Category Archives: Sports Medicine

Preventing Shoulder Injuries

Story by Dr. Albert Diaz, Sports Medicine Specialist at Danbury Orthopedics

Many of the patients I see with shoulder pain have injured themselves as the result of strenuous, weight-bearing exercise.

As high impact, strength-related exercise programs have increased in popularity, many people are putting too much weight on their shoulder joints. While the benefits of exercise are indisputable, it is important to understand how the shoulder works and how best to avoid injuring this delicate joint.

The shoulder is built for range of motion rather than stability. It is a ball-and-socket joint held in place by a thin sleeve of muscles and tendons called the rotator cuff. Excessive weight on the shoulder can damage the cuff as well as other soft tissues around the joint. Exercise programs that work the large chest and back muscles should also include exercises with light weight or elastic bands for the smaller rotator cuff muscles.

If you feel shoulder pain when exercising or playing sports, DO NOT WORK THROUGH THE PAIN. Rest your shoulder for two weeks and take over-the-counter anti-inflammatory medication such as ibuprofen, if necessary. If, after two weeks, you return to your activity and still feel pain, you should consult an orthopedist.

Repetitive or continuous use of the shoulder at a young age can lead to injury. Children under the age of 16 should avoid playing any single sport for more than 8 months of the year, especially swimming, baseball or tennis, to prevent shoulder overuse. Heavy weight training is also a potential cause of injury.

Danbury Orthopedics, a member practice of OrthoConnecticut, offers an expert group of orthopedic specialists, including a team of sports medicine doctors who work with sports-related injuries and conditions of all kinds. The practice has its own x-ray, MRI and on-site physical therapy specialists, allowing patients to recover in one single, integrated location. All the practice’s physicians are fellowship-trained, and experts in their specialty area.

Danbury Orthopedics’ areas of expertise include five Centers of Excellence where you will find integrated comprehensive treatment for bone or joint pain injury and subspecialized orthopedic surgery to get you back to leading a healthy active life.  These include:

All of Danbury Orthopedics’ services are available at our new state-of-the-art location at 2 Riverview Drive in the Berkshire Corporate Park in Danbury.  For more information, go to: myorthoct.com

Dr. Albert Diaz, who is a fluent Spanish speaker, specializes in the field of sports medicine, minimally invasive arthroscopic shoulder and knee surgery. He completed his sports medicine fellowship at the Minneapolis Sports Medicine Center where he served as Assistant Team Physician to the Minnesota Vikings and Timberwolves. He currently serves as Team Physician for Joel Barlow High School in Redding.  He is board certified by the American Board of Orthopedic Surgery and is a member of the American Orthopedic Society for Sports Medicine, the American Academy of Orthopedic Surgeons, and the Arthroscopy Association of North America.

How Do You Prevent Winter Sports Injuries? The Pros at Danbury Orthopedics Give Tips

iStock-153765931Winter is the time some sports enthusiasts look forward to enjoying skiing, ice skating, snowboarding and more.  However, winter is also when orthopedists see many injuries related to those very sports.

Most Common Winter Injuries Orthopedists See

According to Dr. Angelo Ciminiello, a Sports Medicine Specialist at Danbury Orthopedics, the most common injuries he sees this time of year are torn ACLs from skiers, broken or fractured wrists from snow boarders and skaters, and many concussions.

Proper Gear Can Prevent Common Injuries

He recommends always wearing a helmet for any of these winter sports, since this simple step can prevent a serious concussion.  To prevent against broken wrists, he suggests using a specialized glove with a wrist guard built-in, which can help prevent a fracture.  Wearing mouth guards and other protective equipment when playing hockey is also a must.

For skiers, be sure the bindings are appropriate for your weight and height so they will disengage when needed.  A torn ACL occurs when the foot is planted and the knee is turned.  If the bindings release your foot after a fall, you are less likely to tear the ACL.

How to Determine if the Injury is Serious

How do you know if you’ve torn your ACL? “You usually hear a pop in the knee, followed by swelling and pain when putting weight on the knee.  If that happens see an orthopedist immediately,” Dr. Ciminiello advises.  The same holds true for a broken wrist.  If you have swelling after a fall and are unable to use the hand properly, see an orthopedist.  “Do not take a wait and see attitude, since immediate treatment will result in a much more successful recovery,” he adds.

Stretching Really is Important for Injury Prevention

Stretching, too, is important for all winter sports. Athletes who play winter outdoor sports are often cold before they begin playing, so stretching your muscles helps warm them up and prevents hamstring pulls and other injuries.  This includes winter outdoor runners, too.

