Mehul R Shah, M.D. - Orthopaedic Surgeon - New York Hospital for Joint Diseases - NYU LANGONE MEDICAL CENTER
Mehul R Shah, M.D. - Orthopaedic Surgeon - New York, NY: 212-598-3897, 646-501-7417 - Lake Success, NY: 516-467-8600
Mehul R Shah, M.D. - Orthopaedic Surgeon
Mehul R Shah, M.D. - Orthopaedic Surgeon
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Sports

Comparable results seen with high- vs low-intensity plyometric exercise after ACL reconstruction
Source:
Healio

Results from this randomized controlled trial showed both low- and high-intensity plyometric exercise for rehabilitation following ACL reconstruction positively affected knee function, knee impairments and psychological status among patients after 8 weeks of intervention.

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Quadriceps exercise relieves pain in knee osteoarthritis
Source:
Medical Xpress

A quadriceps isometric contraction exercise method is effective for relieving pain in knee osteoarthritis (OA), according to a study published online May 25 in the International Journal of Rheumatic Diseases.

Lanfeng Huang, from the Second Hospital of Jilin University in Changchun, China, and colleagues enrolled 250 patients with a confirmed diagnosis of knee OA and randomized them to an exercise treatment test group (128 patients) and a traditional treatment control group (122 patients). The test group used quadriceps isometric contraction exercise, while the control group used local physical therapy and oral nonsteroidal anti-inflammatory drugs.

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Study looks at needles in treatment for shoulder pain
Source:
Science Daily

According to a new study, the type of procedure used to treat shoulder calcifications should be tailored to the type of calcification. The results of the study will help interventional radiologists determine whether to use one or two needles for an ultrasound-guided treatment for a common condition called rotator cuff calcific tendinopathy.

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Platelet-rich plasma injections may lead to improvements in tissue healing
Source:
Science Daily

After platelet-rich plasma injections, researchers have described the structural change in the healing process as well as improvement in patients' pain and function, in a new report.

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Preventing long-term complications of an ACL tear
Source:
Medical Xpress

A torn ACL (also known as the anterior cruciate ligament) is one of the most common knee injuries, with as many as 200,000 cases per year in the U.S. Young people under the age of 20 are at particular risk, in part because of participation in sports.

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Tenodesis, tenotomy showed favorable results in treatment of long head of biceps tendon lesions
Source:
Healio

Results presented at the Arthroscopy Association of North America Annual Meeting showed favorable results with both tenodesis and tenotomy in the treatment of lesions of the long head of the biceps tendon.

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Intense training without proper recovery may compromise bone health in elite rowers
Source:
Science daily

Bone mineral density, an indicator of bone strength, typically increases with regular exercise, acting as a protective mechanism against bone fractures and osteoporosis. But a new study suggests that the extended, high-intensity training sessions of elite athletes could reverse beneficial bone changes.

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Lifelong physical activity increases bone density in men
Source:
Science daily

Men have many reasons to add high-impact and resistance training to their exercise regimens; these reasons include building muscle and shedding fat. Now a researcher has determined another significant benefit to these activities: building bone mass. The study found that individuals who continuously participated in high-impact activities, such as jogging and tennis, during adolescence and young adulthood, had greater hip and lumbar spine bone mineral density than those who did not.

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Care of Shoulder Pain in the Overhead Athlete
Source:
Healio

Shoulder complaints are common in the overhead athlete. Understanding the biomechanics of throwing and swimming requires understanding the importance of maintaining the glenohumeral relationship of the shoulder.

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Improvements in ACL surgery may help prevent knee osteoarthritis
Source:
Medical Xpress

Injury to the anterior cruciate ligament (ACL) in the knee frequently leads to early-onset osteoarthritis, a painful condition that can occur even if the patient has undergone ACL reconstruction to prevent its onset. A new review looks at the ability of two different reconstruction techniques to restore normal knee motion and potentially slow degenerative changes

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Lifelong physical activity increases bone density in men
Source:
Medical News Today

An innovative psychological treatment can help older people who are suffering from lower-severity depression, say researchers at the University of York. It can also prevent more severe depression from developing.

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Care of Shoulder Pain in the Overhead Athlete
Source:
Healio

Shoulder complaints are common in the overhead athlete. Understanding the biomechanics of throwing and swimming requires understanding the importance of maintaining the glenohumeral relationship of the shoulder.

Read More


Improvements in ACL surgery may help prevent knee osteoarthritis
Source:
Medical Xpress

ACL injury can age the knee by an estimated 30 years," said Dr. Lou DeFrate, author of the Journal of Orthopaedic Research review. "Since this injury is so common in young people, it is important to prevent these degenerative changes to maintain joint health and function long into adulthood.

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Imaging Identifies Cartilage Regeneration in Long-Distance Runners
Source:
RSNA News

Using a mobile MRI truck, researchers followed runners for 4,500 kilometers through Europe to study the physical limits and adaptation of athletes over a 64-day period, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA).

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BLOG: Hardware complications in revision ACL reconstruction take careful consideration
Source:
Healio

Revision ACLR can pose a variety of surgical challenges. Evaluation of patient risk factors, prior surgical technique, prior tunnel placement, tunnel osteolysis, prior grafts utilized and implanted hardware must be considered prior to performing a revision ACLR case.

