MVP Archives

Hockey Player Has No Regrets After Making a Hard Call

by rona@revdojo.com | Sep 21, 2021 | Sports Medicine

In June of 2020, 15-year-old hockey player Daniel was training after an outstanding season as captain of his team. It appeared that they had a great shot at going all the way in the upcoming season when everything suddenly went wrong. As he was going for the puck, Daniel’s knee collided with the knee of a player on the opposing team, and then he crashed into the boards. Daniel and his father, Andrew, knew that something was wrong, but they didn’t realize just how bad it was.

Daniel’s coaches had always recognized his speed since he started playing at ten years old. “They say that Danny’s speed is one of his best assets,” says Andrew. “They say that you can teach skills, but you can’t teach speed, which is a great benefit for him.” Daniel remained positive and motivated as he discovered the extent of the injury and his treatment options.

At the Scottish Rite for Children Orthopedic and Sports Medicine Center in Frisco, an X-ray and MRI showed that Daniel had an osteochondral fracture of the patella (kneecap) and a loose body in the joint, likely a piece of bone or cartilage. When Daniel was hit on the outside of his knee, his kneecap likely slipped out to the side and scraped the thigh bone, causing the bone and cartilage injury. This injury is often called a patellar subluxation or, more generally, patellar instability. Scottish Rite for Children offers care of complex cartilage conditions, including osteochondral fractures like Daniel’s.

Pediatric orthopedic surgeon Henry B. Ellis, M.D., offered Daniel two approaches for treatment. One option was to focus on the osteochondral injury on the patella. This option would likely get him back on the ice faster, which was an important consideration for Daniel. When the patella slipped, a vital ligament stretched and tore. Without fixing it, the knee would be vulnerable, and another similar injury would have put Daniel at risk for knee issues as he got older. The second option Ellis suggested was to combine the first option with the reconstruction of the medial patellofemoral ligament (MPFL), even though it would take him out of the game for at least six months. To add to the complexity, Ellis recognized that Daniel had a discoid meniscus, meaning the cartilage in his knee was misshapen. Though relatively uncommon and often without symptoms, this pediatric condition is very familiar to Ellis, so he recommended reshaping it during the surgery as well. Together, these procedures would leave Daniel with much better stability and a much better outlook for the future. Even though Daniel wanted to get back on the ice as soon as possible with his team, he and Andrew decided to go with the comprehensive plan. “Dr. Ellis explained everything to us very clearly, so it made the decision much easier, even though it wasn’t what Danny wanted at first,” says Andrew.

An MPFL reconstruction requires time for tissue healing and an intensive rehabilitation program to return to activity and progress to sports safely. “It was pretty hard at first, but my therapist told me that I was doing pretty well and that I was progressing pretty fast, so that kept me encouraged,” says Daniel.

When Daniel first returned to the ice about four months after surgery, he was feeling less confident than he did before his injury. His teammates and his coach encouraged and supported him, which helped ease his concerns about using his full speed again. When Daniel scored his first goal after his full release back to hockey, everyone cheered wildly. Daniel says that he is doing great now and that he has total confidence in his knee. Daniel and his team, the Texas Warriors, worked hard all year, and in March of 2021, their hard work paid off when they won the state championship, and he has the ring to prove it. Daniel and his team also played in the 2021 USA Hockey National Tournament as state champions of Texas.

Many patients, including Daniel, acknowledge Ellis’ ability to explain the options and include them and their families in the decision-making process. Daniel is also thankful that he did not settle for the quickest option. “Not always taking the fastest option can be a good life lesson,” says Daniel. “Don’t get discouraged and keep working hard to get back where you were.” Some athletes tell us they end up better than they were, and it looks like Daniel is on that path, too!

“Daniel had to make a tough decision and was mature enough to think about the long term more than the short term,” says Ellis. “Turns out he made the correct decision as both short-term and long-term goals were met. Congrats, Daniel, on a well-deserved ring and championship!”

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

The Work Takes Time, But It Makes You Great

by rona@revdojo.com | Jun 22, 2021 | Sports Medicine

18-year-old Caden has always loved baseball. He has been playing since he was 4 years old, and he’s received numerous awards through the years. When he was just 12, he was awarded Perfect Game’s Super25 MVP pitcher. As a teenager, he was included in Perfect Game’s All-Tournament Selection, Pre-Season All-American and All-Region teams. Caden plays second base mainly, but he has seen time at shortstop and center field. He is also a phenomenal, right-handed pitcher.

