Athletic Injuries

Concussions in Young Athletes – Live Chat on August 9, 2016

concussion260x200Is the peewee football phase too early to wonder about concussions? Maybe not. Concussion rates are rising sharply among U.S. kids and teens, researchers report, and concussion diagnoses more than doubled between 2007 and 2014. According to the CDC, more than 248,000 U.S. children and teens land in the emergency room each year because of a concussion sustained in sports or recreational activities, such as bicycling, football, basketball, soccer and from playground injuries.

If you have a young child or a student athlete who is participating in sports and want to learn more about how to prevent, detect and treat concussions, join us on Tuesday, August 9 from 12:30 p.m. to 1:30 p.m. for a live online chat to discuss the topic. Our host is Dr. Jeffrey Webb, pediatric sports medicine physician at Emory Sports Medicine Center. Dr. Webb will also discuss the laws that Georgia has passed targeting concussion in high school and younger athletes.

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About Dr. Webb

webb-jeffreyDr. Webb sees patients of all ages and abilities with musculoskeletal problems, but specializes in the care of pediatric and adolescent patients. He works hard to get players “back in the game” safely and as quickly as possible. During his training and practice he has provided medical coverage for division I college football and other sports, multiple high schools, ballet, the Rockettes, marathons, international track and field events, and the Special Olympics. He is a team physician for the NFL’s Atlanta Falcons and is also a consulting physician for several Atlanta area high schools, the Atlanta Dekalb International Olympic Training Center, Emory University, Oglethorpe University, Georgia Perimeter College and many other club sports teams.

He is active in the American Medical Society for Sports Medicine and American Academy of Pediatrics professional societies and has given multiple lectures at national conferences as well as contributed to sports medicine text books.

ACL Injury: Mikayla’s Success Story

Mikayla CoombsIn November of 2015, my daughter Mikayla Coombs had a rough start to her basketball season. Mikayla is the number one basketball player in the state of Georgia and the sudden injury came as a surprise. Mikayla was playing in a tournament at Norcross High School and fell during the game. She was not in any pain after falling on the court so the athletic trainer checked her and said she could return to play. After getting back on the court to play, she fell again and was told that she had a lateral collateral ligament (LCL) strain. The next day we had an appointment to see the team doctor without having any testing done and it was confirmed that she had an ACL injury.

After the doctor’s visit we were sent to have an MRI taken of Mikayla’s leg. The results came back around thanksgiving and the news was not good. Mikayla had an ACL tear. At that point, as a mother of a great athlete, I had no clue of what I was going to do. I had tears in my eyes. Mikayla received an invite to the USA trial scheduled for June and was not able to attend because of her injury and scheduled surgery. However, Mikayla was never sad, nor did she complain.

I’ve always heard positive feedback in the community about sports medicine physicians at the Emory Orthopaedics & Spine Center and decided to make an appointment for Mikayla. Mikayla had a successful surgery with Spero Karas, MD on December 31st. 2015. Dr. Karas went above and beyond to help her. After Mikayla’s surgery, she was in minimal pain and hardly needed any of the medications prescribed. Surprisingly, Mikayla was also doing pushups, she was able to sleep and shower with no assistance. Two days later she had her follow-up appointment and she was able to walk into the clinic. She was determined and felt good enough to not have to use her crutches.

It has been an amazing journey. Mikayla got back on her own without a brace and everyone that knows Mikayla has been impressed with her speedy recovery time. Mikayla continues to go to physical therapy with The Emory Orthopaedics & Spine Center and at her high school with an athletic trainer. She is doing wonderful and the good thing is that nothing has changed in terms of opportunities for my daughter and in athletics. Before she had multiple offers to UConn, Stanford, Georgia, Kentucky, Virginia, Penn State, Tennessee etc. , and now those offers are still coming in. Mikayla has a very small scar. It’s been a blessing and I cannot thank Dr. Karas enough. He was very adamant about not allowing Mikayla back on the court until she was in the correct stage of rehab and only allowed court privileges when appropriate. Dr. Karas treated her as if it were his own daughter that got injured.

Several of Mikayla’s team members have had surgery with other offices and compared to Mikayla’s small scar, it’s unbelievable. Mikayla often gets questions on whether or not, she really had surgery.

According to Mikayla “Everything happens for a reason and if Dr. Karas is taking care of any patient, they’ll be alright and are in good hands.”

Mikayla has won: 
AJC 2A Player of the year
METRO ATLANTA PLAYER OF THE YEAR
REGION PLAYER OF THE YEAR
ALLSTAR-MVP
USA TODAY Georgia First Team
USA TRYOUTS INVITE

Thank you to Dr. Karas and the team at the Emory Orthopaedics, & Spine Center!

