Category: Press Releases

A Torn ACL By Any Other Name

For Immediate Release

A Torn ACL By Any Other Name
A Knee Slow to Swell May Still Require Orthopaedic Surgery

At first glance, after hearing a distinctive “pop” in her knee during the championship game for her women’s recreational soccer league, Kristin SanGiacomo thought she might have just sprained something. The 36-year-old Avon, Connecticut insurance executive had played long enough to realize there might have been a serious injury; however, having never injured her knee before and the ability to get up on her own and walk around the bench cheering her team on, led her to believe she might be okay.

“My first reaction was oh my god, this is not good,” she said. “But I didn’t have any of the stereotypical symptoms, my knee didn’t swell horribly. I was able to get up and walk on it slightly. I was convinced with a little rest it would be fine.”

Twenty-four hours later her symptoms got worse. Swelling set in and her knee hurt. SanGiacomo was scheduled to travel the next morning for work. “I was smart enough to realize traveling was a bad idea,” she said.

An initial examination by a local orthopaedist, along with an MRI, provided a diagnosis of a torn anterior cruciate ligament (ACL).

The ACL is one of the most commonly injured ligaments of the knee. Most injuries occur in the young, athletic population. The ACL is injured when it sustains a force that exceeds the strength of the ligament. This may result from a non-contact injury (landing awkwardly, cutting or changing direction), or in the case of SanGiacomo, abrupt movement on an uneven outdoor field. The risk of ACL injury is highest in sports that require pivoting, jumping, cutting or a rapid change of direction (soccer, for example).

“I was presented some surgical options by several orthopaedists, but they all revolved around a hamstring technique, which over time might not hold up. I wanted a different option that would make it in the long run. I wanted to continue playing soccer. I was referred to Dr. Plancher.”

Dr. Kevin Plancher, a renowned Connecticut orthopaedic surgeon and sports medicine specialist and head of Plancher Orthopaedics & Sports Medicine in Greenwich, Connecticut recommended an aligraph option, one that would use a patella bone from a cadaver.

Dr. Plancher performed a minimally invasive ACL surgical repair at Stamford Hospital in Stamford, Connecticut. “The surgery went very well,” said SanGiacomo. “It was an early morning surgery, starting around 7 a.m. I left the hospital by mid-afternoon.”

According to SanGiacomo, the orthopaedists she consulted before Dr. Plancher did not specialize in the aligraph technique and did not have access to a cadaver. “Dr. Plancher was the only orthopaedist I spoke with who had that option available,” she said.

Currently six months out post-surgery, SanGiacomo is receiving physical therapy and counting the days until returning to the soccer field. “Dr. Plancher doesn’t recommend any contact sport before nine months,” she said. “I plan to return to soccer for the fall season.”

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Preparing For Ski & Snowboard Season

For Immediate Release

Ski & Snowboard Conditioning Training is Key in Preventing Injuries
Preparing For Ski & Snowboard Season Takes More Than Readying Equipment & Buying Lift Tickets

As they prepare for the fun and excitement of their first day on the slopes this season, more than 28 million alpine skiers and snowboarders in the United States also know that they face numerous risks associated with these activities, which are considered among the most physically demanding of all sports. The good news is that many of these injuries can be prevented with a pre-season training program to add strength and flexibility to the muscles, tendons and ligaments used while skiing — many of which are rarely, if ever, used during normal everyday activities.

“Skiing and snowboarding are becoming more and more popular, mainly because they offer an opportunity for outdoor activity during the cold winter months,” notes Kevin Plancher, M.D., a leading New York orthopaedic surgeon and head of Plancher Orthopaedics and Sports Medicine. He is also the official surgeon of the United States Ski and Snowboard Teams. “Adding to the risk of injury, especially among novices, is the fact that these sports tend to look easy to the average non-skier, and many people even believe that the soft, powdery snow will cushion their fall and help them avoid injury,” Plancher adds.

This, of course, is not the case. In fact, Dr. Plancher notes, “For skiers and snowboarders alike, we are concerned both with the rate of injury, and with the changes in the types of injuries we are seeing from year to year.” For example, while an increase in helmet use has resulted in fewer head injuries in recent years, and better equipment has all but eliminated instances of severe leg and ankle fractures, the overall bone injury rate among skiers has remained stable for the past ten years. As for snowboarders, injury rates more than doubled during that time. He adds that many of the changes in injury patterns reflect changes in the sports themselves, as younger participants begin to incorporate riskier freestyle moves into both sports. “The most common injuries now involve tendons, ligaments and muscles in the legs, knees, and even in the upper body, which — when specifically trained for added strength and flexibility during skiing — can withstand greater demands and range of motion without injury,” he adds.

