For those that are running in the AJC Peachtree Road Race, I wish you a healthy and successful race!

RUNNING QUESTIONS AND ANSWERS

I’ve heard that stretching prior to a race can rob you from needed strength during the race… So on race day, what would be your suggestions for a pre-race warm-up that doesn’t rob your performance? – Johnny

Light stretching should not rob your performance on race day. You can do simple calf, hamstring and quad stretches along with some simple butt kicks to get your legs warmed up a bit.

I have Achilles tendinitis and I just started training. Should I stop training? It only bothers me when I stop running. – Guest

While I can’t speak specifically to your condition, I recommend you speak with your physician before doing any additional hard training. Achilles tendinitis typically heals bylimiting running, resting it, and doing specific stretching/strengthening exercises. You can do cross training such as swimming, rowing and weight training to maintain your fitness.

What is your recommendation for preventing stitches in the side while training? – Mischelle

To prevent side cramps, I recommend focusing on your breathing and hydration. Getting into a regular breathing rhythm that matches your running stride, taking periodic deep, “cleansing breaths” as you run, and maintaining a regular hydration regiment before, during, and after your run can be very effective. I also recommend to NOT eating a large meal 1-2 hours before going for a run and avoiding sugary training snacks. Core stretches can also help prevent side stitches.

I have large varicose veins and I’ve never used the compression socks. I picked up a pair yesterday to see if it would help with leg fatigue while running. They made my legs feel twice as tired and I had a bad ache in my tibialis anterior muscle. Is that normal for the first time using them, and should I build up to using them? – Chet

I’ve not heard of many runners using compression socks during their runs. Since the goal of compression socks is to decrease fluid accumulation in the legs, wearing them during runs may actually decrease blood flow. You may want to consult with your physician. Some runners will use compression socks after runs for increased recovery and decreasing muscle soreness.

What are the best ways to work on speed work? – Tiffany D.

The answer to this question depends on what level of a runner you are. Beginners should avoid increasing pace too quickly or they may injure themselves. For more experienced runners, interval training is a great way to improve your pace. Add some higher intensity bursts into the middle of your runs to get your legs used to running at a faster pace.

If we are following a running training plan, is it okay to add other types of exercise or even fitness classes on top of the running training? – Guest

Absolutely! Cross training can help to improve your flexibility, endurance, and leg strength. Activities such as swimming, cycling, and rowing can help you increase your endurance and therefore, help your overall performance.

What is the number one rule to follow if you are a heavy-set person using a running routine to lose weight? – Stacy

The key to weight loss is tor burn more calories than you consume. The more you burn while you exercise, the faster you will be able to take off the pounds. Make sure you are doing a variety of exercises to help with weight loss e.g. running, swimming, weight lifting etc.

We received two similar questions on proper socks for runners:

What are the best types of socks for walkers and/or runners? – Guest
My last question is about socks. What type of socks is best for walkers/runners? – K.T.

I don’t think a particular type of sock is better than another – they should be comfortable and the correct size. Having said that, Dry-fit or Cool-Max socks typically are good at wicking away moisture so that your feet don’t blister.

How best to train for the July 4th heat, especially during these cool weeks in the morning, prior to the race? – Guest

As I mentioned during the chat, my biggest advice to anyone training for a big run in the heat is to stay hydrated. Remember to drink electrolytes and not just water, and make sure to drink lots of fluids after your run. I also recommend wearing appropriate clothing, such as dri-fit clothing and a top that wicks the heat away. Before the race, try to do some training runs early in the morning or evening when it’s cooler to help face the heat the day of. Do not forget to pace yourself; slow and steady is the way to go.

We received two similar questions on warming up for a run or race:

Can you describe a warm up? – Guest

Can you describe what is involved in a pre-warm up, and post-warm up? – K.T.

To warm up for a run, it is not recommended to stretch extensively. Overstretching cold muscles can lead to injury. Instead maybe do 5 – 10 minutes of light aerobic exercise to loosen muscles, then do some light stretching. You can jog slowly, cycle on a bike, walk briskly, or go up and down on some stairs.

