Injury Prevention

Meet your Spine Surgeon: A Conversation with Dr. John Heller 

Spine Surgeon

The spine supports the body’s weight and protects the nerves in the spinal cord that run through it. It helps maintain the body’s muscle control and nerve coordination, and without it, we wouldn’t be able to function. Spine surgery, a subspecialty of orthopedic surgery, includes the treatment and management of a wide variety of conditions affecting the neck and back, including herniated discs and fractures.

For Emory Healthcare spine surgeon John G. Heller, MD, the care and treatment of patients with spine issues is personally rewarding. His practice works to improve the lives of patients while training the next generation of spine surgeons.

Patients, understandably, often have many questions regarding spine conditions and their treatment. Recently, Dr. Heller spoke with Dr. Bruce Feinberg for The Weekly Check-up on WSB Radio about a wide range of issues related to the spine surgery. The following are summarized excerpts.

Question: Tell us about your team.

Dr. Heller: Over the last 28 years I’ve been at Emory, our team of spine specialists has grown a lot and so has our field. Right now, we have a team comprised of 11 orthopedic and neuro-spine specialists who are surgeons. We also have more than a dozen non-operative specialists, whose job it is to keep people from meeting the surgeons. It’s the minority of folks who actually need to or end up seeing a surgeon.

Question: How have you seen your practice grow?

Dr. Heller: We’ve been really fortunate in recent years to have the Emory Orthopaedic & Spine Hospital, in addition to Emory Midtown, to work in. It’s been a game changer for us and our patients. We have an entire hospital with a mission focused on joint replacement and spine. It’s a smoother experience for patients and we’ve seen that in our patient satisfaction rates, which are some of the highest in the country. We’re very proud of what we have built as a team, and in doing that alongside our educational and research activities. We now have points of access across the region to serve patients closer to home.

Question: How do you spend your days?

Dr. Heller: I alternate days either in the office all day or in the operating room all day. If I’m in the office, I see about 15 to 20 patients a day, which means I get to spend a good bit of time with each patient.

What we do really takes some time to get to know the patient, what’s going on and their options, and to go over all the information. On the days I’m operating, it can vary between a few operations that are several hours long each, to one operation that lasts anywhere from 10 to 14 hours.

Question: What is myelopathy?

Dr. Heller: We see and treat many cervical spine conditions, and this is one of our most common. Myelopathy is compression of the spinal cord caused by wear and tear which creates multiple points of pressure. We see this most commonly in those aged 55 and over. Myelopathy commonly presents with little to no pain, wobbly legs, and clumsy hands. There are a variety of different operations that we can do to help people with this condition.

Question: What is spinal stenosis?

Dr. Heller: Spinal stenosis is the narrowing of the spinal canal. As patients get older, their discs wear out and the place for the nerves in the low back and neck get crowded out. This condition can be associated leg pain, arm pain, back or neck pain, and sciatica.

Question: What is disc herniation?

Dr. Heller: Disc herniation commonly occurs in young healthy people who have a piece of a disc break off and compress a nerve. More than half the time, they never need to see a spine surgeon.

Question: What are your thoughts on using opioids to manage pain, given the concerns from patients and the medical industry?

Dr. Heller: Opioid abuse is dangerous, and we take prescribing opioids very seriously. Daily, on average, 142 people in the U.S. die because of prescription opioid accidents. We also know that taking opioids for a long enough period of time can make the pain worse, not better since they change the body’s central nervous system. I tell patients to use common sense, use what you need to when you need to, and don’t use it when you don’t need to.

Listen to the full conversation >>

Dr. Heller practices at Emory University Orthopaedics & Spine Hospital. To learn more about Emory Orthopaedics & Spine surgeons and treatment options available to you, visit www.emoryhealthcare.org/ortho or call 404-778-3350.


About Emory Orthopaedics & Spine Hospital

Emory’s Orthopaedics & Spine Hospital has locations across the Atlanta metro area. Emory’s physicians diagnose and treat conditions ranging from simple herniated disc and lower back and neck pain to more complex problems such as spinal tumor scoliosis and spine fractures. Emory Healthcare has the only hospital in Georgia that is dedicated to spine and joint surgery as well as non-operative spine and joint surgical interventions for physical therapy. For more information, or to schedule an appointment or an opinion, visit www.emoryhealthcare.org/ortho.

