Joint replacement surgery is a procedure that should only be recommended when all other modes of treatment to eliminate your pain have been exhausted. Almost any joint in the body can be replaced, but most commonly replaced joints are the knee, shoulder and the hip. If you are referred for joint replacement the goal at Emory Orthopaedics, Sports & Spine is to get an athlete back to a similar level of play or activity after a surgery. In an aging athlete, joint replacement is typically done for pain relief so the patient is allowed to lead an active life. Although, many patients will be able to do all the activities they did before the joint replacement, we recommend doing activities that do not put a lot of pressure on the joint such as swimming, ice skating and doubles tennis. Watch this short video about joint replacement and details on what makes joint replacement surgery at Emory different.
The Ladies Night Out event is an annual health fair held by Emory Johns Creek Hospital for women to talk with physicians and other providers in the Johns Creek and North Atlanta communities and learn about services near them.
At the Emory Orthopaedics, Sports & Spine table, Drs. Hammond and Olufade spoke with women about potential injuries that could occur from wearing high heeled shoes and what women might be able to do to help prevent injuries to their backs, ankles, feet, hips and knees.
As a fun activity at the Ladies Night Out event, we also had a free drawing for high heeled shoes that were displayed at the table. Five lucky women went home with a new pair of shoes and lots of tips to prevent orthopedic injuries.
Symptom: Pain & swelling in lower calf and heel cord resulting in decreased calf flexibility
Achilles Tendinitis Prevention:
- Calf stretches with towel or band
- Calf raises / strengthening exercises
- Heel pads
- Wear short heels or flats
ANKLE SPRAIN / FRACTURE
Symptom: Pain, bruising, swelling and inability to walk
Ankle Sprain & Fracture Prevention:
- Wear short, wide heels (no stilettos)
- Single leg balancing
- Ankle ‘A, B, Cs’
Bunion Symptom: Tenderness and prominence inside of the big toe joint
- Ensure proper shoe size & fit
- Wear short heels with wide toe box
- Use pads to cushion bunions
- Wear heels for brief periods of time if possible
KNEE AND HIP INJURIES
Symptom: Muscles in your hip and knee have to work harder when you wear heels as muscles become fatigued and more prone to injury
- Muscle strain
- Meniscus tear
- Hip impingement
Hip & Knee Injury Prevention:
- Stretch hamstrings, quads, & hip
- Strength training for lower body
- Alternate heels with flats during the work week
- Balance exercises
LOW BACK PAIN
Low Back Pain Causes: Normal center of gravity changes, increasing the curvature of your low back and tilting your pelvis forward.
Low Back Pain Prevention:
- Change into flats for long walking distances
- Strengthen your core (crunches & low back extension exercises)
Although high heels look nice and are fun to wear at special events, try to limit the high heels to special occasions and stick with flats for your day to day activities. Your body will thank you!
About Dr. Kyle Hammond
Dr. Hammond is an orthopaedic surgeon new to the Emory Orthopaedics faculty. He recently completed his fellowship at the University of Pittsburgh Medical Center. While at the University of Pittsburgh he was the Associate Head Team Orthopaedic Surgeon for both the Duquesne University Football team and the University of Pittsburgh Men’s Basketball team. He also worked as a Team Physician for the Pittsburgh Steelers, the Pittsburgh Penguins, the University of Pittsburgh athletics, Robert Morris College athletics, as well as the Pittsburgh Ballet.
Dr. Hammond sees patients at Emory Johns Creek Hospital, as well as Emory Orthopaedics & Spine Center in Atlanta. Dr. Hammond has a special interest in the overhead/throwing athlete, ligament injuries to the knee, Tommy John surgery, joint preservation surgery, and is one of the few fellowship trained hip arthroscopists and concussion specialists in Georgia.
About Dr. Oluseun A. Olufade
Dr. Olufade is board certified in Physical Medicine & Rehabilitation and Interventional Pain Medicine. He completed fellowship training in both Sports Medicine and Interventional Pain 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 sees patients at Emory Johns Creek Hospital.
