Posts Tagged ‘injuries’

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.

What’s It Like To Be The Team Physician For Georgia Tech?

image from Flickr/ brookenovak

Emory Sports Medicine has a strong reputation for offering top-quality orthopaedic care to athletes and non-athletes alike. Recently, people have asked to hear more about our work with college sports teams. Specifically, Emory just became the “Official Healthcare Provider for Georgia Tech Athletics.”

This new initiative involves my work as Tech’s team physician. People often ask me: What does it mean to be the team physician for Georgia Tech? The short answer: It means you’re busy!

I’ve been taking care of all of the Tech teams on the field for 11 years. I’m in charge of orthopaedic care for all of the athletes at Tech – including the football, basketball, and volleyball teams. I’m on call 24 hours a day, seven days a week for the athletes. Thus, if something happens to any of my players, the emergency room, coach or player will call me. (This is fine for me, but it gets old for my wife!)

I also attend all football and basketball games, which can get a little crazy. During football season, I fly to the games on game day, then fly back with the team on the team charter. Thursday night games are the most challenging. I operate on patients until mid-afternoon Thursday, and then fly to the game, which typically gets me back home at around 3:00 a.m.

I end up treating a myriad of injuries. The scary ones are the cervical spine injuries on the field because you have to worry about breathing and paralysis. Most commonly, I deal with knee injuries (ACL and MCL tears) and sprains. Head injuries are handled by a non-operative sports medicine physician. One cardinal rule: Do what is best for the athlete for the long term—i.e., treat him as you would your own son or daughter.

Without a doubt, working with the athletes helps my work at Emory Sports Medicine. It allows me to take the cutting-edge, more aggressive techniques I learn from working with college teams, and apply them to everyday patients.

Reward comes with the hard work—every time one of my athletes returns from an injury, it’s a great moment, and it makes all of the hours worth it. Further, seeing these kids move on successfully to the NFL, NBA or professional baseball is great. And seeing them succeed in life is even better.

Do you have any questions about Emory and GA Tech? If so, please feel free to leave me a comment.

When Doctors Operate on Doctors

A Chat with Dr. Sameh Labib and Dr. John W. Xerogeanes

Four years ago, Dr. X, a popular surgeon at Emory Sports Medicine, suffered a knee injury that required surgery. Who did he turn to? Dr. Sameh Labib of Emory Sports Medicine. The two doctors recently chatted about the surgery and recovery.

DR. X: I started to have back pain when I turned 40. Around that time, the football and basketball teams we treat at Georgia Tech were doing yoga classes with Diamond Dallas Page, the former wrestler. They all told me that it helped their flexibility and joint pains. I started taking the class once a week. As promised, I felt better and the back pain went away.

One year later, my wife was making fun of me for being the “Yogi Kudu.” (For those around my age, you might remember him as the yoga practitioner who made appearances in the 1980s on the TV show “That’s Incredible,” folding his six-foot frame inside small glass boxes.) In playful response to my wife’s comment, I showed her a new pigeon pose. Upon transitioning from one pose to another, I heard a pop in the knee and I had pain.

When the pain continued, I had an MRI, which showed a meniscal tear. To others who might have suffered this injury: When you tear your meniscus, you twist and feel sharp pain on the side of your knee—this is sometimes accompanied by a click.

DR. LABIB: Yoga is not a common cause of knee injuries. Football, basketball, soccer and tennis injuries are much more common. It’s best to have an experienced yoga instructor guiding you to avoid injury. Meniscus injuries usually happen due to twisting and pivoting. In yoga, it happens due to excessive knee bending or flexing with certain poses, such as the lotus pose.

When John injured himself, I remember thinking that doing knee surgery on the busiest knee surgeon at Emory was going to be a challenge! As you may know, sometimes doctors make the worst patients, and they can be noncompliant – as doctors, we tend to think that we’re bulletproof.

For that reason, I try to treat my “doctor” patients exactly as I treat everyone else and hope for them to follow instructions. Is this wishful thinking? Naive? Of course, there is also the “Doctor Curse,” where all the weird complications happen.

With the above in mind, I agreed to do John’s surgery. It went great and, to my surprise, he was very cooperative.

DR. X: My wife told me to listen to Sam, period! It still did not get me out of doing household chores …

Actually, it was no problem being operated on by someone else. The good thing about being a knee surgeon is that you KNOW who you think is the best guy to fix you. Thus, I had Sam take care of me.

If I hadn’t gotten surgery, I would have continued to experience pain. Doing athletic activities would have been painful, and the bending of my knee would be limited. Since I’m an athletic person, this wasn’t an option for me. I wanted to get better.

DR. LABIB: Once the surgery was complete, I told John to ice, elevate and avoid prolonged standing or walking for the first week or so. Also, he needed to start early motion.

I recommend making a gradual return to low-impact sports such as cycling and stepping. Swimming is allowed after the wounds have healed (approximately three weeks after). Knee swelling and stiffness are common in patients. Usually patients see that the incisions are small, and they feel good after the procedure so they end up “overdoing” it. We are often telling our patients to slow down and let the inside heal before they increase their activity. Three to four weeks are often needed before they can return to their sport.

I’m happy that John was a great patient. His knee has healed and he’s doing yoga again. I hope other doctors follow his example!

About Shaina Lane, MEd, ATC, LAT, OTC:

In 2006, Shaina applied and was accepted to the Emory Sports Medicine-Ossur Fellowship. She spent that year working alongside the physicians at Emory Sports Medicine, enhancing her clinical evaluation skills as well as learning how to assist in the operating room. After the fellowship, she spent several months working at a private practice in Tennessee before returning to Emory Healthcare as a clinical coordinator in the sports medicine department and program coordinator for the Emory Sports Medicine-Ossur Athletic Training Fellowship.