MCL Injury Basics with ATI’s Hockey Injury Expert

 MCL Injury Basics with ATI’s Hockey Injury Expert

By Brian Rog with Contributions by: Andrew Grahovec and Katie Christopherson, ATC for ATI Physical Therapy.

To compete at the professional level in any sport requires the most athletic, highly skilled and mentally acute individuals in the world. With constant training, practice and exhibitions throughout a season, pushing your body to the utmost physical limits can take a toll on the body over time. In ice hockey, players, by nature, are regarded as some of the toughest athletes on a mental and physical level.

As one of the fastest sports, the conditions during play are dangerous and require sharp focus, balance and grit to compete at a high level. With the speed and physicality of the game, the risk of injury is significantly increased. It’s no surprise that one of the most common types of injuries sustained during play involve the knees.

To get a better feel for the inner workings of the MCL (Medial Collateral Ligament) and MCL injury insight, we teamed up with ATI athletic trainer and hockey injury expert, Katie Christopherson.

The role of the MCL

Considered one of the four primary stabilizing ligaments in the knee, the MCL is the innermost ligament of the knee designed to protect the knee joint’s stability and strength. It also plays a key role in preventing the leg from over-extending inward. For hockey players, the MCL is crucial in helping the knee manage the on-ice demands of skating, planting for contact and more.

Symptoms of an MCL injury

When an MCL becomes injured, you may experience pain on the inside edge of the knee, along with swelling and tenderness. Several hours after the injury, this discomfort may be coupled with difficulty moving and increased levels of pain. It’s also not uncommon to feel a ‘loose or wobbly’ feeling in the knee when walking. At this point, we recommend getting in touch with your primary doctor or local physical therapist to further assess the injury.MCL Injury assessment with ATI

Grades of MCL injuries

Since the MCL’s primary role is preventing the leg for overextending inward, naturally, it assumes a substantial amount of the body’s weight. Because of this, an athlete is more susceptible and likely to experience an injury to the MCL, rather than the LCL (Lateral Collateral Ligament), which is located on the outer side of the knee – opposite of the MCL.

MCL injuries are classified according to three different grades including:

·         Grade 1 (minor): results from a force strong enough to stretch the ligament, but not tear it.

·         Grade 2 (moderate): stretched ligament with some tearing involved

·         Grade 3 (severe): completely torn ligament – and most sever of the three grades

Which sprain is the most common among hockey players?

Given the fast-paced, high-contact nature of the sport, hockey players are at an increased risk of injuring their lower body structures. When looking at the MCL specifically, it’s more common to see Grade 1 MCL injuries resulting from less abrasive blows to the knee or mild twisting motions at the knee. For Grade 2 and 3 MCL injuries, we tend to attribute those to the more nefarious blows or extreme twists to the outside of the knee, which still happen, but not as often as the former.

Rehabbing an MCL Sprain

Among the three grades, a Grade 1 treatment is a more straightforward than the others. A Grade 1 sprain can take typically one to two weeks to heal, whereas a Grade 2 and 3 injuries may take two to four weeks and four to eight weeks, respectively.

MCL Physical TherapyIn rehabbing an MCL sprain or tear, your physical therapist or doctor first determines the grade of the injury and the effect it has on the knee during weight-bearing (the body’s ability to resist or support weight). They’ll also note how the knee joint moves through flexion (bending motion) and extension and how that force displacement is on the MCL. This will ultimately decide what treatments and strengthening methods to use.

Initially, an athlete’s treatment should consist of pain-free, range of motion exercises, such as knee slides on the table, wall slides, assisted slides and riding a stationary bike.

As pain subsides and range of motion increases, this usually indicates that an athlete is ready to incorporate flexion and extension exercises – like open-chain strengthening (hands or feet are not in a fixed position). But that’s not to say that an athlete should shy away from closed-chain strengthening (hands or feet are in a fixed or stationary position), as these are also effective exercises to build into a program.

Once an injured athlete progresses to the more advanced stages of rehabilitation, a concentration on functional activity will be introduced. This may include plyometric exercises and functional activities to ensure dynamic stability of the knee.

At this stage, a great tool for rehabbing a hockey player is a slide board, which is a slick surface that can mimic the motion of the athlete’s leg on ice.  

Dealing with a knee injury?

ATI experts strongly encourage athletes to take care of any minor aches and pains before they compound and get worse. This can be as simple as heating for 20 minutes before activity and icing for 20 minutes after activity when the athlete feels soreness in one particular area. If the pain persists, it might be a good idea to call your physician or visit your nearest ATI physical therapy clinic. In fact, at ATI, we offer complimentary injury screenings, so stop in and see what we can do for you.

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Injuries Impacting Professional Dancers

Injury-Prevention Tips from Joffrey Dancers Help Recreational Athletes

Injury-Prevention Tips from Joffrey Dancers Help Recreational Athletes

Professional dancers, like professional athletes, are subject to injury because of the constant stress they put on their bodies. And while these dancers and athletes have dedicated medical teams to attend to their needs, recreational athletes can learn from their experience.

“Dancers in a lot of ways are similar to everyday athletes who want to stay in shape and have fun,” says Simon Lee, MD, foot and ankle orthopedic surgeon at Midwest Orthopaedics at Rush and medical director for The Joffrey Ballet.

Just like dancers, recreational athletes can experience stress fractures, sprained ankles, tendinitis and knee issues. To prevent such injuries, it’s important to start with a good warm-up.

