Posts Tagged ‘ACL tear’

Knee Injuries in Young Athletes Live Chat Takeaways

We hosted a live chat with Dr. John Xerogeanes where he answered questions regarding knee injuries and the treatment of them.Knee injuries in young athletes continues to be on the rise. One of the most common sports injuries, an ACL tear, could end a young athlete’s career aspirations in sports before it even begins. Twist your knee sharply or extend it beyond its normal range during play, and you may hear the telltale “pop.” Whether your child participates in football, soccer, basketball or track, their drive for the game may be setting the stage for a serious injury.

We hosted a live chat with Dr. John Xerogeanes, Chief of Sports Medicine at Emory Orthopaedics & Spine Center, on Wednesday, September 28 where he answered questions regarding how to reduce the risk of knee injury, exercises for strengthening the knee, warning signs, what to do following an ACL injury, and the rehabilitation process. Below are some highlights from the live chat, and you can read the full chat transcript here.

 

Question:  What are the signs that I have injured my ACL?

Dr. Xerogeanes: You will usually land from a jump or twist the knee. You will often feel a “pop” in the knee or even hear a pop. Most of the time one will also feel the knee bend in in an abnormal manner.

 

Question: Is it easier to for an athlete to injure their knee again after they’ve already injured it once?

Dr. Xerogeanes: Yes. if you hurt your ACL and do not have surgery, then your knee will go out again when you play. that can injure your knee further. After reconstruction of the ACL, you can alway reinjure it again. My reinjury rate in the last 1500 ACLs that I have done is around 5.5%.

 

Question: What is surgery for an acl tear like?

Dr. Xerogeanes: Surgery takes an hour. I like to borrow tissue from the quad tendon (above the knee). I like this because it is the strongest graft tissue with the least amount of collateral damage. It can be done through a 1-2cm scar. We have followed our patients with a pain app the we created and most patients are off pain meds within3-4 days.

 

Question: Are knee injuries more common in one age group than another? Or in a certain sport?

Dr. Xerogeanes: They are different between sexes. Females increase dramatically at puberty. Males increase in high school but not at drastically as females. We have no idea why, but at this age a female has a 4-5x greater risk of ACL injury than a male.

 

Read the full chat transcript from this live chat about knee injuries here.

 

ACL Injury: Mikayla’s Success Story

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

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

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

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

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

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

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

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

A note from Dr. Karas:

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

Update:

Since our last blog on Mikayla Combs, she signed a letter of intent to play for Gino Auriemma at Connecticut, a top basketball program in the country!

 

About Dr. Karas:

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

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

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

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

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

Tips to Avoid Turkey Day Injuries!

Thanksgiving The holidays are a time to celebrate, spend time with family and hopefully enjoy a few relaxing days off from work. For many weekend warriors, “relaxing” means pulling together a game of football or basketball in the back yard. While these games are often enjoyable, many end in injuries such as:

Although some injuries can not be prevented, others can be prevented with some simple warm up measures and consistent muscle training.

  • Build a cardiovascular base. You should maintain your cardio base by doing cardio exercise about 2 times a week year round. You can do running, biking, swimming, rowing, and walking to maintain this base training.
  • Maintain proper nutrition. A balanced diet is important year round but especially during the holidays when temptations are all around us. Adding extra weight, adds strain and stress to the body and this could lead to injury.
  • Core strength. Develop core strength by doing simple core exercises on a weekly basis such as planks or crunches. Poor core strength can lead to a variety of issues, including back pain.
  • Dress correctly. Use the appropriate footwear and protective gear for the sport you are playing. If you are playing football, put on a helmet to protect yourself from a concussion. This could save you from an emergency trip to the hospital before you can even eat your Thanksgiving turkey.

If you do end up with a sports related injury over the holidays, trust Emory Orthopaedics, Sports and Spine to get you back in the game quickly!

Emory Orthopaedics, Sports & Spine

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, MD 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.

Dr. Mathew PomboAbout Dr. Mathew Pombo, MD

Team Physician: Johns Creek High School, Chattahoochee High School, Berkmar High School

Dr. Pombo is an orthopaedic surgeon new to Emory but has made a big impact on the community in his first 5 years of practicing. Dr. Pombo completed medical school at the University of Georgia, residency at Wake Forest University, and fellowship training at the University of Pittsburgh Medical Center.

Dr. Pombo sees patients in our Duluth clinic and performs surgery at Emory Johns Creek Hospital. He has a special interest in managing sports related concussions. He also specializes in ACL surgery, shoulder, knee, and hip arthroscopy, joint replacement, and sports medicine treatments for pediatric patients through adult patients.