Pre-Season Ski & Snowboard Training 101

Dr. Plancher urges skiers and snowboarders of all ages and skill levels to begin training now for the ski and snowboard season. He recommends concentrating on four key areas of conditioning:

1. Flexibility: “Increasing the flexibility of muscles and ligaments is the most important thing skiers and snowboarders can do to lessen the risk of injury,” Dr. Plancher advises. That’s because virtually every major joint in the body — including ankles, knees, hips, shoulders, wrists and elbows — are relied upon heavily during active skiing and snowboarding, as well as during a fall. “More flexibility can help skiers and boarders stay on their feet, but it can also help them land properly during a fall to reduce the chance of injury,” he notes. Engaging in a 20-minute full body stretching routine daily — after an aerobic activity that has warmed up the muscles — can result in better flexibility within 6-8 weeks.
2. Strengthening: Strength is equally important in preventing ski injury, Dr. Plancher maintains. Here, the key is to strengthen muscles, tendons and ligaments that may not have even been used since last winter! For example, doing squats and rotations on a bosu ball — a device with a large flat surface on top and a soft ball-shaped underside — can give underused leg and knee muscles a stretching, strengthening workout. Dr. Plancher cautions everyone to avoid deep knee squats or leg extension exercises with weights.
3. Endurance: Overall physical fitness is important, as exhaustion or fatigue may make skiers and snowboarders more prone to injury. Up to an hour of daily aerobic exercise can increase cardiovascular endurance, lung capacity and overall fitness; choose walking, running, tennis or biking to strengthen leg muscles simultaneously.
4. Core Development: When well-developed, the structures that make up the body’s core — the spine and abdomen — can improve power, strength, balance and coordination. “This aspect of pre-season training is often overlooked, but it can be one of the most important ones,” Dr. Plancher reveals. “Few sports require such a well-developed sense of balance as skiing and snowboarding do,” he adds. Dr. Plancher recommends yoga and pilates to help develop core strength and to increase mental focus — also key to reducing the risk of ski and snowboard injury.

“There is no way of preventing all skiing and snowboarding injuries,” Dr. Plancher admits. “However, preparation that starts now can have snow-sports enthusiasts well on their way to a safe and enjoyable ski and snowboard season this winter.”

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The Dangers of Steroids

For Immediate Release

New York Orthopaedic Surgeon Warns About the Dangers of Steroids

As a result of the intense competition to enter professional sports, more and more high school and college athletes are using steroids to get a competitive edge in their sport. It is estimated that 4 – 12% of high school males have used steroids and that 15 – 20% of college athletes use steroids.

Steroids prevent natural muscle breakdown and causes increased muscular growth. Anabolic steroids mimic testosterone in the body and may improve endurance, strength and muscle mass, says Kevin Plancher M.D., Head of Plancher Orthopaedics and Sports Medicine in Manhattan. Unfortunately, most users do not realize the potential harmful side effects of steroids.

Anabolic steroids are drugs that resemble the chemical structure of the body’s natural sex hormone testosterone, which is made naturally by the body. Testosterone directs the body to produce or enhance male characteristics such as increased muscle mass, facial hair growth, and deepening of the voice, and is an important part of male development during puberty .

When anabolic steroids increase the levels of testosterone in the blood, they stimulate muscle tissue in the body to grow larger and stronger, Dr. Plancher stated. However, the effects of too much testosterone circulating in the body can be harmful over time.

Adverse Effects Of Steroids: Premature balding, mood swings, nausea and vomiting, trembling increased risk of tendon ruptures, shortening of final adult height, acne and oily hair.

Males Are Specifically At Risk For: Testicular shrinkage, breast development and nipple enlargement medically known as gynecomastia, impotence, sand sterility.

Females Are At Risk For: Facial hair, breast shrinkage, menstrual cycle changes, enlarged clitoris, male-pattern baldness, deepening of the voice and problems with fertility.

Mental Effects Of Steroids: “Roid rage, which is severe, aggressive behavior that may result in violence, such as fighting or destroying property, irritable moods, severe mood swings, hallucinations, paranoia, anxiety and panic attacks as well as depression and thoughts of suicide.

These are potentially serious side effects which may not be reversible, adds Dr. Plancher.

The long term effects of steroids are not entirely known. Steroids can be addictive and people may have a hard time stopping their use. Young people who use steroids are more likely to use other addictive drugs and alcohol.

Finally, Dr. Plancher emphasizes, “using steroids at any age is not smart”. Young athletes should understand that trying steroids is a bad way to improve performance. The best way to improve performance is through regular conditioning, intense practice and a healthy diet.

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Knee Injuries Are the Most Common Injury on the Slopes Each Year

For Immediate Release

Knee Injuries Are the Most Common Injury on the Slopes Each Year
Sports orthopaedist Kevin Plancher, MD on recognizing and treating injury

NY, NY and Greenwich, CT, October 2008 “ It is estimated that each year more than a half a million people will suffer a ski-related injury on the slopes. The most common occurrence, accounting for 30-40% of ski-related injuries each year, is an injury to the knee. While preventive pre-season steps like physical conditioning, equipment checks and refresher lessons can reduce the risks, recognizing the injury when it occurs on the slopes and treating it properly is the best way to quicken recovery time and increase the chances of a return to the slopes before the end of the season.