“I don’t think people realize how much time dancers spend warming up and stretching,” Lee says. “Recreational athletes are pressed for time and want to compress their athletic activity, but that’s the way injuries occur. The older we get the more important it is to get warmed up and stretch.”

Joanna Wozniak, a full member of the Joffrey since 2003, can rattle off a list of aches, pains and injuries she has suffered because of her physically demanding profession. To prevent injuries, Wozniak, like the other Joffrey dancers, starts with a daily 90-minute class of classical ballet exercises to warm up the body.

“Every movement is important to work every different muscle system, just like every brick is important for the foundation in a house,” she says. The class is followed by six hours of rehearsal, during which dancers learn the movements of new choreography and eventually start running through the whole dance.

In addition to dancing, Wozniak is on the move in other ways. She goes for walks, rides her bike, runs to build stamina, takes Pilates classes to strengthen her core muscles and practices Bikram yoga and other forms of yoga for stretching.

“It’s good to practice different forms of exercise because they use different muscles,” Wozniak says. “It’s like rotating the tires on a car because it slows down wear and tear.”

Cross-training with other sports and strengthening core muscles is critically important for recreational athletes, Lee says. He recommends adding cycling or swimming to help maintain body balance, strength and flexibility.

“Running is probably one of the worst activities to do consistently every day,” Lee says, “because it only works certain parts of your lower body in one direction — straight — and causes a lot of issues, such as overuse in the ankles and knees that are mainly strengthened on the anterior and posterior sides.”

“So many of us are constantly getting hurt and in pain that it becomes difficult to differentiate between what is a normal ache or pain and what needs more care and attention,” Wozniak says.

Wozniak takes care of some problems on her own by stretching, staying hydrated and using hot compresses or ice. But when her arm started turning purple and swelling, it was time to consult with Rush doctors. She was quickly diagnosed with thoracic outlet syndrome, which restricts normal blood flow to the arm. In her case, the condition was caused by overuse of her arms. She had surgery to have a rib removed in order to alleviate the problem.

Whether you’re a professional dancer or a recreational athlete, ongoing aches and pains are worth a consultation with a medical professional. “We have a knowledge of physiology and anatomy so we know what can be problematic and what can be ignored or pushed through,” Lee says.

Wozniak, who is 33 and has been dancing since age 7, is so passionate about dancing that she is motivated to do what it takes to maintain and improve the quality of her performance, but recreational athletes may not always be predisposed to work out consistently.

To improve the fun factor of staying fit, Lee suggests recreational athletes participate in a group sport such as flag football or a pick-up basketball league. “When you work out together there is the camaraderie of teammates working to achieve a goal,” he says.

Wozniak finds that camaraderie at the Joffrey. “We all care a lot about each other and support each other,” she says. “We’re like a family.”

Wozniak recently performed in a dance called “Body of Your Dreams” that spoofed the notion that quick fixes can help you effortlessly achieve the ideal physique. “I think people can get caught up in the trap of the importance of the perfect body image,” she says, “but you have to put things in perspective and find happiness and fulfillment in other ways.” And working out safely and preventing injury can help achieve that goal.

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Cold and Flu Prevention and Exercise Restrictions when sick

Image result for athlete with cold and flu

Dr. Jack Kickless from Midwest Orthopaedics at Rush talks to Steve Kashul and Dr. Nik Verma about cold and flu prevention and exercise restrictions when you are sick.

Dr. Nickless was born and raised in the South suburbs of Chicago. He completed his undergraduate training at Loyola University Chicago, where he also played ice hockey. He then went on to obtain his medical degree from Chicago Medical School, andjohn nickless thereafter, completed his residency training in Family Medicine at Advocate Christ Medical Center in Oak Lawn, IL where he also served as chief resident.

After residency, he completed a fellowship in sports medicine at Rush University Medical Center where he served as a team physician for the Chicago White Sox, Chicago Bulls, Chicago Fire, DePaul University, Chicago Steel, and local high school teams. He has also covered events including the Chicago Marathon, Shamrock Shuffle, AVP volleyball tournament, and IGI Chicago Style Gymnastics Meet.

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Aging Atletes and Their Joints.

Steve Kashul talks with Dr. Craig Della Valle from Midwest Orthopaedics at Rush about aging athletes and their joints. Are we getting joint replacements at a younger age and what factors in a more active lifestyle contribute to joint problems.

Dr. Della Valle is a native of New York and received his undergraduate and medical degrees from the University of Pennsylvania in Philadelphia.  He completed his residency at the Hospital for Joint Diseases in New York City.  During his residency he spent a full year devoted to clinical and basic science research in the field of adult reconstructive surgery.  Dr. Della Valle completed a fellowship in adult reconstructive surgery at Rush University Medical Center and Central DuPage Hospital.

He is presently the Aaron G. Rosenberg Endowed Professor of Orthopaedic Surgery and Chief of the Section of Adult Reconstruction at Rush University Medical Center in Chicago, Illinois.

Dr. Craig Della ValleDr. Della Valle is a busy clinician who specializes in primary and revision total joint arthroplasty.  A respected researcher, he has more than 180 peer reviewed publications on topics including unicompartmental, primary and revision total knee arthroplasty as well as total hip arthroplasty, hip resurfacing and revision total hip arthroplasty.

Dr Della Valle is a member of The Hip Society, The Knee Society and The International Hip Society. He currently President for the American Association of Hip and Knee Surgeons, Member at Large for the Knee Society and Secretary of the Hip Society.

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