Archive for the ‘News’ Category

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

  1. Participation in intense training and/or competition in their sport more than eight months per year.
  2. Participation in one sport to the exclusion of others or free play.
  3. 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!

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/

Welcome Dr. Joanne Baird and Dr. Trevor Stubbs!

Posted on: November 15th, 2020

(November 2020)   Bayside Orthoapedic Sports Medicine & Rehab Center is proud to welcome sports medicine fellowship trained orthopaedic surgeons Joanne Baird, MD and Trevor M. Stubbs, MD.  

Dr. Baird was a Lieutenant Commander at Naval Hospital Pensacola where she served as Department Head of Orthopedic Surgery before joining Bayside Orthopaedic this fall.   The New Jersey native completed her undergraduate education at The College of William and Mary with a major in Biology and recognition as a scholar/athlete. Dr. Baird earned her MD from Georgetown University School of Medicine in Washington, DC, followed by service in the US Navy.

She completed her internship and residency in Orthopaedic Surgery at the Naval Medical Center in San Diego, California, including two years deployed onboard the USS GERMANTOWN (LSD 42).  Extensive training in combat care and surgery, leadership roles and achievement during her 12-year military medical career earned LCDR Baird multiple awards including the Naval Commendation Medal for sustained acts of heroism or meritorious service in 2019.   In 2018 she was recognized as one of the top 100 physicians in the Northwest Florida region for patient satisfaction.   

Dr. Baird recently completed a Sports Medicine Fellowship at the Andrews Institute in Gulf Breeze, Florida in 2020. She specializes in sports injuries including thrower’s shoulder and hand injuries as well as arthroscopic joint treatment.   Dr. Baird is Board Certified in Orthopaedic Surgery and a member of the American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, Orthopaedic Trauma Association and Society of Military Orthopaedic Surgeons.

In her free time, you will find her running, playing golf, painting and raising new daughter Ryann with husband Chaz at home in Pensacola, FL.  

Dr. Stubbs recently completed a fellowship in Sports Medicine at Lenox Hill Hospital in New York City. During fellowship, he had specialized training in the arthroscopic procedures of the shoulder, elbow, knee, hip, and ankle as well as cartilage restoration. In New York, he served as an assistant team physician for the New York Jets and New York Islanders hockey team.

The Louisiana native completed his undergraduate education at Louisiana State University where he majored in Biochemistry. He earned his MD from Louisiana State University Medical School in New Orleans where he was inducted into the AOA honor society. Dr. Stubbs then moved to Alabama to complete a residency in Orthopedic Surgery at the University of Alabama at Birmingham.

He is a member of the American Academy of Orthopaedic Surgeons, the Alabama Orthopaedic Society, the Arthroscopy Association of North America, and the American Orthopaedic Society for Sports Medicine.

Dr. Stubbs enjoys treating patients of all ages, including new injuries or chronic problems. He and his wife Megan met during their time at LSU and are the proud parents to son AJ. You’ll find him on the sidelines in the fall as team physician for the Robertsdale Bears.

Dr. Baird and Dr. Stubbs will be seeing new patients in our satellite clinics in Foley and now Gulf Shores.   

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

Know the Warning Signs for Heat Stroke

Posted on: November 2nd, 2020

By Trevor Stubbs, MD

(September 2020) With the normal summer sports routines affected by the COVID-19 pandemic, our children are more at risk for injuries during this upcoming season. Chances are your young athlete had few practices or team activities, so will be returning to the field with less flexibility, strength, and conditioning than they’ve enjoyed in the past.  Unfortunately, parents and coaches are likely to see more injuries like pulled hamstrings or ankle sprains. But they may face even greater health risks – from the thermometer. Heat stroke can be a nearly year-round challenge here in the deep South.

What Kinds of Heat-Related Illnesses are There?

Heat-related illnesses are a spectrum of diseases including heat cramps, heat exhaustion, and heat stroke. Most seen in football players, these symptoms are more likely to occur during practice as opposed to a game. Here on the Eastern Shore, temps are still in the upper 80’s, with humidity that compounds the misery. Heat and humidity are prime risk factors along with obesity, poor hydration, and concurrent infection.

How Do I Know if the Heat is Dangerous?

The symptoms of heat-related illnesses can vary. Heat cramps are painful contractions because of dehydration and electrolyte imbalances. syncope is A temporary loss of consciousness while exercising is caused by heat syncope. Heat exhaustion, the most common of the heat-related illnesses, results in profuse sweating with nausea and vomiting. The most severe of these is heat stroke, a medical emergency that happens once the body’s thermoregulatory mechanisms have failed. These patients are often confused, have a fast heart rate, and are no longer sweating. 

What Are the Best Ways to Beat the Heat?