About Dr. John Heller

John G. Heller, MD, is an orthopedic surgeon specializing in the research and development of instrumentation in cervical spine surgery, including cervical disc replacement and laminoplasty. His clinical interests include herniated disc sciatica, spinal stenosis, and spinal tumors. An internationally renowned lecturer and teacher, Dr. Heller is the past president of the Cervical Spine Research Society and was one of the first surgeons in the country to perform laminoplasty.

Learn more about Dr. Heller >>

The best (and worst) exercises for lower back pain

lower-back-painOver 80 percent of Americans will experience lower back pain at some point in their lives. If you have it, you may think rest is the key to recovery. In fact, back pain is one of the most common reasons people miss work.

But most lower back pain will actually get better when you stay active. Exercise can:

  • Ease your lower back pain
  • Help you heal faster after a lower back injury
  • Maintain your strength and flexibility
  • Prevent re-injury
  • Reduce your risk of disability from chronic back pain

Lower back pain exercises

You should focus on activities that strengthen your back, such as walking, swimming and walking in waist-deep water in the pool.

Also, these strengthening exercises can help combat back pain:

  • Back extensions. While lying on your stomach on the floor, press your elbows into the ground and push your upper body toward the ceiling. Hold this pose for 30 seconds, then allow your body to relax. Repeat four to six times.
  • Chair stretch (for hamstrings). Sit in a comfortable chair with your legs straight out in front of you in another stable chair. Reach forward gently to one foot and then repeat with other foot.
  • Hip stretch. Stand with your feet shoulder-width apart. Take a step back with your right foot and bend your left knee while shifting the weight to the right hip until you feel a stretch. Repeat on the other side.
  • Knee-to-chest stretch. Lie on your back on the floor and bend your knees while keeping your heels on the floor. Place your hands behind each respective knee and bring your knees to your chest for a gentle stretch.
  • Neck stretch. Sit in a comfortable chair with a straight back. Bend your head forward until your chin hits your chest, or you can feel a light stretch in the back of the neck. Return to the starting position.

Note: If at any time you notice increased pain while doing a stretch or exercise, stop immediately.

Exercises to avoid if you have lower back pain

If you have lower back pain, it’s best to avoid these exercises:

  • Heavy lifting above the waist
  • Leg lifts
  • Sit-ups, either with straight legs or with bent legs
  • Touching your toes while standing with legs straight

Many people can relieve lower back pain with simple at-home strengthening and stretching exercises. However, if you have a question about whether you need medical attention, it’s best to talk to your doctor to rule out a more serious injury.

Request an Appointment

To request an appointment, please use the link below.

Request an Appointment

Preparing for Summer Road Races Live Chat Transcript

 

Road race runnersHave you been training hard getting ready for summer races or events like the AJC Peachtree Road Race? Emory sports medicine physician Amadeus Mason, MD and Emory sports cardiologist, and Peachtree Road Race Medical Director, Jonathan Kim, MD, answered questions around preventing injuries, when and how to stretch and discussed appropriate treatment options for select injuries.  The live chat had a good turnout and the transcript is now available below.

Live Chat Transcript

June 13, 2017, 12:01 PM

EmoryHealthcare: Welcome everyone! Thanks for joining us today for our Live Q&A on Preparing for Summer Road Races with Dr. Mason and Dr. Kim.

June 13, 2017, 12:02 PM

EmoryHealthcare: We’ll get started in just a minute. The doctors are here to answer all your questions!

June 13, 2017, 12:04 PM

EmoryHealthcare: Please note that all questions are moderated before appearing in the stream, so you may not see yours appear right away, but we will do our best to answer all your questions today.

June 13, 2017, 12:05 PM

EmoryHealthcare: We received some questions that were submitted in advance of the chat, so we’ll get started by answering a few of those first.

June 13, 2017, 12:06 PM

EmoryHealthcare: Q: What is the number one mistake you see runners make?

June 13, 2017, 12:09 PM

EmoryHealthcare: A: Doing much too soon, increasing the amount of running, or the pace of before they are ready and that leading to overuse/fatigue injury, etc.

June 13, 2017, 12:11 PM

EmoryHealthcare: Q: Does weightlifting make you a faster runner?

June 13, 2017, 12:13 PM

EmoryHealthcare: A: No, lifting is not can a make you faster only speed work and do that. Lifting can help to increase your overall stamina and in turn, allow you to do better quality speed training which will, in turn, make you faster.

