Price Transparency
With Her Knees Back in Sync, Abbee’s Ready to Take It From the Top!

With Her Knees Back in Sync, Abbee’s Ready to Take It From the Top!

by | Aug 18, 2022 | General News, Sports Medicine

A woman in a green jumpsuit is dancing on a stage .

Abbee, age 16 of Denton, isn’t like most kids her age. She attends a unique online school just so that she can devote as much time as possible to her true passion – dancing. She is dedicated, spending more than 40 hours a week practicing her dance, earning an invitation to participate in an exclusive pre-professional program at The Joffrey Ballet School.

Abbee dances all day, every day and is determined to pursue a career as a professional dancer. “I knew from a young age that this is what I wanted to do forever,” she says. When Abbee began noticing that her knees were “buckling” while she was dancing, she knew something was wrong. “It would happen while I was dancing, and it would take me out of dance for a few days until the pain went away,” Abbee says. “Eventually, it was happening so often that we decided it was time to see a doctor.”

Abbee visited our Sports Medicine clinic in Frisco to see Jane S. Chung, M.D., pediatric sports medicine physician for Scottish Rite for Children who has a passion for caring for female athletes and dancers. After discussing her history, performing a physical exam and reviewing X-rays and an MRI, Dr. Chung explained that Abbee’s kneecaps sit higher than normal. This position of the kneecap is referred to as patella alta and it can cause patellar instability or patellar subluxation, which is a partial dislocation of her kneecap. Chung reviewed the treatment options, ranging from physical therapy (PT) to surgery. As many patients do, Abbee chose a nonoperative approach first. She began PT to strengthen the muscles in her knees right away, working with physical therapist Jessica Dabis, P.T., D.P.T., O.C.S., to complete exercises to reduce the frequency and hopefully prevent dislocations. After completing PT, Abbee returned to her rigorous dance schedule, and she noticed that her knees felt much stronger.

Abbee visited with pediatric sports medicine surgeon Philip L. Wilson, M.D., and pediatric orthopedic nurse practitioner Chuck Wyatt, M.S., CPNP, RNFA,  who described the procedure and recovery and put her at ease. In November 2021, Wilson reconstructed the torn MPFL, which also corrected her patella alta. This procedure should prevent the instability episodes in this knee. Abbee began PT with Jessica Dabis at Scottish Rite again to rehab her left knee following surgery, working to get back to dancing

Soon after her surgery, Wyatt and Wilson determined that Abbee’s right knee also had a torn MPFL. Abbee knew this meant she would likely need another surgery, but she wasn’t worried. “I was already going to be out for this entire dance season, why not just get them both done and be completely healthy?” Abbee says. She continued PT of her left knee while preparing for surgery for her right knee, just 59 days after her first surgery. After surgery, Abbee was extremely diligent about her rehabilitation, following every instruction.

A woman in a green leotard is standing on one leg on a stage .

She continued PT through July 2022, strengthening the muscles in her knees and following her therapist’s prescribed dance-specific rehabilitation progression. This included a step-by-step return to dance skills and movements, building up from modified to full-out participation. She’s now back to doing what she loves most, dancing, and is so thankful for the team at Scottish Rite for helping her get where she needs to be. 

“Having two back-to-back knee surgeries before the age of 16 is never something I imagined for myself,” Abbee says. “But now I am so extremely proud of myself for making that difficult decision because now I can go back into dance confidently knowing that my knees will be better. I won’t have that fear that my knees will partially dislocate. This entire experience at Scottish Rite has truly changed my life for the better, and I couldn’t have asked for a better team and medical care.”

WE ENJOY HEARING ABOUT OUR CURRENT AND FORMER PATIENTS’ SUCCESS STORIES. TELL US ABOUT YOUR MVP. 

Overuse Injuries in Pediatric Female Gymnasts

Overuse Injuries in Pediatric Female Gymnasts

by | Feb 9, 2022 | Sports Medicine

Overuse injuries can come in many forms and remain a concern for athletes of various sports.

Many recognize the risk of overuse injuries in the elbow in baseball players, but did you know gymnasts are at risk for elbow injuries as well? In our pediatric sports medicine practice, we see two unique conditions of overuse in gymnasts’ elbows. These conditions are triggered differently than in a throwing athlete. For gymnasts, these injuries are caused by compression when the arms are repeatedly in a weight-bearing position.

Recently published in The Journal of Bone and Joint Surgery, this study from our team described the different aspects between the following elbow conditions induced by repeated activity in a group of 58 competitive gymnasts seen in our practice.

