Introducing the first-ever mascot specialist doctor at Midwest Orthopaedics at Rush – the one and only Benny The Bull!
Introducing the first-ever mascot specialist doctor at Midwest Orthopaedics at Rush – the one and only Benny The Bull!
“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 a 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.
Some of the most common injuries experienced by youth basketball players include muscle strains, ankle sprains, Jumper’s knee and shin splints. Fortunately there are ways to prevent these injuries from happening. Read below to learn more about seven types of injuries that young basketball players are at risk for, as well as some injury prevention tips to help keep young athletes on the court.
One of the most common acute injuries suffered by young basketball players is a muscle contusion, which occurs secondary to impact. In basketball, it is not unusual for a player to accidentally ‘knee’ another player in the thigh causing a bruise to develop. Although painful, this type of injury is typically not serious.
With acute muscle contusions (less than 72 hours after injury), typical treatment includes rest, ice and compression. Once beyond the acute phase of injury, gradual return to activity is recommended and may include light stretching, progressive strengthening, and eventual return to sport once pain has subsided and full function is regained.
In addition to muscle contusions, many young basketball players experience muscle strains, or ‘pulled’ muscles. The hamstring, calf and adductors (inner thigh) are common sites for muscle strains to occur given the functional demands of a sport like basketball. Strains can vary in severity from mild (Grade I) to serious (Grade III). Grade I strains occur when the muscle/tendon is overstretched. Small micro-tears in the muscle may or may not occur and the integrity of the muscle remains intact. Grade II strains involve a greater amount of torn muscle fibers and require longer recovery than a Grade I strain. Lastly, Grade III strains occur when the muscle tears or ruptures completely. This type of strain may require surgical intervention for full function to be restored.
Depending on the severity of the muscle strain (Grades I and II), return to sport may take anywhere from 2-6 weeks in most cases. As mentioned previously with muscle contusions, treatment for a muscle strain may include modalities (e.g. ice or heat), stretching, gradual strengthening, eventually progressing to advanced therapeutic exercises, along with sport specific activities such as drills, running, cutting, jumping, etc.
Most people have experienced the classic ‘low’/lateral ankle sprain that is the result of rolling/inverting the ankle. In basketball, ankle sprains can occur when cutting, accidentally stepping on an opponent’s foot or landing awkwardly. Lateral ankle sprains involve over-stretching of the ATFL (Anterior Talofibular Ligament) and/or CFL (Calcaneofibular Ligament). Much like muscle strains, sprains are graded on a scale from I through III, with Grade I sprains being mild and Grade III sprains being considered severe.
Acute ankle sprains (Grades I-II) are typically treated with RICES (rice, ice, compression, elevation, stabilization). Once beyond the acute phase of healing, gradual pain-free restoration of range of motion, strength, ankle stability, balance and functionality is addressed in order to facilitate safe return to play. Improper progression or returning to play too quickly may place the athlete at an increased risk of re-injury.
Many parents worry about concussions in their young athletes. While most associate concussions with aggressive contact sports like football, hockey, lacrosse and rugby, this type of injury can also occur in basketball players. Such mechanisms of injury may include a player going up for a rebound and getting elbowed in the head, diving for a loose ball and hitting their head against the court, or during the process of defending or executing a layup if contact is involved. Concussions can be a complicated injury and may require rest, follow up with a physician, as well as a proper plan of care under the guidance of a Physical Therapist that specializes in vestibular rehabilitation for safe return to activity.
The Anterior Cruciate Ligament or ACL is one of the four main ligaments providing stability to the knee. ACL injuries typically occur in sports that involve quick changes of direction, pivoting, cutting and jumping. Although ACL sprains can be managed conservatively with physical therapy, an ACL tear/rupture requires surgical intervention to reconstruct the torn ligament. It is also important to note that there are multiple predisposing factors (e.g., gender, bony structure, landing mechanics, playing surface) for ACL injuries. Athletes can take steps to reduce the risk of ACL injuries by engaging in a comprehensive strength and conditioning program.