About Emory Ortho, Sports and Spine in Johns Creek and Duluth
Emory Orthopaedics, Sports & Spine has recently opened two new clinics, one in Johns Creek and one in Duluth. Emory physicians, Kyle Hammond, MD, and Oluseun A. Olufade, MD see patients in Johns Creek. Mathew Pombo, MD and T. Scott Maughon see patients in Duluth. Our new clinic locations care for a full range of orthopedic conditions including: sports medicine, hand/wrist/elbow, foot/ankle, joint replacement, shoulder, knee/hip, concussions, and spine.
To schedule an appointment call 404-778-3350
Iliotibial band (IT) syndrome, also referred to as IT band injury or IT band pain, is an injury that affects the outside of the knee and is caused when irritation or inflammation of the IT band occurs.
If you have ever suffered from IT band syndrome, you know IT band pain is a pain you don’t want to feel again. The good news is that you can prevent IT band injuries with strengthening and stretching exercises. Pay close attention and follow the information/suggestions here and you may be able to steer clear from the pain of IT band syndrome!
What is the IT Band?
The IT band is the long, strong, thick band of tissue that runs along the outside of the leg. It starts at the hip area and runs all the way down to just below the knee. The purpose of the band is to provide stability to the knee during movement.
IT Band Syndrome Causes
An IT band injury is an overuse injury, primarily caused by inflammation of the IT band. Tightness in the IT band can cause friction where the IT band crosses the knee joint. Causes of IT band syndrome can include:
- Running up and down hill repeatedly
- Running on a banked or sloped surface (like an indoor track or edge of a road)
- Running up and down stairs
- Weak hip muscles
- Uneven leg length
- Excessive foot strike force
IT Band Injury Symptoms
- Stinging sensation above the knee
- Swelling or thickening of the tissue where IT band moves over femur
- Pain may intensify over time and may not occur immediately during activity
- Pain occurs when foot strikes the ground
- Pain may occur where the IT band attaches to the tibia
Preventing IT Band Syndrome
- Warm up and stretch before competing or practicing
- Recover properly between events/competitions/practices
- Improve core strength with Pilates type exercises
- Avoid running on banked surfaces
- Avoid running the same direction on the track all the time
- If you have flat fee, where arch supports or orthotics
Check out the exercises in this downloadable document: IT Band Stretching & Strengthening Exercises (PDF). And in this blog post, you’ll find more information on preventing running injuries.
IT Band Syndrome Treatment
- Rest – most runners don’t want to listen to this advice but rest really will help alleviate the pain
- Anti-inflammatory medication
- Ice the painful area
- Improve flexibility by stretching
- Physical therapy
We hope you can steer clear of IT band syndrome and keep your legs moving!
Emory Healthcare is the largest, most comprehensive health system in Georgia and includes Emory University Hospital, Emory University Hospital Midtown, Emory University Orthopaedics & Spine Hospital, Wesley Woods Center, Saint Joseph’s Hospital, Emory Johns Creek Hospital, Emory Adventist Hospital, The Emory Clinic, Emory Specialty Associates, and the Emory Clinically Integrated Network.
Come visit us at the AJC Peachtree Road Race expo in booth 527 to get your blood pressure checked and learn more about how Emory Healthcare can help you and your family stay healthy!
About Dr. Brandon Mines
Brandon 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 and Decatur High School. He is also one of the team physicians for the Atlanta Falcons. His areas of interest are diagnosis and non-operative management of acute sports injuries, basketball injuries, tennis injuries, golf injuries and joint injections.
Do you have pain in the front of your knee behind the kneecap? If so, you may have patellofemoral pain syndrome (PFPS for short), commonly known as “runners’ knee”. Typically runners’ knee is not a product of an injury, but is caused by abnormal leg mechanics including weakness in the quadriceps which result in poor tracking of the kneecap.
You can increase your risk of developing runners’ knee if you have tight hamstrings, or do not warm up enough before an event. Runners often experience patellofemoral pain as they increase their running distance and/or frequency.
Symptoms of Patellofemoral Pain Syndrome:
- Pain in the knee, usually in the front of the knee, behind the kneecap
- Pain in the back of the knee or also above or below the kneecap
- Pain that gets worse after sitting for long periods of time
- Pain that gets worse after going up or especially down stairs or hills
- Pain that gets worse when wearing shoes with high heels
- Pain with jumping, squatting, and lunging
- “Crunching” or “popping” in the knee
- Minimal swelling
The good news is that this condition is treatable with improving your overall leg mechanics. You should think about incorporating strength training into your running training so that you strengthen the quadriceps and gluteus muscles. It is also important to stretch the hamstrings and IT band. If you have flat feet or foot pronation (fallen arches) you should consider inserting orthotics in your shoes to support your arches.