What is capitellar osteochondritis dissecans (OCD)?
A rare, painful developmental bone and cartilage injury to the capitellum on the elbow end of the humerus, the upper arm bone.

What is a radial head stress fracture?
An even less common bone injury to the radial head, the elbow end of a forearm bone, caused by repeated compressive forces in the elbow.

“Even though these are rare conditions, we see them enough that we were able to look at a large group seen over five years in our practice,” study author Chuck W. Wyatt, M.S., CPNP, says,  Comparing multiple details of the images and characteristics of the gymnasts, including activity levels, the study found several key findings.

  • Both injuries present at a young age, 11.6 years on average in this group.
  • Radial head stress fracture may be more likely in a more acute (sudden) manner.
  • Likelihood of returning to competition seemed likelier with higher level of training and competition at the time of diagnosis.
  • Having capitellar OCD on both elbows was associated with the lowest rate of return. One in three returned to same or similar level of competition.

In our sports medicine practice, we will use this information to counsel gymnasts who present with these conditions and more importantly, continue to study and educate the gymnastics community about early recognition, treatment and prevention. “This population has so many unique characteristics to consider when it comes to injuries,” assistant chief of staff and lead author Philip L. Wilson, M.D., says. “We look forward to continuing to study to understand how growing and intense training affect their bones and long-term health, particularly in the elbow.”

This study, “Elbow Overuse Injuries in Pediatric Female Gymnastic Athletes” was published in a highly rated, peer-reviewed journal, The Journal of Bone and Joint Surgery. Authors include Scottish Rite for Children Sports Medicine medical staff and former research coordinators who have gone on to pursue post-graduate degrees in the field.

Read the full article here.

Learn more about Osteochondritis Dissecans (OCD) in the Elbow.

A Soccer Injury Won’t Slow This MVP Down for Long

A Soccer Injury Won’t Slow This MVP Down for Long

by | May 25, 2021 | Sports Medicine

During a soccer game this spring, 14-year-old “Coppell FC” midfielder, Thomas, blocked a shot and fell to the ground. His father, Michael, didn’t think too much of it. Thomas often puts his body on the line to make shots and blocks, and most of the time, he quickly bounces up and continues to play. “When he didn’t get up, I realized that something was different,” says Michael. “We hit the ball on opposite sides at the exact same time, so that twisted my knee, and I heard a pop,” says Thomas recalling the play. Michael ran to Thomas on the field and could see that his knee was already swelling.

The family had taken their children to the Scottish Rite for Children Orthopedic and Sports Medicine Center in Frisco for other injuries in the past, so Michael knew who to call. Thomas was examined by sports medicine physician Shane M. Miller, M.D. The X-ray and MRI confirmed that the “pop”, immediate pain and swelling were caused by the tearing of the medial patellofemoral ligament (MPFL) when his kneecap temporarily dislocated. This ligament helps to prevent the kneecap from slipping to the outside of the knee.

While going over nonoperative and operative treatment options, Miller informed them that without surgery, there was a 50% to 80% chance that his kneecap would dislocate again while participating in sports. They decided to meet with pediatric orthopedic surgeon Philip L. Wilson, M.D., who reassured them that surgery was the best option for long-term recovery and healing. A couple of weeks later, Wilson and certified pediatric nurse practitioner Chuck W. Wyatt, R.N., M.S., CPNP, RNFA, performed an MPFL reconstruction. “Dr. Wilson and his team did a great job!” says Michael. Thomas was happy too and says, “Dr. Wilson was very nice, and so were all the people who helped me, like Dr. Kelly who helped with my IV and pain medication.”

Ten days after surgery, Thomas started twice a week physical therapy at Scottish Rite with physical therapists, Madelyn “Maddie” White, P.T., D.P.T., and Rushi Patel, P.T., D.P.T. He and his father are very pleased with the progress. “Physical therapy has been great!” says Thomas. “Maddie and Rushi are both great. Right now, therapy includes mostly basic exercises, but I can now bend my knee past 90 degrees. I started at like 70 degrees, which is pretty bad, so it’s improving.” Maddie agrees, Thomas is improving. She says, “After most surgeries, the first stage of rehabilitation is to protect and regain motion in the joint. Soon, Thomas will progress to exercises and activities that will improve strength and control in his legs and trunk.”