I have heard that running on pavement is not the best for your knees. Is this true? If so, what surfaces are best to train on and how often should we run on pavement? – Rebecca

Runners can get injured on all running surfaces. The harder the surface, the more ground reaction forces get transmitted to your knees, but the softer the surface, the higher the risk for ankle injury. If you can, mix up the running surface to improve your overall fitness and strengthen the legs. Switch up your route as well. This will help your legs stay balanced.

Any suggestions for increasing time and endurance from the 5k to Peachtree in the seven weeks left? – Jane

General principal: increase your distance, and then increase your pace. Add about a half-mile to your runs each week. You do not need to run 6.2 miles before the actual event. Once you’ve gotten to 5 miles you can start trying to decrease your time by 1-2 mins each run. The excitement of the day will get you to the finish line in a great time.

I have read to improve how far we run, to gradually increase mileage… But, how can we train ourselves to run faster, in a safe manner. Any guidelines? – Guest

I would start out increasing your distance – about 1/2 mile a week. Once you get to 5 miles you can start increasing your pace – attempting to decrease your run time by 1-2 mins each run. You can also increase your pace whenever running up a hill.

How to run safely to prevent injury, if you’ve never run before this training? – Guest

Gradually increase your endurance and pace during training. Most injuries come from starting with too much too soon. Increase your mileage about 1/2 a mile each week over the next 7 weeks. Once you get to 5 miles comfortably and you want to run faster, try adding some short sprints to the middle of your workout.

I have pain in my heel. What could this be? – Guest

There are a number of conditions that could be causing your heel pain. Without seeing you in person, I can’t make an accurate diagnosis. Plantar Fasciitis is the most common cause of heel pain in runners – but this could also be a stress fracture. You should see a sports medicine physician and get appropriate treatment. We recently wrote a blog about Plantar Fasciitis.

As a runner, what percentage of my daily caloric intake should come from carbs, protein, and fat? - Rachael E.

Runners need a good balance of carbs, protein, and fat to fuel their training. Carbs and protein make the bulk of the calories. The typical guideline for a low intensity runner is 1.4 to 2.3 grams of carbs per pound of body weight and about .64 grams of protein per pound of body weight.

How do I train my mind? I’m having difficulties in that my mind tells me I can’t do what I’ve already done! Tips on remaining positive would be helpful… – Johnny

It is always an accomplishment and such a feeling of pride when you cross the finish line at a running race. At the Peachtree, there are tons of people around to cheer for you, and it feels amazing. Make running a social thing and meet up with a friend for a run; the miles click by faster and you will enjoy it more!

Should I practice a day before Race or not? – Guest

This depends on the level of runner you are. If you are a beginner, I recommend taking a rest day before a race. If you are a more experienced runner, you can take the day off or go for a short, easy jog the day before a race to loosen the muscles and relieve some of the nervousness.

What are some ways to prevent Achilles tendinitis? – Guest

Typically, Achilles tendinitis occurs when runners increase mileage or speed too quickly. If you are a runner who has tight calves or pronates excessively, you can develop Achilles tendinitis. Increase your running pace and mileage on a gradual basis. Once you get up to 5 miles on a run and feel comfortable, you can then begin working on your speed. Stretch and strengthen your calves after every run.

I have problems with my Achilles being very tight. It’s painful to stand up in the morning until I’ve completed stretching. Running aggravates the issue. Any suggestions? – Guest

You should really see a Sports Medicine Physician to address this issue because my suggestions would be determined by what the diagnosis is.
In general, Achilles injuries need time off from running and specific regiments of stretching and strengthening in order to heal. You can maintain your endurance by cross-training activities, such as swimming, rowing, cycling, and using the elliptical machine. This will help you maintain some of your fitness. (I don’t like the wording of this answer but this is the gist)

While running, what should I be “listening” to in regards to my body to best avoid injury or pushing myself too hard? – Guest

Before you start running, get a physical examination by your primary care physician to be sure it is medically safe for you to be running. Some discomfort (usually after your run) is normal when you are starting a running routine, but this should resolve in a few days to a week, and it should never increase in intensity. If you feel dizzy, lightheaded, if your heart starts racing or skipping beats, or if you are not sweating on a hot day – see a physician right away, as these may be signs of something serious. If your knees and/or joints start to severely hurt you, you should see a Sports Medicine Physician.

