7 Health Benefits of Swimming

Article featured on verywellfit, Medically reviewed by Vanessa Nzeh, MD

Swimming is the fourth most popular form of exercise in the United States with over 27 million people participating over the age of six.

But there are also many barriers to participating in swimming. For instance, many people don’t learn to swim until later in life and some may experience discomfort or even fear of the water because it’s an unfamiliar environment.

Despite those hurdles, swimming provides a range of unique health benefits. Some people describe the sensation of immersing themselves in water as transformative or healing—and many enjoy the antigravity aspect of floating. There are also many documented health benefits associated with swimming that may inspire you to develop your own program of pool or open water exercise.

Health Benefits of Swimming

Participation in any physical activity—especially on a regular basis—can provide a wide range of health benefits. Regular exercise improves heart health, can help you reach and maintain a healthy weight, reduces your risk of type 2 diabetes and metabolic syndrome, and may even reduce the risk of certain cancers. Exercise can also help you experience sharper thinking, learning, and judgment skills as you age, reduce your risk of depression, and can even promote better sleep. And just a single bout of exercise can provide immediate benefits, including reduced short-term feelings of anxiety.

The water environment and the fact that swimming involves the entire body give it a few unique advantages over other popular activities such as walking, running, or cycling.

Researchers have investigated the many ways participation in different types of swimming can affect the body. It is important to note, however, that just like any physical activity, there are significant differences between participation levels.

For example, lifelong competitive swimmers may experience different health benefits than those who swim for fun just a few times per month. These are some of the findings regarding the health benefits of swimming.

May Improve Body Composition

Swimming may help you to reduce body fat. A small study published in the Journal of Exercise Rehabilitation found that middle-aged women who swam regularly (60-minute sessions, three times per week for 12 weeks) showed an average drop in body fat of almost 3% while a control group (women who did not swim) showed no significant change. The swimmers also showed improved flexibility, cardiovascular endurance, and improved blood lipids.

However, another study examined changes in body composition in younger women who participated in a 12-week swim program. The study involved 34 women in their early 20s who were assigned to a swimming group or a non-swimming (sedentary) group. The swimming group participated in three 60-minute swim sessions per week for 12 weeks.

At the conclusion of the study, researchers found that the swimming group did experience a decrease in hip circumference but did not show significant changes to body composition as compared to the non-swimming group.

Lastly, in 2015 researchers evaluated the psychological, social, and physical health states of competitive swimmers engaged in long-term training. The study took place during four days of the French master championships in 2011. All swimmers selected for the event were invited to take part in the study, but only 490 participated.

May Lower Blood Pressure

A handful of studies have suggested that swimming may help lower blood pressure. One study involved women who had been diagnosed with mild hypertension. Researchers evaluated the effects of different swimming protocols on their blood pressure.

For the study, 62 women were randomly assigned to participate in high-intensity swimming (6–10 repetitions of 30-second all-out effort interspersed by 2 minutes of recovery), moderate swimming (one hour at moderate intensity), or a control group (no training or lifestyle changes).

After 15 weeks, researchers saw no changes in the control group. But both the high intensity and moderate swimming groups saw a decrease in systolic blood pressure. Both groups also decreased resting heart rate and body fat.

Several other studies have also found associations between swimming for exercise and lower blood pressure, especially in people with hypertension.

Reduced Risk of Musculoskeletal Injury

Exercise physiologists have noted that many popular sports and leisure activities require a certain level of technique and can involve impact with the ground leading to bruises, contusions, bone fractures, and more serious injuries. This can make the high risk of injury a point of weakness for many traditional sports and athletic activities.

However, in at least one published review, researchers point out that the probability of these types of injuries taking place in a low-impact swimming environment is minimized given the fact that weight is reduced through the use of the water’s buoyancy.

Fewer Respiratory Infections

If cold weather swimming appeals to you, participation in this extreme sport may help you to avoid upper respiratory tract infections and gain other health benefits.

Also called “winter swimming” or “ice swimming,” the sport involves swimming in cold to ice-cold water, most often in water below 5 °C (41 degrees Fahrenheit). Ice swimming used to be practiced only by extreme athletes, but has grown in popularity and now recreational swimmers compete regularly in both local and international events.

Scientists who published a 2020 study in the International Journal of Environmental Research and Public Health reviewed studies related to ice swimming. They found that regular participation was associated with improvements in hematological and endocrine function (including decreased blood pressure, decreased triglycerides, and better insulin sensitivity), fewer upper respiratory tract infections, relief from mood disorders, and a general sense of well-being.

The researchers note, however, that only experienced swimmers in good health should participate in the sport. They state that “there is a risk of death in unfamiliar people, either due to the initial neurogenic cold shock response or due to a progressive decrease in swimming efficiency or hypothermia.”

If cold weather swimming sounds too extreme, you may still be able to gain better respiratory health with traditional pool swimming. A 2016 study published in the International Journal of Yoga compared the health effects of swimming to yoga.

Also, swimmers who participated in the 2015 study at the French Masters had greater peak expiratory flow values which suggested improved lung function.

