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How to Treat a Concussion – Medical Steps
What Medical Steps Are Taken When You Get A Sports Related Concussion?
Kelly Dike, MS, ATC, is the athletic trainer at South Oldham High School. Based on her keen understanding of how to treat a concussion, she is working with a football player in the photo above.
Preseason preparation:
- In the preseason, all athletes will have a Baseline Impact Test completed. A Baseline Impact Test is a neurological and cognitive test that is given to all the athletes to have a baseline number on what their normal cognitive abilities are based on memory and hand eye coordination. It is about a 45 minute test with multiple sections. It is given on a computer.
Immediately after the sports injury:
- If neck pain stabilize the cervical spine.
- If neurological deficits stabilize the cervical spine.
- If in doubt stabilize the cervical spine.
- If the player has a helmet on and shoulder pads, do not remove, stabilize with the equipment in place.
- EMS needs called and the player placed on a back board with the neck stabilize throughout the moving procedure from the floor to the backboard.
- If the athlete is wearing a helmet , this will not be removed , the athletes head in the helmet will be secured/taped to the backboard. If there’s no helmet on the athletes head then a stabilization collar will be placed .
- Until proven otherwise assume the cervical spine injury exists
Questions to ask the athlete:
- Do you have a neck pain?
- Assess their orientation status. Ask them if they know their name, where they are, and the date.
- Do you have any numbness or tingling anywhere.
- Perform a neurological exam where you asked them to squeeze your hand, wiggle their toes, check their pulses, and try to assess their sensory status via light touch.
- Ask them to recall the events that occurred at the time of the injury and immediately after the injury.
What typically happens in the emergency department:
- Emergency department physician will assess the athlete. Based on the situation a CT scan of the head will/ will not be obtained. That is very individual based on the symptoms of the athlete.
- Most athletes will be discharged to home that day. Typically admission to the hospital is not needed.
The day after the concussion:
- There will be no sporting activities until the athlete is evaluated by their primary care physician or a neurologist.
- If it is a significant concussion in a while just must be consult it before the athlete returns to play.
- If it’s a minor concussion then the primary care physician or pediatrician can see the athlete.
- Questions that will be answered during a doctors visit is if the athletes having any post concussion symptoms: are you having headaches, blurred vision, difficulty concentrating or any nausea, sensitivity to light, headache increases with loud noises, trouble with balance.
How to Treat a Concussion:
- Depending on the concussion the athlete may be placed on brain rest. Brain rest is no school, no video games, no watching any TV, and no reading. Just like it sounds: brain rest. If the athlete has a severe concussion they may even be placed in a dark room for a period of time to totally rest the brain.
- The athlete maybe started on omega-3 vitamins to help heal the brain.
- Once the athlete is symptom-free: no headaches, blurred vision , difficulty concentrating or nausea, the athlete will be re Impact tested.
- If the impact test comes back to normal and they have been cleared to return to play from their physician, they are released to return back to sports with conditioning only for the first day, non-contact practice the second day and full contact the third day. This progression of activity occurs only if they remain symptom-free. Symptom-free means no headaches, visual disturbances, or difficulty concentrating.
Female Athlete Triad – Prevention and Diagnosis
Understanding the Female Athlete Triad
In 1971, before Title IX had past, it was estimated that 310,000 female athletes were participating in 
sports. In 2010 there were approximately 3,373,000 female participants. Over this period of time, a phenomenon described as the Female Athlete Triad has become an increasing concern for female athletes.
An excellent review article was published regarding the female athlete triad: past, present, and future in the July, 2015 issue of the Journal of the American Academy of Orthopedic Surgeons. The article was written by Dr. Elizabeth Matzkin, Emily Curry, and Kaitlyn Whitlock, PA – C. Highlights of the article are covered below.
In 1992, the task force on women’s issues of the American College of sports medicine was assembled, and the term “female athlete triad” was created to define the three components that characterize this condition. The definition of the female athlete triad, at that time, had to include disordered eating, osteoporosis, and amenorrhea.