The Premiere Sports Injury Practice in the Region

Danbury Orthopedics treats more than 2,000 sports injury cases each year — from ACL and rotator cuff surgeries to complicated multi-ligament injuries to tendonitis. They are also at the forefront of concussion management.

With offices in Danbury, Ridgefield and Southbury, Danbury Orthopedics is the area’s premier multi-specialty orthopedic practice. The Sports Medicine Center at Danbury Orthopedics is dedicated to the complete care of the athlete — from professional, collegiate and high school athletes to recreational, youth players and weekend warriors. The Sports Medicine Center specializes in sports injury treatment and rehabilitation through both surgical and non-surgical techniques.  The team of four fellowship-trained Sports Medicine Specialty Physicians include: Dr. Michael G. Brand, Dr. Angelo Ciminiello, Dr. J. Albert Diaz and Dr. Ross Henshaw.  Walk-in orthopedic urgent care services for injuries are also available at the group’s OrthoCare Express location at 2 Riverview Drive at Berkshire Office Park in Danbury, open 8 a.m. to 8 p.m. weekdays and 10 a.m. to 3 p.m. on weekends.

J. Albert Diaz, M.D. Joins The Sports Medicine Center at Danbury Orthopedics

J. Albert DiazDiaz Brings Over 18 Years of Experience as Sports Medicine Specialist

DANBURY, CT – Danbury Orthopedics is pleased to announce that J. Albert Diaz, M.D., will join the practice as of June 1st. A specialist in the field of sports medicine, minimally invasive arthroscopic shoulder and knee surgery, Dr. Diaz completed his orthopedic residency training at The Hospital for Special Surgery in New York City, and his sports medicine fellowship at the Minneapolis Sports Medicine Center where he served as Assistant Team Physician to the Minnesota Vikings and Timberwolves. He attended Dartmouth College and the Tulane University School of Medicine, and currently serves as Team Physician for Joel Barlow High School in Redding.

“We are thrilled to have Dr. Diaz join our sports medicine team to work alongside Drs. Ciminiello, Henshaw and myself,” says Danbury Orthopedics’ President, Dr. Michael Brand. “Our patients will certainly benefit from his arthroscopic surgical expertise, and the eighteen years of experience he brings in this field.”

Dr. Diaz is board certified by the American Board of Orthopaedic Surgery and is a member of the American Orthopaedic Society for Sports Medicine, the American Academy of Orthopaedic Surgeons, and the Arthroscopy Association of North America. He maintains surgical privileges at Danbury Hospital, Danbury Surgical Center and Western Connecticut Orthopedic Surgical Center.

“I am delighted to bring my skills to the highly trained team at Danbury Orthopedics, and continue to care for patients in the greater Danbury area,” says Dr. Diaz. “This organization has made significant advancements to meet the needs of the modern orthopedic patient and I am excited to be a part of it,” adds Dr. Diaz. Danbury Orthopedics offers the full suite of orthopedic services, including the highest quality diagnostics, non-operative and surgical treatment solutions, integrated care by its physical therapy team, its own orthopedic-only outpatient surgical center, and OrthoCare Express, a walk-in orthopedic specific urgent care service, 7 days a week.

Running Right – to Avoid Common Injuries

Story by Ross Henshaw, MD, Sports Medicine Specialist, Danbury Orthopedics

family runnersDANBURY, CT – As any runner will tell you, this simple sport is one of the most rewarding and convenient exercise activities. It’s a wonderfully efficient way to improve your health, except when it produces chronic, nagging injuries. So what’s the best way to safely enjoy a running program? Start smart, with a progressive training schedule that gradually builds the intensity and duration of your workouts.

What the Pros Say

Typically, a running coach or trainer will recommend increasing distances no more than 10% a week. If you have never been a runner, seek advice from friends, trainers or your local athletic store. There are also great resources online and in print. But if you have an underlying health condition or are new to exercise, make your first step a consultation with your physician to be sure it’s OK to start running. Orthopedically, running is a safe exercise for most people but there are exceptions, even among athletes. So if you have a history of orthopedic injury or joint pains, particularly those involving the legs or spine, seek the advice of an orthopedic surgeon.

While any form of exercise can cause or aggravate a preexisting injury, endurance sports generate typical injury patterns. Endurance sports by definition involve prolonged repetitive motion. While a soccer player may run 3-7 miles in a game, depending on position, he or she is rarely only running straight ahead at the same speed. But runners go straight ahead at a maintained speed, which means your hip, knee, ankle and arm motions are roughly the same for the duration of the exercise. Hills change the degree of motion and add more jarring forces.

The longer the duration and hillier the terrain, the more our joints are cycling and the more our tendons and ligaments are pulling and rubbing around our joints. When we start an endurance sport like running and build up too quickly, the abrupt increase in joint motion can lead to ‘overuse’ injuries.