Improved Health Perception

In 2015, a group of researchers investigated how different levels of participation in swimming might affect the health perception of middle-aged women. In their report, the study authors write that health perception is important in the way we manage our overall health because our behavior and choices are based on what we perceive about health in the first place.

They note that this relationship is important now more than ever as stress levels and fatigue are on the rise in many areas.

In the 2015 study involving participants of the French Masters, researchers measured the swimmer’s health perceptions. All of the female swimmers and the older age groups of male swimmers reported significantly higher values when it came to perceptions of vitality as compared to reference values. All of the swimmers who participated in that study also indicated significantly lower scores for the perception of bodily pain.

More Swimming Benefits

Many people who swim describe benefits that are not likely to be reported in clinical studies. In fact, according to U.S. Masters Swimming (USMS), Olympic swimmer Janet Evans once described swimming as the “ultimate all-in-one fitness package” because it improves your physical, mental, and emotional well-being.

These benefits are not groundbreaking news to Marty Munson, a marathon swimmer who has swum around many islands including Key West and Manhattan. Munson is a USMS-certified swim coach, a certified Adult Learn to Swim instructor, and is a USA Triathlon Level 1 coach.

In her experience coaching both new and experienced swimmers, she has seen that the sport can be transformative. She outlines a few keys areas where change is likely to occur.

Elevated Sense of Achievement

“So many people come to the pool feeling that swimming is impossible for them,” says Munson. She adds that people are often sure they can’t learn to swim and see they see the water as “other” or “scary.” Part of this may be due to the fact that breathing in the water is different than breathing on land. But after learning a few basics, “new swimmers learn to luxuriate in it, work with it, and move through it,” she says “And they always amaze themselves when they do.”

For swimmers who have some limited experience in the water, there are also benefits. By refining basic skills, beginning-level swimmers can become proficient in the water. Simple tweaks can make the difference between struggling in the water and being frustrated, and gliding through it, and having fun.

Improved Self-Reliance

When people who are just learning to swim finally get the hang of it, they gain so much more than technique, says Munson. “Swimming isn’t just about moving your arms, legs, and core, and getting to the other side of the pool.”

Instead, she describes a process that involves learning to rely on your own strength and abilities. “A big part of swimming is about learning to not fight with the water,” she says. “That kind of acceptance and surrender, used at the right moments, is a powerful skill both in the pool and out.”

Munson says this sense of self-reliance often carries over into other areas of life. “It’s an amazing feeling to know that you can jump into any body of water and manage it just fine,” she says.

Tips to Get Started

If the benefits of swimming have inspired you to dive in and start your own program, Munson has a few suggestions to help you get started.

Reframe Fears About Breathing

People are often afraid of thinking about the fact that you can’t breathe when your head is under the water. But Munson explains that you do breathe under water. You just breathe out when your face is in and breathe in when your head is above the surface. So, it’s not that you can’t breathe under the water. Instead, you breathe differently underwater.

“Many people think they should hold their breath under the water. When you do that, you’re actually creating a feeling of panic. But if you breathe out underwater and breathe in when you bring your head up or turn your head to the side you’ll be able to create the same in-out rhythm that you have on land.”

To adjust to the new breathing pattern Munson suggests that you practice blowing bubbles under the water before you try swimming. Put your face in the water and make a lot of big bubbles, breathe in when you come up. Practicing this pattern will help you to establish a comfortable breathing rhythm.

Be Patient

Many times people have bad previous experiences with water and a qualified instructor can help you get past them. And remember to be patient and kind to yourself as you learn to swim. “Don’t let people force you into deeper water than you’re ready for,” she says. “But also don’t convince yourself that you can’t make it to the next level.”

Learn to Tread Water

Treading water teaches you to keep your head above water regardless of water depth. “When people learn this skill, they get a huge jump in confidence in the water,” says Munson. It helps new swimmers pause and support themselves when they get uncomfortable. Lastly, Munson suggests that practice is important. You don’t have to spend a long time in the pool each session, just a few minutes on a regular basis can make a difference.

“I can always tell when swimmers in my weekly classes have been in the pool in between sessions,” she says. “It doesn’t take long to develop skills, but you do have to get in the pool to do it.”


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

3 Common Golf Injuries: How to Avoid the “Rough”

Article from Brigham Health Hub, written by Elizabeth G. Matzkin, MD

Golf is a lifetime sport – people of all ages and activity levels can participate. It is a great way to get outside and stay active, especially if you choose to walk the course. On average, a golfer playing 18 holes on foot will walk anywhere from three to six miles. Injuries are common at all levels of play, from first-time golfers to professionals. Before you take your first swing of the season, be sure to check out the tips below on signs, symptoms, and prevention of common golf injuries.

1. Rotator Cuff Tendinitis

What is it?

The rotator cuff is a group of important muscles and tendons in your shoulder. Rotator cuff tendinitis is caused by inflammation of these tendons, leading to pain and decreased function. Rotator cuff tendinitis is commonly associated with overuse. Signs and symptoms include pain with overhead movements or repetitive motions of the shoulder.

How can I prevent this?

