Spring Training is Injury Prevention Time for Young Pitchers

Spring Training is Injury Prevention Time for Young Pitchers

With the Cardinals back at spring training in Florida, youth baseball players in the St. Louis area are also returning to the cages to begin their preseason training regimens. For many young pitchers, that means restarting a throwing program after at least a few months off. Having grown and developed in the off season, they’re finding their balance and release points again, and maybe trying out a new pitch or two.

Though it’s fun to focus on those mechanics, players and parents should also remember that preseason is an exceptionally important time to do the work necessary to keep young arms healthy through the long season to come. Arm care isn’t just about counting pitches. The strength and flexibility training young pitchers do in the preseason can mean the difference between ending the season as an all-star and having season-ending surgery.

Benefits of a Preseason Throwing Injury Prevention Program

In 2016, research presented at the American Orthopaedic Society for Sports Medicine (“AOSSM”) Specialty Day reported that a preseason injury prevention program was shown to significantly diminish the risk of a throwing injury in youth pitchers. In the study, young pitchers participated in a program consisting of resistance training with dumbbells and elastic bands, focusing on flexibility exercises four times per week for at least fifteen minutes per session. The results found that they were four times less likely to suffer a throwing injury than a comparable group of pitchers who only followed a normal preseason throwing regimen. Quoted in the AOSSM press release reporting the findings, one of the study’s corresponding authors emphasized that encouraging “parents, coaches, and youth baseball organizations across the country to adopt similar programs [may give] athletes… a better chance for reducing time off the field because of injury.”

Resources for Developing Your Preseason Throwing Injury Prevention Program

You can find guidance from the National Strength and Conditioning Association on preseason training for youth baseball players here.

Parents, players, and coaches with questions about developing a preseason throwing injury prevention program should consult a certified athletic trainer, or contact our team at Missouri Orthopedics and Advanced Sports Medicine today.

When is a Meniscus Tear Repairable?

When is a Meniscus Tear Repairable?

According to the American Academy of Orthopaedic Surgeons, one of the most common knee injuries is a tear in the meniscus. These rubbery pieces of cartilage act as shock absorbers in the knee to cushion and stabilize the knee joint. There are two menisci in each of your knees: one on the inside of the knee and one on the outer side.

Treatment of a meniscus tear depends on a number of factors, including the type of tear, its size and where the tear is located on the meniscus. Most meniscus tears result either from trauma or are degenerative. Traumatic tears come about from a twisting of the knee, often while engaged in sports and physical activity. Degenerative tears can occur as the body ages and tissue gradually breaks down over time.

The outer one-third of the meniscus has a rich supply of blood flow, which is important for any part of the body to heal. The inner two-thirds, however, have little to no blood flow. Nutrients from blood are necessary for the body to heal naturally, so when there are tears in the inner part of the meniscus, surgical trimming and removal of the torn piece is generally the best option.

Tears in the meniscus that are located near the outer edge of the knee are typically the result of trauma and are longitudinal – basically following parallel to the long side of the meniscus. This makes these injuries the best candidates for surgical repair.

Arthroscopic surgery for such tears can be very successful at repairing the damage. This is a minimally invasive treatment, as only a few small incisions in the knee are needed. A miniature camera is inserted in one incision, and surgical instruments are inserted in the others, allowing the surgery to all take place within the knee. The tear is closed by stitching the torn pieces together.

Recovery time from a meniscus repair is longer than for surgery where part of the meniscus is removed because the tissue must heal together, requiring 3-4 months away from sports. However, you can expect to fully return to your previous level of activity once healing is complete.

If you have sustained a knee injury or are experiencing knee pain, contact us at Missouri Orthopedics and Advanced Sports Medicine. Dr. Irvine has extensive experience in treating knee pain and injuries, and is trained in the most advanced techniques in arthroscopic surgery.

At-home Exercises For Retired People

At-home exercises for retired people can be an efficient way to bridge the gap between health and comfort. After spending years laboring hard in the work-force, spending time commuting and sitting behind desks or working long hours on the floor it can be a blessing to be able to enjoy the comfort of one’s home. Comfort can at times get in the way of the regular exercise our bodies need in order to stay physically as well as mentally fit.