A ski-related knee injury can be as innocuous as a slight sprain or as devastating as a full ligament rupture of the anterior cruciate ligament. And recognizing the difference right away is the first step in ensuring a good recovery, explains Kevin Plancher, MD, a leading sports orthopaedist in the New York metropolitan area and an official orthopaedic surgeon for the U.S. Ski and Snowboard teams. It’s not uncommon for active adults to downplay an injury, in an effort to work through it or out of a desire to continue an enjoyable activity like a day of skiing, Dr. Plancher reveals. But some injuries will only worsen if they are not recognized immediately and treated properly, he warns.

Pop Goes the Ligament
In the world of ski-related knee problems, ligament injuries are king. The Anterior Cruciate Ligament and the Medial Collateral Ligament are the two structures that hold the knee joint in place between the femur and the tibia. Injuries to these two ligaments account for nearly half of all knee injuries on the slopes. Ironically, changes to the design of boots, bindings and skis to prevent the too-common leg fractures of the 1970s and have often been the culprits in ski-related knee injuries.

However, today ski and boot designs are beginning to reverse this trend. Soft boots that allow the ankle more flexibility are overtaking the stiff, unwielding boots of the past, while shorter, hourglass-shaped skis with wider fronts and backs and a thinner binding area are considered the latest and greatest in ski design. These new boot and ski designs are the tools needed to practice the carving technique in skiing, where acceleration and turning are controlled through subtle and fluid movements of the feet and ankles, rather than through skidding, jarring movement of the ski itself. Experts believe that carving can make for a more enjoyable and safer skiing experience. However, as is the case with learning any new skiing technique, the training or retraining period can be a time when risk of injury is greater, particularly to the knee area.

Ligament injuries can be easy to recognize, because they often involve a popping sound that lets the skier know what has happened, Dr. Plancher explains. However, there are times when a torn or ruptured ligament won’t pop, and so the skier must rely on a number of other symptoms in order to properly recognize the injury, Dr. Plancher adds. Additional signs of a ligament injury include:

1. Immediate searing pain, followed by a dull, painful sensation in the knee
2. Swelling around the knee immediately
3. Difficulty bearing weight on the knee
4. A wobbly sensation, as though the kneecap is floating and/or out of place

Less common and/or less severe knee injuries often sustained during skiing or snowboarding include a broken kneecap (usually the result of force trauma to the knee after colliding with or falling onto something hard like a tree or a rock) and ligament sprains and strains of varying severity.

Key Treatment Approaches for Ski-Related Knee Injuries
When the ACL or MCL is torn, ruptured, or even severely strained, it’s critical to begin treatment right away, Dr. Plancher advises. Because of their limited blood supply, some ligaments do not repair themselves or heal properly on their own, he explains. Adding when treatment of ligament damage is delayed, it can increase the need for more aggressive treatment down the line, compromise the chance of a full recovery, lengthen the skier’s return to the sport, and even lead to severe arthritis in the joint. But successful treatment of ACL will get you back for the next ski season.

Initial treatment of all knee injuries should begin with RICE “ Rest, Ice, Compression and Elevation“ and commence to a consultation with an orthopaedist within 24 hours if symptoms persist or worsen during the first six to eight hours. Often the best option for patients who wish to return to an active lifestyle after a knee injury is arthroscopic reconstruction of the ligament, Dr. Plancher explains. The minimally-invasive procedure is usually done in a same-day surgery facility, and involves grafting tendons from the patella or hamstring to replace the torn or ruptured ligaments. With successful surgery, physical therapy and bracing equipment “ which can reduce the risk of reinjury by nearly 300%“ an early season ski injury may not be a season-ending injury after all, Dr. Plancher notes.

*American Journal of Sports Medicine, October 2006

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Staying Injury Free for the Whole Ski Season

For Immediate Release

Staying Injury Free for the Whole Ski Season
U.S. Ski & Snowboard team doctor Kevin Plancher on common injuries and treatments to speed recovery

NY, NY and Greenwich, CT, October 2008 “ For the 28+ million Americans who take to the slopes each winter on skis or snowboards, the chill in the air and the first flakes of snow conjure excitement for the winter sports season ahead. Yet, the thrill of the first few runs of the season is often mixed with apprehension, even for the most seasoned winter sports enthusiasts. The fear, of course, is that an early-season injury will relegate them to the lodge for the rest of the winter.

