- OrthopedicsGeneral Page Tier 3BlogArm injuries in youth sports continue to increase at an alarming rate. In particular, baseball and softball players are at significant risk of overuse injuries during their playing careers. In fact, it is estimated that up to 35 percent of baseball players will experience elbow or shoulder pain each year. Although throwing injuries occur in position players, pitchers are especially at risk for injury. It’s important that parents, coaches, doctors and the athletes understand the risk factors and preventative measures, and work together to decrease pitching overuse injuries. Overuse injury is often the result of specializing in one sport and is the main factor in the rise of arm injuries in throwing sports. Overuse leads to muscle fatigue and weakness, which can alter throwing mechanics and cause injury. In addition, muscles protect the bones and ligaments of the shoulder and elbow during the throwing motion by absorbing the energy of the throw. When the arm is fatigued, the risk of ligament rupture or fracture increases. As the season progresses, the risk of fatigue and injury increases. The total number of throws, not the type of pitch thrown, is the most important risk. Many baseball associations recommend daily, weekly and yearly pitch limits, as well as mandatory rest periods. Throwing too many pitches with insufficient rest is more likely at weekend or showcase tournaments. For example, a 12-year-old who throws 50 pitches on the first day of a tournament should not pitch again until day four. Referenced from “The Bare Minimum: Baseball” (Essential Training for the Baseball Athlete Youth through College) Everyone involved is responsible for preventing pitching overuse injuries. The American Sports Medicine Institute has common sense suggestions to limit overuse: Follow pitch limit guidelines during the season. Pitch on only one team per season. Don’t allow pitchers to play catcher during the same season since these two positions throw the most during a game. Refrain from overhead throwing for three months and competitive pitching for four months each year. It can be hard to take the necessary rest periods when a lot of kids now play year-round baseball. I suggest the months of November through January as ideal time in our area of the country for this essential rest. Players should realize that a good conditioning program for their legs, core, and rotator cuff muscles is crucial to protect the shoulder and elbow from excessive force during the throwing motion. In addition to strengthening, a shoulder stretching program focused on the posterior shoulder capsule is also helpful in preventing arm injuries. Armed with this information, coaches, parents, and players can work together to limit overuse and enjoy a full, injury-free season. Authors Cyrus Lashgari, MD, is an orthopedic surgeon with AAMC Orthopedics. To reach his practice, call 410-268-8862. Originally published March 19, 2018. Last updated March 28, 2019.0
- Cancer Care, Plastic Surgery & Skin Care, Women's HealthGeneral Page Tier 3BlogIf you or someone you know is considering breast reconstruction surgery following a lumpectomy or mastectomy, it’s important to know what options are available. While silicone and saline breast implants are an option, breast reconstruction surgery has advanced tremendously in recent years to include natural ways to rebuild the shape and look of the breast. Oncoplastic breast surgery This is a combination of operations performed by a breast surgeon and a plastic surgeon. At the same time a patient is undergoing a lumpectomy, where a breast surgeon removes a cancerous tumor, a plastic surgeon will use remaining tissue, the nipple and areola to immediately reshape and restore the natural appearance of the breast. The plastic surgeon will also modify the opposite breast to create an even look. This procedure could be a good option for women who are also candidates for a breast reduction or breast lift. Microvascular free flap options Following a mastectomy, a patient can choose to have an entire breast reconstructed with their natural tissue. Plastic surgeons can transfer tissue from other areas of the body to the breast. Historically, surgeons would take skin, fat and muscle from the upper back to reconstruct the breast. This is known as latissimus flap reconstruction surgery. Alternately, plastic surgeons can transfer skin, fat and muscle from the rectus, or ‘six pack’ muscle, from the lower belly to reconstruct the breast. This is TRAM flap reconstruction surgery. However, surgeons now use the latissimus and TRAM flaps surgeries less in favor of more modern reconstructive options. These more advanced options keep the muscles associated with those two procedures intact. One such option is the deep inferior epigastric perforator artery, or DIEP, flap technique. Plastic surgeons transfer the necessary skin, tissue (no muscle) and tiny blood vessels from a patient’s abdomen to form a new breast. Many women choose this option because of the tummy tuck benefit since excess skin and fat from the belly is removed. Fat grafting Liposuction can remove excess fat deposits from areas like a patient’s flanks (the area between your ribs and hip) or thighs. In the operating room, plastic surgeons purify the fat and