It was noted that the athletes that appeared to be at highest at risk were the ones involved in endurance sports that emphasize low body weight, and athletes that were involved in sports that included subjective judging such as figure skating and gymnastics.
For prevention, diagnosis and treatment of this condition it is very important that people involved with the athletes are aware of the diagnosis. This includes coaches, team physicians, parents, colleagues, and teammates. In 2006 there was a survey of Division I college coaches. Sixty-four percent of 91 respondents were aware that the female athlete triad existed, but only 43% were able to appropriately identify the three components. In a separate study of physicians, physical therapists, coaches and athletic trainers, less than half were able to name the three components of the triad, with only 40% of the 139 physicians surveyed able to identify the components.
In 2007, the ACSM updated the diagnostic guidelines, and the female athlete triad was defined as a spectrum of abnormalities in energy availability, menstrual function and bone mineral density, looking at the components as part of a spectrum ranging from normal to varying degrees of pathology. The female athlete no longer needs to demonstrate pathology and all three components of the triad in order to be diagnosed with the syndrome. (more…)
Nick Sarantis ATSC Offers Fitness Training Seminar at YMCA
Dr. Grossfeld Attends YMCA Lecture on Training Methods by Nick Sarantis ATSC
Dr. Grossfeld recently attended a seminar on sports medicine given by Nick Sarantis, ATSC. The seminar was given to the fitness instructors at the Norton Commons YMCA. The purpose of the lecture was to talk about training methods.
Nick’s lecture was comprehensive and very informative. For example, one section of the lecture focused on giving excellent information on core strengthening. He stressed that the core muscles make up the foundation of the body and assist in injury prevention. He also emphasized that the core needs to be rehabbed after injury treatment. The foundation of our muscle function in sport starts at the core.
He also talked about certain core exercises that were bad to do such as crunches and Russians, because they put a significant amount of stress on the lumbar spine. He talked about other exercises that are excellent for the core and are safe such as planks.
The importance of strengthening your gluteus muscles was also emphasized because that also reinforces core strength.
Nick informed the fitness instructors at the Norton Commons YMCA about the benefits of working unilateral exercises. He also provided medical reasons why intervals are important to the workout regimen. And he offered guidance about how to organize exercises.
Exercise organization should be a progression, as explained by Nick. For example, it’s easier to do a box jump then jumping over a box. The progression in working out should start with the core, and then go to the upper body and finally, the lower body.
Dr. Grossfeld is a board member of the Norton Commons YMCA and a very active gym member. She (more…)
Orthopaedic Specialists Kicks Off Monthly “Rock That Cast” Contest
Are you a current patient at Orthopaedic Specialists? Are you currently wearing a cast? If you answered YES to both questions, we’ve got a great contest for you, complete with the opportunity to win a $50 gift card. Check out the flyer below for details and show us how you Rock that Cast!
Louisville Orthopedic Team Supports Breast Cancer Awareness
The entire team at Orthopaedic Specialists in Louisville, Kentucky, is dedicated to supporting Breast Cancer Awareness and to finding a CURE for breast cancer and every other type of cancer too. We’ve got some very personal reasons why we are wearing PINK this month that we’d like to share with you…
Lindsay Rhodus – “I wear pink! I wear pink for ALL the women who have fought and lost, I wear pink for ALL who have fought and won, I wear pink for ALL who will fight, I wear pink for families, friends, moms, dads, brothers, sisters, aunts, uncles, cousins, and co-workers, I wear pink TO FIND A CURE!”
Angel McDowell – “I wear pink to support the fight against breast cancer. I represent my mother who lost her fight with ovarian cancer 3 years ago, so I will give my all to support the fight to find a cure for cancer.”
Rhonda King – “I wear PINK in honor of my mom who passed away 12 years ago from Metastatic Breast Cancer at the age of 56.”
Dr. Stacie Grossfeld – “I wear pink for all my girlfriends that are fighting this disease. It is in support of them and their families, and to promote cancer research.”