At 52 yo and no distance running and nursing hamstring strain since Feb. What can I do to prep for this 10k? -Guest

First, make sure that the hamstring has gotten appropriate treatment and is strong enough for training. Next, build yourself up to walk/run the 10K distance. Start out at about 2 miles every other day, but one day a week, it should be a long run, and you should increase this run by 1 mile each week thereafter. After 4 weeks, you should be at a 6-mile long run and be ready for the Peachtree distance – don’t think you will have enough time to do much with your pace.

Can you discuss hip bursitis causes, prevention and treatment? Thank you. – Guest

A bursae is a soft, fluid-filled sac, that serves as a cushion between bone and soft tissue structures, such as tendon and skin. The hip bursae sac helps reduce friction between the IT band and the greater trochanter (bony bump on the upper outer thigh). Bursitis occurs when the bursa becomes inflamed. The bursae can become inflamed with increased training or long periods of exercise that involve repetitive leg motion.
Treatment for bursitis often includes avoiding activities that worsen your pain and using anti-inflammatory medications. You can also use ice on your hip to help with the pain. Sometimes, a corticosteroid injection may be used. Visit your physician to get the most appropriate treatment for your specific condition.

What advice can you give to an advanced runner running in a large race such as the AJC Peachtree road race for the first time when it comes to preventing injury? – Guest

As an advanced runner, you should already have a training program. In general, I recommend increasing your mileage and pacing gradually. Follow a plan that has worked for you in the past.

How do you feel about the newer minimal shoes reducing joint impact. Is there science to support that or just good marketing? – Chet

Minimalist shoes CAN NOT reduce joint impact – only decreasing your body weight can do that. What the shoes have been shown to do is change a person’s foot strike pattern from a heel strike pattern to more of a mid-foot strike, and this change can sometimes be helpful in alleviating conditions like plantar fasciitis and Achilles tendonitis.

Any suggestions about runners with Asthma? I am taking it slow…and not expecting too much too soon….- Derric

Derric – You should make sure that you have been evaluated by an allergist to get the cause of asthma addressed. Once your asthma is under control, a normal training regiment can be followed. Here is a resource for information for runners with asthma.

I currently have a stress fracture. What can I do in the meantime that will help slow the loss of fitness? – Kristie

There are a few cross training exercises that you can do to maintain fitness while not running. Swimming, core work, cycling, rowing, weight lifting, and using an ALTER – G (an anti-gravity treadmill) are usually good choices.

If you are experiencing patella tendonitis and problems with the knees in general, how often and how many miles should you run a week to be ready for a 10K? I am cross-training some as well through swimming and core exercises. Thank you! – Kathy

If you are having “problems” with your knees while or after running, you should seek the advice of a Sports Medicine physician – running should NOT hurt! The total weekly mileage depends on where you are in your training. Generally, my rule of thumb is to run every other day starting at 1-2 miles each run. You can increase the mileage for each run by ½ to ¾ mile a week till you get to 3 miles. After 3 miles, only increase one of your runs by 1 mile a week while the rest of your runs should stay at the same base distance. So in the beginning you will be running 6 – 8 miles a week, but by the end you are running 12 – 15 miles.

Please explain what is runners knee and how is it relieved and treated? – G

Runner’s knee is a common lay person term used to describe a variety of running related disorders that can impact the knee such as Patellar Tendonitis, Patellofemoral pain, Chondromalacia. The term is vague so I don’t use the term too often because it doesn’t give a runner a true idea of what they have and how to treat it. Treatment for all the conditions referenced earlier is different, so if you are having severe knee pain, I recommend you schedule an appointment with your Sports Medicine physician.

What is your opinion on calf compression sleeves during long distance training/long distance racing? I recently purchased a pair and have found that I have much less calf soreness post-run. Are there any disadvantages to using them? - MS Prucha

I haven’t seen much research on the advantages/disadvantages of using compression socks. The goal of compression socks is to decrease blood pooling in your legs. I recommend runners to use serial compression devices after runs to decrease recovery time and muscle soreness. Using a compression sock during a run may actually decrease blood flow in the legs, which is not a desired effect.

