Even though golf is a low-risk sport, injuries can occur. According to the Academy of Orthopaedic Surgeons, more than 100,000 golf-related injuries are treated each year.  Shoulder, wrist and elbow injuries occur most often in golf. Most shoulder injuries are due to overuse, while wrist and elbow injuries most likely occur due to improper swing or holding the clubs the wrong way.

Dr. Arthur Rettig recommends some simple ways you can prevent an injury from sidelining you from the links:

• Warm Up and Strengthen Your Muscles – Warm up your muscles to prevent strain. Also, by strengthening your forearm and shoulder muscles, it will help decrease shock in the arm when hitting the ball and reduce the risk of tendonitis or “golfer’s elbow.”

• Learn the Correct Technique and Practice Gradually – By learning the proper way to swing, you will put less strain on your muscles and joints.  Tendonitis or tears of the rotator cuff can occur with poor backswing or overuse. Lessons from a golf instructor will help ensure the correct form.

• Use Correct Equipment – Using clubs that are too heavy or light may increase the risk of shoulder strain. It is important to use the correct equipment for your body type. Also, replace club handle grips as needed and get larger, softer grips to decrease wrist injuries.

• Wear the Proper Clothing – Wearing comfortable clothing protects you from the elements and wearing shoes such as cleats help your feet grip the ground, allowing for a more stable swing.
If you experience pain for more than seven days, visit an orthopedic surgeon to determine the extent of your injury and treatment options. While most injuries are not severe, more extensive injuries such as a torn rotator cuff or carpal tunnel syndrome may require surgery.  A delay in treatment could cause further damage and keep you off the course when the greens beckon.

From baseball to soccer to football, everyday millions of children and young adults participate in sports activities. These activities teach children team work and improve their physical fitness, coordination and self-discipline.  It also increases their chance of experiencing sports-related injuries such as concussions, sprains, fractures, muscle tears, and back and neck injuries. However, there are measures that can be taken to help prevent these types of injuries, such as:
• Undergoing medical exams prior to the sport’s season, which should include concussion screenings and physical evaluations;
• Using proper protective gear, such as shin guards for soccer and helmets for football and baseball;
• Staying hydrated and always warming up before practice or a game;
• Never playing through pain or an injury.

If an athlete does experience an injury it is important that it is not ignored or taken lightly.
Sports-related injuries in children are of great concern because their bones, muscles, tendons and ligaments are still growing. To avoid long-term damage, young athletes should seek immediate care for any minor or serious injury.

Following are several signs to help determine if immediate care is needed:
• Inability to play following a sudden injury;
• Decreased ability to play due to a chronic or long-term complication following an injury;
• Visible deformity of the athlete’s arms or legs;
• Severe pain from a sudden injury, which may prevent the use of an arm or leg.

Sometimes, sports-related injuries occur after office hours or on the weekends.  If and when this happens I recommend that my patients visit the emergency room or an orthopedic walk-in clinic like the one we have at Methodist Sports Medicine / The Orthopedic Specialists. One of our fellowship-trained orthopedic surgeons is available to treat patients with sudden or recent sports or active lifestyle-related injuries.  Patients can visit our Avon or Greenwood locations Monday through Friday from 8 a.m. to 10 a.m., or our Carmel location Monday through Saturday from 8 a.m. to 10 a.m. For more information, please visit www.methodistsports.com or call 317-817-1200.

Hand, wrist and finger injuries are common among basketball players. In fact, according to the American Academy of Orthopaedic Surgeons, there are approximately 481,000 basketball-related injuries each year.

Some of the most common injuries include:

Mallet finger: A player can suffer an injury when a ball or other object strikes the tip of the finger or thumb. The force of this action can damage the thin tendon that straightens the finger and may even cause a piece of the bone to pull away from the tendon. One indication a player has suffered a mallet finger is if they are unable to straighten their injured thumb or finger. If this occurs, the player should apply ice immediately and seek medical attention. The majority of mallet finger injuries do not require surgery; however a doctor is the only one qualified to determine the extent of this type of injury.

