Sports Medicine

  During our last lab, I was able to experience the Interferential Stimulation machine. It is a modality that uses electrical currents to help rebuild and repair your muscles. In order to use the modality, two or four of the sticky pads, also known as electrodes, must be placed on the injured area. They were connected to the machine by little wires called leads. Electrical currents would pass through the leads into the electrodes sending stimulation to the muscles that were between the electrodes. Interferential Stimulation is used to relieve pain, for muscle stimulation, and to increase blood flow to the treatment area.

            It is used in these settings: pre and post orthopedic surgery; cumulative trauma disorders; back pain; arthritis; athletic and other joint injuries/syndromes; hand/wrist injuries; podiatric conditions/procedures; and pain control of various origins.

            You are able to change the electrical power of the machine depending on your pain tolerance and the severity of the treatment or injured area. You can also change the pulse of the current in order to change what you would like to do to the treatment area.

            It hurt at first, but after building up a tolerance to the pain I was able to increase the current. The longer I had it on for the higher I was able to put it. It made my muscles jump and you could see it happening. After using it my treatment area felt looser and stronger.

This year, we have the opportunity to offer a Spring Physical Day at Holy Cross for our high school athletes on May 12, 2012 from 8 a.m. – noon in the Student Center. 

8 – 9 a.m.            Football

9 – 10 a.m.          Baseball/Swimming/Wrestling

10 – 11 a.m.        Basketball/Track/CC/Tennis/Bowling

11 – 12 a.m.        Cheerleading/Golf/Soccer

On the day of the physical, athletes are required to have $25 cash or check made out to Holy Cross School and the LHSAA Medical History Evaluation Form attached to this email or found on the HC Website. (As a reminder, high school athletes MUST have a current physical on file each year they plan to participate in varsity or junior varsity athletic practices and competitions.) These physicals will be valid until May 31, 2013. 

We are fortunate to have the support of several medical professionals in our Holy Cross family including Dr. Kevin Watson ’94 of Orthopedic Associates of New Orleans, David Ware, PT of Orthopedic and Sports Therapy, Gentilly Vision Source, and Mrs. Myra DiGange, RN.

If your athlete cannot attend on May 12, we will offer a Summer Physical Day. The date will be announced in the near future. If you have any questions or concerns, please contact dyentzen@holycrosstigers.com.

In wellness,

D Hunter Yentzen

“I recently used the Game Ready Therapy System on my elbow. The Game Ready system is a cryotherapy system. Cryotherapy is the application of cold modalities that have a temperature range between 32 degrees Farenheit and 65 degrees Farenheit. The system uses conduction to transfer heat as the cold is transferred between two objects that are touching. 

The Game Ready System was on my elbow for five minutes.  My arm quickly went numb when the water was being pumped into the sleeve. It was very cold, but at the same time relieving. This is a very good therapy tool.”

Thanks Jeff for reviewing the Game Ready.  Please keep an eye out for our next post as one of the students comments on the use of Electrical Stimulation.

The students in Sports Medicine have been studying therapeutic modalities during this section.  Holy Cross is fortunate enough to have Electrical Stimulation, Ultrasound, Whirlpools, a Hivamat, and a GameReady housed in the athletic training room.

In addition, we are attempting to get local physical therapists and chiropracters to demonstrate manual therapy to the students.  Stay tuned for student blog submissions.

The knee is a major part of the leg, and it helps many actions that go on in the leg.  The knee is one of the more common joints that get injured.  It is more prone to injury due to the natural instability of the joint. 

                Some boney landmarks in the knee include the Medial Epicondyle and the Lateral Epicondyle.  These landmarks make a groove for the patella to fit into and move around it.  The Patella can be better known as the knee cap, and when the lower leg moves up and down, so does the Patella.  The Tibial Tuberosity is inferior to the Patella, and is on the superior portion of the Tibia.  This landmark is where you can find Osgood-Schlatter’s disease.  The patella is the bone in the knee that serves as the “knee cap”, and sits in between two parts of the distal femur (Lateral Epicondyle and the Medial Epicondyle). 

                Other integral parts of the knee the menisci.  The menisci are the parts of the knee that cushions the tibia and the femur from rubbing against each other.  The menisci are crescent shaped and are like found on both the lateral and medial sides of the knee.  A function of this is to spread the load of the body’s weight, which would reduce the amount of stress put on the knee. 

                The knee cannot move in many ways and directions like some of the other joint in the body.  The knee’s primary ranges of motion are extension and flexion.   The ligaments in the knee allow it to stay in place and not to be moved around.  There are several different ligaments located on different parts of the knee, and they all serve a different purpose.