What about the need to maintain a suitable age-related heart-rate? Please give some general guidelines and brackets to work within. – Lori

Before starting any exercise routine, make sure that you consult your Primary Care Physician to make sure that it is safe for you to do vigorous exercise. You can estimate your maximum heart rate with a simple formula. For men, it is 220 – age. For women, it is 226 – age. If you are a beginner training for Peachtree, you should not be hitting your maximum heart rate. Instead you should consider training at 65% to 90% of your maximum heart rate.

Here is a link to calculate how you should be running for easy, moderate, and maximum capacity.

Injury free running tips for heavy set people. – Ansatacia

Before starting any exercise routine, make sure that you consult your Primary Care Physician to make sure it is safe for you to do vigorous exercise.

As with any beginner, you should start slow and be patient with your progress. Start out with a walk-to-run program, breaking your exercise time up into 5-minute intervals. For example, start out walking, and then add a minute of power-walking/jogging/running to each segment every two weeks. As your fitness improves, you will progress from a 5:0 walk run ratio to a 0:5 walk run ratio (4:1 then 3:2 then 2:3 etc.). This will enable you to give yourself a goal to keep going. I would also invest in good shoes – go to a specialty-running store and have them analyze your gait to make sure you are wearing the right shoes for your body and running style. Finally, run every other day or 3 – 4 times per week as to not overwork your body.

What are good ways to combat runner’s knee/patella tracking issues? – Guest

You can find detailed information about patellar compression syndrome here.

I love running. I’ve done many P’tree Rd Races. But several years ago I had repair surgery for a torn meniscus. I recovered well & continued to run. But I’ve noticed as I become regular in my running that the same discomfort is returning to that same knee should I give up running altogether? I fear the same ailment will keep returning. – Laura Lynn

I would recommend that you go back to see the surgeon who previously treated your knee to get an evaluation. Without seeing you in person, it’s hard to give a recommendation on whether or not to continue running.

Pre-Run Stretching & Warming Up Questions:

We received MANY questions in Tuesday’s chat on the topic of stretching and warming up for a race. Many of them were answered in the chat transcript, but the questions below were ones we didn’t get to:

What stretches should we do? – Johnny

Ideas for stretches before and after running? – Alexandria

I have very tight hamstrings. Where can I find exercises that will help me to stretch properly? – Mike

This website has some great stretches for the muscles in your legs.

There are a lot of great stretches for hamstrings and calf muscles, but what about for thighs? Mine are extremely sore during and after a run. – Rebecca

A standing quad stretch is a good stretch for the muscles in your thigh. Stand on one leg near a table or wall, so you can touch the wall to keep your balance. Bend your knee so your heel touches your butt. Use the hand on the same side you are bending to grab your foot and pull towards your butt until you get some resistance, and hold that position for 15 seconds. After 10-15 seconds, you should feel your quad muscle relax a bit allowing you to pull your foot even closer to your butt. When you get resistance again, stop and hold that position for another 10-15 seconds. Switch sides and repeat. Make sure you are standing up straight and that your knee is pointed straight down towards the floor.

Thanks again to everyone who joined my recent online chat for runners! Have a great race!

The pre-participation exam checks for the following:
• Identify any potential life-threatening conditions such as risk of sudden cardiac death.
• Evaluate athlete for conditions that may need treatment prior to participation.
• Identify any orthopedic conditions/concerns that may need physical therapy or other treatment prior to participation.
• Identify athletes who may be at higher risk for violence, substance abuse, STDs, depression, eating disorders, anemia, asthma, hypertension, etc.
• Evaluate history of concussion and determine if the student-athlete is still experiencing post-concussion symptoms if previously concussed.

Student athletes and their parents need to come to the physical prepared to open and honestly discuss all medical history. The doctors need all the information on the athlete’s medical history to be able to properly examine the athlete and clear him or her for participation in their sport or activity. This is not a time to try and hide past injuries or medical conditions.

Many schools perform pre- participation exams but if you would like a more thorough physical exam, visit your family’s personal physician or pediatrician. He or she may refer your child to a Sports Medicine specialists if he thinks the child needs further evaluation for orthopedic concerns or if the student has had a history of concussions.

