Ski Season, Part II.

January 31st, 2012

Strength training specific for skiing involves the hip abductors, quadriceps and hamstrings. Weight training with free weights or exercise machines which emphasize these muscles groups can be equally beneficial. Additionally, for the quadriceps, perform a wall squat. Place your back firmly against the wall with your feet two feet in front of you. Slide down until your thighs are parallel with the floor. Hold this position until you feel the burn. Try to increase the length of time in this position with each session. For the hip abductors, lie on your side and curl your lower leg up, keep your upper leg straight and lift your upper leg two-three feet off the floor,. Start with three sets of 10 and increase the number of sets as this becomes easier. A two-pound weight can be attached to your ankle for added difficulty.

Endurance training is also important. If you ski out West you will probably be in elevation greater than 8,000 feet above sea level. This puts incredible demands on your cardiovascular system. To build endurance, participate in some aerobic activity. These can include walking, jogging, biking, aerobics and swimming. To get at aerobic benefit the activity you choose must increase your heart rate to 60 – 70 percent of your maximum heart rate to be sustained for at least 30 minutes. To compute this use the following formula: 220 – age x 65 percent = target heart rate. This should be repeated at least three times a week. It is important to start off slow and increase the length and intensity of your work out as you get closer to your vacation.

If you have any questions about your fitness levels, call one of our professional staff today…Stay tuned for Part III later this week!

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Ski Season – Part I., Gary A. Levengood, MD

January 25th, 2012

Ski season is fast approaching and with it the thrill of an exhilarating run down the slopes on your skis or an equally exhilarating ride, but it’s not nearly as fun going down the slope on a ski patrol.

Which scenario you end up in is decided in large part by how you prepare for your ski vacation. The biggest cause of ski injuries is lack of conditioning for this demanding sport. If you have that vacation planned for February or March now is the time to get into condition for skiing.

Proper muscular conditioning involved all the components of fitness, i.e. flexibility, strength and endurance. The muscles most involved in skiing are the leg muscles. If you have not started previously, now is the good time to begin a stretching program. Stretch all the muscles around the hip including the hip abductors, flexors, extensors and groin muscles. Once you place your muscles in a position of stretch, hold them for a count of 30, and remember do not bounce. Then proceed to stretch the quadriceps and hamstring muscles again holding for 30 seconds.

Finally, give the calf muscle a good stretch. These stretches should be done at least once a day or more frequently if your muscles are tight. Always stretch prior to your workout and definitely before heading down the slopes.  If you are interested in knowing more about fitness or how to best utilize a flexibility program, call one of our certified athletic trainers today!

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Mulitdirectional Shoulder Instability….What is it? Stephanie H. Hsu, MD

January 23rd, 2012

In recent years, the number of young athletes engaged in sport focused and year round training has continued to increase.  Overhead sports, such as swimming, throwing, and racquet sports place significant demands on the shoulder and can lead to MDI, or multidirectional shoulder instability. This is especially prevalent in young athletes, where developing anatomy and characteristic soft tissue laxity both contribute to the risk of instability.

MDI was described by Neer and Foster in 1980 and is characterized as involuntary subluxation in any combination of anterior, inferior, and posterior directions.   The etiology of MDI may be due to a number of factors, including repetitive overhead activites, traumatic and recurrent dislocations, ligamentous laxity, muscular imbalance and weakness, or scapulothoracic dyskinesia.    Most often, repetitive overhead activities, such as the wide extreme motions in swimming, cause micro-damage to the static stabilizers of the shoulder, leading to MDI.  This is differentiated from acute, traumatic shoulder dislocations which have a extremely high recurrence rate in immature patients.  Glenohumeral joint stability is supported by bony anatomy, the joint capsule, labrum, glenohumeral ligaments, long head of the biceps, the rotator cuff, and periscapular muscles.

Patients with multidirectional instability often complain of vague pain and are able to describe positions of apprehension or subluxation. They may note numbness or tingling in the affected arm reproduced with certain activities, such as carry a heavy load or sport specific motions, such as a butterfly stroke.  MDI can occur bilaterally, and both shoulders of athletes should always be examined for comparison.  Up to 75% of MDI patients have generalized ligamentous laxity that is noted with signs such as hyperextension of the elbows and knees, hyperextension of the MCP joints, and the ability to abduct the thumb to forearm.  A careful history and focused, specific physical exam are essential to make the correct diagnosis and determine the most effective treatment.

