Keeping You Active

Kaitlyn Martin, an eighth grader at MedinaMiddle School, was midway through her bas-ketball season when her knee exploded with

pain.She knew right away she was hurt, but it was an

important game against Bradford Middle School. Shewanted to stay in.

“It just popped,” said 14-year-old Martin. “It kindof scared me. I tried to run on it. I never thought thatI would get hurt to the point I couldn’t play.”

She didn’t know it at the time, but Martin tore heranterior cruciate ligament (ACL). It’s a common buttraumatic injury that will sideline an athlete formonths.

Martin and her mother, Kimberly Manning, wentto West Tennessee Bone & Joint Clinic shortly afterthe injury to get an official diagnosis from Dr. DavidPearce. An X-ray was negative, but an MRI provedwhat they had suspected.

The ACL was torn. Martin was out for the season.“That’s not anything a parent

wants to hear,” Manning said.The ACL is one of the knee’s

four major ligaments. It attaches tothe femur and the tibia, and helpskeep the knee stable, preventing itfrom bending in the wrong direc-tion. You can’t play sports with atorn ACL.

The news was difficult for Mar-tin. She plays basketball in the win-ter and softball in the spring,summer and fall.

And, she’s good. At 5 feet 9 inches, she’s a stand-

out on the middle school basketballcourt, earning MVP honors in theGibson County Athletic Conference her seventh-grade year. In softball, she’s a power hitter and apitcher who was named MVP of the USGF World Se-ries in the 12U division.

She doesn’t like sittingon the sidelines.

“I’m really ready toplay,” Martin said. “I missmy team. I really justwant to get back.”

Martin andher mom metwith Dr.Pearce, whospecializes insports medi-cine and or-thopedicsurgery, as well asarthroscopy and jointreplacement and reconstruction. He performed sur-gery to repair Martin’s knee on December 22, andthen she began the long road to recovery.

Despite her daughter’s tough situation, Manningsaid the clinic has made her daughterfeel comfortable and strong.

“Everybody there has been great,”Manning said. “Dr. Pearce has beenawesome.”

Martin visits the clinic three timesa week for physical therapy. Man-ning expects Martin to continue therehab until July or even August. And,maybe her daughter will be back onthe field in September.

Martin said she feels good abouther prognosis, and she expects to beback on the field as soon as she can.She said the doctors and therapists atWest Tennessee Bone & Joint Clinichave helped her tremendously.

“They’ve been great,” Martin said. “If you feel bad,they’re there to support you. They’re like a new teamaway from my team.”

Keeping you...

ActiveActive

Spring 2012 Sports Medicine • Orthopedic Excellence

Keeping you...Active Active … is a quarterly

newsletter fromWest TennesseeBone & Joint Clinic. The clinic’s tenphysicians specializein sports medicineand orthopedicproblems. Forcopies of thenewsletter, contactAdam Kelley, Mar-keting Director, at731.661.9825.

In thisissue:True or False? Whatdo you know aboutbaseball injuries?

Meet our doctors:They see patients inyour communities

Overuse injuriescaused by repetition• Prevention tips• Age-appropriatepitching charts

Continued, Page 3…

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731.661.9825 n 888.661.9825 n www.wtbjc.com

ACL surgery, rehab put MiddleSchool athlete back in the game

In softball, Kaitlyn Martin is apower hitter and pitcher.

Meet our doctors: They see patients in

True or False? Knee injuries are themost common injuries in baseball.

False: Shoulder and elbow injuries arethe most common Little League injuries,particularly among pitchers.

True or False? Shoulder and elbowinjuries usually occur in youth base-

ball due to poorly conditioned throwingarms and poor throwing/pitching me-chanics.

True: Generally, muscles of the shoul-der are underdeveloped and then become

overused, resulting in increased strainplaced upon both the shoulder and theelbow.

True or False? If a young athlete isthrowing too hard, too much and

without rest, a serious elbow or shoulderinjury may be on the horizon.

True!

True or False? A young athlete shouldbegin throwing breaking pitches at a

young age in order to master the technique

before playing high school baseball.False: Introduction of breaking

pitches to a young pitcher’s repertoiretoo early can actually result in permanentdamage of immature soft tissue structures,as well as growing parts of the bone(growth plate). Growth plates are theareas of developing cartilage where bonegrowth occurs in children. The growthplates are weaker than the surroundingligaments and tendons, making themmore susceptible to injury.

By Marty Grooms, OTR/L

How much do you know about baseball injuries?

Dr. Lowell StonecipherSees patients at Main Clinic only24 Physicians Drive, Jackson

Dr. Stonecipher, board certified in orthopedicsurgery, started the West Tennessee Bone & JointClinic in 1973. His medical degree is from TulaneUniversity School of Medicine, New Orleans.His residency was at Greenville, South Carolina,General Hospital. Dr. Stonecipher specializes in general orthopedicsurgery, spine surgery, arthroscopy and joint replacement. He wasthe first physician in Jackson to do endoscopic surgery to relievecarpal tunnel pain.

