Tag Archives: sports medicine

GETTING TO KNOW YOU – Paul Lento, MD

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Last week we featured Dr Michael Gordon. This week, we asked the same questions of Paul Lento, MD, a triple board certified Physical Medicine & Rehabilitation physician here at SOA.

What inspired you to become a physician?

Not so much “what” but “who”.  My father had a pretty strong influence on my decision. He often talked that I should choose a career to help improve people’s lives but was also challenging. I thought medicine would be the best avenue to achieve both of these goals.

Why Physical Medicine and Rehabilitation (PM&R)?

While I was a General Medical Officer in the Navy taking care of Marines, I realized most of the personnel I saw had non-surgical orthopedic injuries, which often improved with a good rehabilitation program. PM&R focuses on several non-surgical options while treating the entire person, not just one body part.

What do you love most about your job?

Probably learning about the interesting things my patients have done in life. I have seen patients who have played professional tennis to those who taught Vivien Leigh how to talk with a southern drawl. One patient of mine was a bomber pilot in WWII.  Truly amazing people.

(Editorial Note: For the “younger” folks, Vivien Leigh was best known for her two Academy Award winning roles from classic movies as Scarlet O’Hara in “Gone With The Wind” and Blanche DuBois in “Streetcar Named Desire”.)

What is your biggest challenge?

Explaining to patients that I’m not an orthopedic physician. People look at me like I must be from another planet. The specialty of PM&R is very small and not well-known but I chose it as I think it has a lot to offer patients.

If I weren’t an orthopedic physician I’d be a _____________.

Fishing boat captain or a bartender on a beach in St. Barths.  Who knows, maybe combine the two when I retire?

Your proudest moment?

The times when I see my kids being kind to other people.

Where is the most interesting place you’ve travelled?  Why?

While I’ve been to different countries, I would have to say Salt Lake City during the 2002 Winter Olympics. I saw and met people from all over the world. It was like circling the globe in two weeks without having to leave the U.S.

Any hobbies?  Activities?

I love to fish. I would try to fish in any body of water if given the chance. It’s one of the reasons I moved to Florida.

What’s your next adventure?

I may explore Italy in the next year or two if I can get away.

Your guilty pleasure food?

Having lived in both Chicago and Philadelphia, I would have to say deep dish pizza and soft pretzels.

Paul Lento, MD is triple board certified and a Castle Connelly “Top Doc”.  You may read his medical biography by visiting our website here. To make an appointment with Dr Lento, call 941-951-2663. Sarasota Orthopedic Associates has 13 physicians across 4 locations (Sarasota, Lakewood Ranch, Venice, and Bradenton) and we offer same day appointments when needed. Our commitment is to get our patients back on their feet, back to work, back in the game, and back to life.

DID YOU SAY SPORTS INFECTIONS?

MRSA

Most athletes expect injuries and not an infection to be the thing that would most likely make them miss some time. Viral, fungal, and bacterial infections can not only take a person out of the game, but can be serious enough to require hospitalization. Recent outbreaks of Staph infections at schools and even ones affecting professional teams (e.g. Tampa Bay Buccaneers) have shed light on the issue, but many athletes are still unaware of the potential for infection in locker rooms, outdoor sporting activities, and even among family. Here are some commons infections that can afflict athletes.

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Staph Infections

Perhaps the most dreaded and serious of them all are the Staph bacterial infections. Most recently, there has been a surge in community-acquired MRSA infections (a resistant strain) that often affects those with poor hygiene, who live in crowded situations, and have had recent trauma to the skin. They are particularly common in wrestlers, football players, and anywhere there is shared use of contaminated equipment. A recent study showed that there was a 22% prevalence of Staph in locker room whirlpools in college training rooms. It will often present as a red, painful bump but can also develop into abscesses and further soft-tissue infection. Prevention is key with frequent hand washing being the most important prophylaxis. How it presents determines how it is treated. Fluid collections should be drained and all patients should be placed on antibiotics that target the resistant form. Returning to play, per various groups’ guidelines, should only be considered after treatment for 72 hours, no new lesions for 48 hours, and no drainage being present.