Fractured finger: Jammed fingers and falls are common in basketball and often result in broken fingers. Symptoms may include swelling, tenderness, bruising and the inability to move the injured finger completely. A player should seek immediate medical attention to determine the extent of their injury. A medical evaluation will help determine if surgical or non-surgical treatments can be used. Once a doctor has determined that it is okay to move the injured finger, the player should begin rehabilitation exercises to reduce the finger’s stiffness and swelling.

Sprained thumb: If a player overextends the main ligament in their thumb it can become sprained, which can diminish the hand’s ability to grasp items between the thumb and index finger. There may or may not be immediate pain but having a doctor assess the injury will ensure there will not be long-term weakness and instability. If the ligament is only partially torn the thumb joint should be immobilized with a splint or cast until it heals. However, if it is completely torn, surgery may be required.

Wrist sprains/fractures: If a player falls on the palm of their hand they may suffer a wrist sprain, which occurs when the ligaments that connect bone to bone within the joint are stretched and perhaps torn. Most wrist sprains can usually be treated at home with rest, ice, compression, elevation and splinting. Severe sprains may require more extensive treatment, including surgery to repair a fully torn ligament. Fractures may occur in the wrist. One particular fracture involves a bone in the wrist called the scaphoid or navicular, which athletes often believe to be just a sprain. If an athlete suffers this type of fracture the best treatment is surgical intervention.

Finger sprains/dislocations: These injuries are most commonly seen in athletes who play ball-handling sports such as basketball. This injury is often referred to as the “coach’s finger,” due to the feeling that the injury is not very serious. However, these injuries can range from a fracture to a dislocation to a sprain, and can be debilitating. A dislocation occurs when a player jams their finger attempting to catch a ball or block a shot. This may cause the finger to bend too far to the side and the ligaments to tear from the bone. If this occurs the finger may appear swollen or deformed. Depending on the extent of the injury, surgery may be required to fix the joint.

It can be difficult to prevent hand injuries during basketball and athletic activities but the use of proper equipment and technique can reduce a player’s risk of injury. However, if an injury does occur it is important seek medical attention within 24 to 48 hours to determine the severity of the damage and assess treatment options.

Bowling is one of America’s favorite pastimes.  According to the United States Bowling Congress, more than 66 million people in the United States bowl during a year, with over six million bowlers joining leagues and other competitions.  It’s definitely a great way to spend time with family and friends.  It’s also a sport that can be enjoyed by people of all ages and abilities and in any kind of weather. 

But like any other sport, bowling can cause painful injuries – especially to your hands and wrist.  That’s why it’s important to know the common injuries and seek medical attention when necessary to keep the fun in your bowling game. 

Tendonitis is a very common injury and often targets the wrist of a bowler. It is a swelling and irritation of tendons and ligaments and occurs as a result of the repetitive motion of bowling.  Tendonitis can cause a dull ache or sharp pain every time you try to swing a bowling ball. The injury can take anywhere from a couple of days to a few weeks, or in extreme cases, months to heal properly.  Many bowlers wait too long to treat tendonitis.

Another common injury known as bowler’s thumb occurs when there is a pinched nerve at the base of the thumb.  It results from direct pressure on the nerve from the thumb hole of a bowling ball.  This constant pressure eventually can lead to scar tissue that wraps itself around the nerve to cause the ultimate in bowler’s thumb.  Symptoms include numbness and tingling. 

Choosing the right bowling ball is the first step to successful bowling without injury. Your ball shouldn’t be too heavy or too light, and should fit comfortably and naturally on your fingers.  Also, you should stretch before and after bowling to reduce chances of tendonitis.  If you injure yourself, see your doctor or an orthopedic specialist as soon as possible. Ignoring the warning signs will only result in more intense pain and discomfort, and possibly, permanent damage.

One of the most common injuries associated with sports and everyday activities is a dislocated finger. Although a finger dislocation may not appear to be a serious injury, it should not be ignored. It is not a good idea to continue to play through the pain because a more serious medical condition such as a bone fracture could be present.
When a joint is dislocated, the ligaments and joint capsule surrounding the joint are torn. This commonly occurs in the middle of the knuckle of the ring, middle or index finger. Fortunately, there are ways to prevent and treat a dislocated finger so that it does not turn into a serious health concern.

