AN EXERCISE IN ORTHOPEDICS: Dr. Raj Discusses the Angel Out for the Season

Mark Trumbo is known for playing an infielder position for a Major League Baseball team-- the Los Angeles Angels of Anaheim.  He plays right infield and first baseman. 


At only 25 years old, he is a leading contender for the American League Rookie of the Year Award.

For about a month and a half, Mark had been playing several games with pain in his right foot. On Monday, September 26^th, 2011, after several tests- including MRIs, CT scan, and x-rays, the team orthopedist discovered a stress fracture at the top of his right foot in the navicular bone. 


No surgery is indicated for Mark but he will need to rest his foot for the rest of the season. He will be placed in a walking boot with no vigorous activity for at least 6 weeks.


The Breakdown
A stress fracture is one of the most common causes of foot pain. A metatarsal stress fracture is also called a “March fracture” because pain increases with activity specifically seen in solider recruits. In several interviews, Mark stated he felt throbbing pain across his right foot and felt his activity was limited.

These types of fractures need time to heal properly to avoid surgical intervention. An x-ray would have shown a hairline crack in one of the metatarsals (foot bones)-in this case the navicular bone.

Treatment includes rest for 6-8 weeks usually in a stiff orthopedic boot. Mark will be ready to return for next season as a full–time first baseman!

AN EXERCISE IN ORTHOPEDICS: Michael Vick Bounces Back

Michael Vick Back for the Next Game After Concussion
Co-written by Gina Sacco, MPAS, PA-C

Michael Vick is most infamous for being a football quarterback for the NFL’s Philadelphia Eagles. Although he was involved in illegal dog fighting ring several years ago, Vick remains committed to being record-breaking football player.


On Sunday, September 18^th, the Philadelphia Eagles were in a gripping game against the Atlanta Falcons. During a routine play in the 3^rd quarter, Vick was tackled and spun out by an opponent and collided with his teammate’s helmet. He slowly went to the sidelines and sat out for the rest of the game.  

Because of the sudden blow to his head, he was thought to have a neck injury but it turned out to be a concussion.  He was evaluated by a neurosurgeon and underwent several tests this week. He was cleared to return to practice. According to the Eagle’s official Facebook page, Vick is excited to play the NY Giants this Sunday.


Every year, millions of people have suffered from a head injury. A concussion is a traumatic brain injury (TBI) that may result in a bad headache, altered levels of alertness, or unconsciousness. It temporarily interferes with the way your brain works, and it can affect memory, judgment, reflexes, speech, balance, coordination, and sleep patterns. A CT scan is often used to detect brain injury after a concussion.  Most of these injuries are minor because the skull provides the brain with considerable protection. The symptoms of minor head injuries usually go away on their own. 


The Breakdown


More than half a million head injuries a year, however, are severe enough to require hospitalization. Symptoms of a concussion can range from mild to severe. In Vick’s case his symptoms were on the milder side.  They can include: altered level of consciousness (drowsy, hard to arouse, or similar changes), confusion, feeling spacey, or not thinking straight, headache, loss of consciousness, memory loss (amnesia) of events before the injury or immediately after nausea and vomiting, seeing flashing lights, or feeling like you have “lost time”. 


Recovering from a concussion takes time, even up to a month.  Luckily for Vick, on Sunday he will return to play against the NY Giants!

Dr. RAJ in the News: 4 Ways to Avoid Achy Joints

When it comes to health, fitness, and improving your overall quality of life, LiveRight LiveWell is an online powerhouse of helpful, informative content. And the experts within its editorial collective are each considered beyond worthy of any surgeon's ear - and respect, for that matter.

In a recent HEALTH & FITNESS article, I was asked to contribute my thoughts not only on orthopedic analysis of joint pains over time, but was also encouraged to contribute a few fitness and exercise routines to keep the creaks away.

Briefly, the article's key points are...

Listen to your Body.  Your body knows best, which is why you need to pay attention to it. If you feel sore a day or two after working out, that shouldn’t raise any red flags. “But if you have acute pain when you’re exercising, your body’s telling you something’s not right,” says Rajagopalan. Stop the activity and see a doctor if the pain persists.

Cross-Train.  The best way to keep doing the activities you love is to vary what you do. “I never tell people they have to quit their favorite activities just because they’re getting older,” says Rajagopalan. Of course, if you’re having pain during a specific activity, that’s a different story, he adds. But if your joints aren’t protesting and you love playing tennis, for example, try alternating with hiking or yoga. “By cross-training, you work different muscles and avoid putting repetitive stress on the body, which can lead to injury,” he says.

Vary your Impact.  High-impact activities, like running and playing tennis, place a lot of stress on your body -- especially your joints -- whereas low-impact activities like walking, cycling and Pilates place little stress on the body. In fact, people in the above study who did light exercise, like walking, had the healthiest knee cartilage. So if you’re always doing high-impact activities, then give your body a break and swap in some low-impact activities a few times a week.

Modify your Routine.  Tough as it is to accept, there may come a day when injury forces you to give up an activity, perhaps even permanently. But don’t despair. This doesn’t mean you’re completely sidelined. Work with your doctor to come up with alternatives, advises Rajagopalan. For instance, if running is taking too big a toll on your knees, then try taking it down a notch and walk or use an elliptical machine instead. By finding similar, more joint-friendly activities, you can respect your body, avoid achy joints and still enjoy the benefits of a healthy, active lifestyle at every age.

