Posts Tagged ‘Emory Sports Medicine’

Emory Sports Medicine Puts Former Falcons Player Back in the Game After Jones Fracture

Atlanta Falcons Jones Fracture Sports MedicineA couple of years ago, a young recruit of the Atlanta Falcons football team was running during practice when his cleat got caught in the turf, a misstep that led to him both twisting and breaking his foot. The injury turned out to be what’s known as a “Jones fracture,” which is a very specific break in one of the bones in the midportion of the foot.

The Falcons recruit went out of state for surgery to insert a screw in his foot that would secure the bone while it healed, but his injury never healed properly, and on the first day of football practice the next year, he rebroke his foot. This time, he decided to find a surgeon in the Atlanta area and was referred to Dr. Sam Labib, director of the foot and ankle service at the Emory Sports Medicine Center.

During his time practicing at Emory, Dr. Labib has become very familiar with the Jones fracture. “As it turned out, at Emory, we had done extensive anatomic research on this particular type of injury and knew the ideal location for the screw,” he says. “When he came in for surgery, we removed the screw, cleaned up the bone, and replaced the screw in a better, more stable area.”

“Because we are a research environment as well as a surgical practice, we have a wealth of information and experience to bring to bear on injuries such as the Jones fracture,” Dr. Labib says. “Doing anatomic research is like drawing a map for surgery. With practice, we can effectively calculate the path of the screw and place it in the most solid position. Our patients benefit from this research and expertise.”

According to Dr. Labib, a Jones fracture typically takes a minimum of three months to heal. In the football player’s case, the fracture healed beautifully after his surgery at Emory, and he was back to training just three months later.

Have you had foot surgery, or would you like to learn more about foot surgery at Emory? We welcome your questions and feedback for Dr. Labib in the comments section below.

Related Resources:

What is a Biomechnical Injury?

Dr. Amadeus Mason of Emory Sports Medicine explains biomechanical injuries and how they can be prevented and treated.

Biomechanical Injury

In sports medicine, we see a lot of biomechanical injuries. A biomechanical injury is caused by the overuse or incorrect use of a joint or muscle. This type of injury generally occurs when the joint has been stressed in the wrong way or overstressed repetitively over a short period of time. While any joint can sustain a biomechanical injury, at the Emory Sports Medicine Center, I see a lot of runners who come in complaining of knee pain.

Iliotibial band syndrome, or ITBS, is a biomechanical injury. It usually presents as pain on the outer side of the knee and is a common complaint among middle-distance runners or in athletes when they try to do too much running too quickly. This usually occurs early in the season or when athletes increase the intensity of their training, e.g., moving up from 5K to 10K distance.

To prevent a biomechanical injury, no matter where in the body it is, you need to be cognizant of how you’re stressing your joints and give your body enough time to accommodate the increased stress. If you’re a runner, start slow with low mileage (1–2 miles) and a moderate pace and slowly increase distance or intensity, but not both. If you’re lifting, start with a lighter amount of weight and a higher number of reps in each set and then, as you increase the weight, decrease the number of reps per set.

If you think you might have a biomechanical injury, you should be evaluated by a sports medicine specialist who understands biomechanical injuries. He or she can correctly determine the source of your pain and initiate the appropriate interventions so you can get better. If you’re in pain but not sure what type of injury you have, don’t take chances—come see a specialist here at the Emory Sports Medicine Center.

Things to Keep in Mind if You Have (Or Suspect You Have) a Biomechanical Injury:

  • This type of injury will not just “heal on its own” with rest. You need to address the cause of the pain, or the symptoms will come back when you return to whatever activity caused the pain in the first place.
  • Don’t push through the pain. This pain is telling you that you’re doing something wrong. This is not a no-pain, no-gain situation.
  • There’s no quick fix. There’s no pill or quick shot that can cure a biomechanical injury. The best approach is to correct the problem using a holistic approach, which may include therapy, medications, modalities, and injections (as needed). Physiotherapy, in conjunction with steroid injections or platelet-rich plasma (PRP) injections, can help reduce inflammation and, in turn, alleviate pain and facilitate addressing the underlying biomechanical issues. This is why it’s important to seek the help of someone who understands this type of injury.

