Author Archive

The Doctor Is In

Posted on: March 18th, 2021

Joanne Baird, MD talks orthopaedic issues unique to women during pregnancy and early motherhood  – with Devon Walsh on WKRG’s “The Doctor is In” (March 2021)

Watch Video: The Doctor Is In

https://www.wkrg.com/the-doctor-is-in/the-doctor-is-in-orthopaedic-issues-during-pregnancy/

My Child’s Back Hurts – What’s Next?

Posted on: July 29th, 2020

by Jason Determann, MD

(August, 2020) While more common in adults, pediatric low back pain is almost equally prevalent in younger patients. Common causes include a variety of diagnosis; from muscle strains to scoliosis to disc problems. A pertinent history and physical exam can rule out most serious causes of low back pain. In most cases of nonspecific back pain, home-based exercise, physical therapy, and anti-inflammatory drugs can fix the problem.

Is That Heavy Backpack to Blame?

Does carrying a heavy backpack lead to back problems? Short answer is no. Nonspecific pediatric low back pain seems more influenced by psychosocial difficulties, conduct issues, and somatic disorders than it does mechanical problems, such as carrying a heavy backpack or long-term computer use. Nonetheless, the American Academy of Pediatrics recommends backpacks not to exceed 10-20% of the child’s body weight.

What to Ask Your Child About Their Pain

As a parent, the first step is asking your child to try to characterize the pain. Where is it located? When did it start and how long as it been going on? Is it constant or intermittent? What makes it better or worse? Also try to think if there any other symptoms that coincide with the onset of pain – fevers, poor appetite, weight loss or other symptoms that may or may not be related to your child’s aching back.

Acute back pain can be caused by muscle strains, herniated disks, and spondylolysis (a stress fracture or defect in the arch of the vertebral bone.) Chronic conditions can include inflammatory conditions, alignment problems (such as scoliosis or Schermann’s kyphosis.) Systemic symptoms can be associated with some rare causes of back pain, such as tumors or infections.

When to Seek Help

It is recommended that you schedule an appointment with your child’s healthcare provider if any of the following are present:

  • < 4 years old
  • Systemic symptoms (fever, malaise, etc.)
  • Nighttime pain
  • Neurologic symptoms (pain radiates into legs, numbness, etc.)
  • Self-imposed activity limitations

With a physical exam, we consider spinal alignment and mobility, tenderness, and neurological aspects.  Standard x-rays may be performed to help rule out any bony problem associated with your child’s condition. Depending on those results, bloodwork and other analysis may be involved.  Not all pediatric low back pain involves this level of diagnosis, but serious conditions do exist. We’re here to help sort things out.

https://orthoinfo.aaos.org/en/diseases–conditions/back-pain-in-children/

Dr. Determann received his MD from Louisiana State University in New Orleans, followed by residency in Orthopaedic Surgery at the University of Alabama in Birmingham.  He is Board Certified and Fellowship Trained in Sports Medicine with a specialty in Shoulder & Elbow Surgery.

Teach us to Number Our Days….

Posted on: June 29th, 2020

by Albert Jay Savage IV, MD

(July 2020) I dare say that you have not been reading this edition of Eastern Shore Parents the way that you thought you would a few months ago.  This time of year is normally filled with anticipation of summer camps and activities and travel plans.  And, while those things are not completely out of the question, we are all trying to adjust to the “new normal” … my family included!

When this all started back in March (yeah, I know … it feels like longer) one of the first questions we asked ourselves as a group was how we were going to take advantage of this time to challenge ourselves in new areas.  One of those that I hope you as parents were able to take advantage of was a Facebook Live series that we titled “Homeschool Rocks with the Bone Doc”.  Suzanne Crawley, PA-C and I had so much fun for 6 weeks giving online lessons about the skeleton, bone health, muscles, tendons and ligaments, and one day we even played with some power tools!

For us, this was a way to try to use our time to give some educational content to you guys as we were all stuck at home.  And even now, on rainy or just plain hot summer days that lie ahead, if you are looking for something educational and hopefully funny and entertaining for your children, then you can access those video lessons on our practice Facebook page. 

For some really well done educational content, I would also point you to a couple of resources on YouTube from ”Nemours KidsHealth” and “Operation Ouch”.  Each of these inspired much of our content. Another wonderful educational website called “BrainPop” is also offering free access to their entire content.  They have great material on health and the human body, but also many other topics that kids would enjoy.