In 2018, Caden began to have pain in his right elbow, so he visited pediatric orthopedic surgeon Philip L. Wilson, M.D., at the Scottish Rite for Children Orthopedic and Sports Medicine Center in Frisco. “I knew they had an excellent orthopedic program, and I was aware that Dr. Wilson had worked with many high-level athletes,” says Alan, Caden’s dad. “He is very well respected in elbows and shoulders.”

Wilson explained that Caden’s elbow pain and inflammation was caused by repeated stretching of the ulnar collateral ligament (UCL), a tight band of tissue on the middle side of the elbow, from throwing. There are two important components to treatment. First, the ligament needs time to heal, so rest from throwing and pitching is crucial. Then, properly timed rehabilitation focused on strength and flexibility of the shoulder and trunk helps the young athlete return to their pre-injury status. After his prescribed rest, he slowly returned to throwing with a strategic 8-week interval throwing program which gradually increases the quantity and distance of throws. The program also encouraged Caden to focus on proper form with every throw to reduce the risk of reinjury. “I was extremely pleased with Dr. Wilson’s entire staff,” says Caden.

Caden utilized additional resources in his recovery to further improve his flexibility and strength and to further reduce his risk of reinjury. Near his home in Rockwall, Caden completed formal physical therapy and a strength and conditioning program with practitioners knowledgeable in the shoulder and pitching programs. These programs helped build Caden’s strength, not only in his arm but in his core and back as well. “It’s not just one muscle – it’s a combination,” says Alan. “It’s getting everything working and firing together so he can handle the stress of pitching.” Physical therapy was humbling at first for Caden. “I saw charts with the average strength levels of collegiate and professional athletes compared to my strength level in high school and saw how long I had to go,” he says.

After six months of physical therapy, Caden was on the field with his teammates at Rockwall-Heath High School performing at the highest level. He was named 1st Team All-District for infield this season, and on June 12, he and his teammates won the UIL 6A High School State Championship. Caden was also named MVP of the game. Caden graduated high school this year and has received a scholarship to play baseball at Northern Oklahoma College in Tonkawa, OK.

Alan advises both young athletes and parents to pay attention to any inflammation and soreness that the child is feeling. “Always err on the side of caution and rest when you are dealing with pain,” he says. “If it’s not better after about a week, I recommend scheduling a consultation with Scottish Rite.” Wilson advises any athlete with activity-related pain to have an assessment by an athletic trainer or sports medicine specialist.

“Caden is a prime example of an athlete properly responding to pain. He rested, he rehabbed and he’s back at a very high level. If he had continued to throw, he might have ended up tearing the UCL and requiring a longer period out of baseball and possibly surgery. So many are concerned about missing a season, but he’s right – taking recovery seriously pays off in the end.“ – Philip L. Wilson, M.D.

Caden hopes his story can help other young athletes understand the recovery process so they won’t get frustrated when it seems like it is taking too long. “The steady work grind takes time, but it’s what makes you great too,” he says. “I think with shoulder care, it’s important to understand that stretching is not just a warm-up but truly a part of your overall pitching program.”

Keep Pushing

by rona@revdojo.com | May 12, 2021 | Sports Medicine

17-year-old Jazzy has been playing basketball since she was 3 years old. Her mom, Krystal, first began to see signs of Jazzy’s gift for the sport when she was in fourth grade. “She was tenacious,” says Krystal. “She was really good.” As Jazzy got older and continued to play basketball, she became involved with Trey Athletes, a nonprofit organization that helps high school athletes become leaders, role models and influential voices for their communities. “I love it so much!” says Jazzy. “It’s super fun and definitely very educational. I learn a lot about myself and things like my college experience, so I am grateful for that.”

As a sophomore at Frisco’s Liberty High School, Jazzy played on the UIL 5A State Championship team and was recognized as M.V.P. at the 5A State Championship. Soon after this, COVID-19 brought all organized sports to a halt, so Jazzy couldn’t play for several months. Once things began to open again, Jazzy was ready to get back on the court for Amateur Athletic Union (A.A.U.) practice, but she stepped wrong and felt her leg give out on her.