June 13, 2017, 12:20 PM

Guest9090: I’ve heard of people going into cardiac arrest. How concerned should the average Joe be?

June 13, 2017, 12:23 PM

EmoryHealthcare: We published a paper on this exact question – Kim JH New England Journal of Medicine 2012. Cardiac arrests are rare during marathon events. However, as we age, it’s important to get a risk profile work up by your physician before starting training.

June 13, 2017, 12:23 PM

Guest5817: Does the pace of your easy run matter?

June 13, 2017, 12:25 PM

EmoryHealthcare: Yes, it does matter. Your easy run is part of the recovery portion of your workout. Therefore, if it’s too hard, this can negatively impact progress, rest and recovery are crucial.

June 13, 2017, 12:27 PM

Abe: Why do I get a stich in my side when I run?

June 13, 2017, 12:29 PM

EmoryHealthcare: There are a couple of theories, 1) the oxygenation of the tissues in the core of the body is diverted to the legs during exercise.

June 13, 2017, 12:30 PM

EmoryHealthcare: 2) Electrolyte imbalance when you’re running there’s a subtle change in electrolytes which can cause the stitch like pain.

June 13, 2017, 12:31 PM

Guest2147: Is post traumatic injury disorder a real thing?

June 13, 2017, 12:32 PM

EmoryHealthcare: Guest2147, can you provide more information?

June 13, 2017, 12:34 PM

Guest2147: The fear of an injury returning—or a new one developing.

June 13, 2017, 12:36 PM

EmoryHealthcare: It is a real psychological issue and should be addressed for the person to get back to his or her previous level of play. Apprehension is real.

June 13, 2017, 12:38 PM

Guest8697: Any pics on the best running shoes?

June 13, 2017, 12:39 PM

EmoryHealthcare: We can’t give a brand name, but when choosing a shoe to get an assessment from a professional and choose the shoe that is the most comfortable. A German study in the early 2000’s determined that the comfort of the shoe was the most important, not the brand.

June 13, 2017, 12:43 PM

Guest5057: What should I eat before the race?

June 13, 2017, 12:44 PM

EmoryHealthcare: Pre-race diet isn’t important as making sure your overall diet is good throughout your training. Carb loading before a big race has fallen out of favor, especially when not in the context of an overall dietary plan. Eating carbs, protein, and simple fats within 30 mins after the race has proven beneficial. The perfect combination is chocolate milk.

June 13, 2017, 12:45 PM

Guest9090: Will Emory be at the PRR this year?

June 13, 2017, 12:47 PM

EmoryHealthcare: Absolutely! Emory will be providing primary medical oversight during the race. We’ll we work in concert with Grady EMS, Atlanta Fire and Police to provide excellent medical care throughout the entire course.

June 13, 2017, 12:49 PM

Guest2147: My friend’s running form is terrible, should I say something?

June 13, 2017, 12:49 PM

EmoryHealthcare: It depends on how close of a friend you are.

June 13, 2017, 12:49 PM

Guest9186: I’m in my first trimester, is it safe to run the PRR?

June 13, 2017, 12:53 PM

EmoryHealthcare: Consulting with your OB-GYN should be on your list of to-dos. From an environmental standpoint, I would be very conservative with your intensity and pay close attention to the heat and humidity.

June 13, 2017, 12:54 PM

EmoryHealthcare: These questions have been great! We have time for just one more question today. Any remaining questions will be answered by in a post-chat Q&A blog on http://advancingyourhealth.org

June 13, 2017, 12:56 PM

Guest5057: I know we’re not supposed to, but any thoughts on running a 10k with headphones?

June 13, 2017, 12:58 PM

EmoryHealthcare: We don’t think headphones are prohibited from the Peachtree Road Race. However, running on your own vs. on a closed course brings its own dangers, and runners should always be aware of their surroundings.

June 13, 2017, 12:58 PM

EmoryHealthcare: That’s all the time we have for today. Thanks so much for joining us! As we mentioned, we’ll follow up with a blog post to answer any questions we didn’t get a chance to address today.

June 13, 2017, 12:59 PM

EmoryHealthcare: Thanks for your questions!


Want to Learn More?