Infectious Mononucleosis (IM)

Also known as “kissing disease”, IM is a common viral infection that affects teenagers and young adults, and is often caused from sharing water bottles. Patients will experience a sore throat, body aches/pains, fatigue, fevers, and possibly a rash, and it may take upwards of a month for symptoms to present themselves after one is exposed. The most concerning feature associated with IM is spleen enlargement. When an athlete’s spleen is enlarged, especially contact athletes, this puts them at risk for having the spleen rupture, and, while although rare, can be potentially fatal. IM symptoms usually disappear after 3-4 weeks but may take longer till an athlete is ready to return to sports. Controversy exists with regards to when a contact athlete with IM is safe to return to sports, but most studies show that is probably safe after 4-6 weeks for them to return to play.

Fungal Infections

Caused by direct skin-to-skin contact, fungal infections are quite prevalent and can affect all parts of the body. “Athlete’s foot”, “jock itch”, “ringworm” all fall into this category. While they don’t usually cause too much in the way of significant health issues, they can cause athletes to miss quite of bit of practice and competition time. Most commonly, treatment is in the form of topical creams/ointments, but for more serious cases oral treatment may be needed. Current guidelines recommend 72 hours of topical treatment for non-scalp infections and having a protective dressing over all lesions for return to play.

Summary

While infections are an often overlooked cause of athletes and patients missing time from their sports or activities, they can be just as frustrating as an injury with regards to time off, treatment, and recovery. Sarasota Orthopedic Associates is driven to helping get their patients back in the game, no matter the cause.

Trevor Born, MD – Dr Born is a Sports Medicine physician at Sarasota Orthopedic Associates specializing in upper and lower extremity conditions. SOA has three convenience locations in Sarasota, Lakewood Ranch, and Venice and offers same day appointments when needed.

TENNIS ANYONE?

tennis racket and ball

Tennis is one of the more popular sports on the Gulf Coast of Florida. Year round competition at all levels can unfortunately lead to various “overuse” injuries, and some athletes may even sustain acute traumatic injuries which may force them to miss time. An overview of common injuries as well as ways of preventing and treating them may help to keep a tennis player on the court.

Tennis Elbow

Perhaps the most dreaded of all the overuse conditions is “Tennis Elbow,” or lateral epicondylitis. A degenerative process affecting the tendons on the lateral aspect of the elbow, which help to bend the wrist backwards, it is commonly seen in tennis players given that these muscles help resist impact when the racquet strikes the ball. Combined with their importance in gripping the handle, these muscles/tendons are prone to overuse if not properly prepared. Strengthening, a regular warm-up routine, and paying attention to grip size can help minimize the risk of developing the condition. Treatment often includes rest, therapy, braces, medications, and injections. While most cases improve with these conservative measures, occasionally surgery is needed.

Shoulder Injuries

The shoulder, like the elbow, is also predisposed to overuse injuries in tennis players. The serve is a complex motion that not only requires a balance of muscle coordination around the shoulder, but good core and lower extremity flexibility and strength to minimize risk of injury. The rotator cuff muscles can often become fatigued or weak, which can throw off the balance, and irritate surrounding tissues. The tendons and surrounding bursa can become inflamed, which may affect one even off the court. Again, conservative treatment is often all that is needed, not only focusing on the shoulder, but providing a total body program to minimize the stress on the shoulder during strokes. If symptoms persist, then further imaging and possible surgery may be needed, especially if a rotator cuff tear is present.

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Lower Extremity Injuries

The legs are just as important as one’s arms on the tennis court. Rapid changes of direction, sudden stopping and acceleration, and jumping are often needed during a match. Muscle strains, knee and ankle sprains, and stress injuries can occur during these movements. Strains, such as “pulling” a hamstring or calf muscle, can often be prevented by adequate stretching prior to playing. An awkward step or twisting episode may result in a sprain. Ankle sprains almost always improve with conservative measures, but recurrent sprains may result in continued instability and require surgery. Knee sprain treatment depends on what is injured. While certain ligament and tendon issues around the knee can heal with non-operative treatment, meniscal and ACL tears often need surgery, but this is determined on a patient-to-patient basis.  Quickly increasing the amount of tennis one is playing may predispose them to a stress fracture, either in the lower leg or foot. These require rest and off-loading of the limb, possibly with the assistance of crutches. Lastly, proper footwear is vital to the health of the lower extremities and minimizing the risks of these conditions.

