Wednesday, July 31, 2013

Congratulations to Dr. Lederman!

Congratulations to Dr. Lederman! Dr. Lederman's research paper titled "Reverse Total Shoulder Arthroplasty is Associated with Good Clinical Outcomes that are Sustained Through Mid-Term Follow-Up: Prospective Cohort Study" has been accepted for presentation at the 2013 American Shoulder and Elbow Surgeons closed meeting.  Dr. Lederman is the lead author along with Sam Harmsen, MD (Resident-Banner Good Samaritan Orthopedic Surgery Residency program), James Kelly, MD (San Francisco) and Brad Edwards (Houston).


Tuesday, July 30, 2013

TOCA Tips: Ankle Sprains

Ankle sprains are very common in athletes and occur when there is a traumatic injury to the ligaments surrounding the ankle joint. Ankle sprains occur when an abnormal force is applied to the foot. Commonly, this happens while running or jumping on an uneven surface. The foot rolls in (inversion) or out (eversion) and the ligaments are stretched or torn, depending on the severity. Occasionally a pop is heard at the time of the sprain, followed by pain and swelling of the ankle.

Initial treatment for ankle sprains consists of the R.I.C.E. treatment plan (Rest, Ice, Compression and Elevation).  Limit weight bearing with severe sprains early in treatment. Ice should be used for 20 minutes each hour, being careful not to put it directly on your skin as to avoid frostbite. Wrap the ankle in an ACE bandage or compression stocking to minimize swelling. Lace up ankle braces can give added support. Raise the ankle above the heart to minimize swelling. A NSAID can be helpful to reduce pain and inflammation. Early mobilization and physical therapy have been proven to decrease the time to return to sporting activities.

If you are unable to bear weight or have direct tenderness over the bone, seek medical treatment immediately to rule out a fracture.

- Dr. Anikar Chhabra, M.D., M.S.


Friday, July 26, 2013

Monitor young pitchers count, types thrown: - Dr. Padley

Monitor young pitchers count, types thrown:
-        Dr. Padley

     As durable as children are, injuries in young athletes are on the rise.  Thousands of children are seen each year by health-care providers for elbow or shoulder pain.  It’s critical that parents and coaches monitor their sports-related activities.

     For young pitchers, proper form and technique need to be monitored, as well as the number of pitches thrown.  If a young pitcher is throwing improperly, too much, too early and without proper rest, serious elbow or shoulder injuries may occur.  To protect kids from overuse injuries, guidelines have been recommended for the number of pitches baseball players should throw, based on age.  This also needs to be monitored closely by the parents and totaled together if a child plays on more than one team at a time.

     Pitch types require monitoring, as well.  When kids are still physically developing, advanced pitch types, such as screwballs and sliders, can lead to damage and injury to joints, ligaments and growth plates.  These types of injuries, if ignored, can potentially cause significant or permanent damage.  As young athletes mature physically, their elbows and shoulders can handle more.

     Common symptoms of throwing injuries include continued pain, swelling, bruising, weakness and a “dead arm” feeling.

     Other overuse signs include loss in velocity, control and endurance.  If any of these symptoms appear, make sure your child gets plenty of rest.  Ice and ibuprofen can help with soreness and inflammation.

     If symptoms persist, contact your child’s healthcare provider for a thorough examination.

Pitch count by age per game                    Pitch type by age
 Age 7-8: 50                                                        Fastball: 8
 Age 9-10: 75                                                     Change-up: 10
 Age 11-12: 85                                                   Curveball: 14
 Age 13-16: 95                                                   Knuckleball: 15
 Age 17-18: 105                                                 Slider/Forkball: 16

                                                                             Screwball: 17

Tuesday, July 23, 2013

Dr. David Bailie to speak at ICA

Dr. David Bailie has been asked to speak at the ICA (Industrial Commission of Arizona) Seminar. His lecture will be on the topic of Treatment for Shoulder Injuries: Best Practices Reduce Medical Costs, Friday August 9th at 9:15 am.


Friday, July 19, 2013


Any condition that irritates or destroys a joint is referred to as arthritis.  The most common form is osteoarthritis, or as it is sometimes known, degenerative joint disease.   In a normal joint, cartilage covers the ends of the bones and permits their smooth, painless movement against one another.  In osteoarthritis, the cartilage layer wears out, allowing bone to make contact against bone.  As the process worsens, the signs and symptoms of arthritis develop.
The basilar joint, or the first carpometacarpal joint of the thumb, is formed by a small wrist bone called the trapezium and the thumb metacarpal bone.   The unique shapes of these bones permit the thumb to move in and out of the plane of the palm, as well as bend across the palm to oppose the other fingers.  Arthritis involving the base of the thumb is far more common in women than in men, and typically occurs after the age of 40.  A prior history of fracture or other injury to the joint may increase the likelihood of developing arthritis.

