Youth Sports Injuries and Sports Specialized Intensive Training

Posted April 18, 2016 by Orthopaedic Specialists

Nowadays many kids are focusing in on becoming very good in one sport. This often involves investing a considerable amount of time, effort and interest in this one sport. Additionally, many parents and teachers encourage a child to focus on one sport in order Sports Specialized Intensive Training and Youth Sports Injuries to develop a higher proficiency. Yet sports specialization comes with physical complications for some young athletes including a higher risk of youth sports injuries. When children begin to practice and compete year-round in only one sport, certain muscles and joints tend to become overworked and youth sports injuries are a serious risk.

Sports medicine physicians, orthopedics and others have noticed this trend in youth athletics. And researchers have studied the issues that may arise. Specifically, there was an excellent article published in the American Journal of Sports Medicine in April, 2015, written by Dr. Jayanthi. The article looked at 1,214 athletes. There were 822 injured participants and 368 uninjured participants. They found that the injured athletes were older than the uninjured athletes. Athletes that were older than 14 years of age were at a greater risk compared to athletes that were 12 years or younger.

Understanding Risk Factors for Youth Sports Injuries

Researchers also found that athletes that reported more total hours of physical activity, close to 20 hours per week, versus 17 hours a week, had a higher injury risk of youth sports injuries. Additionally, organized sporting activity was another risk factor for injury. If the athlete was participating in 11 hours per week of an organized sporting activity, they were at a higher risk for injury versus 9 hours per week.

In conclusion, this study found that young athletes participating in more sports per week, combined with an older age and a greater than 2 to 1 ratio for organized sports to free play time had increased odds of having a serious overuse injury. They also found that there was a correlation and statistically significant difference in athletes with a serious overuse injury who specialized in a single sport.

Louisville Sports Medicine Doctor Offers Info About Reducing the Risk for Youth Sports Injuries

Based on this article, Dr. Grossfeld recommends that young athletes compete in more than one organized sport throughout the year. Also, it’s beneficial to help reduce the risk of youth sports injuries from overuse by increasing the amount of time dedicated to free play. (more…)

Louisville Doctors Present at the American Medical Society for Sports Medicine 2016 Conference

Posted April 12, 2016 by Orthopaedic Specialists

Dr. Grossfeld and American Medical Society for Sports Medicine

Dr. Jennifer Thomas, Dr. Stacie Grossfeld, and Dr. Preeti Panchang collaborated on a poster accepted at the American Medical Society for Sports Medicine’s 2016 meeting.

As the residents from the University of Louisville rotate through Dr. Grossfeld’s office they get to observe routine and sometimes very unique orthopedic cases. Over the years, some of the medical residents have used these interesting and unusual cases to present at different medical conferences around the country. This year Dr. Brittney Richardson and Dr. Jennifer Thomas, two physicians who have worked very closely with Dr. Stacie Grossfeld at Orthopaedic Specialists, have had poster presentations accepted at the 25th annual meeting of the American Medical Society for Sports Medicine.

Dr. Brittney Richardson, Chief Resident with the Department of Family Medicine and Geriatrics at the University of Louisville, had a poster presentation accepted at the American Medical Society of Sports Medicine conference titled: Ouch Mom, My Hip: Diagnosing Hip Pain in a Limping Child. This write up provided an overview of one of Dr. Grossfeld’s patients with a unusual pediatric condition.

Dr. Brittney Richardson will present at the American Medical Society for Sports Medicine Conference

Dr. Stacie Grossfeld and University of Louisville School of Medicine resident Dr. Brittney Richardson.

Dr. Richardson’s presentation involves a 6 year old male who presented to Orthopaedic Specialists with a complaint of left hip pain for 3 days. According to his mother, she initially ignored his complaints until he woke up complaining that the pain was so bad, he could not stand up. He plays soccer and in his game 2 days prior to presentation he had a fall. He complained about the pain, but it initially did not seem to hinder his activity. The day after the fall, he went to baseball practice and went swimming with no complaint of pain. However, with the pain acutely worsening on the morning of presentation, his mother became concerned. Presenter Dr. Brittney Richardson will discuss the treatment plan and the patient’s final outcome. Authors on this are listed as follows: Brittney M. Richardson, M.D., Stacie L. Grossfeld, M.D., Jessica Stumbo, M.D., Jennifer Daily, M.D.

