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Sports Medicine

Sports injuries can happen to anyone, athletic or not. While these injuries usually occur when playing a sport, they can also occur unexpectedly during your daily activities. Whatever the cause of your injury, our board-certified, sports medicine trained physicians will treat you like a pro! Whether you’re a dedicated competitor, weekend warrior or local youth athlete, you can count on our team to help you get you back to an active lifestyle in the fastest and safest way possible.
At Orthopedic Associates, the most commonly treated sports injuries are to the knees and shoulders. In most cases, sports injuries can be treated with MLS Laser Therapy, physical therapy, bracing, and/or medications. Some injuries however, like certain types of ligament and cartilage tears, require surgery before you can return to the life you love. Orthopedic Associates of Dutchess County’s team of sports medicine physicians treat each individual patient according to your specific injury and needs, and work with you to determine the best course of treatment. Schedule An Appointment
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Meet Our

Sports Medicine Team
Mark D. Aierstok, M.D.
ORTHOPEDIC KNEE & SHOULDER SURGEON / SPORTS MEDICINE
William W. Colman, M.D.
ORTHOPEDIC KNEE & SHOULDER REPLACEMENT SURGEON / SPORTS MEDICINE
Lawrence Kusior, M.D.
ORTHOPEDIC SURGEON / SPORTS MEDICINE
Stephen G. Maurer, M.D.
ORTHOPEDIC SHOULDER SURGEON / SPORTS MEDICINE
John McLaughlin, M.D.
HIP, KNEE & SHOULDER REPLACEMENT SURGEON / SPORTS MEDICINE
Kenneth K. Rauschenbach, D.O.
KNEE, HIP & SHOULDER REPLACEMENT SURGEON / SPORTS MEDICINE / GENERAL ORTHOPEDICS / TRAUMA
Michael Rutter, M.D.
TRAUMA AND ARTHROPLASTY SURGERY
Michael Schweppe, M.D.
ORTHOPEDIC KNEE & SHOULDER REPLACEMENT SURGEON / SPORTS MEDICINE
Andrew Stewart, M.D.
SPORTS MEDICINE / SHOULDER & KNEE SURGERY
Karl Ziermann, D.O.
SPORTS MEDICINE / CONCUSSION MANAGEMENT SPECIALIST / OSTEOPOROSIS MANAGEMENT SPECIALIST Schedule

Common Shoulder Injuries

Most problems in the shoulder involve the muscles, ligaments, and tendons, rather than the bones. Athletes are especially susceptible to shoulder problems. In athletes, shoulder problems can develop slowly through repetitive, intensive training routines.

Some people will have a tendency to ignore the pain and “play through” a shoulder injury, which only aggravates the condition, and may possibly cause more problems. People also may underestimate the extent of their injury because steady pain, weakness in the arm, or limitation of joint motion will become almost second nature to them.

Conditions

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.
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.

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.

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.

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.”

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.
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

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.
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.

 

 

Common Knee Injuries

Your knee is made up of many important structures, any of which can be injured. The most common knee injuries include fractures around the knee, dislocation, and sprains and tears of soft tissues, like ligaments. In many cases, injuries involve more than one structure in the knee.

Pain and swelling are the most common signs of knee injury. In addition, your knee may catch or lock up. Many knee injuries cause instability – the feeling that your knee is giving way.

The most common bone broken around the knee is the patella. The ends of the femur and tibia where they meet to form the knee joint can also be fractured. Many fractures around the knee are caused by high energy trauma, such as falls from significant heights and motor vehicle collisions.

Conditions

A dislocation occurs when the bones of the knee are out of place, either completely or partially. For example, the femur and tibia can be forced out of alignment, and the patella can also slip out of place. Dislocations can be caused by an abnormality in the structure of a person’s knee. In people who have normal knee structure, dislocations are most often caused by high energy trauma, such as falls, motor vehicle crashes, and sports-related contact.

The anterior cruciate ligament is often injured during sports activities. Athletes who participate in high demand sports like soccer, football, and basketball are more likely to injure their anterior cruciate ligaments. Changing direction rapidly or landing from a jump incorrectly can tear the ACL. About half of all injuries to the anterior cruciate ligament occur along with damage to other structures in the knee, such as articular cartilage, meniscus, or other ligaments.
The posterior cruciate ligament is often injured from a blow to the front of the knee while the knee is bent. This often occurs in motor vehicle crashes and sports-related contact. Posterior cruciate ligament tears tend to be partial tears with the potential to heal on their own.
Injuries to the collateral ligaments are usually caused by a force that pushes the knee sideways. These are often contact injuries. Injuries to the MCL are usually caused by a direct blow to the outside of the knee, and are often sports-related. Blows to the inside of the knee that push the knee outwards may injure the lateral collateral ligament. Lateral collateral ligament tears occur less frequently than other knee injuries.
Sudden meniscal tears often happen during sports. Tears in the meniscus can occur when twisting, cutting, pivoting, or being tackled. Meniscal tears may also occur as a result of arthritis or aging. Just an awkward twist when getting up from a chair may be enough to cause a tear, if the menisci have weakened with age.