A note from Dr. Karas:

The surgery I performed on Mikayla was an Anterior Cruciate Ligament (ACL) reconstruction using a hamstring tendon from the back of her thigh. The hamstring tendon is actually stronger than her native ACL, and has less risk of muscle atrophy and tendinitis in her knee. Rehabilitation after ACL reconstruction is lengthy, but most athletes are able to return to their sport approximately 9-12 months after surgery.

About Dr. Karas:

karas-speroDr. Karas joined the Emory Orthopaedic & Spine Center in 2005 as Director of the Emory Orthopaedic Sports Medicine Fellowship Program. In addition to this role, he currently serves as the head team physician for the Atlanta Falcons, a consulting team physician for Georgia Tech University, Emory University, Oglethorpe University, Georgia Perimeter College, and St. Pius X High School. Prior to this, he served as chief of the Shoulder Service, team physician, and director of the Orthopaedic Sports Medicine Fellowship at the University of North Carolina at Chapel Hill Department of Orthopaedics.

Dr. Karas received his undergraduate degree from the University of Notre Dame, and his Doctor of Medicine degree from Indiana University School of Medicine. After medical school, he completed a residency in Orthopedic Surgery at Duke University Medical Center. After residency, Dr. Karas completed a Knee, Shoulder, and Sports Medicine Fellowship at the prestigious Steadman Hawkins Clinic in Vail, Colorado. While in Colorado, he served as an Associate Team physician for the Denver Broncos and Colorado Rockies professional sports teams.

He is the author of more than 150 publications, presentations, and demonstrational videos. He has trained over 100 residents, fellows, and graduate students in subspecialty care of the shoulder, knee and sports medicine. His research has been published in numerous journals, including the American Journal of Sports Medicine, the Journal of Arthroscopy, the Journal of Shoulder and Elbow Surgery and the Journal of Orthopaedic Trauma. Dr. Karas is certified by the American Board of Orthopaedic Surgery and has held leadership positions in numerous societies, including the American Orthopaedic Association, the American Academy of Orthopaedic Surgery, the Arthroscopy Association of North America and the American Orthopaedic Society for Sports Medicine.
Dr. Karas is a recognized expert in the field of shoulder surgery, knee surgery, and sports medicine, and has been awarded numerous grants for research and product development. A frequent speaker throughout the United States and internationally, his work has been featured in Ski Magazine, Men’s Health, and on NBC, FOX, and CNN network television. He is also active in quality musculoskeletal research, and has been honored by his peers with nominations for numerous research awards. He actively collaborates with medical corporations by developing cutting-edge technology to improve the instruments and techniques in orthopedic surgery.

Dr. Karas was selected as one of America’s “Top Sports Medicine Specialists” in Men’s Health Magazine. He has also been named one of the “Top Sports Medicine Doctors for Women” by Women’s Health magazine, “Best Orthopaedic Surgeons in America” by Castle Connoly, and the most trusted sports specialist in Atlanta, Georgia by Atlanta Magazine. He is regularly listed in Atlanta Magazine’s Top Doctors. Dr. Karas is a full member of the American Shoulder and Elbow Society, a prestigious “invitation only” society with rigorous selection criteria.
A former collegiate athlete himself, Dr. Karas was a varsity letterman in wrestling at the University of Notre Dame. He continues to participate in sports such as golf, snowboarding, and fitness training. He also coaches little league sports, and is an active member of his church and community.

Dr. Karas and his wife, Johanna, are blessed with three very active and beautiful children – Gus, Elena, and Nicholas.

Keys to Preventing Soccer Injuries

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Dr. Oludade recently returned from a trip to Turkey, where he provided medical care for the United State’s U-17 Men’s National Soccer Team during the 2016 Mercedes Benz Aegean Cup. Dr. Olufade with head coach, John Hackworth.

Already the most popular international team sport, soccer is also the fastest growing team sport in the United States. With more people playing soccer, it is not surprising that the number of soccer-related injuries is increasing. Although soccer provides an enjoyable form of aerobic exercise and helps develop balance, agility, coordination, and a sense of teamwork, soccer players must be aware of the risks for injury. Injury prevention, early detection, and treatment can keep kids and adults on the field long-term.

The most common injuries in soccer that impact healing time are ankle/knee ligament injuries and muscle strains to the hamstrings and groin. These injuries may be traumatic, such as a kick to the leg or a twist to the knee, or result from overuse of muscles of tendons. Cartilage tears and anterior cruciate ligament (ACL) sprains in the knee are some of the more serious injuries that may require surgery.

