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Elbow Pain? What Parents Should Know

Posted on: September 1st, 2021

Jason Determann, MD (September, 2021) Fall baseball is back in swing along with elbow aches and pains for young throwers. The throwing motion creates repetitive stress that often leads to a variety of both simple and complex conditions. Understanding the disorders that lead to elbow pain in children may help explain why your little guy or girl starts holding their elbow.

First of all, don’t think you’re alone. Nearly 30% of 8-12 year old baseball players will have elbow pain. That number jumps to 45% by age 14. While tendons and ligaments may be strong, they’re still growing. Growth plates around the elbow are called a physis: cartilaginous connection of immature bone often making up the weakest link that can lead to throwing problems

Little League Elbow

Little League Elbow is one of the most common conditions that affects the pediatric growth plates. Also called medial apophysitis, the inflammatory condition stems from repetitive traction or pull from the muscles and ligaments on the inside growth plate. The inside bump on the elbow will likely be sore to the touch, but should improve with a period of rest, ice, and over the counter NSAIDs such as ibuprofen or naproxen.

Another condition is known as Osteochondritis Dissecans : fragmentation of elbow cartilage and bone due to a repetitious compressive load. Loss of motion and symptoms such as locking or catching in the elbow are usually involved. X-rays are needed to confirm the diagnosis and often MRI is used to determine the severity of cartilage injury.

As children continue to grow, the concern of ulnar collateral ligament injury (UCL) comes into play. This ligament is the primary stabilizer of the inside of the elbow and is needed in overhead athletes. This ligament can get strained, develop partial tearing, or even complete tearing in severe cases. Due to sport specialization at a young age and year-round competition, the incidence of UCL problems in pediatric throwers is rising.

Elbow Injury Prevention

Regardless of the problem, the first step is a simple one: stop throwing! Most elbow pain in children we encounter stems from overuse: the body is telling our child it needs a short break. This break can range anywhere from 2 to 6 weeks, and is often shortened with NSAIDS and physical therapy. Continuing to play or throw through the pain should be avoided to prevent even more serious injury.

In sum, the key treatment to elbow pain in children is prevention. We all share this responsibility. Emphasis should be placed on an adequate warm up and cool down. Additionally, proper throwing mechanics should be taught at a relatively early age and constantly re-evaluated. Most youth leagues, including ours here on the Eastern Shore, have pitch counts per game, week, and season. Adhering to these guidelines is critical to maximizing the health of your child’s arm.

Beat the Backpack Blues

Posted on: August 5th, 2021

Dr. Joanne Baird (August 2021) Can you believe we’re turning the calendar already? Back to school is around the corner. August brings excitement, a busier schedule (especially for parents), a return to academic and sporting activities, heavy backpacks, and computer time. We can still avoid the aches & pains of back to school with thoughtful conditioning and healthy habits!

Conditioning

Injuries often occur when athletes suddenly increase the duration, intensity or frequency or their activities. Before organized sports begin, young athletes should gradually increase activity toward a higher fitness level, especially if out of shape from other summer activities. Proper technique is important, and coaches are great resources in a conditioning plan. In addition, our Gulf Coast temps stay peak-of-summer hot well through August, so staying properly hydrated is critical to preventing heat-related illnesses. Finally, a healthy, well-balanced diet is key in optimizing bodies and brains for a new school year.

Back Pain Prevention

Even with the growth of laptop learning, millions of children each year are walking to school with a backpack full of heavy books and materials. This backpack strain can often impact the back, neck, and shoulder muscles. Usually, the discomfort is short-term but heavy weight to the back can produce lingering issues.

Distort the natural curves in the middle and lower backs, causing muscle strain and irritation of the spine joints and rib cage.
Lead to rounding of the shoulders.
Cause a person to lean forward, reducing balance and making it easier to fall.
Habitually carrying backpacks over one shoulder will strain muscles to compensate for the uneven weight and the spine will lean to the opposite side. This muscle imbalance can cause muscle strain, spasm, and back pain.

A smart guideline is to limit the weight of the backpack to 10-15% of your child’s body weight. Usually, pain will diminish with a period of rest, and there is no evidence backpack use can lead to permanent injury or structural spinal deformity.