Have you had a biomechanical injury? We’d like to hear about your experience. Please take a moment to give us feedback in the comments section below.

Dr. Amadeus MasonAbout R. Amadeus Mason, MD:

R. Amadeus Mason, MD, is an assistant professor in the Orthopaedics and Family Medicine departments at Emory University. He is board certified in Sports Medicine with a special interest in track and field, running injuries and exercise testing. He has been trained in diagnostic musculoskeletal ultrasound and platelet rich plasma (PRP) injection. Dr. Mason is Team Physician for USA Track and Field and the National Scholastic Sports Foundation Tucker High School, and Georgia Tech Track and Field.

Related Resources:

More Runners’ Chat Questions Answered

Dr. Amadeus MasonOn Wednesday, I held a live chat on the topic of running to help those preparing for the Peachtree Road Race and to educate runners of all skill levels on injury prevention, nutrition, and technique. It was my first so-called “live chat,” so I really didn’t know what to expect. The questions that I received in yesterday’s chat were fantastic. Not only do I feel like I got to help the 50+ people who joined me in the chatroom, but I myself was able to learn something in the process. Typically when I chat with people who have questions for me, they are my patients, in a one-on-one setting. This really gives me the time to feel them out and learn about them as individuals. Wednesday, I was charged with a new and equally inspiring and fulfilling task– to educate a group, without being able to see them in person or learn about them before we talked. It was an extremely eye opening experience.

I want to thank those who joined me Wednesday for a wonderful chat. It was so successful, in fact, that I didn’t get a chance to answer each and every question. For those who were in the room, I promised to follow up with a blog to answer all questions that were unaddressed, and I have done so below. At the bottom of this blog post, you will also find the documents I mentioned in the chat for your further reference. As an added bonus, to make sure everyone gets a chance to discuss the topic of running and all of its facets with me, we will be holding the next live chat on running on June 15th. PART II CHAT TRANSCRIPT

Larry: I ran a marathon with IT band issues.  What can I do to prevent it in the future?
Dr. Mason: Larry, to prevent IT band problems, you should strive to work on increased flexibility. I’d advise that you watch the rate at which you increase your mileage/distance and start training early enough to allow for a slow and steady progress with sufficient recovery times between training sessions.

Shirley: Dr. Mason, Why does my back hurt periodically when I am tired while running?  Should I bend over to stretch?  I am a beginner.
Dr. Mason: I can’t speak to your specific medical circumstances without seeing you in-person, but generally speaking, oftentimes people experience back pain while running due to hamstring tightness. For these patients, I advise that they avoid the typical stretch that involves bending over, and instead focus on extension type exercises.

M. White: How do I know when it is time for new running shoes?  This will be my first time running longer than a 5k.
Dr. Mason: My recommended guidelines for footwear are if you run more than 20 – 25 miles a week you should change you shoes every 3 – 4months ( ~300 miles); if you run less than 20 miles a week can change shoes twice a year.

Sylvia: Hi. Dr. Mason. Is there any particular type of shoe that you would recommend as best for protecting against injuries; Knees, ankles, shin splints, etc.?
Dr. Mason: Studies have shown that shoe comfort is a more important factor in preventing injury than the actual type of shoe.  I would recommend you get evaluated at your local running store to determine what class of running should would be best for you. After doing that, go ahead and pick the most comfortable one in that class.

Judy: I’m used to walking about 3 miles about 3 times a week.  I am signed for the Peachtree.  Obviously I will be walking it.  I have 6 weeks to step up my training.  How would you suggest I proceed to get to 6 miles in time for the race?  Thanks.
Dr. Mason: Good question, Judy. I’d recommend adding about ½ mile to your distance each week.

Steve: Dr. Mason, I have a chronic hamstring issue.  What can I do to help the issue?  What type of Dr. or therapist should I seek out for help?
Dr. Mason: I would recommend you see a physician with sports medicine training.