At Emory Sports Medicine Center, you have access to a broad range of services to care for sports injuries that affect bones, muscles, and tendons. We provide evaluation and treatment of sports-related injuries for athletes of all ages, at all levels, in all sports.

Live chat

The 4 Most Common Causes of Shoulder Pain

Causes of shoulder pain Whether you’re throwing a football, unloading the dishwasher or scratching your back, shoulder pain can compromise even the most basic daily activity. Here’s how to identify and treat the biggest instigators of shoulder pain, which include:

  • Arthritis
  • Fracture (broken bone)
  • Instability
  • Tendon inflammation and tears

The shoulder is made up of tendons, muscles and bones. Its main purpose is to position your hand for your everyday tasks and movements. Since the shoulder is such a mobile joint, it’s more prone to instability or impingement in its soft tissues. This can lead to acute (sudden) or chronic pain.

1. Arthritis

Arthritis is a frequent cause of shoulder pain. The most common form of arthritis in the shoulder is osteoarthritis, which is known as “wear and tear” arthritis and may crop up as you age.

Many people respond to arthritis pain by reducing their shoulder movements, but this can backfire and cause tightness or stiffness in the soft tissues of the shoulder joint. It can also lead to significant pain when moving the shoulder.

Osteoarthritis is often caused by chronic movements, inflammation of the joint lining from rheumatoid arthritis, work injuries or sports injuries.

Treatments: Rest, physical therapy and at-home range-of-motion exercises can be helpful in relieving pain. Your doctor may also suggest anti-inflammatory medication, such as ibuprofen, to reduce your symptoms. If conservative treatments don’t help, you may need to have joint replacement surgery.

2. Fracture

A fracture, or broken bone, is another common cause of shoulder pain, swelling and bruising. Shoulder fractures often involve the:

  • Collarbone (clavicle)
  • Shoulder blade (scapula)
  • Upper arm bone (humerus)

Fractures are typically caused by a fall in older patients or a sports or vehicle injury in younger patients.

Treatments: Depending on the severity of the injury, you may need to wear a basic sling for three to eight weeks. For worse injuries, you may need surgery.

3. Instability

Shoulder instability means the head of the arm bone (the humeral head) is displaced from the shoulder socket, often as a result of trauma or serious injury. This can cause a “catching” or slipping feeling the shoulder or even a complete dislocation where the ball of the arm bone comes out of the shoulder socket completely.

This can cause the muscles, tendons and ligaments around the shoulder to tear or loosen, which can lead to repeated dislocations. Repeated dislocations lead to pain, unsteadiness and eventually, arthritis.

Treatments: Your doctor will maneuver the arm bone back into the shoulder socket. After that, you will likely wear a sling for a few weeks as the injury heals. If you experience future shoulder dislocations, you may need surgery to correct the problem.

4. Tendon Inflammation and Tears

Shoulders are prone to overuse injuries from repetitive tasks, such as overhead lifting. This often shows up in the form of tendinitis, an inflammation of the tendons, and bursitis, inflammation of the bursa.

The bursa is a fluid-filled sac between tendons and bones that allows them to glide easily. If the bursa is inflamed, the tendons may scrape against the shoulder bones resulting in weakness or tearing. This is called impingement.

The four rotator cuff tendons are the most susceptible to tendinitis. When the tendons are inflamed, there’s less space for the tendons and muscles to move within the joint.

Treatments: Rest your shoulder and avoid positions or activities (like overhead lifting) that cause pain. If this doesn’t help, your doctor may recommend a cortisone injection to decrease inflammation and pain, as well as physical therapy.

Get Treatment for Shoulder Pain

If you’re experiencing frequent, disruptive pain throughout your day — and caring for your shoulder injury at home hasn’t helped — it may be time to get help from a medical professional.

The orthopedic surgeons at Emory Orthopaedic & Spine Center specialize in treating all types of shoulder conditions and injuries. Don’t live with the pain another day.

Call us today at 404-778-3350 to schedule an appointment.

Should You Use Heat or Ice to Treat an Injury?

Should You Use Heat or Ice to Treat an Injury?Whether you have arthritis pain, a sprained ankle or a pulled muscle, it’s important to know when to use—and when not to use—heat or ice to treat an injury.

Heat and ice—also known as temperature therapy—are very effective complements to medication and self-care when treating an injury at home. While both therapies can reduce pain, inflammation, and swelling, they aren’t appropriate for every injury.