Dr. Michael CobbSees patients in Brownsville every two weeks Haywood Park Community Hospital 2545 N. Washington Ave.

Dr. Cobb earned his medical degree at UTHealth Science Center in Memphis. His intern-ship and residency were at the City of MemphisHospital; his residency in orthopedic surgery was at the CampbellClinic in Memphis. He is board certified in orthopedic surgery. Dr.Cobb specializes in general orthopedic surgery, arthroscopy, sportsmedicine and joint replacement and reconstruction.

Dr. David JohnsonSees patients in Parsons monthlyDecatur County Hospital, Outpatient Dept.969 Tennessee Ave. S

Dr. Johnson earned his medical degree at theUT Health Science Center, Memphis. His in-ternship was at Methodist Hospital; his residen-cies were at Methodist Hospital and theCampbell Clinic, all in Memphis. He is board certified in orthopedicsurgery. Dr. Johnson specializes in general orthopedic surgery, sportsmedicine, arthroscopy and joint replacement and reconstruction.

Dr. Kelly PucekSee patients in Selmer every two weeksMcNairy Hospital Outpatient Dept.705 E. Poplar Ave.

Dr. Pucek’s medical degree is from the Univer-sity of Arkansas in Little Rock. His internship andresidency were with UT at Erlanger MedicalCenter in Chattanooga. He received specialtraining in trauma and is board certified in orthopedic surgery. Dr.Pucek specializes in general orthopedic surgery, joint replacement,arthroscopy and trauma surgery.

Dr. Harold M. “Trey” Antwine IIISees patients in Lexington every weekFamily Physicians of Lexington, 250 Boswell St.

Dr. Antwine, board certified in orthopedic sur-gery, graduated from Tulane University School ofMedicine. His internship and residency were atGreenville Memorial Hospital and Shriner’s Hos-pital for Crippled Children in Greenville, South Carolina. He has asubspecialty certificate in orthopedic sports medicine. He specializesin orthopedic surgery, sports medicine, arthroscopy and joint re-placement and reconstruction.

Dr. David PearceSees patients in Union City every weekDoctor’s Clinic of Union City 1020 E. Reelfoot

Dr. Pearce, a graduate of Georgetown Univer-sity School of Medicine, completed his residencyat the Medical College of Virginia in Richmondand then had a fellowship in sports medicine at Thomas JeffersonUniversity in Philadelphia. Dr. Pearce, who is board certified in or-thopedic surgery, specializes in sports medicine, general orthopedicsurgery, joint replacement and reconstruction and arthroscopy.

For an appointment at a satellite clinic, call 888.661.9825

Martin is expected to make a full recovery. And when she re-turns to sports, she won’t be playing for Medina Middle Schoolanymore. It will be a new challenge with a new team, but Mar-tin can’t wait to get back in the game.

“High school is a totally new competition that I feel I’mready for,” Martin said. And she will be ready — thanks to WestTennessee Bone & Joint Clinic.

your communities

Kaitlyn Martin Continued from front cover…

Overuse injuriesPrevention tips

Overuse injuries, especially thoserelated to the shoulder and ulnar

collateral ligament in the elbow, arepreventable.

Here are some tips to keep youhealthy and in the game… n Warm up properly with stretching,running and easy, gradual throwing.

n Rotate playing other positions be-sides pitcher.

n Concentrate on age-appropriatepitching. Master the fastball firstand the change-up second, beforeconsidering breaking pitches. (Seebox, top right.)

n Adhere to pitch count guidelines.(See box, at right.)

n Don’t pitch with elbow or shoul-der pain; see a doctor if the painpersists.

n Don’t pitch on consecutive days.n Don’t play year-round.n Never use a radar gun.n Communi-cate regu-larly abouthow yourarm is feel-ing and ifthere ispain.

n Avoid pitch-ing on mul-tiple teams with overlapping seasons.

n Emphasize control, accuracy and good mechanics.n Speak with a sports medicine professional or athletic trainer if youhave concerns about baseball injuries or injury prevention strategies.

These sports tips provide general information only and are not a substitute for yourown good judgment or consultation with a physician. Information is provided throughthe website, www.STOPSportsinjuries.org.

Maximum Pitch CountsAge Pitches/Game7-8 509-10 7511-12 8513-16 9517-18 105

Source: Little League Baseball

RecommendedAverage Age

for Various Pitches

Pitch AgeFastball 8Slider 16

Change-up 10Forkball 16Curveball 14Knuckleball 15Screwball 17Source: James R. Andrews, M.D.,

and Glenn S. Fleisig, Ph.D.