Dr. Pombo is very engaged with the community and serves as team physician for several schools and youth sporting groups. Dr. Pombo attended Duluth High School and is proud to be back in his community giving back to young athletes.

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ACL Tear & Repair Patient Story – Freddy Assuncao, MMA Fighter

ACL tear repair surgery MMA Fighter Freddy AssunacoAnterior Cruciate Ligament tears in the knee don’t just happen to athletes playing football or soccer. Emory’s Chief of Sports Medicine, Dr. John Xerogeanes, recently repaired an ACL tear for MMA fighter, Freddy Assuncao.

Assuncao tore his ACL in training, helping one of his teammates prepare for an upcoming fight. For the repair of his potentially career-jeopardizing knee injury, Assuncao sought out renowned ACL surgeon, Dr. Xerogeanes – who is affectionately known as “Dr. X” by patients and staffers at Emory Sports Medicine – and a strong team of experts on rehabbing professional athletes from the Emory Sports Medicine Center.

Robert Griffin III: On the Road to ACL Injury Recovery

Dr. John Xerogeanes Emory Sports Medicine

Emory’s Chief of Sports Medicine, Dr. John Xerogeanes (Dr. X), recently spoke with the team from USA Today about the significance of NFL Washington Redskins’ quarterback, Robert Griffin III’s knee injury and the surgery to repair it.

Check out the video below via USA Today to see what Dr. X believes Robert Griffin III’s biggest recovery challenges will be and more on ACL injuries:

About John Xerogeanes, MD

John Xerogeanes MD
Dr. Xerogeanes is Chief of Sports Medicine at the Emory Orthopaedic & Spine Center. Known as Dr. “X” by his staff and patients, he is an Associate Professor of Orthopaedic Surgery at Emory University as well as an Adjunct Professor at Georgia State and Mercer University. Dr. Xerogeanes is entering his 11th year as Head Orthopaedist and Team Physician for Georgia Tech, Emory University, Agnes Scott College and the Atlanta Dream of the WNBA. Dr. X specializes in the care of the knee and shoulder for both male and female athletes of every age. He is board certified in orthopaedic surgery and has his sub-specialty certification in orthopaedic sports medicine.

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Athletic Injuries: Young Athletes Play Through the Pain

Athletic Injury Young AthletesA new study shows that many young athletes keep on playing after they’ve been injured. And all too often, those injuries could have been prevented. Safe Kids Worldwide, a global nonprofit organization with a mission of preventing unintentional childhood injury, found that kids are suffering from overuse injuries, dehydration, and even head injuries.

Kids are under pressure to play at a much higher level and with more intensity than they did decades ago. A pitcher who shows potential may play on two or three different teams during a single season. And Safe Kids found there’s a lot of pressure to stay in the game—even when you’re hurt.

A new Safe Kids study shows a third of young athletes who play team sports suffer injuries severe enough to require medical treatment. But nearly 90% of parents underestimate how much time kids need to recover.

As a result, Emory pediatric orthopedic surgeon Dr. Nicholas Fletcher says, a lot of kids play hurt.

“Kids think if they take a week off, they’ll get kicked off the team, or their parents won’t let them play anymore. It’s very important for the kid to stay on the team, so a lot of times they’ll mask the injury,” says Dr. Fletcher.

Safe Kids found that half of the coaches said they’d felt pressure—either from kids or parents—to put an injured child back in the game. And nearly a third of kids said they would play hurt unless their coach made them stop.

“One of the biggest take-home messages I try to convey to coaches is that this 11-year-old also has a 12-year-old and a 13-year-old and a 14-year-old season,” says Dr. Fletcher, who sees a lot of young players with ACL tears, hip injuries, and throwing injuries. Many of those problems are from overuse. He says if a young athlete is not given time to heal and given proper treatment, he or she can be left with lifelong problems.

Has your son or daughter suffered a sports injury and kept on playing? We welcome your questions and feedback in the comments section below.

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Returning to Competition after an ACL Injury and Surgery

ACL Rehab ProgramBecause our sports medicine specialists have created a new program dedicated entirely to ACL injuries and your successful recovery from them, we’ve been sharing blog posts that correspond with the stages of the program. In first post, we helped you identify goals and prepare for ACL surgery after an injury and also introduced you to the concept of prehabilitation, which is equally as important as rehabilitating after surgery. For more on that topic, check out part I of our ACL injury blog series. After helping you prepare for surgery, we then moved on to identifying your post-ACL surgery recovery goals week-by-week in part II of our series. Today, we’ll be covering the last stage of the program and the portion that’s probably most important to those who consider themselves athletes: Returning to Play.