The earliest symptom of basilar joint arthritis is pain with activities that involve pinching.  These include opening jars, doorknobs, car door and turning keys.  Prolonged or heavy use of the thumb may produce an aching discomfort at the base of the thumb.  Changes in the weather may produce similar symptoms.  As the disease progresses, less stress is required to produce pain.  Pinch strength diminishes.  Activity-related swelling may develop.  Later, any motion of the thumb, even without stress, may become painful.  Eventually the joint begins to appear larger and out of place.  This is usually accompanied by decreased thumb motion.  Often the most difficult maneuver is grasping objects.
A careful history by the physician will give a high index of suspicion of basilar arthritis.  Inspection of the thumb will sometimes reveal a tender prominence at the base of the thumb.  As a diagnostic test your physician may press the thumb metacarpal against the trapezium and move the joint.  This grind test will usually reproduce the symptoms of pain, and may produce a gritty sensation called crepitation.  This represents bone on bone contact, which also may show up on x-ray.
Initially, the symptoms of basilar joint arthritis will respond to limited activities and rest.  If this fails, use of an anti-inflammatory medications and a protective splint may be of benefit.  Additional relief of symptoms can sometimes be achieved by a cortisone injection into the joint.  When conservative methods of treatment no longer provide benefit, surgery may be warranted.
The goal of surgery is to decrease pain and preserve motion in the thumb. This is accomplished by removing the destroyed joint and creating a substitute joint called an arthroplasty.  Unrestricted use of the thumb is usually allowed at 12 weeks from surgery.

Tuesday, July 16, 2013

Hip Pain Causes: Dr Grant Padley

Hip Pain Causes: Dr Grant Padley

Hip pain can be the result of a number of causes not associated with arthritis.  Some common causes of non-arthritic hip pain include fracture, inflammation in the hip joint, bursitis, and femeroacetabular impingement (FAI, which is friction caused by abnormally shaped hip bones).

Arthritic hip pain is typically described as a “constant ache” pain that is felt in the groin area and increases with physical activity and prolonged use.  Non-arthritic hip pain, however, is often felt deep in the front of the hip, on the side, and in the buttocks.

How hip pain is treated depends on the cause of the pain.  Treatment should be sought after injury that limits your ability to move or perform routine activities as you normally would.

Additionally, any hip pain that doesn't go away after two to three weeks of conservative therapy, which includes anti-inflammatory medication, ice, rest and activity modification, should be evaluated by a health-care provider.  Your provider can conduct physical examination and order any tests or radiographic images that may be necessary to properly diagnose the source of your hip pain.

Conservative treatment, including physical therapy, is always the first and preferred approach to treat hip pain.  However, when attempts to address hip pain through conservative methods are not successful, hip arthroscopic surgery might be indicated.


Tuesday, July 9, 2013

Benefits of Sports far outweigh risks of potential injury: Dr Grant Padley

Benefits of Sports far outweigh risks of potential injury: 
Dr Grant Padley

     Sports-related injuries are a regular part of being an athlete.  Most athletes will suffer some type of injury, such as sprains and strains, knee and shoulder injuries, fractures, dislocations, and bumps and bruises.  Sometime, ice, rest or physical therapy are all that’s needed.  However, occasionally as with a majority of ACL injuries surgery is needed.

     Knee injuries are common and, as a result, surgical and rehabilitative techniques have been developed to repair the knee and help prevent future problems, such as reinjury, structural weakness, or arthritis.  In fact, sometimes surgery and focused exercise can make the injured part even stronger than before.

     In a recent study of professional football players who underwent surgery and rehabilitation to reconstruct isolated ACL tears, the results revealed that there were little, if any, long-term limitations on their athletic performance as a result of the injury.

     Of course, there are certain injuries that are more severe and that can have long-lasting effects.  We hear regularly about amateur and professional athletes who have suffered catastrophic or career-ending injuries to the neck, spine, hip and knee, for example.  Still, considering the number of people playing sports, such instances are the exception rather than the rule.

     Sports provide young people with an opportunity to develop social skills and camaraderie while maintaining an active lifestyle.  By and large the benefits of participating in sports and team competition greatly outweigh the fear of or potential for injury.  Always consult your doctor when injuries occur or if you have additional concerns or complications.

Monday, July 8, 2013

Dr. Yacobucci to instruct Orthopedic Surgeons on new techniques

Dr. Yacobucci has been asked to instruct a group of Orthopedic Surgeons on new techniques for resurfacing cartilage defects in the knee on July 20th in Las Vegas, NV. 

Dr. Yacobbuci is specialist in Sports Medicine, Arthroscopic & Reconstructive Surgery of the Knee & Shoulder.


Wednesday, July 3, 2013

TOCA pledge to 100 Club of Arizona

In light of the tragic events at the Yarnell fire in which 19 firefighters lost their lives, TOCA has pledged $1,900 to the 100 Club of Arizona to honor the memory of these fallen Heroes and to provide support for their families. This tragedy has touched many.

If you would like to donate you can find the 100 Club of Arizona on facebook:

as well as online at:


Tuesday, July 2, 2013

Dr. Padley speaks at A.T. Still University

For the 3rd Year Dr. Padley has been asked to speak at A.T. Still University for their Physician Assistant program. He gave a lecture on Hip Disorders. Dr. Padley specializes in Arthroscopic Surgery, Sports Medicine, Knee, Hip, Shoulder & Elbow. TOCA is proud of his commitment to continuing to support higher education in the community.