Dr. Jennifer Thomas had a case study accepted for the conference, which she will present, titled: Biomechanical Evaluation: A Case of Delayed Diagnosis. This includes a case history and detailed discussion about an 18 year-old female competitive cross country runner who presented to the office with complaints of tightness, pressure and pain in the bilateral calves as well as numbness in the feet while running. She had been symptomatic for the past 6 months and treated for multiple different etiologies with no relief of her symptoms. She states these symptoms start within 15 to 20 minutes and resolve after resting for several minutes. She was treated for anterior tibialis tendonitis and medial tibial stress syndrome with physical therapy, rest, ice, and NSAIDs without relief. The authors on this project also include: Dr. Stacie Grossfeld and Dr. Preeti Panchang. The presentation details the treatment plan and final outcome of the patient.

About the American Medical Society for Sports Medicine:

The American Medical Society for Sports Medicine (AMSSM) was founded in 1991. The organization is focused on supporting practitioners in sports medicine including primary care doctors and those offering non-surgical sports medicine treatment. The 25th Annual AMSSM Meeting is being held in Dallas, Texas, at the Sheraton Dallas on Friday April 15th through Wednesday April 20th 2016.

20 Running Tips and Injury Prevention Methods

Posted April 7, 2016 by Orthopaedic Specialists

Running Tips To Keep You On The Roads

Injury prevention is an important topic for runners at every level, from beginners to long-time veterans. Running tips and prevention methods for runners Louisville orthopedic surgeon and sports medicine physician
Dr. Stacie Grossfeld has many years of experience treating common running injuries and helping runners continue to enjoy the sport they love. In this article, Dr. Grossfeld offers some helpful running tips to keep you on the roads, regardless of your level of ability and experience.

Follow along for more information about common running injuries, and helpful running tips including: things you should do before you run, reasons for having your feet assessed before starting a running program and more, to keep you successful and injury free.

Top Five Reasons Why I have Leg Pain When I Run:

Shin splints
Stress fracture
IT band tendonitis
Patellofemoral syndrome
Meniscal tear

Top Five Things That Are Key to do Before You Run:

Make sure you have properly fitted running shoes. It is recommended that you are fitted with your running shoes at a store that is familiar with runners and it may help to have a gait analysis performed prior to you purchasing running shoes.
Warm up properly. We like to tell our patients to warm up before you warm up, do a very light run, just where you break into a sweat or get on a bicycle till you break into a sweat and then actually do your stretches and then go out and do your true run.
Make sure you are well hydrated, maintain hydration throughout the day prior to run.
Listen to your bodies. This means as 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.
Maintain 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 enough calories and proper calories to keep up with your energy expenditure. The second most common reason for stress fractures is lack of proper caloric intake. The number one reason for stress fractures is too much training too quickly.

Top Five Reasons to Have Your Foot Assessed Before You Begin a Running Program:

It is a documented medical fact that if you are pronated, you are more likely to sustain a stress fracture involving your metatarsal, developed shin splints, and plantar fasciitis.
If your foot is pronated, an over-the-counter semi-custom orthotics or custom orthotics would be indicated.
If you have a wide forefoot or a narrow forefoot or narrow heel, it might be more difficult to be fitted in a running shoe; therefore, it is important to assess your foot and have somebody at the running shoe store also asses her foot to make sure that your running shoe fits you properly.
Check to make sure there are no blisters on the bottom of your feet. If blisters start to form, that may mean your shoe is not fitting well, and care should be taken to make sure that the blisters do not become infected.
If you are developing bunion deformity, it is helpful to have a custom pair of orthotics made to counterbalance abnormal forces on the plantar aspect of your foot that are created secondary to the bunion deformity.

Top Five Things You Should do Before Starting a Running Program If You Haven’t Run Before:

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 you start a running program.
It is recommended that you consult with a running coach to determine your fitness level to help formulate a program specialized to your baseline fitness. It is important to speak with a running coach or wellness coach through any local running club or even through the YMCA.
It is helpful to follow a program to help guide you with increasing your mileage. Very common mistake that runners will make is they try to increase their mileage too quickly and then they become injured.
If you are going to start a running program, it is also important to do some cross-training to allow the muscles to rest on the days that you are not running.
Complete rest days are important and that should be discussed with your wellness coach prior to your running program to learn when and when not rest days should be utilized. It is helpful for new runners to set a goal, make the goal realistic. Even training for a race in the future can help motivate and keep you in your running program.

Hopefully you have found these running tips from Dr. Grossfeld helpful and educational. (more…)

Patella Dislocation in High School Athletes

Posted April 4, 2016 by Orthopaedic Specialists

What is the risk of having a patella dislocation or subluxation among high school athletes in the United States?

