Dr. Greene discusses “Surfers Shoulder”

ShoreOrtho Sports Performance
& Injury Prevention Tips

A monthly series presented by:
Damon A. Greene, MD
Board Certified Orthopaedic Surgeon
Shore Orthopaedic University Associates

November 2019

“Surfers Shoulder” also known as Shoulder Impingement is a common overuse injury of the shoulder.

When we paddle we use the front of our shoulder the pectoralis major, pectoralis minor and anterior aspect of our deltoid. We also strengthen shoulder elevators the trapezuim and levator scapula among others. This causes a net upward and anterior directed force across our shoulder. This then leads to impingement of the rotator cuff on the acromion (the roof of the shoulder).  Intern the tissue around the rotator cuff becomes inflamed which then will lead to bursitis.

If left unaddressed scar tissue can form in the capsule causing a loss of a range of motion and chronic shoulder pain and ultimately rotator cuff tears. In order to prevent this proper paddling technique is crucial. Secondly learning to activate the posterior and inferior aspects of our shoulders while preforming activities will help keep us paddling stronger and out of pain.

While there are many different exercises that can achieve this, one of my favorites is an exercise called Wall Angels. 

To begin, plant yourself against a nice, roomy wall space. Elbows start at a 90 degree bend, with the elbows parallel to the ground. Hips, spine, shoulder blades…all against the wall! To get to the stretch-and-strengthen part – although you might already feel some tension while holding the arms at 90 degrees – begin to straighten the arms directly overhead, trying to at least keep the elbows sliding up against the wall. As you get stronger and looser, maybe the forearms and back of the hands will be able to stay in contact with the wall, as well.

 

Dr. Greene is a Sports Medicine Fellowship-Trained, Board Certified Orthopaedic Surgeon.
He specializes in; acute and chronic ligament, tendon, or cartilage injuries to all major joints; primarily shoulders, elbows, knees and hips. He treats fractures surgically when necessary, but performs casting, bracing, and other non-operative treatments such as specialized injection therapies.

 

Dr. Greene discusses a common surfing injury

ShoreOrtho Sports Performance
& Injury Prevention Tips

A monthly series presented by:
Damon A. Greene, MD
Board Certified Orthopaedic Surgeon
Shore Orthopaedic University Associates

October 2019

It’s finally fall and time for surfing season especially here in South Jersey.

So let’s discuss a surfing injury that commonly gets overlooked the “Hips Flexors”. When we are surfing the front foot and hip rotate forward this puts stress across the spine, hip, knees and even ankles. The back foot turns out because the gluteal muscles (buttock muscles) contract and shorten rotating the back hip out. This means that unless we stretch and strengthen to our hip flexors, we are setting ourselves up for other injuries and limiting our ability to enjoy the waves. One stretch that I like is called the Lizard. This stretch predominately targets the hip flexors but also targets the groin and glutes. Draw one foot to the outside of your arms and place both hands flat on the ground. Bring your forearms to the floor or as far as your body allows. Your back leg stays off the ground. Hold the stretch for approximately 30 seconds and repeat.

 

 

 

Dr. Dalzell Explains Treatment and Prevention of the “Most Common Golf Injuries”

MOST COMMON GOLF INJURIES

Frederick G. Dalzell, MD
Board Certified Orthopaedic Surgeon

Fractured ribs, herniated discs, injured wrist and knees, we’re not talking the Eagles injury report, but rather some of the injuries suffered on the PGA tour! Hard to believe that what’s been described as “a good walk spoiled” and debated by others as not even being a sport could result in this litany of injuries.

So what are the most common problems suffered by the weekend golfer and how can you treat and prevent them?

BACK PAIN 
It’s been estimated that 80% of Americans will experience back pain at some time in their life. That number becomes even higher when you enjoy golf as an activity. With the average golfer generating torque and swing speeds of 80 to 90 miles an hour and pros well over 110 it is not surprising that the raid generation and sudden stop put significant stress on the lumbar spine. Pre and in-season stretching and core strengthening can be good preventatives. Rest, anti-inflammatories (like Motrin or Aleve) stretching, deep tissue massage and bracing all may be helpful early on. If not responding after a week you may need to see your health care professional.