After months off the slopes, the body needs time and practice to readjust to the physical requirements of these sports  even if skiers and boarders have spent months training in advance of the season, explains Kevin Plancher, M.D., a leading NY-area orthopaedist and an official surgeon of the U.S. Ski and Snowboard Teams. This is a time when everyone from experts to novices and in between, for different reasons, may be more susceptible to injury. Dr. Plancher notes that, while new skiers and boarders are likely to sustain an injury because of inexperience, the more advanced winter athletes can suffer and injury if they try to do too much too quickly. Many well-trained, experienced skiers and boarders get into trouble early in the season when they expect to jump right back in to the sport at the level at which they left off last year, Dr. Plancher warns.

Preventing Early-Season Injury
Skiing and snowboarding are among the most physically demanding sports, mainly because they place an inordinate amount of stress on the body’s ligaments. These tough, fibrous structures that connect bone structures together to form the joints are responsible for providing much of the body’s flexibility, Dr. Plancher explains. Being flexible is a crucial aspect of downhill skiing or snowboarding, he adds. The most relied-upon ligaments “and the most prone to injury“ in skiing and snowboarding are those of the knees (about 25% of all ski injuries), followed by the hands. Early season injuries most often involve the Medial Collateral Ligament, the Anterior Cruciate Ligament (ACL) and the Medial Meniscus in the knee, along with the ulnar collateral ligament located at the base of the thumb, Dr. Plancher explains. While knee ligament strains and tears can occur during active skiing and boarding, most injuries to the thumb happen during a fall, when the grip on the ski pole can jam the thumb backwards causing an injury now known as skier’s thumb.

Dr. Plancher recommends these steps that skiers and snowboarders can take during the first few excursions of the season to reduce the risk of early injury.

Get your bearings: Even if you’re skiing or boarding at a resort you’ve been to before, Dr. Plancher always recommends reviewing slope maps, lift systems and resort policies for any changes that may have taken place during the off-season. Know key information, such as what to do if you sustain a mid-run injury, and how to find the nearest first aid stations, he advises. Remember that injured skiiers and boarders on the slopes can pose additional collision hazards to themselves and to others if they are not quickly relocated to a safe area outside of the flow of traffic, Dr. Plancher adds.

Take a lesson: Whether you’re planning to while away the day on the bunny slope or taking on the double-diamond, make a pre-ski lesson the first item on your agenda. A brief 30-minute group or private lesson provides an opportunity for novices to practice in a controlled situation, and allows experts to hone skills that have been unused for more than half the year, Dr. Plancher points out. He encourages skiers to practice falling safely as well, paying attention to the positioning of poles and bindings to reduce risk of ligament strains. What’s more, a lesson will give participants insight into the topography of the resort, the day’s snow and weather conditions, and other variables that can affect safety and enjoyment.

What to Do if you Sustain an Early-Season Injury
The majority of ski- and snowboard-related ligament injuries are not serious, which is good news for those who want to return to the slopes as quickly as possible, Dr. Plancher assures. However, failing to recognize and properly treat minor injuries can cause them to worsen and extend the time needed for recovery. Following are guidelines for assessing and treating an early-season injury to maximize healing and hasten a return to the slopes:

Recognize the injury: It’s tempting to ski or board through an injury, especially early in the season because participants have been waiting for months to return to a sport they love, Dr. Plancher admits. However, recognizing the injury and relieving pressure on the ligaments immediately are critical to reducing its severity and getting skiiers or boarders back onto the slopes as quickly as possible, he advises. Sudden pain after a fall or during a maneuver in which the ligaments are in flex, or a popping sound at the knee followed by acute pain, are signs of ligament injury and should prompt skiers and boarders to seek medical help immediately.

RICE: Most sports enthusiasts are familiar with this term, which stands for Rest, Ice, Compression and Elevation. Dr. Plancher recommends icing a sore joint in 30-minute intervals for about three hours. If swelling and pain remain the same or worsen during that time, patients should seek medical attention, he advises.

Call an expert: Skiers and snowboarders who want the fastest possible return to the season should have their injury evaluated by an orthopedic sports medicine physician. There are many options “from physical therapy to orthopedic braces and other devices“ that can help speed healing and speed a patient’s return to the slopes, Dr. Plancher advises. In addition, an orthopedic specialist can provide a number of new options that reduce both the invasiveness and the recovery time usually associated with surgery, which could mean a same-season return to the slopes, he concludes.

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Injury Prevention on the Roster as Youth Soccer Season Heats Up

For Immediate Release

Injury Prevention on the Roster as Youth Soccer Season Heats Up
Top sports orthopaedic surgeon Dr. Kevin Plancher on avoiding, treating kids soccer injuries

NY, NY and Greenwich, CT, October 2008 “ Youth soccer is one of America’s most popular team sport, with millions of kids in the U.S. participating in soccer programs each year. While soccer is considered far safer than contact sports like football, injuries on the soccer field still number more than 100,000 each year and account for 75,000 emergency room visits annually. The good news is that simple preventive strategies can help keep kids injury free on the soccer field this season and when injuries do occur, there are effective techniques to help children recover more quickly and completely.