Rest Periods RequiredNo. of Pitches for ages... Required14 & Under 15-18 No. of Rest Days

66+ 76+ 4 days51-65 61-75 3 days36-50 46-60 2 days21-35 31-45 1 day1-20 1-30 None

Source: Little League Baseball

Little League shoulder describes an injury to the growth plate in the shoulder. This oc-curs from repetitive microtrauma from overhead activities, such as throwing. X-rays,above, often show widening of the growth plate.

Dr. Jason HutchisonSees patients in Dyersburg every week Med-South Clinic, 1700 Woodlawn

Dr. Hutchison earned his medical degreeat UT Health Science Center in Memphis.His internship was at Methodist Hospitaland his residency was at the CampbellClinic, both in Memphis. Board certified, hespecializes in general orthopedic surgery, sports medicine,arthroscopy and joint replacement and reconstruction.

Dr. Adam SmithSees patients in Bolivar every two weeks Bolivar General Hospital, 650 Nuckolls

Dr. Smith earned his medical degree fromthe University of Kentucky College of Medi-cine. His internship and residency were atWake Forest University Baptist Medical Cen-ter in North Carolina. He did a fellowship atMayo Clinic, Rochester, Minnesota. Dr. Smith is board certifiedin orthopedic surgery. He specializes in shoulder and elbow re-construction and has a strong interest in hip arthroscopy.

Dr. Doug HaltomSees patients in Ripley every weekRipley Medical Clinic, 202 Tucker Avenue

Dr. Haltom earned his medical degree atUT Health Science Center in Memphis. Hisinternship was at UT at Chattanooga andhis residency was at the University of Mis-souri-Columbia. He did a fellowship at theIndiana University/Methodist Sports Medicine Center. He isboard certified in orthopedic surgery.

Dr. John EverettSees patients in Dyersburg every two weeks Med-South Clinic, 1700 Woodlawn Ave

Practicing at West Tennessee Bone &Joint Clinic since 1978, Dr. Everett receivedhis medical degree from UT Health ScienceCenter in Memphis. His intership was atParkland Hospital, Dallas, and his residencies were at MethodistHospital and the Campbell Clinic in Memphis. He has a specialinterest in osteoporosis and sees patients with the conditionevery other Monday at the main clinic in Jackson.

tt

Jackson • Brownsville • Selmer • Lexington • Parsons • Dyersburg • Union City • Bolivar • Ripley

24 Physicians Drive, Jackson n 731.661.9825 n 888.661.9825 n www.wtbjc.com

As we move intospring and thensummer, baseball is back. Sports requiring repetitive over-

head motion, such as baseball, can lead to shoulder and elbow over-use injuries, especially in children and adolescents.

Unique to children and adolescents are their developing phy-ses, or growth plates. These areas are inherently weak and aretherefore susceptible to overuse injuries.

Growth plates are the areas of bone that contribute to thegrowth of that particular bone.These areas are weakerthan the tendons and ligaments that attach to them,making them more susceptible to overuse injuries.The proximal (upper) part of the humerus at theshoulder and the medial (inside) part of the elboware the most common areas for these types of injuries inadolescents.

Little League shoulder is the term used forthis type of injury to the growth plate in theshoulder. This occurs from repetitive microtraumafrom overhead activities, such as throwing. Patientscomplain of shoulder pain, made worse with throwing.

A recent increase in the amount of throwing often precedesthe symptoms. Patients usually have tenderness of the shoulderand weakness of the shoulder muscles. X-rays often show widen-ing of the growth plate. (See image, inside.)

Likewise, Little League elbow is a term

used to describe an overuse injury to the inside part of the elbow’sgrowth plate and its surrounding structures. This area does seesignificant tension during a portion of the throwing motion. (Seepicture, below.)

Patients complain of elbow pain, decreased throwing velocity,and decreased throwing distance. X-rays can benormal or can show several distinctive growth plateabnormalities around that part of the growth plate.

Treatment for both of these conditions is rest. The initial pe-riod of rest and avoidance of throwing is usually four to eight

weeks, followed by stretching, strengthening and athrowing progression. Athletes usually return to their

pre-injury level of play, and long-term conse-quences are rare. Proper throwing mechan-

ics and careful attention to pitch counts(specific for age) are very important in

preventing these overuse injuries.

See inside for a chart on pitchcounts for each age and in-

formation on howto prevent theseinjuries.

By Doug Haltom, M.D.

Overuse injuries caused by repetition

Keeping You ActiveThe physicians and staff at West Tennessee Bone & Joint Clinic, P.C.

specialize in comprehensive orthopedic care. They diagnose and treat diseases and injuries of the bone,

muscles, tendons, nerves and ligaments in adults and children.