Finally, I want to encourage everyone that if you are successful in getting your family to spend some time continuing to learn and find new things that interest them during this time, you are doing a great job.  Keep up the good work.  This time isn’t just a crisis for us to manage our way through, but one to find new ways to thrive in.  We can do it if we share our successes, and even our failures, with one another. We all have a certain number of days to be parents and we don’t get that time back, even though it feels like this pandemic owes us one!

So as the psalmist wrote years ago and it still rings true today, “Teach us to number our days, that we may get a heart of wisdom”. 

Dr. Savage received his MD from the University of Alabama at Birmingham, followed by residency at the UAB Department of Orthopaedic Surgery.  He is Board Certified and Fellowship Trained in Sports Medicine

Parents – Make Your Own Health a Priority for the New Year

Posted on: February 29th, 2020

Jennifer Firestone, MSN, CRNP, FLS

(January 2020) A New Year likely finds you getting kiddos back in the school swing, planning spring sports and more. Where is your own health on that 2020 to-do list?  Parents – especially Moms – often bump themselves down the priority chart.   

As part of our Bone Health Clinic team, I work with patients every day suffering fractures, fragility and the other challenges of osteoporosis.   And it might surprise you to know the exercise habits of your late 20’s -40’s determine whether you’ll be a patient of ours years later. Bone health begins to diminish in our 30’s, if we’re not taking healthy steps to prevent it.

Weight bearing exercises build bone strength, and should be part of an overall routine that’s fun and not too tiring. Burnout and boredom can be the first culprits to a fresh fitness plan. So mix it up with indoor and outdoor options, set a goal like finishing a 5K run and stick with it!

Once you find an accountability buddy and get ready to roll, consider a few tips for a safe and healthy routine.  Don’t buy into the “no pain no gain” notion that exercise should be difficult to be beneficial. Normal muscle soreness fades in 24-48 hours. If you’re experiencing real pain, it should be checked out.

weight bearing exercise is key to bone health

Tips for A New Exercise Routine

  • Ensure Proper Equipment.  New running shoes? Make sure they’re comfortable, supportive and won’t cause calluses or blisters.   Test new exercise gear in the store.
  • Choose a Balanced Exercise Regimen. The best routine includes aerobic exercise, strength training, and flexibility.  The American Heart Association recommends 30 minutes of moderate-intensity aerobic activity at least 5 days per week for maximum heart health.  
  • Always Warm Up.   Warming up increases your heart rate and blood flow, which loosens up muscles, tendons, and ligaments.  
  • Be Sure and Stretch.  Stretching – at the end of your workout – helps our range of motion, how well we move, and limits muscle soreness as well as risk of injury.   
  • Take Your Time.  Strength training is good for muscles and bones – move slowly through the entire range of motion.
  • Stay Hydrated. Water is key!  Drink 16 ounces of water 15 minutes before and just after your workout during cooldown.
  • Cool Down.    Take twice as long cooling down as you did warming up – gradually lessening intensity for the final ten minutes of your workout.

Hit those new fitness goals gradually – and keep going.   The benefits of exercise begin to diminish in two weeks and completely disappear in 6-8 weeks.  Track your progress, prevent injuries, and pat yourself on the back.   Healthy bones depend on overall fitness. Wishing you a well and wonderful New Year!

Jennifer Firestone received her Bachelor of Science in Nursing from Jacksonville State University followed by her MSN from the University of Alabama at Birmingham.  With a specialty in aging, Jennifer is part of Bayside Orthopaedic’s Bone Health Clinic team – creating personalized treatment plans to reduce the overall fracture risk, accelerate healing, prevent subsequent fractures and break the fragility cycle.

The Truth about Growing Pains

Posted on: January 29th, 2020

Dr. Jason Determann

Has your young one ever complained of general aches and pains… that have you stumped? The phenomenon we call “growing pains” is one of the most common causes of recurrent musculoskeletal discomfort in children. First described by a French physician in the early 1800s, we have spent nearly two centuries trying to get a better grasp on the exact cause and best treatment for such a common problem.

What Exactly are Growing Pains?

So what are growing pains?  The syndrome is described as intermittent pain, usually in the lower extremities, that occurs late in the day or early evening. The pain is typically gone in the morning and not worsened by physical activities. Discomfort with growing pains usually begins between the ages of 3 and 6, with the average age around 8 years old. Despite the coined term “growing pains,” there’s no direct connection to rapid growth.