carefully inject it into the breast to enhance the appearance of a reconstruction or in some cases to make an entire breast. As we discuss your options, it’s also important to shed light on the “Go Flat” movement. Women eligible for reconstruction but disinterested in additional surgeries, or the idea of reconstruction in general, embrace the idea of wearing their mastectomy scars with pride. Your surgeon should review your medical history and overall health, and explain which reconstructive options might be best for you based on your age, health, body type, lifestyle and other factors. Your surgeon should explain the limits, risks, and benefits of each option. Deciding whether or not to have breast reconstructive surgery following cancer treatment is a very personal choice. Find a surgeon you feel comfortable with, and talk openly about any concerns and preferences you may have. Author Drs. Devinder Singh and Tripp Holton are plastic surgeons at Anne Arundel Medical Group (AAMG) Plastic Surgery and specialize in breast reconstruction including microvascular surgery at Anne Arundel Medical Center. You can reach their office at 443-481-3400 or AAMGPlasticSurgery.com.0
- Orthopedics, Physical Therapy, WellnessGeneral Page Tier 3BlogRunning: It’s a form of exercise that doesn’t require spending money on fancy gear, and can be done anywhere, alone or with friends. Some scientists say it can even make you feel happier and live longer. Best of all? You only need the right pair of shoes to get started. But, whether you’re a seasoned runner or just working up to your first mile, it may not be as simple as lacing up your running shoes. While research shows that runners’ joints and bones are actually healthier than the average person’s, some runners do get injured. A growing number of doctors and physical therapists (including myself) believe people can prevent running-related injuries by fixing how they run. Evaluating how you run can help identify the root cause of an injury or identify a bad habit that may lead to injury. For example: Runners with long strides tend to develop knee pain. Runners with a narrow gait are prone to shin splints and IT Band syndrome. Runners with an excessive bounce are prone to Achilles tendonitis and plantar fasciitis. Muscle weakness is another frequent cause of injury. For example, weakness in your hips may lead to pain in your knees. A physical therapist can perform a professional running assessment, which usually takes place at a hospital or sports center and lasts about an hour. During a running assessment your physical therapist will analyze your readiness to run, injury history, running goals and training and race schedule. The therapist can also assess your form by looking at balance, strength and flexibility as well as how your joints move. To do this, the therapist may take a look at how the small joints in your foot move while sitting and what changes when your foot bears weight as you stand, walk or run. Is your foot stiff, flexible, flat or high-arched? Do your toes have enough motion when pushing off? How does the ankle joint move when you squat? The physical therapist may also record your running with a high speed camera to collect information about your gait. The therapist slows the footage down to study your movement closely, looking at the runner from head to toe to make any necessary corrections. By slowing the video down, the therapist has a detailed view of the different running stages at various angles and can see what could be triggering injuries or affecting your running efficiency. A video evaluation can also help runners find the right shoe with the right support. The physical therapist can look at your current running shoe and wear pattern to see how they fit to give suggestions and a plan that works for you. If you experience pain while running or want to improve your form and efficiency, a professional running assessment can really help. Running shouldn’t lead to injuries. AAMG Physical Therapy’s Running Program offers running gait assessments at most outpatient rehab clinics. To schedule your exam with a physical therapist, call 443-481-1140. Author By Dat Quach, PT, a senior physical therapist at AAMG Physical Therapy and supervisor at the Bowie Pavilion clinic. Originally published June 22, 2016. Last updated June 4, 2018.0
- WellnessGeneral Page Tier 3BlogYou’ve probably seen them at the gym, on social media or tucked in a friend’s purse — little packets promising hydration and energy. Electrolyte packets are everywhere these days, but what is in them, and do you really need them? Let’s break it down. What is an electrolyte? Electrolytes are minerals that help your body function properly. They carry an electric charge (hence the name electrolytes) and are essential for many body functions, like: Keeping your heart rhythm steady Maintaining fluid balance Supporting nerve and muscle function What ingredients are in electrolyte packets? Most electrolyte packets contain a blend of the following ingredients: Calcium, which is important for bones, muscles and nerves Flavors or colors, which are added for taste and appearance Magnesium, which helps with muscle relaxation and energy production Potassium, which supports muscle and heart function Sodium, which helps your body retain fluid