Proper preparation is essential for preventing injuries from playing soccer.  Here are some tips:

  • Warm up and stretch. Always take time to warm up and stretch. In order to increase your flexibility and decrease the likelihood of injury, there are number of stretching methods you can use:
    • Dynamic soccer stretching – Often used at the beginning of a warm up. Making circles with the arms to loosen the shoulders, twisting from side to side and swing each leg as if kicking a ball are examples of dynamic stretching.
    • Static soccer stretching – Muscles are stretched without moving the limb or joint itself. A good example of a static stretch is the traditional quad stretch – standing on one leg, you grab your ankle and pull your heel into your backside.
  • Maintain fitness. Be sure you are in good physical condition at the start of soccer season. During the off-season, stick to a balanced fitness program that incorporates aerobic exercise, strength training, and flexibility.
  • Hydrate. It’s important to make sure you get the right amount of water before, during, and after exercise. Water regulates your body temperature and lubricates your joints. If you have not had enough fluids, your body will not be able to effectively cool itself through sweat and evaporation. You may experience fatigue, muscle cramps, dizziness and more serious symptoms, all of which can increase the likelihood of injury.
  • Ensure Proper Equipment. Wear shin guards to help protect your lower legs, as leg injuries are often caused by inadequate shin guards. You should wear the proper cleats depending on conditions, such as wearing screw in cleats on a wet field with high grass.
  • Prevent Overuse. Limit your amount of playing time. Adolescents should not play just one sport year round — taking regular breaks and playing other sports is essential to skill development and injury prevention.
  • Cool down and stretch. Stretching at the end of practice is too often neglected because of busy schedules. Stretching can help reduce muscle soreness and keep muscles long and flexible. Be sure to stretch after each training practice to reduce your risk for injury.

At Emory Sports Medicine Center, our team of specialists is constantly conducting research and developing new techniques for diagnosing and treating the full range of sports-related injuries. Whether you are a professional athlete, or simply enjoy an active lifestyle, Emory provides comprehensive care, in a patient–family- centered environment, so together we achieve the best possible outcome and you can return to the sport you love. To schedule an appointment, call 404-778-3350 or complete our online appointment request form.

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About Dr. Olufade

olufade-oluseunOluseun Olufade, MD, is board certified in Physical Medicine & Rehabilitation and Interventional Pain Medicine. He completed fellowship training in both Interventional Pain Medicine and Sports Medicine. During his fellowship training, he was a team physician for Philadelphia Union, a major league soccer (MLS) team, Widener University Football team and Interboro High School Football team.

Dr. Olufade employs a comprehensive approach in the treatment of sports related injuries and spinal disorders by integrating physical therapy, orthotic prescription and minimally invasive procedures. He specializes also in concussion, tendinopathies and platelet rich plasma (PRP) injections. He performs procedures such as fluoroscopic-guided spine injections and ultrasound guided peripheral joint injections. Dr. Olufade individualizes his plan with a focus on functional restoration.

Dr. Olufade has held many leadership roles including Chief Resident, Vice-President of Resident Physician Council of AAPM&R, President of his medical school class and Editor of the PM&R Newsletter. He has authored multiple book chapters and presented at national conferences.

Sports Cardiology: Heart Healthy & Being Active Live Chat on January 26th

sports-cardio-cilAsk the experts! Talk to the physicians who are the medical providers for the Atlanta Falcons, Atlanta Dream, Georgia Tech athletes and more!

When you’re an athlete, professional, amateur or weekend warrior, you have unique health needs. Optimal health is vital to your performance and in some cases, your ability to participate at all. Even with the best training and care, the body doesn’t always cooperate. That’s where we come in.

Emory Healthcare is the first and only health system in Atlanta to launch a Sports Cardiology practice. Collaborating with the Emory Sports Medicine Center, the program not only focuses on diagnosing and treating cardiovascular disease, but also preventing future issues.

The unique partnership between Emory Sports Medicine Center and Emory Cardiology means our physicians work together to diagnose your condition and deliver a proper treatment plan so you return to the activity you love, safely. This level of collaborative care is not available in programs that focus on cardiovascular health or sports medicine exclusively.

