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Free Webinar – Treating Our Youth From Head To Toe

By Jim Monaghan
Baseball Health Network

Jim Monaghan

Youth sports specialization is on the rise. As a result, the prevalence of pediatric ACL injuries is also increasing. Join Columbia University Sports Medicine on November 13th for Pediatric Sports Injuries: Treating our youth from head to toe to learn about the latest techniques for prevention and treatment of these injuries in our young athletes.

Children are playing sports in record numbers across the United States, and with this increase in participation there has been an alarming rise in the number of sports injuries. Taking optimal care of these injured kids requires extensive knowledge and comfort in techniques that have previously been thought of as only pediatric, or only adult. This webinar reviews and discusses treatment strategies to maximize outcomes and get these developing athletes off the sidelines and back onto the field. Understanding the etiology, diagnosis, surgical, and non-surgical modalities are the key elements of a successful treatment plan. This course will be of interest to Team Physicians, Certified Athletic Trainers, Physical Therapists, Primary Care Sports Medicine Physicians and coaches of all youth levels.

At the conclusion of this activity, participants will be better able to:

  • Interpret and differentiate the physiology of pediatric sports injuries to formulate a treatment plan
  • Classify and identify different graft options to reconstruct a pediatric ACL injury in order to generate an appropriate recovery plan
  • Analyze and recognize the role of Orthobiologics such as PRP in the Developing Athlete
  • Understand and implement treatment options for patellar instability in the growing athlete
  • Produce a workup and plan for the developing athlete with lower back pain

FACULTY/AGENDA –
Charles A. Popkin, MD
Pediatric ACL Reconstruction: What you need to know in 2018
Elan L. Goldwaser, DO
Concussion in the Developing Mind: Pearls for concussion management in kids under 12
Lauren H. Redler, MD
Patellar Instability in the Developing Athlete
Benjamin D. Roye, MD, MPH
Back Pain in the Developing Athlete: When should you be concerned?
Christopher S. Ahmad, MD
The Tommy John Epidemic in Youth Throwers: How can we stop it?

This course is free to all participants.

Tagged With: Baseball Health Network, Columbia Orthopedics, Dr. Christopher Ahmad, high school baseball, Little League Baseball, Tommy John Surgery, Youth Baseball

Growth Plate Injuries In Baseball

By Dr. Christopher Ahmad
Frank Alexander
Baseball Health Network

Dr. Christopher AhmadFrank AlexanderMost players and parents are aware of the term “Little Leaguer’s Elbow,” but may not fully understand what it truly is. Little Leaguer’s Elbow was first coined in 1960 to describe an injury caused by the repetitive throwing motions in children. Technically, it’s an inflammation of the growth plate in the part of the bone called the medial epicondyle. The medial epicondyle is the palpable bump or knob on the inside of our elbow. Little Leaguer’s Shoulder is an inflammation of the growth plate of the shoulder called the proximal humeral physis which is in the bone called the humerus. Inflammation causes a widening of the growth plate which causes the pain players feel while throwing. In most cases, only an x-ray is needed to diagnosis Little Leaguer’s Elbow or Shoulder.

Little Leaguer's Shoulder & Elbow
X-rays of the shoulder (left) and elbow (right) demonstrating Little Leaguer’s syndrome of that joint (arrows)
While commonly seen in pitchers, Little Leaguer’s Elbow and Shoulder can occur in any young baseball player. Typically, the players who suffer from these injuries are between 12-16 years old and are still growing. The inflammation is caused by the repetitive stress of overhead throwing. Improper throwing mechanics, muscle imbalances, and fatigue also play a role in the development of growth plate injuries.

