We care about keeping you informed and hope you’ll find the Summer 2009 edition of our Doctor’s Orders e-newsletter filled with helpful information, health tips and interesting updates from our Bone and Joint family.
On Call:
Meet O. Christian Hall, D.P.M.
The Bone and Joint Clinic of Baton Rouge proudly welcomes Dr. O. Christian Hall as our newest associate. Dr. Hall has maintained a successful podiatry practice in Baton Rouge for the past thirty years and provides a multidisciplinary approach to the diagnosis and treatment of foot and ankle problems.
As a Baton Rouge native, Dr. Hall graduated from University High and Louisiana State University before receiving his degree in podiatric medicine from the Ohio College of Podiatric Medicine. After completing his residency in Memphis, Tennessee, he became board certified by the American Board of Podiatric Surgery and is a member of the Fellow of the American College of Foot and Ankle Surgeons. He is a longtime clinical instructor with the Family Medicine Residency at the Baton Rouge General Medical Center.
Did You Know—
Platelet rich plasma (PRP): A novel treatment approach for tendinosis
— by Joseph E. Broyles, M.D.
Before beginning this article, I would like to express my gratitude to Allan Mishra, MD, a fellow orthopedic surgeon whose pioneering work in the use of platelet rich plasma for chronic tendinosis allowed me to heal my own quadriceps tendinosis.
Platelet rich plasma injection is a treatment option for chronic tendinosis; click here download a PRP brochure. Common examples of tendinosis include tennis elbow, Achilles tendinosis, rotator cuff tendinosis, and Plantar Fasciitis, but any other tendon may be involved. Tendinosis (often mislabeled as tendonitis) is a degenerative, often painful, non-inflammatory condition of a tendon usually affecting people over the age of 35. This degenerative tendon has a poor blood supply and only a limited ability to heal on its own. This section of tendon is weaker than normal tendon, and may be at risk of progressing to a tear later in the course of the disease.
Platelet rich plasma is prepared by centrifugation of a patient’s blood and extraction of specially prepared platelets with a small amount of plasma. The platelets are then injected into the area of tendinosis. Platelets contain high concentrations of growth factors known as cytokines which initiate a cascade of events leading to tissue regeneration through new blood vessel growth and collagen synthesis.1
An initial visit with Dr. Broyles will be needed to determine if you are a candidate for PRP injection. An MRI may be needed to confirm the diagnosis and to rule out other local complicating conditions. Patients who have failed traditional treatment with medications and therapy may be candidates for PRP injection. If PRP is determined to be an option, the procedure will be scheduled on a different day, requires only local anesthesia, and will take about one hour. There are no specific activity restrictions following the procedure; patients may return to full activity as tolerated.
PRP injection does not provide immediate relief; instead, it sets in motion a repair mechanism that does take some time. A study published in the American Journal of Sports Medicine showed 46% pain relief by 4 weeks, 60% by 8 weeks, and 81% by 6 months in patients with chronic elbow tendinosis. At the conclusion of the study, 93% of patients were completely satisfied with the PRP treatment and had avoided surgery.2
1. Mishra et al, Clinical Sports Medicine, 2008
2. Mishra and Pavelko, American Journal of Sports Medicine, 2006
For more information about PRP or to schedule an appointment with Dr. Broyles, please call (225) 766-0050.
Sporting Goods
From simple swimming to wrestling, stretching is the #1 way you can prevent injury
— by Jason Ghahramani, PA-C
In our Winter, 2009 Doctor’s Orders enewsletter our article on preventing sports injuries was so popular that we thought we’d provide our readers with more information on additional sporting activities. Summer is now underway and whether that means you’ll simply be hopping into the pool more often to cool off or participating in rigorous sports camps, injuries will occur.
We’ve assembled a range of sports with varying levels of intensity, each with it’s own common injuries.
Click any category below for a complete list:
- Swimming
- Wrestling
- Running
Common Swimming and Shoulder Injuries:
Most sports come with injuries to accompany them. Although swimming is, by most standards, not a sport associated with high risk of injury, it does have its own problems. For swimmers, by far the biggest source of injury is the shoulder. Appropriate levels of flexibility in the rotator cuff and general shoulder region will promote a proper range of motion in all planes of movement to help decrease injury. Suggestions include:
-Complete a proper warm-up of muscles before beginning any flexibility work
-Perform stretches in planes and positions of use, not in random directions
-Avoid the use of pull buoys and paddles. Although tempting they may place unnecessary tension on your joints
- Burners and Stingers –Burners and Stingers are a common injury in contact or collision sports. The injury is named for a “stinging” or “burning” pain that radiates (spreads) from the shoulder to the hand. This can feel like an “electric shock” down the arm and can be accompanied by a warm sensation.
- Shoulder Sprain – An overexertion of the ligaments around the shoulder joint that causes a partial tearing.
- Thumb Fractures – Are caused by direct stress to the joint and result in severe pain, swelling and extreme tenderness.
- Kneecap Bursitis – Athletes who spend a lot of time on their knees can experience swelling in the front of their knees.
- Ankle Sprain - A stretching, partial tear, or tear of ligaments in the ankle joint. This is one of the most common injuries and has different ranges of severity.
- Runner’s Knee – Also called jumper’s knee, this condition is caused by an excess of stress on the knees common from excessive running. It leads to pain and inflammation of the patellar tendon.
- Shin Splints – (Medial Tibial Stress Syndrome) Pain and swelling in the front of the lower leg or shin area. This is caused by an inflammation of tissues covering the bone. Most often, shin splints occur from repeated pounding during running.
- Plantar Fasciitis – This is the inflammation and irritation of the plantar fascia, ligaments that attach the heel to the toes. This condition results in pain in the heel.
- Achilles Tendonitis – An inflammation and irritation of the Achilles tendon which connects the back of your foot to your calf muscle. This can cause severe pain and discomfort.
- Hamstring Strain – A stretching or partial tearing of the hamstring muscle(s). This injury is often called a pulled hamstring.
Summer means lots of fun in the sun, but don't let heat-related illness or injuries ruin your days. Avoid serious conditions by drinking plenty of water, and take frequent breaks if you're out in the sun for extended periods of time. If you can, wear light-colored clothing.
Make sure to stay hydrated and find some shade every now and then. Keep the kids cool wherever you go by bringing along umbrellas and fans. Pack some extra water that you can use to wet rags and drape on the backs everyone's necks.
Drink water before you're thirsty! Avoid consuming beverages with caffiene or alcohol while out in the sun because these types of drinks speed up dehydration.
Signs and symptoms of heat exhaustion include:
- Feeling weak, faint, or dizzy, with an accompanying headache or nausea
- Cold, clammy skin with ashen pallor
- Dry tongue and thirst
- Severe muscle fatigue
- Loss of appetite
- Profuse sweating
- Physical collapse, with muscle fatigue and sometimes cramping
Being aware of your skin is an important part of summer safety. Tanned skin may be revered as beautiful, but that golden color you see is the result of injury to the epidermis, the top layer of skin. Exposure to UV rays accelerates the effects of aging and increases your risk for developing skin cancer. To prevent sun damage, use a sunscreen of SPF 15 or higher when outdoors. If you have fair skin or burn easily, boost your SPF to 30 or higher.
Cataracts can also be a caused by the sun. Prevent cataracts by wearing a hat and sunglasses when in the sun.
Did You Know
Sporting Goods
In Season
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Orthopedic Center at: 7301 Hennessy Blvd., Suite 200
Baton Rouge, LA 70808
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