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The Relationship Between Shoulder Stiffness and Rotator Cuff Healing
Source:
JBJS

Retear and stiffness are not uncommon outcomes of rotator cuff repair. The purpose of this study was to evaluate the relationship between rotator cuff repair healing and shoulder stiffness.

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Rate of injuries among youth soccer players doubled, new study finds
Source:
Science Daily

From 1990 through 2014, the number of soccer-related injuries treated in hospital emergency departments in the US each year increased by 78 percent and the yearly rate of injuries increased by 111 percent among youth 7-17 years of age, a new article reports.

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Study finds predictors for ACL injury are dissimilar between male and female athletes
Source:
Healio

Except for increased anterior-posterior knee laxity, results from this study indicated female athletes and male athletes were not similar with regard to predictors for first-time noncontact ACL injury.

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Hamstring injuries in baseball may be preventable
Source:
Medical Xpress

Creating a program to prevent hamstring injuries in minor league and major league baseball players might be a possibility say researchers presenting their work today at the American Orthopaedic Society of Sports Medicine's (AOSSM) Annual Meeting in Colorado Springs, CO.

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Wearable neuromuscular device may help reduce ACL injuries in female soccer players
Source:
Medical Xpress

Using a wearable neuromuscular device can reduce the risk of ACL injury in female soccer athletes, according to new research presented today at the American Orthopaedic Society for Sports Medicine's (AOSSM) Annual Meeting in Colorado Springs, CO.

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Knee Injections vs. Knee Replacement: What are My Options?
Source:
Medical Xpress

According to the Arthritis Foundation, over 50 million Americans have arthritis. The most common form of arthritis is osteoarthritis, which is a degenerative joint disease. Though it can occur in younger people, it often affects people 50 years of age and older.

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Comparable results seen with high- vs low-intensity plyometric exercise after ACL reconstruction
Source:
Healio

Results from this randomized controlled trial showed both low- and high-intensity plyometric exercise for rehabilitation following ACL reconstruction positively affected knee function, knee impairments and psychological status among patients after 8 weeks of intervention.

Read More


Lifelong physical activity increases bone density in men
Source:
Medical Xpress

Men have many reasons to add high-impact and resistance training to their exercise regimens; these reasons include building muscle and shedding fat. Now a University of Missouri researcher has determined another significant benefit to these activities: building bone mass. The study found that individuals who continuously participated in high-impact activities, such as jogging and tennis, during adolescence and young adulthood, had greater hip and lumbar spine bone mineral density than those who did not.

Read More


Why is calcific tendinitis so painful?
Source:
Medical Xpress

Calcific tendinitis of the shoulder, typically characterized by calcium deposits on the rotator cuff, is an extremely painful condition that can severely impair movement and life quality. A new study appearing in today's issue of the Journal of Bone and Joint Surgery, found a significant increase in blood vessel and pain receptor growth among patients with this condition.

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New work on knee cartilage structure to aid better replacements and injury treatments
Source:
Medical News Today

Fibrocartilage tissue in the knee is comprised of a more varied molecular structure than researchers previously appreciated, according to a new study by researchers from the Perelman School of Medicine at the University of Pennsylvania and the University of Delaware. Their work informs ways to better treat such injuries as knee meniscus tears - treatment of which are the most common orthopaedic surgery in the United States -- and age-related tissue degeneration, both of which can have significant socioeconomic and quality-of-life costs. The team published their work this week online ahead of print in Nature Materials.

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Recommendations for patient activity after knee replacement vary among surgeons
Source:
Healio

During recovery after knee replacement surgery, exercise is critical. After initial recovery, patients will want to resume more strenuous activities. In addition to exercise prescribed by a physical therapist, several studies have shown patients who participated in athletic activities prior to surgery will want to continue this practice after surgery. However, how much activity and how strenuous this activity should be remains unclear.

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Cholesterol levels and tendon pain may be related
Source:
Reuters

(Reuters Health) – People with unhealthy blood cholesterol levels are more likely to have tendon pain or altered tendon structure, according to a new review.

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Activity could help keep knees lubricated
Source:
Science Daily

Cartilage is filled with fluid -- about 80% of the volume of the cartilage tissue -- that plays the essential roles of supporting weight and lubricating joint surfaces. Loss of this fluid, called synovial fluid, results in a gradual decrease in cartilage thickness and increase in friction, which is related to the degradation and joint pain of osteoarthritis. Since cartilage is porous, fluid is readily squeezed out of the holes over time. Yet the symptoms associated with osteoarthritis usually take decades to develop. Researchers have now proposed a mechanism that explains how motion can cause cartilage to reabsorb liquid that leaks out.

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Bats and balls, not base runners, cause worst injuries to major league catchers
Source:
Medical Xpress

Contrary to popular belief, the worst injuries baseball catchers face on the field come from errant bats and foul balls, not home-plate collisions with base runners, according to findings of a study led by researchers at the Johns Hopkins University School of Medicine.

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Stiff shoulders less likely to re-tear after rotator cuff repair vs non-stiff shoulders
Source:
Healio

Patients who had preoperative shoulder stiffness and those who developed stiffness at 6 weeks and 12 weeks postoperatively after rotator cuff repair were less likely to experience a re-tear compared with patients who had no stiffness, according to results presented here.

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Researchers call for consideration of pre-injury status in ACL reconstruction evaluations
Source:
Healio

Investigators who studied outcomes following ACL reconstruction said they believe patients’ pre-injury status has been overlooked in determining postoperative results.

