By Dev K. Mishra, M.D. President, Sideline Sports Doc Clinical Assistant Professor of Orthopedic Surgery, Stanford University Key Points: High intensity interval training (HIIT) is an extremely time-efficient way to build cardiovascular fitness Many people with orthopedic or medical impairments are scared off by the words “high” and “intensity” but should not be afraid- everything…
“Wear and tear” of the cartilage in a joint is a common issue, especially in active people as they age. This type of arthritis is called osteoarthritis. As the cartilage wears away, it becomes frayed and rough, and the joint space between the bones decreases. This can result in bone rubbing on bone.
Osteoarthritis develops slowly and the pain it causes worsens over time. If you are an active person in your 40s or 50s and you have hip arthritis you’ve traditionally had a limited number of options. You could modify activity, lose weight, maintain proper exercise, or take medication. And when all else fails you could consider surgery.
A “total hip replacement” is an outstanding operation for individuals with hip arthritis, but the problem is that it’s not recommended for younger people. Also, almost all surgeons recommend against high-impact activity after a total hip replacement. And that’s where hip resurfacing enters the picture. This procedure may offer the chance to save the athletic life of the very active adult with hip arthritis.
Stress fractures in adolescent athletes are unfortunately fairly common. Here’s an interesting recently published scientific study that aims to identify risk factors for stress fractures in adolescent athletes. The authors found several characteristics associated with stress fracture risk: lower than normal body mass index, four weeks or more history of shin splints, minimal involvement in weight training, decreased amount of sleep, daily stress, and low dairy intake.
I wrote last week about improvements in ACL surgery over the last 25 years and this week I’d like to explore improved results from another commonly performed sports medicine surgery- stabilization surgery for the dislocating shoulder. The results here mirror those of ACL surgery in many ways.
Many young athletes dislocate a shoulder from trauma, typically a dive with the arm outstretched overhead. This can happen in any sport involving that kind of motion, and any contact sport.
Most surgeries were performed through a large “open” incision 25 years ago, but nowadays can be performed arthroscopically in most cases. For uncomplicated stabilization of shoulders that have had a small number of dislocations from trauma, we should expect 90% of shoulders to remain stable and satisfaction rates upwards of 80% out to about 5 years with current methods, for recreational athletes.
In today’s blog post I’d like to take a look at improved outcomes over the last 25 years from a commonly performed orthopedic sports medicine surgery: ACL reconstruction. We’ve come a long way over this time, with improvements in patient reported outcomes as well as improvements in measured stability of the knee.
Orthopedic surgeons use various objective criteria to assess the stability of the knee. In 1994 when I started my orthopedic practice I typically quoted an 80% success rate in terms of restoring excellent stability to the knee after ACL reconstruction surgery. Today, that number is about 95%.
How the patient who’s had surgery feels about his or her own knee has also improved quite a bit over this time. It’s difficult to find published patient reported outcomes from the early 90s but it’s fair to say that a large percentage of patients weren’t entirely happy with their knees after surgery. Perhaps 40% of people reported difficulties with their knees. Nowadays patient reported outcomes are generally very favorable for about 80% of knees at least two years after surgery.
I’m sure pretty much everyone knows that exercise is a good thing and makes us fitter and better. The right kind of exercise will make you feel better, look better, and likely add to your healthspan. But the exact mechanisms that lead from exercise to better health are surprisingly hard to pinpoint.
A recently published scientific studyshows that certain groups of proteins in the body are present in larger quantities in people who exercise regularly, suggesting that the proteins are somehow responsible for actions leading to improved health status. This study did now investigate cause and effect, but it sheds light on a previously poorly understood area. The field of “proteomics”- the study of body proteins and their functions- may lead to exciting discoveries in exercise science.
It’s very easy to get caught up in moonshots, longshots, and fantasy in the world of medicine, but I believe there are three highly innovative technologies that will have an increasingly prominent role and impact sports medicine in 2019.
The first of these is increasing use of biologics in sports medicine injury treatment. Second is the rapidly expanding range of treatment options for active individuals with knee arthritis. And finally, I expect to see an exponential increase in telemedicine and mobile algorithms to provide initial injury guidance.
We truly hope you make 2019 your best year ever! We’ll be back with new posts starting next week to help you reach your potential. – Your friends at Sideline Sports Doc
We hope you had a great Christmas Day! From your friends at Sideline Sports Doc.
I’m sure this is true everywhere in the country but it seems to be particularly true here in Silicon Valley where I practice: people naturally consult the Internet for information about their injuries. But can you actually trust what you’re reading?
When a patient comes to see me in the clinic I will frequently ask them whether they have consulted any Internet sources as this helps me get some context behind the knowledge about their condition. As long as the source of the information is good I welcome this kind of research as it tends to improve their recovery from the problem.
In this time of “fake news” which sites can you trust? The most important factor is to consider the source of the information.