Summary

Understanding the spectrum of conditions that can affect tennis players is often a good first step into learning ways to avoid them. Every patient/athlete is unique and working with them through their condition in a customized approach will best enable them to get back in the game.

Trevor Born, MD  is a Sports Medicine Physician at Sarasota Orthopedic Associates treating upper and lower extremities with non-surgical treatment as well as minimally invasive options. Click HERE for more information.

 

SHOULD MY CHILD PLAY THE SAME SPORT ALL YEAR LONG?

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Ahhh!!! Florida, with its beautiful warm sunny days and virtually endless opportunities for sporting events, is a hotbed for the development of youth sports.  Here in the Sarasota/Bradenton area, there are numerous opportunities for the young athlete to participate in sports year round.  Too often, however, young athletes are playing only one sport all year long without the potential for rest or recovery.

Unfortunately, sports medicine specialists now understand that this is not a healthy strategy. In fact, young athletes who play or perform a single sport greater than eight months out of the year are at a significantly increased risk of experiencing an injury compared to the other youths who participate in different sports.  In a recent sports medicine article, youth athletes who focus on a specific specialization of sport program are twice as likely to get injured compared to their friends who participated in self-directed unstructured free play.

There are a few theories as to why this may occur. Playing only one sport may overload developing structures causing overuse injuries.  Additionally, proper development of other diverse muscle skills which occur during regular free play or from participating in array of different sports may not occur when a child only plays one sport.

Based on these theories, it is recommended that young athletes be given time away from their specific sport so that they can participate in free unstructured play with their peers.  Parents and educators should provide opportunities for free play as well so that our young athletes can improve their motor development in general during the growing years which can reduce injury rates and encourage life-long activity free of injury.

Paul H. Lento, MDDr Lento is Fellowship Trained and Triple Board Certified in Physical Medicine.  He is a nationally recognized Sports Physician having served as team physician for major sporting events such as Winter Olympics and major city marathons. Locally he is team physician for Lakewood Ranch High and Booker High Schools. He holds the distinction being named a Castle Connelly Top Doc and sees patients at Sarasota Orthopedic Associates.  Learn more HERE.

DON’T WORRY BABY … WE’VE GOT YOU COVERED

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Sure, playgrounds are the most obvious place for a childhood injury or fall, but what about other places? Children are creative, curious, and uncoordinated, as well as energetic and a fall can happen in an instant, with or without supervision. Falling and injuries are a natural occurrence of childhood resulting in cuts, bruises, sprains, fractures, broken bones, and even concussions.

The CDC (Center for Disease Control) reported over 8,000 children nationwide are seen each day for fall injuries. Children under 5 years of age represent the highest proportion of childhood fall emergency room visits.

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Prevention is the best remedy and the #1 rule is supervision. Reported common injuries are from:

  • Falls from windows – Window screens do not adequately prevent a child from falling out of a window. Best practice is to never place a child on or near a window sill. Window guards on those above one story add an extra safety measure for your child. When closed, keep windows locked.
  • Bouncy seats/portable car seats – These should never be placed on a table. A child vigorously kicking and bouncing may slowly move the carrier to teeter over the edge.
  • Stairs – A gate is an excellent deterrent to prevent serious falls down a staircase.
  • Shopping carts – Never allow a child to stand in a shopping cart. A loss of balance or any slight movement from the child or even being bumped into by another cart can send a child tumbling to the ground.
  • Cribs – Always ensure the rails are raised and locked. Children are masters of escape in an unsecured crib. It’s also wise to frequently check all parts of the crib for any loose parts.
  • Changing tables – It seems to take a contortionist to navigate changing a baby and reaching for changing supplies while keeping one hand on the baby, but maintaining constant contact will avoid the possibility of the child falling from the table.
  • Beds – Jumping on a bed is great fun however, it can be dangerous. Bunk beds without safety railings are an accident waiting to happen.
  • Sports – Always, always, always have your child outfitted in the sport-appropriate protective gear.
  • Playgrounds – Look for those with wooden chips or sand and avoid playgrounds with cement or grass.