Rotator cuff tendinitis can be caused by overuse or improper technique during your swing, putting too much stress on the shoulder. Consult a golf instructor for suggestions on improving swing technique. You should always stretch out your shoulders and warm up with a few exercises before you start swinging for the day.

How is it treated?

If your doctor suspects you have rotator cuff tendinitis, they may prescribe rest, ice, and an anti-inflammatory medication. Your doctor also may recommend physical therapy to help maximize shoulder strength and function. If you have a flare-up of significant pain that limits motion, sometimes your doctor may recommend a corticosteroid injection to decrease acute inflammation.

2. Golfer’s Elbow

What is it?

Medial epicondylitis, also known as golfer’s elbow, is caused by inflammation of the tendons and muscles on the inside of the elbow. Golfer’s elbow is a common overuse injury, caused by repetitive motions. Signs and symptoms of golfer’s elbow include persistent pain on the inside of the elbow and pain during movements of the wrist, such as turning a doorknob or shaking hands.

How can I prevent this?

Golfer’s elbow can be caused by improper swing technique that puts additional stress on the tendons of the inside of the elbow. Ask a golf instructor to recommend techniques that minimize stress on the elbow during a swing. In addition, make sure you are using golf clubs that are the right fit for your size and strength.

How is it treated?

If your doctor suspects you have golfer’s elbow, they will likely prescribe rest, ice, non-steroidal anti-inflammatory medication, and physical therapy to strengthen your elbow muscles and tendons. Your doctor also may prescribe a wrist brace or forearm band to help reduce pain with movements of the wrist.

3. Knee Pain

What is it?

A golf swing requires rotation of the knee as you turn your hips and shoulders to follow through. This movement can cause or aggravate a torn meniscus, a cartilage structure in the knee that helps absorb the impact of walking and rotation during a swing. For older golfers, this movement also can exacerbate pre-existing arthritis.

How do I prevent it?

Weakness in the thigh muscles, like the hip flexors, quadriceps, and hamstrings, puts additional pressure on the knee joint when walking and especially during a golf swing. Specific exercises that target these muscle groups will maximize your strength and help to take pressure off of the knee joint, decreasing pain during golf or other daily activities. Proper swing technique is also important to minimize the rotational forces on the knee.

How is it treated?

If your doctor suspects you have arthritis or a tear in the meniscus, they may recommend ice, non-steroidal anti-inflammatory medication, and physical therapy to increase the strength of your thigh muscles. By maximizing strength and decreasing swelling, you can get back to a pain-free golf swing. However, if you have persistent pain and severe limitations in your activities, your doctor may recommend a corticosteroid injection or further intervention.

Golf is a great way to exercise and stay active for many people. Unfortunately, injuries can occur at any age or level of play. Be on the lookout for these common injuries and be sure to stretch and warm up your arm and leg muscles before you hit the course. If you have persistent pain from golfing, be sure to consult your doctor for a proper diagnosis and treatment plan.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Causes of foot pain all runners need to know

Causes of foot pain all runners need to know

Article Featured on OSMS

A total ankle replacement, also called total ankle arthroplasty, is a surgical treatment option for patients suffering from ankle pain, typically due to arthritis or injury. If this pain is impacting a patient’s quality of life or keeping them from walking comfortably, they might benefit from a total ankle arthroplasty. While lesser known than a total hip, knee or shoulder replacement, total ankle replacements are gaining popularity.

Read more

5 Expert Tips for Preventing Winter Sports Accidents

5 Expert Tips for Preventing Winter Sports Accidents

BY KAYLA MCKISKI | Article Featured on US News

Hitting the slopes or the skating rink as the winter of 2020 winds down? Don’t let an accident or injury spoil your fun.

“Winter sports and recreational activities have great health and cardiovascular benefits,” said Dr. Joseph Bosco, vice president of the American Academy of Orthopaedic Surgeons (AAOS). “However, it’s important not to underestimate the risks that cold weather can bring.”

He noted that hospitals and health care clinics see a surge of bone and joint injuries during the winter months and many could be prevented with the right preparation.

Sprains, strains, dislocations, fractures and more traumatic injuries can happen to anyone. Here, Bosco and the AAOS offer suggestions on how to protect yourself:

  • Be prepared: Before you tackle a winter sport, make sure your muscles are warmed up and in good condition. Cold muscles, tendons and ligaments are more prone to injury. Make sure to have water and other supplies on standby.
  • Wear appropriate gear: Well-fitting protective equipment like goggles, helmets, gloves and padding is crucial. Your clothes should be layered, light, loose and wind-resistant. Footwear should be warm, provide ankle support and keep your feet dry.
  • Follow the rules: If you’re unsure of the rules of your sport, it’s time to take a lesson with a qualified instructor, especially with sports like skiing and snowboarding. Knowing how to fall correctly and safely can drastically reduce your risk of injury.
  • Keep an eye on the weather: Warnings about storms and extremely low temperatures are red flags. If you’re experiencing hypothermia or frostbite, seek immediate shelter and medical attention.
  • Use common sense: Always have a buddy when participating in an outdoor sport or activity. If you feel pain or fatigue, don’t push yourself and stop the activity.