We encourage athletes and exercising individuals, and their families, of all ages and levels to join us for a live chat on Tuesday, January 26, 2016 at 12:00 p.m. EST hosted by Emory sports cardiologist, Jonathan H. Kim, MD, and sports medicine physician, Neeru Jayanthi, MD. Don’t miss your chance to get your general sports and sports cardiology related questions answered by the same physicians who treat the Atlanta Falcons, Hawks, Dream, Georgia Tech and other professional and recreational athletic organizations across metro Atlanta. Register below.

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Key Steps To Diagnosing And Treating Concussions

orth-concussion-checklistv3The current medical definition of a concussion is essentially a ‘transient alteration in mental status that may or may not require loss of consciousness that may result from a direct or indirect blow to the head.’ The struggle many of us feel when we read this is, ‘What does that mean?’

It is critical for orthopaedic surgeons who work on the sidelines of athletic teams, athletic trainers, athletes, parents of athletes, coaches and school administrators to be able to correctly recognize and diagnose a concussion. After an athlete suffers a head injury, any misdiagnosis may lead to severe brain damage, prolonged disability, and even death.

However, a concussion may be tough to diagnose if a person does not know what to look for, or if an athlete does not report his or her symptoms. A concussion can present itself in a variety of ways, making it difficult for non-concussion experts to detect, diagnose and treat. Other than temporary loss of consciousness, which is most recognizable, other signs and symptoms of a concussion include:

  • Headache or “pressure” in head.
  • Nausea or vomiting.
  • Balance problems or dizziness, or double or blurry vision.
  • Bothered by light or noise.
  • Feeling sluggish, hazy, foggy, or groggy.
  • Confusion, or concentration or memory problems.
  • Just not “feeling right,” or “feeling down.”

Concussion diagnosis

While signs and symptoms of a concussion generally show up shortly after the injury, some symptoms may not show up for hours or days. Currently, the Centers for Disease Control and Prevention (CDC) estimates that between 1.6 and 3.8 million sports-related concussions occur each year in the United States. However, it is believed that around 50 percent of concussions go unreported.

Because the effects of a concussion are not always visible, many athletes return to their sport too quickly following a head injury. That’s why it’s crucial to educate parents, coaches and other athletic officials about the importance of having head injuries examined by a specialized physician who has experience caring for patients with concussion.

Concussion treatment

According to recent studies, 79 percent of Americans believe there is no way to cure a concussion and only 29 percent of Americans believe all concussions are treatable. These days, a concussion is fully treatable, but the key is to identify risk factors that may prolong and complicate recovery early on. At Emory, our team of concussion experts pioneer and utilize the latest treatment therapies to deliver treatment plans developed for each athlete. Some treatment recommendations include cognitive and physical rest, while others require more aggressive therapies. No two concussions are alike; therefore no two concussion treatment plans should the same.

To schedule a consultation with a concussion expert at Emory, or to see one of our sports medicine specialists, please request an appointment online or call 404-778-3350.

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About Emory Sports Medicine Center

The Emory Sports Medicine Center is a leader in advanced treatments for patients with orthopaedic and sports-related injuries. From surgical sports medicine expertise to injury rehabilitation, our sports medicine physicians and specialists provide comprehensive treatments for athletic injuries in Atlanta, Dunwoody and Johns Creek. Constantly conducting research and developing new techniques, the sports medicine specialists at Emory are experienced in diagnosing and treating the full spectrum of sports injuries, including concussions.

About Dr. Pombo

pombo-matMathew Pombo, MD, joined the Emory Orthopaedic Surgery faculty as a highly regarded orthopaedic surgeon, speaker, author and researcher who specializes in getting patients with injuries back to an active lifestyle. His professional interests include anatomic single- and double-bundle ACL reconstruction, rotator cuff tears, shoulder instability, meniscal/cartilage injury and repair, joint preservation in the aging athlete, and minimally invasive joint replacement surgery of the knee and shoulder.

Dr. Pombo has conducted extensive scientific research, published multiple journal articles, written several book chapters, and has presented at both national and international meetings on topics related to sports medicine, concussions, and orthopaedic surgery. He has been instrumental in bringing awareness to sports-related concussions and the new Georgia “Return to Play” Act and is one of the top regarded experts in the area for the treatment of concussions. He currently serves as the Director of the Emory Sports Concussion Program.

Dr. Pombo, his wife, and two boys, Eli and Henry, live in Johns Creek, GA. Dr. Pombo enjoys spending time with his family during his days off. Many of his patients also enjoy watching him succeed in his second career as a professional race car driver, where he can be found driving at race tracks across North America.

Best Ways To Recognize And Treat An Ankle Fracture

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What is an ankle fracture?

