Patient Completes Ironman after Knee Replacement

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Several years ago, lifelong swimmer Laura Parker, now 47, of St. Charles, IL, took an interest in running because some friends were competing in a local triathlon. Training for this event got her hooked on competing and since 2009 she has completed four Ironman triathlons – the most difficult of all triathlons.

Her fourth triathlon was very special.

In an Ironman, competitors complete a 2.4-mile swim,112-mile bike and 26.2-mile run. – a total of 140.6 miles.

It’s all about training and committing to a process. “Training is harder than the race,” says Parker. “It’s not about racing against them, it’s a race against yourself.”

The training did take a toll on her body, however. Her first Ironman left her with knee pain that made it difficult to walk. She went for an MRI, which revealed that she had end stage arthritis in all three compartments of her left knee.

Heeding her doctor’s recommendation, Laura did physical therapy for six weeks to strengthen her vastus medialis oblique (VMO), a muscle located just above the kneecap.  She then went back to training but the pain worsened.

Eventually, even though she did two more Ironman competitions, it became increasingly harder to train, walk and perform every day activities. Then, in 2016, her doctor recommended a total knee replacement.

Laura immediately began her research to find the best surgeon for this procedure. One of her cycling friends had great success at Midwest Orthopedics at Rush, so she started there.

She discovered Dr. Craig DellaValle, a top ranked hip and knee replacement doctor, set up an appointment, and felt confident to that he was an excellent choice. She was excited to get back to pain-free training, but exactly what kind, she wasn’t yet sure. She was hoping to compete in another Ironman competition and discussed this in detail with Dr. DellaValle.

Laura’s knee replacement surgery went very well and she began stretching, lifting lightweights and was eventually able to start fully training again. She did so well that, eventually, Dr. Della Valle approved her to compete as long as she walked in the running portion of the races.

Laura did accomplish her goal of competing in yet another Ironman. She successfully completed her fourth in January 2017, a year and a half post- surgery.


“Being able to say you did an Ironman after surgery is a great reward,” she explains.


Next up for Laura is the biking season.  She will take a year off from the Ironman, but plans to resume them again in 2019.

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“Getting your knee replaced is not a death sentence when it comes to your activity at all,” she explains. “Adjust your expectations and commit!”


For more information on keeping your knees healthy, visit www.kneesforlife.org. For an appointment with Dr. Craig Della Valle, call 877-MD-BONES. Visit www.dellavalleortho.com for more information.

Monitoring Training Metrics on Elite Athletes; Clavicle Fractures; Concussion & Youth Football Participation

Episode 17.24 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 (01:23): Dr. Kevin Sprouse from Podium Sports Medicine describes the key elements in monitoring the unique biomechanical and physiologic variables widely applicable to any level of athlete who wishes to ensure that they are optimizing their overall health and performance.

Dr. Kevin Sprouse is a Knoxville native, now working with elite athletes and active individuals around the world. Trained and certified in both Emergency Medicine and Sports Medicine, he obtained his Bachelor’s degree in Exercise Science at Wake Forest University before attending medical school at the Virginia College of Osteopathic Medicine at Virginia Tech.

He then completed his Emergency Medicine residency in New York City, where he was elected Chief Resident. Following residency, he attained a fellowship in Sports Medicine at the Steadman Hawkins Clinic in Greenville, SC.

The focus of his academic interests and practice has been the care of the endurance athlete, as well how exercise, diet, and movement effect the health and well-being of all active individuals. His patients have included professional and Olympic cyclists, runners and triathletes, and he now brings his experience and expertise in this field to Podium Sports Medicine.

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Segment Two (11:40): Dr. Cole and Steve talk about the causes, treatment and recovery for Clavicle Fractures.

A clavicle fracture is a break in the collarbone, one of the main bones in the shoulder. This type of fracture is fairly common—accounting for about 5 percent of all adult fractures. Most clavicle fractures occur when a fall onto the shoulder or an outstretched arm puts enough pressure on the bone that it snaps or breaks. A broken collarbone can be very painful and can make it hard to move your arm.

Most clavicle fractures can be treated by wearing a sling to keep the arm and shoulder from moving while the bone heals. With some clavicle fractures, however, the pieces of bone move far out of place when the injury occurs. For these more complicated fractures, surgery may be needed to realign the collarbone.

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Segment Three (17:00): Coach Paul O’Toole, Commissioner of the St. Raphael Youth Football Program in Naperville IL, talks with Dr. Cole and Steve about the decrease of football enrollment due to risk of concussion; technique, program and protocol changes to make the game safer for young players; addition of trainers onsite at all games.

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Related article: Counsel patients, parents on concussion risks in football

How You Can Avoid Biking Injuries

Dr. Gregory Nicholson, Midwest Orthopaedics at Rush shoulder surgeon, treats many patients that have sustained bike injuries. He talks with FOX 32 Chicago host Sylvia Perez about how cyclists can prevent these injuries.