In addition to soccer, Thomas also plays baseball. His previous experience with physical therapy at Scottish Rite was for Little Leaguer’s shoulder, which helped him to commit quickly and fully trust in the postoperative rehabilitation plan. Thomas will miss this year’s baseball season and playing in one of his favorite events, Middle School Matchup (MSM) Summer Smash. As a Scottish Rite patient and alumni of the MSM, Thomas was invited to throw out the opening pitch for the 2021 tournament. It’s no surprise that Thomas loves this event. The fun-focused tournament brings together unlikely baseball and softball teams formed through middle school affiliations, reminiscent of sandlot play where skill isn’t a deciding factor.

 

Thomas is very focused on what he can do instead of what he can’t. Thomas is looking forward to trying out for the soccer team his freshman year at Coppell High School. “I’m doing a lot better,” says Thomas. “I’m walking without crutches, and hopefully, the brace will be off my leg soon.” He is already thinking ahead about exercises that he can do once the brace comes off to strengthen the muscles around his knee to help reduce the chances of reinjury. As he heals and progresses in rehabilitation stages, his physical therapists will introduce exercises that include more functional and soccer-specific movements. When he completes his formal physical therapy, Thomas will be a good candidate for our bridge program, designed to progress the patient back to sports safely.

Thomas encourages young athletes to stick with physical therapy and to do what their trainers say. “They know what is best,” he says. “You want to be back on the field as soon as possible, and if that means taking things slow now, it’s worth it in the long run.” Michael wants parents of young athletes to know that it is hard when your child is taken out of the sport that they love because of an injury. It hurts to see your child in pain, but he says it is important to have a positive attitude and to work closely with your medical team. 

 

“Their advice is the best we can get, so open communication with your medical team is going to help your child make progress,” says Michael. “With Scottish Rite’s help, Thomas is getting better every day. Not just physically, but emotionally and mentally too.”

A Soccer Injury Won’t Slow This MVP Down for Long

A Soccer Injury Won’t Slow This MVP Down for Long

by | May 25, 2021 | Sports Medicine

During a soccer game this spring, 14-year-old “Coppell FC” midfielder, Thomas, blocked a shot and fell to the ground. His father, Michael, didn’t think too much of it. Thomas often puts his body on the line to make shots and blocks, and most of the time, he quickly bounces up and continues to play. “When he didn’t get up, I realized that something was different,” says Michael. “We hit the ball on opposite sides at the exact same time, so that twisted my knee, and I heard a pop,” says Thomas recalling the play. Michael ran to Thomas on the field and could see that his knee was already swelling.

The family had taken their children to the Scottish Rite for Children Orthopedic and Sports Medicine Center in Frisco for other injuries in the past, so Michael knew who to call. Thomas was examined by sports medicine physician Shane M. Miller, M.D. The X-ray and MRI confirmed that the “pop”, immediate pain and swelling were caused by the tearing of the medial patellofemoral ligament (MPFL) when his kneecap temporarily dislocated. This ligament helps to prevent the kneecap from slipping to the outside of the knee.

While going over nonoperative and operative treatment options, Miller informed them that without surgery, there was a 50% to 80% chance that his kneecap would dislocate again while participating in sports. They decided to meet with pediatric orthopedic surgeon Philip L. Wilson, M.D., who reassured them that surgery was the best option for long-term recovery and healing. A couple of weeks later, Wilson and certified pediatric nurse practitioner Chuck W. Wyatt, R.N., M.S., CPNP, RNFA, performed an MPFL reconstruction. “Dr. Wilson and his team did a great job!” says Michael. Thomas was happy too and says, “Dr. Wilson was very nice, and so were all the people who helped me, like Dr. Kelly who helped with my IV and pain medication.”

Ten days after surgery, Thomas started twice a week physical therapy at Scottish Rite with physical therapists, Madelyn “Maddie” White, P.T., D.P.T., and Rushi Patel, P.T., D.P.T. He and his father are very pleased with the progress. “Physical therapy has been great!” says Thomas. “Maddie and Rushi are both great. Right now, therapy includes mostly basic exercises, but I can now bend my knee past 90 degrees. I started at like 70 degrees, which is pretty bad, so it’s improving.” Maddie agrees, Thomas is improving. She says, “After most surgeries, the first stage of rehabilitation is to protect and regain motion in the joint. Soon, Thomas will progress to exercises and activities that will improve strength and control in his legs and trunk.” 

In addition to soccer, Thomas also plays baseball. His previous experience with physical therapy at Scottish Rite was for Little Leaguer’s shoulder, which helped him to commit quickly and fully trust in the postoperative rehabilitation plan. Thomas will miss this year’s baseball season and playing in one of his favorite events, Middle School Matchup (MSM) Summer Smash. As a Scottish Rite patient and alumni of the MSM, Thomas was invited to throw out the opening pitch for the 2021 tournament. It’s no surprise that Thomas loves this event. The fun-focused tournament brings together unlikely baseball and softball teams formed through middle school affiliations, reminiscent of sandlot play where skill isn’t a deciding factor.

