• Don’t Forget Your Brain Exercises

    Posted by Stacie Grossfeld

    With all of the latest research, studies and exercises created to improve your muscle and bone health, it’s easy to forget to strengthen your brain as well. Your brain is responsible for your thoughts, actions, relationships, and so much more.

    Brain Exercises, Puzzles and Games at Orthopaedic Specialists in Louisville KY

    Orthopaedic Specialists in Louisville, Kentucky, offers clients the opportunity to do brain exercises in the waiting room (extreme mazes, crosswords, sudoko, coloring, and more!) …

    As we age our brains begin to slow down and some cognitive abilities may decrease without proper brain health maintenance. The good news is that there are several ways to increase your brain health at any age. It’s recommended that you follow a healthy diet of exercise, adequate sleep and proper nutrition. Living a balanced and healthy lifestyle, free from tobacco use, will greatly improve your chances of staying sharp in your later years.

    While it may be difficult to fight biology and heredity if certain health problems run in your family, there are are several ways to improve and strengthen your brain health.

    Cognitive training games have been proven to sharpen the mind and slow down the effects of aging on the brain. These different games may involve memory challenges, strategy formation, problem solving and socialization. Action and adventure games, for example, have been proven to provide cognitive benefits to users that can carry over to real life situations or work.

    Brain games come in many varieties to help strengthen different areas of the brain like language and logic puzzles, optical illusions, and memory and pattern recognition. All of these different games work to target specific areas of the brain and keep the mind sharp. There are many games and puzzles available in print and online. If you want to improve your brain health, no matter your age, try out some of your favorite puzzles and games.

    5 Interesting Medical Facts About Your Brain:

    1. The typical brain weighs around 1.4 kilograms.
    2. Seventy-five percent of your brain is water.
    3. There are about 100 billion neurons in your brain.
    4. Your brain does not have pain receptors.
    5. Your brain has around 100,000 miles of blood vessels.

    For more information about your brain, check out this interesting article in National Geographic.

    Dr. Grossfeld and the entire team at Orthopaedic Specialists believes in promoting your health and well-being. It’s important to strengthen your entire body from your brain to your toes. The waiting room (more…)

    What Does it Take to be a Team Physician?

    Posted by Stacie Grossfeld

    The American Academy of Orthopedic Surgeons published an article this June where they interviewed four prominent orthopedic surgeons who are also team physicians for pro sport teams. Dr. James Andrews, Dr. Brian Cole, Dr. Anthony Miniaci, and Dr. Frederick Azar. The orthopaedic surgeons talked about what it takes to be a team physician. This includes some of the trials and tribulations that come with being a team physician for a pro-team or high school and college teams.

    Being a Team Physician — “It Takes a Team”

    Dr. Cole explained the first role of the being a team physician is always remembering that he/she is part of a larger medical team. He quoted author and humorist Mark Twain, saying that: “really great people make you feel that you, too, can become really great.” He stated that there is a large group of people that are needed to take care of a sport team. He used the example of a hub and spoke diagram. The athletes comprise the hooks and the team members are the spokes. The team members involved are the physicians, the athletic trainer, the nutritionist, the sport psychologist, and any other providers that are helping take care of the athletes. Dr. Cole stated that he followed the SCOR which emphasized the importance of knowing when to Support, Collaborate, Oversee, and Refer the athletes.What does it take to be a team physician?

    Dr. Jimmy Andrews stated that the athletic trainer is the “glue that holds it all together, and does not forget about the emergency medical technicians.”

    Dr. Cole also talked about the importance of the “six Cs of being a team doctor.” He discussed the six Cs as showing Compassion, Communication, Confidence, Charting, Coverage and Contract. He noted that compassion means letting the athlete know you care and you are available 24-7. Communication encompasses a do it yesterday mentality. He continues with a clear instruction about the treatment plan and information about the risk of condition and sports participation. Confidence means a physician must stay current. Charting means documenting all encounters no matter when they occur. Coverage involves clarifying malpractice insurance and asset protection, and the contract means filling out the details of services provided, insurance coverage, volunteered or paid status and the final say about return to play. The physicians all noted that you must remember these student athletes or pro-athletes are patients first, athletes second, and that there is life after sports.

    “It Takes Trust”

    Dr. Cole noted one of the greatest challenges a team physician faces especially at the professional team physician for professional athletes level, is earning and cementing the trust of the athlete. “Loyalty is earned in this field and can be very temperamental,” Dr. Cole said. He noted that in the national football league, it was reported recently that a significant percentage players distrusted their team physician.

    Another part of the team physician’s job that can bring headaches is dealing with the media. Dr. Cole stated this can be a challenging area. “My general approach is that I do not talk to them. The only time I will talk is when an organization ask me to address the press, and then it is a talking point.” You never want to be called off guard. The athletes have privacy law that protects them such as HIPAA and ethical concerns abound. Dr. Cole stated that he always respect the player first and the organization first.