If you are diagnosed with this condition, you may have to stop running temporarily until the knee pain subsides, but continuing to run will not cause long term damage. You should at least consider adding in cross training with activities such as swimming and cycling which will be easier on the knee with PFPS and maintain your fitness. Make sure to ice your knee after exercise and take anti-inflamatories like ibuprofen. You may also want to try a neoprene sleeve for comfort. Refer to this Patellofemoral Syndrome document for some exercises you can safely do to strengthen the muscles, increase flexibility and stretch the quadriceps.
If your knee pain has not improved within 4-6 weeks, you should consult your sports medicine physician.
Emory Healthcare is a proud sponsor of the AJC Peachtree Road Race.
Emory Healthcare is the largest, most comprehensive health system in Georgia and includes Emory University Hospital, Emory University Hospital Midtown, Emory University Orthopedics & Spine Hospital, Wesley Woods Center, Saint Joseph’s Hospital, Emory Johns Creek Hospital, Emory Adventist Hospital, The Emory Clinic, Emory Specialty Associates, and the Emory Clinically Integrated Network.
Come visit us at the AJC Peachtree Road Race expo in booth 527 to get your blood pressure checked and learn more about how Emory Healthcare can help you and your family stay healthy!
About Dr. Jeff Webb
Jeff Webb, MD, is an assistant professor of orthopaedics at Emory Orthopaedics & Spine Center. Dr. Webb started practicing at Emory in 2008 after completing a Fellowship in Primary Care Sports Medicine at the American Sports Medicine Institute in Birmingham, Alabama. He is board certified in pediatrics and sports medicine. 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 team 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.
Dr. 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. He is currently 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. Dr Webb is an avid runner and has completed 16 Peachtree Road Races.
- Exercises for Patellofemoral Pain Syndrome (PDF)
- Debunking Common Running Myths
- Is it Possible to Over-train for a Running Race?
- How to Prevent Plantar Fasciitis
The decision to get a hip or knee replaced is a difficult one for many patients. Hip and knee replacements are typically advised only when all other options have not worked for you. If you are considering a hip or knee replacement or already have had one and want to speak to a physician, join Emory Orthopedic Surgeon, Thomas Bradbury, MD on Tuesday, June 11, 2013 at noon for an online web chat on Hip and Knee Replacements. He will be available to answer questions such as:
• What are hip and knee replacements?
• Why have the surgery?
• Who are candidates for hip or knee replacements?
• What are the newest advances in Hip and Knee replacements?
• What is Emory’s approach on when to get knee or hip replacement surgery?
• What is the recovery after a hip or knee replacement?
• What types of exercise are suitable for someone with hip or knee replacements
• What kind of outcome can you expect?
Come prepared to ask your questions and learn more about your options!
About Dr. Bradbury
Dr. Bradbury is an Assistant Professor of Orthopaedic Surgery at Emory. He specializes in hip and knee arthroplasty. He really enjoys this area of orthopaedic surgery because of the consistency of success in the properly selected patient. Dr. Bradbury’s professional goal is the improvement in quality of life for patients with pain secondary to hip and knee problems.
His research interests center around infections involving hip and knee replacements which are rare, but difficult problems. Dr. Bradbury is researching the success rate of current treatment methods for hip and knee replacement infections caused by resistant bacteria (MRSA). Through his research, he hopes to find better way to both prevent and treat periprosthetic hip and knee infections.
It is reality now! Physicians at Emory Orthopaedics & Spine are among a select group of physicians around the country to offer a unique procedure using stem cell injections to relieve osteoarthritis (OA) pain. During the procedure, the physician extracts stem cell blood from the bone marrow in a patient’s hip and then injects the stem cells directly into the patient’s damaged joint. The stem cells are from the patient’s own body so the risk of rejection is very low.