Dr. David Irvine has extensive experience treating patients who suffer from joint and tendon disease which can sometimes occur due to lack of sufficient resistance exercises. Let’s spend some time and talk about how an active retired person can remain healthy by following a few exercises at home, whether in the comfort of the living room or braving the outdoors.

How does inactivity lead to weaker joints and tendons?

Looking at the human body one might think that the parts make up the whole. However, unlike a car, the body doesn’t have components which can be treated as stand-alone parts. The knee, for example, requires adequate muscle mass in the hamstrings, gluteus muscles as well as the calves in order to protect it during exercise or even when going for a walk.

Strength is not the only factor, tendons are part of the equation as well, requiring adequate elasticity in order to allow proper movement of the knee-joint. Weak tendons can allow for unstable motions of the knee and if in turn these structures are too tight they may cause excess wear and tear of the sensitive joint surfaces.

In medicine we have learned that a sedentary lifestyle inevitably will lead to decreased muscle mass and tighter tendon structures. The main reason for this is nerve stimulation, the lack of which decreases the blood supply to these structures causing them to become less important to the body which in turn causes degeneration – or simply put, if you don’t use it, you might lose it.

Combining daily indoor activities with exercise

You likely have common daily routines at home which may offer some relaxation such as listening to podcasts, reading a magazine or watching entertainment/news on TV. Combining exercise with such activities is the most efficient way to get mental as well as physical stimulation.

  • Stand at the kitchen counter with you feet close together, flex your calves and raise your heels off the floor and lower your weight down to a count of 5 seconds.
  • When seated on that comfy couch raise one leg at a time up to the level of your pelvis and lower it down and repeat with the other leg.
  • When listening to your favorite podcast or news source stand with your feet at arm’s-length away from the wall and gently lower your weight into the wall, performing a standing push-up.
  • Don’t forget that cleaning your home manually is an exercise by itself. A good rubdown of the counters and that circular polishing motion of the interior mirrors will definitely get your heart pumping and provide a wonderful upper body resistance exercise.
  • A couple of inexpensive 10-lb dumbbells should be used to perform biceps curls by standing erect with arms at your sides while flexing the biceps and bringing the weights to your shoulder.
  • A variation of the above exercise is to then go from the flexed biceps position directly into an overhead press by pushing the dumbbells over your head and straightening the arms as if reaching for the stars.

Exercising the body in your outdoor space

  • Gardening is one of the most meditative and laborious activities you can do in your outdoor space. Aerating the lawn, plucking weeds, planting flours and vegetables serve as wonderful exercises.
  • If you have room for potted plants consider adding them to your garden, besides requiring watering such plants need to be regularly re-potted – this is less of a chore and more of an exercise – said the optimistic doctor.
  • Consider waking up early and performing a Tai chi routine before you start your day either out on your patio, in front of some beautiful plants or under the shade of your tree.
  • Don’t let those stairs stop you, if you have stairs leading up to the house then turn on some music and go up and down them daily to provide stronger quads and calves.

Limitations to exercise

At our practice we often encounter patients who have given up exercising either because they are unable to get to a nearby gym or are limited by aches and pains.

The former is easily remedied by performing some simple home exercises as outlined above. Get creative and use common household items to perform resistance exercises.

The latter is a common concern. Patients often associate pain with causing damage. This isn’t always the case but it certainly is worth investigating. If you are trying to be more active but constantly experience pain in a specific part of your body please don’t ignore it. Dr. Irvine’s experience with muscles, ligaments and joint pains allows him to differentiate between benign pains which can be overcome with changes to your exercise routine while identifying more serious disease processes which may require proper intervention such as advanced arthritis, frayed tendons, inflamed joint surfaces etc.

We hope that you gained some useful tips from this article regarding home exercises. If you are experiencing aches or pains while doing them please contact us so that we can guide your exercise better.