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Factors affected variability in PF instability injuries among high school athletes
Source:
Healio

Understanding that patterns of patellofemoral instability injuries among high school athletes may vary by sport, sex and type of exposure, which investigators in this study found, may help with the formulation of new injury prevention strategies and to decrease the risk of further patellofemoral instability injuries.

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Similar results seen for ACL reconstruction with autograft, hybrid graft
Source:
Healio

Satisfactory and similar subjective and objective clinical outcomes were reported in a study of patients who underwent primary ACL reconstruction with either hybrid graft or autograft.

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More Americans getting knees replaced, and at younger ages
Source:
Medical Xpress

Aging baby boomers are getting bum knees replaced at a greater rate, and at a younger age, than ever before, a new U.S. study confirms.

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Greater strength, endurance found in quadriceps after PCL tear vs ACL tear
Source:
Healio

Compared with ACL tears, the quadriceps muscle of the injured limb had greater strength and endurance after PCL tears, according to study results.

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Treatment of shoulder instability helps return collegiate athletes to playing field
Source:
Medical News Today

Athletes who suffer a shoulder instability injury may return to play more successfully after being treated arthroscopically compared to nonoperative treatment, say researchers presenting their work at the American Orthopaedic Society for Sports Medicine's (AOSSM) Annual Meeting.

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Pitchers. blood flow decreased in provocative shoulder position
Source:
Healio

After one competitive baseball season, the blood flow of pitchers significantly decreased when in a provocative shoulder position, according to researchers’ findings.

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Make no bones about it: The female athlete triad can lead to problems with bone health
Source:
Medical Xpress

Participation in sports by women and girls has increased from 310,000 individuals in 1971 to 3.37 million in 2010. At the same time, sports-related injuries among female athletes have skyrocketed. According to a new study in the Journal of the American Academy of Orthopaedic Surgeons (JAAOS), women with symptoms known as the "female athlete triad" are at greater risk of bone stress injuries and fractures.

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Girls suffer more overuse injuries in teen sports
Source:
Medical News Today

A new study performed by researchers at The Ohio State University Wexner Medical Center shows that when it comes to overuse injuries in high school sports, girls are at a much higher risk than boys. Overuse injuries include stress fractures, tendonitis and joint pain, and occur when athletes are required to perform the same motion repeatedly.

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How does aging affect athletic performance?
Source:
Medical Xpress

I remember the moment a few years ago while watching TV when I realized that if I were riding in the Tour de France, at age 42 I'd be the oldest person in the race. It hit me that my dream of racing in cycling's biggest event was over…it was not going to happen.

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Osteochondral autograft transplantation may offer higher rate of return to pre-injury athletics
Source:
Healio

Among patients who underwent cartilage repair of the knee, osteochondral autograft transplantation enabled a much higher rate of return to pre-injury athletics, according to results presented at the International Cartilage Repair Society Annual Meeting.

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University of Iowa team developing bioactive gel to treat knee injuries
Source:
Medical News Today

Injectable gel encourages self-healing of cartilage

Knee injuries are the bane of athletes everywhere, from professionals and college stars to weekend warriors. Current surgical options for repairing damaged cartilage caused by knee injuries are costly, can have complications, and often are not very effective in the long run. Even after surgery, cartilage degeneration can progress leading to painful arthritis.

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High risk of capsular restretching found among women and elite athletes
Source:
Healio

Even after successful arthroscopic Bankart repair and capsular shift, women, elite athletes and patients with frequent dislocations were at high risk of capsular restretching, according to study results.

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MRI showed imaging abnormalities but good clinical results with ACI
Source:
Healio

CHICAGO — MRI appearance of autologous chondrocyte implantation showed imaging abnormalities at 65.8-month follow-up; however, autologous chondrocyte implantation was still found to produce good clinical results, according to data presented at the International Cartilage Repair Society Annual Meeting, here.

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Noncontact lower-extremity injury risks likely differ by sport, gender
Source:
Healio

According to recently published data, differences were noted between sport and sex with regard to the risk for sustaining a noncontact lower-extremity injury.

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Male track and field athletes at greater risk of injury
Source:
Healio

Compared with other sexes and competition levels, male track and field athletes, particularly masters male athletes, are at a greater risk of injury, according to researchers

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A hip and trunk training program for athletes reduces ACL injuries
Source:
Medical Xpress

With the help of the Hockeyroos UWA researchers have developed a hip and trunk training program that could reduce the high rates of anterior cruciate ligament (ACL) injuries in all levels of sport.

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An Injury Curveball for Young Pitchers
Source:
Daily Rx

The love of America's pastime might lead many young players to play as often and as hard as they can, sometimes for multiple teams. However, that might increase these players' risk of getting hurt.

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Year-round baseball leads to more youth injuries, study says
Source:
Medical Xpress

Being able to play baseball year-round puts young pitchers in the southern United States at increased risk for an overuse injury in their throwing arm, a new study finds.

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One ACL Injury Might Mean More Down the Road
Source:
DailyRx

Injuries are a potential risk athletic kids face. Concussions may be getting a lot of press lately, but injuries to the knee may be just as important.

A new study found that young athletes who needed ACL (anterior cruciate ligament) surgery were likely to re-injure their knees over a 15-year period.