and supports nerve function Sugar or sweeteners, which are added for taste or as a quick source of energy Some packets also contain B vitamins that support energy metabolism. But not all packets are created equal; some contain large amounts of sugar, while others use sugar-free alternatives. Be sure to read the label. Why do sugar and sodium levels matter? While a little sugar can help your body absorb electrolytes faster, too much can do more harm than good. Unless you're exercising for more than an hour or in extreme heat, you probably don’t need added sugar. Sodium is vital for hydration, but too much can be a concern. The sodium in electrolyte drinks is designed to replace sodium lost through sweat. If you haven’t lost a lot of sodium, this extra sodium isn’t good for you. Many electrolyte packets are designed for endurance athletes and have more sodium than the average person needs. To make sure you aren’t going overboard on sugar or salt, look for products that: Contain around 100-150 mg of sodium per 8-oz. serving Don’t have artificial colors or unnecessary fillers Have no more than 6g of sugar per 8-oz. serving If you have special sodium restrictions, you should consider how electrolyte packets fit into your diet and if you should use them at all. Keeping a food diary, like this one from the American Heart Association, that tracks sodium is an easy way to see how much you’re consuming each day. When is the best time to use electrolyte packets? They’re not just for professional athletes. You may benefit from added electrolytes if you: Exercise for more than an hour, especially in the heat Are recovering from fluid losses due to vomiting or diarrhea Follow a low-carb or keto diet Sweat heavily during workouts In any of these situations, use electrolyte packets by mixing according to the package instructions and sipping the solution over the course of 30-60 minutes. Why not just drink water? Water is great for daily hydration, but it doesn’t replace minerals lost through sweat or illness. Electrolyte drinks give your body a faster way to recover and stay balanced. Compared to plain water, they can help prevent muscle cramps, hydrate you faster and support energy and focus. The bottom line Electrolyte packets can be a useful tool for staying hydrated, especially during intense activity, illness or extreme temperatures. But be sure to check the label for sugar and sodium content, so you can select a product that’s right for you. Need help picking the right one? A Luminis Health registered dietitian can help you find the best electrolyte products for your needs and lifestyle. Authors Vincenza N. Garcia, RD, LDN is a Registered Dietitian for Luminis Health Weight Loss and Metabolic Surgery.0
- Men's Health, Orthopedics, Women's Health, Patient StoriesGeneral Page Tier 3BlogChristopher Bell first injured his knee playing tennis nine years ago. Seven years and two surgeries later, he was still in pain, and his options were narrowing. Fortunately, a new study at the AAMC Research Institute brought state-of-the art treatment to the Annapolis resident that no one else in the region could offer him. After his injury, one of the bones in Christopher’s knee had developed what doctors called small potholes. They caused enough pain that he could no longer play tennis. Microfracture surgery, which involves drilling into the pot holes to encourage scar tissue growth provided nearly two years of relief. But when the pain returned, his only other option was a partial knee replacement. “I went to three other doctors,” Christopher said, “including the orthopedic doctor for the Baltimore Ravens, and it was either quit playing tennis or have a partial knee replacement.” That’s when Thomas Harries, M.D., at Orthopedic and Sports Medicine Center offered him another option. Through the AAMC Research Institute, Dr. Harries was participating in a national study of a new procedure called HemiCap joint resurfacing. It’s an outpatient procedure that has been used in Europe for four years, and is now being evaluated for Food and Drug Administration (FDA) approval in the U.S. “A hemi cap is a small metal implant that restores the joint surface and keeps the joint from deteriorating further,” said Dr. Harries. “It’s like filling a pothole in the road. If you don’t fill it, it’s just going to get worse and worse.” The metal implants provide a permanent solution to this kind of chronic knee pain and preserve the healthy portion of the knee. Dr. Harries said 30 or 40 other institutions participated in the study, and after two years of patient follow up, the procedure is in review by the FDA. “It’s not available to the general public yet,” Dr. Harries said. “For me, being involved in the research end means an opportunity to gain more knowledge of these cutting edge procedures and the different products out there. It benefits your patients to have a physician who is keeping up with the modern technology and involved in developing it.” Christopher is walking proof of those benefits. His knee feels great, and he plays tennis every Thursday night. “It was absolutely surprising that I was able to be part of the study and have this cutting edge procedure at Anne Arundel Medical Center right here in Annapolis.”0
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