Little Leaguer's Elbow
X-rays demonstrating screw fixation of a medial epicondyle fracture due to excessive throwing and progressive Little Leaguer’s Elbow
In the elbow, the pitching motion creates a pulling stress to the inside part of the elbow and is primarily resisted by the ulnar collateral ligament (UCL). The UCL is like a rope or shoelace that is firmly attached to bone and in a growing child, the exact attachment location includes a growth plate called the medial apophysis. This is also the location where the forearm muscles attach, which can add additional stress to the growth plate. In children, the growth plate and UCL are weaker than in an adult. The growth plate is the weak link in the chain in kids and can be injured with inflammation or can sustain a fracture. In some instances of Little Leaguer’s Elbow where players continue to play through the pain, the growth plate can become so damaged that the athlete may need surgery. Surgery entails a screw being inserted into the elbow to correct the injury. For players who are no longer growing, the more common injury is to the UCL, an injury that often requires Tommy John Surgery in order for the athlete to resume high-level competitive throwing.

Our recommended treatment for Little Leaguer’s Elbow or Shoulder is complete rest from baseball activities – including hitting – for a minimum of 6 weeks. We also prescribe physical therapy for the player to work on leg and core exercises in addition to their upper body regimen to enhance their kinetic chain that is developed while throwing. After the 6 weeks of rest, we repeat a clinical examination. If the player is pain free, we implement a gradual throwing program. The throwing program is designed to make sure the player builds back up their throwing strength before returning to full, unrestricted competition. Players typically return to full competition in around 3 months.

Regardless if a player is suffering from Little Leaguer’s Elbow or Little Leaguer’s Shoulder, they can still run and play other sports that do not involve overhead throwing while they’re shut down from baseball activities. Should a player not adhere to the prescribed rest, this injury can be cumulative – meaning if the player rushes back too soon then they’ll have to sit out for 12 weeks the second time they become injured, 24 weeks the third time and so on.

Players can avoid these injuries by making sure they get enough rest. When we say rest, we mean taking time off between pitching outings, and for position players, enough rest between games. These types of injuries are overuse in nature so making sure a player gets adequate rest is important. We also suggest players rest during the off-season as well. Studies have shown that players who do not rest for 3 months have a 3600% chance of injuring their throwing shoulder or elbow where surgery is recommended. Another good tip for injury prevention is to not play on multiple teams in a single season. Playing on multiple teams can lead to overuse, and lack of communication between coaches may put a player in a position where they may feel obligated to play through pain. Keeping a log or journal of how many innings and pitches the player has thrown is a good way to keep track of how a player is being used.

Dr. Christopher Ahmad is a founding member of the Baseball Health Network and is the head team physician for the New York Yankees.

Frank J. Alexander, Jr., M.S., ATC, is a Physician Extender to Dr. Christopher Ahmad, Department of Orthopaedic Surgery at Columbia University Medical Center.

Tagged With: Dr. Christopher Ahmad, Frank Alexander, Little League Elbow, Little League Shoulder, Tommy John Surgery, UCL, ulnar collateral ligament

Understanding Tommy John Surgery – And How To Avoid It

By Dr. Christopher Ahmad
Baseball Health Network

Dr. Christopher AhmadIn baseball, we have reached epidemic levels of players needing Tommy John Surgery. At the Major League level, one in four pitchers has had Tommy John as a result of tearing their ulnar collateral ligament, or UCL. Unfortunately, these numbers translate to many younger players needing the surgery as well. To help combat the issues facing America’s pastime, I, along with Frank Alexander and Charlie Ahmad put our heads together and wrote Understanding Tommy John Surgery and How To Avoid It: A Guide for Young Baseball Players.

Understanding Tommy John SurgeryTo reverse these epidemic trends our goal is to start changing the culture at the youth levels before bad habits develop, similar to how we educate children on the dangers of smoking. In our office, we’re seeing younger and younger players walk through the door at an alarming rate. We hope that by educating younger athletes, they won’t wind up in our office when they’re older.

Adds Frank, “I remember playing and even when I worked at the college level, guys walked around the clubhouse or dugout with their scar from Tommy John as a badge of honor. They viewed it as a rite of passage. No player should ever want to have surgery and it’s time that we change that line of thinking.”

Understanding Tommy John dives into the anatomy of the elbow, what the process is like when a player gets injured, and offers tips and tricks for youth baseball players to stay healthy. By taking action earlier, players can make better decisions and avoid injury by understanding how the elbow works and what mistakes can be avoided before they land in our office!