Dorothy Cochran – “I wear Pink for my Grandma Dorothy who passed away 35 years ago after a very long battle. Although I have never had the opportunity to meet her, I know she was a fighter and I’m happy to have been named after her. I support the cure for her!”
Heather Hardiman – “I wear pink for my very good friend Ginny, she is a 2 time survivor!”
Angel Porter – “I wear pink for my “sis” Glenda!!”
Tisha Robison – “I wear pink for my aunts and friends who have gone through and will go through this battle. I wear pink to remind myself and others to do the testing and to never give up on the fight!”
Marti Spencer – “I wear pink for my very good friend Tammi Poole. She is the bravest woman I have ever met in my life. I watched her during her struggle and the effects it had on her mentally, physically, emotionally as well as the effect it had on her family. She was always positive, upbeat and STRONG!!! She is now in remission and has kicked Cancer’s tail!!! She is my Hero!!!!”
Jennifer Yocum – “I wear pink to support all women who are fighting this horrific disease and to remind all of us to perform monthly breast exams, get yearly exams by a physician and mammograms.”
Meghan Dawson – “I wear pink for Aunt Amy & Aunt Bridget who are both Breast Cancer survivors!”
10 Facts About Your Spine
World Spine Day is recognized annually on October 16 as a way to raise awareness about disorders of
the spine and spine health. The spine is a very important part of your body. Learn more about your spine with the following facts.
10 Facts About Your Spine
- Back and neck pain is one of the most common reasons for workplace sick leave.
- Your spine is made up of small bones, called vertebrae, which are stacked on top of one another. Your spine also includes various muscles, ligaments and nerves.
- There are seven vertebral bodies in your cervical spine, twelve in your thoracic spine and five vertebral bodies in your lumbar spine.
- Half of the working population will experience back or neck pain symptoms at least one time per year.
- In a recent study, low back pain ranked as one of the most “disabling” conditions and sixth in terms of usage of health funding.
- One in three Americans (33 percent) older than age 18 required medical care for a musculoskeletal condition for each year from 2009 to 2011. This represents a 90% increase from the previous decade.
- When somebody has a disc herniation, most of their pain is typically down one or both legs with only some of the pain in the low back or buttock area.
- Osteoarthritis of the lumbar spine or spinal stenosis typically causes pain that is localized in the low back area and it does not radiate down the legs.
- Degenerative disc disease happens when the intervertebral disc begins to wear down. These discs will become smaller in size and provide less cushion between the bones in the back. It can cause the back bones to rub together which leads to stiffness and pain.
- Physical therapy and conditioning can significantly help people with low back pain.
10 Facts About Osteoarthritis on World Arthritis Day
World Arthritis Day 2015
Arthritis affects millions of people around the world. And nearly 40 million Americans have some kind of arthritis including millions of children. Over 20 million people in the U.S. have osteoarthritis.
Osteoarthritis is a joint disease characterized by the degeneration of joint cartilage in your body. It can affect any of your joints including hands, hips and knees. Follow along to learn more important facts about osteoarthritis from Louisville orthopedic Dr. Stacie Grossfeld.
Top 10 Facts about Osteoarthritis
- Osteoarthritis causes the breakdown of articular cartilage. Articular cartilage covers the ends of the long bones that form a joint.
- Osteoarthritis is progressive: it advances with time.
- Osteoarthritis is currently irreversible.
- Osteoarthritis causes swelling and joint enlargement.
- Treatment goals are to control joint swelling and pain, and to maintain range of motion and strength.
- Obesity is associated with osteoarthritis.
- There are specific exercises that are for osteoarthritis. These exercises help maintain strength and range of motion.
- Supplements such a glucosamine may help reduce osteoarthritic symptoms.
- Injections that help to reduce osteoarthritic symptoms are cortisone and hyaluronic acid.
- Joint replacement is reserved for people with osteoarthritis who have failed non-surgical treatment options.
Suffering from Foot Pain? Here’s an Overview of 7 Common Foot Injuries
Your feet are responsible for many different functions. These flexible, complex structures are comprised of several different components including tendons, muscles, joints, bones and tissue. All of these important pieces work together to help us perform many different physical activities and navigate through life.
