Web chat transcript: Sports injuries

Welcome to our Wednesday Health Web chat. Today’s topic is Sports Injuries – how you can prevent them and how to treat them.

Please welcome Dr. Sean Hooker of Riverside Orthopaedics and Sports Medicine in Newport News

Dr. Hooker is ready to answer your questions. I’m going to start by asking a question about how you can work out safely in this heat if you work out outside.

Readers: This is your opportunity to ask all those questions you’ve been wondering about. How to deal with the heat, sprains and strains etc.

First and foremost when working or excercising in the heat, hydration is the key.

The recommendation is for 8 ounces of water every 15 – 20 minutes under heavy activity conditions.

Should that just be with water? I have a theory that I need Gatorade or something else with minerals when it’s really hot. What do you think?

If excercising greater than 1 hour – you should supplement with a rehydration drink such as Gatorade.

Also, I don’t want to overload you with my questions, but should you drink water before you exercise?

your theory is correct, you need to replace your electorlytes with prolonged activity but less than one hour water is your best bet.

As for preloading with water, that is a good idea.

for athletes in season particularly in the summer months. weighing pre and post excercise and making sure that your urine is clear are good ways to make sure you are replacing what you are losing and are staying hydrated.

the most common injuries I see in the early part of the season is sprains and strains. this is because the ligaments are most vulnerable when athletes are fatigued

What are the treatments for these?

This seems to improve as conditioning improves. the best treatment depends on the severity of the injury but in general ice and compression in the first 72 hours

after 72 ice or heat works equally as well

Should you rest when you strain a muscle? Does exercise make it worse?

Readers: We are talking to orthopedic surgeon Michael “Sean” Hooker. He can answer your questions about preventing and treating sports injuries. Send them in now.

Resting should be limited actually early Physical therapy for low grade sprains and strains is the best way to get back to athletics faster.

When you say faster, how long do you mean? With short athletic seasons many students want to be out on the field without delay.

With sprains and strains again severity is the limiting factor. low grade injuries can return sometimes within 48 hours. more severe sprains and strains can require up to 8 weeks of rehab.

For tennis elbow, eccentric excercises and strengthening can help, nsaids usually do not work. cortisone injections can be beneficial and for more long term symptoms, surgery or platlet rich plasma injections can work.

Yes I do, the literature is still wrestling with their effectivness and because its a newer therapy insurance does not always cover the cost.

Can you explain what platelet rich plasma injections are? Are those what Tiger Woods used in his knee or is that something different.

Readers: We are here until 12:30 p.m. EST with Dr. Sean Hooker, an orthopedic surgeon from Riverside Orthopaedics. He can answer your questions about sports injuries and prevention.

platleet rich plasma is blood that is spun down to the active stem cells and platelets, these concentrated products are then injected at the site of injury

For all your health news, go to www.dailypress.com/health. Also, we have a new e-letter that you can receive FREE in your email every Monday morning. It combines the top national and local health news. Just go to the Daily Press home page at www.dailypress.com and register. There is no charge.

What results have you seen with this type of blood therapy?

I am not sure exactly what was used in Tigers knee but their is ongoing work with stem cells and the platelet products that is being used more and more commonly in early degenerative knees.

What injuries do you use it for?

The results are mixed in the literature and in my hands but I would say I have an 80% success rate for tendinopathies treated with PRP.

Tendinopathies? Please explain!

I use PRP for tennis elbow, patellar tendinitis, plantar fasciitis, and rotator cuff

Tendinopathies are chronic degenerative changes in tendons it is when the tendon most out of an inflammatory stage (itis) and into a more avascular stage (opathy)

Is there anything you can do to prevent the change from “itis” to “opathy”?

Stretching actually is best after the muscles are warm at the end of excercise

So how should you warm up — or is that a myth that you need to?

a warm up has not been shown in the literature to prevent injury. but stretching post excercise consistently has been shown to reduce injuries. so stretching in general is good but stretching before activity does not seem to make a difference.

clicking in hips knees and shoulders is very common, painless clicking is nothing to worry about but painful clicking is probably something you want to have looked at

How long should that stretching be? Some recommended stretches?

Readers: We have 5 more minutes for you to ask your questions about sports injuries — their treatment and better yet prevention — from Dr. Sean Hooker, orthopedic surgeon.

A stretching program of 10 to 15 minutes is probably adequate. difficult to describe stretches in this media but trunk twisting, core, quad and hamstring stretching are the best for overall mobility

contact sports such as football, hockey, and lacrosse have the highest rate of injury and therefore the most longer term consequence for playing.

The best way to protect yourself is conditioning prior to a athletic season.

Which sports have the highest rates of fractures?

Football and Rugby would be the highest

Females and athletics is a complex mix, a large component is nutrition, and then conditioning. dieting can be a problem and with mulitiple fractures in a younger athlete this is something you may want to get a second opinion on

Dr. Hooker — Thank you so much for all your excellent advice today. Please let our readers know how they can contact you — then I’ll close out the chat.

Readers: If you want to see the full transcript of the chat, then go to www.dailypress.com/health. All our archived chats are there. Join us each Wednesday to get your health questions answered.

please feel free to contact my office at 757-838-5055. It has been a pleasure participating today! Be safe!

Thanks again to Dr. Sean Hooker of Riverside Orthopaedicsa and Sports Medicine in Newport News and Williamsburg for providing the expertise in today’s chat.
Join us again next Wednesday at noon.