Many of you basketball fans may have heard of Kobe Bryant’s wrist injury back in December. He sustained an injury to the lunotriquetral ligament. This is an injury that the physicians of our Hand and Upper Extremity Center are called upon to treat in a number of athletes.

When the athlete comes in for early treatment, many of these injuries can be successfully treated with a program of sports specific bracing and exercises. This can allow some athletes to participate in their sport quickly. Chronic injuries may need surgery to return to sports.

A different ligament-the scapholunate ligament- behaves differently when injured, and frequently requires surgery in an acute injury situation. An exam and X-ray can detect a number of these injuries but an MRI or wrist arthroscopy may also be necessary.
Learn more about wrist injuries and available treatments.

Starting today, we have launched a public campaign around the theme “You Want an OAM Doc.” The campaign messaging uses idiomatic expressions – like “We’ve Got Your Back” and “We Know Hand Surgery Like the Back of Our Hands” to highlight the range of subspecialty practices OAM houses.

You can view our campaign spots below, and be sure to watch for them on various TV channels airing in West Michigan. They share our firm belief that if you have a bone, joint or spinal issue – you don’t want just any orthopaedic doctor, you want an OAM doc!

To learn more about OAM and our specialized centers of excellence call us at 616-459-7101.

Additionally, a study published by Brad Coffiner in Cornell University’s ergonomic department indicated “…when handling heavy snow with a shovel, the L5/S1 disc has been identified as the weakest link in the body segment chain. The most severe injuries and pain are likely to occur in the back region.” Recognizing the lower back is especially susceptible to strain or injury, it would be prudent to review steps to prevent injury. Health.com and MyOptumHealth.com both offer tips you can follow that will help prevent injuries and make show shoveling a bit safer.

• Warm muscles work better. Warm up inside and incorporate stretches to help prepare your muscles for the upcoming work.
• Dress appropriately. Wear warm clothing and insulated snow boots or shoes with good traction.
• Choose a proper shovel. Consider two types of snow shovels: one lifts loads of snow, while the other – with a wide, curved blade – is used as a “plow.” Make sure both types of shovels have curved handles with plastic, lightweight blades. The curved handle helps you keep your back straight when lifting the snow-filled blade off the ground – or when you push snow aside with the plowing shovel. Make sure the handle of your snow shovel reaches your chest.
• Do not try to shovel all the snow at once. Shovel small amounts at a time, preferably fresh snow. Fresh snow is lighter weight; so clear it as soon as it has fallen if possible.
• Practice the proper technique. It is advised to push the snow with the shovel as opposed to lifting it.
  • Space your hands apart for leverage. This makes it easier to lift a blade filled with snow.
  • Space your feet shoulder-width apart.
  • Bend at the knees – not the waist. If you do bend at the waist, bring your hands closer to the end of the shovel or get a shovel with a longer handle.
  • Tighten your abdominal muscles every time you lift a load of snow.
  • Keep your head down and in line with a straight back.
  • Keep each shovelful close to the body. Avoid extending your arms.
  • Minimize the distance you carry the snow. Walk each shovelful just a few feet, as close to the ground as you can, then dump it by flipping the handle with your wrists. Avoid throwing loads of snow over your shoulder.
  • Clear deep snow layer by layer.
  • Pace yourself, and stay hydrated.

Unfortunately, we see many injuries from snow shoveling each winter. It is necessary that you pace yourself and practice common sense. If you are unable to physically handle the work, you can hire a snow removal company, or even a neighbor to assist you. For those of us who are able-bodied, it is important to remember those who may need assistance. A few minutes to help clear someone’s path and driveway can make a world of difference for them, as well as make you a good neighbor!

For details on how Orthopaedic Associates of Michigan can help you recover from a snow shoveling injury, call us at 616-459-7101.

Sources:  American Academy of Orthopaedic Surgeons,  Cornell University, Health.com,  MyOptumHealth.com

Taking a break from a hobby doesn’t sound that hard. But what about taking a break from a sport you’ve loved to compete in for the past 40 years? This was the choice long-time tennis player, Jan B. had to make at a time in her life she never saw coming.

“I just kept telling myself that I was too young for this type of pain,” said Jan. Only 50 years old and on a highly competitive travel tennis league, Jan refused to give in to the pain. “I pretty much denied it was happening for a solid year,” she recalled, laughing. “I even had a surgeon tell me I needed a hip replacement, and yet I still found a way to deny it.”

Jan spent the next year trying everything from acupuncture to general sports massage, with nothing to show for it but more pain. She didn’t understand why the incessant pain in her hip wouldn’t leave, but more importantly, why it was getting worse. A family friend finally spoke up and suggested she visit Dr. Gregory Golladay from Orthopaedic Associates of Michigan. “I was fearful at first, then excited, followed by the dread of post-surgical pain,” Jan admitted. “Dr. Golladay calmed my fears and finally I just told myself that I could do it!”