    “It Takes Understanding”

    Dr. Andrews discussed some of the challenges specific to sports at the amateur or professional level. He also identified differences among the major sports. In college, he explained one issue looms the largest — pre-participation clearance. Dr. Andrews stated that it is pretty well accepted in the sports medicine world that team physicians have the final word on disqualification for participation though he/she can use consultants. He also stated that some pre-participation issues might not be so self-evident. For example, should walk-on athletes be able to participate with a medical problem that could be compounded? He believes that they should not allow walk-on athletes to take much risk especially with preexisting problems. (more…)

    MRI Research Reveals Cause of ACL Injury

    Posted by Stacie Grossfeld

    ACL injuries are responsible for pain, surgery and lots of physical therapy. Most of these injuries occur through non-contact sports or accidents sustained off of the courts or field. Researchers and physicians are working tirelessly to understand the cause of ACL injury to develop preventive programs to reduce this knee injury. Because of the current known information and a recent study that was published, athletes are learning how to lower their risk of sustaining an ACL injury.

    We know at the time of ACL injuries, there are bone bruises that occur during MRI results. The bone bruises tell us that there has been contact with the femur and the tibia at the time of the ACL injury. A very interesting study published in the American Journal of Sports Medicine in October 2015, examined the position of the knee during non-contact ACL injury determined from the bone bruise location. The study was performed at Duke University with the lead author, Sophia Kim.

    ACL and Knee Position Explain Cause of ACL InjuryRemember that the most common way to sustain an ACL injury occurs through non-contact situations, such as the basketball player dribbling the ball down the court, stopped quickly, and tears his ACL. This is similar to the soccer player who is running down the field and she stops and pivots quickly and tears her ACL. A contact ACL injury occurs when there was actually contact from another player to the injured athlete’s knee, which is less common that the previous examples.

    The researchers looked at MRI results of eight subjects with a non-contact ACL injury. They examined MRI results from a subject who suffered a non-contact ACL injury and created a 3D model of each subject’s knee and its position during the MRI position. (more…)

    What Are Rotator Cuff Treatment Options for Patients with Massive Rotator Cuff Tears?

    Posted by Stacie Grossfeld

    For athletes involved in sports like baseball, tennis and swimming, there is often a common fear of sustaining a shoulder injury like tearing a rotator cuff. As a board certified orthopedic surgeon and shoulder doctor, Stacie Grossfeld MD offers effective rotator cuff treatment to people in the Louisville, Kentucky area. Rotator cuff tears can become severe and may even halt a person’s athletic career. Shoulder Injuries and Rotator Cuff Treatment OptionsAthletes are not the only one’s susceptible to this type of injury, but their level of activity and repetitive movements put athletes at a higher rate of risk for sustaining this injury. Fortunately there

    The rotator cuff is a group of tendons and muscles that form around the shoulder joint that is located at the top of the humerus. All of these parts work together to form a “cuff” that is responsible for stability and moving the arm in different directions. Too much stress, repetition and fatigue can cause the tendons to swell and tear.

    This type of injury produces pain, fatigue, reduced range of motion and other symptoms. It is important to seek medical attention if you suspect a shoulder injury that may require rotator cuff treatment. This could help you get back out on the playing field or pool much more quickly and successfully than if you try to ignore your symptoms. For athletes that have been diagnosed with this injury, it is important to discover all of your rotator cuff treatment options.

    What are the Surgical Options for Rotator Cuff Treatment?

    With massive rotator cuff tears, this often requires surgical treatment to repair the tear to allow the patient to heal properly before returning to their sports. There have been several studies performed and research has uncovered the outcome of massive rotator cuff repairs through surgery.

    As an experienced orthopedic surgeon and shoulder doctor, Dr. Grossfeld explains that patients with massive cuff tears, greater than 3 cm or the involvement of two of the four rotator cuff tendons, have high risk for their tendons not healing or re-tearing very quickly after rotator cuff surgery. (more…)

    Study Finds that Vitamin D is a Risk Factor for Stress Fractures

    Posted by Stacie Grossfeld

    Stress Fracture Treatment and Vitamin D

    Stress fractures are known for causing tiny cracks in a bone and pain to the affected area. This type of injury is often sustained through repetitive movements or overuse common in sports like long-distance running. Many individuals and athletes that run long distances or those that engage in activities that Stress fractures are a result of vitamin D inefficienciesinvolve a lot of jumping can be prone to developing stress fractures. Also, those with osteoarthritis often developed stress fractures due to their weakened bones.

    Stress fractures frequently occur in the weight-bearing bones of the lower leg and foot. This type of pain tends to worsen over time and could potentially cause swelling to the affected body part.