• Prevent a dislocated finger: It is important to use the correct technique when playing a sport and utilize protective hand equipment, whenever appropriate. Also, you should try to avoid getting your finger caught in equipment or a jersey, or “jamming” your finger with a baseball or basketball. Various exercises can be performed to strengthen the hand and fingers as well as increase the range of motion. These preventative measures will decrease your chance of experiencing a dislocated finger.

• Recognize the signs:  Symptoms include a bent or crooked finger along with pain, swelling and/or bruising. Sometimes the finger will be dislocated and also have an open wound. In almost all cases, the finger bones have moved away from each other, making the finger look abnormally aligned.

• Take proper care of the finger: If you dislocate your finger, apply an ice pack, elevate the hand above the heart, remove all jewelry on the hand and visit an orthopedic hand specialist for an evaluation. Do not to try to manipulate the joint back into place because this may cause further damage to the bones and joints. If someone does realign the joint on the playing field, seek medical attention from a physician to be sure the bones are stable and not fractured.

A dislocated finger is usually not cause for alarm, but it can be more severe than a simple sprain. The doctor will put the joint back into place and the finger will be splinted to heal torn ligaments and the joint capsule. You can return to your sport once your dislocated finger has been realigned, your doctor has confirmed that the injured joint is stable and that no bone is fractured, and your finger tenderness and swelling have improved. If conditions do not improve through non-surgical treatment, it is important to follow up with your orthopedic specialist to determine if surgery is needed.

According to The American Journal of Sports Medicine, five injuries occur for every thousand hours of tennis played. One of the most common and painful injuries is tennis elbow, affecting almost half of athletes in racquet sports. Tennis elbow occurs when an individual repeatedly tightens the forearm muscles, which are used to straighten and raise the hand and wrist. People may assume that this injury only affects tennis players but this is not the case. Other outdoor activities that require repetitive and vigorous use of the forearm muscle, such as gardening and painting, can also cause similar elbow injuries.

Fortunately, there are several steps individuals can take to prevent tennis elbow from occurring:

• Stretch and warm up: Before and after a match or practice, it is extremely important to gently stretch and warm up the forearm muscles. Tennis professionals recommend warming up for 35 minutes prior to any tennis match or practice. Forcing a cold muscle to stretch and bend can cause stress on the elbow.

• Use proper technique: Having a skilled tennis coach teach players proper technique is essential to avoiding tennis elbow. Practice makes perfect, therefore it is important to take the time to develop the skills to hit each stroke correctly.

• Build strength: Strengthening exercises are an ideal way to help prevent tennis elbow from occurring. A good strengthening exercise for athletes is to use hand weights and gently bend the wrist while the palm is face down and the elbow is elevated. Athletes should repeat this exercise as often as needed.

• Keep wrists straight: Keeping a straight wrist during a tennis stroke or any repetitive activity allows the larger muscles in the arm to do most of the work. The larger muscles are better designed for taking on stress and force than the smaller forearm muscles.

• Use ice: Proper post-workout care will help prevent tennis elbow from occurring. Applying an ice pack following an exercise routine or tennis match that utilized the arm muscles is beneficial.

The pain of tennis elbow doesn’t have to keep you from enjoying your favorite activities. Rest and over-the-counter pain relievers often help. However, if left untreated, tennis elbow can result in prolonged chronic pain.

It is important to speak to an orthopedic specialist if elbow pain persists beyond a few days, occurs at night or while resting, or if there is swelling or significant bruising around the joint or arm. A doctor may recommend a number of non-surgical options such as physical therapy or wearing an elbow brace. If non-surgical options are not enough to alleviate pain, a doctor may suggest surgery.

Arthritis of the hand can occur in many areas and have multiple causes. While symptoms can vary, early warning signs to look for may include:

• Dull pain or a burning sensation in the hand: These symptoms typically occur when there is overuse of the joint due to heavy gripping or grasping. As the cartilage wears away and there is less material to provide shock absorption, these symptoms appear with less use and tend to last for longer periods of time.