Nearly half of all youth soccer injuries happen to adolescents between the ages of 10 and 14, a time period when kids begin to develop more strength but are still struggling with body control, explains Dr. Kevin Plancher, MD, a leading orthopaedic surgeon in the NY metro area and an official surgeon of the U.S. Ski & Snowboard Team. Concurrently, this age group might also begin to take more physical risks on the playing field, but tend to downplay the need for comprehensive preparations before practice or competition, he notes. Through proper coaching and training, youth soccer participants can learn to protect themselves from injury, and to recognize an injury when it does occur.

AN OUNCE OF PREVENTION: Pre-Season Training and Pre-Game Warm-Ups
Dr. Plancher stresses that two major strategies “training and conditioning, along with pre-competition and practice warm-ups“ can go a long way toward keeping young players injury-free. Most injuries to soccer players over the age of five involve the lower extremities, he points out. Beginning a preseason strengthening and conditioning program can help these players increase strength and flexibility in the muscles, tendons and ligaments of the hips, legs, knees and ankles, reducing the risk of injury once competition begins.

Dr. Plancher recommends that teams hire a certified athletic trainer when possible to work with young athletes, or to train coaches on tactics aimed at reducing the risk of injuries on the field. Sports medicine research confirms the importance of training, and more specifically, the types of exercises that are appropriate “and inappropriate“ for developing children and adolescents, Dr. Plancher advises

Certified trainers work with teams to teach proper running and pivoting techniques to reduce the risk of knee injuries such as ACL and meniscus tears which are on the rise among young athletes. At Plancher Orthopaedics, trainer Hunter Greene, MS, ATC/L, OTC, works with local middle school, high school and college teams. Trainers like Hunter can work with young athletes to help them avoid overuse injuries, which occur when children engage in a single repetitive motion over a long time period that puts stress on a muscle, ligament, tendon or joint. In soccer, the ankles and knees are most prone to these types of injuries, and athletic trainers provide conditioning to help children avoid them. Soccer is a game of constant movement, Dr. Plancher points out, and so young athletes need to learn the proper techniques to protect their joints and ligaments during long stretches of running and physical exertion.

Finally, coaches and athletic trainers should ensure that youth players warm up adequately before engaging in full competition or practice. Dr. Plancher suggests that warm-ups consist of several minutes of light cardiovascular exercise such as jogging around the field, followed by 10-15 minutes of stretching the core muscles that will be taxed during practice or game play.

IN CASE OF INJURY: Recognizing and RICE-ing a Child’s Soccer Injury
When injuries do occur, Dr. Plancher notes, the most important strategy to reduce its impact and ensure a positive and timely recovery is recognition. In game situations, particularly among young players, there is frequently a temptation to shake off or play through an injury, Dr. Plancher points out. However, tendon and ligament injuries can worsen with additional activity, and so it is important that an injured child be removed from play until a certified athletic trainer or a physician can evaluate the injury. Dr. Plancher suggests that any young athlete who experiences swelling or hears a tearing or popping sound at the site of the injury, or has difficulty bearing weight in the injured area, should refrain from play. The RICE technique “ rest, ice, compression and elevation“ should be applied immediately, and if the symptoms persist or worsen after several hours, the child should be taken to an emergency room or a board-certified orthopaedic surgeon, he advises.

Soccer can be one of the safest and most enjoyable sports for young athletes to participate in, Dr. Plancher concludes. As with any sport, soccer is most enjoyable when the players are conditioned and prepared to play in ways that help them reduce their risk of painful injuries that sideline them from the game.

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Kevin Plancher, MD Serves as Manhattanville College’s Team Physician

For Immediate Release

Renowned Orthopaedic Surgeon, Kevin Plancher, M.D., Serves as Manhattanville College’s Team Physician

Kevin Plancher, M.D. the renowned New York and Connecticut Orthopaedic Surgeon has recently been selected to serve as Manhattanville College’s Sport Teams physician. As part of the new partnership between Plancher Orthopaedics and Sports Medicine and Manhattanville College, located in Purchase, New York a comprehensive allied health team has been formed to enhance the quality of care for student-athletes.

Manhattanville College Sports Medicine is privileged to be affiliated with Plancher Orthopaedics and Sports Medicine as our student-athletes will benefit from our close working relationship, said Scott McIver, Manhattanville College’s Head Athletic Trainer.

