Sports Medicine Center of Excellence

Our Fellowship-Trained Sports Medicine Specialists

Ronald D. Gardner, MD:  Sports Medicine & Arthroscopic Reconstructive Surgery
Fletcher A. Reynolds, MD:  Sports Medicine & Joint Replacement of the Shoulder, Hip & Knee
Jeremy A. Schwartz, MD:  Foot & Ankle Reconstruction, Sports Medicine
Charles P. Springer, MD:  Sports Medicine & Joint Replacement of the Shoulder, Hip & Knee

Sports Medicine: Not Just for Athletes

Sports medicine is usually associated with athletics: baseball, soccer, football, tennis. Exercise from sports helps keep us healthy and fit. But many are fit because they are active in ways not associated with sports: walking the dog, gardening, playing in the park with grandchildren.

No matter what the activity, there is always a chance of injury - whether you tear a ligament in your knee sliding into home plate or hurt your shoulder after slipping off the ladder while painting your house.

Sports medicine benefits both athletes and those who get their exercise in other ways. This is because sports medicine focuses on prompt diagnosis and treatment of your injury, along with a comprehensive rehabilitation plan to safely return you to the activities you enjoy.

Orthopedics is the area of medicine specializing in the diagnosis and treatment of bone, joint, ligament and nerve disorders, including those caused by injury during activity or exercise.

Orthopedic Specialists Sports Medicine Center of Excellence combines the specialties of orthopedics and sports medicine to provide the comprehensive care needed to successfully diagnose, treat and rehabilitate any sports or activity-related injury. The goal is to return you as closely and safely as possible to your full functional level before the injury.

Our continuum of care includes comprehensive Imaging Services to effectively diagnose your condition and rehab services to help you get you back to the activities you enjoy.

If you have prolonged discomfort as the result of any injury, call for an appointment with our Sports Medicine Center of Excellence.

Sprains and Strains: What's the Difference?

Being outdoors is a favorite pastime in Southwest Florida. Increased activity means a greater chance of injury, and sprains and strains are among the most common. Taking a few precautions and knowing the difference between a sprain and strain can help prevent injury.

What is the difference between a sprain and a strain?

A sprain means you've stretched or torn a ligament, which is a band of tissue connecting bones together. A strain occurs when you pull or tear a muscle or tendon, a thick cord of tissue that attaches muscle to bone.

Sprains are usually caused by some sort of trauma like falling while rollerblading or sliding into a base. The impact knocks a joint out of place which could overstretch or tear the connecting ligaments.

Strains can be acute or chronic. An acute strain is usually triggered by overstressing muscles by doing things like lifting heavy objects incorrectly. A chronic strain is caused by overuse and repetitive motion, like pitching a baseball.

Although sprains and strains can occur in the upper and lower parts of the body, strains are most commonly seen in the ankle. According to the National Institutes of Health, more than 25,000 individuals sprain an ankle in the U.S. each day.

Ankle sprains usually happen when the foot turns inward while a person is walking or running, or lands on the ankle after jumping.

Treating Sprains and Strains

RICE (Rest, Ice, Compression, Elevation) is the first line of treatment for a sprain or strain. A physician should be consulted as soon as possible to evaluate the extent of the injury and develop a treatment and rehabilitation plan for optimal recovery.

Safety Tips to Help Prevent Injury

Whatever activity draws people outdoors, Orthopedic Specialists recommends the following safety tips for outdoor activity at any age:

• Always wear appropriate safety gear. If you bike or rollerblade, wear a helmet.
• Wear the appropriate shoes for each sport and replace shoes with worn tread.
• Warm-up before any exercise, even a walk in the park or a softball game.
• Exercise for at least 30 minutes a day. You can break this into shorter periods of 10 or 15 minutes throughout the day.
• Follow the 10 percent rule. Never increase your activity - whether it's walking, running or inline skating - by more than 10 percent a week.
• Try not to do the exact same routine two days in a row. For example, alternate your activities by walking one day and playing tennis another. Different activities will work different muscles and keeps exercise more interesting.

Stop all activity if you experience severe pain or swelling. 

Despite Youth, Teens Experience Knee Pain

Crackling, sore knees are often associated with a sure sign of aging. But it is not unusual for teenagers - especially those active in sports - to experience serious knee pain. Aching pain in the front, or anterior, of the knee is especially common in athletic girls.

Generally there are two categories of injury: chronic and acute. Chronic knee injuries occur gradually as a result of repetitive motion such as running, jumping or turning. Acute knee injuries are caused by immediate trauma like a sudden, hard fall or twist.