The goals and exercises outlined below will guide you from 3 months until 8 months post surgery. It is vital to faithfully adhere to the following program to avoid re-injury to the ACL reconstruction. Having a physical therapist or certified athletic trainer to help hide you through this program is often helpful. If you’ve had ACL surgery, but are still in the early stages of rehabilitation, check out part I and part II of our ACL injury blog series before moving forward.

Months 3-4: Jogging Phase

During months 3 and 4 of your recovery after ACL surgery you will work on improving functional strength with forwards and backwards movement, increasing your cardiovascular fitness and starting a jogging progression, core strengthening and overall lower extremity flexibility. Tip: when performing exercises such as Schlopy Mini Jumps, use a mirror for feedback. Your hips should stay even and knees should not buckle in, you should flex at your knees not your hips.

Months 4-5: Agility Phase

Building agility in months 4 and 5 of your recovery is a key step in returning to play. During months 4-5, focus on your strength, cardio, flexibility, core, and agility workouts. From the exercises outlined by the program, lower extremity strength should all be done on same day and make sure you get 48 hours rest between strength exercises. Cardiovascular exercises should be done 3-5 times per week.

Months 5-6: Return to Drills Phase

Throughout months 5-6 you will continue to work on improving strength and balance and start getting back to your game. You can add the BOSU ball with your strengthening exercises and start sport specific drills and start to be a part of your team.

Months 6-7: Return to Practice Phase

During months 6-7 of your post-ACL surgery recovery, you can start practicing your sport with your team. You can get physical in practice but only progress to play when you are fully confident. You will need both the physical strength and mental confidence before you start to compete and play.

Months 7-8: Return to Competition Phase

Congratulations! Once you’ve made it this far through the ACL surgery and rehabilitation program, you are ready to return to competition!  Make sure you are in the best shape possible to return both physically and mentally. Your ACL strength and flexibility will only improve as long as you continue to challenge yourself and continue your strengthening.

Remember you won’t be 100 percent, fully recovered until 12 to 18 months. Professional athletes take one year to return to high level competition. Be patient!

If you’ve injured your ACL, whether or not you’ve had surgery yet, check out our ACL rehabilitation program website. All of the phases listed above are outlined on the site with detailed instructions, exercises and tips for making your recovery after ACL surgery as effective as possible.

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Defining Post-Op Goals After ACL Surgery

ACL post operative goals

It is estimated that there are approximately 80,000 anterior cruciate ligament (ACL) tears in the U.S. each year. Not surprisingly, 70% of those injuries take place while the person injured is participating in athletic activity. Because ACL tears are so common and can put a hindrance on an athlete pursuing his or her career or passion, our Emory Sports Medicine team has put together an ACL program specifically for people seeking guidance in their treatment and recovery from ACL injuries and tears.

In our last blog post on ACL injuries, we got you familiar with the idea of prehabilitation, or care and steps to take before surgery for an ACL-tear. which is part one of the ACL program at Emory. In this post, we’ll cover some of the details and goals of your post-op recovery from ACL surgery, including what you should expect to see week by week:

ACL Surgery Post-Op Weeks 1-3

Goals: The goals in the first three weeks of your recovery from ACL surgery are fairly straight forward, to get patients back on their feet (off crutches), reduce swelling in the joint by faithfully icing (20 min every 2-4 hrs), and to increase the knee’s range of motion and focusing on getting extension back. For specific measurements you should track and exercises to consider, check out the materials on our website.

ACL Surgery Post-Op Weeks 4-6

Goals: Consistently reducing swelling in the knee and continuing to work on increasing the knee’s range of motion are the core goals of ACL surgery recovery weeks 4-6. At this point in your surgical recovery, your knee should be able to be straight or equal to other knee. Your knee joint should be cooing and not warm to touch. Those 4-6 weeks out from surgery should focus on being able to walk without limping and strengthening quadricep muscles.

ACL Surgery Post-Op Weeks 7-12

Goals: 2-3 months after ACL surgery, swelling should be controlled and there should be minimal effusion in the knee joint. Range of motion should be nearly full or equal to the other side full extension and knee flexion should be to 120 degrees. Knee joint should be cool and normal temperature, compared to other side. By this point, patients should have achieved good quadriceps tone with their vastus medialis oblique (VMO) firing effectively. Patients should also seek to establish normal gait pattern and be able to walk without limping at this point.

Does your recovery timeline after ACL surgery match up with what you see here? If so, or if not, please feel free to share your story with us and with our readers.

Emory Sports Medicine’s ACL injury program specializes in providing care ranging from the prehabilitation stage to getting you back in the game. So, in our next ACL injury post, we’ll share with you specific exercises you can use and steps you can take (including video demonstrations) to help you return to play more quickly. Stay tuned!

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