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The MUSC Health shoulder and elbow team is constantly working to provide the best orthopaedic care for our community by staying up to date on the current research and leading the field with their own studies right here in Charleston,  SC. This week the team is traveling to San Diego, California for the Annual meeting of the American Academy of Orthopaedic Surgeons (AAOS) to both learn and teach about the future of orthopaedic care. One area of research we are actively studying is shoulder replacement surgery as treatment for individuals with debilitating shoulder arthritis pain.

AAOS logoShoulder surgeon Dr. Richard Friedman presented a study of 238 patients to help determine the optimal design for a total shoulder replacement. In a total shoulder replacement, the socket of the “ball and socket” shoulder joint is replaced with an artificial new surface. Friedman et al. analyzed patient outcomes to conclude that a hybrid cage glenoid component results in fewer radiolucent lines and less intra-operative blood loss than the traditional cemented glenoids. Fewer radiolucent lines and less blood loss means better bone fixation and improved longevity of the shoulder replacement.

Your shoulder and elbow team prides itself on being at the forefront of orthopaedic research, as this study is just one of the many presented at the AAOS. Our number one priority is providing the best care for the greater Charleston community, so if you or a loved one has a shoulder or elbow concern be sure to make an appointment with a member of the team.

In honor of Kidney Health Month, MUSC Health and the National Kidney Foundation (NKF) are working together to increase kidney health awareness throughout South Carolina. With the increase in diabetes and high blood pressure – two major kidney disease risk factors – kidney disease is on the rise. South Carolina ranks among the highest for those being treated for kidney failure and awaiting lifesaving transplants.

Quick Kidney Facts:

  • One in three American adults is at high risk for developing kidney disease today.
  • 26 million Americans have kidney disease –– and most don't know it.
  • High blood pressure and diabetes are the two leading causes of kidney disease.
  • Kidney disease is the ninth leading cause of death in the United States.

Kidney Health Awareness Event Calendar:

World Kidney Day – Thursday, March 9, 2017

  • Wear orange to show your support of Kidney Health Awareness!
  • The NKF will be hosting an information table and kidney screenings at the S.C. Statehouse

Kidney Walks

More than 100 Kidney Walks take place across the U.S. each year, at­tracting over 125,000 walkers, 6,000 teams and raising over eight million dollars to sup­port NKF's early detection, awareness, and education programs. MUSC is supporting all South Carolina walks and encourages participation from our patients, staff and surrounding communities. More than 80 cents of every dollar donated directly supports NKF programs and services.

Charleston Kidney Walk
Sunday, March 12, 2017
More information about the Charleston Kidney Walk

Columbia Kidney Walk
Sunday, March 26, 2017
More information about the Columbia Kidney Walk

Greenville Kidney Walk
Sunday, April 22, 2017
More information about the Greenville Kidney Walk

Guest post by:
Kathleen Choate
Certified Athletic Trainer
MUSC Health Sports Medicine

What Do I Do Now to Prepare?

You've been running several times a week, have an outfit picked out and you know you can finish the 6.2 mile run. With two weeks to go, what else is left to do to prepare?

Tapering

Consider tapering your training program. If you are new to this, the idea of scaling back on your training may feel like the opposite of what you should be doing. Try to remember that more isn't always better. In fact, pushing yourself too hard the last week or two before the race could lead to overtraining and a decrease in your performance. If you approach these last two weeks of Group of runnerstraining the right way, you could decrease your fatigue and see improvements in your performance.*

Progressive tapering does not involve extra rest days, but rather a ten to fifteen percent reduction in training volume. While this volume is reduced, plan to keep the intensity and frequency of your workouts the same. Tapering these last couple weeks will allow your body to recover and your performance to peak on race day!

Shoes

While trying to decide on what outfit to wear for the run, the most important piece of equipment for a runner to buy is shoes. A poor pair of shoes doesn’t just affect your feet. They can throw off the alignment of your entire body. The wrong pair can lead to common injuries such as plantar fasciitis, shin splints, runner’s knee, back pain and even fractures. Make sure the shoes on your feet at the starting line also fall in line with the below guidelines.

  • The cushioning in shoes break down over time. The general rule of thumb is to replace shoes every 300 to 500 miles.
  • Shoes should be comfortable; if you feel like they need to be "broken in," then they are not the right shoe for you.
  • Do the shoes fit? If your toes go all the way to the end of the shoe, then no, they don't fit. That portion of the shoe where your toes go in the shoe is called the toe box. There should be about a half to three quarters of an inch between the end of your toes and the end of that space in the shoe. With your shoe on, try pulling your toes up into the air, so it's easier to find the end of your toes, then push down with the tip of your thumb. There should be a section at the end of the shoe where your thumb is not pushing down on your longest toe.

The specific brand/type of shoe will vary from person to person. Your weight, foot width, arches, etc. all affect what specific shoe is best for you. Consider going to a running store that can recommend a shoe based on an evaluation of your foot.

Lastly, don't make race day the very first day you are running in shoes. Wear them while you train these last two weeks or alternate between your new pair and the old pair.

With a new pair of shoes and a good training program, you should be in a great position to tackle the bridge!

