Posts filed under ‘Dr. Jaren Riley’

Commonly asked questions of sports medicine physicians

Should my child drink water or sports drink?
Water usually is the best choice for exercise unless your child is involved in work-outs longer than 60 minutes. At that point, the energy stored in muscle is becoming depleted and electrolytes in the body have been lost in the sweat. Therefore, for these longer bouts of exercise, have your child consume a sports drink that contains carbohydrates (for fuel) and salt/potassium (for electrolytes).

When can my child start to lift weights?
Research has shown that even young children can safely begin strength training. If your child is ready to participate in organized sports, they are probably ready to begin strength training (This typically corresponds to age 6-8 years). The key to making this activity safe is to provide supervised training that emphasizes safety precautions and proper technique/ use of equipment. The training regimen should involve lower weight, higher repetition lifting. Body resistance exercises are a great choice for young athletes. Maximal lifts or any type of Olympic-style lifting should be avoided.

Should my child compete wearing a brace?
If your child is recovering from an injury, it might be appropriate to wear a brace to compete. For example, if the athlete has had a significant ankle sprain, research has shown that an ankle brace may help prevent another ankle sprain. Not all braces have been shown to be as effective as the ankle brace, but there are other braces that may help athletes compete during the recovery phase. For athletes who have not had an injury, the use of bracing is controversial, as there is a lack of evidence that bracing is helpful to prevent an injury from happening in the first place. The most important concept for the athlete to understand is that regaining range of motion, strength, and balance after an injury is the best method of preventing future problems. Bracing cannot substitute for the hard work needed to rehabilitate an injury.

Should my child take performance-enhancing supplements?
Prior to considering a supplement, an athlete needs to determine what they are wishing to accomplish by using the supplement. Proper training, adequate rest, and optimized nutrition are the best ways to enhance performance. If an athlete is not maximizing these methods, supplementation will likely be unsuccessful and the athlete’s expectations will continue to prove unrealistic. In general, most supplements have not been studied in youth and using them should be discouraged because of this fact. There is no requirement for supplements to be proven safe by the Food and Drug Administration (FDA). The products often do not live up to claims and they may not contain what they list as ingredients. Additionally, because of the lack of regulation, the product may contain traces of illegal, potentially dangerous, substances.

How can my child stay active if he or she is injured?
Having an injury can sometimes be a blessing for an athlete! During the injured period, the athlete can focus on gaining strength of other muscle groups. For example, core muscle training is usually allowed and can be an effective method of enhancing sports performance in a multitude of sports. Additionally, time can be spent on stretching tight muscles, a common problem in children and teens that may have contributed to injury. During the injury recovery period, flexibility around the injured joint and other joints can often help the athlete once they are ready to return to participating.

Which is better for my child’s injury – ice or heat?
In the case of a sudden, acute injury, the best choice is to use ice. The swelling and inflammation associated with acute injury often results in significant pain. Ice applied directly to the injured area helps to reduce swelling, and therefore can be useful in controlling pain in the first 24-48 hours after a new injury. Ice can be applied with an ice pack. Applying ice directly to the skin should generally be avoided. Joints like the ankle respond well to submersion in a bucket of ice water. Heat tends to more useful in more chronic injuries as a method of increasing blood flow to the area in order to relax and loosen tight, painful tissues. Physical therapists may even alternate ice and heat during specialized treatments for the athlete.

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May 6, 2014 at 1:11 pm Leave a comment

Common Knee Injuries: What You “Knee-d” to Know

It’s one of the most common reasons patients see their orthopedic physician—but how much do you know about knee injuries and how to protect the largest joint in your body from injury?

Your knees play a critical role in keeping you flexible and mobile, but unfortunately, they are often vulnerable to injuries. Fractures, dislocations and tears are all injuries your knees could sustain from sports and other physical activities.

According to the American Academy of Orthopaedic Surgeons, here’s what you need to know regarding common knee injuries:

