpatrick as our Student Intern from Centre College! As an intern, Sean was able to shadow Dr. Stacie Grossfeld during her regular office hours as well as in surgery. 

“I gained valuable knowledge on diagnosing patients and treatments for certain injuries. Watching Dr. Grossfeld’s surgeries gave me a better understanding of the human body. I was even able to talk to some anesthesiologists about the process of preparing the patient for surgery and got the opportunity to watch surgeries like Rotator Cuff repairs, an Achilles repair, one treating Carpal Tunnel syndrome, an ACL repair, and many more. It was a very enjoyable experience that gave me valuable knowledge to help further my pursuits in becoming a physician.”

As always, we enjoy working with both medical residents and interns. It’s encouraging to see more and more college students choosing a career path in health and science, and we are glad to mentor them in anyway possible! To learn more about how you can participate in an Internship with Dr. Stacie Grossfeld or the many other programs available to medical students, just visit our website or call our office at 502-212-2663!

The Orthopaedic Specialists’ Employee of the Quarter!

Introducing our First Employee of the Quarter, Heather Hardiman!

A completely employee voted on award, each Employee of the Quarter receives a special bonus. Here are just a few of the reasons why the staff at Orthopaedic Specialists nominated Heather to win this quarter:

  • She is diligent and efficient in her job.
  • She is sensitive to patients and coworkers.
  • You rarely hear her speak negatively about her coworkers.
  • She always stays on task.
  • She does her best at everything she is asked to do.
  • She is usually here early and stays late.
  • She takes pride in her work.
  • She is always willing to help.
  • She goes the extra mile for patients.
  • She never complains.

From everyone on the team, we thank you for all your hard work Heather and hope you know what a pleasure it is to work with you! (:

How To Help Your Kids Build Strong Bones

bone healthWhen was the last time you thought about your bones? Did you hit your elbow and get that feeling associated with the “funny bone”? Was it the last time you broke a bone and had to get a cast put on? Or can you not even remember? Bones don’t get a lot of attention until they are broken or weakening, but they should. While they go unseen, they are constantly at work to keep us upright and a step above the animal world. Bone health is crucial to a long, prosperous life, and the importance of healthy bones should be taught from a young age. If you are a parent, it is up to you to help your kids build strong bones.

A lifetime of bone health is determined when a person is a child. Healthy bones during childhood lay a solid foundation for bone health through adulthood. The majority of your bone density is built throughout childhood and into the teenage years. By the age of 20, bone growth is completed and, while old bone is replaced with new bone throughout adulthood, it is a slow process and bones continue to weaken. There are three key steps that you can take, as a parent, to ensure your kids build strong bones and avoid weak bones later in life.

3 Ways to Help Your Child’s Bone Health

1. Establish a Diet That Includes High-Calcium Foods

Calcium is a nutrient found in foods that help to build strong bones. Not only does it help with bone strength, but calcium also helps nerve function and muscle strength. By including foods that are high in calcium in your child’s diet, you are helping them build strong bones. While a lot of people think of milk when they think of high-calcium foods, there are plenty out there. This is especially important if your child is lactose-intolerant or otherwise sensitive to dairy. Some other foods that are good sources of calcium include orange juice, cereal, cheese, and yogurt.

2. Incorporate VItamin D Into Their Diet

Just like calcium, vitamin D is another important nutrient that contributes to bone health. It can be a little trickier to get children to eat foods that are high in vitamin D. Why? A lot of foods aren’t high in vitamin D naturally. Those that are high in vitamin D include fatty fishes and oils which kids don’t often eat. This is why a lot of health providers recommend giving children a vitamin D supplement. Talk to your child’s pediatrician about the amount of vitamin D you should be giving your children to ensure bone health.

3. Encourage Daily Exercise

Just like our muscles, our bones need to be used in order to grow stronger. Encouraging your children to exercise daily will help them to build up their bone health. Exercising doesn’t even have to be exercising in the sense of working out, either. Taking your children to the park where they can run around or to the pool where they can swim count! It’s recommended your child gets an hour of activity in every day to promote healthy bones.

While bone health should be maintained throughout your life, there is only one period where it’s possible to establish good bone health and that’s childhood. When kids have strong bones, they are more likely to avoid weakening bones early in adulthood. By incorporating high-calcium foods and a vitamin D supplement into your child’s diet, you’re helping them in the long run. The same goes for exercise. If you can get them running, jumping, climbing, and swimming from a young age, they’ll be better off in the future.

Dr. Stacie Grossfeld is a double board-certified orthopedic surgeon with a focus on sports medicine. If you have a child and are concerned with their bone health, contact Orthopaedic Specialists today. Orthopaedic Specialists has two convenient locations in Louisville, KY and can be reached by calling 502-212-2663.

How Stretching Helps Injury Prevention

injury preventionAnyone who considers themselves an athlete is aware of the importance of stretching. There are numerous benefits to stretching and you should stretch before and after a workout to prevent injuries. Whether you are a runner, someone who loves lifting weights, or on a competitive sports league, you must stretch your muscles. While injury prevention is a top reason to stretch, stretching also helps to increase flexibility, improve posture, reduce aches, and much more.

Stretching helps with injury prevention by warming up the muscles. Movement is easier when your muscles are warm and stretched. When you prepare your muscles for exercise, your risk of injury significantly decreases. However, to properly stretch, you must know the correct technique and target each muscle individually. Learn more about how stretching can help with injury prevention and what stretches should be done to target specific areas of the body before you start your next workout.