Tagged With: Baseball Health Network, Dr. Christopher Ahmad, Major League Baseball, Tommy John Surgery, UCL, Youth Baseball

Returning To Exercise After Shoulder Or Elbow Surgery

By Frank Alexander
Baseball Health Network

Frank AlexanderWhen someone is injured and needs surgery, the hard part is not undergoing the surgery itself. The hard part is being patient and maintaining the drive to get through each physical therapy session. For our patients with active lifestyles, the desire to get back to the activities they love may feel far away. But there is light at the end of the tunnel. Many patients want to get back to playing their sport or even just get back into the weight room or gym. In some cases, getting on a stationary or recumbent bike is possible within days of surgery. However, that may not be enough. The type of surgery a patient has determines the length of time away from the gym and sports.

Once being cleared to return to working out, there are a number of exercises we would like our patients to steer clear from. Whether you are recovering from surgery or not, we strongly advise our overhead athletes to avoid these exercises.

free weightsExercises to avoid include: dips, chest flyes, lat pull-downs behind the neck, heavy-weight overhead shoulder presses and wide-grip bench presses. Patients should also avoid allowing the shoulders to be stretched to the extreme end range of motions. While these exercises are discouraged, there are variations and other exercises that can be substituted. Variations include: lat pull-downs with the hands in front of the body, using a medium grip for chest press and lat pull-downs, and using dumbbells for bench pressing. Substitutions include: the Thrower’s Ten exercises (internal/external rotation with TheraBands) and lying light dumbbell exercises such as Y’s, T’s, and A’s.

Upon being cleared to return to the gym or weight room, it is best for a gradual return to activities. For example: when returning to cardio, avoid using the moving arms on the elliptical for a number sessions or stick with the bike a little longer. As for weight training, it is suggested to start with light weights and gradually progress to heavier weights. If you are not sure if you should progress, feel free to ask in the office or check in with your physical therapist. Your physical therapist is a great resource for guidance when returning to unsupervised exercising.

Thrower's TenWhile some exercises should be avoided, many should be done regularly. The Throwers Ten Exercises are a staple of all throwing athletes’ shoulder programs and should be done throughout the off-season and regular season to help keep the shoulders healthy. Core and leg exercises are integral for any throwing athlete. When performing lower body exercises with a load, be sure to listen to your body. If soreness is present, modify the lift or avoid it if possible.

If you are ready to return to weightlifting, our office has a handout with guidelines that you should follow as well as the Thrower’s Ten. Following these guidelines and the advice of our team and your physical therapist will help ensure the ability to safely return to the gym and sports!

Frank J. Alexander, Jr., M.S., ATC, is a Physician Extender to Dr. Christopher Ahmad, Department of Orthopaedic Surgery at Columbia University Medical Center.

Tagged With: Baseball Health Network, Dr. Christopher Ahmad, Team Ahmad, Thrower's Ten, Tommy John Surgery

Orthopedics Today Round Table Discussion On Tommy John Surgery

By Dr. Christopher Ahmad
Baseball Health Network

Dr. Christopher AhmadSerious arm injuries are happening to baseball players at the youth, high school, college and professional levels at an alarming rate. Just this week, the eyes of the professional baseball world turned toward the St. Louis Cardinals #1 pitching prospect Alex Reyes underwent season-ending Tommy John surgery.

I was privileged to serve as the moderator on the Orthopedics Today Round Table with a panel that included Dr. James Andrews, Dr. Michael Ciccotti, Steve Donohue (trainer, New York Yankees), and others.

Dr. Christopher Ahmad arm surgeryThe goal of the discussion was to elicit expert opinion about the reasons for increased numbers of elbow ulnar collateral ligament (UCL) injuries, elucidate the scope of the problem, understand prevention strategies, establish realistic expectations for nonoperative and operative treatment, and provide thoughts about the future.

Read the entire discussion here on the Orthopedics Today website.

Tagged With: Baseball Health Network, Dr. Christopher Ahmad, James Andrews, Tommy John Surgery, Youth Baseball

Steve Hayward On “The Sports Doctor” Radio Show

By Jim Monaghan
Baseball Health Network

Baseball Health Network founder Steve Hayward brought the BHN story to a national audience Steve Hayward - Baseball Health Networkwith his January 4, 2017 appearance on “The Sports Doctor” Internet radio show hosted by Dr. Robert Weil.

