April 16th, 2013
As Minnesotans, we have been struggling the past few months with this SLOW transition into warmer weather. Let’s be honest; it doesn’t look like it is going to get warm any time soon. That be said, many avid walkers and runners are well into their spring training. If this applies to you, hopefully your training has been going well and you have been free of aches or pains. For those individuals who have not been as fortunate, there is an alternative walking/running treadmill in the Twin Cities.
The Alter G Anti-Gravity Treadmill originally was developed for NASA astronauts. It has now been tailored to assist every day athletes to train with minimal weight-bearing pressure on their joints. According to the Alter G website, the machine uses Differential Air Pressure (DAP) to rehab lower extremity injuries, neurological conditions, weight reduction, aerobic conditioning, and general training for combating age-related injuries. Clinical studies have found that unloading by 20-80% can encourage protection/healing of tissues, promote joint/muscle range of motion, prevent muscle atrophy, and encourage return of lost motor control.
If any of the issues listed above apply to you, this could be a great training alternative to give those joints a break. Not injured? Perhaps you would like to switch up your training regimen or see what it feels like to run on the moon.
More information on the clinical case studies supporting Alter G use can be found on their website: http://www.alter-g.com/rehabilitation-treadmill-clinical-research
April 4th, 2013
Hip pain… who hasn’t had hip pain? The real question is what is it and how do you get rid of it? There are a plethora of hip injuries, but the most common that I see clinically is the infamous Gluteus Medius Tendinopathy. Let’s call it “Glute Med Tendinopathy” for short.
Tendon-what, you ask? Tendinopathy translates as “pathology of the tendon”. Once a tendon is injured, inflammation and fluid starts to accumulate around the strained tendon. This initial injury is called “tendonitis” or inflammation of the tendon. If you are lucky and your musculoskeletal system is in tiptop shape, the tendonitis will heal and you will continue with your activity pai- free in one to two weeks.
If the tendonitis does not heal properly, then you are left with a tendinopathy. Glute Med Tendinopathy consists of chronic nagging posterior hip pain worsened by activity. This is commonly linked to bursitis of the hip. A bursa is a fluid filled sack that helps the tendons glide smoothly over the joints. This is the type of injury that you don’t want to “wait it out.” The best time to take care of a tendinopathy is to address it right away.
Now that we know what it is, how do you get rid of it? Contrary to belief, a tendinopathy is easily treatable. Seeking early treatment and a proper diagnosis is the biggest hurdle with this injury. Deep tissue sports massage, active release technique, PRP injections, Prolo therapy injections, or, the beloved, foam roller will help heal this chronic injury by causing micro trauma to the injured tendon. The controlled (key word here) injury sustained from this type of treatment will cause swelling and inflammation to occur at the targeted damaged site. This is a key factor in the natural healing process of the body. Surprise! Inflammation is not all bad.
The second, and equally important, treatment for Glute Med Tendinopathy is to strengthen it. Strengthening the gluteus medius muscle correctly and all the other hip muscles, as well as the core, will give the injured tissue a break and allow it to heal without complications.
If you suspect that you are suffering from Gluteus Medius Tendinopathy and two weeks of “at home treatment” doesn’t seem to be working, it is time to seek treatment from a sports provider.
February 6th, 2011
Adolescence is a critical period for attainment of PBM, an important predictor of future fracture risk. Encouraging adolescents to consume adequate calories and nutrients, such as calcium and vitamin D, is important for healthy progression through puberty and for optimal skeletal health. Enhancement of normal skeletal development can be achieved with the addition of frequent weight bearing exercise in the presence of adequate nutrition. While we do not yet have an ideal exercise prescription, it is now widely believed that activities that confer high-impact forces in unusual loading patterns are osteogenic. Ground reaction forces in addition to the pull of muscles on bone can enhance bone building during adolescence and beyond. Because prevention is better understood and has fewer potential negative side effects than adult treatments for low bone density, we need to enforce good habits early to prevent development of any of the components of the female athlete triad, and to optimize bone mass acquisition in adolescent athletes.
February 6th, 2011
Abstract: Platelet-rich plasma (PRP) is an autologous blood-derived product with an increased concentration of platelets in plasma, which are used to deliver supraphysiological levels of growth factors. Platelet-rich plasma has been used in many fields, including oral, maxillofacial, and plastic surgery. Its use in sports medicine has been increasing after recent evidence and media publicity suggest that it may augment the treatment of muscle strains, as well as tendon and ligament healing. Basic science and animal studies show promising results, but high-level clinical trials have yet to prove its efficacy. With increasing media coverage on the use of PRP in athletes, it is paramount that orthopedic surgeons and sports medicine physicians understand the various methods of preparation and administration, potential clinical applications, and available clinical results to best counsel patients on its advantages and disadvantages.
There remains limited evidence for or against the clinical efficacy of PRP therapy. Continued research is needed to establish the potential clinical uses and biological effects of PRP and to assess whether PRP is more effective than conventional approaches in the treatment of sports injuries. Whether the established molecular and cellular effects of PRP on human tendon cells and chondrocytes translate to a clinical benefit remains to be determined. Furthermore, due to qualitative differences in methods of preparation, it is difficult to generalize results of clinical studies without an in-depth understanding of the specific method of preparation and administration, and if these factors affect the outcome of PRP use. Although PRP may provide an alternative to surgical intervention for many common orthopedic sports injuries, more evidence is needed to confirm preliminary results and validate its efficacy to support its current widespread use. Until then, its clinical use should be approached cautiously with appropriate indications.
February 6th, 2011
Abstract: Background Fluoroscopically guided intra-articular (FGIA) anesthetic hip joint injections have been used to determine whether the hip joint is the source of a patient’s hip pain. However, there have been no reports documenting the efficacy of their use for defining the pain referral patterns (PRPs) of patients with labral tears. The aim of this study was to determine the PRPs of patients with labral tears and evaluate a new pain “circle” diagram (PCD) developed for this analysis. Methods Fifty-two patients were evaluated at our institution who had: 1) a preoperative FGIA anesthetic hip joint injection; 2) completed our PCD and a visual analog pain scale pre- and postinjection; 3) significant (≥ 80%) pain reduction after their FGIA injection; and 4) a labral tear and minimal (≤ grade II) degenerative joint disease, as documented by hip arthroscopy. The PCD had circles in which patients put an “X” in to indicate pain in the following locations: anterior superior spine, lateral peritrochanteric area, central groin, symphysis pubis, proximal inner thigh, anterior thigh, posterior iliac crest, sacroiliac joint, sciatic notch, and ischial tuberosity. Results Based on the percentage of patients with significant (≥ 80%) pain reduction after administration of FGIA, 2 areas demonstrated substantially more and consistent presence of pain, which improved after injection. These were the central groin (P < 0.001) and the lateral peritrochanteric area (P = 0.02). Conclusion The most common locations of pain were the central groin and the lateral peritrochanteric area. The least common were the ischial tuberosity and the anterior thigh, which are 2 areas often associated with osteoarthritis of the hip. The use of the PCD combined with an FGIA anesthetic injection may help physicians reconcile the expectations of those patients with labral tears who believe that hip arthroscopy will treat their multiple areas of “hip” pain.