As biking becomes more popular, bike injuries are becoming more common. Researchers found that there were 288,501 cases of non-fatal bike accident injuries in the United States in 2013, up from 177,275 in 1997.  Chicago actually has more bicycle commuters per capita than New York or Los Angeles.

Bicycle injuries are on the rise in Illinois and the majority of them occur on the roads.  With the staggering rise of bike injuries being reported, it is important to follow basic safety tips and prevention techniques to stay safe and reduce injury while cycling.

How to Do the Shortest Workout Possible

Martin Gibala Credit McMaster University

Super-short workouts are a favorite topic in this column. I have written about seven-minute, six-minute, four-minute, and even one-minute workouts. They are appealing because they require so little time, but they also demand straining effort.

Martin Gibala is the scientist we most have to thank for the popularity of very brief, very hard exercise. All of these workouts are built around the concept of high-intensity interval training, in which you push yourself almost to exhaustion for a brief spurt of minutes or seconds, and then rest and recover for a few minutes before repeating the intense interval.

Athletes have long used interval sessions as part of a varied weekly training program to improve their competitiveness. But Dr. Gibala, a professor of kinesiology at McMaster University in Hamilton, Ontario, has helped to popularize the idea that we can rely on high-intensity intervals as our only exercise, and do very, very few of them while still improving our health and fitness.

Since 2004, he has published multiple studies about the potent effects of intervals. Perhaps the most important and illustrative was a 2014 experiment that I wrote about at the time. For it, he and his colleagues asked sedentary men and women to complete three 20-second intervals on a stationary bicycle, pedaling as hard as they could manage, with two minutes of gentle, slow pedaling between each interval. This was the one-minute workout.

After six weeks of performing three of these sessions per week, for a total of 18 minutes of intense exercise tucked in to slightly longer periods of less intense exercise, the volunteers were significantly more aerobically fit and healthier, with improved blood pressure numbers and markers of muscular health.

Because of Dr. Gibala’s studies, I do some type of interval training most weeks now. I no longer have the excuse of skipping workouts because I’m too busy. Now Dr. Gibala has written a new book, “The One-Minute Workout” (co-authored with Christopher Shulgan), which will be published on Tuesday. It details his research and provides a number of different, high-intensity interval training workouts, in addition to the one-minute version.

After reading the book (for which I provided an early reader’s review but had no other involvement), I spoke with Dr. Gibala by phone from his office at McMaster University about what science does and does not yet understand about this type of exercise and about how he works out. Here are edited excerpts from our conversation.

Whenever I write about H.I.I.T., people ask me whether intense interval training is actually better for you than more-traditional longer, slower types of workouts. Is it?

“Better” is a loaded word. I don’t think we have proven that one type of exercise is substantially better for you than another, from a physiological standpoint. Both improve health and fitness. But one is far more time efficient. So if the obstacle keeping someone from exercise is time, then H.I.I.T. is the preferred exercise option. I think almost everyone can find a few minutes in their day for a short interval workout.

But most of the studies you describe in your book involve stationary bicycling, which usually means a gym membership that not everyone has. Can other types of activity be adapted for H.I.I.T.?

Absolutely. That’s one of the great things about interval training. It only requires that for a brief period of time, you push yourself out of your comfort zone. You don’t have to reach any set percentage of heart rate or anything like that. You just need to feel some brief discomfort. You can achieve that by running hard to the next signpost when you are out on a trail or picking up the pace while you are walking. In the book, we describe how different types of exercise can be used for H.I.I.T. We have even shown that you can complete a very effective H.I.I.T. program in a stairwell during your lunch break.

Another question I often hear is about weight loss. Since the sessions are so short, does H.I.I.T. burn many calories?

In general, exercise is not a huge contributor to weight control. People don’t like to hear that, but it’s true. It is much easier to cut calories in the diet than to burn large numbers of them with exercise of any kind. With H.I.I.T., there is some evidence that you develop a slight metabolic after-burn, meaning that for up to 24 hours after a session, you burn slightly more calories than if you had not exercised. But the numbers are small, so it’s better to eat less if weight loss is a goal.

Is one minute the shortest possible H.I.I.T. workout or will I be writing about a 30-second workout soon?

I think one minute may be the limit. We are still looking for the exact sweet spot in terms of how little intense effort people can do and still get significant health and fitness benefits. So far, it looks as if three repetitions of 20-second intervals is the lowest effective load. But we are still experimenting. Stay tuned.

What is your exercise routine?

I do something physical every day, and it’s not all H.I.I.T. I play a weekly hockey game. But life is busy. My wife works and we have young kids. So most of the time, it’s intervals, sometimes on a stationary bike, sometimes on other equipment in my basement. I do high-speed pull-ups and push-ups. I’m like everyone else. I fit in as much exercise as I can, when I can, and that would be my advice to anyone.

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