M. White: I have been training for a 5k (took 30min) – which I ran a couple of weekends ago.  To train for the Peachtree what should I do?  Increase distance or time?
Dr. Mason: My answer here depends on whether you want to run the Peachtree for time or just for fun.  Since this race is twice the distance of a 5k,  I would start out increasing your distance (1/2 mile a week. Once you get to 5 miles then you can start increasing your pace.

Mac: What are some good lower-fat proteins for vegetarian novice runners?
Dr. Mason: As a vegetarian you should be concerned about getting in GOOD fats as opposed to LOW fat.  To that end eating things like beans, nuts and/or soy would be good choices.

Dawn: When I ran the Peachtree last year, I found it difficult to actually drink water at the hydration stations (did more of a swish-and-spit).  I am concerned about dehydration during the race.  Should I increase my fluids before the race?
Dr. Mason: Yes, in a 10K there is LESS risk/concern for dehydration that in half or full marathons, but you should be starting your hydration process now.  I recommend increasing you fluid intake (electrolyte/water) weeks before you run and incorporating “water stops” in to your training.  You know you are well hydrated when you have to use the bathroom 30 min after fluid intake (when you’re not running).

1st Timer: Are there any weight training exercises you recommend?
Dr. Mason: In order to answer this question in detail, I would need more information from you.  What I can say is that weight /strength training should be a part of any running program. This type of training should primarily (but not solely) focus on lower body strength and be accompanied by a good flexibility program.

Jacqui: How frequently should you increase pace or distance?
Dr. Mason: I normally recommend increasing distance then pace. But, as we mentioned in the chat, it really depends on the goals you’re looking to achieve. If you are looking to run a long distance race, you’ll probably want to focus on increasing distance, more often than pace, and doing so every 2 weeks should work well. Just remember to never increase both distance and pace at the same time.

Shalewa: What about energy enhancers like sports beans or 5 hour energy drink?  Are those bad for you?
Dr. Mason: Most “energy enhancers” are just caffeine or a caffeine derivatives and I would stay away from them as they greatly increase dehydration risk.  Good nutrition that balance carbohydrates, proteins and good fats should give you the energy you need for a 10K.  With marathons, ultra marathons, and triathlons in-competition metabolic supplements (which are very different from the energy enhancers) are often provided and can be helpful.  You’ll want to be careful and make sure that you are using them throughout your training so your body has time to adjust.

Jennifer: Hi, Dr. Mason.  I am an active person who is new to running.  After my training runs I am experiencing some discomfort/tightness in my upper and outer knees.  What can I do to help prevent this?
Dr. Mason: If these symptoms are not preventing you from doing the type/intensity of run that you want, then I would recommend working on the flexibility and strength of you quads and hamstrings.  If you are having to modify your training runs then you should see a Sports Medicine Physician.

Thanks again to those who joined me in Wednesday’s chat. I hope to see you all in Part II on June 15th! Below are the documents I referenced in the chat, please feel free to download them and keep them for reference. If you missed Part I of the chat, you can check out the chat transcript. You can also sign up to attend Part II of the chat, which is taking place on June 15th at 12pm.

Related PDF Downloads:

 

 

Are You a Runner Looking to Prepare for the Peachtree Road Race?

Peachtree Road RaceDr. Amadeus MasonThe Peachtree Road Race is right around the corner! Whether you’re a beginning runner and wondering how to get started, or a seasoned pro and have been running for years, there always new things to learn about training, nutrition, attire, and even injury prevention. As a runner, training for peak performance is key.

No matter what running category you fall into, you can join me on Wednesday, May 18 from 12 – 1:00 p.m. for an interactive online Q & A web chat TRANSCRIPT on healthy running. Much of what we cover will be dependent upon your questions, but the chat will span a wide array of running related topics and I will be available to answer questions and discuss them, including how to best prepare for Peachtree Road Race success!

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 18th!

RUNNERS 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.