Kevin Plancher, M.D. formed Plancher Orthopaedics and Sports Medicine with offices in New York City, The Bronx and Greenwich, Connecticut. Plancher Orthopaedics is a leader in the field of Orthopaedics, Sports Medicine, and acute emergency treatment of sports injury and rehabilitation. He is an official orthopaedic surgeon for the U.S. Ski and Snowboard teams and is the Chairman of the Orthopaedic Foundation for Active Lifestyles in Greenwich, Connecticut, a not-for-profit foundation whose major mission is to effectively promote, support, develop and encourage research and education concerning orthopaedic care and advancements in musculoskeletal diseases. Dr. Plancher has once again been selected to be in the prestigious 7th and latest edition of Castle Connolly’s America’s Top Doctors, as well as New York Magazine’s Best Doctors in New York and Connecticut Magazines Best Doctors in Connecticut.

Injury prevention, treatment options and effective rehabilitation are vital keys for young athletes to stay in the game, said Kevin Plancher M.D.

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Don’t Let a Sports Injury Keep Your Child on the Sidelines

For Immediate Release

Don’t Let a Sports Injury Keep Your Child on the Sidelines

Nearly four million young athletes suffer a sidelining injury each year in the United States, according to the American Academy of Pediatrics. While half of these injuries are sustained during individual activities like biking or skateboarding, roughly 25% occur while children are playing team sports like football, baseball, softball, soccer and basketball. With more children playing organized sports than ever before (30+ million last year alone) injury prevention, treatment and return-to-play guidelines should be at the top of every coachs and parents game plan.

Sports injuries in children are complicated, not only by the physical nature of the injury, but by the vast developmental differential at each age, and by the variety of emotional responses each patient may have to his or her injury, explains Kevin Plancher, MD, a leading Manhattan Orthopaedic Surgeon and Sports Medicine Specialist and head of Plancher Orthopaedics & Sports Medicine PLLC in New York City and founder of the Orthopaedic Foundation for Active Lifestyles (www.ofals.org) a non-profit organization dedicated to advancements in research and education for orthopaedics and sports medicine.

Childhood sports injuries can be as simple as a sprained ligament or as serious as a growth-plate fracture, Dr. Plancher notes. So, it is critical to prevent as many injuries as possible, and to properly recognize and treat those injuries that do occur as quickly as possible, he adds.

Preventing Sports Injuries In Young Athletes

Participation in organized sports benefits children’s physical fitness, social integration and self-esteem, Dr. Plancher notes. But these benefits can be outweighed by the risks of injury when young athletes are unprepared, unprotected or uninformed about the game they’re playing, he adds.

To reduce the risk of injury, Dr. Plancher offers these prevention tips: Focus on fun, learning, effort and teamwork, and not on winning or performing at a certain level. This can help avoid overuse injuries which account for nearly half of all injuries to middle and high-school athletes that can occur when children push themselves too hard to achieve a certain level of play, or return too quickly from an injury, says Dr. Plancher. Overuse injuries are particularly common in the upper extremities like the back, shoulder, elbow and wrist in young athletes, a result of the throwing motion thats required in baseball, softball and basketball.

It is important for young athletes to gear up with protective equipment during games and practices (when 60% of injuries occur). Be sure all equipment is both appropriate for the game or practice and properly fitted for the child. This is as important for individual sports like biking and boarding as it is for organized sports, Dr. Plancher advises. While education efforts have resulted in the vast majority of children wearing helmets during these activities, acute injuries to the wrists and elbows are still common among kids who ride bikes, skateboards and scooters without protective padding for those areas, he adds.

Proper Treatment Strategies Can Get Kids Back in the Game

We can’t always rely on the emotional reaction of the child athlete to clue us in on the extent of his or her injury, Dr. Plancher warns. Certain young athletes may mask a serious injury with a brave face in order to stay in the game, while others may overreact to less serious injuries due to pain and fear of additional injury.

Dr. Plancher’s Guidelines for Recognizing and Triaging Sports Injuries in Young Athletes

Err on the side of caution and remove a child who may have been injured from play immediately. Coaches should be trained to recognize the basic signs of injury, including discoloration, swelling, difficulty bearing weight on the affected area, or pain. If in doubt, the child should be seen by an orthopaedist or at the local hospital Emergency Room before he or she resumes play.

Provide RICE (Rest, Ice, Compression and Elevation) at the first sign of injury to avoid further damage and begin the healing process. Every team should have a first aid kit stocked with ice packs and compression bandages for possible sprains and strains, along with antiseptic wash and sterile bandages and tape for cuts and scrapes.

Contact a professional orthopaedist for an expert diagnosis, treatment plan and return-to-play strategy which will vary depending upon the severity and location of the injury, and a number of factors relating to the individual child. However, advances in treatment and technology have made it possible for children with certain injuries to return more quickly than ever to the sports they love. For example, young athletes may be able to return to play from a recent injury to the hand or wrist by wearing a playing cast such as the GE RTV-11. These types of casts help to stabilize the joints and protect against re-injury, Dr. Plancher explains. Although most casts are prohibited from the field of play due to the potential they have to injure other athletes, the RTV-11 is acceptable because of its soft exterior construction, he adds.