Many high school athletes, coaches, parents and physicians are discovering that the intensity and competition in high school athletics is growing every day. With this level of activity, it seems that athletes are more prone to injuries than ever before. A research study has been released that Patella dislocation and subluxation in high school athletes addresses the issue of patella dislocation or subluxation in high school athletes. Before reviewing these research findings, it may be helpful to define these two types of injuries.

For young athletes, their kneecap is usually right where it is supposed to be during activities. In the event of a hard blow or fall, one’s patella may slip out of place.

A patella dislocation causes pain and loss of function for these young athletes. A subluxation is a temporary, partial dislocation that relocates the patella from its normal position in the leg.

Patella Dislocation and Subluxation for Young Athletes

Dr. Joshua Mitchell looked at the national high school sports-related injury surveillance system-reporting online information, which is an internet based sports injury surveillance system. What they found was that patients undergoing a patella dislocation or subluxation were most commonly reported secondary to a no-contact injury mechanism. When all contact subcategories were combined, the overall contact mechanism re-presented 59.3 percent of injury.

The authors noted after reviewing all the data in the computer system that patellofemoral instability rates vary by sport, gender, and type of exposure – competitive versus practice. This big word (patellofemoral instability) just means that there is loss of strength and instability in one’s kneecap.

The researchers also found that 60 percent of the athletes return to play after a patella instability injury within three weeks. Those returning to play after more than three weeks represented 15 percent of athletes. And a smaller percentage were unable to return to play for the remainder of the season.

When looking specifically at sports and gender, they found that the highest injury rates for patella dislocation or subluxation occurred in girls’ gymnastics, boys’ football, and boys’ wrestling.

The authors found that surgery was only required 8.5 percent of the times when a patella subluxed or dislocated.The authors noted that girls have a significantly higher proportion of injury caused by a non-contrast mechanism compared to boys. (more…)

NAWBO Louisville VIP Celebration Breakfast

Posted April 1, 2016 by Orthopaedic Specialists

As the recipient of the National Association of Women Business Owners (NAWBO Louisville) 2016 Epic award for small business owners, Dr. Grossfeld celebrated with a VIP celebration breakfast held at Big Springs Country Club in Louisville, Kentucky. NAWBO Louisville EPIC Award recipients As owner of Orthopaedic Specialists, a sports medicine and orthopedic surgery medical practice with multiple locations in Louisville, KY, Dr. Grossfeld has committed her time and efforts to providing excellent patient care, while also managing her own business. Dr. Grossfeld and Summer Auerbach, the owner of Rainbow Blossom stores and Large Business Owner of the Year recipient, were guest speakers at this event.

2016 NAWBO Louisville VIP Breakfast

Both award winners at the NAWBO Louisville event were instructed to speak about their experiences as female business owners. Dr. Grossfeld began her speech discussing the many things that she learned as an orthopedic surgery resident in a primarily male-dominated field. Only five percent of orthopedic specialists in the U.S. are women. With this gender disparity in the field of medicine, Dr. Grossfeld explained some of the challenges she faced while entering this field of medicine. For example, she discussed how it was often difficult for her to find surgical instruments to fit a smaller hand and she often had to use two step stools to reach the patient on the operating table.

Despite these obstacles, Dr. Grossfeld went on to become a distinguished orthopedic surgeon and sports medicine doctor in Louisville, Kentucky. As a small business owner, Dr. Grossfeld believes in creating a positive work environment for her employees. She explained that her workplace philosophy revolves around creating and maintaining a welcoming environment that can be described as a village. Dr. Grossfeld is full of gratitude when she sees her employees having a vested interest in their positions and in their interactions with the patients.

Before patients shake Dr. Grossfeld’s hand, they will have already had contact with four different employees. Dr. Grossfeld explained how all of these interactions are working to create a positive experience for every person that comes to Orthopaedic Specialists. She understands what it is like to be a working mother and creating that work life balance. Dr. Grossfeld said in speech, “We all change our hats when we come from working gal to mom.” This understanding is beneficial for Dr. Grossfeld as a female business owner working with female employees. (more…)

Centre College Student Spends Spring Break Learning About a Career in Orthopedic and Sports Medicine

Posted March 29, 2016 by Orthopaedic Specialists

Louisville orthopedic surgeon and sports medicine physician Dr. Stacie Grossfeld enjoys working with students who are interested in a career in medicine. And this has included students at many different points in their educational careers – ranging from high school, college and those in graduate school.

