Ankle Injuries Common to Soccer Athletes

Some of the most common injuries involving youth soccer players occur to the
foot and ankle.  Common foot and ankle injuries that adolescent soccer players
may incur include ankle sprains, heel pain secondary to inflammation of the
growth plate (Sever’s Disease), and fractures/stress reactions involving the
foot and ankle bones.

Ankle sprains occur when the ligaments that support the
ankle stretch or tear and can range in severity from mild to severe depending on
how much damage and tearing there is to the ligaments.  Most ankle sprains are
lateral ankle injuries that are often minor in severity and can heal on their
own with rest and home treatments.  The length of time that an athlete may be
out of action can vary from a few days to 4-6 weeks.  A majority of ankle
sprains occur when the foot turns inward (i.e., “rolling” the ankle), damaging
the supporting ligaments on the outside/lateral aspect of the ankle.  Everyone
that sustains an ankle sprain can benefit from instruction in an exercise
program to promote optimal recovery and restoration of stability, which can
reciprocally decrease the likelihood you will re-injury.  When there is injury
to the ligaments that support the bones, nerves within the ligamentous tissue
that help with balance that are within ligaments are also affected which
increases the likelihood that you may sustain future ankle sprains.  The best
way to minimize your ankle sprain from becoming a chronic issue is to perform
exercises that help to strengthen the muscles around the ankle and improve your
balance on the injured leg.  Repeated ankle sprains can lead to long term
problems, including chronic ankle pain, arthritis, and ongoing instability.

A high ankle sprain is a more severe form of injury and occurs when the ligaments
and strong connective tissue, called the syndesmosis, between the two lower leg
bones are torn and injured during a twisting movement.  The recovery from a high
ankle sprain is typically much longer than a lateral ankle sprain.

Sever’s
disease, also known as calcaneal apophysitis, is one of the most common causes
of heel pain in growing children and adolescents.  It is inflammation of the
growth center in the heel (calcaneus) bone where the Achilles tendon attaches.
When a child becomes fully grown; the growth plates close and are replaced by
solid bone.  Until this occurs, the growth plates are weaker than the
surrounding tendons and ligaments and are vulnerable to stress.  Sever’s disease
is caused by repetitive stress to the heel and most often occurs during growth
spurts, when bones, muscles, tendons, and other structures are changing
rapidly.  Sever’s disease affects the part of the growth plate at the back of
the heel where bone growth occurs.  This growth area serves as the attachment
point for the Achilles tendon, where the calf muscles attach to the back of the
heel bone. Children and adolescents who participate in activities that involve
running and jumping are at increased risk for this condition, particularly when
an element of calf muscle tightness is present.  Additional stress from the
pulling of the Achilles tendon at its attachment point can sometimes further
irritate the heel. In most cases of Sever’s disease, rest combined with
over-the-counter medication, change in footwear, and physical therapy that
consists of stretching and strengthening exercises will relieve the symptoms and
allow a return to activities with resolution of symptoms.

Injuries such as
fractures resulting from significant force and direct trauma to the bones of the
foot and ankle or stress fractures from overuse and repetitive activity are not
uncommon in young soccer players.  Most fractures of the ankle involve the
outside bone of the lower leg called the fibula.  Management of the fractured
bone can vary depending on the type of fracture and how much displacement there
is between the two ends of the broken bone.  X-rays and MRI are commonly used
imaging techniques to diagnose the injury and help guide treatment decision
making.  Sometimes surgery is necessary in order to properly align the two ends
of the broken bone to ensure proper healing and minimize the risk of nonunion of
the fracture, in additional to stabilizing/repairing any associated ligamentous
injury.

Pain along the outside border of the foot, particularly when acute in
onset and associated with perception of a “pop” and difficulty with weight
bearing can sometimes be a specific fracture called a Jones fracture.  This
fracture is tough to get to heal without surgery given the poor blood supply to
this region of the bone.  Due to risk of poor healing or re-injury with
conservative treatment, orthopedic surgeons often choose to fix the fracture
surgically which usually involves placement of a screw across the fracture
site.  Jones fractures are most often due to stress or overuse, but can also be
due to trauma.