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Preparation to Help Avoid Skiing Injury

For Immediate Release

Preparation to Help Avoid Skiing Injury
Sports orthopedist on pre-season strength, flexibility training

NY, NY and Greenwich, CT, September 2008 Downhill skiing continues to be one of America’s favorite winter pastimes, attracting nearly 20 million participants to the snowy slopes each year. Snowboarding is gaining popularity too, as recent reports found more than 8 million Americans participate in the sport each year. Yet, along with the excitement of a day on the slopes, alpine skiers and snowboarders face numerous health risks associated with these activities, which are considered among the most physically demanding of all sports. The good news is that many of these injuries can be prevented with a smart pre-season training program to add strength and flexibility to the muscles, tendons and ligaments used while skiing many of which are rarely, if ever, used during normal everyday activities.

“Skiing and snowboarding continue to rise in popularity because they are fun and they offer an opportunity for outdoor activity during the cold winter months,” notes Kevin Plancher, M.D., a leading NY-area orthopaedist and official surgeon of the U.S. Ski and Snowboard Teams. Moreover, these sports have a very benevolent reputation; and they sometimes look easy to the average non-skier, and many people even believe that the soft, powdery snow will cushion their fall and help them avoid injury, Plancher adds.

Not so. In fact, while an increase in helmet use has resulted in fewer head injuries in recent years, and better equipment has all but eliminated instances of severe leg and ankle fractures, the overall boney injury rate among skiers has remained stagnant for the past ten years. As for snowboarders, injury rates more than doubled during that time.

For skiers and snowboarders alike, we are concerned both with the rate of injury, and with the fluctuation in the types of injuries we see from year to year, explains Dr. Plancher. He notes that many of the changes in injury patterns reflect changes in the sports themselves, as younger participants begin to push the envelope by incorporating riskier freestyle moves into both sports. The most prevalent injuries now involve tendons, ligaments and muscles in the legs, knees, and even in the upper body, which “when specifically trained for added strength and flexibility during skiing“ may withstand greater load and range of motion without injury, he adds.

Dr. Plancher, who serves as Chairman the Orthopedic Foundation for Active Lifestyles (www.ofals.org) a non-profit organization dedicated to advancements in research and education for orthopedics and sports medicine encourages skiers and snowboarders of all ages and skill levels to begin training early for the winter season. He recommends a program that focuses on four key areas of conditioning:

1. Flexibility: Increasing the flexibility of connective tissue is the most important thing skiers and snowboarders can do to reduce the risk of injury, Dr. Plancher advises. That’s because virtually every major joint in the body including ankles, knees, hips, shoulders, wrists and elbows are relied upon heavily during active skiing and snowboarding, as well as during a fall. More flexibility can help skiers and boarders stay on their feet, but it can also help them land properly during a fall with the least chance of injury, he notes. Engaging in a 20-minute full body stretching routine daily after an aerobic activity that has warmed up the muscles can result in better flexibility within 6-8 weeks, Dr. Plancher assures.
2. Strengthening: Strength and flexibility go hand-in-hand in preventing ski injury, Dr. Plancher maintains. Here, the key is to strengthen muscles, tendons and ligaments that may not have even been used since last winter’s final trek to the slopes! For example, doing squats and rotations on a bosu ball a device with a large flat surface on top and a soft ball-shaped underside can give underused leg and knee muscles a stretching, strengthening workout. Dr. Plancher cautions everyone to avoid deep knee squats or leg extension exercises with weights.
3. Endurance: Overall physical fitness is important, as an exhausted, winded skier or snowboarder may be more prone to injury than a fit one. Thirty to sixty minutes of daily aerobic exercise can increase cardiovascular endurance, lung capacity and overall fitness; choose walking, running, tennis or biking to strengthen leg muscles simultaneously.
4. Core Development: When well-developed, the structures that make up the body’s core “the spine and abdomen“ can improve balance, coordination, gracefulness and overall power and strength. This is an often overlooked aspect of pre-season training,Dr. Plancher reveals, But it can be one of the most crucial ones, because few sports require such a well-honed sense of balance as do skiing and boarding, he adds. Dr. Plancher recommends professional guidance, and for those who enjoy yoga and pilates to help develop those core muscles, and for increasing mental focus also key to reducing the risk of ski and snowboard injury.

There is no magic bullet to preventing all skiing and snowboarding injuries, Dr. Plancher admits. However, preparation that starts now can have snow-sports enthusiasts well on their way to a safe season this winter.

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Importance of Exercise for Patients Facing Arthritis and Total Knee Replacement

For Immediate Release

New York Orthopaedic Surgeon and Sports Medicine Specialist Stresses Importance of Exercise for Both Pre- and Post-Op Patients Facing Arthritis and Total Knee Replacement

Everybody knows that exercise is good for you, unless you’ve got arthritis.

