Do High Schools Need Athletic Trainers?; Understanding Elbow Injury; Advancements in Regenerative Medicine

Episode 17.02 with Hosts Steve Kashul and Dr. Brian Cole. Broadcasting on ESPN Chicago 1000 WMVP-AM Radio, Saturdays from 8:30 to 9:00 AM/c.

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Segment One: Katie Varnado from ATI Physical Therapy talks about the responsibilities and qualifications for Athletic Trainers, the difference between pro & non-pro team trainers, the importance of having High School Trainers and how to promote their use.

Katie Varnado is a certified and licensed athletic trainer who is passionate aboutKatie Varnado educating others about concussions, growth plate injuries in athletes, and the need for athletic trainers. In her role as Sports Medicine Director at ATI Physical Therapy, she oversees and provides guidance to the athletic trainers ATI provides to local high schools and colleges and ensures all athletes are receiving comprehensive care to return to sport as quickly and safely as possible.

Katie received her bachelor’s degree in kinesiology with a concentration in athletic training from Illinois State University.  She then went on to earn a prestigious year long sports medicine fellowship at the Steadman Hawkins Clinic in Vail, CO.  Katie has over fourteen years of experience working with both collegiate and high school athletics as well as working with physicians.


Segment Two: Steve and Dr. Cole discuss the various types of elbow injuries, causes and treatments. Dr. Cole describes the many new and interesting advancements in Regenerative Medicine and Stem Cell Therapy – the future of research and applications.

Related Posts: 

Improve your Understanding with 3D Animation on UCL Reconstruction (Tommy John Surgery)

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Limiting Innings Pitched after Tommy John Surgery for MLB Players

Shoulder and Elbow Overuse Injuries

Overuse Injuries in Young Athletes


  

Concussion Alters Neuromuscular Function in Collegiate Athletes

Despite being cleared to return to play following a concussion, research has suggested that athletes may be at a greater risk for other kinds of injuries – namely, those affecting the lower extremities. However, the mechanism for this increased risk of a lower extremity injury after a concussion is unclear. Neuromuscular changes following concussion that persist beyond return to play may contribute to this increased injury risk.


In this study, the investigators identified altered lower extremity stiffness in the hip, knee and leg stiffness in a jump-landing task – finding this increased stiffness in athletes who had sustained a concussion when compared to uninjured matched teammates.


Changes in lower extremity stiffness have been shown to be a risk factor for lower extremity injury. Clinicians may need to include neuromuscular measures during concussion treatment programs. This may improve patient outcomes and decrease risk of lower extremity injury when these individuals return to sports activity.

For more information, view the abstract

The Gift of Bone -Twice!

By Matt Arrasmith, tissue recipient

m-arrasmithLike most boys in middle school, sports were my passion.  I played baseball, basketball, football, ran cross-country and enjoyed pretty much anything where I was active.  When I was in the seventh grade, I began to experience knee pain – but as most teenage boys would be told, it was shrugged off as just growing pains. As the years passed, the pain continued to get worse and finally my parents took me to the doctor where they did an x-ray of my knee.  At first it appeared that nothing was wrong, but thankfully my doctor delved deeper. Little did I know, my world would be turned upside down.

I had just turned 15-years-old, in March of 1996, when I was diagnosed with bone cancer in my leg.  My parents and I were told the particular type of cancer I had, chondrosarcoma, does not respond to chemotherapy and the most common treatment is amputation. This was devastating news. To say that we were matt-grad2stunned was an understatement. This would have meant as a 15-year-old athletic young man, my left leg would have been amputated at the hip.  My life would never be the same.  It is pretty rare that this cancer is contained within the femur but I was told that my tumor was contained. Because of that silver lining, my doctors recommended a brand new procedure.

They suggested that the six-inch portion of my femur containing the tumor be taken out and replaced with donor bone. I underwent three surgeries, including a 12-hour procedure, and then spent about a year on crutches. Today, after a total of six surgeries on my leg, including one in 2011 where I received a second amazing gift of donor bone, I am still walking and enjoying life. And, unfortunately while playing certain sports is no longer an option, I still have my leg!

m-arrasmith-dartsI took part in the 2016 Transplant Games of America, playing Texas Hold ‘em poker, bowling and golf, thanks to the generosity of my donor. It was an awesome experience, meeting people from across the country who have been touched by organ, eye and tissue donation.

I am thankful to all of the doctors that helped drastically change my life. But I am most thankful to my two bone donors – I was incredibly lucky to have had the option of using donor bone to save my leg – and my life as I know it. Won’t you say “yes” to organ, eye and tissue donation?

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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.”

New study suggests strategies for keeping off pounds

You’ve succeeded in losing weight. Now, what can you do to keep the pounds off? Most people seem to struggle with long-term weight loss. By some estimates, only about 20% of overweight individuals are successful in keeping off at least 10% of their initial body weight for a year or longer. A new study, however, suggests that using specific strategies — such as weighing yourself regularly and planning for situations in which you might backslide — could modestly slow the rate of weight regain in obese adults who have lost weight.