The search for a cause hasn’t been completely successful.  Theories include:

  • generalized hyperlaxity (loose ligaments,)
  • psychological stress that leads to somatic symptoms
  • deficiency in blood flow
  • low vitamin D levels
boy having back examined

How Do I Know if Growing Pains are Something More?

The diagnosis is one of exclusion. Simply stated, “Everything checks out OK.” A few highlights:

Characteristic Typical Findings
Pain Location Bilateral
Lower Extremity (calves, thighs, shins)
Timing/Onset Late afternoon/evening
Resolution by morning
Intermittent
Not activity related
Severity Improves with massage, over the counter analgesics Does not increase in severity over time
Physical Exam Normal

The first thing we’ll do is look at a full medical history with a thorough physical exam to determine any other potentially serious causes of pain.  That might include fever, malaise, or decreased appetite. If your child can’t put their weight on a leg or has an altered gait (walk), we’re dealing with something beyond growing pains.  Any recent viral illnesses, rashes or travel are clues to alternative diagnosis as well.

If the physical exam is normal, we typically don’t need any further workup to make the diagnosis.  X-rays or bloodwork may be ordered to rule out a more serious condition. These can  include developmental abnormalities, infections, growth plates conditions, or even a remote injury or trauma.

What Relieves Growing Pains?

When the diagnosis of growing pains is made, often reassurance is the only treatment rendered. Some studies have found benefit to stretching the quadriceps, hamstring, and calves. Most children get relief with massage to the areas of pain, as well as the addition of heat. Over the counter medications such as acetaminophen or ibuprofen can alleviate some the pain and discomfort.

At the end of the day, the term “growing pains” describes a specific, benign pain syndrome in young children.   Even though we still don’t know much about the underlying causes, there’s no need for long-term concern.   If you have any doubts whatsoever – we’re here to help you sort it out.

“Though he may stumble, he will not fall. For the Lord upholds him with His hand.”  Psalm 37:24

Jason R. Determann, MD

Dr. Determann received his MD from Louisiana State University in Baton Rouge, followed by residency in Orthopaedic Surgery at the University of Alabama in Birmingham.  He is Board Certified and Fellowship Trained in Sports Medicine with a specialty in Shoulder & Elbow Surgery.

Sport Specialization: Is it Safe? Is it Necessary?

Posted on: December 29th, 2019

Albert Jay Savage IV, MD

(June 2020) Youth sports have surged across the country, and a weekend drive around Eastern Shore ballparks proves we’re part of that trend.  By all accounts, the physical, mental and emotional benefits of individual and team sports are well documented.  From a sports medicine perspective however, this boom in youth sports has raised some alarm:   increasing “sport specialization” at a young age means an increase in youth sports overuse injuries, too.

Doesn’t My Child Need to Focus on One Sport?

Sport specialization has been defined as “year-round intensive training in a single sport, at the expense of other sports.”  Some parents reading this may be skeptical , as conventional wisdom suggests young athletes determined to “up their game” as they age will fall behind if not working consistently on their skills.    However, a quick dive into current research reveals some surprises:  (1) most players in Division 1 athletics did not pursue early specialization, (2) baseball pitchers from colder climates that do not throw year-round tend to excel over those from warmer climates, and (3) early specialization may actually decrease the likelihood that an athlete will reach an elite level.

Furthermore, studies find overuse injuries consistently linked with the following risk factors: (1) a high level of sports specialization, (2) playing their sport for more than 8 months of the year, and (3) playing their sport for more hours per week than their age. 

child throwing baseball

Tips to Prevent Youth Sports Overuse Injuries

Most overuse injuries can be prevented with proper training and common sense.

  • Learn to listen to your body and listen to what kids are telling you.
  • Remember that “no pain, no gain” does not apply here. 
  • These young athletes are not just little adults.  They have growing bones and soft tissues and are susceptible to different types of injuries.
  • Follow the 10 percent rule. In general, you should not increase your training program or activity more than 10 percent per week. This allows your body adequate time for recovery and response.

From a parent’s perspective I want my kids to enjoy playing sports –and to soak up the character traits and teamwork skills that healthy competition offers.  From my former athlete perspective, I know the value of hard work in reaching their greatest potential.    But all of us as parents can agree in the goal of safety first and foremost. Nothing is achieved when our children are sidelined with preventable injuries. 