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It’s hard to keep our children safe from everything, but close supervision is the best preventive measure.

If your child does suffer an injury, it’s good to know Sarasota Orthopedic Associates treats children as well as adults.  Our pediatric orthopedic specialists and sports medicine physicians are here to help get your little ones back in action.  We have offices in Sarasota, Lakewood Ranch, and Venice and, when needed, offer same day appointments. Visit our website at www.soa.md for more information about us.

 

 

 

 

 

ANATOMY OF A GOLF SWING

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With today’s modern golf swing, there are numerous muscle groups and joints which need to be on the same page to best provide one with an effective, powerful stroke while minimizing the risk of injury. An often neglected part of the body with regards to many players’ swings is the hip joint and its surrounding structures.

Prevention

Placing focus on properly preparing the hip joint to maintain appropriate flexibility will best ensure that it can withstand the forces seen with one’s golf swing. Basic stretching exercises for the hamstrings, hip flexors, and rotators are essential. The average PGA golfer has roughly 45° of hip internal rotation. Lacking internal rotation leads to increased extension of a golfer’s pelvis which can result in low back pain and decreased drive. In addition, recent studies have shown that golfers with strong hip musculature have lower handicaps and longer driving distances compared to those with weak hip muscles. Combined with safe core strengthening, these steps will help one produce the maximum power with their swing while reducing the risk of back and other joint injuries.

Causes

Hip pain in golfers may be the result of minor strains, soft-tissue inflammation, such as bursitis, and even arthritis. The modern golf swing, with its requirement for large amounts of body rotation, can subject one’s body and hip joint to perhaps more than it can tolerate, rendering it vulnerable to injury. Labral tears, while perhaps more common in other sports, can also be a cause of hip pain in golfers. A stabilizing and supportive structure, the labrum can be damaged when subjected to increased pressure in a hip joint which lacks the necessary flexibility to withstand the forces seen with the modern golf swing. This may result in groin pain, clicking or locking sensations, discomfort when squatting to read a putt or pick up a ball, or even restricting one’s swing.

Treatment

The first steps to take in treating hip pain associated with golf involve the usual conservative measures, including rest, ice, and over the counter pain relievers and anti-inflammatory medications. If these fail to alleviate the discomfort, formal physical therapy with an experienced provider familiar with golf related injuries can often target the specific muscle imbalances and tightness which made one prone to such an issue in the first place. Injections, such as steroid and platelet-rich plasma (PRP), can also be useful for a variety of hip related pathologies. Lastly, when non-operative treatments fail, surgery can be considered. For labral tears, recent advances in hip arthroscopy have enabled surgeons to repair this important anatomic structure through minimally invasive techniques, and best preserve the hip joint for countless rounds of future golf.

Our commitment at Sarasota Orthopedic Associates is to get our patients back on their feet, back to work, back in the game, and back to life.  Trevor Born, MD is fellowship trained in Sports Medicine at SOA and will help you get back in the game. Same day appointments are available at any our three locations by calling 941.951.2663.

SEND IN THE CLOWNS … THE 24 HOUR GIVING CHALLENGE

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A few months ago, we announced our official orthopedic partnership with the Circus Arts Conservatory (CAC). You may wonder what orthopedics has to do with a circus.

