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Stay in the Game: Avoid Those Nagging Sports Injuries

Dr. Bradley Dunlap June 25, 2009 12:00 PM This chat has ended. Thank you for participating.
Kristin Philbin (Moderator) - 11:58 AM:
Welcome! Today’s chat, Stay in the Game: Avoid Those Nagging Sports Injuries, will begin shortly. Please start submitting your questions and Dr. Bradley Dunlap, will begin answering them as soon as we get started. For more information about NorthShore's Orthopaedic department visit us here.

Dr. Bradley Dunlap (NorthShore) - 11:59 AM:
Hello. My name is Dr. Brad Dunlap and I look forward to answering your questions today. I am an orthopaeic surgeon at NorthShore specializing in sports medicine and arthroscopic surgery.

Pat Evans (Evanston, IL) - 12:00 PM:
I was diagnosed w/ plantar fasciitis a year ago and it still nags me now and then. Any suggestions for rehab exercises?

Dr. Bradley Dunlap (NorthShore):
Plantar fasciitis is a common problem. Most times it can be treated with a stretching type program, especially stretching of the calf and Achilles. Thumb and ice cup massage to the area can also be helpful. If it does not resolve on its own, you may need formal physical therapy.

Bina Jamnadas (Chicago, IL) - 12:03 PM:
My husband is training for the Chicago marathon (this will be his 4th marathon) and last week, he complained of numbness going down his leg, along the peroneus muscle, and he felt like his ankle was giving out, forcing him run on a limp for a little while. These symptoms are inconsistent e.g. he just ran a half-marathon this past weekend with no symtoms. Could this be something serious?

Dr. Bradley Dunlap (NorthShore):
It could be something serious. There typically should be no numbness or joints giving out, and running with a limp can lead to other problems such as back, hip and knee pain. Long distance runners can also get stress fractures from training, so it may be advisable to get this evaluated.

Catherine (Arlington Heights, IL) - 12:04 PM:
Despite stretching prior to jogging, I am frequently bothered by shin splints. What is causing them and how can I avoid them?

Dr. Bradley Dunlap (NorthShore):
Shin splints can be caused from anything from muscle inflammation to stress fractures of the tibia. Thorough stretching before running can be helpful, as can having good supportive running shoes and running on soft surfaces. Sometimes you can also try to mix in lower impact activities such as swimming or biking to help take the stress off of your legs.

Lindsey (Carol Stream, IL) - 12:06 PM:
Should I use hot or cold pads on injuries?

Dr. Bradley Dunlap (NorthShore):
This is one of the most common questions we get from patients. The general rule is that heat brings in blood supply to help "warm up" muscles and joints, while cold helps decrease the blood supply and cut down on swelling and inflammtion. Generally for an acute injury, ice tends to be better to keep down the swelling.

Edwardo (Palos Heights, IL) - 12:08 PM:
I Sprained my ankle a week ago and want to play in a flag football game coming up. How do I know when I am properly healed and ready to play?

Dr. Bradley Dunlap (NorthShore):
There are varying degrees of ankle sprains, but for minor ankle sprains that you are able to walk on without any difficulty, these generally resolve in several days to weeks. Generally, the swelling should be down, and your range of motion should be identical to the opposite side. Also, you should be able to run and, in the case of flag football, be able to cut without any pain or discomfort. You should also ice after your first few times back on the flag football field. If it takes longer than you would like, you could always get into some physical therapy to help accelerate the process.

Nancy Degnan (Des Plaines, Illinois) - 12:12 PM:
How can I strengthen my ankles? I recently fell and sprained my ankle. This is the second time I've done this.

Dr. Bradley Dunlap (NorthShore):
You can work on range of motion of the ankles, some people talk about "writing the alphabet" with your ankle, so that you are moving the ankle in all directions. You can also get those rubber strengthening bands and then perform the same exercises with resistance. You can also do single leg toe raises, where you go up on your tip toes while standing on one leg. You should be able to do this 10x in a row without any problem. Most ankle sprains resolve without problems, but once you sprain your ankle you are more likely to do it again. Therapy can also sometimes be helpful, if you do not feel you are making progress on your own.

Nancy (Evanston, IL) - 12:16 PM:
I often get shin splints when I'm doing my walking exercise routine, is there any way to prevent them?

Dr. Bradley Dunlap (NorthShore):
A good pre-exercise stretching program is helpful, but some people are more prone to get shin splints than others. Again, good supportive shoes, a soft walking surface will help, and if there are still problems, consider mixing in lower impact activities such as biking and/or swimming/water exercises.

Lindsey (Carol Stream, IL) - 12:17 PM:
I have been working out 7 days a week since high school and I am now in my late twenties and I feel like these hard workouts are beginning to take a toll on my body. What do you recommend for staying in great shape, but without over doing it?

Dr. Bradley Dunlap (NorthShore):
I think that everyone, from professional to recreational athletes, needs time off to let their body recover. So I would give yourself a day off now and again. I think the key is mixing in different exercises and doing a variety of different activities. For example, if you want to work out several times a week, do weights for different body parts or different forms of cardio exercises everyday. That will help keep you from overtraining one particular body part.

Jim (Northbrook) - 12:21 PM:
I received a cortisone shot to alleviate pain in my right elbow brought on by tendinitis. I've been hesitant to participate in sports activity because I don't want to reaggravate the area. How do I ease back into sports from here?