Hip Arthroscopy Recovery Tips

How to Boost Your Recovery after Hip Arthroscopy

Having hip arthroscopy is scary when you do not know what to expect afterwards. Science has found that psychological stress is detrimental to the body’s healing process and can prolong your recuperation. Learning how to prepare for the typical recovery period before your scheduled surgery will help ease your mind and give you time to make arrangements for the necessary post-procedural support. These are all great questions to explore with Dr. Irvine before you have hip arthroscopy:

  • How long will you experience pain during your recovery? Recovery from joint surgery is different for each person. It is not unusual to experience pain and soreness for 3-6 months after the procedure. Talk with Dr. Irvine about pain control methods that will work best for you. Keeping on top of your pain levels reduces your psychological stress and aids in your healing process.
  • Will you need to use a walker, crutches, or a cane? Crutches are used for the first 2 weeks (possibly up to 6 weeks) after the procedure so that you are not placing weight on the affected side.
  • Will you need to stay at an inpatient rehabilitation facility afterwards? Typically this is not the case, however, inpatient rehabilitation may be required in rare instances and Dr. Irvine can address this with you.
  • When should you expect to start physical therapy? A post-operative appointment is scheduled about a week after the surgery to remove any stitches and check on your progress. During this visit Dr. Irvine will assess if you are ready to begin physical therapy, which often begins the following week.
  • How long does physical therapy usually last? The usual course of physical therapy is 2-6 weeks, though this varies from patient to patient.
  • Who will help you at home and transport you to your appointments? Enlist a friend or family member to stay with you for at least the first few days after the procedure. You will need assistance with activities of daily living, such as preparing food, toileting, and bathing. If you anticipate needing additional help, you may wish to arrange for visits from a home healthcare service.
  • When will you be able to start driving again? You may be able to drive as soon as a week after the surgery if Dr. Irvine clears you to drive at your initial post-operative appointment. Talk with Dr. Irvine to find out what criteria is used to determine when you will be ready to drive again.

At Missouri Orthopedics, we strive to help you achieve your mobility goals so you can get back to the activities you enjoy. Please contact us to find out how we can serve your physical rehabilitation and orthopedic needs in the Greater St. Louis area.

Advancements in Knee Arthoscopy

Crystal Ball Technology

Advancements in Knee Arthoscopy, Missouri Orthopedics and Advanced Sports Medicine

Most of us are familiar with arthroscopic surgery. This procedure uses tiny cameras and tools to explore and/or repair joints. The word root “arthro-“ actually means joint. Therefore, virtually any joint in the body, such as hip, elbow and knee, can be helped with the use of arthroscopy. The knee is probably the one most people think of when they hear “arthroscopy”, and an estimated one million people in the U.S. are expected to have the procedure performed this year alone.

Synovial fluid is located in each of our joints. This fluid has been used in the past to determine causes or severity of conditions involving those joints. A small sample is taken of the fluid and sent to a lab for analysis. It can be used to test for several disorders, but for our purposes, let’s concentrate on inflammation and degenerative diseases. Typical testing checks the physical appearance of the fluid, including color and clarity. The chemical composition is analyzed. Synovial fluid is comprised of glucose, protein and uric acid. Fluctuations in any of one of these components will signify certain issues are present. For example, lower than expected glucose levels would indicate problems with inflammation or infection.

Researchers have now discovered that these same synovial fluid biomarkers can be an indicator for predicting postoperative outcomes. There are several factors, such as age and duration of symptoms, which were included, along with the biomarker data, to help determine potential results. In other words, physicians would be able to tell how a person will respond after surgery and how successful the procedure will be for each patient.

Much of the terminology and chemical names are meaningless to a non-scientist, but one of the items looked at was T-cell response. T-cells may sound familiar to most as they are mentioned frequently in regards to cancer. They are part of the immune response system, and in cases of infection and inflammation, they are stimulated to respond in an effort to slow down or stop certain processes.

In the near future, surgeons may be able to provide patients with a fairly accurate prognosis regarding their recovery time and expectations after surgery using this technology, much like a prognostic crystal ball.

If you or someone you know is experiencing knee pain or discomfort, please contact us to set up a consultation.