“Don’t let winter sports injuries freeze your fun,” Bosco said in an AAOS news release. “By keeping in good physical condition, staying alert and stopping when you’re tired or in pain, you can enjoy the best of winter and reduce your risk of injury.”


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Shoulder Injuries in the Throwing Athlete

Shoulder Injuries in the Throwing Athlete

Article Featured on AAOS

Overhand throwing places extremely high stresses on the shoulder, specifically to the anatomy that keeps the shoulder stable. In throwing athletes, these high stresses are repeated many times and can lead to a wide range of overuse injuries.

Although throwing injuries in the shoulder most commonly occur in baseball pitchers, they can be seen in any athlete who participates in sports that require repetitive overhand motions, such as volleyball, tennis, and some track and field events.

Anatomy of the Shoulder

Your shoulder is a ball-and-socket joint made up of three bones: your upper arm bone (humerus), your shoulder blade (scapula), and your collarbone (clavicle).

The head of your upper arm bone fits into a rounded socket in your shoulder blade. This socket is called the glenoid. Surrounding the outside edge of the glenoid is a rim of strong, fibrous tissue called the labrum. The labrum helps to deepen the socket and stabilize the shoulder joint. It also serves as an attachment point for many of the ligaments of the shoulder, as well as one of the tendons from the biceps muscle in the arm.

Strong connective tissue, called the shoulder capsule, is the ligament system of the shoulder and keeps the head of the upper arm bone centered in the glenoid socket. This tissue covers the shoulder joint and attaches the upper end of the arm bone to the shoulder blade.

The bones of the shoulder

The bones of the shoulder. Reproduced with permission from J Bernstein, ed: Musculoskeletal Medicine. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2003.

The ligaments of the shoulder

The ligaments of the shoulder. Reproduced with permission from J Bernstein, ed: Musculoskeletal Medicine. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2003.

Your shoulder also relies on strong tendons and muscles to keep your shoulder stable. Some of these muscles are called the rotator cuff. The rotator cuff is made up of four muscles that come together as tendons to form a covering or cuff of tissue around the head of the humerus.

The biceps muscle in the upper arm has two tendons that attach it to the shoulder blade. The long head attaches to the top of the shoulder socket (glenoid). The short head attaches to a bump on the shoulder blade called the coracoid process. These attachments help to center the humeral head in the glenoid socket.

rotator cuff anatomy

This illustration shows the biceps tendons and the four muscles and their tendons that form the rotator cuff and stabilize the shoulder joint. Reproduced and adapted with permission from The Body Almanac. (c) American Academy of Orthopaedic Surgeons, 2003.

In addition to the ligaments and rotator cuff, muscles in the upper back play an important role in keeping the shoulder stable. These muscles include the trapezius, levator scapulae, rhomboids, and serratus anterior, and they are referred to as the scapular stabilizers. They control the scapula and clavicle bones — called the shoulder girdle — which functions as the foundation for the shoulder joint.

Muscles in the upper back

Muscles in the upper back help to keep the shoulder stable, particularly during overhead motions, like throwing. (Note: this illustration has been drawn in such a way to show the many layers of muscle in the back.) Reproduced with permission from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010.

Cause

When athletes throw repeatedly at high speed, significant stresses are placed on the anatomical structures that keep the humeral head centered in the glenoid socket.

baseball pitching phases

The phases of pitching a baseball. Reproduced and adapted with permission from Poss R (ed): Orthopaedic Knowledge Update 3. Rosemont, IL. American Academy of Orthopaedic Surgeons, 1990, pp 293-302.

Of the five phases that make up the pitching motion, the late cocking and follow-through phases place the greatest forces on the shoulder.

  • Late-cocking phase. In order to generate maximum pitch speed, the thrower must bring the arm and hand up and behind the body during the late cocking phase. This arm position of extreme external rotation helps the thrower put speed on the ball, however, it also forces the head of the humerus forward which places significant stress on the ligaments in the front of the shoulder. Over time, the ligaments loosen, resulting in greater external rotation and greater pitching speed, but less shoulder stability.
  • Follow-through phase. During acceleration, the arm rapidly rotates internally. Once the ball is released, follow-through begins and the ligaments and rotator cuff tendons at the back of the shoulder must handle significant stresses to decelerate the arm and control the humeral head.

When one structure — such as the ligament system — becomes weakened due to repetitive stresses, other structures must handle the overload. As a result, a wide range of shoulder injuries can occur in the throwing athlete.

The rotator cuff and labrum are the shoulder structures most vulnerable to throwing injuries.

Common Throwing Injuries In the Shoulder

SLAP Tears (Superior Labrum Anterior to Posterior)

In a SLAP injury, the top (superior) part of the labrum is injured. This top area is also where the long head of the biceps tendon attaches to the labrum. A SLAP tear occurs both in front (anterior) and in back (posterior) of this attachment point.

Typical symptoms are a catching or locking sensation, and pain with certain shoulder movements. Pain deep within the shoulder or with certain arm positions is also common.

shoulder labrum and SLAP tear

(Left) The labrum helps to deepen the shoulder socket.

