TOCA Talks with Dr. Huston: Physical Medicine and Rehabilitation (PMR)

Physical Medicine and Rehabilitation (PMR) specialists diagnosis, treat and rehabilitate individuals suffering from a wide variety of neuromuscular and musculoskeletal conditions.  As the complexities in medicine have grown, many PMR specialists subspecialize with additional fellowship training in the area of brain injury, spinal cord injury, pain management, sports medicine and interventional spine.

Interventional spine specialists receive advanced training in the diagnosis, interpretation of advance imaging studies such as MRI, treatment, rehabilitation and utilization of minimally invasive fluoroscopically guided spine procedures in the management of painful spine disorders.  This is a relatively new subspecialty.  The goal is to provide more accurate diagnosis of painful spine conditions to provide better and more specific treatment. 

An individual with chest pain will often see an interventional cardiologist. The interventional cardiologist will make a diagnosis and determine the best way to manage the patient cardiac condition. An individual with back or neck pain will want to see an interventional spine specialist to obtain the correct diagnosis and treatment.  Treatment may be as simple as activity modification and medication to working with a physical therapist to correct biomechanical deficits and develop muscle memory to dynamically stabilize the spine—to fluoroscopically guide spinal injections to promote healing to ablative procedures for degenerative conditions. Kyphoplasty is a procedure utilized to restore height of osteoporotic compression fractures and injection of cement to stabilize the fracture.

A study published in Spine 2013 found those individuals scheduled to undergo surgery who consulted with a PMR specialist were often able to avoid surgery and were satisfied with their care (Fox, et al. Spine 2013).

Minimally invasive procedures are constantly being developed to relieve pressure off of nerves for both disc herniations and stenosis. These procedures will need continued development before more generalized use in the population.

Gene therapy to rebuild discs using recombinant DNA has been performed in animals.  The future in the treatment of degenerative disc disease will probably utilize interventional procedures to introduce gene therapy into a diseased disc to allow the disc to repair or regenerate. 

#RESULTS.RECOVERY.RELIEF.

TOCA

602-277-6211

www.tocamd.com 

Dr. Burgess Speaks to Fellow Hand Surgeons!

Dr. Burgess Speaks to Fellow Hand Surgeons! 

Dr. Kraig Burgess, one of the hand and upper extremity specialists here at TOCA recently delivered a talk to area hand surgeons, physician assistants and orthopedic residents on an exciting new form of treatment for scaphoid nonunions. “A scaphoid nonunion is a difficult to treat broken bone in the wrist that fails to heal and has continued to challenge hand surgeons for decades,” said Dr. Burgess. Current treatment has been placement of bone graft and a central screw. “This new treatment involves placement of a highly specialized plate and the early results have been very encouraging,” said Dr. Burgess. Dr. Burgess is coordinating efforts with two other valley hand surgeons to investigate the biomechanical properties of the device and they also intend to publish there results upon completion of the data collection. “This is something that could revolutionize the care of these injuries and create a complete paradigm shift for the future,” commented Dr. Burgess. Dr. Burgess is one of three hand surgeons here at TOCA specializing in the surgical and nonsurgical treatment of disorders affecting the hand, wrist and elbow. Visit our webpage at www.tocamd.com to learn more about the hand surgeons at TOCA serving your community.

#RESULTS.RECOVERY.RELIEF.

TOCA
602-277-6211
www.tocamd.com

TOCA Tip: BASEBALL INJURIES IN YOUTH AND INJURY PREVENTION

TOCA Tip: BASEBALL INJURIES IN YOUTH AND INJURY PREVENTION

Injuries in young athletes are on the rise, but elbow and shoulder injuries in children are on the verge of becoming an epidemic. Thousands of children are seen each year complaining of elbow or shoulder pain. Damage or tear to the ulnar collateral ligament (UCL) is the most common injury suffered and is often caused by pitchers throwing too much. This ligament is the main stabilizer of the elbow for the motions of pitching. When it becomes damaged, it can be difficult to repair and rehabilitate.

HOW IS AN ELBOW OR SHOULDER INJURY DIAGNOSED?
If a young athlete is throwing too hard, too much, too early, and without rest, a serious elbow or shoulder injury may be on the horizon. If the athlete complains of elbow or shoulder pain the day after throwing, or movement of the joint is painful or restricted compared to the opposite side, see a physician familiar with youth sports injuries immediately.