A fracture is a partial or complete break in a bone. An ankle fracture can range from a simple break in one bone, which may cause discomfort but not stop you from walking, to more serious fractures, which damage multiple bones that hold your ankle joint in place and may require surgery or immobilization for some time.

There are three bones that make up the ankle joint:

  • Tibia – shinbone
  • Fibula – smaller bone of the lower leg
  • Talus – a small bone that sits between the heel bone (calcaneus) and the tibia and fibula

Any one of the three bones could break as the result of a fall, twisting, rolling or rotating your ankle, a car accident or some other trauma to the ankle. The more bones that are broken, the more unstable the ankle becomes and the longer the recovery time.

What are the signs and symptoms of a fractured ankle?

Common symptoms of an ankle fracture include:

  • Immediate and severe pain, which can extend from the foot to the knee
  • Swelling
  • Bruising
  • Tender to touch
  • Decreased ability to walk or put any weight on the injured foot
  • Deformity or protruding bones

Because a broken ankle can frequently be confused with an ankle sprain, most severe injuries to the ankle should be examined by a musculoskeletal specialist.

What are the treatment options?

First, to prevent further complications, make sure to stay off the injured ankle until you receive medical evaluation from a physician. Other ankle fracture treatments include:

  • Elevate the ankle and apply ice to the injured area to decrease swelling and pain.
  • Rest and make sure to stay off the affected ankle.
  • Depending on the type of the fracture, a splint/cast/boot may be used to stabilize and realign the ankle joint.
  • Some patients may require surgery if the fracture is severe enough.

What is the best way to heal from a fractured ankle?

Healing of an ankle fracture depends on the severity of the injury. To optimize bone healing we advise patients eat a good diet, get enough calcium and vitamin D, and follow treatment instructions from their physician.

Will an ankle fracture heal by itself?

Some ankle fractures will heal without surgical intervention but most require some period of immobilization in boot or brace if treated without surgical intervention.

What should someone with a fractured ankle do to keep relatively fit during the period of immobility?

Patients often worry about their fitness when they are immobilized or unable to put weight on their extremity after an ankle fracture. I recommend my patient at Emory Orthopaedics & Spine Center begin upper body exercises as soon as they can resume activity. We also have patients frequently use rolling knee walkers, which allow them to be as mobile as possible while they are healing.

If you’ve suffered an ankle fracture, seek medical attention from an orthopaedic physician specializing in fractures. The physician will conduct a physical exam, perform appropriate imaging and recommend a treatment plan (non-surgical or surgical) to get your back to your pre-injury functional level safely and as soon as possible. If the injury is severe, please call 911 or visit the nearest hospital emergency room.

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About Dr. Bariteau

bariteau-jasonJason Bariteau, MD, grew up in a small town just outside of Albany, New York. After completing his undergraduate degree in Biology at College of Saint Rose, he then pursued his medical degree at Upstate Medical University in Syracuse, NY where he graduated Magna Cum Laude. Following completion of his medical training he developed his surgical skills during his orthopedic surgery residency at Brown University. He then subsequently completed two advanced orthopedics fellowships; the first at Brown University in orthopedic trauma and the second at Baylor Medical Center in Dallas Texas under the tutelage internationally known Foot and Ankle Surgeon James W Brodsky MD. He currently resides in Atlanta, GA with his wife and three children.

Related Resources
Takeaways from Dr. Olufade’s Ankle Sprain Chat

Protect Your Knees at Any Age

knee-painKnee problems are the most common reason people visit an orthopaedic or sports medicine surgeon. May seem like common sense, but if you want healthy knees later in life, start taking care of them now, even if you are young.

The knee is the largest and strongest joint in your body and the major support structure of all your lower extremities. Unfortunately, as people age, knee issues become more common. Possible knee symptoms are aches, stiffness, and swelling and are usually caused by two main factors.

First, as we age, we lose some of the natural cartilage that acts as a cushion between the four bones in your knee joint. Damage to, or wearing down of, the cartilage causes pain and makes it hard to do many everyday activities, such as walking or climbing stairs.

Second, if you play sports, live an active lifestyle, or have suffered a knee injury, it is likely you may experience future or further knee problems as you continue to age.

Obesity has more recently become a major risk factor for knee conditions such as arthritis, not only of the knee, but also the hip and ankle.

Now that we know the major causes of knee problems, what’s a person with aging knees to do? While you can’t stop the aging process, you can follow these key tips to protect your knees.

1. Monitor changes in your knee health and record any signs and symptoms to share with your orthopaedic physician.

Symptoms from the aging process may be knee pain, but swelling is another common indicator. With age and cartilage loss, the body naturally responds by trying to repair itself, so there may be fluid in the knee, which is the body’s way of trying to increase shock absorption and lubrication in the knee.