Steve and Dr. Weil talked about the history of the BHN, the epidemic of arm issues in baseball, especially at the youth level, the bad rap curve balls are getting, and how both parents and players need to be pro-active with regard to the physical health of athletes.

https://baseballhealthnetwork.com/go/wp-content/uploads/2017/01/Steve-Hayward-Dr-Bob-Excerpt-1-4-17.mp3

 

Dr Robert WeilDr. Robert Weil, D.P.M. specializes in podiatric medicine, orthotics and sports medicine. He’s written a column for the Naperville Sun and Aurora Beacon since 2007 as “The Sports Doctor,” providing sports medicine information to athletes, their families, coaches and all readers.

His weekly Internet radio show, “The Sports Doctor” is hosted on Healthy Life.net. He addresses current topics in medicine and sports, and often includes guest speakers who bring a wealth of knowledge from their various professional backgrounds.

Tagged With: Baseball Health Network, Dr. Christopher Ahmad, Dr. Robert Weil, Pitching Healthy, Steve Hayward, Tommy John Surgery, Youth Baseball

Seasonal Timing For Baseball Players

By Frank Alexander MS, ATC
Baseball Health Network

Frank AlexanderWith the winter season approaching, many baseball players take this time to ready themselves for the upcoming season. While strength and conditioning training and a throwing program are essential to improve skills, a period of rest is imperative. This down time gives the athlete’s body the recovery time it desires and can even help with achy and sore muscles. A period of rest can vary depending upon the athlete’s level of competition or how prone to injury they may be. For example, an athlete coming off of a shoulder injury or surgery may want a longer period of rest in the off-season. However, an athlete that made it through the previous season healthy may want to shorten their rest. Again, these time frames are dependent on skill levels and individual health.

As the holidays rapidly approach, this is an optimal time for athletes to take their break from training and throwing. High school athletes may want to take month or so off since their season typically does not start until late February or early March. Conversely, collegiate athletes may want to take a few weeks off since their season starts not long after the New Year arrives. Once you resume your throwing program, start with a simple flat-ground throwing program. Be sure not to confuse flat-ground throwing with flat-ground pitching! Having access to a well-versed pitching coach can greatly help achieve optimal throwing after a period of rest.

Flat ground throwing
Flat ground throwing
When it comes to strength and conditioning, make sure your core, legs, and shoulder are strong enough to take you through the spring season and into the summer and fall. Many athletes are specializing in a single sport at an alarmingly young age and maintenance programs are often neglected, leading to younger athletes needing career-altering surgeries such as Tommy John. Upon resuming a conditioning program, be sure to include the Thrower’s 10 exercises on a regular basis!

Off-season training is great for athletes of all ages and skill levels. Having access to well-versed coaches, such as pitching and strength-and-conditioning coaches, can help an athlete achieve longevity in their career. Additionally, periods of rest built into a training regimen can do the body some good and allow aches and soreness time to resolve. While some of your teammates may be training every day without a break, remember that a few weeks off now can save your career down the road!

Frank Alexander, a member of Team Ahmad, is a Physician Extender to Dr. Christopher Ahmad at Columbia University Medical Center.

Tagged With: Baseball Health Network, Dr. Christopher Ahmad, high school baseball, Pitching Healthy, Team Ahmad, Tommy John Surgery

New Surgical Technique Cuts Rehab Time In Half

By Jim Monaghan
Baseball Health Network

Dr. Jeff Dugas is on the staff of Andrews Sports Medicine & Orthopaedic Center in Birmingham AL where he deals with all types of orthopedic sports injuries.

He has recently pioneered a new surgical technique that is a terrific alternative for young athletes who have injured their ulna collateral ligament.