(Right) This cross-section view of the shoulder socket shows a typical SLAP tear.

Bicep Tendinitis and Tendon Tears

Repetitive throwing can inflame and irritate the upper biceps tendon. This is called biceps tendinitis. Pain in the front of the shoulder and weakness are common symptoms of biceps tendinitis.

Occasionally, the damage to the tendon caused by tendinitis can result in a tear. A torn biceps tendon may cause a sudden, sharp pain in the upper arm. Some people will hear a popping or snapping noise when the tendon tears.

biceps tendinitis

(Left) The biceps tendon helps to keep the head of the humerus centered in the glenoid socket. (Right) Tendinitis causes the tendon to become red and swollen.

Rotator Cuff Tendinitis and Tears

When a muscle or tendon is overworked, it can become inflamed. The rotator cuff is frequently irritated in throwers, resulting in tendinitis.

Early symptoms include pain that radiates from the front of the shoulder to the side of the arm. Pain may be present during throwing, other activities, and at rest. As the problem progresses, pain may occur at night, and the athlete may experience a loss of strength and motion.

Rotator cuff tears often begin by fraying. As the damage worsens, the tendon can tear. When one or more of the rotator cuff tendons is torn, the tendon no longer fully attaches to the head of the humerus. Most tears in throwing athletes occur in the supraspinatus tendon.

rotator cuff tear

Rotator cuff tendon tears in throwers most often occur within the tendon. In some cases, the tendon can tear away from where it attaches to the humerus.

Problems with the rotator cuff often lead to shoulder bursitis. There is a lubricating sac called a bursa between the rotator cuff and the bone on top of your shoulder (acromion). The bursa allows the rotator cuff tendons to glide freely when you move your arm. When the rotator cuff tendons are injured or damaged, this bursa can also become inflamed and painful.

Internal Impingement

During the cocking phase of an overhand throw, the rotator cuff tendons at the back of the shoulder can get pinched between the humeral head and the glenoid. This is called internal impingement and may result in a partial tearing of the rotator cuff tendon. Internal impingement may also damage the labrum, causing part of it to peel off from the glenoid.

Internal impingement may be due to some looseness in the structures at the front of the joint, as well as tightness in the back of the shoulder.

The muscles and tendons of the rotator cuff

The muscles and tendons of the rotator cuff. Reproduced with permission from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010.

shoulder impingement

This illustration shows the infraspinatus tendon caught between the humeral head and the glenoid. Reproduced with permission from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010.

Instability

Shoulder instability occurs when the head of the humerus slips out of the shoulder socket (dislocation). When the shoulder is loose and moves out of place repeatedly, it is called chronic shoulder instability.

In throwers, instability develops gradually over years from repetitive throwing that stretches the ligaments and creates increased laxity (looseness). If the rotator cuff structures are not able to control the laxity, then the shoulder will slip slightly off-center (subluxation) during the throwing motion.

Pain and loss of throwing velocity will be the initial symptoms, rather than a sensation of the shoulder “slipping out of place.” Occasionally, the thrower may feel the arm “go dead.” A common term for instability many years ago was “dead arm syndrome.”

Glenohumeral Internal Rotation Deficit (GIRD)

As mentioned above, the extreme external rotation required to throw at high speeds typically causes the ligaments at the front of the shoulder to stretch and loosen. A natural and common result is that the soft tissues in the back of the shoulder tighten, leading to loss of internal rotation.

This loss of internal rotation puts throwers at greater risk for labral and rotator cuff tears.

Scapular Rotation Dysfunction (SICK Scapula)

abnormal positioning of the scapula

This photograph shows abnormal positioning of the scapula on the right side. Reproduced with permission from Kibler B, Sciascia A, Wilkes T: Scapular Dyskinesis and Its Relation to Shoulder Injury. J Am Acad Orthop Surg 2012; 20:364-372.

Proper movement and rotation of the scapula over the chest wall is important during the throwing motion. The scapula (shoulder blade) connects to only one other bone: the clavicle. As a result, the scapula relies on several muscles in the upper back to keep it in position to support healthy shoulder movement.

During throwing, repetitive use of scapular muscles creates changes in the muscles that affect the position of the scapula and increase the risk of shoulder injury.

Scapular rotation dysfunction is characterized by drooping of the affected shoulder. The most common symptom is pain at the front of the shoulder, near the collarbone.

In many throwing athletes with SICK scapula, the chest muscles tighten in response to changes in the upper back muscles. Lifting weights and chest strengthening exercises can aggravate this condition.

Doctor Examination

Medical History and Physical Examination

The medical history portion of the initial doctor visit includes discussion about your general medical health, symptoms and when they first began, and the nature and frequency of athletic participation

During the physicial examination, your doctor will check the range of motion, strength, and stability of your shoulder. He or she may perform specific tests by placing your arm in different positions to reproduce your symptoms.

The results of these tests help the doctor decide if additional testing or imaging of the shoulder is necessary.

Imaging Tests

Your doctor may order tests to confirm your diagnosis and identify any associated problems.

