Introducing the first-ever mascot specialist doctor at Midwest Orthopaedics at Rush

Introducing the first-ever mascot specialist doctor at Midwest Orthopaedics at Rush – the one and only Benny The Bull!

Chicago recreational basketball player recovers after Achilles rupture

basketball patient

“I heard a ‘bang’ and then felt as if someone stomped on the back of my left calf, slamming me down to the court. But, when I looked up, both the basketball and the other players were all several feet away staring at me. That’s when I knew I likely had a serious problem.”

This is how Ganesh Sundaram, 31, of Chicago, describes the incident that left him with a ruptured left Achilles tendon earlier this year. “I was playing with a bunch of friends on the weekend and went up for a rebound. Then, I quickly reversed my direction to get back on defense,” he explains. “I later found out that this rapid deceleration followed by acceleration and change of direction is a common cause of injury to the Achilles tendon at the back of the heel.”

He felt numbness, then pain as he limped off the court. He went directly to the nearest emergency department where the physician on duty conducted the Thompson test to determine whether or not his Achilles tendon was intact. After his foot hung loosely when his calf was squeezed, the physician told him it was most likely a full rupture and should see a foot and ankle specialist right away. Sundaram, at the suggestion of his brother-in- law (a Chicago-area physician), made an appointment with Dr. Simon Lee of Midwest Orthopaedics at Rush. Dr. Lee, an expert in treating Achilles injuries, confirmed the diagnosis and presented options for both surgical and non-surgical repair of his tendon.

Given Sundaram’s very active lifestyle which included a regular fitness and full-court basketball regimen, Tough Mudder/Spartan races and keeping up with his toddler son, he chose surgery given the higher likelihood of returning to full pre-injury function, strength and mobility. They also discussed the warning signs that Sundaram experienced several months earlier. After running in high heat while dehydrated and on vacation, Sundaram felt stiffness and pain in his left Achilles tendon when getting up after a long flight home.

Concerned, he took a rest from running, jumping and basketball for a few weeks but maintained the rest of his fitness regimen. He then resumed these activities once he felt minimal discomfort, but didn’t do any pre-activity stretching or warming up and he didn’t see a physician. Midwest Orthopaedics at Rush foot and ankle physicians explain that this scenario is becoming more and more common in their practices. “Over a recent ten-year period, we have seen our number of Achilles patients increase by almost 300 percent,” explains Dr. Lee.

So many more people are participating in extreme sports, like Tough Mudders, marathons and Spartan Races. They aren’t stretching or strengthening their Achilles tendons properly – or at all. We also see lots of weekend warriors who do the same thing.

For both types of athletes, Dr. Lee and his fellow foot and ankle physicians created aMOR300x250 useful resource for athletes to keep their ankles and tendons healthy called ‘Ankles for Life’. It includes injury prevention tips in both a downloadable brochure and video format. It was developed in conjunction with the Illinois Athletic Trainers Association. Sundaram, who is now back to basketball and working out, knows that he should have listened to his body when he had heel pain several months before the rupture.

“Dr. Lee told me that surgeons have a saying that ‘healthy tendons don’t rupture’. Mine was irritated or maybe even partially torn at the time and I should have attended to it earlier,” he says. Sundaram now incorporates lower body and heel stretching and strengthening into his routine before any sports activity – and encourages all athletes to do so.

For more information on preventing Achilles injuries and to request a gym bag tag with ankle injury prevention tips, visit the Ankles for Life website.

To schedule an appointment with Dr. Simon Lee to discuss your foot or ankle condition, click here or call 877-MD- BONES.

Meet the White Sox’s New Top Doc

Head team physician discusses his role keeping players on field

Dr. Nik Verma from Midwest Orthopaedics at Rush will be discussing his new role with Dr. Brian Cole & Steve Kashul on ESPN Chicago, Sports Medicine Weekly this coming Saturday, April 8th at 8:30AM . Tune in to WMVP AM 1000 to hear how he and the other team physicians at Rush help keep Sox players healthy through the long baseball season.

Exercise Caution

How to stay safe while keeping fit

Exercise is essential to good health. But if you don’t use common sense while working out, you’re putting yourself at risk for injury.

As a primary care and sports medicine specialist at Rush University Medical Center, as well as a team doctor for the Chicago Bulls and Chicago White Sox, Kathy Weber, MD, MS, sees firsthand the injuries that can result from overdoing it or not using proper form during physical activities.