Overuse injuries such as Patellofemoral Pain Syndrome (PFPS), Jumper’s knee/patellar tendinitis, shin splints and stress fractures tend to develop over the course of a season. Many athletes are hesitant to bring up injuries to their coaches because they don’t want to miss playing time. That being said, overuse injuries tend to get worse as the season progresses. This is because overuse injuries can be linked to repetitive jumping, hip/ankle weakness, muscle imbalances (e.g. quad dominance), and running/playing/practicing while not allowing for a proper rest and recovery period. Because of this, coaches and parents should encourage young athletes to speak up when they are feeling unusual pain and discomfort.
Apophyseal injuries are specific to the pediatric population. These types of injuries occur at sites where tendons attach to bony prominences and include inflammation and soreness to avulsion fractures. Common sites of apophyseal injuries in youth basketball players include the calcaneus/heel (Sever’s disease) and the tibial tuberosity/shin (Osgood-Schlatter’s disease). Apophyseal injuries are typically associated with skeletal immaturity, flexibility deficits, repeated trauma (e.g. repetitive jumping and running) and muscle imbalances. Conservative treatment is usually effective in managing such conditions, making physical therapy an excellent treatment option.
The Importance of Injury Prevention
Injury prevention is important because it lessens potential healthcare costs and keeps athletes playing their respective sports at a high level. As such, many chronic and even some acute injuries may be mitigated or prevented through a proper “pre-hab” exercise program along with incorporating a sport-specific warm up routine. For example, youth basketball players may benefit from balance training, dynamic and static stretching, hip/ankle stability exercises, as well as strengthening of the core and lower extremities.
Should an injury linger, further follow up with a physician and formal physical therapy treatment may be the best route for optimal outcomes.
Athletico also provides complimentary injury screens at a location near you. Click here to get started.
In the last few weeks there have been several prominent NBA players sidelined for an injury called a “hip pointer”. We’ll see a fair number of these at all levels of basketball, including at the youth level.
What’s A “Hip Pointer”?
The term “hip pointer” has been used by sports medicine specialists for many decades, and in 1967 Dr. Martin E. Blazina from UCLA specifically noted that the phrase “hip pointer” should be used to describe a deep bruise to an area of the pelvis called the iliac crest (bone on the side of the body roughly near the top of your shorts or pants). So in actuality a hip pointer doesn’t really involve the hip, but the pelvis. Still we use the term somewhat broadly today. A hip pointer is an injury that occurs when there is direct contact to the iliac crest. This can occur by getting hit or falling onto your side and landing on a hard surface.
How the Injury Happens
The pelvic bone can see trauma during basketball if there is a direct blow from an opponent’s knee, or from a fall directly on to the basketball floor.
What’s The Story?
Hip pointers typically result in immediate, intense pain and localized tenderness over the iliac crest or pelvic bone. There will usually be significant bruising and swelling around the front, outside and inside of the hip. Due to the bleeding and swelling, movement of the hip will usually be limited and painful. Decreased range of motion and weakness are also typically seen. In young athletes I’ll typically get an x-ray to look for a fracture around the pelvis. One area particularly vulnerable in the growing athlete is the upper edge of the bone, where growth is still occurring.
Treatment starts with a proper diagnosis from a skilled sports medicine professional. These injures can be very uncomfortable, so crutches may be needed for the first several days, along with “RICE”: rest, ice, compression, and elevation. This will help to reduce inflammation and control the swelling. After the initial healing, the focus will shift to soft tissue mobilization. Soft tissue massage can help improve range of motion of the hip joint, further reduce swelling and prevent scar tissue. The athlete can then be progressed to range of motion, flexibility, strengthening, and sport specific exercises. For many young athletes I’ll prescribe physical therapy.
Time To Return To Play
Once pain free gait has been resumed sports specific training can be initiated. Full return to competition usually takes about 1-3 weeks for older teenagers, but may take longer in younger athletes, and longer still if there’s a fracture to the bone. After full healing, you should expect to be able to participate in full activity without restrictions.
Dr. Kathleen Weber, sports medicine primary care physician and team physician for the Chicago Bulls joined BullsTV host Steve Kashul during Bulls Pre-Game Live on December 19th, 2016. Dr. Weber discussed the NBA’s new Concussion Protocol and the efforts being made to protect all players from returning too soon to the court.
Kashul and Dr. Weber also talked about how the physicians at Midwest Orthopaedics at Rush all work together in treating the Chicago Bulls players.