                The Anterior cruciate ligament (ACL) runs from posterior to anterior and it resists the knee from moving forward.  The Lateral collateral ligament (LCL) is the ligament that is located on the lateral side of the body, hence “Lateral collateral ligament”.  This ligament runs from the femur to the fibula, and is more flexible than the medial ligament which makes it less prone to injury.  The Medial collateral ligament (MCL) is on the inside part of the body, and runs from the femur to the tibia.  The last ligament holding the knee together is the Posterior cruciate ligament (PCL) and it is located on the back portion of the knee running from the posterior area of the tibia to the medial condyle of the femur.  The PCL restricts the knee from moving any further back posteriorly.

  The ankle is a joint, it is formed were the foot and leg meet. This joint is synovial hinge joint that connects the distal ends of the tibia and fibula in the lower limb with the proximal end of the talus bone or foot. Ankles consist of three bones and three ligaments. For such a small portion of the human body the ankle has a lot of crucial structures for the human body. One of the most common injuries in sports is an ankle sprain.

        The three bones the ankle consists of are the tibia, the fibula, and the talus. The tibia is the larger and stronger of the bones in the leg. It connects the knee with the ankle bones. It is looked at as the strongest weight bearing bone in the body. The fibula is found on the lateral side of the lower leg and is noticeably smaller than the tibia. It has a good length but is considered a very small bone. The Fibula forms the lateral part of the ankle joint. The talus is an underrated bone. It often gets lost in a collection of bones in the foot that is known as the tarsus. The tarsus is the lower part of the ankle joint. It goes with the lateral and medial malleoli of the two bones of the lower leg.

        The Anterior talofibular ligament passes from the anterior margin of the fibular malleolus to the talus bone. It prevents the foot from sliding forward in relation to the shin. The posterior talofibular ligament runs horizontally from the depression at the medial and back part of the fibular malleolus. The calcaneofibular ligament is a narrow ligament. It runs from the apex of the fibular malleolus downward and somewhat backwards to a tubercle on the lateral surface of the calcaneus. This ligament is covered by tendons.

Anterior Cruciate Ligament

                The Anterior Cruciate Ligament is commonly known as the ACL.  It is one of the four major ligaments of the knee. There are two bundles of ligaments of the ACL. They are distinguished where they attach inside of the knee and are known as the anteromedial and posterolateral.  Injuries in sports are very common to the ACL because of the lateral rotational movements. Most injuries are caused by the twisting and force applied to the knee. This injury is common in all contact sports.

 If the ligament is strained, sometimes repairs and healing can be made through physical therapy.  However if the ACL is torn, the only way to repair it is with surgery.  This surgery is called arthroscopic surgery.  With most cases, damage to the ACL comes with additional problems, namely tears of the cartilage, the MCL, or the meniscus.  When surgery is needed, doctors use tendons and graphs to repair the ACL.  Many doctors like to use graphs and tendons from cadavers, so the patient does not have more than one surgery site to heal. Others doctors have a different viewpoint and like to use tissue from the patient to avoid immunity difficulties. There are three particular surgery techniques being used and studied today: staple fixation, tying sutures over buttons, and screw fixation.  So far the studies do not show significant findings that any one way is better than the other.

                The rehabilitation of the ACL is not easy. It is a very long and painful road to recovery. Rehabilitation has four main focuses:  restoration of joint anatomy, provision of static and dynamic stability, maintenance of aerobic conditioning and psychological well-being, and early return to work and sport. All of these points are difficult to maintain and endure. The pain of this surgery is great and can get to anyone. A person would not be able to rehabilitate own his own, so he must be in the care of a physical therapist.  The graph is the weakest six to twelve weeks after the surgery, so precautions must be taken to take special care during this very delicate time of recuperation. It is important to become mobile as early as the doctor recommends because it is important to circulation, cartilage nutrition, and bone mineralization.  In the first two weeks there should be a focus on reducing the swelling after surgery and pain management. Developing range of motion is also a focus at this time. Walking with crutches is the first main accomplishment.  During the second to sixth week, more focus is added to range of motion.  Managing to bear weight is also beginning to develop.  The patient is usually out of the knee brace sometime between the third and fifth week. From the sixth to the twelfth week there tends to be a focus on muscle control. The patient works on balance exercises and eventually to light jogging, such as on a mini trampoline. The patient should gain full range of motion during this phase of therapy.  After the sixth week, the patient enters the final phase of rehabilitation that can last up to six months. The patient should be reentering his sport. He should be doing exercises for strength and agility. The patient should be able to return to his team sport six to nine months after surgery.