The majority of atraumatic MDI can be treated non-operatively.  Emphasis is placed on initial pain control and moves to activity modification and rehabilitation.  A well coordinated physical therapy program consisting of shoulder proprioception,  rotator cuff and periscapular strengthening,  and scapulothoracic synchrony is critical to return an MDI athlete back to their sport with shoulder stability and confidence.

If an athlete with MDI fails 6 months of non-operative management or has more severe instability affecting daily activities, surgical management may become necessary to attain the level of shoulder stability necessary for sport.

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Functional Movement & Corrective Exercise, James Williams MS, ATC

January 16th, 2012

This past Sunday (1/15/12) Charlie Weingroff, DPT held a one day clinic on “Corrective Exercise for the Rehab Professional.”  This clinic focused on body movement.  From the time we are babies we begin neuromuscular development.  As babies we start on our back cooing and cawing and playing with our toes.  As we develop we learn to roll over onto our bellies.  Next we learn to push ourselves up and stand.  As we begin to walk we take wobbly steps and usually fall backwards several times.  At that point we roll over, push ourselves up and eventually, after several tries, we finally take that first big step.  To be clear, this course took us back to basic fundamental movements.

Dr. Weingroff explained how every movement, we as individuals make, is a derivative of the first year.  We learn to do things a certain way.  We train our brains that this is the way we are going to do things.  But through corrective exercise we can change our subconscious dysfunctions to a subconscious function over time.  It will make us all feel better from our toes to our head.

Dr. Weingroff began by defining corrective exercise.  Using corrective exercise we can train our brain to perform a new task.  This is also known as motor learning.  There are joints in our body that are designed to be mobile and joints designed to be stable.  Dr. Weingroff showed that if a stable joint is mobile or a mobile joint is stable, it can change the integrity of each of the other joints up the chain.  He then explained that our movement patterns might occur in one plane or another or it could occur in multiple planes.  He showed how our legs might be moving in one plane and our hands in another.  He finally showed that our upper body and lower body might be moving in multiple planes and multiple directions.  At this point we began to warm up and be interactive with our movements.  First Dr. Weingroff had us do movements in a single plane.  Maybe that was stepping or lunging or hoping or jumping.  This was seemingly easy.  Then he had us do similar movements with multiple planes.  This was a little more of a challenge.  Finally, Dr. Weingroff showed us a movement such as a skip on the left side and a run on the right side.  I’m glad he did not have us do that one because I can only imagine what that would have looked like.  But it does show that if we use corrective exercises to retrain our brain, we can do strange but productive things with our bodies without getting injured.  Sometimes we put our bodies in weird positions trying to do things at the house or playing the weekend sport and this showed that corrective exercises might help reduce the chance of injury with everyday activities.

The afternoon session focused on introducing the principles of the Functional Movement Screen (FMS).  If you don’t know about the FMS, I recommend you look into it.  We can use the screen to assess our risk of injury, whether we are changing a light bulb or running the 400 meter hurdles.  After you have your score on the screen we first look at asymmetries, correcting ourselves so the left and right are moving together and equally.  We also looked at dysfunctions in the movement pattern and how we could do exercises as simple as lying on the floor and breathing to correct these movement dysfunctions.  Dr. Weingroff focused on the shoulder mobility test and the active straight leg raise (ASLR) test during our session.

Dr. Weingroff focuses most of his therapy on the FMS and how we as humans move.  It was interesting to see that correcting dysfunctional movement patterns can make us more productive on the field, in our rehab and just in our daily lives.  Movement is the basis of us as humans.  If we are not moving properly, we will have an increased risk of injury.

If you are interested in the Functional Movement screen, call one of our professionals today at 770-237-3475.

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Cast or Brace?

January 12th, 2012

When you are evaluated by a provider you might be diagnosed with an injury such as a sprain or strain, a fracture or even some diagnosis you may not have ever heard of.  After the provider looks at your x-rays and does special testing, you might receive a cast or a brace.  Why do you receive a cast or a brace?  When the provider orders a cast it is typically to stabilize the joint.  At this point the provider feels the injury will heal best if you have no/minimal movement of the joint.  Casts are typically ordered when there is a fracture that does not need to move or post surgical when something has been repaired and the provider wants to make sure the suture anchors that are placed in the repair will not tear.

On the other hand, the provider will usually order as brace when there is an injury that requires protection but does not have to be completely immobilized.  A brace is ordered so you can take the injured body part out the brace and perform some strengthening exercises or stretching exercises in order to speed up the healing process.  The brace is there typically to remind you there is a healing injury and get you to think twice before gripping or running or whatever our daily activities might include.

