Sports Injuries-Ladies

[CBOMB8]

There are a few ways you can repair an ACL. You can use a cadaver(heterograph-graft taken from another person or species.) or autograph(graft transfered from one part of the body to another). Orthopods will either take the hamstring tendon, patellar tendon from the same knee or the patellar tendon from the other knee. EVERY ORTHOPEDIC CAN GIVE YOU REASON WHY EACH WAY IS THE BEST. My opionion, as a ATC is to take the graft from the same knee because you are only rehabbing one knee as opposed to having both knees cut on.

 

As far as returning to play, Jerry Rice returned after having an ACL repair at 8 weeks and fractured his patellar. I have heard success stories of people coming back at 10-12 weeks and being at about 90 percent. A lot of that has to do with each individuals pre-injury level of play and athleticism.

 

The young lady from Oakland, have no clue what is wrong with her, but the surgery is probably set for the 12th for a reason. You can not go in and do surgery with a significant amount of fluid and edema. Two weeks would give her enough time to get rid of the swelling and regain her range of motion.

 

We need to have a strength and conditioning/injury board. Hope this helps, just my two cents

[givbakr2]

There was an interesting article in USA today in 2004 talking about ACL injuries ,who is most likely to have one and exercises to help prevent them.I had it and gave to someone else who lost the article .Does anyone remember this or happen to still have a copy.

[PHargis]

There are a few ways you can repair an ACL. You can use a cadaver(heterograph-graft taken from another person or species.) or autograph(graft transfered from one part of the body to another). Orthopods will either take the hamstring tendon, patellar tendon from the same knee or the patellar tendon from the other knee. EVERY ORTHOPEDIC CAN GIVE YOU REASON WHY EACH WAY IS THE BEST. My opionion, as a ATC is to take the graft from the same knee because you are only rehabbing one knee as opposed to having both knees cut on.

 

As far as returning to play, Jerry Rice returned after having an ACL repair at 8 weeks and fractured his patellar. I have heard success stories of people coming back at 10-12 weeks and being at about 90 percent. A lot of that has to do with each individuals pre-injury level of play and athleticism.

 

The young lady from Oakland, have no clue what is wrong with her, but the surgery is probably set for the 12th for a reason. You can not go in and do surgery with a significant amount of fluid and edema. Two weeks would give her enough time to get rid of the swelling and regain her range of motion.

 

We need to have a strength and conditioning/injury board. Hope this helps, just my two cents

Your post is informative and gives a great deal of information that were missing links as to what is happening. it is extremely perceptive that from a parent, coach, trainer point of view that there needs to be a strength, conditioning/ injury board. Especially when female participation is increasing at a high level and there are risks which are mostly female in participation, strength and conditioning are certainly highly important. Some young people do not understand the value of conditioning and they only want to play. If they want to play at a high level, it is necessary to go thru the conditioning or get hurt and go thru the pain. this is a great post and hope if anyone else has thoughts, please post.

[PHargis]

There was an interesting article in USA today in 2004 talking about ACL injuries ,who is most likely to have one and exercises to help prevent them.I had it and gave to someone else who lost the article .Does anyone remember this or happen to still have a copy.

Givbakr2- Do you agree that it would be of value for a strength and conditioning/injury board on the Coacht web site. Is information that you have seen in reading some of these posts been of value for the education of the readers? I would like your thoughts.

[PHargis]

There are a few ways you can repair an ACL. You can use a cadaver(heterograph-graft taken from another person or species.) or autograph(graft transfered from one part of the body to another). Orthopods will either take the hamstring tendon, patellar tendon from the same knee or the patellar tendon from the other knee. EVERY ORTHOPEDIC CAN GIVE YOU REASON WHY EACH WAY IS THE BEST. My opionion, as a ATC is to take the graft from the same knee because you are only rehabbing one knee as opposed to having both knees cut on.

 

As far as returning to play, Jerry Rice returned after having an ACL repair at 8 weeks and fractured his patellar. I have heard success stories of people coming back at 10-12 weeks and being at about 90 percent. A lot of that has to do with each individuals pre-injury level of play and athleticism.

 

The young lady from Oakland, have no clue what is wrong with her, but the surgery is probably set for the 12th for a reason. You can not go in and do surgery with a significant amount of fluid and edema. Two weeks would give her enough time to get rid of the swelling and regain her range of motion.

 

We need to have a strength and conditioning/injury board. Hope this helps, just my two cents

What about the situation in my post about the surgury to fix an acl including a piece of the hamstring and it required two recuperative periods, one for the hamstring and one for regenerating the hamstring? Is this common and how much longer is the recuperative period which means to an athlete" When can I get back on the floor and go full speed".

 

What about the situation in my post about the surgury to fix an acl including a piece of the hamstring and it required two recuperative periods, one for the hamstring and one for regenerating the hamstring? Is this common and how much longer is the recuperative period which means to an athlete" When can I get back on the floor and go full speed".