HOW CAN OVERUSE BASEBALL INJURIES BE PREVENTED?
Overuse injuries — especially those related to the UCL and shoulder — are preventable. Some tips to keep you in the game throughout your life include:

• Warm up properly by stretching, running, and easy, gradual throwing
• Rotate playing other positions besides pitcher
• Concentrate on age-appropriate pitching
• Adhere to pitch count guidelines, such as those established by Little League Baseball (See tables)
• Avoid pitching on multiple teams with overlapping seasons
• Don’t pitch with elbow or shoulder pain, if the pain persists, see a doctor
• Don’t pitch on consecutive days
• Don’t play year-round
• Never use a radar gun
• Communicate regularly about how your arm is feeling and if there is pain
• Develop skills that are age appropriate
• Emphasize control, accuracy, and good mechanics
• Master the fastball first and the change-up second, before considering breaking pitches
• Speak with a sports medicine professional or athletic trainer if you have any concerns about injuries or prevention strategies

HOW IS AN OVERUSE ELBOW OR SHOULDER INJURY TREATED?
The most obvious treatment for overuse is rest, especially from the activity that created the injury. Ice is also used to reduce soreness and inflammation. Ibuprofen can be takento help with any pain. If symptoms persist, it is critical that a physician be contacted, especially if there is a lack of full-joint
motion. An examination and radiographs should be done. An MRI scan may also be helpful.

Usually a simple “rest cure” approach will not be enough, because even though it allows symptoms to subside, it also creates loss of muscle bulk, tone, flexibility, and endurance.
Once pain is gone and full motion is present, a throwing rehabilitation program can start.

Under some circumstances, surgery may be necessary to correct a problem. Overuse and stress related problems can affect growing parts of bone, not just the soft tissue (muscles, tendons, and ligaments). If the condition is not treated, it could cause deformity of the limb and permanent
disability. The athlete should return to play only when clearance is granted by a health care professional.

‪#‎baseballseason‬ ‪#‎injuryprevention‬ ‪#‎RESULTSRECOVERYRELIEF‬

TOCA

602-277-6211

www.tocamd.com

Dr. Bailie: "Getting Back in the Game: Orthopedic Rehabilitation in the Athlete"

Dr. Bailie was asked to contribute and recently published 3 book chapters with co-author Todd Ellenbecker PT in "Getting Back in the Game: Orthopedic Rehabilitation in the Athlete" (Reider, Davies, Provencher, editors). The chapters are titled: Postoperative Rehab after Arthroscopic Rotator Cuff Repair (p 292-304), Post-Surgical Rehabilitation after Shoulder Arthroplasty (p 428-441), and Beyond Basic Rehabilitation: Return to Golf, Swimming and Tennis after Shoulder Replacement (p.441-448).

#RESULTS.RECOVERY.RELIEF. 

TOCA
602-277-6211
www.tocamd.com

Dr. Carter presented on ACL Allografts

Saturday March 21st, Dr. Carter presented on ACL Allografts during the Sports Medicine Specialty Day at the American Academy of Orthopedic Surgeons Annual meeting in Las Vegas.

Dr. Carter is an expert in the field of orthopedic surgery and sports medicine. Since 2000, he has been the head team physician for the Phoenix Suns (NBA) and has served as the head of orthopedic surgery at Arizona State University for 14 years. Dr. Carter has also served as a member of the American Academy of Orthopedic Surgeons Sports Medicine Subcommittee, and a member of several committees for the Arthroscopic Association of North America. He has served as the state representative for the American Orthopedic Society for Sports Medicine. Dr. Carter has published numerous articles pertaining to orthopedic and sports medicine topics and has given presentations world wide. He was also awarded a patent for arthroscopic surgical instruments. Dr. Carter is considered a national authority on the topics of meniscal allografts and articular cartilage. He is also a member of the Herodicus Society which is considered the premier organization for Sports Medicine Orthopedic Surgeons with just over 100 members world wide.

#RESULTS.RECOVERY.RELIEF.

TOCA

602-277-6211

www.tocamd.com