A stress fracture is a small crack in a bone, or is sometimes
referred to as a stress reaction when severe bruising within a bone occurs.
Most stress fractures/reactions are caused by overuse and repetitive activity,
and are common in athletes who participate in running sports such as soccer.
These injuries occur over time when repetitive forces result in microscopic
damage to the bone that the body is unable to heal/recover from with continued
activity.  Overuse stress fractures occur when athletic movements/activities are
repeated so often that the weight-bearing bones and supporting muscles do not
have enough time to heal between training sessions.  Bone is in a constant state
of turnover – a process called remodeling in which new bone develops and
replaces older bone.  If an athlete’s activity is too great, the breakdown of
older bone occurs rapidly and can outpace the body’s ability to repair and
replace it.  As a result, the bone weakens and becomes vulnerable to fracture
(e.g., stress fracture).  The most common cause of stress fractures is a sudden
increase in physical activity.  This increase can be in frequency, duration,
and/or intensity of activity.  The most common symptom of a stress fracture in
the foot and ankle is pain.  The pain typically develops gradually and worsens
during weight bearing activity, and is often relieved with rest.

Although all
too frequently utilized, self-diagnosis and delay in treatment can be one of the
more harmful things you can do for an ankle/foot injury, particularly those
mentioned above.  If you experience an ankle injury and are in need of treatment
you can request an appointment with one of our 25 board-certified orthopedic
physicians at our physician-owned hospital on our website
www.kcoi.com.  If you are needing physical
therapy treatment for your injury you can receive treatment through
“self-referral”, which means you do not need a prescription or a physician
referral to begin your treatment.  For immediate diagnosis and treatment our
Ortho Urgent Care is open seven days a week and our hospital is equipped with
diagnostic imaging on-site for all of your x-ray and MRI needs.

References:
https://orthoinfo.aaos.org

https://medbridgeeducation.com

How ACL Sports Injuries Happen and Recovery

Anterior cruciate ligament (ACL) injuries are becoming more and more common in sports.  There are numerous reasons why an ACL injury occurs and unfortunately, not all of these are very well understood.  A recent study indicates that 3 out of every 4 ACL injuries are non-contact in nature.  While this is true of both males and females, females are 2 to 8 times more likely to experience an ACL injury during sport.

Kansas City Chiefs safety, Juan Thornhill is the latest high profile athlete to suffer a non-contact disruption of the ACL ligament.  We wanted to share some information about the causes of ACL tears and expected recovery from an ACL injury for athletes.  While not everyone has access to the resources at the disposal of professional players, many of the principals and timelines still apply to athletes at all levels. Most ACL injuries occur due to a rotational and shearing force being applied to the knee.  This force is often generated when the foot on the injured side is planted and the body moves forward or rotates forcefully about this stationary lower leg.  As you can probably imagine, the ACL ligament’s main function is the prevention of excessive movements in these directions.  The amount of force that today’s athletes can generate plays a large role in the number of ACL injuries that occur.  Think about how much control it takes to land, cut, slow down or change directions in today’s sports.  Athletes who are bigger, stronger and faster generate more force and place more strain on the ligaments of the knee and the subsequent movements that those ligaments are trying to prevent. The extent of the tear/involvement of associated tissues and return-to-sport requirements are the two biggest factors that will affect the length of recovery in athletes.  In the case of Juan Thornhill we don’t know if the medial collateral ligament (MCL) and/or the medial meniscus are involved with his injury.  Because of the close proximity of these structures to the ACL and their associated roles in controlling knee movement, they are often involved with an ACL injury.  Having “only” an ACL injury can be a good thing, when thought of in that framework, as in most instances, having only an ACL disruption and reconstruction will result in a shortened recovery. The position of Safety in the NFL requires a great deal of acceleration, deceleration and change of direction in order to be effective.  Because of these requirements an athlete playing that position might experience a more extended length of recovery when compared to an offensive lineman, whose role requires slightly less change of direction force throughout the lower body. What is the timetable for returning to play for this type of injury?  Assuming that there was no MCL or meniscus involvement and assuming no complications from the reconstruction/surgery, it’s likely that a full recovery could be expected in 9-12 months.