Thomas is very focused on what he can do instead of what he can’t. Thomas is looking forward to trying out for the soccer team his freshman year at Coppell High School. “I’m doing a lot better,” says Thomas. “I’m walking without crutches, and hopefully, the brace will be off my leg soon.” He is already thinking ahead about exercises that he can do once the brace comes off to strengthen the muscles around his knee to help reduce the chances of reinjury. As he heals and progresses in rehabilitation stages, his physical therapists will introduce exercises that include more functional and soccer-specific movements. When he completes his formal physical therapy, Thomas will be a good candidate for our bridge program, designed to progress the patient back to sports safely.

Thomas encourages young athletes to stick with physical therapy and to do what their trainers say. “They know what is best,” he says. “You want to be back on the field as soon as possible, and if that means taking things slow now, it’s worth it in the long run.” Michael wants parents of young athletes to know that it is hard when your child is taken out of the sport that they love because of an injury. It hurts to see your child in pain, but he says it is important to have a positive attitude and to work closely with your medical team. “Their advice is the best we can get, so open communication with your medical team is going to help your child make progress,” says Michael. “With Scottish Rite’s help, Thomas is getting better every day. Not just physically, but emotionally and mentally too.”

Helping Truth Achieve Her Goals

Helping Truth Achieve Her Goals

by | Oct 21, 2020 | Sports Medicine

“Truth has pretty much grown up on the soccer field,” says her mother, Agatha. Truth watched her father coach soccer, and both of her older sisters play, so she developed an undeniable love of the game early. She also developed an amazing talent. Truth has played for Solar Soccer Club in Dallas since she was 5 years old. She has participated in training camps with the USA National team, and when she was in seventh grade, she committed to play collegiate soccer for Southern Methodist University (SMU).

In January, Truth was playing in a scrimmage. Positioned to score, her leg collided with a defender attempting to block her shot. Truth felt a “pop”, fell to the ground, and had to be carried off the field. Fortunately, Truth’s mother knew exactly where to take her daughter for treatment. 

Her mother was a pediatric nurse at Scottish Rite for Children for five years before going to graduate school to become a family nurse practitioner. As part of her clinical training, Agatha worked with Assistant Chief of Staff and pediatric orthopedic surgeon Philip L. Wilson, M.D., and certified nurse practitioner Chuck Wyatt, M.S., CPNP, RNFA. Since Agatha experienced the expertise and caring clinical approach of Scottish Rite during her time there as a nurse practitioner student, she immediately called Wyatt at the Scottish Rite for Children Orthopedic and Sports Medicine Center after Truth’s injury.

Truth-soccer-3.jpg

After a physical examination, X-rays and confirmation with an MRI, Wyatt explained to Truth and her parents that she had torn the lateral meniscus and damaged her articular cartilage in her knee. One week later, Wilson performed surgery to repair the meniscus and address the bone and cartilage defect in the joint. This type of meniscal repair and joint surface treatment required Truth to wear a special brace and use crutches for two months.

Wyatt says, “Rehabilitation is an extremely important component of an athlete’s course of recovery and safe return to sports.” Unfortunately, not long after Truth’s surgery, the coronavirus pandemic forced facilities to stop seeing patients in person. Wyatt and the Sports Medicine team were able to continue Truth’s care and monitor her range of motion and recovery virtually with telemedicine visits.

When it was safe, she transitioned from her home exercise program to in-person physical therapy. Truth was motivated and engaged when her physical therapy began because she knew her physical therapists wanted to get her back on the field as much as she did.

Today, Truth is back on the soccer field with the Solar Soccer Club, playing the game she has loved since she was little. She has been training hard since she was cleared three months ago to achieve her goal of getting back into “soccer shape.” “Scottish Rite for Children works effectively and purposefully to heal our young, growing athletes,” says Agatha. “We are all delighted that Truth had a healthy, speedy recovery full of people in her corner who cared about her and helped make this challenging process a very pleasant experience.”

Wilson says, “Truth’s injury would have made some kids second guess their future in sports, but her drive and commitment to her sport and her physical therapy program are second to none. Our team is inspired and motivated by athletes like her, and we can’t wait to see her succeed at SMU and beyond.”

We enjoy hearing about our current and former patients’ success stories. Tell us about your MVP.