When to Use Cold Therapy

It’s best to use cold therapy for acute or sudden pain caused by a recent injury that’s sensitive, red or inflamed. Inflammation is a normal bodily response to an injury, but it can be quite painful. Here are some of the most common acute injuries that benefit from cold therapy:

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

A joint or muscle sprain damages the blood vessels in the injured part of the body, which causes swelling. Applying something cold—such as an ice pack wrapped in a towel—helps constrict those blood vessels, which can reduce bruising and swelling.

Cold therapy is also beneficial for treating soreness or pain related to exercise. For example, you can apply an ice pack to the painful area after going for a run to reduce post-exercise inflammation.

How to Safely Use Cold Therapy

Cold therapy is safest and most effective when you follow these tips:

  • Apply ice as soon as an injury happens or after intense, high-impact exercise.
  • Do not apply ice to areas of the body that have poor circulation.
  • Never use cold therapy for more than 20 minutes at a time.
  • Only apply cold to the injured area.
  • Wrap the ice pack in a towel before applying it to the affected area.

When to Use Heat to Treat an Injury

Ice is most beneficial for treating acute injuries, while heat is best for chronic pain. Heat therapy allows the blood vessels to expand and the muscles to relax.

Heat Therapy:

  • Relaxes muscle spasms
  • Stimulates blood flow to the injured area
  • Soothes sore muscles

It’s Most Beneficial for:

  • Arthritis pain
  • Ongoing muscle pain or soreness
  • Stiff joints

How to Safely Use Heat Therapy

Get the most benefits from heat therapy with these tips:

  • Apply heat before exercising to relax the muscles. If you apply it after exercise, it can aggravate inflammation and existing pain.
  • Avoid direct contact with heating devices (like a heating pad). Wrap your heated device in a folded towel to reduce your risk of burns.
  • Drink plenty of water to stay hydrated during heat therapy.
  • Minimize prolonged exposure to higher heat therapy.

If heat relieves your pain, you can try a continuous, low-level heat wrap for up to eight hours at a time, even while you sleep. These wraps are available at most drug stores.

What to Avoid When Using Heat or Ice to Treat an Injury

Ice can worsen muscle spasms and tension, while heat can increase inflammation in a recent injury. The best thing to remember is to not overdo it with either form of treatment.

While it’s normal for your skin to be slightly pink after using heat or cold therapy, call your doctor if you notice blisters, hives or additional swelling.

Otherwise, simply follow these guidelines depending on your condition. Using heat and ice to treat an injury can be very helpful in reducing pain if used correctly. When in doubt about which therapy to use, ask your doctor.

Heat-Related Illnesses & What To Do

man suffering from heat-related ilnessesHave you ever heard of heat exhaustion, heat rash, heat cramps or heat stroke? Yes, heat stroke! It’s a real thing! In this blog we’ll discuss the wide range of heat-related illnesses and how to prevent them.

Heat-related illnesses occur when the body is unable to cool itself down. The body is designed to cool off naturally through sweating, this helps maintain an average internal temperature of 98.6 degrees. However, when temperature is hot and the air humid, it’s hard for sweat to evaporate fast enough to cool your body so it overheats. This is when heat-related illnesses happen.

SO WHAT ARE HEAT-RELATED ILLNESSES?

Heat-related illnesses are a group of conditions brought on by staying outside in hot temperatures for too long and/or exercising too much. Here are the four types:

  • Heat Cramps Pain or muscle spasms that typically happen during intense exercise or work in hot temperatures. Symptoms can include: thirst, fatigue, and excessive sweating
  • Heat Rash Skin irritation resulting from heavy sweating. Symptoms can include: blisters or bumps filled with fluid or red, itchy bumps
  • Heat Exhaustion This happens before heat stroke. Symptoms can include:
    • Fatigue
    • Weak, fast pulse
    • Excessive sweating
    • Rapid breathing
    • Nausea
    • Faintness
    • Clammy skin
    • Low blood pressure
    • Headache
    • Muscle cramps
  • Heat Stroke This life-threatening condition can lead to brain damage and/or organ failure. During heat stroke, your body temperature can reach 106 degrees or higher. Call 911 immediately if someone is experiencing one or more of the following symptoms:
    • Dizziness
    • Weakness or muscle cramps
    • Confusion
    • Difficulty walking
    • Strong, fast pulse
    • Dry, hot and/or red skin
    • Headache
    • Nausea
    • Vomiting
    • Shallow, rapid breathing
    • Unconsciousness
    • Seizures

WHO’S AT RISK FOR HEAT-RELATED ILLNESSES?