Hear first hand from Dr. Mautner and one of our patients how this new treatment option is helping relieve pain from Osteoarthritis:
About Ken Mautner, MD
Ken Mautner, MD is an assistant professor in the Department of Physical Medicine and Rehabilitation and the Department of Orthopedic Surgery. Dr. Mautner started practicing at Emory in 2004 after completing a fellowship in Primary Care Sports Medicine at the American Sports Medicine Institute in Birmingham, Alabama. He is board certified in PM&R with a subspecialty certification in Sports Medicine. Dr. Mautner currently serves as head team physician for Agnes Scott College and St. Pius High School and a team physician for Emory University Athletics. He is also a consulting physician for Georgia Tech Athletics, Neuro Tour, and several local high schools. He has focused his clinical interest on sports concussions, where he is regarded as a local and regional expert in the field. In 2005, he became one of the first doctors in Georgia to use office based neuropsychological testing to help determine return to play recommendations for athletes. He also is an expert in diagnostic and interventional musculoskeletal ultrasound and teaches both regional and national courses on how to perform office based ultrasound. He regularly performs Platelet Rich Plasma (PRP) injections for patients with chronic tendinopathy. Dr. Mautner also specializes in the care of athletes with spine problems as well as hip and groin injuries.
Marcus Hutchinson knows all too well about surgery and physical therapy – he has had 6 surgeries on his left knee. He has also been a physical therapist for 22 years. As a teenager, Marcus was diagnosed with osteochondritis dissecans, also known as OCD, a joint condition in which a piece of cartilage, along with a layer of the bone beneath it, comes loose from the end of a bone due to trauma or lack of blood flow to this area. Osteochondritis dissecans is most commonly found in the knee and often occurs in young men.
By the time Marcus arrived at Emory Orthopaedics & Spine in Dr. Sam Labib’s clinic in 2006, his left knee had been operated on 4 different times. Dr. Labib examined Marcus and determined he had a massive osteochondral defect in his left knee that involved his entire lateral femoral condyle, a portion of the top bone of the knee joint.
Previous doctors had told Marcus that the only option he had left was total knee replacement. Dr. Labib did not recommend knee replacement because Marcus was too young to have this procedure. Typically, a joint replacement will only last about 15-20 years so if Marcus were to have the knee replaced in his 30’s, he would probably need to have another knee replacement by his 50s.-
Dr. Labib was able to offer Marcus a unique procedure called cartilage replacement surgery. Marcus had a massive fresh allograft implantation taken from a cadaver in February 2010 to treat his osteochondral defect.
There are several surgical techniques available to treat patients with OCD.
Below are three that Dr. Labib regularly performs.
• Microfracture Surgery – In microfracture surgery, small holes are drilled into the underlying bone, creating blood clots. As the blood clots heal, new repair cartilage or fibrocartilage forms.
• Autologus Osteochondral Plug Transfer – In this procedure, the patient’s own cartilage and bone are harvested from a low-stress area of the knee and implanted into the patient’s knee in the damaged area to fill the holes and defects with healthy cartilage and bone.
• Fresh Allograft Implantation – In this surgery, the cartilage and bone are taken from a fresh cadaver that has been donated for medical use. The donated tissue, also called an allograft, is thoroughly screened and matched to the patient defect to give it the best possible chance of successful healing. The surgeon prepares the patient’s knee by removing the damaged area. The allograft is then implanted and anchored to the surrounding bone.
Marcus’ surgery was performed at Emory University Orthopaedics & Spine Hospital. When asked about his experience he states, “I had such a positive experience at the hospital. Great care! Very attentive staff. Clean, professional and efficient.”
Marcus had one major goal following surgery and that was to walk and stand without pain. “I stand all day at work when seeing my patients for physical therapy. Before surgery with Dr. Labib, I had so much pain in my knee that it was affecting my job and day to day life. I feel so much more stable and pain-free now after having cartilage replacement surgery.” Marcus says he has a new perspective on what patients are experiencing after surgery and during physical therapy which has made him better at his job as a physical therapist. He is back to enjoying life with no pain and participating in low-impact activities such as swimming, cycling, and yoga.
About Dr. Sameh (Sam) A. Labib
Sam Labib, MD, is a sports medicine fellowship-trained surgeon and director of the foot and ankle service at Emory. Dr. Labib started practicing at Emory in 1999. He is an Associate Professor of Orthopedic Surgery.