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Height, pitching velocity of adolescent baseball pitchers likely indicative of shoulder and elbow injuries
Source:
Healio

Adolescent baseball pitchers who are taller, throw harder and pitch for multiple teams are more likely to have a history of shoulder and elbow injuries than their peers, according to research presented here.

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Exercise science study shows no increased risk of injury from uphill/downhill running
Source:
Medical Xpress

Like many runners, former BYU track star Katy Andrews Neves has had her share of injuries. Unlike most runners, one of those injuries has been witnessed by millions of people around the world.

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Osteoarthritis patients will benefit from jumping exercise
Source:
Medical Xpress

Progressive high-impact training improved the patellar cartilage quality of the postmenopausal women who may be at risk of osteoporosis (bone loss) as well as at risk of osteoarthritis. This was found out in the study carry out in the Department of Health Sciences at University of Jyväskylä, Finland. The effects of high-impact exercise were examined on knee cartilages, osteoarthritis symptoms and physical function in postmenopausal women with mild knee osteoarthritis. The study was conducted in cooperation with the Central Finland Central Hospital and the Department of Medical Technology, Institute of Biomedicine in University of Oulu in Finland.

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Early knee arthritis symptoms first felt when using stairs
Source:
Medical News Today

People who suffer from knee pain when using the stairs may be experiencing the early symptoms of osteoarthritis, according to a new study by University of Leeds experts.

The research, published in the medical journal Arthritis Care & Research, aimed to investigate which patient-reported activities are first associated with knee pain, in order to improve early detection of osteoarthritis and so increase the chances of people seeking effective treatment.

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Walking Groups: Easy Steps to Better Health
Source:
DailyRx

Exercise doesn't have to be complicated. Even simple walks with friends may improve your health.

A recent study found that adults who joined outdoor walking groups had improved overall health. These patients had better heart health and were less likely to be depressed than those who didn't exercise regularly.

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Why treating shoulder pain in baseball pitchers and other throwing athletes is so difficult
Source:
Science Daily

Despite increasing medical knowledge, treating shoulder pain in baseball pitchers and other throwing athletes remains one of the most challenging tasks in sports medicine. Results of treatment as not as predictable as patients, doctors or coaches would like to think.

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Link possible between oral contraceptive use, ACL injury in females
Source:
Healio

Researchers from Denmark have uncovered a potential link between oral contraceptive use and instances of ACL injuries that required surgical intervention in women. The researchers evaluated 4,497 women who were treated operatively for an ACL injury between July 2005 and December 2011 and 8,858 age-matched, uninjured controls.

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Prompt, appropriate medical care for dislocated shoulder injuries
Source:
Science Daily

Prompt and appropriate treatment of a dislocated shoulder -- when the head of the upper arm bone is completely knocked out of the shoulder socket -- can minimize risk for future dislocations as well as the effects of related bone, muscle and nerve injuries, according to a literature review.

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Overuse injuries becoming more common in young athletes
Source:
Science Daily

From Little League players injuring their elbow ligaments to soccer and basketball players tearing their ACLs, sports injuries related to overuse are becoming more common in younger athletes.

Dr. Matthew Silvis, medical director for primary care sports medicine at Penn State Hershey, says specialization is a big reason why.

"It has been a kind of societal thing that kids are specializing in one sport at the exclusion of others at a younger age," he says. "The specialization is often driven by parents who believe that their child has to start early and stay serious in order to get a scholarship or be the best."

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Identifying risk factors for ACL re-injury
Source:
Medical News Today

Re-tearing a repaired knee Anterior Cruciate Ligament (ACL) happens all too frequently, however a recent study being presented today at the American Orthopaedic Society for Sports Medicine's (AOSSM) Annual Meeting suggests that identification and patient education regarding modifiable risk factors may minimize the chance of a future ACL tear.

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Exercise intensity often overestimated
Source:
Medical News Today

Do you work out for health benefits and feel you are exercising more than enough? You might be among the many Canadians who overrate how hard they work out or underestimate what moderate intensity exercise means, according to a recent study out of York University's Faculty of Health.

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Risk factors identified for little league shoulder
Source:
MedicalNewsToday

As cases of Little League Shoulder (LLS) occur more frequently, the need for additional information about the causes and outcomes of the condition has become clear. Researchers presenting at the American Orthopaedic Society for Sports Medicine's (AOSSM) Annual Meeting shared new data identifying associated risk factors, common treatment options and return to play.

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NFL players return to the game after stabilizing shoulder surgery
Source:
MedicalNewsToday

Shoulder instability is a common injury in football players but the rate of return to play has not been regularly determined following surgery. A new study, discussed at the American Orthopaedic Society for Sports Medicine's (AOSSM) Annual Meeting, details that return rates for NFL players is approximately 90 percent no matter what the stabilization procedure (open vs. arthroscopic).

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Anatomic features not tied to pain in rotator cuff tears
Source:
MedicalXpress

Anatomic features associated with the severity of atraumatic rotator cuff tears are not associated with pain level, according to a study published in the May 21 issue of The Journal of Bone & Joint Surgery.

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Extended capsular release unnecessary for shoulder stiffness in arthroscopic surgery
Source:
Healio

Although arthroscopic capsular release is a known treatment for shoulder stiffness, posterior extended capsular release might not be necessary in arthroscopic surgery, according to study results.

Researchers enrolled 75 patients who underwent arthroscopic capsular release for shoulder stiffness. The patients were randomly assigned to one of two groups: those in whom capsular release, including release of the rotator interval and anterior and inferior capsule, was performed (n = 37), and those in whom capsular release was extended to the posterior capsule (n = 38).