*Mujika, Inigo, and Sabino Padilla. "Scientific bases for precompetition tapering strategies." Medicine and science in sports and exercise 35.7 (2003): 1182-1187.

On December 1, 2016, Air Force Sgt. Chris Goodwin and his newborn celebrated their birthdays together in what was MUSC Health’s first cesarean experience via FaceTime. His wife, Jessica, asked her obstetrician if they could bring a smartphone into the OR since her husband is serving in the Middle East. David Soper, M.D., agreed, knowing how much of a family man Chris is.

Jessica, who was relieved to have her husband ‘virtually’ present, said he’s the type of guy who likes to take care of others. He even changed hard-to-reach light bulbs before he left so she wouldn’t have to.Mom with baby and FaceTime on cell phone

“Chris is the kindest person I know, and he would do just about anything for anyone. He is everyone’s ‘go-to’ person, if that makes sense. If you need something done, he's the person to ask. He will always find a way to help people, but he always puts his family first.”

There are some moments that are not to be missed, and this was definitely one of them. Jessica says parenthood has changed both of them.

“The little moments are now the big moments. The best way to explain it is that I've now learned how to live with my heart outside of my chest.” 

Chris says he’s so thankful for the staff making it happen. “It’s indescribable. I don’t know what I would do without being over there in some kind of way,” he says, admitting that he shed tears during several moments of the birth.

“Of course, I cried. I’m trying to hold it back now just talking about it. If you don’t cry at the birth of your son, then something’s wrong with you.”

Find the full story in the MUSC News Center.

Guest Post by:
Michael J. Barr, PT, DPT, MSR
Sports Medicine Manager
MUSC Health Sports Medicine

Pitch Counts and Strengthening Programs

The “crack” of the bat, “pop” of the glove, and cheering fans … the sounds of spring. That’s right, spring training has started; our favorite players are back and we get a chance to see the future stars of tomorrow on the field. Along with the professionals, this also means that youth spring baseball is on its way; unfortunately, that also means the rise of shoulder and elbow injuries. There are approximately 19 million amateur baseball players, with approximately 25 percent (4.75 million) participating in pitching at some level. Although there is not a national database tracking youth injuries in baseball, multiple studies have shown that 15 percent of amateur pitchers (712 thousand) complain of either shoulder or elbow pain in a single season. Research also suggests that approximately five percent of all pitchers (237 thousand) experience a serious injury to the shoulder or elbow, which is defined as either needing surgical intervention and/or causing retirement from pitching.

So, is pitching dangerous for youth baseball players? NO! If you follow some simple guidelines including pitch counts and rest, as well as participate in an injury prevention program; youth baseball pitchers can have a long and healthy career.

Pitch Smart through Major League Baseball and American Sports Medicine Institute (ASMI) describe 11 guidelines to follow. To simplify things, I am going to focus on my top four suggestions. For the full list of guidelines, visit the Pitch Smart page.

1)      Rest

  • Pitching While Fatigued – the mechanics change, which causes increased stress on the elbow and shoulder increasing the risk for injury.
  • Time Off the Diamond – youth pitchers should take at least four months off from any type of throwing activities per year.
  • Playing for Multiple Teams at the Same Time – coaches should track pitch counts for their players, however playing for multiple teams makes it more difficult to monitor overall counts and it limits the player’s rest days.

2)      Pitch Count Guidelines – Pitch Smart has developed very simple to follow guidelines to determine number of pitches per day and number of days rest required between pitching:

Age Daily Max (Pitches in Game) Required Rest* (Pitches)
  0 Days 1 Day 2 Days 3 Days 4 Days
7-8 50 1-20 21-35 36-50 N/A N/A
9-10 75 1-20 21-35 36-50 51-65 66+
11-12 85 1-20 21-35 36-50 51-65 66+
13-14 95 1-20 21-35 36-50 51-65 66+
15-16 95 1-30 31-45 46-60 61-75 76+
17-18 105 1-30 31-45 46-60 61-75 76+
19-22 120 1-30 31-45 46-60 61-75 76+

* Rest means that players are not participating in repetitive overhead activities, so that also mean that pitchers should not be catching on their rest days.

3)      Strengthening Program – Participate in a strengthening program for the rotator cuff, periscapular musculature (traps, rhomboids, serratus anterior) and core muscles. Focus on muscular endurance through low resistance and high repetition exercises completed in a slow and controlled manner. I suggest a combination of band and stability ball exercises completed two to four days per week during the season and three to five days per week in the offseason. Maintaining appropriate shoulder mobility is also key to a player’s prevention program; stretching should focus on the posterior capsule. A pitcher’s range of motion may be different from their dominant to non-dominant side but their total arc or range should be equal.

4)      Proper Warm-Up – When stepping on the field, before picking up a baseball or bat, all players should complete a full body warm-up focusing on the entire body and then start their baseball specific warm-up.

Baseball is a great sport enjoyed by millions of athletes every year. There is inherently a greater risk for injury with pitching compared to other positions, but that should not discourage anyone from participating. When pitching, there needs to be a greater focus on preventative techniques. Good luck this season and remember to follow pitch counts, rest, and complete your baseball specific strengthening and stretching program.

 

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