Certain people are more susceptible to heat-related illnesses than others. This includes:

  • Children under 4 years of age
  • Those over 65
  • Those who are overweight
  • Those who are sick
  • Those not used to warm temperatures
  • Those using certain medications for allergies, high blood pressure, heart issues, etc.

You may also increase your risk of heat-related illness if you:

  • Become dehydrated
  • Drink alcohol
  • Wear too many clothes
  • Exercise or work in high-heat, high-humidity conditions

HOW DO YOU TREAT HEAT-RELATED ILLNESSES?

Here are the most effective ways to treat most heat-related conditions at home.

Heat Cramps

  • Rest
  • Move to a cooler place, such as the shade or indoors
  • Drink cool water or a sports drink with electrolytes

Heat Rash

  • Seek air conditioning or a fan to cool off
  • Take a cool shower or bath
  • Allow your skin to air-dry and avoid oil-based lotions until symptoms subside (oil prevents your skin from sweating)
  • See your physician if your rash does not go away after a few days

Heat Exhaustion

  • Rest
  • Drink cool water or a sports drink with electrolytes
  • Loosen your clothing and/or remove unnecessary items
  • Place a cool, wet towel on your neck or take a cool shower

Heat Stroke

  • Call 911 if you are experiencing signs of a heatstroke

HOW DO YOU PREVENT HEAT-RELATED ILLNESSES?

Prevention of illnesses is the best way to avoid the negative health consequences. Here’s what you need to do.

  • Avoid spending excessive time outdoors in direct sunlight and high temperatures
  • Lose weight if overweight or obese
  • Use sunscreen, a wide-brimmed hat or an umbrella
  • Visit air-conditioned places such as a malls or coffee shops
  • Stay well hydrated
  • Avoid alcohol when outdoors in high temperatures
  • Talk to your physician about your medications to see if any put you at risk of heat illness
  • Do not leave a child or pet in a hot car, even for just a few moments

Are you looking for a physician or hospital near you?

About Dr. Mines

Brandon Mines, MDBrandon Mines, MD, is an assistant professor of orthopaedics. Dr. Mines started practicing at Emory in 2005 after completing his Sports Medicine Fellowship at University of California – Los Angeles. Dr. 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.

Dr. Mines is a rotational physician for United States soccer teams and team physician for the NFL’s Atlanta Falcons along with various local high schools, colleges, and community club teams. He 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.

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.

cta-chat-blue

 

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?

How to Recognize & Prevent Heat-Related Illness

heat-exhaustionWith the extremely hot temperatures this summer and school sports about ready to start up, heat illness is a problem that should be on every athlete, coach, and parent’s mind. According to the Center for Disease Control and Prevention, about 618 deaths per year are due to heat-related illness. Heat illness is triggered by environmental heat exposure and occurs when the body is unable to cool itself down. Heat can cause a wide range of problems from tight muscles and flushing to complete organ shut down and death. Heat-related illnesses include the following:

  • Heat cramps – muscle pains or spasms that happen during heavy exercise
  • Heat rash – skin irritation from excessive sweating
  • Heat exhaustion – an illness that can come before a heatstroke as the body is beginning to overheat and shut down
  • Heatstroke – a severe, life-threatening illness in which body loses it’s ability to regulate heat and core body temperature may rise above 106° F in minutes

People who are at greatest risk for heat-related illnesses are infants and children up to four years of age, people age 65 and older, and people who are overweight, ill or on certain medications.

Heat-related deaths and illness are preventable. Below are some warning signs to watch out for as well as tips for how to respond:

Signs of Heat Exhaustion

• Weakness
• Headaches or mild confusion
• Cold, pale, and clammy skin
• Fast, weak pulse
• Nausea or vomiting
• Cramping
• Abnormal Breathing
• Fainting

What You Should Do:

• Move to a cooler location.
• Lie down and loosen your clothing.
• Apply cool, wet cloths to as much of your body as possible.
• Sip water.
• Seek immediate medical attention if vomiting begins and persists.