The researchers used American Shoulder and Elbow Surgeons scores, Simple Shoulder Test, VAS pain scores and range of motion (ROM) for evaluation before surgery, at 3, 6 and 12 months postoperatively, and at the last follow-up. Mean follow-up was 18.4 months.

ROM increased significantly among both groups at the last follow-up compared with preoperative scores (P < .05). However, there were no statistical differences between the two groups in American Shoulder and Elbow Surgeons scores, Simple Shoulder Test and VAS pain scores at the last follow-up (P > .05), according to the researchers.

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Shoulder activity not associated with severity of atraumatic rotator cuff tear
Source:
Healio

Among patients with atraumatic rotator cuff tears, shoulder activity was not associated with severity of the tear, but was affected by patients’ age, sex and occupation, according to study results.

Researchers prospectively enrolled patients with an atraumatic rotator cuff tear on MRI in the Multicenter Orthopaedic Outcomes Network shoulder study of nonoperative treatment. Patients were asked to complete a previously validated shoulder activity scale; 434 patients completed the scale and were included in the analysis. Mean patient age was 62.7 years.

The researchers performed a regression analysis to assess the association of shoulder activity level to rotator cuff tear characteristics, including tendon involvement and traction, as well as patient factors such as age, sex, smoking and occupation.

Shoulder activity was not associated with severity of the rotator cuff tear, according to the researchers. However, shoulder activity was negatively associated with age and female sex. According to the regression model, 69-year-old patients with rotator cuff tears were 1.5 points less active on the 20-point scale vs. identical 56-year-old patients; female patients were 1.6 points less active vs. similar male patients. Occupation was also a significant predictor of shoulder activity level, with unemployed patients predicted to be 4.8 points less active compared with employed patients.

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Elbow surgery risk may be increased by early entry to Major League Baseball
Source:
Medical News Today

The common elbow surgery made famous by Major League Baseball (MLB) pitcher, Tommy John, definitely does its job to return pitchers to the mound, but risks for having the surgery may be able to be recognized earlier in a player's career, say researchers presenting their work at the American Orthopaedic Society for Sports Medicine's (AOSSM) Annual Meeting. The study was the largest cohort of MLB pitchers, to date, that have undergone UCL reconstruction.

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In 'tennis elbow' tendon stimulation is the key to repair
Source:
Medical News Today

New data presented at the European League Against Rheumatism Annual Congress (EULAR 2014) show that ultrasound-guided injections of growth factors-containing platelet-rich plasma (PRP) are no more effective in treating recently developed epicondylitis than injections of saline.

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ACL injury risk reduced in young athletes by universal neuromuscular training
Source:
Medical News Today

The ACL is a critical ligament that stabilizes the knee joint. An ACL injury, one of the most common sports injuries, often requires surgery and a lengthy period of rehabilitation before an athlete can return to sport and other activities. Recent research has found that screening tools, such as "hop" or isokinetic (computer/video) tests to identify neuromuscular deficits, as well as neuromuscular training programs, may reduce ACL injuries.

Read more


'A glass of milk a day' may delay knee osteoarthritis in women
Source:
Medical News Today

A degenerative disease causing pain and swelling of the knee joints, knee osteoarthritis currently has no cure. But researchers say drinking milk every day has been linked to reduced progression of the disease.

Publishing their results in the American College of Rheumatology journal Arthritis Care & Research, the researchers say while their findings show that women who regularly drank fat-free or low-fat milk experienced delayed progression of knee osteoarthritis (OA), those who ate cheese actually experienced an increase in progression of the disease.

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Study: UCL reconstruction surgery likely to put major league pitchers back on the field
Source:
  Healio

Major League Baseball pitchers who undergo ulnar collateral ligament reconstruction have a strong likelihood of resuming their professional baseball careers after surgery, according to results of a recently published study.

“When compared with demographic-matched controls, patients who underwent [ulnar collateral ligament] UCL reconstruction had better results in multiple performance measures,” Brandon J. Erickson, MD, and colleagues stated in the study. “Reconstruction of the UCL allows for a predictable and successful return to the [Major League Baseball] MLB.”

The study analyzed 179 MLB pitchers who underwent UCL reconstruction. Overall, 174 (97.2%) resumed pitching in professional organized baseball and 148 (83%) returned to the MLB level. Mean time to return to MLB was 20.5 months and the average career after surgery was 3.9 years, however, 56 pitchers were still pitching at the start of the 2013 MLB season.

Pitchers had fewer losses, lower earned run average, losing percentage, hits per inning and fewer walks, hits and home runs allowed after UCL reconstruction than before surgery.

“There is a high rate of [return to pitching] RTP in professional baseball after UCL reconstruction,” Erickson and colleagues concluded. “Performance declined before surgery and improved after surgery.” -by Christian Ingram

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Silk-based surgical implants could offer a better way to repair broken bones
Source:
ScienceDaily

Using pure silk protein derived from silkworm cocoons, investigators have developed surgical plates and screws that offer improved remodeling following injury and can be absorbed by the body over time. When a person suffers a broken bone, current treatment calls for the surgeon to insert screws and plates to help bond the broken sections and enable the fracture to heal. These "fixation devices" are usually made of metal alloys. But metal devices may have disadvantages: Because they are stiff and unyielding, they can cause stress to underlying bone, among other problems.