X-rays. This imaging test creates clear pictures of dense structures, like bone. X-rays will show any problems within the bones of your shoulder, such as arthritis or fractures.

Magnetic resonance imaging (MRI). This imaging study shows better images of soft tissues. It may help your doctor identify injuries to the labrum, ligaments, and tendons surrounding your shoulder joint.

Computed tomography (CT) scan. This test combines x-rays with computer technology to produce a very detailed view of the bones in the shoulder area.

Ultrasound. Real time images of muscles, tendons, ligaments, joints, and soft tissues can be produced using ultrasound. This test is typically used to diagnose rotator cuff tears in individuals who are not able to have MRI scans.

Treatment

Left untreated, throwing injuries in the shoulder can become complicated conditions.

Nonsurgical Treatment

In many cases, the initial treatment for a throwing injury in the shoulder is nonsurgical. Treatment options may include:

  • Activity modification. Your doctor may first recommend simply changing your daily routine and avoiding activities that cause symptoms.
  • Ice. Applying icepacks to the shoulder can reduce any swelling.
  • Anti-inflammatory medication. Drugs like ibuprofen and naproxen can relieve pain and inflammation. They can also be provided in prescription-strength form.
  • Physical therapy. In order to improve the range of motion in your shoulder and strengthen the muscles that support the joint, your doctor may recommend specific exercises. Physical therapy can focus on muscles and ligament tightness in the back of the shoulder and help to strengthen the structures in the front of the shoulder. This can relieve some stress on any injured structures, such as the labrum or rotator cuff tendon.
  • Change of position. Throwing mechanics can be evaluated in order to correct body positioning that puts excessive stress on injured shoulder structures. Although a change of position or even a change in sport can eliminate repetitive stresses on the shoulder and provide lasting relief, this is often undesirable, especially in high level athletes.
  • Cortisone injection— If rest, medications, and physical therapy do not relieve your pain, an injection of a local anesthetic and a cortisone preparation may be helpful. Cortisone is a very effective anti-inflammatory medicine. Injecting it into the bursa beneath the acromion can provide long-term pain relief for tears or other structural damage.

cortisone injection in shoulder

A cortisone injection may relieve painful symptoms. Reproduced with permission from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010.
Your doctor may recommend surgery based on your history, physical examination, and imaging studies, or if your symptoms are not relieved by nonsurgical treatment.The type of surgery performed will depend on several factors, such as your injury, age, and anatomy. Your orthopaedic surgeon will discuss with you the best procedure to meet your individual health needs.

Arthroscopy. Most throwing injuries can be treated with arthroscopic surgery. During arthroscopy, the surgeon inserts a small camera, called an arthroscope, into the shoulder joint. The camera displays pictures on a television screen, and the surgeon uses these images to guide miniature surgical instruments.

Because the arthroscope and surgical instruments are thin, the surgeon can use very small incisions (cuts), rather than the larger incision needed for standard, open surgery.

During arthroscopy, your doctor can repair damage to soft tissues, such as the labrum, ligaments, or rotator cuff.

shoulder arthroscopy

During arthroscopy, your surgeon inserts the arthroscope and small instruments into your shoulder joint.

Open surgery. A traditional open surgical incision (several centimeters long) is often required if the injury is large or complex.

Rehabilitation. After surgery, the repair needs to be protected while the injury heals. To keep your arm from moving, you will most likely use a sling for for a short period of time. How long you require a sling depends upon the severity of your injury.

As soon as your comfort allows, your doctor may remove the sling to begin a physical therapy program.

In general, a therapy program focuses first on flexibility. Gentle stretches will improve your range of motion and prevent stiffness in your shoulder. As healing progresses, exercises to strengthen the shoulder muscles and the rotator cuff will gradually be added to your program. This typically occurs 4 to 6 weeks after surgery.

Your doctor will discuss with you when it is safe to return to sports activity. If your goal is to return to overhead sports activities, your doctor or physical therapist will direct a therapy program that includes a gradual return to throwing.

It typically takes 2 to 4 months to achieve complete relief of pain, but it may take up to a year to return to your sports activities.

Prevention

In recent years, there has been a great deal of attention on preventing throwing injuries of the shoulder.

Proper conditioning, technique, and recovery time can help to prevent throwing injuries. Throwers should strive to maintain good shoulder girdle function with proper stretches and upper back and torso strengthening.

In the case of younger athletes, pitching guidelines regarding number of pitches per game and week, as well as type of pitches thrown, have been developed to protect children from injury.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Hip Pointers in Contact Sports

Hip Pointers in Contact Sports

Article Featured on Nationwide Children’s Hospital

Hip Pointers

Bumps and falls are all a part of everyday life as an athlete, and can often result in bruising and injury. The majority of these types of injuries are seen in contact sports. The term “hip pointer” is often used as a catch all phrase for any injury resulting in pain to the front of the hip. However, this is not always the case.

What is a Hip Pointer?