    Stress fractures are a common sports injury, and treating stress fractures typically involves a simple treatment plan of resting the area. Additionally, there is new information that has been found to reduce a person’s risk of developing stress fractures.

    Latest Research on Stress Fracture Treatment Identifies Vitamin D as Key

    An article published in the American Journal of Sports Medicine in August 2015 looked at serum 25-hydroxyvitamin D levels and stress fractures in military personnel. Dr. Dyda Dao and a team of researchers began this study by searching multiple databases and doing a meta-analysis on nine studies looking at lower extremity stress fractures and Vitamin D levels. They found that military people that sustained stress fractures had a lower Vitamin D level than the military personnel with normal level of Vitamin D.

    The authors concluded that normalizing Vitamin D levels could potentially lead to a lower rate of sustaining a stress fracture. (more…)

    Doctor, What Happens to My Harvested Hamstring Tendon After ACL Surgery?

    Posted by Stacie Grossfeld

    The most common graft used for ACL reconstructions is a hamstring tendon graft.  Once you’ve torn your ACL, you cannot sew the end of the ACL back together.  A ligament needs to be reconstructed. Most ligament reconstructions use the semitendinosus and gracilis tendons. These make up part of your hamstrings: the central part of your patellar tendon also known as bone-patellar-bone graft, and the mid region of his quadricep tendon. This decision comes with less anterior knee pain or kneecap pain after surgery and it also requires a smaller incision compared to other types of grafts.Hamstring Tendon Regeneration

    Many patients often wonder about the outcome of a hamstring tendon, if it is used as a graft to replace the ACL. Many studies have shown that the hamstring tendon will regenerate within a year after ACL reconstruction after using the hamstring tendon as an autograft.

    Researchers Study Hamstring Tendon Regeneration After Harvesting

    There was an excellent article that did a systematic review of the worldwide literature looking at hamstring tendon regeneration after harvesting. This was published in the October American Journal of Sports Medicine in 2015.

    The lead author, Dr. Suijkerbuijk, BSc, reviewed 18 publications that met the inclusion criteria. The researchers found that the majority of athletes (70%) that had their ACL reconstructed with a hamstring autograft had regenerated the tendon. They noted that in some of the studies, tendon regeneration started at approximately one month post-op, but in all cases, regeneration occurred within one year of surgery.

    Though the authors were not able to identify the exact time frame upon which the tendon most likely regenerated, they did note that in 100% of the cases, by a year, if tendon regeneration was going to happen, it had occurred.

    So, to answer the question: What Happens to My Harvested Hamstring Tendon After ACL Surgery?The answer is in 70% of the patients, the hamstring tendon will regenerate and this occurs within a year after surgery.

    ACL Reconstruction Surgery and Sports Participation in Athletes

    Posted by Stacie Grossfeld

    We’re constantly learning new information regarding ACL injuries and sports participation. This common sports injury requires extensive rehabilitation, handwork and commitment. And there is always the fear of tearing the ACL again for athletes that gotten back out on the court or field. While ACL Reconstruction Surgery Return to Sportevery case is specific for each athlete and injury, new information about ACL reconstruction surgery has been published to provide a better insight into this type of injury.

    The American Journal of Sports Medicine published an article written by Dr. Clare Ardern, PT, PhD, assessing athletes that had undergone ACL reconstruction surgery and had not returned back to play one year post-injury. The authors wanted to decide why these athletes had not returned back to playing their sport. The ACL injury is a common injury among young, active and otherwise healthy athletes.

    Typically, this group of athletes would like to return back to their pre-injury sport. Recognizing this is generally an important part of the recovery process. After ACL reconstruction surgery most athletes are not released to return back to twisting, turning, jumping sports until six to 12 months post-injury, and there is a constant need for more information on this process. (more…)

    The Mayo Clinic Studies the Epidemiology of Tennis Elbow

    Posted by Stacie Grossfeld

    Lateral epicondylitis, also known as tennis elbow, is a commonly seen condition in general practice clinics and has been reported to affect 1 to 3 percent of adults in the U.S. each year. A study conducted at the Mayo Clinic in Rochester, Minnesota, with lead author Dr. Thomas Sanders, Jr. was reported in the Journal of American Sports Medicine in May, 2015.

    An Overview of the Latest Tennis Elbow Research by Mayo Clinic Researchers

    This study noted that the right elbow is more likely to be affected than the left elbow, 63 percent of the time versus 25 percent. The researchers also found that 12 percent of patients had both elbows affected. Twenty-five percent of the patients were referred to a specialist, such as an orthopedic surgeon like Dr. Stacie Grossfeld in Louisville, Kentucky.

    The researchers found that the highest incidents of tennis elbow is among individuals age 40 to 49 years, with the majority of them being female -10.2 per 1000 female patients versus Tennis Elbow Study Mayo Clinic7.8 per 1000 male patients. The second highest incidents were among those ages 50 to 59 years of age, where the distribution of male and the female patients was equal.