Sorry, meant one for the ACL and one for the hamstring

[Dark Man]

I am not a trainer, but when I read the post about the extensive pre-practice stretching program UT's women do I have to wonder how effective it is when they had at least 2 or 3 players (Candice Parker and Alex Fuller) that they lost last season to season ending knee injuries. My personal believe is that pre-practice stretching is vastly over-rated and the key is to start practices with drills that are non-contact and produce a gradual warm-up before getting into full speed drills and scrimmaging. I have coached girls basketball for several years and have only had one ACL injury during that period. The real time to stretch effectively is after excercise, not before. I'm sure I will get some argument about this approach, but it has been effective for me.

[givbakr2]

The article I read and other articles I have read offer no definitive reasons for the occurence being higher in girls than boys.I chose not to get into the debate earlier because I have read and even talked to an orthopedic surgeon and the jury is still out.Strength conditioning has been talked about as one of the causes for the greater incidence among females and I didn't want to debate the issue without sound facts to back up those assertions.One article I read suggested that because of the different biological makeup between the sexes ,females are more prone to the injury because the excercises make them more rigid and likely to the tears of the ACL and MCL.The article I read in the USA Today stated people who are pigeon toed, knockneed stand back on their legs and are dispropoitionately top heavy are more prone to the injuries. The excercises that were mentioned in the article were aimed at preventing the injury specifically.I wish i still had it.

[sofine]

Best I remember, Coach T did have a user forum for Sports Medicine a couple of years ago. But I think it was for "Plus" members only.

 

I know that there are many schools throughout Tennessee that do not have any licensed medical personnel available during practices or games....specifically Athletic Trainers. But please be patient. The Tennessee Athletic Trainers Society is working with the state government to make it a law that EVERY school has an Athletic Trainer on-site and available every day. I don't know when or if this will ever happen, but keep your fingers crossed.

 

In the meantime, I think we should petition Coach T to start a forum for sports injuries. And I would hope this forum would be available to all members year round. I know that there are a lot of Athletic Trainers that browse these sites, and although I can't speak for everybody, I love giving my opinions on the correct things to do.

 

Of course, there are going to be several dip-wads that want to talk BS and other smack if this forum should become available.....but I am interested if any others think this would be a good idea or not.

Edited December 1, 2005 by sofine

[PHargis]

I am not a trainer, but when I read the post about the extensive pre-practice stretching program UT's women do I have to wonder how effective it is when they had at least 2 or 3 players (Candice Parker and Alex Fuller) that they lost last season to season ending knee injuries. My personal believe is that pre-practice stretching is vastly over-rated and the key is to start practices with drills that are non-contact and produce a gradual warm-up before getting into full speed drills and scrimmaging. I have coached girls basketball for several years and have only had one ACL injury during that period. The real time to stretch effectively is after excercise, not before. I'm sure I will get some argument about this approach, but it has been effective for me.

I thought the same thing when i saw the post. But if you read it, ten minutes is not a long time. Certainly your experience is valuable but do you think part of the problem is that the skill levels are getting higher and players are trying to do more? Every year players are (pardon for the reference) bigger, stronger, and are trying to do more. These are still high school girls, not the MNBA, and the game still needs to be geared there.

 

The next post mentioned 25-30 minutes, I believe. I wonder if UT had the problems was because of the change in the procedure that the girls had been used to going thru and it put a strain on muscles and joints that had not been built up and they did not recognize this was happening until there were three injuries. It is very likely they re-evaluated the situation and changed some of their techniques since it was a high publicity event.

 

You may be saying the same thing as the second poster. Twenty five the thirty minutes of stretching and low contact could meet your criteria. So that all can meet the goal of reducing major athletic injuries, and that is the goal that this site was started on, it appears to me professionals and professional education led discussions are valuable. The answer to this increasing problem in female athletes I believe will come from different directions. But injuries can only be reduced by frank discussions by those posting on this Forum. Athletic trainers at schools is an answer but what parents are probably looking for is what to look for in making decisions best for their child in their selection of a high school or middle school to go to and what that school has to offer for the safety of their child. What procedures of conditioning, what equipment is recommended, what shoes to wear,

are inserts valuable, what are the warning signs of an impending injury during a stress situation are issues that it will be difficult to find school personnel help. Contracting this out to private industry to train school personnel seems to me to be a viable alternative. And then there is the money issue. Major injuries cost someone money. Usually it is the family involved. Why should the family not take more of an active role, if they are not now, of investigating all of these things and also the school as to how many injuries are occuring and what is being done about it. Are the school techniques meeting the needs? If a school is having a lot of ankle sprains, knee problems , what are the reasons?

 

In game situations, are injuries so prevelent that the rules do not take into effect the safety of the student/athlete and are the interpretation of the rules allowing for incidental contact being stretched too far. Safety should be a major consideration. There is no place, in high school athletics for intentionally hurting another athlete. The only place that this is really gray is in football. That is not this particular threads focus.

 

I hope Coacht will consider a more permanent Forum on Athletic Injuries and Conditioning and will seperate male and female and will solicit all who have an opinion to post. As many can see, there are a lot of opinions. but a lot of the difference of opinion are in the words used and the conditions. When you look at it, nobody is too far away from anybody else. It even looks as if the medical profession doesn't have uniminity on some issues but as long as it is understood that conditions are not the same in every situation, there is probably more uniminity than one thinks.