At Sports Medicine South, we have a state-of-the-art Cast Room and a full brace fitting and supply center.  One of our nationally certified professional staff members will assist you in making sure either your cast or brace fits properly to help you get BEYOND BETTER!

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Celebrate PA Week!

October 2nd, 2011


A Prevention First Approach Offers Relief to Our Ailing Health Care System

Obesity … diabetes … hypertension … cardiovascular disease.

One of the most frustrating realities in health care is that the illnesses most dangerous and most costly are also often the most preventable. A recent report by the National Prevention Council finds that half of all Americans do not get the preventive care they need, yet tens of thousands of lives would be saved if they did.

The solution to this problem lies in putting prevention first. While our health care system excels at treating Americans to help them live longer with chronic disease, it often ignores the steps that are necessary to keep them from developing life-long illnesses in the first place. An emphasis on prevention also helps patients to see themselves as partners with their health care providers in providing the most effective, high quality care for themselves and their families.

Physician assistants, essential members of today’s integrated health care team, have long recognized the valuable role that prevention plays in improving overall health and saving the nation millions in health care costs. Educated in the same manner as physicians, PAs alleviate the workload of overburdened physicians, allowing them to spend more time caring for patients with advanced or complex conditions.

“By putting prevention first we can help patients and their families avert a lifetime of limitations and significant health complications,” said Harris Patel, PA-C, ATC, “It’s time for all us to shift our thinking toward a more pro- active approach to providing top-quality health care.”

When used effectively as part of an integrated health care team, PAs can spend more time with patients, listening to their individual concerns and detecting the warning signs and symptoms of chronic illnesses of which patients and sometimes even their doctors may not be aware.

PAs must undergo rigorous education that involves both clinical and classroom components. The average length of a PA program is 27 months, and PA students complete, on average, more than 2,000 hours of supervised clinical practice prior to graduation. There are more opportunities to join this profession than ever before, with 150 accredited PA educational programs located at academic medical centers, colleges and universities, and most of these programs offer a master’s degree.

By standardizing preventive care for all patients, the health care system can improve the present and future health of individuals, families and communities across the nation.

“I have worked with Physician Assistants for a long time in my practice and I have complete faith that PAs make healthcare more efficient.  The mission of Sports Medicine South is to provide the best medical care for all of our patients.  It is a fact that Physician Assistants help get our patients BEYOND BETTER. I am truly thankful for Diana Dean and Harris Patel.”- Gary A. Levengood, MD, Founder, Sports Medicine South


 

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Dr. Stephanie H. Hsu joins Sports Medicine South

September 5th, 2011

Sports Medicine South Welcomes Atlanta Native Stephanie H. Hsu, M.D. To Practice!

Stephanie H. Hsu, M.D. is a fresh addition to the Sports Medicine South family. With her interest and specialized training in both adult and adolescent sports medicine, shoulder surgery and the athlete’s elbow, Dr. Hsu easily complements the SMS practice mission to provide the highest quality orthopaedic care to ensure a quick and convenient recovery, allowing patients to become beyond better.
A native Georgian, Dr. Hsu grew up playing competitive softball and tennis in Roswell and attended Chattahoochee High School. She graduated early, with honors, in Mechanical Engineering from Georgia Tech. After completing her undergraduate studies, Dr. Hsu attended medical school at the Medical College of Georgia, then pursued a master’s degree in Mechanical Engineering and Biomechanics at the University of Southern California to expand her understanding of surgical implant design.
Dr. Hsu then traveled across the country to Boston, to complete her orthopedic surgery residency at Tufts University-New England Medical Center. Prior to joining Sports Medicine South, Dr.Hsu completed the prestigious Shoulder, Elbow and Sports Medicine fellowship at Columbia University in New York City. While in New York, Dr. Hsu provided care for collegiate and professional athletes under the direction of Columbia University and New York Yankees team physicians. Additionally, Dr. Hsu has published research in prestigious journals, and has authored book chapters and teaching videos covering topics including total and reverse shoulder arthroplasty, arthroscopic shoulder labral repair and examination of the athlete’s elbow.
Dr. Hsu is delighted to be joining the Sports Medicine South family and returning home to Georgia. In her free time, you may find her running in the park, playing tennis, relaxing with friends or cooling off with a big bowl of ice cream.