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The leading cause of failed prosthetic knee joints is infection
Source:
Medical News Today

The number of total knee replacement (TKR) procedures continues to climb, as does the number of revision total knee replacement (RTKR) surgeries.

Elderly and female patients with a moderate number of comorbidities represented the largest proportion of the revision population. The authors suggest that optimizing patient health before surgery and paying meticulous attention to efforts by the surgical team to minimize the risk of periprosthetic joint infection may decrease the number of knee replacement revisions.

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Improving knee replacements with iASSIST system
Source:
ScienceDaily

Each year, approximately 600,000 total knee replacement procedures are performed in the United States, a number that is expected to rise in the next decade as the population ages. For the first time in the United States, an iASSIST system is now in use. iASSIST is a computer navigation system with Bluetooth-like technology that improves surgical precision and accuracy in total knee replacements, decreasing the need for revision surgery.

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Trials to begin on new degradable surgical implant
Source:
BBC News Health

Researchers in Oxford have developed a degradable implant which they say has huge potential to improve surgical success rates.

The protective patch, which wraps round soft tissue repairs, will be trialled in patients with shoulder injuries.

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82% of college football players return to field after ACL surgery, shows study
Source:
News Medical

High-level college football players frequently return to the field after an ACL reconstruction, according to research presented today at the American Orthopaedic Society for Sports Medicine's (AOSSM) Specialty Day. The study added to earlier research by exploring specific factors that affected return to play, including player standing on rosters and year in school.

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Houston Methodist sports medicine experts discuss important facts about mouthguards
Source:
News Medical

After every play, we all see the athletes adjusting their mouthguards, but what do they actually protect? Houston Methodist sports medicine experts discuss important facts about mouthguards. Can wearing a mouthguard prevent a concussion? "No, mouthguards cannot prevent a concussion," said Dr. Vijay Jotwani, a sports medicine-focused primary care physician with Houston Methodist Orthopedics & Sports Medicine. "Mouthguards do not affect the movement of the brain within the skull and cerebrospinal fluid, so they are ineffective at reducing the forces on the brain that cause concussions."

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How to Prevent Winter Sports Injuries
Source:
US News

Get out and enjoy winter but take steps to protect yourself from common ski- and snowboard-related injuries such as sprains, strains, dislocations and fractures, an orthopedist says. "No matter your skill level, everyone is susceptible to injury on the slopes," said Dr. Allston Stubbs, an associate professor of orthopedics at Wake Forest Baptist Medical Center, said in a center news release. "Most of these injuries happen at the end of the day, so you may want to think twice before going for 'one last run,' especially when you're tired."

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Research aims to improve repair of rotator cuff injuries
Source:
MedicalXpress

Rotator cuff tears are among the most common orthopedic injuries suffered by adults in the United States, due to wear and tear or the effects of age. With a 94 percent failure rate for surgical repairs of large tears in older patients, it's no surprise that the injury is a major cause of pain and disability.

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Stem Cell Therapy Following Meniscus Knee Surgery May Reduce Pain, Restore Meniscus
Source:
ScienceDaily

A single stem cell injection following meniscus knee surgery may provide pain relief and aid in meniscus regrowth, according to a novel study appearing in the January issue of the Journal of Bone and Joint Surgery (JBJS).

In the first-of-its-kind study, "Adult Human Mesenchymal Stem Cells (MSC) Delivered via Intra-Articular Injection to the Knee, Following Partial Medial Meniscectomy," most patients who received a single injection of adult stem cells following the surgical removal of all or part of a torn meniscus, reported a significant reduction in pain.

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Study highlights importance of Bankart lesion size for arthroscopic repair techniques
Source:
Healio

One of the first studies to analyze the outcomes of arthroscopic repair according to lesion size suggests small-sized bony Bankart lesions should be treated with a different procedure than lesions measuring 12.5% to 25% of the inferior glenoid width.

“In small Bankart lesions, restoration of capsulolabral soft tissue tension alone may be enough,” whereas in medium lesions, the osseous architecture of the glenoid should be reconstructed for more functional improvement and less pain,” Young-Kyu Kim, MD, and colleagues wrote in their study.

The researchers conducted a minimum 24-month follow-up of 34 patients with small- and medium-sized lesions that were measured by CT and treated arthroscopically. Surgeons performed capsulolabral repair using suture anchors without excision of the bony fragment for 16 small-sized lesions (<12.5% of the inferior glenoid width) and anatomic reduction and fixation using suture anchors for 18 medium-sized lesions (12.5% to 25% of the inferior glenoid width).

Overall, the investigators found the Visual Analog Scale score improved from 1.7 preoperatively to 0.5 at final follow-up (24 months). The mean modified Rowe score also improved from 59 to 91. In the medium-sized lesion group, the mean postoperative Rowe scores increased from 60 to 95 in cases of anatomic reduction compared with an increase from 56 to 76 in cases of nonanatomic reduction.

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Early motion shows results comparable to immobilization after arthroscopic rotator cuff repair
Source:
Healio

In a 30-month follow-up of young patients who underwent arthroscopic rotator cuff repair, researchers found no significant differences in shoulder function between those who had early passive range of motion and patients who were immobilized.

“There is no apparent advantage or disadvantage of early passive range of motion compared with immobilization with regard to healing or functional outcome,” Jay D. Keener, MD, and colleagues from Washington University wrote in their abstract.