Here, she offers advice for safer workouts — and explains why the latest exercise craze can potentially do more harm than good.

Common exercise-related injuries.

Exercise-related injuries are commonly overuse injuries, such as stress fractures, muscle strains, patellar tendinitis or rotator cuff tendinitis, and illiotibial band syndrome (a hip disorder from injury to the thick band that runs from your hip to the outside of your knee). Basically, any activity that involves repetitive movement — running, cycling, hitting a tennis ball, swinging a golf club, etc. — can cause damage to a specific area or areas of tissue over time.

Injuries can also occur when you’re not properly conditioned for a certain type of exercise, or when you return to an activity too quickly and don’t give your body time to adjust to increased levels of activity.

Always start out slowly in terms of both the duration and the intensity so your body has time to adapt. You should gradually increase first the amount of time and then the intensity level of your workouts. Depending on your level of conditioning when you get started, you may do only 15 to 20 minutes per workout the first week or two. But that’s OK.

After you’ve built up your endurance and have a great baseline, then you can start to work out at a higher intensity. If you do a gradual build, you’ll be a lot less likely to end up with overuse injuries.

Also, make sure that you’re giving your body a sufficient recovery period between activities. Recovery time should always be individualized. Initially, a day or two in between exercise bouts should be adequate, but make sure to listen to your body.

Clues that you are not allowing enough recovery time may include continued muscle soreness and/or fatigue. If you try doing high intensity workouts seven days a week, the risk of breaking down and sustaining an injury is high. Your body needs time to recover and rebuild. That’s true even for elite athletes. They train hard, but they also take time to rest.

Yoga safety.

It’s interesting that yoga is generally perceived as this relaxing Zen kind of thing. But the thing about yoga is that it can involve getting into positions that your body hasn’t adapted to, and that’s when injuries may occur.

If you’re starting out and have never done yoga before, use common sense as you would with any type of exercise program. If your body doesn’t seem able to get into a pretzel position, that’s probably not a good position for you. If you feel pain, that’s a sign something’s wrong.

When you’re in a class setting, you may push yourself too hard because everyone around you is doing these positions, so you think you should be able to do them, too. You may feel a bit of embarrassment or self-consciousness. What you need to remember is that some of these people who make it look so easy have been doing yoga for a long time.

Just take a moment and ask yourself, “Does this seem like a position that is comfortable for my body? Since I’m just starting this, should I really be trying to put my foot behind my head?” If you ease into it and use common sense, you’ll be less likely to get hurt.

We all want to get in shape and lose weight yesterday, but as we get older, it takes more time for the body to adapt to changes. You have to think of exercise as a lifelong pursuit — it’s a marathon, not a sprint.

No pain, no gain? 

It’s true that you might experience a little muscle soreness from exercise and feel achy the next day. But pain is always an indicator that something is not right. If you have pain that’s not going away on its own, and if that pain is affecting your quality of life — including your ability to participate in physical activities — you should get it checked out.

When we say “no pain no gain,” we’re talking about Olympians and high level athletes who are really pushing hard to achieve and excel and be competitive. For everyday folk, “no pain no gain” shouldn’t be the mantra. You should feel like you worked out hard, but you shouldn’t feel like you have to sit down because you just killed yourself.

Most strains heal on their own within 4 to 6 weeks. But for instance, if you’re at the gym and you tweak your shoulder, and it’s still bothering you after a couple of weeks of rest and ice, make an appointment with an orthopedic specialist.

Don’t try to tough it out, and definitely don’t engage in activities that may make the injury worse. Of course, if you’re exercising and you feel something pop and have immediate pain or swelling, or if you hit your head, you should see a doctor right away.

The reality of DVD-based workout programs.

People assume that if there’s a hot new program like P90X that everyone — including celebrities — is trying, it must be the best program. But what’s right for one person isn’t necessarily right for another.

The reality is, I’ve seen a lot of P90X injuries in my practice. You’re given a DVD featuring someone who is supposedly an expert in their field, and you’re trying to mimic the exercises with no supervision. No one is telling you if you’re doing everything correctly; you’re just following a DVD.

But what you need to keep in mind is that there are some exercises people with certain conditions shouldn’t do. For example, if you have knee problems, you may not want to do exercises that are high impact or require you to twist your knees.

If you want to try a DVD-based program, I suggest not trying to do the whole DVD the first time. P90X is a 90-day program, and that’s a lot of exercise for the body to adapt to quickly, which is why it’s easy to injure yourself.