Soon after her visit with Dr. Golladay, Jan went in for a Zimmer total hip replacement. “The surgery was over before I even knew what happened. I had to rate my pain right after surgery and it was only a four out of 10,” she said. “And to be honest, it was a *zero out of 10 after that!”

Only three short months later, Jan was back on the tennis court and slowly but surely getting back in the groove. “I couldn’t wait for the three-month post-op restrictions to be lifted!”

The smooth recovery has continued to be a blessing that Jan remains thankful for. “I was relieved that it was done and amazed that the pain was gone,” said Jan. “I have no more hip pain and I am beginning the road back to playing tennis! Thank you for giving back such an important part of my life!”

For details on how Orthopaedic Associates of Michigan can help you live pain-free, call us today at 616-459-7101.

*The above results are based on an OAM client’s experience. Results may vary.

The Own the Bone® program provides a simple, easy-to-use tool to enable hospitals, medical centers, and practices to:

• Identify, evaluate, and treat fragility fracture patients over the age of 50 who are at risk of osteoporosis.
• Coordinate patient care among different specialties and physicians for each patient.

Own the Bone® is aimed at better identifying, evaluating and treating patients who suffer from an osteoporosis or low bone density-related fragility fracture (a broken bone that results from a fall from standing height or less). The program brings focus to the severe health implications of fragility fractures and the multi-faceted approach hospitals and orthopaedists can take to assure patients receive consistent, complete, and comprehensive care.

The program consists of a national registry that allows OAM to qualitatively evaluate how our patients compare to others in the US, showing how OAM patients are positively affected by the Own the Bone® program.

“OAM has done even more now that they touch all patients who come to the office with consistent care,” said Clifford Jones, MD, OAM Bone Heath Clinic. “It’s an honor to be listed as one of the top programs in the US concerning bone health, especially when you compare that to which nationally known programs are listed in the registry.”

For additional information about Orthopaedic Associates of Michigan and our involvement in the Own the Bone® program, please contact our Bone Health Clinic at (616) 459-7101.

Sources: American Orthopaedic Association – Own the Bone®, Clifford Jones, MD

An ACL injury can occur when the knee joint is hyperextended, twisted and bent backwards or from side to side or twisted. This can happen when you suddenly change direction or experience a blow directly to the knee. Many factors contributing to the injury include ground hardness, grass type and cleat type.

Over the past few years, doctors have seen a significant number of female athletes with ACL injuries. Research shows that women are twice as likely to experience an ACL tear than men. Researches have developed several theories as to why women experience more injuries. The top theories include:

• Anatomic Differences
  There are many anatomic differences between men and women, including pelvis width, Q-angle, size of the ACL and size of the intercondylar notch (where the ACL crosses the knee joint).
• Hormonal Differences
  It is known that the ACL has hormone receptors for estrogen and progesterone, and it has been thought that hormone concentration could play a role in ACL injuries. (There has been come conflicting data with this research, and research continues to be conducted to support this theory.)
• Biomechanic Differences
  Stability of the knee is dependent on different factors. The two most important are the static and the dynamic stabilizers of the knee. The static stabilizers are the major ligaments of the knee, including the ACL. The dynamic stabilizers of the knee are the muscles and tendons that surround the joint. Women have been found to have differences in biomechanic movements of the knee seen when pivoting, jumping, and landing – activities that often lead to an ACL injury.

The symptoms of an ACL injury usually appear suddenly, because most commonly the injury occurs during activity (such as playing sports). The injury may include hearing or feeling a popping sound in the knee, pain, swelling and feeling the knee buckle or give out.

Your doctor can confirm the injury by looking for signs of instability of the knee or conducting an MRI. Once your doctor has diagnosed the severity of the injury (the ACL can tear partially or completely), it is necessary to follow the treatment prescribed, or the injury can be come a long-lasting problem. Treatment can include exercise and training rehab or surgery. The healing process can take anywhere from seven to nine months.  The goals of treatment are:

• Make the knee stable if it is unsteady.
• Make the knee strong enough to do all the activities you use to do.
• Reduce your chance of damaging the knee more.

To avoid experiencing an injury to the ACL, there are several techniques athletes can use. Training drills that require balance, power and agility helps improve the neuromuscular conditioning and muscular reactions, which has shown a decrease in the risk of an ACL injury. Dr. T.O. Souryal, a member of Professional Team Physicians indicated in an interview with ESPN that flexibility, strength and endurance are crucial to protecting the knee, along with using common sense. While trying a sport you have never played before, it is important not to push yourself too hard and risk an injury. In regards to flexibility, athletes should stretch before a sporting activity, at halftime or time-outs and after the activity. Strength and endurance are important because strength gives you the power you need to run and jump during activities, and endurance gives you the ability to participate for the full activity.