In the study, employing such strategies in a maintenance program increased theHow to really lose weight proportion of adults who stayed at or lowered their weight, after initial weight loss, by 13.9 percentage points, said Corrine Voils, research career scientist at William S. Middleton Veterans Memorial Hospital in Madison, Wisconsin and lead author of the study. However, more research is needed to determine which specific strategies offered the most benefit and which may have not had much of an impact. The study, which involved mostly men of various races and involved self-reports, was published in the journal Annals of Internal Medicine on Monday.

“We went into this study unsure what to expect,” said Voils, who is also a professor of surgery at the University of Wisconsin-Madison. “We knew that maintaining weight loss is hard and that previous maintenance studies have tended to focus on middle-aged white females. We were unsure if a mainly telephone-based program would work in a population that is primarily men and of mixed race,” she said. “We were happy to see that our strategies reduced the rate of weight regain.”

More than one-third of American adults are considered to be obese, meaning their body mass index is 30 or higher, according to the Centers for Disease Control and Prevention. Obesity has been linked to numerous health problems, including heart disease, stroke, type 2 diabetes and several types of cancer.

Obesity is now recognized as a chronic disease

The new study involved 222 obese patients, of whom only 34 were women. All of the patients had lost at least 8.8 pounds in a 16-week weight loss program. They were randomly assigned to participate in either an intervention group that provided weight maintenance strategies for an additional 42 weeks or a group that received usual medical care, with no emphasis on weight maintenance.

Those in the intervention group participated in three in-person group meetings and eight individual telephone calls, in which they were given a maintenance calorie budget and strategies on how to exercise, get support from their family and friends, and monitor their weight. The phone calls also involved the patients reflecting on how their lives have improved as a result of weight loss, making a plan for situations when they might feel tempted to go back to old habits, and specifying how frequently they weigh themselves and revisit weight loss efforts if they have gained weight.

All participants, in both groups, were scheduled for assessment appointments at the beginning of the study and then after 14, 26, 42 and 56 weeks. After 56 weeks, Voils said, 58.6% of patients in the intervention group either regained some weight or saw no change in weight, while 72.5% of patients in the other group regained or saw no change, a difference of 13.9 percentage points.

The average weight regain in the intervention group was only about 1.6 pounds, compared with about 5.2 pounds in the other group, the researchers found. “Although this may not seem like a lot of weight, given the low program costs and the high benefit of carrying less weight over the longer term, this is an important finding that adds to our understanding about how best to help patients with obesity,” said Dr. Jennifer Kraschnewski, associate professor at the Penn State College of Medicine, who was not involved in the new study.

What might help weight control the most?


It remains unclear in the study whether regular weighing, planning for high-risk situations or obtaining outside support was most effective in weight loss management, Voils said. “Our study design did not allow us to say which component of our intervention was most effective,” Voils said. “There is evidence that self-weighing and relapse prevention help people maintain weight loss. Our intervention incorporates those skills and adds having patients reflect on the benefits they experienced with weight loss and talking with a support person about what they can do to support weight maintenance efforts,” she said.

Though it remains difficult to establish which part of the intervention had the most impact on patients, having constant interaction with a supportive coach probably played a significant role in weight maintenance, said Dr. Samuel Grief, associate professor of clinical family medicine at the University of Illinois College of Medicine at Chicago, who was not involved in the study.

“Group dynamics tend to be more helpful, or a team-based approach using care coordination,” Grief said. “That would be my answer. Because strategies like food journaling or diaries or writing out what activities you do every day or emotions that you’re feeling, all that is relevant, but there’s not a lot of science behind those causing weight loss or mitigation of weight regain. Otherwise, everybody would do it,” he said. “Also, it would have been helpful to gauge their self-efficacy.”

Studies suggest that having self-efficacy, or believing that you will be successful in losing weight, has been linked to greater success in weight management, Grief said.
Additionally, the researchers were unable to assess longer-term weight maintenance and relied on self-reports about dietary intake and physical activity. “Our population was primarily middle-aged men who were white or African-American, and results may not generalize to other populations,” Voils said.

Tips for keeping the weight off

The National Weight Control Registry, which has tracked more than 10,000 individuals who have maintained significant weight losses, offers some recommendations on how to maintain weight control.

Rena Wing, a professor at Brown University’s Warren Alpert Medical School, and James Hill, director of the Center for Human Nutrition at the University of Colorado Health Sciences Center, established the registry in 1994. “To maintain weight loss, there must be continued adherence to a low-calorie diet and high physical activity,” Wing said. She said the registry suggests that the following strategies may help someone who is trying to maintain their weight loss:

>Maintain high levels of physical activity, in which the recommended goal is 250 minutes per week of moderate-intensity activity, such as brisk walking.
>Monitor your weight by weighing yourself frequently.
>Monitor and keep track of your diet and activity.
>Take immediate action in the face of small weight regains.

By Jacqueline Howard, CNN

Out of Despair, the Gift of Life

After losing her sister, one writer discovers a sense of peace.

1216 diary essay organ donation plnmph

Karen Abercrombie recently shared insight into her experience with donation after her sister, Julie, passed away. Karen describes how the compassion of the donation community helped her heal and her amazement when she learned about the impact of Julie’s tissue donation. Read more>>

“I was astounded to learn that upward of 80 people’s lives were either saved or enriched by Julie’s donations, including, of course, Carson Palmer’s.”

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