2. Maintain a healthy weight

Every extra pound you put on places about four 4 extra pounds of pressure on your knees. Getting rid of extra weight may help alleviate knee pain or cure it altogether.

3. Exercise

Living an active lifestyle and incorporating low impact exercise into your routine promotes healthy knees. Make sure you leave enough time to properly warm up and stretch before starting your activity. Strength training uses resistance to build strong muscles and flexibility in the skeletal muscles.

4. Don’t overdo it!

Make sure you do not ignore the ongoing knee pain. If you play sports, consider additional training to learn proper techniques and alignment. When doing squats and lunges, don’t bend your leg beyond a 90-degree angle and make sure your knee stays directly over your foot. If injured, try using the RICE method to relieve immediate pain and reduce swelling: Rest, Ice, Compression and Elevation. And contact your healthcare provider if the pain persists or intensifies.

The team of knee specialists at Emory Orthopaedics & Spine Center includes orthopaedic surgeons, non-operative and sports medicine physicians, and trainers. At Emory, we offer the most advanced knee treatments in the Southeast, including anatomic ACL reconstruction, PRP knee therapy, meniscus repair, and more. To schedule an appointment, call 404-778-3350 or complete our online appointment request form.

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About Dr. Spero Karas

karas-speroDr. Karas is the Director of the Orthopaedic Sports Medicine Fellowship Program and an Associate Professor of Orthopaedic Surgery at Emory University. Dr. Karas is an internationally recognized expert in the field for sports medicine, surgery of the shoulder and knee, and arthroscopic surgery. He has been recognized as one of America’s “Top Orthopaedic Doctors” in Men’s Health Magazine and “Top Sports Medicine Specialists for Women” in Women’s Health Magazine. Atlanta Magazine has named him in “Atlanta’s Best Doctors” for the past eight years.

Dr. Karas came to Emory in 2005, after serving as Chief of the Shoulder Service and team physician at the University of North Carolina in Chapel Hill. He currently serves as head team physician and orthopedic surgeon for the Atlanta Falcons, as well as a consulting team physician for Emory University and Georgia Tech athletics. He cares for patients and athletes of all levels: professional, collegiate, scholastic, and recreational.

How to Recover From a Patellar Tendon Tear

The patellar tendon is the tendon below the kneecap (patella) that attaches the quadriceps (front thigh) muscles to the tibia (shinbone). This tendon is extremely important in straightening the knee or slowing the knee during bending or squatting. Basically, any physical activity or sport requires an intact patellar tendon.

Patellar tendon tears can be either partial or complete. When there is a complete tear, the patellar tendon separates from the kneecap and the knee cannot be straightened.

Athletes tend to overexert themselves during play and when too much body weight or force is placed on the knee, the patellar tendon can rupture or tear. Because this tendon is very small and vital to knee support, choosing an orthopaedic surgeon and physical therapist who specialize in knee injury treatment is crucial. Recovery from a patellar tendon tear can take a long time, so your best friend during those rehabilitation months needs to be your physical therapist.

The general phases to recovery from a patellar tendon injury are provided below for reference to the average patient, but individual patients will recover at different rates depending on age, associated injuries, pre-injury health status, rehab compliance, tissue quality and severity of the injury.

Phase I: Called the “protection phase,” requires about 6-8 weeks of strengthening exercises after surgery. These specific exercises work to restore strength to your quadriceps and range of motion in the knee.

Phase II: Six weeks after surgery, your therapist will remove your brace so you can move more freely with a greater range of motion. Exercises will continue to be conservative to normalize gait and assess control without the brace, including leg stands and squats.

Phase III: This phase starts around 4 months after surgery and focuses on restoring more of the knee function. Running and biking are incorporated in the session as well as sport-specific drills tailored to the athlete’s sport and position. We add impact into the drills and hope to see good control and no pain during participation.

Patellar tendon ruptures are typically major injuries, yet athletes can and should expect to return to their previous level of play after surgery and rehabilitation.

Have you suffered an injury or are recovering from surgery? Make sure you have a team of highly-specialized sports medicine and physical therapy experts who will work together to design an individualized treatment program to meet your goals so you can return to the sport you love.

The highly-trained physicians and surgeons at the Emory Sports Medicine Center treat a wide variety of sports medicine conditions and athletic injuries, including sprains and strains from the foot and ankle to the elbow and hand. To see an Emory Sports Medicine specialist, call 404-778-3350 or complete our online appointment request form.