• Looseness or grinding: As the cartilage in the hand begins to wear away, damaged cartilage surfaces rub against each other. This can create a sensation of grating or grinding in the affected finger joint. On the other hand, if arthritis is caused by damaged ligaments, joints may feel “loose” or less stable than they once were.

• Change in surrounding joints: For advanced thumb-based arthritis, joints located near the thumb may become more flexible and mobile than usual.

• Swelling and warmth: An arthritic joint in the hand or fingers may feel warm to the touch or have swelling in and around the joint. This is due to the body’s inflammatory response.

• Cysts: If small cysts appear on or near the end joints of the fingers, this may be an indication that arthritis is developing. These cysts may also cause ridging or dents in the nail of the affected finger.

Treatment for hand arthritis can include nonsurgical options such as anti-inflammatory medications, injections containing a long-acting anesthetic and steroids, and splinting to help support the affected joint in the hand or fingers. If nonsurgical treatments do not relieve arthritic pain then surgery may be something to consider.

There are several types of surgical procedures to treat hand arthritis. These include removal of an inflamed joint lining, joint replacements and joint fusions. However, the type of procedure depends on the joints involved, the degree of damage and the condition of the surrounding joints.
 
Recognizing early arthritis symptoms and getting an accurate diagnosis are important for preventing joint damage. If arthritis is not treated in a timely manner, the bones that make up the joints in the hand and fingers can lose their normal shape and become severely painful and debilitating. If you are experiencing any of the symptoms of arthritis, it is important to seek help early so you can undergo necessary treatments and return to a normal life.

Bounded by bones and ligaments, the carpal tunnel is the narrow passageway, about as big around as a thumb, located on the palm side of the wrist that houses the median nerve. Pressure placed on this nerve produces the numbness, pain and, eventually, hand weakness that characterize carpal tunnel syndrome.

Some studies suggest that carpal tunnel syndrome can result from overuse or strain in certain job tasks that require a combination of repetitive, forceful and awkward or stressed motions of your hands and wrists.  Other risk factors can include pregnancy, obesity, repetitive hand motions, smoking (which reduces blood flow to the median nerve) and illnesses such as hypothyroidism, diabetes and rheumatoid arthritis.

While there are no proven strategies to prevent carpal tunnel syndrome, the following measures can be taken to decrease the likelihood of its occurrence:

• Reduce your force and relax your grip: Most people use more force than needed to perform many tasks involving the hands. If your job requires you to spend hours at the keyboard, hit the keys softly. For prolonged handwriting, use a big pen with an oversized, soft grip adapter and free-flowing ink. This way you won’t have to grip the pen tightly or press as hard on the paper.

• Take frequent breaks: Gently bending and stretching your hands every 15 to 20 minutes will give your hands a much-needed break from repetitive motions and exerting great amounts of force.

• Watch your form: Keep a relaxed middle position and avoid bending the wrist all the way up or down. Avoiding working with your arms too close or too far from your body will also help decrease tension and unnecessary strain in your wrists.

• Improve your posture: Slouching or hunching over can cause the neck and shoulder muscles to shorten and in turn compress the nerves in the neck. The compression of these nerves can affect the wrists, fingers and hands.

If you are experiencing signs of carpal tunnel syndrome or your symptoms persist after treatment, see an orthopedic surgeon. Your doctor may prescribe alternative therapies or medications and, in some cases, surgery. As with any prolonged discomfort, leaving carpal tunnel syndrome untreated can result long-term damage.

• Throwing the breaking ball at an early age
• Throwing too many pitches per game or innings per week
• Participation in more than one youth baseball league simultaneously
• Participation in year-round baseball
• Poor pitching mechanics due to faulty coaching / instruction
• Poor practice and condition habits due to substandard coaching practices

If a young pitcher does suffer from an injury, non-operative treatment is usually the first step taken to reverse the damage.  Treatment options may include reducing inflammation and controlling pain, stretching and strengthening exercises, throwing technique modifications, and cessation of throwing. If these methods are unsuccessful, surgery may be the only option in order to return the athlete back to the field. For more information visit the American Sports Medicine Institute at www.asmi.org.