Signs of Heat Stroke

• High body temperature (above 103°F)*
• Hot, red, dry or moist skin
• Rapid and strong pulse
• Seizures
• Possible unconsciousness or severe mental changes

What You Should Do:

• Call 911 immediately — this is a medical emergency.
• Move the person to a cooler environment.
• Reduce the person’s body temperature with cool cloths or even a bath.
• Do NOT give fluids.

During hot weather it is important to increase your fluid intake, regardless of activity level. Drink two to four glasses (16-32 ounces) of cool fluids each hour and avoid drinks containing alcohol or a lot of sugar as they will essentially cause you to lose more fluid. It is important to drink some electrolytes too. A watered down sports drink is probably the best balance of fluids and electrolytes. Make sure you are “pre-hydrating” by drinking fluids prior to the activity. If you start a practice or game dehydrated, then you will only become more dehydrated and are more likely to have problems. You can monitor your hydration status by checking your urine when you use the restroom. Your urine should be clear if you are well-hydrated; a dark yellow means you need to drink more fluids.

Remember to keep cool, wear appropriate clothing and sunscreen, and stay indoors if possible. Finally, be sure to speak up and notify coaches, teammates, parents if you are starting to feel bad with cramping, confusion, or other concerning signs.

Related Resources
Preventing & Recognizing Symptoms of Dehydration Among Student Athletes

About Dr. Jeff Webb

Jefwebb-jeffreyfrey Webb, MD, 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 serves as the primary care sports medicine and concussion specialist for the team. He 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.

Takeaways from Dr. Mason’s Chat on How to Train and Prepare for Summer Running Races

Running Live ChatThank you for attending the live chat on How to Train and Prepare for Summer Running Races on Tuesday, June 9 with Emory Sports Medicine physician Amadeus Mason, MD. We had a great discussion, so thank you to all who participated and asked questions. From tips for preventing shin splints to advice on how to train for a 5K, we were thrilled with the number of people who were able to register and participate in the chat. (You can check out the transcript here).

The response was so great that we had a few questions we were not able to answer during the chat so we will answer them below for your reference.

Question: I have inflammation behind my knee. What can I do?

Amadeus Mason, MDDr. Mason: Inflammation behind the knee can be due to a number of knee conditions. Baker’s cyst are common and can be caused by injury to the knee, arthritis, damage to the cartilage of the knee, and other problems. Sprains (caused by overstretching and tearing of the stabilizing ligaments) can lead to swelling of the knee area as well.

Seek immediate medical attention if you are in serious pain, or are experiencing symptoms such as: paralysis, loss of sensation, absent pulses in the feet, the inability to move the knee joint, severe bleeding, chest pain, difficulty breathing, or uncontrollable pain.

Swelling behind the knee may not produce any other symptoms, but if your condition persists and continues to cause concern, seek an evaluation from a sports medicine physician or knee specialist.

Question: What is the best way to correct an IT band injury that has caused can imbalance and pain while running?

Amadeus Mason, MDDr. Mason: If treated appropriately with conservative treatment and resting of the affected area, IT Band Syndrome is usually curable within 6 weeks. If your injury was not appropriately treated, or not given adequate time to heal, the source of your current complications may be due to:

  • Chronically inflamed tendon and bursa, causing persistent pain with activity that may progress to constant pain.
  • Recurrence of symptoms if activity is resumed too soon through overuse, a direct blow, or poor training technique.
  • Inability to complete training or competition.

Until you are able to seek an evaluation from a sports medicine physician, I would discontinue the activity (ies) that are causing you pain so you do not further damage the iliotibial band.

Question: I get cramps in my calf when I run but not when walking. Is there a remedy?

Amadeus Mason, MDDr. Mason: Cramps are a result of a few factors, but dehydration and improper warm-up are the most common causes.

To prevent muscle cramps, runners need to consume enough fluid before exercising. Some healthy tips are:

  • Drink 16 to 20 ounces 45 minutes before training.
  • Drink 2 to 4 ounces every 15 minutes during a training session.
  • Before you begin your run, warm up with 5 to 10 minutes of low impact activity, like walking to warm up the muscles.

For more information about all our orthopedic and sports-related injuries, visit Emory Sports Medicine Center. Think you need to be evaluated by a sports medicine physician? To make an appointment with an Emory physician, please complete our online appointment request form or call 404-778-3350.

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