A hip pointer is bruising caused by a fall or a direct blow to the iliac crest, or front and top of the pelvis. This bruising is not always visible and may actually occur deep below the skin. Bruising may also occur in the abdominal muscles which attach to the pelvis. Most often hip pointers are seen in contact sports such as football and soccer. Hip pointers are extremely painful and may be aggravated by walking, running, laughing, coughing, or deep breathing.

Treatment

Hip pointers are treated immediately with rest and ice. Resting the injured hip from extremely painful movements will help to reduce swelling and speed the healing process. It may take 1 to 2 weeks before the injured hip is pain free with movement. During this time the athlete should be allowed to stretch the hip in all directions to avoid stiffness. The rule here is to stretch in the pain free range. Any pain will only slow the healing process and delay their return to sport.

It is important to consult your physician if your pain last more than two weeks or worsens overtime. This may be a sign of a more severe injury. Ice should be applied directly to the hip for 30 minutes of every 1-2 hours for the first 72 hours. A regimen of gentle stretching for 20-30 seconds can help to loosen the muscles around the injured hip and reduce pain. For more information on strains please see the article “The Sprains and Strains of Sporting Injuries” located on the Nationwide Children’s Hospital website.

Prevention

Hip pointers can be prevented by wearing appropriate protective equipment. For example, football and hockey wear protective hip pads to help prevent this injury. In other sports where padding is not worn, such as soccer, certain skills and techniques can be taught to avoid this injury. Padding can also be worn to prevent further injury to the hip.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Neck Injuries Among Athletes Are Serious. Here's Why.

Neck Injuries Among Athletes Are Serious. Here’s Why.

By Neel Anand, M.D., Contributor | Article Featured on US News

WHEN IT COMES TO football-related head injuries, the headline-grabbers are usually about concussion. However, it’s not infrequent that a hard-enough hit to the head can result in both a concussion and a significant injury to the cervical spine, or neck. What’s more, it isn’t the professional players who are sustaining the majority of neck injuries related to football play. It’s mostly collegiate and youth athletes. When a hard enough hit or fall can result in a fracture or paralysis, it’s essential to look at why and how these injuries occur. Then, we must figure out ways to prevent them – or at least reduce the risk.

It might seem delicate on the outside, but your neck is one biological powerhouse on the inside. It must be flexible enough for you to turn your head from side to side, but strong enough to support the head, which weighs about 10 pounds. Neck stability occurs through the intricate arrangement of vertebrae in the cervical spine – the seven vertebrae in the neck. Between each vertebra is shock-absorbing cushions called disks, and surrounding the neck are muscles that provide strength and allow for flexibility.

Though designed for strength, the neck can be gravely injured. Hard football tackles and falls can result in severe neck injury – in much the same way and by the same force that happens with whiplash during a car accident. When the neck is hyperextended (flung too far backward) or hyper-flexed (thrown too far forward), ligament tears, sprains and strains can be the result. On the other hand, a tackle or fall that pushes the head too far to one side can result in a burner or stinger type of injury. Burners and stingers get their name from the electricity-like jolt of pain they can cause, which may also send the sensation down the arm. These injuries are the result of damage to the brachial plexus, a group of nerves that provides feeling to the arms. The incidence of burner or stinger injuries is quite high among collegiate football players, with up to 70% having sustained one.

The risk of neck injuries in football isn’t only high for collegiate or professional players. Sports-related emergency room visits for neck-related fractures number into the thousands each year, with football among the top five sports contributing to these numbers. And the age of incidence is highest in kids who are 15 years old or younger.

Any neck injury as the result of a hard tackle or fall should be evaluated a qualified medical professional, though most will resolve with minimal intervention. However, there are some signs of serious neck injury that warrant an emergency room visit. These include severe, uncontrollable pain; pain that shoots or radiates into the arms or legs; any tingling or numbness sensations; and trouble with bowel or bladder control.

Like any other injured body part, the neck needs time and care to heal properly. Even if a player is seemingly “fine” after the incident, neck injuries should be given at least a few days to recover. Of course, the best neck injury is the one that never happens. So taking proper safety precautions is always a must. If it’s tackle football, ensure that the equipment is functioning correctly. Shoulder pads and helmets should always be worn (in practice and during games) and must fit appropriately based on both the age and size of the player. Proper technique is also crucial. Remember: You should always see what you hit. Just because you wear a helmet does not mean it should be used as a weapon.

Serving as the director of spine trauma at a major metropolitan hospital for several years, I’m heartbroken to see kids come in with catastrophic but preventable neck injuries. For as much time and attention as coaches and team staff put into concussion detection and prevention, I firmly believe there should also be a significant amount dedicated to protection against serious neck injuries.

 


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Top 10 Most Common Sports Injuries

Top 10 Most Common Sports Injuries

Whether you are a highly-trained athlete or a weekend warrior, there’s always a chance you could get injured. Unfortunately, when injuries happen, it can be hard to know what you’ve tweaked or how to treat it. Brian McEvoy, PT, UnityPoint Health, counts down the most common sports injuries, from the least common to the most common, along with possible causes, treatments and recovery strategies.