The investigators studied 124 patients younger than 65 years who underwent arthroscopic repair of full-thickness rotator cuff tears and were randomized to either an early range of motion rehabilitation process or to an immobilization group that had range of motion delayed for 6 weeks. The investigators evaluated the patients using the Visual Analog Scale (VAS) for pain, American Shoulder and Elbow Surgeons score, Simple Shoulder Test, relative Constant score and strength measurements. There were 114 patients available for final follow-up.

At 3 months postoperatively, the immobilization group had significantly better mean active range of motion into elevation and external rotation compared with the early motion cohort. “After 3 months, there were no significant differences in VAS pain score, active range-of-motion values, shoulder strength measures, or any of the functional scales between the groups at the time of the 6-month, 12-month, or final follow-up evaluation,” wrote Keener and colleagues wrote in their study.

Although the investigators’ research did not study patient satisfaction, “Immobilization did not appear to lead to greater risks of shoulder stiffness,” they wrote. There was also no difference in terms of tendon healing between groups.

“Either early passive motion or a period of early immobilization is equally safe and effective after surgical rotator cuff repair in this cohort,” the researchers wrote.

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Improper way of working out may do more harm than good
Source:
News Medical

With the coming of the new year, many people will vow to get in shape after overindulging during the holidays. However, not knowing the proper way to work out might do more harm than good.

Nearly 500,000 workout-related injuries occur each year. One reason is people want to do too much too fast and overuse their muscles. These injuries occur gradually and are often hard to diagnose in the bones, tendons and joints. Another reason is poor technique during weight and other training.

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Hours spent in organized sports may predict young athlete injury
Source:
Medical News Today

Athletes ages 8 to 18 who spend twice as many hours per week in organized sports than in free play, and especially in a single sport, are more likely to be injured, according to an abstract presented at the American Academy of Pediatrics (AAP) National Conference and Exhibition in Orlando.

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Reason for seeking treatment influences preoperative expectations of arthroscopic shoulder surgery
Source:
  Healio

Researchers from the Steadman Philippon Research Institute analyzed patient expectations before arthroscopic shoulder surgery and found that while the main expectation of all patients was return to sport, secondary expectations varied in importance depending on the reason why patients sought treatment.

“Elevated importance of specific expectation questions did not universally correlate with worse preoperative subjective scoring systems,” Ryan J. Warth, MD, and colleagues from the Steadman Philippon Research Institute in Vail, Colo., wrote in the study. “Whereas return to sport was the most important expectation overall, the importance of other expectations varied by patients’ reasons for seeking treatment. The current questionnaire may have limited use in patients with shoulder instability.”
Warth and colleagues evaluated QuickDASH, American Shoulder and Elbow Surgeons (ASES) pain and function and SF-12 mental and physical component scores collected from 313 patients, according to the abstract. The expectation data was also collected from patients in the form of a questionnaire that asked for their expectations in relation to their reason for seeking treatment.

Return to sport and for the shoulder to return to pre-injury levels of pain and function were the most important reasons for the surgery; however, the reasons for seeking treatment influenced preoperative expectations. Patients with subluxation were more likely to have fewer expectations than other patients overall, and patients who wanted return to sport were more likely to have higher ASES pain scores, according to the abstract.

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Surgeons describe new knee ligament
Source:
Medical News Today

At the Belgian University Hospitals Leuven, two knee surgeons have for the first time given a full anatomical description of a new ligament that they term the anterolateral ligament (ALL).

The new ligament is thought to play an important role in anterior cruciate ligament (ACL) tears.

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Study: Early loading improves mechanical properties of healing Achilles tendons
Source:
Healio

Researchers found patients had increased mechanical properties of tendon healing with early tensional loading after repair surgery for Achilles tendon rupture compared to patients completely immobilized in a cast postoperatively.

“Despite the fact that both groups were allowed full weightbearing on their injured leg, the group with early tensional loading showed a higher modulus of elasticity. We could also confirm earlier results, showing that an early elastic modulus correlates with the heel-raise index after 1 year,” Thorsten Schepull,MD, and colleagues wrote in the study. “However, we could not find any difference in functional outcomes after 1 year between the groups. Short episodes of early tensional loading did not influence tendon length, as measured by the heel-raise height.”

Between February 2009 and October 2011, 35 consecutive patients with acute sports-related Achilles tendon rupture underwent surgical repair with a single suture. Surgeons placed metal markers in the tendon distally and proximally. One group wore a cast for 7 weeks and the other group wore a cast for 2 weeks and used a walking boot for 5 weeks.

Researchers had the walking boot group remove the boot twice daily and push a training pedal to add tensional load to the healing tendon. At 7, 19 and 52 weeks after surgery, researchers tensionally loaded all the patients’ tendons and studied its effect with Roentgen stereophotogrammetric analysis and CT.

The walking boot group had a higher modulus of elasticity at 19 weeks and 52 weeks, Schepull and colleagues noted, but at 52 weeks the Achilles tendon Total Rupture Score and heel-raise index were not significantly different between the groups, according to the results.

One limitation to the study may be the fact that patients and investigators were aware of the treatment used in each group, and the test group could remove the foam boot at times other than during tensional loading, although they were instructed not to, the researchers noted.