Kansas City Orthopaedic Institute Receives 2020 Press Ganey Guardian of Excellence Award for Achieving and Sustaining Excellence in Patient Experience

Kansas City Orthopaedic Institute Receives 2020 Press Ganey Guardian of Excellence Award for Achieving and Sustaining Excellence in Patient Experience

Released September 21, 2020 Kansas City Orthopaedic Institute is pleased to announce it has been named a 2020 Guardian of Excellence Award® winner by Press Ganey. The Guardian of Excellence Award recognizes top-performing health care organizations that have achieved the 95th percentile or above for performance in Patient Experience. The Press Ganey Guardian of Excellence Award is a nationally recognized symbol of achievement in healthcare. Presented annually, the award honors clients who consistently sustained performance in the top 5% of all Press Ganey clients for each reporting period during the course of one year. According to Kansas City Orthopaedic Institute CEO Charles E. Rhoades, M.D. “The award means a lot to us considering it speaks specifically to what is of upmost importance to us as an organization, Patient Experience. And we are extremely proud to win this award for the second consecutive year.” Kansas City Orthopaedic Institute (KCOI) is a physician owned acute care hospital dedicated solely to orthopedics.  KCOI provides truly comprehensive care, from diagnostic imaging, inpatient and outpatient surgery, pain management, urgent care, and inpatient and outpatient physical and occupational therapy “The caregivers and staff of Kansas City Orthopaedic Institute touch the lives of patients and their families in profound ways,” said Patrick T. Ryan, Chairman and Chief Executive Officer, Press Ganey. “This award reflects their deep commitment to listening to the voices of their patients and our shared mission to reduce suffering and improve the safety, quality, and experience of patient-centered care. I continue to be humbled and inspired by their heroic efforts to care for patients in the face of the uncertainty, stress, and fear brought on by the COVID-19 pandemic. Press Ganey is proud to partner with them in this noble work and we congratulate them on this tremendous achievement.” For more information about the services offered at Kansas City Orthopaedic Institute, or to make an appointment, call (913) 319-7633 or visit www.kcoi.com.

About Kansas City Orthopaedic Institute

As the area’s first and only hospital dedicated exclusively to orthopedics, Kansas City Orthopaedic Institute provides comprehensive orthopedic care, from diagnostic imaging to inpatient and outpatient surgery, pain management services, urgent care, and outpatient physical and occupational therapy. Kansas City Orthopaedic Institute is a physician-owned orthopaedic hospital and a joint venture with Saint Luke’s Hospital. Located in Leawood near Overland Park, Kansas, the hospital and its Ortho Urgent Care center proudly serve the Greater Kansas City metropolitan area. 3651 College Boulevard, Leawood, Kansas 66211

Dr. James P. Halloran Discusses Patrick Mahomes Injury

Dr. James P. Halloran met with McKenzie Nelson of 41 Action News to discuss the dislocation of the knee cap suffered by Kansas City Chiefs quarterback Patrick Mahomes.

“Right after it happens, it’s always easiest to get it back in, so if you wait, if you would have left it out, it’s just the muscles tighten up, everything starts to swell and you can have a lot more problems trying to get the knee cap back into position and more painful, so you usually have to use some sort of anesthesia,” Dr. Halloran said. Halloran expects several weeks of rehab for Mahomes, beginning soon after any inflammation decreases. “Off the bat, you’re really trying to reduce a lot of the inflammation that’s going on, a lot of the swelling because he’s probably going to have a fairly swollen knee today,” Halloran said. “After we get that resolved, then we’re working on range of motion, strengthening the quadriceps, trying to prevent any further what I call translation or subluxation of that kneecap, so probably immobilization for a week to two weeks, controlling your inflammation and also just working on strengthening around the knee.” You can find the entire story and video on 41 Action News’ website.

Lisfranc Injury Repair With InternalBrace™ Ligament Augmentation

Dr. Kirk McCullough gives a presentation that demonstrates the repair of a Lisfranc injury with intercuneiform instability using the InternalBrace™ ligament augmentation implant system. InternalBrace repair addresses the intraosseous component of the Lisfranc ligament using a collagen-coated FiberTape® suture with a metallic button on the second metatarsal and a 4.75 mm SwiveLock® anchor in the medial cuneiform for knotless fixation. You can watch the entire presentation here.

What You Need To Know About Ankle Sprains

Ankle sprains occur when the ligaments that support the ankle stretch or tear and can range in severity from mild to severe depending on how much damage and tearing there is to the ligaments. Most ankle sprains are minor injuries that can heal on their own with rest and home treatments. The length of time that an athlete may be out of action can vary from a few days to 4-6 weeks. A majority of ankle sprains occur when the foot turns inward damaging the supporting ligaments on the outside of the ankle (or what many people think of as rolling the ankle). Everyone that sustains an ankle sprain would benefit from instruction in an exercise program to ensure optimal recovery occurs and to decrease the likelihood that you will injure it again.  When there is injury to the ligaments that support the bones, nerves that help with balance that are within ligaments are also affected which increases the likelihood that you may sustain future ankle sprains. The best way to minimize your ankle sprain from becoming a chronic issue is to perform exercises that help to strengthen the muscles around the ankle and improve your balance on the injured leg. Repeated ankle sprains can lead to long term problems, including chronic ankle pain, arthritis, and ongoing instability. A high ankle sprain is a more severe form of injury and occurs when the ligaments and strong connective tissue, called the syndesmosis, between the two lower leg bones are torn and injured during a twisting movement.  The recovery from a high ankle sprain is typically much longer than a lateral ankle sprain.