A couple of years ago, Orthopaedic Specialists formed a unique partnership with Centre College in Danville, Kentucky, to offer Centre students the chance to work with Dr. Grossfeld during school breaks. A number of students have taken advantage of this opportunity to complete medical internships. Most recently, Centre College sophomore Drew Burns Centre College Student works at Orthopaedic Specialists decided to spend his spring break vacation learning more about a career in medicine at Orthopaedic Specialists. Here is what Drew had to say about this:

Entering college, my best guess at what I wanted to major in was Economics. I soon discovered after my freshment year that I had a desire to pursue a science major, and started toying with the idea of medical school. From having two surgeries and being hospitalized for weeks due to MRSA, the compassion and skillset the doctors displayed was not only impactful but meaninful. Watching Dr. Grossfeld’s extreme competence in teh OR and building genuine caring relationships has taught and given me a lot to strive for. I am envious and impressed by Dr. Grossfeld’s compassion towards her colleagues, employees, patients and community. As a two-year collegiate basketball player, I would love to be a part of the incredible teamwork and environment that Dr. Grossfeld and her employees maintain. These experiences have strengthened my desire to pursue a career in medicine and I am extremely greatful to spend my spring break learning from Dr. Grossfeld and her staff.

(more…)

Returning to Sports at the Age of 70

Posted March 28, 2016 by Orthopaedic Specialists

Can you return back to sporting activities if you have a rotator cuff repair when you are older than age 70?

This specific question was answered through an article published at the Stedman Hawkins Clinic in Vail, Colorado. The research study specifically looked at patients who are recreational athletes over age 70, that underwent rotator cuff repairs. Dr. Bhatia’s research was published in the American Journal of Sports Medicine in July 2015. This article involved 44 patients with the average age of 73 years. They were all recreational athletes. Based on the analysis, more than three out of four, or 77 percent of the patients, were returning to sports at a similar level of intensity following rotator cuff repair surgery. Returning to Sports for Older Athletes

In addition, many of the patients had improvement in their levels of activity compared to what they were experiencing prior to surgeries. Their pain levels reduced, while their strength improved.

In conclusion, the authors noted that arthroscopic rotator cuff repairs were highly effective at reducing pain, improving function, and returning patients to the sport in high demand elderly individuals over 70 years of age.

A Growing Number of Seniors are Returning to Sports of All Kinds Including Competitive Events

Peak performance for athletes of many different ages has gotten better and better over the course of the last 100 years due to a wide variety of things. And more than ever before, older adults are participating in sports and setting records. Examples include Canadian runner Ed Whitlock who was the oldest person to complete a marathon in less than 3 hours (at 73 years of age) in 2003. (more…)

Risk Prediction Tools for Hip and Knee Replacement Surgery

Posted March 24, 2016 by Orthopaedic Specialists

The current healthcare environment in America has been driven by the concepts of quality, cost containment and value. Based on this, the federal government is starting a program that will incentivize physicians to maximize and reduce the patient’s risk factors prior to hip and knee replacement surgery. In fact, a physician’s reimbursement for the procedure will be directly related to post-surgical outcomes of their patients. Because of this, there are many studies right now looking at “tools” to predict high-risk patients to figure out if those patients should even be offered a knee replacement or if there are pre-surgical ways to reduce the risk factors.

There was an article published by Dr. David Manning in the American Academy of Orthopedic Surgeries Journal, this January. This report looked at risk prediction tools for hip and knee replacement surgery.

In this article, Dr. Manning noted that total knee Total Hip and Knee Replacement Surgery and total hip surgeries comprised a largest procedural expenditure in the Medicare budget. And the complication rate for these surgeries varies anywhere between 2 percent and 14 percent. Higher complication rates are associated with the elderly and patients with additional disorders and high risk factors. Between 1991 and 2010, the mean number of comorbidities among Medicare patients undergoing elective total knee replacement nearly doubled from 1.2 to 2.1, and this trend is expected to continue.

Patients treated with total knee replacement show that the rate of diabetes mellitus increased from 10.5 percent to 24.2 percent. The rate of obesity increased from 4 percent to 10 percent during the same period. Complications that are seen after total joint replacement such as infection, blood clots, heart attacks, pneumonia, are associated with poor patient outcomes, and in addition represented a substantial cost burden to the American healthcare system.

Quality Improvement Initiatives Target Total Hip and Knee Replacement Surgery

Over the next five years, elective total hip and total knee replacements will be incorporated into several quality improvement initiatives, developed by the Center for Medicare and Medicaid Services. Because risk prediction tools or risk calculations are being developed, physicians are receiving help to determine who is eligible for a knee replacement or hip surgery. It is also working to understand if those risk factors can be modified pre-surgical efforts. (more…)

YMCA Norton Commons Gym Expansion

Posted March 22, 2016 by Orthopaedic Specialists

Norton Commons YMCA Board of Directors visit the gym expansion site.