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Lower degrees of dominant humeral torsion results in severe upper extremity injuries for pitchers
Source:
Healio

Major League Baseball pitchers with lower degrees of dominant humeral torsion had more severe upper extremity injuries, and pitchers with lower side-to-side differences in torsion experienced more severe dominant upper extremity injuries, according to results of this recently published study.

In the study, 25 professional pitchers from a single Major League Baseball organization underwent CT on dominant and nondominant humeri. Image data were processed with a 3-D volume-rendering post-processing program. Researchers then modified the software program to model a simplified throwing motion to measure potential internal impingement distances in number of days missed from pitching as a measure of injury severity and incidence.

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Contact-sport brain trauma may affect personality and cognition
Source:
Medical News Today

Scientists have discovered that repeated brain trauma, which commonly occurs in athletes, may affect behavior, mood and thinking abilities, according to a study published in the journal Neurology.

All athletes had been diagnosed with chronic traumatic encephalopathy (CTE) following death. CTE is a brain disease linked to repeated brain trauma - most commonly found in athletes.

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How to Know If Shoulder Pain Might Be Rotator Cuff Disease
Source:
Medscape

A positive painful arc test and a positive external rotation resistance test in a patient with shoulder pain has a high likelihood of being rotator cuff disease (RCD). And a positive lag test (external or internal rotation) likely means a full-thickness rotator cuff tear.

That's according to a meta-analytic review of relevant studies. Dr. Job Hermans from Erasmus Medical Center, Rotterdam, the Netherlands and colleagues say they did the analysis to identify the most accurate clinical examination findings for RCD.

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Orthopedists Name Needless Kinds of Care
Source:
dailyRx

American Academy of Orthopedic Surgeons issues list of unnecessary treatments. Knowing which medical treatments are needed and which aren't plays an important role in personal wellness and in creating an efficient healthcare system. Now, individuals with arthritis and other difficulties getting around have a shortlist of procedures many of them can do without.

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Women more likely to tear ACL due to 'knock knees'
Source:
Medical News Today

Researchers say that women are nearly four times more likely to suffer from a tear to the ACL (anterior cruciate ligament) in the knee than men, but that it may be prevented by a different "landing strategy."
ACL injuries are defined as a tearing of the anterior cruciate ligament inside the knee joint. The injury causes the knee to swell, and the joint becomes too painful to bear weight.

These injuries are very common in sports where the participants are required to do many "jump stops and cuts." This includes basketball, soccer, tennis and volleyball.

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Knee osteoarthritis risk unaffected by moderate exercise
Source:
Medical News Today

A new study suggests that the risk of middle-aged and older adults developing knee arthritis is unaffected by doing up to 150 minutes per week of moderate physical activity, the level recommended by the US government.

Knee arthritis leading cause of disability and joint pain

Osteoarthritis occurs when the cartilage and underlying bone in a joint break down, leading to bony overgrowth, pain, swelling and stiffness.
The joints most affected are the knees, hips and those of the hands and spine. The condition, for which there is currently no cure, develops gradually, usually in the over-40s.

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A Popular Myth About Running Injuries
Source:
NY times

Almost everyone who runs (or has shopped for running shoes) has heard that how your foot pronates, or rolls inward, as you land affects your injury risk. Pronate too much or too little, conventional wisdom tells us, and you’ll wind up hurt. But a provocative new study shows that this deeply entrenched belief is probably wrong and that there is still a great deal we don’t understand about pronation and why the foot rolls as it does.

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Losing Your "Sole": Is Barefoot Running Right For You?
Source:
Medical Breakthrough

A Wake Forest University study finds up to 65 percent of runners suffers an overuse injury each year. More and more are looking for new ways to avoid these aches and pains. Now, there’s one trend that some swear by, but you may have to say goodbye to what many consider to be the most important piece of running gear.

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ACL surgery techniques using double versus single bundle ligaments provide equal stability
Source:
Daily Rx

Surgery for a blown anterior cruciate ligament (ACL) inside the knee is becoming more and more common. New techniques to perform the surgery are on the rise across the country.

Damaged ACLs that were replaced using a double-bundle technique during surgery were as stable as patients who received the single-bundle technique, according to a study presented at a conference.
In double-bundle, the new ligament has two parts whereas the single bundle just has one.

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3-D system could prevent shoulder injuries in baseball pitchers
Source:
Science Daily

A new 3-D motion detection system could help identify baseball pitchers who are at risk for shoulder injuries, according to a new study. The system can be used on the field, and requires only a laptop computer. Other systems that evaluate pitchers' throwing motions require cameras and other equipment and generally are confined to indoor use.

Loyola University Medical Center sports medicine surgeon Pietro Tonino, MD, is a co-author of the study, published in the journal Musculoskeletal Surgery.

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Help Young Pitchers Avoid Overuse Injuries
Source:
US news

The start of baseball season is a good time for parents and coaches to talk to young pitchers about how to prevent overuse injuries, an expert suggests.

Bones, muscles and connective tissues are not fully developed in most children up to age 16, so too much pitching can lead to injury, explained Dr. Michael Freehill, an assistant professor of orthopedics at Wake Forest Baptist Medical Center.

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Sidelined from Sports Specialization
Source:
DailyRx.com

Sports injury more likely in young athletes who specialize in one sport Competition among young athletes can be fierce—so fierce, in fact, that some athletes may play their sport more than they can handle. And that intense focus on one sport may put these growing athletes at risk of serious injury.

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