 

 

Ultrasound is Not Just for Babies Anymore

Melanie Hof, MS, ATCWhen most people think of an ultrasound, they imagine a pregnant woman getting a preview look at her baby’s fingers and toes while a doctor makes sure that all is well inside the womb—however, in recent years the medical field has found many new uses for ultrasound technology. At Emory Sports Medicine, where I work as an athletic trainer with Dr. Ken Mautner, we frequently use ultrasound diagnostics to pinpoint the causes of tendon and ligament pain. From time to time, Dr. Mautner even brings out the ultrasound as an aid in treating the injury.

Until a few years ago, the go-to test for diagnosing the cause of chronic tendon and ligament pain was an MRI. We still frequently use MRI at Emory Sports Medicine – it’s the best diagnostic tool in many situations – but more and more often we’re turning to diagnostic ultrasound to get a better picture of what is going on inside our patients’ bodies.

Ultrasound offers several advantages in diagnosing tendon and ligament injuries. One of my favorite advantages – and one our patients appreciate as well – is the instant gratification we get with an ultrasound. There’s no waiting for a report on an MRI that is just a static snapshot of one moment in time. You can point to where you’re hurting, and we can immediately get a look at that precise area, in real-time motion, as you’re moving and experiencing the pain. Dr. Mautner can show you pictures from the ultrasound right there during the appointment and explain to you what he sees. It’s always interesting to watch him take a picture that might first look like a confusing blob to most of us—then he explains the picture in such a way that patients can see what he’s seeing in it and understand what’s wrong. (I stick around after he leaves to answer any further questions patients might have about the ultrasound or their injury.) I love this aspect of diagnostic ultrasound. Often, in the span of a single appointment, we can hear what’s hurting, take a look at the affected area, find the problem, show it to you, and come up with a plan of action. It’s much easier for everyone involved.

Ultrasounds also allow us to look at injuries in greater depth, picking up very small tears that an MRI might miss. “Mystery pains” with no clear cause often reveal their secrets to the ultrasound. We’re seeing this quite a bit with hip pains, which have historically been very tricky to diagnose. Diagnostic ultrasound can look deep into the hip and the many crisscrossing tissues within it to find the source of the pain. Dr. Mautner even uses the ultrasound to guide treatment of the hip pain once the cause is found. Injections are often used to treat tendon and ligament pain, but they are notoriously difficult to administer precisely deep within the hip. Dr. Mautner uses ultrasound to guide him, in real-time, as he inserts the needle, delivering the injection to the optimal spot for healing.

The more we use diagnostic ultrasound, the more advantages we’re finding. Ultrasounds do not emit any radiation, so they are safe for people with pacemakers, spinal cord stimulators, and other medical devices that cannot handle the radiation of other diagnostic tools. And there’s no risk of feeling claustrophobic.

Just to be clear, ultrasounds are not replacing other diagnostic tools. For some injuries, an MRI or other test is the best approach, and Emory Sports Medicine has some of the finest, most innovative radiologists around. But for some injuries, we’re finding that ultrasounds are very helpful to us as we diagnose and treat the source of tendon and ligament pain.

And they’re still great for looking at babies, too!

Melanie Hof, M.S., A.T.C., is an athletic trainer at Emory Sports Medicine. She enjoys ultramarathon canoe and kayak racing, biking, and running.

Are Football Players Suffering Concussion-Like Damage in the Absence of a Concussion?

Ken Mautner, MDWith the NFL playoffs just around the corner – and our Atlanta Falcons certain to be in them – most of us have been watching a lot of football lately. Like many football fans, I watch simply to enjoy the games, but lately I’ve been watching with a new question in the back of my mind: Are any of the players receiving what we call “sub-concussive hits” that might over time, contribute, to concussion-like brain problems?

The question was prompted by a recent study published in the Journal of Neurotrauma. The study looked at youth football players who had never had a concussion, had never complained of the symptoms typically associated with a concussion, yet showed changes in brain activity and cognitive ability that are normally associated with people who have suffered one or more concussions.