Most student athletes are cleared for full participation in sports. Those who need more follow-up often times resume normal activities after ensuring they are cleared from all potential complications from participating in sports.

About Jeff Webb, MD

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.

About Emory Sports Medicine

The Emory Sports Medicine Center is a leader in advanced treatments for patients with orthopedic and sports-related injuries. From surgical sports medicine expertise to innovative therapy and athletic injury rehabilitation, our sports medicine physicians and specialists provide the most comprehensive treatment for athletic injuries in Atlanta and the state of Georgia. Constantly conducting research and developing new techniques, Emory sports medicine specialists are experienced in diagnosing and treating the full spectrum of sports injuries.

Our sports medicine patients range from professional athletes to those who enjoy active lifestyles and want the best possible outcomes and recovery from sports injuries. Our doctors are the sports medicine team physicians for the Atlanta Falcons and Georgia Tech and provide services for many additional professional, collegiate and recreational teams. Appointments for surgical second opinions or acute sports injuries are available within 48 hours. Call 404-778-7777 for an appointment

Related Resources

• Emory Sports Medicine Website
• Governor Deal Signs New Youth Concussion Bill
• 6 Tips for an Injury-Free Transition from Indoor to Outdoor Sports
• Sudden Cardiac Death in Young Athletes
• Understanding Cardiac Arrest in Athletes Such as Fabrice Muamba

Your heart and running

Consistent running reduces your risk of heart disease.

o Your increased heart rate from running for an extended period makes your heart stronger!

o Running can help lower blood pressure by helping to maintain the elasticity of your arteries.  When you run, your arteries expand and contract more than normal so this keeps the arteries elastic and your blood pressure low.  Most elite and very serious runners have very low blood pressure.

o Running can help reduce or maintain your weight.  Running burns more calories than most other exercise and it can be done relatively inexpensively.  A 150 pound man will burn over 100 calories for every mile running at moderate pace.    With a lower body weight you also have less chance of developing type II diabetes.  Type II diabetes is typically associated with obesity.

o Running often can help improve cholesterol numbers.  Bad cholesterol (LDLs) typically go down and good cholesterol (HDL) can go up.

I recommend consulting with your physician before starting to run if you are not a runner to get a full physical to ensure your heart is in tip top shape to start a running schedule.

Your bones and joints and running

Your body was built to run!  Evolution has developed our bodies so that we have the necessary tools to move and stay physically active.  To prove this, a recent study by the American Journal of Preventive Medicine revealed that long distance-runners did not have accelerated rates of osteoarthritis.  In fact, weight-bearing exercises like running can help maintain or build bone mineral density by helping you avoid osteoporosis. Therefore, experts tend to agree that running can help you fight against arthritis and other bone and joint problems.  Injuries that runners usually suffer are typically from doing too much too soon or at a quicker than natural pace for your body.  Runners will also see injuries due to wearing incorrect shoes, shoes that are too old or running with incorrect form.  Eliminate bad running habits and you will run injury free!

One myth that is true and you should take careful note of is the dangers of developing skin cancer as a runner.   The more miles you put in, the more time you are probably spending in the sun.  I recommend wearing sunscreen on every run, regardless of the time of day you run and wearing a hat and/or sunglasses.  I also recommend  running in the very early morning or in the evening instead of running when the sun is the hottest.  If you suspect any abnormal lesion or marking, see your dermatologist right away!
So get out there and run!  You will be happy you did!

Upcoming Live Chat with Emory Sports Medicine Specialist

UPDATE: CHAT TRANSCRIPT

Are you training for the AJC Peachtree Road Race or another running race this summer or fall? If so, join Emory Sports Medicine physician, Dr. Amadeus Mason for a live online web chat on Tuesday, May 14 to learn how to run injury free.  Dr. Mason will be available to answer questions on training, stretching, how to prevent common running injuries and treating injuries when they occur.

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 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!

Related Resources

• 10 Tips for a Healthy Peachtree Road Race Run
• AJC Peachtree Road Race 2013 Chat Transcript
• Is it Possible to Overtrain for a Running Race?
• Running is Great for Your Heart; Make Sure Your Workout Snacks are Too
• Emory Sports Medicine Website

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.