KCOI Announces Expansion of Physical Therapy Services with Performance Rehab

Performance Rehab KOCI Logo

Kansas City Orthopaedic Institute Announces Expansion of Physical Therapy Services with Performance Rehab

Released September 1, 2020

In its ongoing commitment to delivering quality orthopaedic care to the region, Kansas City Orthopaedic Institute announces a partnership with Performance Rehab. This will expand the Kansas City Orthopaedic Institute physical therapy services to five locations across the metro.

“The healthcare landscape has shifted to shorter inpatient stays and a greater reliance on outpatient rehabilitation and therapy,” said Kansas City Orthopaedic Institute CEO Charles E. Rhoades, M.D. “Now more than ever, patients need access to high quality care, convenient to where they live. Our expanded network of outpatient physical therapy clinics helps meet that need.”

The Performance Rehab – KCOI footprint will now encompass five locations, one on site at the KCOI hospital in Leawood, and four others conveniently located around the metro.

  • 3651 College Boulevard, Leawood, KS 66211
  • 11408 West 135th Street, Overland Park, KS 66221
  • 1495 Mahaffie Circle, Olathe, KS 66062
  • 15445 Metcalf Avenue, Overland Park, KS 66223
  • 8825 West 75th Street, Overland Park, KS 66204

Mark Buckingham, MSPT and founder of Performance Rehab said, “The demand for exceptional physical therapy is incredibly high in the Kansas City area, and we’re thrilled with this new synergy being part of the Kansas City Orthopaedic Institute’s network. This allows us to be fully integrated into the full cycle of orthopaedic care.”

Rehabilitation services, such as physical therapy and occupational therapy, provide effective treatment for many orthopedic conditions and play an important part in injury prevention, nonsurgical treatment, and post-op recovery.

The staff at Performance Rehab – KCOI includes highly skilled therapists who offer the following rehabilitation services:

  • One-on-one Evaluations and Treatments
  • Physical Therapy
  • Occupational Therapy
  • Manual Therapy
  • Hand Therapy
  • Pre/Post Op Rehab
  • Custom Splinting
  • Work Conditioning
  • Dry Needling
  • Injury Prevention
  • Sports Rehab
  • Kinesiology/Rehabilitative taping
  • Functional Capacity Evaluations (FCEs)
  • Corrective Exercise Techniques
  • Sports Conditioning / Performance Arts
  • Astym® Treatment

For more information about the services offered at Performance Rehab, or to make an appointment, call (913) 319-7633 or visit our page for occupational therapy.

About Kansas City Orthopaedic Institute

As the area’s first and only hospital dedicated exclusively to orthopedics, Kansas City Orthopaedic Institute provides comprehensive orthopedic care, from diagnostic imaging to inpatient and outpatient surgery, pain management services, and outpatient rehabilitation therapy. Kansas City Orthopaedic Institute is a physician-owned orthopaedic hospital and a joint venture with Saint Luke’s Hospital. Located in Leawood near Overland Park, Kansas, the hospital and its Ortho Urgent Care center proudly serve the Greater Kansas City metropolitan area.

3651 College Boulevard ● Leawood, Kansas 66211

 

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FOR IMMEDIATE RELEASE

Melissa J. Heck

Director of Marketing & Business Development

Kansas City Orthopaedic Institute

mheck@kcoi.com

913-253-8956

Dr. Kirk McCullough on PARS (Percutaneous Achilles Repair System)

Dr. Kirk McCullough presents surgical pearls for using PARS (Percutaneous Achilles Repair System). The PARS features an anatomic contoured jig designed to fit within the paratenon. The PARS suture kit contains either color‐coded SutureTape or #2 FiberWire® sutures and PARS needles used to create strong percutaneous locking sutures on the distal and proximal ends of the Achilles tendon. You can watch the entire presentation here.