    In this epidemiological study, the researchers found the treatment options for most patients included some type of tennis elbow bracing and anti-inflammatory medication. A large percentage of patients receive ultrasound iontophoresis with the physical therapist. This treatment option uses ionic medicinal compounds through the skin with an electric current produced through an ultrasound machine. Less than 6 percent of patients being treated for tennis elbow need any surgical intervention.

    The study also found that after three months, 74 percent of the patients were no longer seeking care for their initial diagnosis. The researchers found that only 18 percent of the patients receive care six months after their first diagnosis. For the patients that eventually needed surgical intervention, this occurred about nine months after their initial presentation to their orthopedic surgeon or healthcare provider with a diagnosis of lateral epicondylitis/tennis elbow. (more…)

    Dr. Grossfeld and Team Attend PNC Workshop for Business Women

    Posted by Stacie Grossfeld

    Orthopedic Medical Practice Leaders Attend Business Training for WomenThe Orthopaedic Specialists’ management team, including Dr. Stacie Grossfeld (orthopedic medical practice owner) Tisha Robison (orthopedic medical practice manager) and Dorothy Cochran (assistant practice manager)) enjoyed participating in a workshop for Louisville, KY-area businesswomen sponsored by PNC and held at the PNC tower downtown. A presentation by Susan Packard was streamed in live to the meeting. Susan discussed her book: New Rules of the Game: 10 Strategies for Women in the Workplace.

    Susan Packard has been on the ground floor helping to build powerful media brands including: HBO, CNBC, and HDTV. She is a co-founder of Scripps Networks Interactive and is the former Chief New Rules of the Game Book by Susan PackardOperating Officer of HDTV. Under Packard’s leadership, HDTV became one of the fastest-growing cable networks in TV history. Packard help build Scripps Networks Interactive into a market value worth over $10 billion. Now Susan works as a writer, speaker and consultant to business women in every stage of life. She serves as mentor and guide, helping women learn how to achieve success at home and at work.

    During her presentation, Susan Packard emphasized the point that there is a fundamental difference between men and women and how we communicate, how we do business, and how we interact. And she parallels business with athletics on so many different fronts. Not only does she emphasize the benefits of being an athlete, but she also explains the importance of thinking and acting like a winner.

    Gamesmanship, according to Packard, is a key to success. The way you stand, the way you sit, the way you look at people, even the words that you use — all of this is very important on the playing field and at the office. Here are some important takeaways from Susan Packard’s presentation that any women business leaders can use (including orthopedic medical practice managers).

    1. Be Clear and Concise: Women speak 21,000 words per day and men only speak an average of 7,000. Women are less inclined to “get to the point.” In contrast, men do not like a lot of words. The simpler women can communicate the better. Clarity is key. Make your words pack a punch. Do not speak a blast but speak efficiently.
    2. Play it Cool: Composure is necessary to win whether you are on the playing field or in the board room. It is a very important trait. It is about how you handle yourself so you can command the room. Women are being watched and evaluated all the time. Expect nonstop scrutiny from all angles.
    3. Take Care of Yourself: Know how many hours of sleep you need to feel good and think clearly. Make sure you eat a healthy diet, exercise regularly and limit alcohol, especially at work events. Massage, yoga and meditation may help relieve stress.
    4. Play Offense: Score points for your team and be a team player. Ask for and accept opportunities and promotions if you want to advance in your company. Ask and talk in a way that explains how the company (rather than just you alone) will benefit. And negotiate your salary upfront. Only 12% of women do this.
    5. Practice Artful Assertiveness and Verbal Finesse. It’s important to have backbone without breaking someone’s back; this means communicating directly and honestly with a smile. Learn how to ask for what you need, for yourself, your team, and your company. When you don’t use the right balance of finesse, women are often targeted with certain “b” words – e.g. bossy, bitchy. You need to be strong and use a certain voice but the right level of volume to be heard. Be polite but not painfully polite.
    6. Know How to Walk Away – The bluff is a strategic process for outsmarting your opponent. Know when to consider this tactic.
    7. Support your Fan Club: Build a network outside of your office that is encouraging and beneficial.
    8. Suit Up: Don’t dress provocatively but do dress appropriately for your position.
    9. Engage in Positive Practices: Emotional maturity, resilience, courage, respect, and inclusiveness.
    10. Come Prepared: Be ready for whatever the day brings.

    Good leaders realize that it isn’t about the job title. Certain traits are common among good leaders including: excellent listening skills, a high level of engagement, and the ability to be fully present. (more…)

    Youth Sports Injuries and Sports Specialized Intensive Training

    Posted by Stacie Grossfeld

    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 Injuriesto 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…)