Wrist Fracture Symptoms:

• Wrist Pain
• Swelling of or around the wrist
• Deformity of the wrist

Wrist Fracture Treatment

Treatment for a wrist fracture can vary on a case by case basis.  Some wrist fractures can be treated in a cast.  Physicians can reset the fracture and cast it and the bones can heal themselves.  There are cases though when a wrist fracture needs surgery.    Physicians take into consideration other factors to determine whether a patient needs surgery such as:

• Age of patient – if the patient is young and very active, physicians will do everything possible to restore the wrist to completely normal function.  As the patient gets older, he/she may not need perfect restoration of function.
• Quality of the bone –  a patient must have good bone quality for surgery because surgery is traumatic to the bone.  If bones are thin and weak, surgery could be less beneficial.
• Fracture location  – If cartilage in the wrist can not be lined up properly to heal well in a cast, physicians may have to do surgery to ensure full recovery of motion in the wrist.
• Bone positioning – It can at times be difficult to hold bones in position during casting so surgery is needed to restore bones to proper position.

At Emory Orthopaedics and Spine, hand specialists Dr. Claudius Jarrett or I can many times decrease your recovery time and quicken your return to prior recreational activity with a minimally invasive surgery.  The recovery could be much less than the average 3 month period that many patients spend in a cast.

Patients should consult their physician right away if you suspect you have a broken wrist so they can evaluate and provide the best options for you and your particular case.

About Gary McGillivary, MD, FRCS

This bill will help coaches, parents and players make the right decisions for their athletes.  The bill requires public and private schools to provide information to parents on concussions and establish certain policies for dealing with student head injuries. Under the law, any youth athlete who is suspected of having a concussions must be removed from play.  The athlete must then receive medical clearance from a health care provider trained in concussion management before he or she can return to play.

The Return to Play Act was written in such a way to implement basic protections and give schools flexibility to build their own programs depending on how much funding they can commit. Georgia joins 43 states with similar laws. Government estimates show hospitals treat some 173,000 traumatic brain injuries among youth that are connected to sports and recreation activities each year.

About Ken Mautner, MD
Ken Mautner, MD is an assistant professor n 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.

About Emory Sports Medicine Center
The Emory Sports Medicine Center is a leader in advanced treatments for patients with orthopedic and sports-related injuries. From surgical sports medicine expertise to innovative therapy and athletic injury rehabilitation, our sports medicine physicians and specialists provide the most comprehensive treatment for athletic injuries in Atlanta and the state of Georgia. Constantly conducting research and developing new techniques, Emory sports medicine specialists are experienced in diagnosing and treating the full spectrum of sports injuries.

Related Resources

• Blog – Youth Concussion Law in Georgia – House Bill 284
• Blog – How to Recover Fully and Quickly from a Concussion
• Blog – Female High School Soccer Players 64% More Likely to Suffer from Concussions Than Males 
• Emory Sports Medicine Website

All levels of runners are welcome to join us on Tuesday, May 14, 2013 from 12 – 1:00 p.m. for an interactive online Q & A on healthy running. The chat will span a wide array of running related topics – so join us and bring your hardest running questions! I will be available to answer questions to help you best prepare for AJC Peachtree Road Race, your first 5k or a marathon PR.

If you are interested in learning more about running benefits, prevention, and tips, register for the live chat now. Spread the word about our online runner’s chat to your fellow runners, friends and neighbors. I’ll see you on the 14th!

CHAT TRANSCRIPT

About Dr. Mason
Dr. R. Amadeus Mason is a board-certified physician at Emory Sports Medicine with a special interest in track and field, running injuries and exercise testing. He is the team physician for USA Track and Field and the Nike/National Scholastic Sports Foundation Track and Field and Cross Country meets, Tucker High School, and Georgia Tech Track and Field. Dr. Mason is an active member of the Atlanta running community

The most common type of sarcoma that develops in the bone is called an osteosarcoma while sarcomas that develop in the connective tissue are called soft tissue sarcomas. Soft tissue sarcomas can develop in soft tissues like fat, muscle, nerves, fibrous tissues, blood vessels, or deep skin tissues. The rarity of sarcomas means most doctors seldom see one, which explains why patients are often referred to specialty hospitals where experienced surgeons utilize limb-sparing (no amputation) surgery whenever possible.