7 Common Medical Conditions That Cause Foot Pain
Foot health is extremely important for continuing an active and healthy lifestyle. It is easy to take your feet for granted until you experience some type of foot injury. Here are seven types of foot injuries that require special attention and treatment. While there are many different kinds of foot injuries, these tend to be some of the most common.
- Gout: This complex form of arthritis brings about sudden severe attacks of pain and tenderness to the joint at the base of the big toe. If you begin to notice redness, swelling and heat around this area, it could be gout. This condition is mostly caused by a buildup of uric crystals in your blood. You should seek medical attention if you are experiencing this type of pain in order to get an accurate diagnosis, and if necessary, get treatment.
- Bunions: While this disorder may be caused by wearing tight shoes or through genetics, this bony bump can become a larger issue. Bunions begin to form after prolonged periods of pressure between the big toe and second toe. This condition tends to bring about toe pain and swelling. If this problem persists, it may potentially cause other foot and toe injuries.
- Morton’s Neuroma: People often complain about the feeling of standing on a pebble when experiencing Morton’s neuroma. This nerve condition causes a buildup of tissues and nerves around your toes and ball of your foot. The pain may leave your toes stinging or going numb without proper treatment. It can become painful to walk if left untreated.
- Plantar Fasciitis: This condition is mostly described as intense heel pain. The thick band of tissue, called the plantar fascia, becomes inflamed and produces stabbing pains in your heel and midfoot. The pain associated with plantar fasciitis tends to be more severe in the morning and after sitting for a prolonged period. This can be treated through stretching, wearing proper footwear and other medical remedies.
- Hammertoe/ Mallet Toe: While the name might sound frightening, this simple foot injury or deformity is often caused by wearing improper footwear. After wearing shoes with a narrow toe box or high heels, pressure builds up to create an unnatural bend in your toes. Treatment for this condition typically requires a change in footwear and some new stretches.
- Achilles Tendinitis: This tends to be an overuse injury caused by continuous movement or activities that engage the calf muscles and heel bone. Runners are most commonly plagued with this injury. The pain associated with achilles tendinitis runs from the back of your calf down into your ankle and foot. While tenderness and stiffness may occur, the best treatment options include stretching and choosing a new shoe.
- Bursitis: This common foot injury is a condition that can occur all over the body. Bursitis is caused by continuous overuse in and around joints. These fluid filled sacs tend to become inflamed after performing repetitive motions and have been known to cause severe pain around the big toe. Treatment requires rest and a shift to different types of physical activities to avoid prolonged repetitive pressure on your feet.
Common Complications after Total Hip Replacement that Lead to Patient Dissatisfaction
Total hip replacement is an increasingly popular operation that can significantly improve the quality of the lives of the patients that undergo the procedure. A total hip replacement can significantly reduce pain, improve range of motion of the joint and lead to a more active life.
On the other hand there are sometimes complications after total hip replacement that can lead to a poor result, and even require revision surgery. According to research by Drs. Mark Dwyer, Victor Goldberg and Glenn Wera, as reported in the July 2015 American Academy of Orthopaedic Surgeons (AAOS) journal, the most common complications of total hip replacement surgery that can lead to a poor result are: hip dislocation, infection and osteolysis (or the destruction/disappearance of bone tissue).
According to the researchers, there were approximately 332,000 total hip replacements in 2010 with a 3.9% dislocation rate. Risk factors for complications after total hip replacement can be divided into two major groups: 1) patient-related and 2) surgically-related.
Risk factors that are associated with complications following a total hip replacement include the following:
- Female gender
- Advanced age
- Obesity
- Poor compliance
- Elevated American Society of Anesthesiologists score
- Previous hip surgery
- Neuromuscular conditions
Surgery related risk factors associated with problems following a total hip replacement include the following:
- Surgical approach
- Component position
- Restoration of leg length and offset
- Implant choice
- Soft tissue repair
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