“Lots of people believe that strenuous, weight-bearing exercise can cause arthritis, and that someone with arthritis should definitely avoid those kinds of activities,” says Kevin Plancher, MD, a leading sports orthopaedist in the New York metropolitan area and an official orthopaedic surgeon for the U.S. Ski & Snowboard teams. But the truth is that exercise doesn’t cause arthritis — and it can even improve joint function, even in people who are having joint replacement surgery.

Osteoarthritis, also known as degenerative joint disease, affects close to 21 million people in the US. And according to the Arthritis Foundation, osteoarthritis, or OA, in the knee or hip is the most common cause of arthritis-related disability. As baby boomers get older (and more arthritic), orthopaedic surgeons are performing more and more total joint replacement surgeries, with total knee replacements, or TKRs, the most common type. More than 300,000 people undergo the procedure each year, according to the American Academy of Orthopaedic Surgeons.

TKRs have been performed in the US since the 1960s, and today, knee replacement is one of the safest and most successful types of major surgery. In fact, in well over 90% of cases, TKR significantly reduces a patient’s pain and restores his mobility — without complications. A knee replacement can be expected to last for 20 or more years.

In a TKR, a surgeon resurfaces of the worn out parts of the knee and replaces the lost cartilage and diseased bone with a new device, made of metal alloys and high-grade plastics and designed to move just like a healthy human joint. Dr. Plancher does this minimally invasive. TKRs are most often performed on people with advanced OA, but they’re also necessary in certain cases of traumatic injury or rheumatoid arthritis, an autoimmune disease. The common denominator in all TKR surgeries is a knee that’s simply worn out.

OA can run in families, and it’s usually worse in older people, whose joints have had more years of wear and tear, Dr. Plancher explains. But nobody knows why arthritis can be much worse in some people than others, or why it can occur in one knee and not the other.

“We know that having a previous injury and being obese can exacerbate arthritis, but we also know that being physically active doesn’t.” Dr. Plancher notes that a major study published in early 2007 found no connection between physical activity — even vigorous activity — and OA. “Some people believed that the repetitive motions of physical activity, particularly in people who are overweight, might contribute to knee OA. But this study debunked that.” Moreover, he notes, another study showed an actual benefit of exercise in building cartilage — and staving off arthritis. Specifically, it showed that both casual and vigorous physical activities are associated with an increase in cartilage volume, and that those benefits increase with frequency and duration of exercise.

But what about people who’s OA has advanced so far that they’re considering joint replacement? Dr. Plancher says that appropriate physical activity is imperative for anyone with knee OA, and it can significantly improve the outcome of a total knee replacement operation. New research shows that patients who follow a program of exercise and rehabilitation, both before and after their surgeries, fare better than those who sit still.

For example, a 2006 study found that a six-week exercise regimen before a total knee replacement operation helped patients recover more quickly. One group did no exercise, while the other worked out three times a week, first in a pool (exercising spine, shoulders, arms and legs in chest-deep water), later on recumbent stationary bikes or elliptical machines. Patients also did strength training and stretches for flexibility during the program’s last three weeks. After surgery, the exercisers were much more likely than the nonexercisers to go straight home following their discharge from the hospital (the nonexercisers were more likely to be sent to an inpatient rehabilitation facility before going home).

Earlier this year, another study showed that a preoperative rehabilitation program, including patient education as well as physical therapy, could improve postoperative outcomes after total knee replacement. And yet another study, also published this year, found that post-op exercise improved the functional activities of daily living, walking, quality of life, muscle strength, and range of motion in the knee joint.

The key to exercising for people needing TKR is to find activities that work the major muscle groups but place as little stress on the knee as possible. “We do have patients who return to very strenuous activity and walk more than three miles a day after a total knee replacement,” says Dr. Plancher. “You shouldn’t have any significant restrictions of your normal activities following knee replacement. But just remember that knee replacement, at times, can even return you to most sports.”

Dr. Plancher’s Recommendations for Pre- and Post-Op Exercise:

• Before your surgery, do strengthening exercises to help stabilize the knee joint. “Getting stronger beforehand means you’ll have an easier time in post-surgery rehabilitation and physical therapy,” he says. In the case of TKR, that means working the muscles in your legs that surround and connect to the knee joint.
• As soon as you can after surgery (typically within a couple of hours), start your physical therapy — and get back on your feet as soon as you can (you’ll probably be using a walker or crutches at first).
• Pick the right activities. Generally speaking, TKR patients will be told to skip any activities that might injure the replaced joint. That means swimming and golf are great — and sports that involve heavy lifting, running, and jumping are verboten. Many patients return to skiing and tennis after TKR.
• Protect your knees. No matter what you’re doing, take care of your knees. Avoid bending knees past 90 degrees when doing squats, avoid twisting your knees by keeping your feet as flat as possible when stretching, and always warm up and stretch before doing any physical activities.

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