Dr. Bradley Dunlap (NorthShore):
The most common form of tendinitis in the elbow is lateral epicondylitis, or tennis elbow. If the cortisone shot has helped and your pain is gone, you can probably slowly get back into your activities. The key is to go slow, use anti-inflammatory medication if you are able to, and ice the area after. You can also wear one of those tennis elbow straps just below the elbow. Any sport, such as tennis or racketball, that puts stress on your forearm could aggrevate the problem, so if your goal is to get back to those sports I would just go slow, maybe hit balls for 10-15 minutes, see how it feels the next day, and go from there.

Rebecca (Vernon Hills, IL) - 12:24 PM:
I have a broken pinky toe and was told that there is nothing that will heal it except for time. Is this true and if it is how long will it take to heal?

Dr. Bradley Dunlap (NorthShore):
It depends on exactly where the break is, but yes, in general, fractures of the small toe of the foot tend to heal with time and modifying your activties. The time frame is variable from person to person, but generally it can take 6-8 weeks for the pain to completely go away, and sometimes even longer for the swelling to resolve. Again, this is for a fracture of the toe, and not the metatarsal bone which is in the foot. If you are unsure, you should probably consult with your physician.

Dave (Glenview, Illinois) - 12:29 PM:
How often should I replace my running shoes? I try to run at least three times a week.

Dr. Bradley Dunlap (NorthShore):
Having well supported shoes is very important for runners. There is no specific time that shoes last, and the durability of the shoe will depend on your running mechanics and your foot alignment (ie if you run on the outside of your feet, then they will wear down quicker in that area.) You can inspect your shoes and the heels to see how they look, and when they begin to wear down, it is probably time for a new pair.

Matt (Chicago) - 12:31 PM:
What is your take on sports/energy drinks? I find water works for me. But some of my friends swear by these drinks. Do these drinks offer the body more than bottled or tap water?

Dr. Bradley Dunlap (NorthShore):
There are a number of sports drinks on the market, and in the end it is probably a personal preference. Staying hydrated while exercising, be it with water or sports drinks, is the most important thing. Most sports drinks have electrolytes in them. Assuming you have a balanced diet, water is probably sufficient for normal exercise regimens, but again, it is a personal preference and staying hydrated is what counts.

Robert (Glencoe, IL) - 12:35 PM:
I often find that when I have not exercised in a long time, I get sick during my first week back at it. What could cause this?

Dr. Bradley Dunlap (NorthShore):
This is somewhat difficult to answer because it depends what you mean by "sick". The cause could be any number of things from plain deconditioning to a more serious medical problem. As always, if you have any questions, you should consult your primary care physician before starting a new exercise program.

Edwardo (Palos Heights, IL) - 12:37 PM:
Could you give a step by step of a proper warm up before exercising, say going out for a run?

Dr. Bradley Dunlap (NorthShore):
There are many variations on the theme, but in general you should start with something to get your blood flowing through your body (jumping jacks, light jogging in place, etc). After doing this for a few minutes, you can then stretch your muscles. Most people will tell you to stretch the major muscle groups of your legs (quads, hamstrings, calves, etc). Usually you would try to hold a stretch for several seconds, rather than "bouncing" while stretching. You can repeat the stretches several times. In general, you should feel loose before you start running, not stiff. A good warm up and stretch can take 10 minutes or more.

Cory Tabachow - 12:42 PM:
What resources do we have for enhancing performance? I imagine we could develop a service line for athletes aimed towards prevention (strength, flexibility, etc). It seems most ortho and PT treatments are geared towards the less physically active and / or those with acute injury.

Dr. Bradley Dunlap (NorthShore):
You are right, a great deal of orthopaedic care, just like medicine in general, has historically been aimed at treating problems once they occur and not necessarily preventing them. Several injury prevention programs have been developed. As an example, there is a comprehensive program aimed at young female athletes to help prevent ACL tears. Females have a much higher risk of ACL injuries, and this program helps re-train the neuromuscular control of these athletes, and help teach them how to jump and land in a way that is safer for their knees. Additionally, NorthShore has several programs throughout the year aimed at injury prevention. The physical therapy department hosts several "hands on" workshops during the year for runners and golfers, for example, to help prevent injuries. There are therapists, orthopaecic surgeons as well as coaches for the specific activities. You could find more on the northshore.org website.

Kristin Philbin (Moderator) - 12:48 PM:
Thank you everyone for your great participation, the chat will be ending in approximately 10 minutes. Please submit any final questions you have.

Edwardo (Palos Heights, IL) - 12:49 PM:
I play a lot of baseball, mostly pitching, and have noticed some tightness in my mid back, what do you think could be the cause of this?

Dr. Bradley Dunlap (NorthShore):
The tightness could be due to frequent pitching, or perhaps your throwing mechanics. As we have discussed earlier, be sure to stretch out before throwing and ice the shoulder when you are done. If it does not resolve, you may need to consult your physician.

Dr. Bradley Dunlap (NorthShore) - 12:54 PM:
Thank you to everyone who participated in this webchat and submitted questions. If you have any futher questions, my office number is 847-570-2825. Alternatively you can visit www.northshore.org and click on the orthopaedics section for more information. Finally, the American Academy of Orthopaeic Surgeons has a comprehensive patient information website on a number of sports medicine topics. That web site is www.orthoinfo.org. Have a great day!

Kristin Philbin (Moderator) - 1:01 PM:
Thank you again for participating in our chat today. For more information please visit our Sports Medicine pages.

Also, a transcript of this chat will be available shortly.
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