Members of the YMCA Norton Commons Board of Directors (including Louisville orthopedic Dr. Stacie Grossfeld) gathered with Norton Commons Elementary School principal, Allyson Vitato, on March 17th, to visit the new gym that is currently being built to connect to Norton Commons Elementary School. This 1,909 square foot expansion will allow the YMCA to increase their kids club space. The administrator of the Norton Commons YMCA, Mike Bramer, gave board members an informal walk-through of the current conditions of this expansion. He announced that construction will begin this summer in August 2016.

The board meeting kicked off with an introductory session, followed by a prayer and a relationship building discussion led by Dr. Grossfeld. She explained the importance of networking and relationship building for the YMCA and other organizations in Louisville. Dr. Grossfeld enjoyed sharing her ideas for this new expansion that involves connecting with the community in various ways. She has an idea to host a joint parent night out with the YMCA and Kentucky Country Day School.

Along with serving on the YMCA Norton Commons Board of Directors, Dr. Grossfeld is also on the Board of Directors for the Louisville Sports Commission. She is hoping to connect these two great organizations while increasing community involvement. The Louisville Sports Commission has discussed ideas for gathering used equipment, as well as creating other benefits through the YMCA. The board is in contact with family medicine practitioner, Dr. Jesse Jenkins, to discuss initiatives that (more…)

Experiencing Elbow Pain? 5 Things it Could be

Posted March 21, 2016 by Orthopaedic Specialists

5 Common Elbow Injuries that Cause Elbow Pain Many people experience elbow pain at some point in time. Your elbow is a somewhat complex mechanism that relies on three different bones for support and movement. The elbow gives your arm the ability to rotate outward and inward, while also working like a hinge upward and downward.

The functional design of your elbow allows movement, flexion and rotation of your arms. Sometimes, these repeated and irregular movements can cause elbow pain. While minor elbow pain may indicate a small strain, more constant or severe pain may be cause for concern. For those struggling with elbow pain, here are 5 common causes.

5 Causes of Elbow Pain

Tendinitis: Elbow tendinitis or “Tennis Elbow” is a real source of pain for many active individuals, and for those repeatedly using forearm muscles often in certain workplace environments. Activities like window washing, swinging a tennis racket, or making home repairs, can aggravate your elbow and cause the tendons to become inflamed. This is often followed by swelling and warmth at the site. Typically, when a physician identifies tendinitis as the cause of your elbow pain, he or she will suggest rest, ice and possibly a brace for the affected area. Anti-inflammatory medications may also be helpful when treating pain and inflammation.
Bursitis: Bursae are fluid-filled sacs designed to provide cushioning between bones and tissue. In the case of elbow pain, the flat olecranon bursa is located at the back of the elbow. When this bursa becomes irritated and inflamed, the area may become fluid-filled and bursitis will start to develop. This injury tends to occur after trauma or prolonged pressure such as leaning on your elbows while typing on the computer. This condition causes pain, swelling and redness to the affected area. Following a physician’s examination and diagnosis, anti-inflammatory medications may be recommended. Changing your activities and wearing an elbow pad may also be advised. This condition is for the most part easily treatable and comes with a speedy recovery.
Arthritis: Arthritis located in your elbow is the cause of swelling, tenderness, pain and decreased range of motion. This condition targets joints and causes inflammation and erosion of cartilage and bone. In order to combat this pain, your doctor may prescribe anti-inflammatory medications, while alternating between heat and ice for the affected area. Other possible treatment options for arthritis in your elbow include: bracing the elbow, changing activities and undergoing cortisone injections.
Sprain or Broken Elbow: During irregular movements, accidents or intense physical activities, your elbow may take the brunt of the pain. A collision or unusual impact could cause your elbow to strain the ligaments or fracture the bones. If you suspect a break or strain, you should see a physician for a physical exam and possible x-rays. If your elbow is broken, the treatment generally requires immobilization or surgery. If a strain is present, your physician will suggest rest, ice, immobilization, compression and anti-inflammatory medications to reduce pain and swelling.
Cellulitis: Another common cause of elbow pain actually involves inflammation of the skin. Cellulitis occurs when an abrasion or puncture wound allows bacteria to move from the surface of the skin, into the deeper layers. The symptoms of this condition are characterized by redness, warmth, swelling and heat on the surface of the skin. Often, individuals with cellulitis will exhibit a low-grade fever. Treatment for this condition involves antibiotic medication, rest and over-the-counter pain relievers. This infection can worsen if left untreated, so make sure to seek medical attention if you suspect cellulitis.

Just because you feel pain in your elbow doesn’t mean you have a broken elbow or cellulitis. (more…)