Understanding Osteosarcomas

Osteosarcomas are aggressive malignant bone tumors and are the most common type of bone cancer in young people. They usually occur between the ages of 10 and 25, but can occur at any age and are more common in males than females. They encompass about 20% of all primary bone cancers and it is estimated that the incidence rate in U.S. patients under 20 years of age is 5 per million. Osteosarcomas most commonly start in the ends of long bones of the arms or legs where new bone tissue rapidly forms.

Symptoms of Osteosarcoma

• Pain near the affected bone is the most common osteosarcoma symptom
• Swelling of the bones and joints. Noticeable swelling or protrusion near the location of the tumor
• Brittleness/weakness of the bone which can lead to fractures
• Difficulty moving during physical activity
• Noticeable limp when the osteosarcoma is in the leg

Treatment for Osteosarcoma

Typically chemotherapy is given to shrink the tumor before surgery. Most often, chemotherapy results in a necrosis (or death) of the tumor and allows the physician to treat possible cells in the blood stream. In most cases, surgery is required to remove the section of cancerous bone. Limb sparing surgery (LSS) is a special operative procedure performed by oncology orthopedic surgeons and has become the accepted standard of care for patients with sarcomas of the extremities. Limb sparing surgery can be accomplished in approximately 90% of the cases. During limb sparing surgery, the cancer in the bone is removed surgically and the portion of the bone that was removed is either replaced with special metal prostheses or a bone allograft. An allograft is a bone transplant obtained sterilely from a person that has died and agreed to be an organ donor. Emory Orthopaedic surgeons have mastered the limb-sparing surgery in order to save as much bone as possible without compromising the ability to cure the patient.

Emory offers a unique multi – disciplinary treatment approach to bone sarcoma care. Emory Orthopaedic oncology surgeons collaborate with medical oncologists, radiation oncologists, pathologist, radiologists, thoracic surgeons, plastic surgeons and vascular surgeons to develop a treatment plan catered to each individual patient.

About Dr. Monson
David K. Monson, MD, assistant professor of Orthopaedic Surgery and Chief of Orthopaedic Surgery at Emory University Hospital Midtown, started practicing at Emory in 1988. Dr. Monson is an expert in the treatment of rare tumors (sarcomas of the bone and soft tissue). Dr. Monson’s specialties are Orthopaedic Surgery (Board certified since 1990) and Orthopaedic Oncology. His areas of clinical interest are orthopaedic tumors, sarcoma, and limb reconstruction.

About Dr. Oskouei
Shervin V. Oskouei, MD, assistant professor of Orthopaedic Surgery at Emory University, is an expert in the treatment of musculoskeletal (extremity) tumors, total hip and total knee replacements and revisions. Dr. Oskouei started practicing at Emory in 2004. Dr. Oskouei is board-certified and fellowship trained in orthopaedic surgery. Combining his experience and interests with the state-of-the-art facilities of Emory University and the Winship Cancer Institute of Emory University allows Dr. Oskouei to treat patients with the latest modalities using a multi-disciplinary approach.

About Emory Orthopaedic Oncology
Dr. Monson and Dr. Oskouei lead the Emory Musculoskeletal Oncology and Limb Reconstruction program at Emory. The world – class program treats a variety of conditions, including benign and malignant tumors of the extremities and spine, as well as metastatic disease. Together, they offer a combined 34 years of clinical practice experience. They care for both pediatric and adult aged patients.

Both of these physicians belong to the Musculoskeletal Tumor Society which requires fellowship training in orthopaedic oncology. Physicians belonging to this group must also have a primary clinical focus in orthopaedic oncology. This is important for patients because it means the specialist you are seeing has had extra training in this area and is viewed by peers as an expert in the care of orthopaedic oncology. Patients should take the time to research physicians in their area to determine if they are seeing an orthopaedic oncology specialist that belongs to this organization.