In this video, Dr. Christopher Ahmad from the Baseball Health Network shares this new technique that includes the use of a swivel lock and high-strength sutures.

https://baseballhealthnetwork.com/go/wp-content/uploads/2016/08/UCL-Repair-Using-InternalBraceâ„¢-Ligament-Augmentation.mp4

 

The result of this procedure is accelerated rehabilitation of the arm in which the athlete can begin a throwing program within ten weeks and be back to full competition in six months, or about half the time using current methods.

PLEASE NOTE – the video contains graphic scenes of a surgical procedure.

Tagged With: Baseball Health Network, Dr. Christopher Ahmad, James Andrews, Jeffrey Dugas, Pitching Healthy, Tommy John Surgery

Tommy John Town Hall Meeting June 28, 2016

By Jim Monaghan
Baseball Health Network

Jim MonaghanBaseball Health Network members Dr. Christopher Ahmad and Leo Mazzone were among the members of an all-star panel at the “Tommy John Town Hall Meeting” on June 28 in New York City.

Tommy John, the man for whom the celebrated surgical procedure was named was also joined by Dr. Glenn Fleisig from the American Sports Medicine Institute, moderated by WFAN’s Ed Randall.

Fans 4 the Cure Town Hall Meeting
L-to-R: Ed Randall, Tommy John, Leo Mazzone, Dr. Christopher Ahmad, Dr. Glenn Fleisig

Among the many highlights –

* Tommy John saying that in all the years since his surgery, not one MLB pitcher who’s undergone the same procedure has ever reached out to him.

* Leo Mazzone on one of his secrets to pitching without injury – “Pitchers should throw more often, but with less intensity. Throw a lot so that you find your max effort you can put on a pitch without maxing out.”

* Tommy John remembering an instance in which renowned player agent Scott Boras said that Tommy John doesn’t know what he’s talking about when it comes to the surgery that bears his name.

* Dr. Christopher Ahmad on studying Tommy John surgery technique under legendary Dr. Frank Jobe – “As he began an operation, Dr. Jobe turned to me and said, ‘I’ve done so many of these procedures…I think I’ll do this one left-handed.’ The joke was on all of us in the operating room, since he was, in fact, left-handed.”

* Dr. Glenn Fleisig – “There was a recent study that demonstrated that overexertion on full-speed fastballs and not curve balls were the cause of the majority of arm injuries.”

* Tommy John saying that it’s a myth pitchers throw harder after undergoing Tommy John surgery.

Proceeds from the event went to Ed Randall’s Fans For the Cure.

Tagged With: Baseball Health Network, Dr. Christopher Ahmad, Glenn Fleisig, Leo Mazzone, Major League Baseball, Tommy John, Tommy John Surgery

Tommy John Surgery Panel With BHN Members Chris Ahmad & Leo Mazzone

By Jim Monaghan
Baseball Health Network

Ed Randall’s Fans For the Cure has a very special event planned for Tuesday June 28 at 7 PM at SVA Theatre at the School for Visual Arts in Manhattan.

Tommy JohnA panel of experts will join former Major League pitcher Tommy John for a discussion about pitch counts, best practices for pitching and throwing, the importance of extended recovery periods for young athletes, and the truths and myths of Tommy John surgery.

Guests also include one-time Braves pitching coach Leo Mazzone and Yankees’ Dr. Christopher Ahmad from the Baseball Health Network, and American Sports Medicine Institue Research Director Dr. Glenn Fleisig.

Moderated by WFAN radio personality Ed Randall, all proceeds will go to Fans for the Cure.

Tickets are $50 per person in advance and $75 at the door. Click here to purchase now and reserve your seat.

Ed RandallEd Randall is well-known to baseball fans in the NY/NJ area. A long-time host of “Ed Randall’s Talking Baseball” on WFAN, Ed is the CEO and Founder of Ed Randall’s Fans for the Cure (FFTC), a 501(c)(3) charity he started in 2003 to promote prostate cancer awareness and the life-saving value of screenings and early detection.

All proceeds go to Fans for the Curea,, a charity that promotes awareness and education about prostate cancer.

Tagged With: Baseball Health Network, Dr. Christopher Ahmad, Ed Randall, Leo Mazzone, Major League Baseball, pitch counts, Tommy John Surgery, WFAN

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