Knowing the signs is essential to prevent progression of a heat-related illness toward long term complications or even death. Treatments include:

  • stopping the activity
  • moving to a cool and shaded environment
  • rehydrating with water or an electrolyte-containing drink
  • cooling measures such as ice packs, submersion baths, or by spraying water on the skin and using a fan to promote evaporation

If nausea and vomiting make rehydration difficult, the patient may need medical attention for IV fluids.

As distancing guidelines continue, preseason training may be limited and makes an eye toward heat-related illness even more essential.  Look for shade, avoid exercise in the heat of the day and build up intensity gradually with periods of rest.     

We all look forward to sports – and some semblance of normal – this fall! Let’s be vigilant toward the impact of heat on our young athletes. And if sprains or strains are slowing them down – we’re here to help.

  https://www.hopkinsmedicine.org/health/wellness-and-prevention/heat-related-illness-and-young-athletes-3-important-things-parents-and-coaches-need-to-know#:~:text=Staying%20hydrated%20is%20one%20of,and%20after%20activity%20as%20well.

Dr. Stubbs received his MD from Louisiana State University in New Orleans, followed by residency in Orthopaedic Surgery at the University of Alabama at Birmingham. He is Board Certified and Fellowship Trained in Sports Medicine with Lenox Hill Hospital in New York City. He specializes in arthroscopic procedures of the shoulder, elbow, knee, hip, and ankle as well as cartilage restoration.

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

Avoiding the Physical Pitfalls of Working from Home

Posted on: April 29th, 2020

By Joey Carter, MD

(May 2020) Coronavirus (COVID-19) has thousands of Baldwin County children suddenly “schooling” from home. And that means thousands of Baldwin County parents are unexpectedly at home alongside them. Avoiding the physical pitfalls of working from home takes some planning.

Fortunately, technology and new software platforms like Zoom and Google Classroom keep us connected to teachers and co-workers.  But those same tools come with pitfalls, when we’re suddenly on a keyboard or tablet several hours a day.  Overuse of handheld devices can lead to unintended problems with the hand, wrist and arm. And poor desk posture without breaks to stretch can leave you slouched and strained with the potential for musculoskeletal injuries.   

Tips for a Healthy Home Work Space

If you’re working from home for the first time, it’s important to set up a healthy work space:

  • Check the height of your desk  – should be elbow level when sitting
  • Make sure you have a natural posture – no hunching  or twisting
  • Find a chair that adjusts and supports the curve of your lower (lumbar) back

Good posture is essential:

  • Spine: Keep ears in line with tops of shoulders and shoulders in line with hips
  • Shoulders: Upper arms hang relaxed and close to the body
  • Wrists: Hands are in straight lines with lower arms

How Do I Know if I Have Carpal Tunnel Syndrome?

Repetitive use of a computer keyboard and mouse can sometimes lead to Carpal tunnel syndrome. Symptoms are tingling or numbness in the fingers, caused by pressure on your median nerve. This nerve gives you feeling in your thumb and all fingers (except the pinky).  When the median nerve goes through your wrist, it passes through a narrow path – the carpal tunnel – that’s made of bone and ligament. If you have any swelling in the wrist, this tunnel gets squeezed and pinches the median nerve, which causes your symptoms.

Avoid the PItfalls of Working from Home - tips from Bayside Orthopaedic

While there’s no surefire way to prevent Carpal tunnel, a lighter touch helps.   Keep your fingers relaxed while typing and using a mouse.  Avoid holding a pen or anything else in your hands while you type.   Keep your hands stretched and relaxed: make a tight fist then relax your fingers and spread them out. Repeat 5-10 times.

Your Smartphone May Be the Culprit

You might be surprised how many patients we see with “smartphone tendinitis” – caused by repetitive typing and swiping that irritates the thumb flexor tendon.     Did you know many of us type hundreds of text messages a day? Not exactly what our hands were designed to do.    Holding a smartphone with the wrist in an awkward position for a prolonged period of time can irritate forearm tendons and lead to a painful condition known as “DeQuervain’s tendinosis.”  

The primary treatment includes common sense changes like texting less frequently, improving posture, and modifying the way you hold your phone or tablet.  If symptoms don’t improve with rest, options include splints, medications, hand therapy or a cortisone injection.

Using a laptop?  Its design can be inherently problematic for our posture.  Either your head/neck bends to see the screen or your hands/wrists use poor posture at the keyboard.  If your laptop has become the “home office”, consider buying either an external monitor or keyboard.

Remember, our bodies weren’t designed to sit still – even in correct position – for long periods of time. Take a break!  Change your seated position occasionally, stand up and stretch every 30 minutes or walk around outside.  These are challenging times – staying home means staying well for all of us.

https://orthoinfo.aaos.org/en/diseases–conditions/carpal-tunnel-syndrome/

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.

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.