 

There are too many injuries and there are pockets of too many injuries. Look at the posts. There is a lack of information and somewhere along the line, the school public is going to recognize it if they haven't already. Information will be valuable.

[ooldrebel]

There are a couple of schools of thought on using the hamstring to repair the acl. The first is that rehab and recovery are sped up, because taking the hamstring tendon does not interrupt the quadriceps muscle. Rebuilding the explosive quad muscle is imperative after surgery to make sure that the knee can get fully extended or straight. By not cutting into the quad tendon, that muscle remains pretty strong after surgery, allowing quicker return to strengthening and decreased loss of motion in getting the knee straight. Also, there is decreased pain in the front of the knee. And, for athletes that are on the floor or ground often, such as football players and wrestlers this is an important factor in returning to their sport.

 

There is no significant studies that shows that hamstring grafts last longer or are better than quad tendon grafts.

 

On the other hand, the quad tendon has bone chips on both ends which allows for a better and more snug fit where the acl attaches to the bones in the knees. This makes the graft more stable immediately. The hamstring does not have the bone chips on each end which is less stable and require a little more protection in rehab. There is substantial muscle loss by cutting into the quadriceps tendon and a considerable amount of early rehab time goes to strengthening it, in the long run the quad tendon has a better result.

[hoopitup3]

I am not a trainer, but when I read the post about the extensive pre-practice stretching program UT's women do I have to wonder how effective it is when they had at least 2 or 3 players (Candice Parker and Alex Fuller) that they lost last season to season ending knee injuries. My personal believe is that pre-practice stretching is vastly over-rated and the key is to start practices with drills that are non-contact and produce a gradual warm-up before getting into full speed drills and scrimmaging. I have coached girls basketball for several years and have only had one ACL injury during that period. The real time to stretch effectively is after excercise, not before. I'm sure I will get some argument about this approach, but it has been effective for me.

Parker & Fuller both were injured in high school before they arrived at Tennessee. Parker's injury had been incorrectly diagnosed and had she not had the advise of the Tennessee trainer she could have potetially lost her career. This story is in the latest issue of SI.

I think athletic trainers, universally, recommend a thorough stretching period prior to exercise. The program at UT is heavily designed to stretch the hamstrings and stregthen the quads. Both important in deterring ACL injuries.

[Mr. Polesit]

I think that in asking ATC's(Certified Athletic Trainers) of their opinions you will find that most will respond with very similar beliefs and teachings.. As we have seen with posts from sofine and cbomb8 who I do know are ATCs. Ooldrebel has also responded with what I believe is reliable info and would think that sofine and cbomb8 would agree.

 

I don't think that parents and MOST COACHES realize how much ATCs could benefit their program other than just evaluating an injury or covering up a cut!

They don't realize that ATCs spend approx. 4 yrs studying human anatomy and physiology, eval. of orthopaedic injuries, emergency first aid and cpr, exercise physiology, nutrition, rehab techniques, therapuetic modalities and countless others. ATCs are state licensed health care providers who have passed an extensive national board of certification exam. Also, over 800hrs are spent being supervised by Cert. Athl. Trainers performing first aid, injury evaluation and injury rehab(just to name a few) before being accepted to sit for the national exam. This is not something that anyone can study at home for 6wks and take an online exam. This is not something that could just be taught to teachers thru a 3day course. As for all concerns that Phargis previously posted such a conditioning programs, injury prevention, injury evaluation, dr referral, etc. can all be performed by athletic trainers and are currently being done so at many high schools. I undoubtedly believe that the success of Jackson Co. girls bask would not be possible without the supervised strength and conditioning program designed by their ATC. I personally know of one hospital that spends over $400,000 annually(salary, benefits, school health supplies) to provide ATCs for four area high schools at absolutely no cost to the schools. And the sad thing is that most parents have no idea that this service is being provided. In most cases the parent or coach does not respect the ATC's decision simply because they are unaware of the extensive training that Cert. Athletic Trainers go thru... I have seen lots of cases where general practice physicians have missed injuries that ATCs have evaluated and found. Ask 10 orthopeadic surgeons specializing in sports med.(and yes there is a difference in some orthos and sports med. orthos.) if they had rather trust an injury evaluation from a general md or athletic trainer and 8 out of 10 will choose the athletic trainer. You know that typical ankle sprain?, go to the ER and they say stay off of it for a couple weeks then ease back in to activity, when you could see the ATC(ruling out fx of course) could start rehab, maintain conditioning, prevent the injury from happening again, and begin sport specific activity in probably half the time. But as usual we don't have MD after our names. And what really gets me is when people value the opinion of a nurse practioner over that of ATCs. Not putting them down by any means but ATCs are the more qualified healthcare provider for othopaedic needs.... Sorry for such a long post, I could go on and on but I will stop......

 

PHargis(or anyone), If you would like more info about Cert. Athl. Trainers, visit NATA.org.

Hope this helps.....