Emory Physical Therapy offers a complete range of services for patients needing rehabilitation services at seven convenient locations around metro Atlanta. Our experienced staff includes board certified clinical specialists in orthopedics and sports medicine, certified intramuscular and manual therapists, Pilates certified specialists, certified strength and condition specialists.

About Dr. Karas

karas-speroSpero Karas, MD is a team physician for the Atlanta Falcons. He is the Director of the Orthopaedic Sports Medicine Fellowship Program and an Associate Professor of Orthopaedic Surgery at Emory University. Dr. Karas is an internationally recognized expert in the field for sports medicine, surgery of the shoulder and knee, and arthroscopic surgery. He has been recognized as one of America’s “Top Orthopaedic Doctors” in Men’s Health Magazine April 2007 and “Top Sports Medicine Specialists for Women” in Women’s Health Magazine. Atlanta Magazine has named him “Atlanta’s Most Trusted Sports Medicine Specialist” for the past three years.

He has authored over 200 manuscripts, presentations, and instructional videos and has presented his research at numerous institutions both internationally and throughout the United States. His work has been featured in NBC television, Men’s Health Magazine, Ski Magazine, and numerous internet health services. He works closely with industries in the design of orthopaedic devices and teaches physicians throughout the world in their use.

Dr. Karas came to Emory in 2005, after serving as Chief of the Shoulder Service and team physician at the University of North Carolina in Chapel Hill. He currently serves as team physician for the Atlanta Falcons, Georgia Tech Baseball and Lakeside High School, as well as a consulting team physician for Emory University and Georgia Tech athletics. He cares for patients and athletes of all levels: professional, collegiate, scholastic, and recreational.

Using Heat and Cold to Treat Injury

back-painIt’s hard to get through life without straining a muscle, spraining a ligament, or wrenching your back. When something hurts, ice and heat are often the go-to solutions, and using temperature therapy to complement medications and self-care can be very effective. But while both heat and cold can help reduce pain, it can be confusing to decide which is more appropriate depending on the injury. Our tips below give you the facts on when to use (and not use) heat and cold therapies.

When to Use Cold Therapy

Cold is best for acute pain caused by recent tissue damage is used when the injury is recent, red, inflamed, or sensitive. The inflammatory process is a healthy, normal, natural process that also can be incredibly painful. Here are some examples of common acute injuries:

  • Ankle sprain
  • Muscle or joint sprain
  • Red, hot or swollen body part
  • Acute pain after intense exercise
  • Inflammatory arthritis flare ups

When you sprain something, you damage blood vessels causing swelling to occur. Applying something cold causes the blood vessels to constrict, reducing the swelling and limiting bruising. Cold therapy can also help relieve any inflammation or pain that occurs after exercise, which is a form of acute inflammation. However, unlike heat, you should apply ice after going for a run to reduce post-exercise inflammation.

Tips for Applying Cold

  • Cold should only be applied locally and should never be used for more than 20 minutes at a time.
  • Apply cold immediately after injury or intense, high-impact exercise.
  • Always wrap ice packs in a towel before applying to an affected area.
  • Do not use ice in areas where you have circulation problems.

When to Use Heat Therapy

While ice is used to treat acute pain, heat therapy is typically used for chronic pain or conditions. Unlike cold therapy’s ability to constrict blood vessels, heat allows for our blood vessels to expand and our muscles to relax. That’s why overworked muscles respond best to heat. Heat stimulates blood flow, relaxes spasms, and soothes sore muscles. Some common chronic conditions that heat is used to treat are:

  • Muscle pain or soreness
  • Arthritis
  • Stiff joints

Tips for Applying Heat

  • Unlike cold therapy, heat should be applied before exercising. Applying heat after exercise can aggravate existing pain.
  • Protect yourself from direct contact with heating devices. Wrapping heat sources in a folded towel can help prevent burns.
  • Stay hydrated during heat therapy.
  • Avoid prolonged exposure to heating sources.

Low Level Heat

If you find that heat helps ease your pain, try a continuous low-level heat wrap, available at most drugstores. You can wear a heat wrap for up to 8 hours, even while you sleep.

What to Avoid

Heat can make inflammation worse, and ice can make muscle tension and spasms worse, so be careful. Just like anything else, don’t overdo it! It’s normal for your skin to be a little pink after using cold and heat therapies, but if you start to notice any major skin irritation like hives, blisters or swelling, you should call your doctor. Otherwise, use whatever works for you depending on your condition. Both ice and heat can be very effective if used correctly!