Dr. Labib has a particular interest in problems and procedures of the knee, ankle, and foot. He is the head team physician for the athletic programs at Oglethorpe University, Spelman College, and Georgia Perimeter College. He is also an orthopaedic consultant to the Atlanta Falcons, Georgia Tech and Emory University.
He has lectured both nationally and internationally at many orthopedic meetings. His research has been published in several journals, including the JBJS, Arthroscopy, Foot and Ankle International and the American Journal of Orthopedics as well as numerous video presentations and book chapters. Dr. Labib is Board Certified in orthopedic surgery with additional subspecialty certification in Sports Medicine Surgery. For the past 5 years, Dr. Labib has been nominated by his peers as one of “America’s Top Doctors” as tracked by CastleConnelly.com.
The American Physical Therapy Association (APTA)’s National Physical Therapy Month (NPTM) is celebrated each October as a way to bring awareness around the potential health benefits to be sustained via physical therapy. Over 90% of back and neck problems, for example, will resolve themselves without surgery, and for some patients, there are unique benefits achieved from treatment by a physical therapist.
Physical therapy is a form of treatment—practiced by a licensed physical therapist under the referral of a physician. The purpose of physical therapy is to improve and/or restore mobility in patients for whom it is limited due to a medical condition, surgical procedure, accident or fall, neurological disease or other medical condition that has limited a patient’s functional mobility. Often the injury limits the performance of everyday tasks.
Physical therapy programs at Emory Healthcare are available to support every type of mobility and functionality issue patients may experience. Whether a patient’s functional mobility issues relate to a neurological occurrence like a stroke, or an athletic injury like a torn ACL, our physical therapists available on both an inpatient and outpatient basis are here to help.
For more information on our physical therapy programs, including information on our department of Rehabilitation Medicine, please visit the links below.
Approximately 294,000 children age 16 or younger are affected by pediatric arthritis and rheumatologic conditions.
In adults, arthritis typically affects the joints. While juvenile arthritis can cause bone and joint growth problems, it also can affect the eyes, skin, and gastrointestinal tract.
The most common symptoms of juvenile arthritis are joint swelling, pain, and stiffness that won’t go away, particularly in the knees, hands, and feet. Symptoms are generally worse in the morning and after naps. Other signs of juvenile arthritis include:
• Limping due to a stiff knee
• Excessive clumsiness
• High fever and skin rash
• Swelling in the lymph nodes
The most common type of juvenile arthritis is juvenile idiopathic arthritis. (Idiopathic means “from unknown causes.”) You may have heard this referred to as juvenile rheumatoid arthritis. This type of arthritis is diagnosed when a child has swelling in one or more joints for at least six weeks.
There are several different types of juvenile idiopathic arthritis. The type is usually determined by the number of joints affected as well as by the results of a rheumatoid factor blood test. While children may have a genetic predisposition that makes them more likely to develop the disease, at this point, researchers have not determined a direct cause, and there’s no evidence that toxins, foods, or allergies can cause it. Most children with juvenile arthritis experience remission, when the symptoms get better or go away, and times when symptoms flare, or get worse.
If your child has juvenile arthritis symptoms, the first thing to do is get an accurate diagnosis. Your child’s pediatrician can run tests that will rule out other potential causes, but if the signs point to juvenile arthritis, he or she may suggest you make an appointment with a pediatric rheumatologist.
There is no cure for juvenile arthritis; however, a number of treatments can improve your child’s quality of life, including:
• Nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and analgesics to help relieve inflammation and control pain
• Disease-modifying anti-rheumatic drugs (DMARDs) and a biologic response modifiers (biologics), which can alter the course of the disease, put it into remission, and prevent joint damage
• Splints to help keep joints in the correct position and to relieve pain and orthopedics or shoe inserts to compensate for any difference in leg length or to improve balance
• Physical therapy to help restore motion and flexibility in joints that have become stiff and occupational therapy to help children learn how to do basic activities without aggravating their arthritis
And, of course, it’s super important for kids with juvenile arthritis to eat healthy foods and get regular moderate exercise, to keep joints strong and flexible.
Does your child have juvenile arthritis? How does your family cope? We welcome your questions and feedback in the comments section below.