We have a lot of experience treating concussions at Emory Sports Medicine. My focus is to get athletes, parents and coaches to know and recognize the symptoms of a concussion, and to seek out prompt concussion treatment when they have those symptoms. What should be done when athletes may not present any of the traditional symptoms? Or what about athletes who have not, in fact, had a concussion but who are experiencing similar problems associated with concussions?

We’re learning about this phenomenon because our tests for concussions have become far more sensitive and sophisticated in the last few years. In the study mentioned above, “hit monitors” – telemetry units – were installed in the studied athletes’ football helmets to measure the g-forces they took with every hit in practice and games throughout the season. Computerized neuropsychological testing (CNT) was administered, both pre-season and post-season, to assess changes in cognitive functional ability. And functional magnetic resonance imaging (fMRI) was used to look for telltale increases of activity in certain areas of the brain that are typical in those who have suffered concussions.

The surprising finding was that some athletes never sustained a hit strong enough, as measured by the hit monitors, to cause a concussion, and yet the fMRI and CNT results showed evidence of the characteristic increases in brain activity and decreases in cognitive ability normally associated with a concussion. This result was most common among offensive linemen, who may take 40-50 sub-concussive hits in a single, ordinary practice. Over the course of a season, this massive accumulation of lower g-force hits seems to have caused the same effects we’d usually expect only from more powerful, concussion-causing hits.

Long-term consequences are what concern me most here. It’s possible that brain activity and cognitive ability return to normal after the season is over and the youth athletes have had some time to recover. It’s also possible that some of these effects are enduring. Just as with those who suffer multiple concussions, it may be that this accumulation of sub-concussive hits will, years later, result in higher incidences of depression and cognitive impairment. We don’t know yet if this is the case, but the study has raised the possibility.

My own son plays Pee Wee Football, and I appreciate the self-discipline, toughness, and teamwork he learns from it. But like any parent, I have to weigh that value against the potential for negative long-term consequences. Everything in life is a trade-off of risks and benefits, but this recent finding adds a new variable to the decision.

So, what’s to be done? Well, first of all, we have to keep pressing forward with efforts to prevent, identify, and treat concussions. Concussions remain a serious problem in football and other contact sports, particularly among adolescent athletes, whose brains are especially vulnerable. I’m part of a group of health care providers and state action planners who are working in partnership with the NFL to pass legislation in Georgia to better prevent concussions and provide better treatment for those who do suffer concussions.

Some of the same measures being considered to prevent concussions, such as better helmet technology, may also prevent the damages of sub-concussive hits. The NFL is even considering more drastic changes, such as eliminating the traditional three-point stance, thereby requiring linemen to start with their hands off the ground. This change would greatly reduce the number and force of helmet-to-helmet hits. Should the NFL make this change, it will most likely be adopted by college, club, high school, and lower grade football leagues.

Ultimately, what we need is more research. The concussion testing we perform at Emory Sports Medicine has become far more sophisticated in recent years, and it will continue to become even more sensitive. Now that we’re aware of the effects of sub-concussive hits, I’m confident we’re just a few years away from being able to identify those athletes who may be at risk. I look forward to the day when I can again watch the gridiron drama without worrying that the players are fighting their way toward that Super Bowl ring at the cost of the long-term health of their brain functions.

For more information, check out the study, Functionally-Detected Cognitive Impairment in High School Football Players Without Clinically-Diagnosed Concussion. If you have questions, please don’t hesitate to leave them in the comments below.

About Dr. Ken Mautner, MD:

Dr. Mautner is an Assistant Professor in Emory’s Department of Physical Medicine and Rehabilitation and the Department of Orthopedic Surgery. 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, the Atlanta Ballet, and several local high schools.

Dancing Again After a Broken Foot & Torn Achilles Tendon

A few years ago, I treated a delightful young woman, Erin Weller, who broke her foot while rehearsing for a performance in a contemporary dance show. The show was being produced by Crossover Movement Arts, a dance company managed by her significant other, Blake Dalton. Erin’s injury was a simple fracture requiring no surgery—just a cast. Unfortunately, due to the injury she had to drop out of the show, but a few months later she was back to dancing and to studying martial arts with Blake.