The obvious answer is the circus is comprised of athletic performers and SOA specializes in Sports Medicine, so it’s a PERFECT match.  MOST important, SOA supports the educational aspect of the CAC. When people think of the CAC, they first think of spectacular entertainment.  What many don’t realize is the phenomenal contribution the CAC makes to our community from their Education curriculum. Did you know:

  • the Circus Education program teaches in 15 area schools across Manatee and Sarasota Counties
  • 80% of ticket revenue supports community outreach
  • Sarasota is known as  the Circus Capital of the World
  • the CAC Circus Education program teaches Newton’s physics, law of Universal Gravitation, through juggling
  • the CAC donates over 5,000 tickets annually to over 50 non-profit organizations
  • they depend on 300 volunteers annually to run their programs
  • their educational program is designed to include students who would otherwise not respond to traditional instruction
  • their outreach program proves when children are actively engaged, they are able to understand
  • their Humor Therapy educational program goes far beyond entertainment, improving the quality of life for those in hospitals and ALFs…Humor Heals
  • the Humor Therapy team made 368 visits to local care facilities this year
  • physical activity in children = higher academic achievement in school … Circus Education reaches out to grades K-8

 Wow, that’s a lot … and there’s so much more as to how the Circus Arts Conservatory reaches out to folks of all socio-economic circumstances, ethnicities, gender, and ages.

So why are we telling you this?  The Circus Arts Conservatory needs our help and we need yours. Beginning September 1st and continuing for 24 hours, the CAC will participate in the 2015 Giving Challenge. Over 400 local non-profit organizations work tirelessly without sleep to garner donations for their cause as well as vie for grant money through the Community Foundation of Sarasota and the Patterson Foundation. Over the past three years, the Giving Challenge has raised over $8 million dollars for local non-profits. Special grants will be awarded for Most New Donors, Best Overall Campaign, Best Video, and Best Business Partnership … as the CAC Business Partner, SOA is encouraging all our patients, staff, family, friends, and social media followers to join the challenge.

On September 1st at noon (not before!), please go online to www.circusarts.org/givingchallenge and make a donation.  This year, new online donations between $25 and $250 will be matched, making your gift even more important.   At the online site, you will be able to follow the 2015 Giving Challenge leaderboard of all the local non-profits to see how much is being raised in real time.  For a closer look at the CAC educational program, watch this video:  https://vimeo.com/134961942   … then donate on September 1st.  Everyone one of us at SOA appreciates your participation … WE APPLAUD YOU FOR HELPING!

CONCUSSION: Causes, Symptoms, and Treatment

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What is it and what causes it? Concussion in sports involves a complex process whereby trauma induced to the body or head creates abnormalities in processing of the brain.  While most people believe that a concussion requires a direct hit to the head, many athletes can develop a concussion even from blows to the body, which involve a sudden acceleration or deceleration force.  An estimated 3.8 million concussions occur in the US during recreational and competitive play with many more going unreported.

What are the symptoms of concussion? The symptoms from a concussion are extremely variable and no one concussion is the same as another.  Many athletes will experience headache, fogginess, dizziness, sleep difficulties, irritability, and difficulty concentrating just to name a few. Unfortunately, the symptoms of dizziness and fogginess can be associated with a longer time to recover completely.

Who is at risk of a concussion? Unfortunately some athletes may be a greater risk for a experiencing a concussion.  Younger athletes, female athletes, athletes with Attention Deficit Disorder (ADD/ADHD) as well as those who have experienced a previous concussion are at greatest risk for experiencing a concussion.

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How are concussions treated? This area of sports medicine continues to evolve and clinicians are changing the way concussions are managed.  With appropriate history, physical examination, and testing, clinicians are better able to gear specific treatment strategies towards an athlete’s symptoms.  While 90% of athletes will recover from a concussion in 3-4 weeks with relative rest and modifying aggravating activities, the other 10% may need dedicated rehabilitation strategies to help them overcome symptoms.  Once an athlete is symptom free, they can begin a graded exercise program that helps return them back to the sport safely.

At SARASOTA ORTHOPEDIC ASSOCIATES we have physicians who are trained at identifying high school athletic concussions and are able to recommend appropriate treatments, which will help them get back on their feet, back to work, back in the game, and back to life.

PAUL LENTO, MD / FAAPMR (click here for more on Dr Lento) / Triple Board Certified in Physical Medicine and Sports Rehabilitation