Related Resources:

• Emory Musculoskeletal Oncology Program
• Sarcoma information from the Winship Cancer Institute

Watch Doug’s incredible story in the video below and learn more from Emory physicians Dr. Gerald (Rusty) Rodts and Dr. Daniel Refai on what makes spinal tumor treatment at Emory different.

 

VIDEO: Spine Tumor Patient Story

About Dr. Rodts
Dr. Gerald Rodts is a Professor of Neurosurgery and Professor of Orthopaedic Surgery at Emory University School of Medicine. In addition, he is the Director of the Spine Fellowship Program in the Department of Neurosurgery at The Emory Spine Center and Chief of Neurosurgery Spine Service at The Emory Clinic.

Dr. Rodts graduated from Princeton University with a degree in biology and a Certificate of Study of Science in Human Affairs. He received his M.D. from Columbia University’s College of Physicians and Surgeons in New York and completed his neurosurgery residency training at the University of California in Los Angeles, followed by a 1-year fellowship in complex spinal neurosurgery at Emory University. Dr. Rodts has served as the President of the Congress of Neurological Surgeons as well as serving as the Secretary. He has also served as the Chairman of the AANS/CNS Joint Section on Disorders of the Spine and Peripheral Nerves. He is also a founding editor of the award-winning website, Spine Universe.

Dr. Rodts manages patients with spinal disorders and specializes in neoplastic, rheumatoid, degenerative, traumatic spinal disorders, syringomyelia and Chiari malformations. His research interests are in computer-assisted, image-guided surgery and minimally-invasive spinal techniques.

About Dr. Refai
Dr. Daniel Refai is an Assistant Professor in the Departments of Neurological Surgery and Orthopaedic Surgery at Emory University School of Medicine. In addition, he is the Director of Spinal Oncology at the Emory Spine Center.

Dr. Refai earned his Bachelor of Science in Chemistry and French at Tufts University in 1997 and his Medical Doctorate at the University of Chicago School of Medicine in 2003. He completed his neurosurgical residency at Washington University, St. Louis in June 2003, and completed a one-year advanced sub-specialty fellowship in spinal neurosurgery and orthopaedics at The Cleveland Clinic, Inc. in June, 2010.

Dr. Refai enjoys teaching and has received numerous patient and medical education distinctions throughout his training. He joined the Emory Departments of Neurosurgery and Orthopaedics in September, 2010. He performs spine radiosurgery and has a special focus on patients needing complex spine surgery. He sees outpatients at the Emory Orthopaedics and Spine Center at Executive Park, and performs surgery at Emory University Hospital-Midtown.

Related Resources:

• Emory Orthopaedics Program
• Winship Cancer Institute

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.

Related Resources

• Emory Orthopaedics and Spine
• PRP Therapy Patient Success Video

• More about Knee Osteoarthritis

Dr. Spero Karas

University of Louisville basketball player Kevin Ware sustained a bad injury while playing in an Elite 8 basketball game on Sunday. He quickly was taken to the hospital for surgery and was up on crutches on Monday!

Emory Sports Medicine physician Spero Karas, MD says Kevin’s prognosis should be good. Karas has treated similar fractures in his tenure at the Emory Sports Medicine Center. He anticipates Kevin could be healed in six – nine months if he doesn’t face any complications and starts rehabilitation immediately.

Watch Dr. Karas’ interview with CNN

Fredricka Whitfield talks to Dr. Spero Karas, about Kevin Ware’s gruesome leg break and his rehabilitation.

Watch another interview with CBS

About Dr. Spero Karas
Dr. Karas is an Associate Professor of Orthopaedic Surgery at Emory University and the Head Team Physician for the Atlanta Falcons. He is also the Director of the Orthopaedic Sports Medicine Fellowship Program at Emory University School of Medicine. His specialties include sports medicine, surgery of the shoulder and knee, and arthroscopic surgery. He 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 is Board Certified in Orthopaedic Surgery, with a subspecialty certification in Orthopaedic Sports Medicine. He is 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.

Dr. Karas was 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. Dr. Karas is an internationally recognized expert in the field of shoulder, knee, and sports medicine.

Related Resources

• CNN Interview
• CBS Interview
• Website – Emory Sports Medicine Center
• Should you see a Sports Medicine Physician