Start out doing 10 to 15 minutes at a lower intensity, and if an exercise doesn’t feel comfortable or you’re not sure about the proper way to do it, skip that particular exercise. Gradually increase the amount of time you spend on the workout. Once you’re able to do the whole DVD at a moderate level of intensity, then you can start to increase the intensity.

We all want to get in shape and lose weight yesterday, but as we get older, it takes more time for the body to adapt to changes. You have to think of exercise as a lifelong pursuit — it’s a marathon, not a sprint.

Creating a safe and successful exercise program

I would say the key is doing a variety of exercises — asking your muscles to do some different activities and working different muscles in your body, giving specific muscle groups breaks. Also, your program should include flexibility, strength and aerobic components. That’s extremely important.

If you’re stronger, you’ll have better endurance and be less likely to sustain injuries. People like to do activities at which they excel. I have patients who are very flexible and don’t need to work on their flexibility, but they are drawn to activities that require greater flexibility, like yoga, because they’re good at it. I also see people who are very good at aerobics, and that’s all they want to do; they don’t want to lift weights.

But they should be doing some weight training because fitness is really about balance: You need to have good flexibility, good strength and good aerobic conditioning to optimize your body’s overall condition.


Custom-Fitted Spine Implants

Personalized rods may improve outcomes, cut surgery time

spine_colman_storyCustom fit is the key when it comes to spinal implant rods, which an estimated 38,000 people need each year. This need is especially great for people who have a spinal deformity such as scoliosis, which causes the spine to twist and turn into complex and sometimes dangerous positions. In 2010 and 2011, an estimated 1.6 million people received treatment for scoliosis according to the Bone and Joint Initiative, a consortium of professional medical societies.

Correcting this deformity involves moving a distorted spine into a different position, which is no simple task. To accomplish it, surgeons attach metal rods to the bones surrounding the spinal column in order to support and straighten the spine.

To perform this demanding procedure, surgeons previously needed to be as much a sculptor as a physician. Over the years, they have mastered the art of cutting, bending and twisting metal rods to fit each patient.

Often, however, this manipulation may create weak spots in the rod where it can break in the future. In addition, the manipulation of the rods traditionally has been done in the operating room during surgery, adding to the time a patient spends in surgery under anesthesia.

Now, however, advances in medical imaging and implant manufacturing are making it possible to tailor an implant to the patient receiving it.

Matthew Colman, MD, has begun using patient-specific rods in reconstructive surgery — giving patients with spinal deformities implants designed to fit their anatomy perfectly. An assistant professor of orthopedic surgery at Rush University Medical Center, Colman is one of few spinal surgeons in the world who also specializes in spine cancer treatment and was one of the first doctors in Chicago to use these patient specific rods.

The customization is done in advance of the operation in cooperation with an implant manufacturer. To create the rods, Colman uploads the patient’s calibrated X-rays to a computer. Then he uses a sophisticated software program to plan the reconstructive surgical procedure.

The software allows him to simulate deformity correction and other surgical maneuvers in order to map out and determine the exact length and shape of the rod. The specifications are sent to the manufacturer, and the finished rod is delivered to Rush.

Because so much of the planning is done before surgery, less time is needed during the operation itself. “When we reduce time operating room we help to decrease the chances for infection and blood loss during surgery — and we decrease potential mistakes with the measurements,” Colman says. “In addition, manipulating the rod by hand-bending them may cause them to break more easily, which is theoretically avoided with the custom manufacturing process.”

In addition to custom-made spinal rods, Colman has also been involved in the design of patient-specific 3-D printed vertebral cages, which are used to provide anterior (frontal) support for spinal reconstructions when the area in front of the spine has been MOR300x250destroyed or removed due to infection, a tumor or trauma. The cages are in the process of receiving U.S. Food and Drug Administration approval for use in the United States.

“The future of implants is in customization,” Colman says. “New technology is streamlining the process, making surgery more efficient and effective by employing faster and better working methods.”

Preventing ACL Injuries

Dr. Adam Yanke, MOR sports medicine physician, recently sat down to discuss a study that showed athletes with fatigue are at higher risk for anterior cruciate ligament (ACL) injuries. One of the ACL injury prevention programs that Yanke recommends for young athletes is Knees For Life (, which offers a downloadable brochure and an opportunity to obtain complimentary gym bag tags featuring warm up exercises and other prevention strategies.