                Although this is a painful and long procedure, the patient should heal to complete capacity. The team of surgeons and therapists should keep him on a very structured path watching his progress closely. As with any surgery, the rehabilitation will have to be specialized to fit the patient’s needs. The ACL is a common knee complication to many athletes.

Today’s Blog post is brought to you by an Alum of Holy Cross and the Sports Medicine Program.  “Dubus” is a former athlete and athletic training student that is now working hand in hand with the Nicholls State football program as a work study student during his freshman year.

We caught up with Dubus before a game and got his take on working with sports:

“My old job as an athletic training student at Holy Cross has helped me in my new job at Nicholls as an athletic manager. I know what you must be thinking, “athletic trainer, and athletic manager are two different things right?” Well you are right.

The main reason I got my job at Nicholls was because of my athletic training job. When a football scout came to scout two of our players (Brenton Bowman and Darryl Watson), Coach Hunter mentioned my name to the scout. Later I received an e-mail asking if I would accept a scholarship. I have never been an athletic manager, but I have been around a football team as a player and an athletic training student.

I was able to use that experience to help me with my job here. I was a little worried on my first day of work when I met the other guy they just hired. He has been a manager for all four years of his high school career. The difference between him and I is that I am able to view the job in multiple angles, which gives me the upper hand at work. I am able to help out in all parts of my job.

I have always been a hard worker, but in college it is a whole different experience. Just for my manager job I have to wash clothes, fix equipment, make sure my coach is ok, set the field, and other things in a short period of time. Although it’s a lot of work it comes with its advantages, I had an opportunity to fly to Michigan for free (with the team). That was a fun trip, and after the work was done we got to hang out. I also get a lot of free stuff like clothes, shoes, bags, food, and that’s barely the stuff I am going to get in the future.

I love my job here almost as much as I loved my job at Holy Cross. If it was not for my job as an athletic training student at Holy Cross, I would not have gotten my job at Nicholls.”

The students in Sports Medicine seemed to enjoy Laura Waples and her presentation on Fort Benning.  The presentation was a great opportunity for the students to see how broad the profession of athletic training really is.  Below are just a few of the quotes from the class after the presentation:

“Something I learned from Ms. Waples that I didn’t previously know was that there were 14,000 soldiers to two athletic trainers. She informed us, through her insightful words, that ‘her job isn’t always easy to do.’ Although I wanted to look into the practice of athletic training, she has further inspired me to pursue my path into the medical field and help people who may be hurt.” – Andrew Copple

“I thought her athletic training position was unique and different because she did not only train athletic teams, but she trained and got our soldiers back into fighting shape to defend our country. Ms. Waples actually did the military drills and proved herself and showed that if she could do the drills, so could the soldiers.” – Cody Sanders

“I learned from Ms. Waples that as a female she had to work extra hard to prove to the men that she was as tough as them.” – Michael Lockwood

“I thought her job is pretty cool and would probably be a fun job.” – Brandon Roy

“The speaker (Ms. Waples) was informative and interesting because she was able to tell us how dangerous the obstacles were. It must be pretty cool being able to work with those soldiers every day.” – Cooper Gioe

“This job is a very rewarding job because you get to help people get better and help them get back to their normal lives or in Ms. Waples case, their job life” – Jeff Winters

“I was extremely impressed with how committed Ms. Waples was concerning her job. Not every person can wake up at 2:30 am to fulfill her responsibilities at Fort Benning, and then go through the rest of her day which consisted of school, research and social life.  It was impressive how she built the athletic training program from nothing, to a fully functional training room.” – Jordan Fontenelle

As we begin a new academic year, the sports medicine class will be focusing on careers and academic programs directed toward athletic training, physical therapy and orthopedics.  On Friday, August 26, we welcome Laura Waples to class to discuss her experience as an athletic trainer both on the high school level and as a healthcare professional for the military.

Ms. Waples worked toward her graduate degree at Auburn University while providing healthcare coverage at Fort Benning.  The pilot program allowed athletic trainers to care for an estimated 14,000 soldiers who are attached to the 192^nd Infantry Brigade.  Currently, Ms. Waples is employed by East Jefferson General Hospital and works hand-in-hand with Dominican High School.

Please follow the link below to read more information regarding Auburn’s partnership with Fort Benning.

http://education.auburn.edu/news/2009/december/trainers.html

Please check back for responses from our students regarding the guest speaker.