Helpful Hints to Prevent Backpack Strain

Choose a pack with lightweight material (nylon vs leather), padded back, wide (2-inch adjustable shoulder straps and individualized compartments.
Help distribute weight from shoulders with a hip strap or waist belt.
Consider a separate bag for the laptop or heavy electronics.
Use both shoulder straps and wear the backpack on the back rather than over one shoulder.
Pack the heaviest objects into the backpack first so they are carried lower and closest to the body and distribute the load between compartments.
Lift the backpack using the leg muscles, keeping close to the body.
Try not to lean forward when walking. If this is necessary, it’s time to lighten the load.

In sum, what’s the backpack bottom line? If your child complains of discomfort, reduce the weight. Have them carry only what is necessary and encourage frequent trips to the locker during the day. Back to school brings enough butterflies…without aches and pains, too!

*for more information: AAOS/orthoinfo.org

Youth Sports? Best to Mix it Up

Posted on: April 6th, 2021

Joey F. Carter, MD

(April, 2021) Need a sure sign of spring? You’ll find it on Saturday mornings at the ballpark and soccer fields these days. Some of these young athletes may be playing not just during a traditional season but year-round, with club travel leagues starting as early as 7. But is sports specialization in children a healthy choice?

What is Sports Specialization?

The past twenty years have brought a significant shift from unstructured free play and school-based sports to what’s called “sport specialization.” The numbers are astounding: close to 30 million children between the ages of 6 and 18 and close to 60 million in organized programs are participating in year-round sports.

Conventional wisdom may lead us to think kids will fall behind their peers if not putting in the “10,000 hour rule” of practice making perfect. But the growing intensity of this early specialization may lead to more harm than good. The American Orthopaedic Society for Sports Medicine * has found the trend alarming enough to define a list of risk factors associated with overuse injuries in young athletes.

Know the Risk Factors for Overuse Injuries

Participation in intense training and/or competition in their sport more than eight months per year.
Participation in one sport to the exclusion of others or free play.
Playing their sport for more hours per week than their age.

Do any of these hit close to home? Overuse injuries we see in young athletes include knee disorders with soccer, basketball, and volleyball players. Shoulder injuries include “Little League Shoulder” due to repetitive pitch counts for pitchers and the intensity of throws catchers must make during a game. “Little League Elbow” often results from high-throwing volume. Racket sports and gymnastics also fall into the year-round sport specialization/overuse injury loop.

Mix it Up – and Don’t Forget Free Time Too

Finding the right balance in training and competition is a tough topic for coaches and parents, who may feel pressured to keep up… and keep their child’s spot on the team. Clearly, our children find enormous benefit from individual and team sports – with physical development, socialization, teamwork, and a strong work ethic. But too much of a good thing also leads to psychological burnout and loss of motivation. What’s the answer? Limit practice, ensure plenty of rest, and keep it fun! Mix up other sports, and find time for free play, too. We all want our children to succeed on the field of play – without preventable injuries.

*www.sportsmed.org.

Ankle Pain? Don’t Tough it Out.

Posted on: March 29th, 2021

Joanne M. Baird, MD

(February 2021) Training for early spring sports unfortunately brings some quite common injuries. We see ankle strains and sprains in children and teens whether from overuse, lack of conditioning, or just because they are back on the field of play again!

What Sports Produce the Most Strains?

Ankle sprains are common, especially in sports that involve cutting like soccer or lacrosse. In addition, these ankle-impacting sports usually involve uneven ground. A sprain occurs when the strong ligaments in the ankle stretch beyond their limit and tear.

Most ankle sprains are minor and will heal with home treatment including rest, ice and elevation. If serious swelling and pain make it too painful to walk, seek medical attention. Severe sprains that are not properly treated early on and rehabilitated appropriately can potentially weaken the ankle and make it prone to reinjury.

How Do I Know if I Have an Ankle Sprain?

The lateral ligaments on each side of the joint are impacted in ankles strains and sprains as the foot or ankle twists unexpectedly. We grade sprains on the amount of tearing, from mild and microscopic to high ankle sprains that may require surgery.

Symptoms:

Swelling
Bruising
Tenderness to the touch
Instability – when there is a complete tear of the ligaments
May hear or feel a “pop”

A severe sprain may feel much like a fracture or broken bone, and you should have a physician examine the ankle as soon as possible. How much can you move? Where is it tender? A physician may call for X-rays to rule out a fracture.

How Do I Treat a Sprained Ankle?

Most ankle strains and sprains are treated successfully without surgery – even a complete tear. Home treatments include the RICE protocol:

R = Rest your ankle by not walking on it. Crutches may be recommended for a few days.