ELBOW PAIN 
Tennis elbow (outside of the elbow) and golfer’s elbow (medial elbow) are also the bane of the duffer and pro golfer alike. Over use, hitting off mats, too stiff a shaft and improper grip size can lead to these problems.  Stretching, tennis elbow straps, ice, anti inflammatories and injections all have a place in treatment. Sometimes a switch to graphite or a more flexible shaft may be beneficial and could be a reason to consult a golf professional.

WRIST PAIN
Most wrist pain related to golf comes from tendonitis and over use. Taking time off (sorry fellow golfers), ice and anti-inflammatories will cure most cases. If the pain follows striking a root or another object, results in joint swelling or lasts more than a week after treatment than a more serious injury (fracture or ligament tear) is a possibility and a trip to the doctor is more advisable.

KNEE PAIN  
The stiff lead leg is exposed to high stress during weight shift, and while not as common as some of these other problems these injuries often involve ligaments  or meniscus and may need medical attention earlier. Those with arthritis also may see flares during golf season. Bracing and an evaluation of your swing by your golf pro may help.

Better Golf through fitness: Shore Orthopaedic’s Physical Therapist LJ Georgetti, DPT

“Its all In The Hips” By Larry Justin “LJ” Georgetti, DPT

Any aging golfer can count on one of his/her friend’s bailing on an eight o-clock tee time due to “back pain”. Range of motion and strength of the whole body are essential when building a strong foundation to a healthy golf swing. I believe that the abnormalities in swing mechanics and mobility limitations in the hips/spine will cause restrictions in how one develops force in the golf swing.  These abnormalities over time will result in dysfunction and eventually pain.

The golf swing has many variables, as does the human body. However, one thing remains consistent throughout all golf swings: energy must be delivered to a stationary golf ball in order to move it a desired distance. In the most efficient swings, energy is generated by the lower extremities via the ground. How this energy is gained, stored and eventually transmitted are exactly where the variables begin to differentiate between professional and recreational golfers. A golfer utilizes his/her lower extremity to generate force through the ground and eventually to the ball at impact. It is worth noting that the musculature surrounding the hips, known as the “glutes”, are the strongest in the body. These are the ones responsible for getting us up out of a chair and keeping us erect when walking. Problems arise when we do not train and utilize these muscles appropriately. As my colleague, Chris Hanson, previously discussed, the hip and the lumbar spine are closely related in the golf swing. If dysfunction arises in one, the other will suffer.

Hip Mobility and the Golf Swing

By Christopher C. Hanson, PT, MPT, DMT, OCS, FAAOMPT

 

Most golfers are weekend warriors and if there is extra time in anyone’s schedule for golf activities, more times than not this is allocated to swing training.  As the last few articles have discussed, physical fitness is equally important.  In order to have a world class swing, the function of one’s musculoskeletal system also needs to be equipped. Golf is a sport that requires strength, power, coordination and mobility; no one of these is more important than the other. This weekly dive into the physical care of a golfer’s body will discuss the importance of hip mobility and stability in all golfers.

In the golf community the importance of spinal mobility and strength is well documented. There have been numerous social media campaigns since the start of this golf season showing new creative ways to improve spinal mobility and strength.  However, absent from these posts have been ways to improve hip strength and mobility; negating altogether the connection between the hip and the spine.

The hip and the spine are intricately related. If one has movement issues in one area, it can transmit increased forces along the kinetic (movement) chain.  In the presence of hip mobility issues the body increases motion in other joints.  The body is almost too good at this compensation and creating more (too much) movement in order to allow someone to function in a way that seems correct.  In the presence of limited hip mobility there may be an excessive forces through the lumbar spine. This can happen at different points in the swing.  Limited hip mobility can create issues in the back swing, during the initiation of swing and during the follow through. This also relates to other sporting activities as well.