The debate over single sport injuries is likely to grow along with the options and enthusiasm for youth sports overall.  I encourage parents and coaches to learn more – some great resources can be found at the American Orthopedic Society for Sports Medicine website, www.sportsmed.org.

Dr. Savage received his MD from the University of Alabama at Birmingham, followed by residency at the UAB Department of Orthopaedic Surgery. He is Board Certified and Fellowship Trained in Sports Medicine.

Enjoy Alabama’s Great Outdoors – Safely!

Posted on: November 29th, 2019

November marks fall and all its outdoor glory in full swing, with cooler weather at long last here in South Alabama and plenty of outdoor pursuits filling up weekend calendars.  Hunting is one of those fall pastimes that allow families and friends to get together and get outside to appreciate nature.  Whether dove, deer season, fishing or hiking is your plan; Alabama offers thousands of acres of public and private lands to enjoy.   From tree stands to firearms to ATV’s, there are several safety tips to keep in mind: 

If hunting with family or friends:

  1. Know your target and what is beyond it.
  2. Attend a hunting safety course.
  3. Make sure all guns are safe to operate.
  4. Don’t mix cartridges from different calibers.
  5. Wear ear and eye protection.
  6. Store guns so that they are inaccessible to unauthorized persons.
  7. Understand that some guns and activities require additional safety precautions.
  8. Do not use alcohol and be aware of drugs that might impair your ability to safely handle a firearm or weapon safely.

 *NRA Family

You might be surprised how many injuries we see in the orthopaedics field – especially in the early days of the season when hunters may be out of practice in the “ups and downs” of climbing a tree stand.   Twisted ankles, shoulder injuries or broken bones from a fall can happen in a flash.  Alabama Fish and Wildlife recommends before you hunt:

  1. Know your equipment which includes checking your stands, straps, and chains every season and replace them as needed.
  2. Select the right tree:  straight, the correct size for your stand, avoiding smooth barked trees, and check for insect nests.
  3. Wear a full body safety harness, know how to use it properly, and wear it at all times.
  4. Use a haul line to raise and lower your equipment.
  5. Make sure your weapon is unloaded while raising and lowering in your stand.
  6. Have emergency equipment available: knife, cell phone, and flashlight.

Off road recreational vehicles are often essential in exploring and accessing hunting grounds, and come with their own potential risks.  Protective head gear, eye wear, appropriate sizing and training are a must. Safety courses are a smart idea – and available through ATV dealers or the ATV Safety Institute.

We’re fortunate to live in a place with ample opportunity to get outdoors and up close to wildlife and nature.  All of us here at Bayside Orthopaedics care about your health whether on the field of play… or in the field… literally! Get out there – but do so safely.

Joey F. Carter, MD

Dr. Carter received his MD from the University of Mississippi School Of Medicine in Jackson, MS. He is

Board Certified in Orthopaedic Surgery and a Fellow of the American Academy of Orthopaedic Surgeons.

A Repetitive Problem – The One Sport Injury

Posted on: October 29th, 2019

Gregg Terral, MD

( August 2019) Summer break is over, kids are back in school and fall sports are in full swing from elementary to high school. With more and more young athletes under 12 focusing on just one sport and training year-round, we’ve seen a growing number of our younger patients with what’s called a “one sport injury” caused by repetitive movements.  The condition is called apophysitis.   

What Causes the One Sport Injury?

The apophysis is a growth plate that provides an attachment site for a muscle to attach to bone via a tendon. Apophysitis occurs due to repetitive or chronic traction at either the origin or insertion site. This is because the growth cartilage present in this younger age group is the weak link in the muscle-tendon unit and is prone to injury. Continuous stress can lead to injury with pain and swelling.

The knee is the most commonly seen site of apophysitis where the patellar tendon attaches to the upper tibia. Other common sites are the Achilles tendon at the heel, the lower part of the kneecap, the outer side of the foot), the inner elbow (Little League elbow), and shoulder (Little League shoulder). Runners, sprinters, and soccer players are especially prone to locations in the pelvis causing hip or groin pain.

child throwing baseball

Among athletes between the ages of 5 to 14, overuse injuries impact:

  • 27% of football players
  • 25% of baseball players
  • 22% of soccer players
  • 15% of basketball players
  • 12% of softball players *                                   
  • *American Academy of Orthopaedic Surgeons

How Can We Treat Overuse Injuries?