•Fractures: Fractures to the kneecap are the most common types of fractures around the knee. Patellar fractures account for nearly 1 percent of all fractures and most often occur in 20-50-year-old individuals as a result of falls and vehicle collisions. Men are almost twice as likely to fracture their kneecaps as women.
•Symptoms of patellar fractures include severe bruising and inabilities to walk or straighten the knee. If the patella has been displaced, surgery will be required. Your doctor will discuss this procedure and any possible complications. If the fracture does not require surgery, your knee will be placed in a cast or splint to allow the broken ends to remain firmly in place while they heal. Recovery can take between six and eight weeks, and your doctor may suggest avoiding activities requiring frequent bending or squatting to protect your knee from future injuries.
•Dislocations: When a bone in the knee slips out of place, this is referred to as a dislocation. Patellar dislocations are the most common type of dislocation, and they can either be complete or partial. When the knee bends, the patella slides up and down over the trochlear groove of the articular cartilage – a slippery substance cushioned between the ends of the femur and tibia. A patellar dislocation as a result of a direct blow or fall occurs when the patella slides out of the trochlear groove either partially or completely.
•While the patella can easily slide back into place with assistance or even by itself, a patellar dislocation still requires medical attention. Dislocations are painful and can result in a loss of function to the knee joint. Your orthopedic surgeon will need to x-ray your knee and may even order a Magnetic Resonance Imaging scan (MRI), if more detailed images are required to diagnose the injury. Dislocations to the knee can typically be treated with a brace to immobilize the knee during the healing process and physical therapy to help restore the knee joint to full motion.
•Tears: Tears can occur in the following areas in the knee: •Anterior Cruciate Ligament (ACL) tear: An ACL tear is a most common injury for athletes who play high-contact sports such as football, soccer and basketball. The ACL is a ligament found inside the knee that crosses over the PCL to aid in your knee’s ability to move back and forth. When athletes change direction quickly or land incorrectly, the ACL can sprain or tear. Unless the individual is elderly or has a low activity level, injuries to the ACL require surgery to reconstruct the ligament with a tissue graft. Recovery can take at least six months.
•Posterior Cruciate Ligament (PCL) tear: A PCL tear occurs when an individual receives a powerful blow to the knee when the knee is bent. As with other knee injuries, this type of tear typically happens as a result of vehicle collisions and contact during sports. PCL tears are typically partial tears and can often heal without surgery. Your orthopedic physician will most likely recommend a brace, physical therapy and the RICE treatment method: Rest, Ice, Compression and Elevation.
•Collateral Ligament tears: This type of tear occurs when the knee is pushed to the side from a direct blow to the outside of the knee. Your knee is comprised of two types of collateral ligaments found on the sides of your knee: the medial collateral ligament (MCL) is on the inside, and the lateral collateral ligament (LCL) is on the outside. Both work to manage the sideways movements of your knee. LCL and MCL tears are not as common as other types of tears, and they rarely require surgical treatment. Surgery is only required if your LCL or MCL injury affects other areas in your knee. Ice, bracing and physical therapy are the most effective treatments for collateral ligament tears.
•Meniscal tears: Meniscal tears often occur during sports or as a result of arthritis or aging. The menisci are two wedge-shaped pieces of cartilage between the femur and tibia that support and stabilize your knee joint. Sudden twisting or pivoting motions during contact sports can cause a meniscus to tear. Treatment is dependent on the size and location of the tear.
•Tendon tears: Tears to the quadriceps and patellar tendons are common in middle-aged individuals involved in sports requiring running or jumping. Tendon injuries can either be partial or complete, and they most often occur from falls or landing incorrectly from a jump. While partial tears typically can be healed with nonsurgical treatments, complete tears require immediate surgery to repair the tendon.

April 30, 2014 at 2:48 pm Leave a comment

Dr. Riley, Pediatric Orthopedic Surgeon, spent the week in Peru doing spine surgery. Read some excerpts from his trip below.

It’s one of the most exciting events I’ve ever witnessed. Dozens of families wait on pins and needles in a crowded hospital plaza to hear the announcement of the surgery schedule in Guayacil, Ecuador. Some families have traveled hundreds of miles by bus, train, taxi, and foot just to be seen by the visiting American surgeons. Last night, some slept on the benches lined up outside the clinic, either because they had nowhere else to sleep, or because they wanted to be sure that they would be seen today. Clinic began at seven in the morning, it is now almost midnight, and the room hums with excitement and anticipation. The first surgery for Monday morning is announced to the crowd, a teenage girl with severe scoliosis will get her surgery this year. The family, and all of the surrounding families, erupt in applause, shouts, hugs, and tears.
The goals of my surgical missions to South America are to provide surgeries that are otherwise unavailable, and to educate local surgeons. Surgical correction of scoliotic deformities is a particularly crucial service that meets both of these goals. These surgeries are also very complex, even here at Rocky Mountain Hospital for Children. They require a skilled team of scrub technicians, nurses, neural-monitoring, anesthesiologists, pediatric hospitalists, and physical therapists. They all sacrifice their time and comfort so they can work at an exhausting pace in tough conditions.
During surgery, I invite the local surgeons to scrub in and participate. We talk about the treatment of scoliosis, the indications for surgery, the planning process for the surgery, and the technical pearls and pitfalls of the surgery. We work, eat, think, and learn together, so by the end of an exhausting week, we have established a community of learning, service, and friendship. By Friday, we have completed twenty seven surgeries. We round together on all of the patients. There is another round of applause, hugs, and tears as the patients get out of bed to show us how well they are walking, and how tall they are now that their spines are straight.
The families are overflowing with thanks, but we are just as grateful for everything we learn from them.
Organizing such humanitarian trips for so many people, and the communication it requires with the local hospitals, is a monumental task. I’ve worked with two wonderful groups, Project Perfect World and Eagle Condor.

January 17, 2014 at 11:49 pm Leave a comment


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