The coverage has been quite impressive, and to all who shared, including several regional FOX and MSNBC networks, I am most humbled and grateful.

To read the original article by well-known Health & Fitness wordsmith Karen Asp, click here...

AN EXERCISE IN ORTHOPEDICS: British Star Rocks Boot at VMAs

Co-written by Gina Sacco Pac

Jessica Ellen Cornish, better known by her stage name - Jessie J - is an R&B and soul artist from the UK, who rocked the stage as the house band at the annual MTV Video Music Awards in Los Angeles on Sunday, August 28th.

Just breaking into the music scene in the US, Jessie J is currently at the top of the UK singles charts.  During the show, Jessie J gave the performance while sitting down with a decorated cam boot. The audience can also see her being interviewed leaning on glittery crutches.
           
In June, Jessie J was at rehearsal for an upcoming show when she got injured. Unfortunately, during a dance routine, she fell off the stage and fractured her foot and ankle- in two places.

The Breakdown from DR. RAJ

The fracture was severe enough to require surgery, which she had a week later. After surgery, she sports the cam boot and crutches that VMA viewers saw on Sunday.

Fractures of the feet can range in severity. In most cases, they do not require surgery-- only rest. However, in Jessie J’s case, the bones were severely out of place and in an area of poor blood supply, where surgery was needed. Afterwards, a non-weight bearing cast will be used for more than a month to aid the healing process.

The injury certainly didn’t stop this rising star though- she continues to perform all her shows sitting on gold thrones, and not disappointing her fans!

AN EXERCISE IN ORTHOPEDICS: Drew Carey Injures Collarbone

Although a comedian well-known for a variety of shows, Drew Carey currently hosts the famous game show, The Price is Right. And while he thinks nobody can replace Bob Barker, he took over his role in 2007 and continues to make audiences laugh with his variety of successful TV and comedy show appearances.

According to Drew’s Twitter account on Tuesday, August 16^th, he injured his collarbone when he fell during a morning jog.  He went to a local hospital to be x-rayed. The x-ray showed a separated clavicle. Unfortunately, Drew had to cancel the game show taping for the day. He reported that all his injury will need is time to heal and plenty of ice. In this case, no surgery is needed.

The Breakdown

A separation of the shoulder occurs when the collarbone (clavicle) separates from the shoulder joint (acromioclavicaular joint) and shoulder blade (scalpula). One of the most common ways for this injury to happen is falling on an outstretched hand. Drew most likely felt severe pain, swelling, and bruising.

The Recovery i$ Right!

There are six grades of shoulder separations depending on the degree of severity.  Type I and II only require conservative care including rest (sometimes with a sling), oral anti-inflammatory medications and ice every 4 hours for a period of 15 minutes. This should be done for several days until the swelling around the joint subsides.


Surgical repair is required in the more severe types where the ligaments need to be reconstructed to hold the top of the shoulder in place or stabilize the clavicle. Luckily in Drew’s situation, he was back to hosting the game show the following day!

AN EXERCISE IN ORTHOPEDICS: Moto-X Star Travis Pastrana Out Until 2012

Motocross champion and stunt performer Travis Pastrana continues to return to the X-games to compete for more gold metals. Travis was invited to drive a car in the NASCAR nationwide series, but will need to postpone his appearance until next year, due to his injury during a stunt at this summer’s X-games in Los Angeles.            
On Thursday, July 28^th at the X-games 17 Best Trick Event, Travis was attempting to perform his signature stunt called “the toilet paper roll.” This trick involves Travis propelling from a steep ramp while back flipping on his motorcycle during an off-axis spin with a 720-degree rotation.

Unfortunately, Travis landed on his leg while the motorcycle fell on top. He was taken off on a stretcher to the sidelines and sent for X-rays.

The X-rays revealed fractures of both his right foot and ankle. Since the fractures required surgical repair, Travis was in the operating room a week later. The surgery was a success but will require Travis to sit out for the rest of the year. He is to follow a strict healing process without putting weight on his right leg for one month.
           
The Breakdown

Travis suffers from the most common type of motocross injury, which include the legs and ankle.  The ankle consists of 3 bones- tibia (shin bone), fibula (small bone on the outside of the ankle) and the talus (heel). Travis would have felt immediate and severe pain along with swelling, bruising, and instability.

Getting Back on the Track

Depending upon where the fracture was in each bone determines the treatment. Surgical repair is used to make the ankle stable. Using a plate and screws on the side of the bone or a screw or rod inside the bone, which may be used to re-align the bone fragments and keep them together as they heal, stabilizes the bone.

The bones will take at least 6 weeks to heal properly. Physical therapy and home exercises will speed the recovery process and get Travis back in shape for next year!

Dr. Raj in GLOBE Magazine's Alex Trebek Feature!

In my last post, we discussed the details of Alex Trebek's recent injury, the breakdown of its cause, and his next steps to...what is, recovery? And apparently, the talented editorial crew at GLOBE Magazine took notice.

NEW Feature in EverydayHealth.com

EverydayHealth.com is a fantastic resource for health, fitness, and all-around better living - which is why I was honored to have been contacted by them for an interview.

In this feature, Everyday Health talks to authorities on health and wellness to uncover their real-life habits.

The article is titled "An Inside Look at How Top Nutritionists, Doctors, and Personal Trainers Eat and Exercise" and the full article can be found here.