We treat all types of apophysitis with a period of rest, ice, activity modification, and potentially physical therapy depending on the condition severity. Depending on the location, a variety of straps, braces, and orthotics can aid in providing comfort, protection and stabilization of the involved site. Healing time varies from a few days to weeks or months depending on a patient’s willingness to rest and avoid contributing activities.

What Parents and Coaches Can Do

  • Have a pre-season wellness check to determine any health concerns that could lead to injury
  • Warm-up and cool-down before and after athletic activities
  • Use correct sport specific equipment
  • Train in proper techniques like throwing or running
  • Hydrate!  Drinking plenty of water maintains health and minimizes cramps
  • Play different positions or sports throughout the year to minimize overuse injury risk
  • Don’t  play with pain – allow time to rest and heal

Keeping those growing bones, joints and muscles healthy ensure the ultimate goal: a healthy lifetime love of sports, too.

Dr. Terral received his MD from Louisiana State University Medical Center in New Orleans, followed by residency in the Department of Orthopaedic Surgery at the University of Mississippi Medical Center in Jackson, MS.  He is Board Certified and Fellowship Trained in numerous specialties including trauma-related musculoskeletal injuries and joint reconstruction.

Dr. Gregg Terral Performs 100th Mako Joint Replacement Surgery

Posted on: October 24th, 2019
Gregg Terral, MD (right) performed the first Mako-assisted joint replacement in Baldwin County. South Baldwin Regional Medical Center recently added a second Mako robot.

(Foley)  Sixteen months after performing the first Mako robot-guided joint replacement surgery in Baldwin County, Dr. Gregg Terral marked his 100th surgery this month.  The 3D virtual model of a patient’s unique joint offers a revolutionary capability for customized joint replacement making lengthy, painful recovery a long-gone experience.

South Baldwin Regional Medical Center partnered with Bayside Orthopaedic Sports Medicine and Rehab Center in launching the robot-arm assisted joint procedure in May, 2018.  A significant leading-edge investment for SBRMC, Mako is a $1 million system designed for total hip and total or partial knee replacement.

Terral is a board-certified and fellowship-trained orthopaedic surgeon specially trained in the robotic arm. Dr. Jay Savage and Dr. Jason Determann of Bayside Orthopaedic have teamed with Terral to perform 256 of South Baldwin’s 359 surgeries to date.

“It’s been very rewarding to see my patients return to the lives they’ve enjoyed before arthritis so quickly, and with much less pain with the Mako process,” said Terral. “Every knee is different. Until we had the precision of a robot arm and customized model, we would typically make the cut and work with what we had.  The unexpected would often made procedures tougher, with more tugging and pulling. The precision now reduces the potential for complications, and we’re in and out quickly – that’s always better for the patient.”

The robotic arm uses CT-based 3D modeling of bone anatomy to identify the implant size, orientation and alignment based on the individual patient’s unique anatomy. The technology is able to help administer microscopic, precise cuts and measurements during surgery and even change the plan mid-procedure, if needed.  The robotic arm can position the cutting tool to the exact degree of cut needed, an impossible task with human hands.  “We’re in control of the tool at all times, and can stop at any time. It only does what we tell it to do and so far it’s been perfect.”                                               

For more than 40 years, Bayside Orthopaedic Sports Medicine & Rehab Center has provided Baldwin County’s most comprehensive leading-edge orthopaedic care.  Our fellowship-trained and board-certified doctors have extensive specialization in joint replacement, fracture care, sports medicine and physical therapy.  Founded in Fairhope in 1977, the practice today includes on-site rehabilitative care, a Bone Health Clinic, and additional offices in Foley, Gulf Shores and Brewton.     We’re committed to the wellness of body, mind & spirit in restoring patients to active, healthy lives.

WKRG’s The Doctor is In

Posted on: October 24th, 2019

WKRG’s The Doctor is In – featuring Dr. Jason Determann discussing shoulder pain and its causes September 13th.

THE DOCTOR IS IN: Dr. Jason Determann with Bayside Orthopaedic Sports Medicine and Rehab is talking about shoulder pain and sports injuries. Ask him your questions now!

Posted by WKRG on Friday, September 13, 2019

Watch Joshua Wing with the Bayside Orthopaedic Bone Health Clinic – June 7th on The Doctor is In .