Read more

Water Polo Study Highlights Head Injury Risk

Water Polo Study Highlights Head Injury Risk

Water polo players appear to face similar head injury risks as athletes in better-known sports, a new study finds. “For years, water polo’s head trauma risks have been downplayed or overshadowed by football-related brain injuries,” said study co-author James Hicks.

“Our data quantifies the extent of the problem and sets the stage for additional research and possible rule changes or protective gear to improve water polo safety,” Hicks added. He is chairman of the department of ecology and evolutionary biology at the University of California, Irvine.

“People who’ve never seen a game may not realize how physical it is,” Hicks said in a university news release. “Head-butts and elbows. Balls flying up to 50 miles per hour.”

And while no concussions were diagnosed among players in the study, the force of the head blows was “similar to those observed in collegiate soccer, another sport that is commonly studied for the risks associated with repeated head impact exposure,” he added.

For the study, Hicks and his colleagues tracked several dozen players in Division 1 NCAA Men’s Water Polo over three seasons. The players wore caps embedded with electronic sensors.

Overall, the researchers counted an average of 18 head hits per game. Offensive players were far more likely to get hit in the head than players in defensive and transition positions (60%, 23% and 17%, respectively), the findings showed. Players attacking from the left side of the goal suffered more head hits than players on the right, possibly because right-handed athletes commonly throw shots from the left zone, the researchers noted.

Offensive center was the most dangerous position in terms of hits to the head. On average, those players took nearly seven blows to the head per game, which amounted to 37% of all head impacts recorded in the study. The second-most vulnerable position, defensive center, averaged two head hits per game, according to the report.

The study authors concluded that “intercollegiate water polo athletes may represent a valuable cohort for studying the acute and chronic effects of repeated head impacts in sport to extend our knowledge of athlete physiology and neurology and to inform evidence-based policies to promote the safety of athletes and the benefits of sport.”

The study was published online May 2 in the journal PLOS ONE. In a previous study, Hicks and a colleague found that 36% of 1,500 USA Water Polo players recalled at least one concussion during their playing career.

More information

The American Academy of Pediatrics has more on water polo injury risk and safety.

Kid's Sports Injuries: The Numbers are Impressive

Kid’s Sports Injuries: The Numbers are Impressive

Article Featured on Nationwide Children

The Numbers Are Impressive

The picture of youth sports in America is changing. Youth athletes often begin their competitive sports careers as early as age seven, with some youth participating in organized sports activities as early as age four, if not sooner. With an estimated 25 million scholastic, and another 20 million organized community-based youth programs in the United States, the opportunity for injury is enormous.

This is why sports injuries are the second leading cause of emergency room visits for children and adolescents, and the second leading cause of injuries in school. Approximately three million youth are seen in hospital emergency rooms for sports-related injuries and another five million youth are seen by their primary care physician or a sports medicine clinic for injuries. These numbers leave out the injuries not seen by a physician.

What Does This Mean?

Physical activity is necessary for normal growth in children. However, when the activity level becomes too intense or too excessive in a short time period, tissue breakdown and injury can occur. These overuse injuries were frequently seen in adult recreational athletes, but are now being seen in children. The single biggest factor contributing to the dramatic increase in overuse injuries in young athletes is the focus on more intense, repetitive and specialized training at much younger ages.

Overuse injuries such as stress fractures, tendinitis, bursitis, apophysitis and osteochondral injuries of the joint surface were rarely seen when children spent more time engaging in free play. The following risk factors predispose young athletes to overuse injuries:

  1. Sport specialization at a young age
  2. Imbalance of strength or joint range of motion
  3. Anatomic malalignment
  4. Improper footwear
  5. Pre-existing condition
  6. Growth cartilage less resistant to repetitive microtrauma
  7. Intense, repetitive training during periods of growth

What Should Be Done?

Early recognition and treatment of injuries is critical in returning athletes to their sport safely and quickly. Any injury that involves obvious swelling, deformity, and/or loss of normal function (i.e. movement or strength) should be seen by a physician immediately. All other injuries that appear to be minor should resolve themselves within a few days. However, if it does not heal on it’s own, and your child is not back to full participation without pain, it is best to have him/her evaluated by a physician. Nagging injuries that go untreated can turn into chronic problems that require a much longer time away from the sport to allow the injury to heal properly.

If your child does get injured while playing sports, the best treatment plan is R.I.C.E:

Rest

  • Do not use the injured area until seen for further evaluation by a physician
  • If walking with a limp, have the athlete use crutches

Ice

  • Apply ice to the injured area to help decrease pain and swelling
  • Use ice 15 – 20 minutes at a time
  • Crushed/cubed ice or frozen peas/corn works best, avoid using chemical cold packs
  • Always ice for the first 48 – 72 hours after injury
  • Never sleep with ice on the injured area

Compression

  • Elastic wrap/compression sock should be used to reduce swelling
  • Apply wrap beginning below the injured area and wrapping upward
  • Always leave toes/fingers exposed
  • Watch for numbness, discoloration or temperature changes (loosen wrap if needed)
  • Do not sleep with wrap on the injured area

Elevation

  • Use gravity to control swelling
  • Prop injured area higher than the heart

New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.