Anterior adolescent knee pain is gradual and typically felt behind the patella bone, or kneecap.

Symptoms of anterior adolescent knee pain can include dull achy pain, swelling and popping sensations in the knee. Usually a combination of ice, rest and rehabilitation will help ease anterior adolescent knee pain.

To help prevent recurrences of pain behind the kneecap, the American Academy of Orthopaedic Surgeons recommend these tips:

• Wear the correct shoe for the correct activity; one shoe does not fit all sports
• Warm up with stretching exercises before any physical activity
• Do not overdo sports and other activities

If the pain does not let up and continues to build over time, an examination by our Orthopedic Sports Medicine Specialists is recommended. He may check for: Alignment of the lower leg, kneecap and quadriceps muscles

Inflexibility of the thigh muscles supporting the knee joint

• Knee stability, hip rotation, and range of motion in the knee and hip
• Tenderness under the kneecap
• Hamstring muscle strength

 A common acute knee injury is an anterior cruciate ligament (ACL) tear. The ACL is a stabilizing ligament in the knee connecting the thighbone to the shinbone. An ACL tear is usually associated with an immediate pop after a sudden fall or twist. The knee swells quickly and gives out when weight is put on it.

Unfortunately, a torn ligament does not heal on its own and may require surgical reconstruction.

The surgery is an outpatient procedure, allowing recovery to take place in the comfort of home. Physical therapy following surgery helps return the athletic teen to the active lifestyle enjoyed before surgery.

Ligament Injuries in the Knee

As the largest joint in your body, your knee is a complex structure of muscle, bone and ligaments. Two sets of ligaments - the cruciate and the collateral ligaments - work together to stabilize the knee joint during movement.

The cruciate ligaments cross each other inside your knee joint, holding your knee in place during movement. As the ligament’s name implies, the anterior cruciate ligament (ACL) is located at the front of your knee and the posterior cruciate ligament (PCL) is found at the back. The ACL and PCL connect the femur, or thighbone, to the tibia, or shinbone.

Your collateral ligaments are located on the sides of your knee. The medial collateral ligament (MCL) connects the femur to the tibia on the inner side of your knee and the lateral collateral ligament (LCL) connects the femur to the fibula, another bone in your lower leg, on the outer side of your knee.

Although injury can occur to any of your knee ligaments, the most common is tearing the ACL. Injury to the ACL also causes the greatest instability to your knee joint. This is because your ACL allows your knee joint to bend and turn easily, and prevents your tibia from sliding under your femur when you move.

Athletes participating in sports requiring sudden pivots, turns and similar maneuvers - such as soccer, football, basketball and skiing - are at a greater risk of an ACL tear. According to the American Academy of Orthopaedic Surgeons, ACL injuries commonly occur by:

• Changing direction rapidly
• Slowing down when running
• Landing from a jump
• Direct contact, such as tackling

The AAOS also points out that after an ACL injury, you may not immediately feel pain. You will most likely hear a popping noise and feel your knee give out from under you. Your knee usually swells within a few hours of injury and there is pain when weight is put on your knee.

Treatment immediately after any ligament injury should include applying ice and elevating your knee to control swelling until you are able to see an orthopedic physician. Walking or running on an injured ACL could damage the cartilage in your knee. A complete tear to the ACL will require surgical reconstruction whereas a partial tear may not need surgery.

Tears to your other knee ligaments can happen but are not as common as ACL tears. In the PCL, sprains are more common than tears and occur when the ligament is stretched too far during activity.

Like an ACL tear, a PCL sprain or tear makes your knee joint unstable. If your PCL is torn, the tibia can begin to slip backwards causing the femur and tibia to rub against each other, which breaks down cartilage over time and may lead to arthritis.

Your MCL helps stabilize your knee joint by preventing the joint from widening. As a result, injury to the MCL is usually caused by impact to the outside of your knee. The blow causes your knee to collapse and your joint to widen because the MCL is overstretched.

Because all your ligaments work together to stabilize your knee, MCL tears can be isolated injuries or part of a more complex injury to your knee. It is not uncommon to tear your ACL and MCL during the same injury.

Tearing or other injury to the LCL is not a common occurrence. To determine the severity of any ligament tear or injury, our orthopedic surgeons will test your knee joint to see if it stays in proper position. Imaging studies, such as x-rays or MRI, are also used. Regardless of a partial tear, complete tear, or sprain, a physical therapy program may be put in place to help strengthen your muscles and restore motion to your knee joint.

For more information about knee ligament injuries, or to schedule an appointment, call Orthopedic Specialists.