Stretches That Are Important for Injury Prevention

Leg Stretches

Stretching your legs is important if you’re preparing to do any kind of cardio or court sport. While Runner’s Knee and Achilles tendinitis top the list of common running injuries, hamstring issues are third on the list and preventable with stretching. Some great stretches to warm up your hamstrings are standing toe touches and knee-to-chest stretches. Butterfly stretches will protect your groin from injury and standing soleus’ will help prevent Achilles tendon tears. This is especially important for anyone over the age of 35 as Achilles tears are more common after that age. Shin splints are also in the top ten on the list of common running injuries, so shin stretches are also important for injury prevention.

Arm Stretches

Having warmed up arms is just as important as having warmed up legs in regards to injury prevention. This is especially true when it comes to court sport athletes and weightlifters. Your arms are built of so many muscles including your triceps, biceps, and brachioradialis. it is important to stretch them all to prevent injury from occurring. The overhead tricep stretch and standing bicep stretch may bring back memories of gym class, but they are tried and true stretches that are effective. Alternating wrist pulls where you pull your hand towards your body will stretch your brachioradialis and leave your arms ready to work.

Shoulder Stretches

You may not think that your shoulders are being strained during exercise if you’re not playing tennis, squash, or another racket sport. However, it’s important to remember your shoulders are more than just a joint. They work with the neck, ribs, and scapula to create a complex area of the body that needs stretching. Arm circles are a great shoulder stretch that is easy to perform anywhere. The cow-face pose is another stretch you may remember from gym class.  When you stretch both of your arms, like you do in this stretch, you’re not only stretching muscles but increasing flexibility, too. 

When stretching for injury prevention, it is important to remember the proper technique. Stretching may seem like the warm-up, but it’s not. You need to increase your heart rate and raise your body temperature to effectively stretch. Additionally, you should hold each stretch for 30 seconds. That is the proven amount of time it takes to lengthen tissue safely and effectively. If your stretching starts to hurt, you’re pushing yourself too far. Relax, take some deep breaths, and pull back on the intensity of the stretch before continuing.

By incorporating stretching into your day-to-day routine, you’re practicing injury prevention. An injury like a torn Achilles tendon or torn ACL can devastate an athlete’s future in sports. Therefore it is crucial to remember the important of stretching and practice it diligently.

Treating Carpal Tunnel Syndrome

The carpal tunnel is located in our wrist and contains a nerve as well as several tendons used to flex our fingers and thumb. When the tunnel’s nerve gets compressed or pinched, this is known as carpal tunnel syndrome.

A constant ache, weakness in the hand or wrist, as well as numbness, tingling, swelling or stiffness are warning signs of carpal tunnel syndrome. While many health conditions such as arthritis, diabetes or pregnancy can be at the root of the cause, often carpal tunnel syndrome is brought about by overuse.

Repetitive movements from one’s job and or lifestyle can result in the nerve in the wrist to be compressed. Tasks ranging from a desk job, to playing musical instruments or racquet sports can be at fault if they mean the wrist is being kept in the same position for too long throughout the day.

While carpal tunnel syndrome is a common condition brought on slowly overtime, the pain can be disruptive and long lasting. However, if treated early and effectively, it is not a permanent condition.

At Home Treatment Options

  • Wearing a wrist brace or splint can offer relief to those with mild or moderate carpal tunnel syndrome. Wearing it while sleeping helps keep the wrist from bending and can reduce symptoms that interfere with sleep.
  • Flexing the hand and wrist in warm water routinely is known to lessen the pain and improve blood flow.
  • Elevation helps drain excess fluid that may be built up around the nerve, especially in cases of pregnancy.
  • Ice and anti-inflammatory medicine will reduce inflammation near the nerve.

Preventative Measures

In addition to at home treatment options, often lifestyle changes are required to prevent carpal tunnel syndrome from reoccurring.

Resting your hands and wrists from the activities that cause the symptoms to flare up is key. Whether it be taking breaks from typing, holding your phone, or participating in strenuous sports, not overusing your wrists and hands is best when it comes to being proactive.

If you suspect your job to be the main culprit, consider arranging your work space to better support your wrist and ensure it remains in a neutral position.  

Additionally, try to be conscious of your grip when holding things. A relaxed grip is better for staving off carpal tunnel syndrome than one that is tight.

Consulting with Your Doctor

If at home treatment methods and preventative measures aren’t doing the trick, it’s time to consult with an orthopaedic doctor. Physical therapy can provide you with stretches and exercises that will help strengthen the hand and wrist muscles, as well as relieve pain.

Cortisone or steroid injections can offer temporary relief as well. In the most severe cases where extensive nerve damage is present, surgery may be required in order to remove pressure from the nerve. While surgery is never a first choice, carpal tunnel surgery often results in permanent relief.

An alternative to surgery, stem cell recruitment therapy can help restore flexibility and strength to the area. A less invasive option, stem cell injections have also proven to be more effective than steroid shots.

To learn more about how stem cells can regenerate inflamed tissues, and explore the treatment options best suited for you, contact Dr. Stacie Grossfeld. Dr. Grossfeld has over 25 years of experience in orthopedic medicine and is a double board-certified orthopedic surgeon. If your carpal tunnel symptoms persist,  make an appointment with the Orthopaedic Specialists today by calling 502-212-2663.