The quadriceps and patellar tendons can be stretched and torn. Although anyone can injure these tendons, tears are more common among middle-aged people who play running or jumping sports. Falls, direct force to the front of the knee, and landing awkwardly from a jump are common causes of knee tendon injuries.

In Osgood-Schlatter disease, children have pain at the front of the knee due to inflammation of the growth plate at the upper end of the tibia (shinbone). This growth plate (known as the tibial tubercle) is a bump near the top of the tibia where the tendon from the kneecap (patellar tendon) attaches to the bone.

When a child is active, the quadriceps muscles of the thigh pull on the patellar tendon which in turn, pulls on the tibial tubercle. In some children, this repetitive traction on the tubercle leads to inflammation, swelling, and tenderness. The prominence, or bump, of the tibial tubercle may become very pronounced. Painful symptoms are often brought on by running, jumping, and other sports-related activities.

Most symptoms will completely disappear when a child completes the adolescent growth spurt, around age 14 for girls and age 16 for boys. However, the prominence of the tubercle will persist.

Until a child is fully grown, however, Osgood-Schlatter disease can lead to more severe problems if it is not allowed to heal. Continued stress on the tibial tubercle from athletic activity could potentially lead to a break in the tubercle bone.

Other Common Sport Injuries

Conditions

A dislocation occurs when the bones of the knee are out of place, either completely or partially. For example, the femur and tibia can be forced out of alignment, and the patella can also slip out of place. Dislocations can be caused by an abnormality in the structure of a person’s knee. In people who have normal knee structure, dislocations are most often caused by high energy trauma, such as falls, motor vehicle crashes, and sports-related contact.

The anterior cruciate ligament is often injured during sports activities. Athletes who participate in high demand sports like soccer, football, and basketball are more likely to injure their anterior cruciate ligaments. Changing direction rapidly or landing from a jump incorrectly can tear the ACL. About half of all injuries to the anterior cruciate ligament occur along with damage to other structures in the knee, such as articular cartilage, meniscus, or other ligaments.
The posterior cruciate ligament is often injured from a blow to the front of the knee while the knee is bent. This often occurs in motor vehicle crashes and sports-related contact. Posterior cruciate ligament tears tend to be partial tears with the potential to heal on their own.
Injuries to the collateral ligaments are usually caused by a force that pushes the knee sideways. These are often contact injuries. Injuries to the MCL are usually caused by a direct blow to the outside of the knee, and are often sports-related. Blows to the inside of the knee that push the knee outwards may injure the lateral collateral ligament. Lateral collateral ligament tears occur less frequently than other knee injuries.
Sudden meniscal tears often happen during sports. Tears in the meniscus can occur when twisting, cutting, pivoting, or being tackled. Meniscal tears may also occur as a result of arthritis or aging. Just an awkward twist when getting up from a chair may be enough to cause a tear, if the menisci have weakened with age.

The quadriceps and patellar tendons can be stretched and torn. Although anyone can injure these tendons, tears are more common among middle-aged people who play running or jumping sports. Falls, direct force to the front of the knee, and landing awkwardly from a jump are common causes of knee tendon injuries.

In Osgood-Schlatter disease, children have pain at the front of the knee due to inflammation of the growth plate at the upper end of the tibia (shinbone). This growth plate (known as the tibial tubercle) is a bump near the top of the tibia where the tendon from the kneecap (patellar tendon) attaches to the bone.

When a child is active, the quadriceps muscles of the thigh pull on the patellar tendon which in turn, pulls on the tibial tubercle. In some children, this repetitive traction on the tubercle leads to inflammation, swelling, and tenderness. The prominence, or bump, of the tibial tubercle may become very pronounced. Painful symptoms are often brought on by running, jumping, and other sports-related activities.

Most symptoms will completely disappear when a child completes the adolescent growth spurt, around age 14 for girls and age 16 for boys. However, the prominence of the tubercle will persist.

Until a child is fully grown, however, Osgood-Schlatter disease can lead to more severe problems if it is not allowed to heal. Continued stress on the tibial tubercle from athletic activity could potentially lead to a break in the tubercle bone.

Posted in on January, 2022