The doctors at Orthopaedic Associates of Michigan have worked with patients experiencing varying severities of ACL injuries. They can determine the extent of your injury and the best course of treatment. For an appointment, please call 616-459-7101.

Sources: WebMD, Sportsmedicine.about.com, ESPN, Orthopadeics.about.com, Online Orthopaedics

Falls in the home account for an average of 5.1 million injuries and almost 6,000 deaths each year, according to The Home Safety Council. These falls are preventable by following safety guidelines and recommendations in and around your home. The Home Safety Council provides the following home safety tips to keep people of all ages safe in their home.

•    Have handrails on both sides of stairs and steps.
•    Make sure there is adequate lighting at the top and bottom of the stairs.
•    Keep stairs clear of tripping hazards.
•    Tape rugs to the floor to prevent tripping over them.
•    Have nightlights in the bedroom, hall and bathroom so you can see if you need to get up at night.
•    Have a mat or non-slip strips in the bathtub and shower.
•    Use non-skid bottom bath mats on the bathroom floor.
•    Add grab bars in the tub or shower, especially for senior citizens.
•    Clean up all spills as they happen. Do not leave them where someone else could slip on them.
•    In homes that have children, use safety gates at the top and bottom of stairs.
•    Have well lit porches and walkways.
•    Keep sidewalks and paths clear.
•    Fix broken or chipped steps and walkways as soon as possible.
•    Always use a sturdy ladder when climbing; do not climb on chairs.
•    When using a ladder make certain it is firmly on the ground. Never climb to the top rung of a ladder.

With winter quickly approaching, it is necessary to assure that your driveway, stairs and yard are maintained to prevent outside falls.  Most people love snow in the wintertime; it is beautiful to look at and can provide fun outdoor activities like skiing, sledding and building snowmen. But for some individuals, especially senior citizens, snow can be scary and hazardous. The following tips can help assure the safety of your home and yourself if followed correctly.

•    Wear shoes that have traction. The better the traction of the shoe, the more they will grip the ground. If you go somewhere that you need to wear dress shoes, be sure to take them with you and change once you are safely inside.
•    Check the railings on your sidewalk or steps to assure they are sturdy. If you were to slip, you can catch yourself on the railing. It is important to keep the railing itself clean too, to make sure you can grip it if needed.
•    Keep salt and shovel inside your house. That will prevent you from having to walk outside in the snow to get it.
•    Carry a cell phone with you while you are outside; if you were to fall, you could call for help. It also provides security if you are driving in winter weather conditions and have an accident.
•    Don’t be afraid to ask for help while in public. If you do not feel that you can safely make it to your vehicle, speak to an employee and they will provide assistance. If you are in public and see someone having difficulty walking on the ice and snow, offer assistance if you are able.
•    While in public, take notice of floors and stairs that may be wet and slippery due to snow melting off shoes. Walk carefully.
•    Go slow to keep your balance. Be sure to allow for extra time so you do not have to rush.
•    Strengthen your legs. If you slip, your leg muscles can help catch you. If you do fall, they can help you get up easier.
•    Be aware of falling snow and ice from your roof or gutters. Try to keep the area above your doors and garage free of ice and snow by safely removing what you can, or having it removed by professionals.
•    Before the snow arrives, be sure to remove wet leaves from your sidewalk and walkways. Wet leaves can become slippery and pose a hazard.

Falls can happen to people of all ages. By following the above recommendations, you can help keep your family and houseguests safe. If you have experienced a fall, the doctors at Orthopaedic Associates of Michigan can provide the help you need to get back on your feet. To schedule an appointment, please call us at 616-459-7101.

Sources: Home Safety Council, Winter Fall Prevention Tips for Seniors, WebMD

There are two general types of sports injuries. An acute traumatic injury usually involves a single blow and can result in a fracture, bruising, strain, sprain, abrasion or laceration. The second type of sports injury is an overuse or chronic injury. These injuries happen over a period of time, and can include a stress fracture, tendonitis or epiphysitis (growth plate overload injury).

An article by Cory Darrow in the American Journal of Sports Medicine indicates that more than 150,000 football players under the age of 15 seek treatment for injuries in hospital emergency rooms each year. One of every seven severe high school football injuries (e.g., those that result in a loss of more than three weeks of sports participation) are to the hand, finger or wrist. Some of the most common hand and wrist injuries obtained while playing football are wrist sprains, finger fractures and wrist tendonitis.