Stephanie H. Hsu, M.D. Education:
University of Southern California
Masters if Science in Mechanical Engineering and Biomechanics – Los Angles, California – 2005
Medical College of Georgia
Doctor of Medicine – Augusta, Georgia – 2004
Georgia Institute of Technology
Bachelor of Science, Mechanical Engineering – Atlanta, Georgia – 1999
Post-Doctoral Training
Columbia University/New York Presbyterian Hospital
Shoulder, Elbow, and Sports Medicine Fellowship – New York, New York – 2011
Tufts-New England Medical Center Combined Program
Chief Resident in Orthopaedic Surgery – Boston, Massachusetts – 2010

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One Size Doesn’t Fit All! ConforMIS: Personalized Knee Implants

August 31st, 2011

It’s Your Knee. Help Keep It That Way!
Surgical Personalization from ConforMIS performed by Dr. Gary Levengood of Sports Medicine South

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Personal Advantage: ConforMIS implants have a unique advantage: they’re personalized. The ConforMIS approach gives you notably more bone preservation than traditional variations so you’re able to preserve your knee for possible future treatment options. You may also experience faster recovery time and reduced post-operative pain.
ConforMIS personalized implant offers unique advantages versus a traditional knee replacement.

  • Provides Superior Fit Specific To You: Customized implants mirror the surface contours of your knee to help provide greater coverage and implant fit.
  • Preserves Your Future Surgical Options: With less bone cuts, more of your knee is preserved for future, more aggressive solutions if necessary.
  • Restores Your Knee’s Normal Motion: By preserving healthy cartilage, bone and ligaments, your knee is able to to retain more of its natural function.
  • Allows for a Less Traumatic Procedure: Customized instrumentation is built to match your knee, reduce the amount of bone preparation and simplify your procedure.

For more information on ConforMIS personalized knee implants, contact

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“Parent Your Best”…..another way to GET BEYOND BETTER!

August 28th, 2011

The athletic trainers of Sports Medicine South had the great opportunity to spend some time with Jeremy Boone at the NSCA Southeast Regional Conference earlier this month. He presented on the techniques and system for improving the speed and agility of athletes.  Coach Boone not only demonstrated great drills and techniques but also provided a system in which to apply those drills.

That hands-on session was tremendous but what made it even better was his following presentation on how to best create the environment for success.  As parents, coaches and trainers, we all have a major impact on the athletes we work with.  And although we all have great intentions, many of us simply do not plan for this success.  We spend time learning how to get stronger, faster, decrease injuries.  But how do we become better parents?  How do we plan and train to do this?

Coach Boone has produced an educational program that provides those answers.  Sports Medicine South believes in always finding the BEST ways to improve…finding ways in which to not only get you better but get you BEYOND BETTER.  Coach Boone has done this!  Check out this great resource on his facebook page.

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SMS’s PA Travels to Korea with the USA Track and Field Team

August 16th, 2011

Harris Patel, PA, ATC, a Sports Medicine South Physician Assistant and Certified Athletic Trainer, is jet setting off to Daegu, Korea. Daegu (pronounced day-goo) is the host city for the 2011 IAAF World Outdoor Track & Field Championships, and as a member of The USA medical team, Patel will embark on his three week journey to Korea beginning Monday, August 15th.

Although this is his first trip to Korea, Patel is no stranger to the world travels of the USA Track and Field Team.  In fact, he has landed in Bejing, China; Rio de Janeiro, Brazil; Helsinki, Finland; and Sherbroke, Canada as part of the official medical support staff for the USA T&F team. This year, Patel will act as one of only two selected Physician Assistants-Athletic Trainers (PAC-ATC) for team USA. As a country, we will be sending 66 male and 63 female athletes to represent the United States in the World Track & Field Championships. Patel, in conjunction with the rest of the medical team, will work to provide medical coverage, as well as injury prevention and rehabilitation to each athlete. Thorough medical coverage for 129 of the finest USA athletes can lead to long and demanding days. On average, the medical staff will be working 18 to 20 hours daily; however, comprehensive medical support is a vital element in achieving success for both the athlete and, more importantly, for the United States team as a whole.

Although rigorous and performing purely as a volunteer, being selected to serve is an extremely prestigious honor. As Patel says, “It is an honor to represent the USA across the world. We are dressed in red, white, and blue from head to toe, and work as a team to be exceptional American ambassadors. At any world championship, USA athletes from across the nation come together for one purpose and as one team – needless to say, it is in invaluable experience to be a part of.” The USA team, comprised of 19 World Championship-reigning medalists and 16 Olympic-reigning medalists, has a multitude of talent and equally high expectations. The considerable effort and expertise of Harris Patel and the remaining medical staff members will help to ensure maximum athletic performance and achievement for the USA Outdoor Track and Field Team!

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