About Emory Sports Medicine Center

At the Emory Sports Medicine Center, our experts specialize in advanced procedures to treat and repair a wide range of sports related injuries. Recently recognized as one of the nation’s TOP 50 orthopaedics programs, Emory Orthopaedics, Sports and Spine has 6 convenient locations across metro Atlanta, as well as 6 physical therapy locations. Click to learn more >>

About Dr. Mines

mines-brandonDr. Brandon Mines is board certified in both family practice and sports medicine. He has focused his clinical interest on sports injuries and conditions of the shoulder, elbow, wrist/hand, knee, foot and ankle. He is head team physician for the Women’s National Basketball Association’s (WNBA) Atlanta Dream, Decatur High School and a team physician for NFL’s Atlanta Falcons. He is also a rotational physician for United States soccer teams.

Dr. Mines enjoys giving talks and lectures regarding the prevention of sports injuries. In fact, as an active member of the American Medical Society for Sports Medicine and the American Society for Sports Medicine, Dr. Mines has attended and presented at various national conferences. Through the years, he has helped all levels of athletes return to the top of their game.

What is a ruptured ligament?

sprained-ankleA sprained ankle is a very common injury in athletes, non-athletes and people of all ages. Approximately 25,000 people experience this injury each day. Ankle sprains are usually caused by an injury that places stress on a joint or ruptures the supporting ligaments. A ligament is an elastic structure that connects bones to other bones.

A ruptured ligament indicates a severe sprain. The ligaments in the ankle hold the ankle bones and joint in position, providing stabilization and support. Rupturing occurs when the ligaments tear completely or separate from the bone, impairing proper joint function.

Causes of ankle sprains

  • Sprains are common injuries caused by sports and physical fitness activities. These activities include: walking, basketball, volleyball, soccer and other jumping sports. Contact sports such as football, hockey and boxing put athletes at risk for ankle injury.
  • Falls, twists, or rolls of the foot that stretch beyond its normal motions are a result of ankle sprains.
  • Uneven surfaces or stepping down at an angle can cause sprains.

Treatment for ankle sprains

When treating a severe sprain with a ruptured ligament, surgery or immobilization may be needed. Most ankle sprains need a period of protection to heal that usually takes four to six weeks. A cast or a cast brace protects and supports the ankle during the recovery period. Rehabilitation is used to help decrease pain and swelling and ultimately prevents chronic ankle problems.

A sports medicine specialist should evaluate the injury and recommend a treatment plan. Meanwhile, using the RICE method is a simple and often the best treatment for injuries.

  • Rest
  • Ice
  • Compress
  • Elevate

Surgical treatments are rare in ankle sprains, but surgery may be needed in the event the injury fails to respond to nonsurgical treatment. Possible surgical options include:

  • Arthroscopy is a procedure done on the joint to see how extensive the damage is. Surgeons look for loose fragments of bone or cartilage or if a ligament is in caught in the joint.
  • Ligament reconstruction repairs the torn ligament with stitches or sutures.

How to prevent ankle sprains

Tips to prevent ankle sprains include:

  • Stretching and warming-up before physical activity
  • Wearing shoes that fit properly
  • Paying attention to walking, running or working surfaces

The highly-trained physicians and surgeons at the Emory Sports Medicine Center treat a wide variety of sports medicine conditions and athletic injuries, including sprains and strains from the foot and ankle to hand and elbow.

About Dr. Olufade

olufade-oluseunDr. Olufade is board certified in Physical Medicine & Rehabilitation and Interventional Pain Medicine. He completed fellowship training in both Interventional Pain Medicine and Sports Medicine. During his fellowship training, he was a team physician for Philadelphia Union, a major league soccer (MLS) team, Widener University Football team and Interboro High School Football team.

Dr. Olufade employs a comprehensive approach in the treatment of sports related injuries and spinal disorders by integrating physical therapy, orthotic prescription and minimally invasive procedures. He specializes also in concussion, tendinopathies and platelet rich plasma (PRP) injections. He performs procedures such as fluoroscopic-guided spine injections and ultrasound guided peripheral joint injections. Dr. Olufade individualizes his plan with a focus on functional restoration.

Dr. Olufade has held many leadership roles including Chief Resident, Vice-President of Resident Physician Council of AAPM&R, President of his medical school class and Editor of the PM&R Newsletter. He has authored multiple book chapters and presented at national conferences.

Related Resources
Is it a Sprain? Or a Fracture?
Find Out How to Prevent, Diagnose & Treat Ankle Sprains
What Should You Do When You Sprain Your Ankle?