Earlier this year, I saw Erin in my office again. She and Blake had recently married, and Erin was still dancing and studying martial arts. She was also working as a communications coordinator with Moving in the Spirit, an organization that teaches dance and life skills to at-risk youth. She was doing good work in the world.

While it was nice to see them both again, the reason for their visit wasn’t so nice. Blake had torn his Achilles tendon after landing badly from a high leap. A 12-year veteran professional dancer with Core Performance Company, a contemporary dance company in Atlanta, Blake makes his living through dance, and he had the kind of injury that could have once ended his career.

Fortunately, we’ve made great advances in the surgical repair of torn Achilles tendons. I was able to repair the tendon, and after a few months of working hard at his physical rehabilitation with our superb physical therapists, Blake recently started performing once again, just in time for the launch of Core’s 30th anniversary season.

Have a look at this video to meet this charming couple and learn more about how Emory Sports Medicine was able to help them get back on the dance floor:

Kinetic Chain & Shoulder Injuries

The baseball world was recently abuzz with news that rookie pitching phenom, the Washington Nationals’ Stephen Strasburg, was placed on Major League Baseball’s 15-day disabled list due to “inflammation” and “stiffness” in his shoulder. While patient privacy and other issues often prevent the release of specific injury details, these kinds of symptoms likely indicate a bout with shoulder tendonitis.

Tendonitis is a common condition experienced not just by elite pitchers but by active people in sports such as baseball, swimming, volleyball, weightlifting, golf, even bowling – all activities that involve vigorous or repetitive use of the shoulder. And while the team at Emory Sports Medicine treats all shoulder injuries – with a particular focus on repair of rotator cuff tears – we also investigate the cause of the injury. Quite often, the cause of the injury leads us to a completely different body part.

Let’s talk about the kinetic chain. If you are a pitcher like Strasburg (and congratulations if you are), this is the chain of power generated by your core muscles – abdomen, glutes and the spine. All the power that your arm puts out – a 99 mile per hour fastball – is actually done with the legs. Breakdowns up the stream of this chain – in the shoulder, for instance – often indicate trouble “downstream.” It could mean a specific area of your core is weak or not performing properly. The result: You’re putting too much stress on your shoulder. (You can learn more information on kinetic chain here.)

Whether you’re Stephen Strasburg or a B-Level tennis player, failure to treat this injury and its cause can have permanent results. Tendonitis can lead to rotator cuff tendon degeneration. Tendinopathy – chronic tendonitis – weakens the tendon and leads to tears in the rotator cuff. Partial tears may lead to higher-grade tears until a full thickness tear results. Once this occurs, rotator cuff repair – surgery – is needed. Pitchers like Strasburg rarely return to the mound after surgery for full thickness rotator cuff tears. However, athletes with lower demands than a major league pitcher can frequently return to their sports after rotator cuff repair.

If you have a shoulder injury, the staff at Emory Sports Medicine can help you determine what you’re dealing with – tendonitis, tendinopathy, tears, etc. – and give you a plan to recover. We’ll also investigate your “kinetic chain” and determine the root cause of the problem.

You can bet the 22-year-old Strasburg’s trainers and physicians (not to mention his agent) are making sure he’s treating the injury properly and understanding what’s causing it. He has a valuable and exciting career ahead of him, if he can avoid injuries.

Do you have questions about tendinitis or any shoulder injuries in particular? If so, fire away in the comments section.

About Spero Karas, MD:

Dr. Karas joined the Emory Orthopaedic & Spine Center on February 1, 2005. Prior to that 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. In addition to his role as director of the Orthopaedic Sports Medicine Fellowship Program at Emory, he serves as a consulting team physician for Georgia Tech and Emory University Athletics.