I = Ice immediately to help with swelling. Use 20-30 minutes, three to four times a day, do not apply ice directly on the skin.

C = Compression dressing with bandages or ace wraps to immobilize and support the ankle.

E = Elevate the ankle above the level of the heart as often as able in the first 48 hours.

Non-steroidal anti-inflammatory medications, like ibuprofen or naproxen, can help alleviate pain and swelling. For moderate or severe sprains your doctor may recommend a removable boot or air-cast and sometimes a cast may be recommended. Physical therapy and rehabilitation exercises are important to prevent stiffness, improve strength and prevent chronic ankle problems. Balance training – or proprioception – will ensure a steady return to action. No need to just grin and bear it– we’re here to help!

Bone Health for a Lifetime

Posted on: January 28th, 2021

(February, 2021) As parents, we all want our children to be happy and healthy, both now and when they are adults. Typical advice sounds something like “eat a healthy diet and get plenty of exercise.” While completely true, some of us might need a little more instruction! Bone health in children starts far earlier than you might imagine, and is essential to preventing fractures in the future.

When Does Bone Health Begin?

Bone health begins in childhood and is essential through adolescence. Research shows that building bone mass early reduces the risk of osteoporosis later in life. This common disorder leads bones to become very fragile and more likely to break. Older adults with osteoporosis are most vulnerable to breaks in the wrist, hip, and spine. These fractures can seriously limit mobility and independence. We reach peak bone mass by our 20’s, meaning we need to invest in bone health well before then with three important variables:

Calcium

Calcium is a mineral required to build and maintain strong bones. Because our body cannot make calcium, we must get it from the foods we eat. If we don’t ingest enough, the gradual loss of calcium from our bones makes them weak.

Good Sources of Calcium:

Dairy products like milk & yogurt
Leafy vegetables like kale & broccoli
Calcium-fortified foods like cereals & juices

Sweetened carbonated beverages can decrease the body’s ability to absorb calcium – another reason (as your dentist agrees) to avoid sodas. Reaching the healthy calcium target of 1300mg a day would require 1 cup of yogurt, milk, orange juice, and cereal plus 1 slice of cheese every day. Is your child packing that much in? If not – consider an over-the-counter calcium supplement. Typical multivitamins don’t contain enough.

Vitamin D

Vitamin D ensures our body can absorb calcium in our intestine. Children develop brittle and bowed bones – or rickets – when the body is short on Vitamin D. Despite the name, Vitamin D is technically a hormone, because our body can make it when exposed to sunlight. Some studies suggest 10-15 minutes of sun exposure without sunscreen several times per week. Of course, the need for sunscreen and cold weather can make that sunshine goal a challenge. Fish and fortified milk are the best sources of Vitamin D in food, but your child is likely not getting enough. Optimal Vitamin D takes 100 IU in 1 cup of milk. If your little one is drinking less than 4 cups per day and not spending much time outdoors, consider supplementing with 400 IU of Vitamin D in common multivitamins.

Exercise

Get moving! Kids need at least 35 to 60 minutes of physical activity every day. Bones respond to this exercise by building more bone. Besides the bones, staying active is good for the heart and lungs, decreases obesity and improves overall mental health. How to get kids off the video games and outdoors?

Make it fun! Consider a team sport, racquet sport, dancing, skating, hiking or just playground time
Be a role model and plan activities together like a family walk
Look for toys that require physical activity

Here’s a breakdown on just what we need at each age. If you’re over 50 and concerned about your own bone health, consider an evaluation with our Bone Health Clinic. Own your bones early! Your body will thank you later.

Age Group	Recommended Daily Calcium (mg)	Recommended Minimum Vitamin D (IU)
1-3	700 mg	600 IU
4-8	1000 mg	600 IU
9-18	1300 mg	600 IU
19-50	1000 mg	600 IU
51-70 (Men)	1000 mg	600 IU
51-70 (Women)	1200 mg	600 IU
71+	1200 mg	800 IU

*American Association of Orthopaedic Surgeons

Knee Pain and the Female Athlete

Posted on: November 14th, 2020

By Joanne Baird, MD

(November 2020) Amidst this ongoing pandemic, fall sports are back in full swing. With the disruption of our routine training and activities during the last several months, we are seeing an unfortunate increase in injuries in our athletes across all age groups. Knee pain in female athletes is especially common.

What Kinds of Knee Pain are There?