The Top 5 Complaints

In my practice, the most common running injuries are hip bursitis, kneecap pain, shin splints, Achilles tendonitis and plantar fasciitis. Here’s a quick anatomy lesson:

Hip Bursitis – ‘Trochanteric Bursitis’ is an overuse injury caused by friction between the illiotibial tendon band and the hip bone. This large tendon travels over the bony prominence on the outside of the hip, goes all the way down to the leg and attaches just below the outer side of the knee. When we run, this band rubs back and forth over the outer hip bone; over time the friction creates inflammation. Our bodies have natural ‘cushions’ called ‘bursa’ that are designed to reduced this friction, but if they have not had time to adapt they can swell and hurt. (A related injury is ITB syndrome.)

Kneecap pain and Patella Tendonitis – Often grouped as ‘anterior knee pain’, this refers to pain in the front of the knee and is common among runners. The quadriceps muscle in the front of the thigh powers our ability to straighten the knee. It works by using the kneecap or ‘patella’ for leverage across the knee. This generates pressure and can cause the kneecap to become sore. It’s especially evident when people walk down stairs or inclines and is precipitated by excessive downhill running. The quadriceps muscle tapers to become a tendon that attaches to the kneecap and then to the shin bone (tibia) via the patella tendon. When strained, the quadriceps and patella tendons can also develop micro tears and become inflamed. Treatment includes rest, anti-inflammatories, strengthening exercises, cross training and progressing back to running while avoiding hills.

Shin Splints – Shin splints, or ‘posteromedial tibial stress syndrome’, can occur on one or both shins, but most commonly on the dominant leg depending on your stride. Pain originates at the lower third of the inner part of the shin just behind the bone. The pain is usually discrete and easily reproduced by pressing on the trigger point. This condition is caused by inflammation where the Soleus muscle in the calf attaches to the tibia. As the muscle helps runners with ‘pushing off’ it pulls on the attachment site, which may become inflamed and swollen. This pain usually hurts only when running, early or later in a run. Some people try to run through the pain, which worsens it so that even walking becomes painful. Treatment for this overuse is rest and cross training. Some people may be predisposed to shin splints because of running style or leg, ankle or foot alignment.

Achilles Tendonitis – The strong Achilles tendon is prone to inflammation when starting a running program, particularly on hilly terrain. Our calf muscle tapers off to become the Achilles tendon that inserts into the heel and powers the push-off of the running stride. Running uphill demands more stretch from the calf, forcing it to work harder. This can lead to micro tears of the small Achilles fibers. Micro tears do not become full tendon ruptures, but cause inflammation and swelling as the body tries to repair and regenerate the area. The usual treatment for this pain is rest, stretching, strengthening, cross-training and as the pain dissipates, a gradual return to running with limited hills.

Plantar Fasciitis – Dreaded heal pain! Its most common early symptom comes not with running, but with the morning’s first step. The plantar fascia is a tight band of tissue that supports the foot arch. It attaches to the heel and traverses across the sole, attaching broadly across the end of the foot. When we run the plantar fascia can become overstressed at the smaller attachment on the heel, especially in individuals with tight calf muscles. Initially, inflammation starts after the run and hurts upon standing after a period of inactivity. When the foot and ankle bend to stand flat, the fascia stretches and hurts. Best treatment is to recognize it early and rest, cross train and take an anti-inflammatory. More severe cases may require calf stretching, night splints that keep the plantar fascia stretched, and heel pads.

Pain is a warning!

While it sounds like a lot can go wrong, most of us can enjoy running without ever suffering from these common maladies. As a sports medicine specialist, my best advice is to recognize symptoms early and not ignore the pain. Early recognition and treatment generally lead to a quicker recovery. I also recommend cross training. Even if you prefer running as your primary aerobic exercise, you’ll benefit by incorporating other forms of conditioning such as biking, elliptical or swimming into your routine. If you pay attention to symptoms and mix it up, you can help avoid painful injuries due to repetitive overuse of the joints … and stay active.

Accidents happen

Should an unexpected injury occur, runners in the region can access the orthopedic urgent care service offered at Danbury Orthopedics. OrthoCare Express, the walk-in, orthopedic emergency treatment center, is open 7 days a week in the heart of downtown Danbury, CT at 226 White Street. The Center is staffed by fellowship trained orthopedic surgeons and highly trained Physician Assistants, and is open weekdays from 8 am – 8 pm, and on weekends from 10 am – 3 pm. No appointment is necessary and no referral is required. Visit orthocareexpress.com or call 203.702.6675 for more information.