The Tour de France and Common Cycling Injuries

We’re in the final stages of what has been a fascinating Tour de France. We’ve seen some heroic climbs, nail-biting descents, and more than a few changes of fortunes for cyclists who started out as top contenders. The once unbeatable Lance Armstrong is now far back in the field, his best hopes dashed by a series of crashes, and Team RadioShack is now working for Levi Leipheimer. Andy Schleck saw a mechanical problem steal away his hopes for a Tour win. And other favorites, such as Cadel Evans and Fabian Cancellera, are now out of serious contention. Alberto Contador appears poised to ride victorious into Paris… but, as this Tour has demonstrated, all it takes is one bad or unfortunately timed crash to completely change the standings. There’s surely plenty more excitement to come!

The crashes started early, in stage two, when it seemed like hardly anyone could stay on their bikes as they rode over slick terrain. In addition to some serious injuries, there was a lot of road rash that day. “Road rash,” as you may know, is the grimly lighthearted name that cyclists give to the extensive abrasions they often get when they fall off the bike and slide along pavement. Along with saddle sores, which are caused by the constant rubbing of the bike seat, road rash is one of the most common injuries in cycling. I spent a lot of time treating them both when I was the assistant medical director and head athletic trainer for the Tour de Georgia.

Treating road rash and saddle sores is, frankly, pretty straightforward. The interesting work on the Tour de Georgia had to do with figuring out and fixing the root causes of neuromuscular and mechanical issues. For example, we once had a cyclist – a talented, experienced competitor – whose cadence inexplicably became very inefficient, and he started having some trouble with his IT band (also a common problem for cyclists). We spent a day following him in a car, and I noticed that his right knee was dropping with every revolution. We ended up tracing the problem to weakness in his right adductor, which wasn’t properly supporting the force that his legs were delivering. The result? He had to compensate for that weakness, and that led to an overuse injury.

Scenarios like this happen quite a bit in sports medicine. A neuromuscular problem in one area of the body frequently ends up being the result of muscle deficiencies elsewhere. If you solve that deeper problem, the presenting issues go away as well. In the case of this cyclist, we worked with him to strengthen his adductor. He then went from having trouble even keeping up with the peloton in the early stages to being one of three cyclists in a breakaway in the final stage. It’s deeply satisfying when we can deliver those kinds of results.

At Emory Sports Medicine, we also use cycling as an important component of physical therapy, most commonly in the case of knee injuries and procedures such as ACL surgery. A lot of this therapy starts out on stationary bikes. We try to get many of our knee patients onto the bike as soon as possible after surgery – often within a week of the procedure – in order to keep down swelling and restore range of motion. At first, they’re cycling with no resistance – just spinning, promoting blood flow and range of motion. Then we gradually increase resistance to build back strength. Some patients eventually choose to graduate from the stationary bike to riding outside. Of course, fans of cycling might want to stick with the stationary bike for a little bit longer, so that, while they ride, they can turn on the TV and watch a very exciting Tour de France!

About Forrest Q. Pecha:

Forest is the Director of Athletic Training Services at Emory Sports Medicine. He was the assistant medical director and head athletic trainer for the Tour de Georgia from 2005 through 2008. He also serves as the liaison between Emory Sports Medicine and the United States Soccer National teams for athletic training coverage, and provides support coverage to the US Men’s Alpine Ski Team. Forest has been with Emory Sports Medicine since 2004.

Introducing the Emory Orthopedic Blog

Welcome to the Emory Healthcare Orthopedic blog—a hub for all topics related to Sports Medicine, Orthopedics, and Spine Care.

Our multi-media blog will feature forum discussions, patient stories, educational material and coverage of exciting new technological advancements.  Most importantly, it will feature you—and your thoughts, questions, and opinions.

We’re very excited about this opportunity to connect with you, and we look forward to entering conversations with you surrounding Sports Medicine, Orthopedics, and Spine Care.

We’ll kick off the blog with a post by Forest Pecha, the Director of Athletic Training Services at Emory Sports Medicine. Forest will provide coverage and commentary on the Tour De France and touch on common injuries associated with cycling.

Again, we welcome your interaction and look forward to hearing from you!