Anterior knee pain is one of the most common complaints with one of every ten musculoskeletal patients to our office. Adolescent anterior knee pain often occurs in healthy athletes, and can be extremely common in females. Typically athletes complain of pain in the front of the knee, usually underneath the kneecap (patella). Pain more distally (upper shin bone area) or proximally (lower thigh) are different conditions related to the tendons or secondary growth centers (apophyses) of the leg including quadriceps or patella tendinitis or Jumper’s Knee, Osgood Schlatter Disease, or Sinding-Larsen-Johansson syndrome.

Adolescent anterior knee pain is particularly common after changes in training routine without adequate stretching or strengthening. Fortunately, there is usually no physical abnormality and in most cases it will improve with simple treatments.

What are the Symptoms of Anterior Knee Pain?

Dull, achy activity-related pain that begins gradually
Popping when climbing stairs or standing from sitting
Pain at night
Pain during activities that involve repeated knee bending (jumping , squatting, running, weight-lifting)

What to do? If your knee pain will not go away after and interferes with activity, see your doctor to examine the knee and rule out other problems with X-ray and potentially MRI if internal joint problems are suspected.

How do I Treat Anterior Knee Pain?

Stop and limit the activities that make your knee hurt until the pain goes away
Change training routines
Pursue low-impact activities that put less stress on the knee joint (biking, swimming)
Weight loss may help if overweight
Change training techniques with the guidance of a certified trainer or physical therapist
Gradually return to higher impact sports and activities

athlete in physical therapy for knee injury

Physical therapy exercises may be recommended to help improve your range of motion, strength, and muscle endurance. Additionally, ice may relieve discomfort after activities and over-the-counter nonsteroidal anti-inflammatories such as ibuprofen and naproxen may help alleviate pain .

In sum, knee pain in female athletes is common but preventable and usually improves with simple treatments. Make sure to condition muscles with changes to training and activities to keep the pain at bay. Whether evaluation, treatment or physical therapy is needed – we’re here to help.

* American Academy of Orthopaedic Surgeons: orthoinfo.org

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.

The Limping Child

Posted on: March 29th, 2020

Gregg Terral, MD

(May 2019) Limping is a common complaint that prompts parents to seek medical attention for their child. Usually the limp is caused by minor injury that will get better by itself. However, limping that last longer than a week and that is not improving may indicate a more serious condition requiring medical evaluation. The challenge for both the parent and the physician involve the difficulty in young children at describing their symptoms as well as with older children trying to play through their pain even when it is not safe. As a parent, it’s important to understand a limping child.

What is Causing My Child to Limp?

Injury:

Minor injuries such as contusions, low-grade sprains and strains will resolve quickly. Pain and limping related to more serious ligament sprains and muscle strains as well as traumatic and stress fractures will however persist.

Overuse injuries:

Overuse injuries to various sites of growth can also occur – typically the heel, mid foot, leg, kneecap, as well as the pelvis. These causes of pain fall under the general diagnosis of apophysitis. Patella maltracking as well as patella tendinitis or jumpers knee may also be a concern.

Infection and inflammatory disease:

Viral and bacterial infections can settle in growing bones and adjacent joints causing significant pain at times. Several types of inflammatory disease such as juvenile arthritis can also be a cause.

More Serious Issues Behind a Limp

Other less common causes of leg pain or limping can be related to congenital abnormalities such as a congenital hip dislocation or congenital foot deformities

Legg-Perthes disease is caused by insufficient blood supply to the hip, leading to a flattening of the ball within the ball and socket joint of the hip. This condition usually occurs between the ages of 4 and 10 in otherwise healthy children.

Slipped capital femoral epiphysis occurs just before puberty and is a slippage of the growth plate within the hip socket.

Diskitis is an inflammation of the disc spaces within the spine which can also cause painful limping.

Nervous system disorders create a problem with the nerve signals that control walking. Disorders of the nervous system can cause weakness or tightness in the muscles which can also cause a child to walk differently.

Tumors of various types can grow into bone and soft tissue and cause pain locally.

A thorough history and physical exam by your physician accompanied by appropriate imaging which may include studies such as x-rays, ultrasound, bone scans, MRI, or CT scan can readily provide a diagnosis. Occasionally bloodwork will also be needed to make the appropriate diagnosis and develop a treatment plan.

If your child has an issue lasting more than a few days, we’re here to help.

https://orthoinfo.aaos.org/en/diseases–conditions/the-limping-child/

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 joint reconstruction.

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

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.

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