A wrist sprain can be an injury to a muscle or tendon and causes pain, tenderness, swelling, redness and warmth to the touch. R.I.C.E. is the first line of treatment for a sprained wrist and includes: Rest, Ice, Compression and Elevation. Finger fractures are considered minor trauma but can become a serious problem if not given the opportunity to heal properly. The signs of a fracture are swelling, pain and tenderness, pain in the hand when you tap the end of the finger while it is straight, inability to move finger completely and deformity. To properly treat a finger fracture, you will need to see a doctor who will put the finger back into place and put it in a splint or cast to heal. Wrist tendonitis is an irritation and swelling of the tissue that surrounds the tendons of the thumb. Symptoms include pain in the front of the wrist, pain while bending and extending the wrist and swelling. Steroid injections and anti-inflammatory medicines are most commonly used to treat tendonitis. In more serious cases, surgery may be necessary.

Another popular fall sport that can lead to hand and wrist injuries is volleyball. Hand and finger injuries are common in volleyball while setting, spiking and blocking the ball. Most injuries occur when the ball forcefully hits the fingertips. According to volleyballheadquarters.com, the most common injuries are sprains and strains, followed by fractures, contusions and dislocation of thumb or fingers. The joint of the thumb is the most commonly injured ligament in the hand (known as a thumb sprain) along with finger sprains. To reduce the risk of injury, keep your fingers close together and loosely tape them if necessary. (Symptoms and treatment of volleyball injuries are similar to those listed above for football injuries.)

The good news is that most sports injuries can be treated effectively, and many people who suffer injuries can return to physical activity after recovering. Fortunately, many sports injuries can be prevented if people take the proper precautions. It is important for athletes to wear protective gear, regularly perform strengthening exercises, stretch before every practice and game and learn proper form and techniques. Additionally, athletes need to understand that they should not play through the pain. If there is pain or an injury, playing sports before it has properly healed could lead to further, more severe, damage.

If you have suffered a sports injury or are experiencing chronic pain that progressively increases with activity, it is important to refrain from further activity until you can be examined by a doctor. The doctors at Orthopaedic Associates of Michigan can determine the extent of your injury and the best course of treatment. For an appointment, please call 616-459-7101.

Sources: Darrow, Cory et al., “Epidemiology of Severe Injuries Among United States High School Athletes.” American Journal of Sports Medicine, 37, no. 9 (2009): 1798-1805. TeensHealth,  Sports Medicine at About.com, Volleyballheadquarters.com

According to the American Society for Surgery of the Hand (ASSH), pumpkin carving can result in serious lacerations to the hand and also injuries to bones and tendons if precautions are not taken. The most common accidents associated with pumpkin carving are stab wounds to the fingers and palm. A study conducted by the Research Institute at Nationwide Children’s Hospital in Columbus, OH examined holiday-related pediatric injuries. The study results indicated that Halloween was one of the top three holidays producing ER visits, with the highest percentage of injuries being to the finger and hand. Of those injuries, 33.3% were lacerations and 20.1% were fractures. Children ages 10-14 sustained the greatest proportion of injuries at 30.3%.

An injury can happen very quickly, which is why it is necessary to be cautious and attentive while carving pumpkins. The ASSH recommends the following safety tips while carving:
•    Carve in a clean, dry, well-lit area to prevent slipping of the pumpkin or the knife.
•    Always provide adult supervision for children.
•    Let adults handle all carving. Children can help draw patterns, scoop out the insides and decorate the pumpkin once it has been carved.
•    A sharper knife is not necessarily better because it can become wedged in the thicker part of the pumpkin, requiring force to remove it.
•    Use a pumpkin carving kit that includes a small, serrated pumpkin saw. They are less likely to get stuck in the thick pumpkin tissue. These types of kits are recommended by most physician organizations such as the American Society for Surgery of the Hand, American Academy of Family Physicians and the American Academy of Pediatrics.

If an injury were to occur, the ASSH recommends the hand be elevated above the heart and direct pressure applied to the wound with a clean cloth to stop the bleeding. If continuous pressure does not slow or stop the flow within 15 minutes, a trip to an emergency room may be necessary. If there is any numbness in the fingers or an inability to move the fingers, then the individual should go to an emergency room. The American Academy of Orthopaedic Surgeons believes it may be wise to follow-up with a hand surgeon to make sure everything is okay and nothing needs to be repaired.

While some of the injuries are minor, many involve nerves and tendons in the fingers that require complex surgery for reconstruction and months of therapy for recovery. In situations with severe lacerations, an orthopaedic hand specialist will be brought in to assess the injury and check if a tendon, blood vessel, nerve or combination of the three have been severed and will determine if surgery is required.

Be sure to follow the above safety tips to have a safe, accident-free pumpkin carving experience!

The Orthopaedic Associates of Michigan have experience working with injuries of all types. Please call 616-459-7101 to set up an appointment.

Sources: American Society for Surgery of the Hand, American Academy of Orthopaedic Surgeons, American Academy of Family Physicians, American Academy of Pediatrics, PubMed.gov – Epidemiology of pediatric holiday-related injuries presenting to US emergency departments.