Krystal found out about the Scottish Rite for Children Orthopedic and Sports Medicine Center in Frisco from Jazzy’s assistant coach. When she brought Jazzy to meet with pediatric orthopedic surgeon Henry B. Ellis, M.D., he determined that she had torn her Achilles tendon and that surgery was needed to repair it. “Dr. Ellis was great,” says Jazzy. “This was my first surgery, so there was definitely a lot of doubt and questioning. He made the experience so much better, and I was very comfortable, and I trusted him through the process.”

After a successful surgery, Jazzy’s natural tenacity and the strong sense of self and resilience developed as Trey Athletes helped her get through a long physical therapy process. “It was definitely a mental struggle more than anything just because I would be fighting with myself more so than my body,” says Jazzy. “But it was a great process. I learned a lot, and I feel like I got better, even with the rest of my body.” Krystal was very impressed with physical therapist Jessica Penshorn, P.T., D.P.T., A.T.C., L.A.T., and physical therapy tech Timothy Nuckols. Although it was hard work, Penshorn and Nuckols made the experience enjoyable for Jazzy, and she looked forward to going every day. “J.P. and Tim are one of the best teams that I’ve seen,” says Krystal. “We are trying to figure out ways to go back to see them. I’m like, ‘Jazzy, does anything else hurt?'”

After another winning season at Liberty, she and the Redhawks fought for the state championship again in 2021. For her performance in that game, Jazzy was named to the 5A All-Tournament Team. Today, Jazzy says that she feels great and that she is 100% recovered. As she continues to build her strength in certain parts of the game, Jazzy realizes that she wasn’t as strong as she thought she was before surgery. “Now, the stretches and exercises that I did in physical therapy have become a part of my whole process of playing basketball,” she says. “These ways of strengthening my legs are things that I’ll keep with me forever.” Jazzy hopes to play basketball in college and says her recruiting process is very open right now.

Jazzy tells other young athletes with injuries not to get discouraged. “You can have a bad moment, that’s understandable, but don’t let it turn into a day, a week or even a month,” she says. “Just have that moment, recollect and keep pushing.”

Want to learn more about the exercises J.P. recommends to young basketball players? Check out this article and warm-up program designed to help prevent injuries like Jazzy’s.

Rising Elite Gymnast

by rona@revdojo.com | Feb 4, 2021 | Sports Medicine

When 12-year-old Julia began gymnastics eight years ago, her coaches immediately recognized her strength, focused attention and determination. They knew she could be great. Julia continues to prove them right and has earned her spot on the Hopes team at Plano’s World Olympic Gymnastics Academy (WOGA). Hopes is a pre-elite program for gymnasts under the age of 14 to begin their journey through the Elite Program, where National Team coaches look to find the next generation of Olympians.

While preparing for the Hopes Competition season, Julia was practicing new gymnastic skills progressions, which required her to land on her left leg repeatedly. She began experiencing soreness in her hip, and her coach could tell that something was wrong by the way she was moving. She suggested that Julia get it checked out to prevent further injury. Her mom, Heather, brought Julia to the Scottish Rite for Children Orthopedic and Sports Medicine Center in Frisco, Texas. She was seen by sports medicine physician Shane M. Miller, M.D., who is very familiar with the demands of gymnastics.

Miller recognized that Julia had an injury to a growth center where the hamstring tendon attaches to the pelvis, called the apophysis. The apophysis is made of soft cells called cartilage that will later be replaced by bone. In growing athletes Iike Julia, the apophysis is vulnerable to injury from repetitive activity. Until Julia finishes growing, this activity-related inflammation called pelvic apophysitis could continue to be a problem.

Fortunately, surgery is not required to treat the condition, so the Scottish Rite team developed a care plan focused on physical therapy to get Julia back in the gym for the USA Gymnastics (USAG) Development Camp. Physical therapist Lorenzo Vite, who frequently works with elite and pre-elite gymnasts, worked closely with Julia to help her achieve her goal. “We began by assessing musculoskeletal dysfunctions. Once dysfunctions were identified, we started low-impact movement skills and then we put her into our brand new Hydroworx® underwater treadmill to allow the muscles to work without too much stress,” says Vite. “From there, we progressed her to strengthening programs, monitoring her all the time to make sure that we didn’t exacerbate the hip pain.”

Julia enjoyed the variety of exercises that she did with Lorenzo. “At first, physical therapy was hard, but after a little bit, it all started getting easier,” she says. Over the course of eight sessions, Vite carefully managed and monitored Julia’s progress until they believed that she was able to perform. After she passed a rigorous functional test with flying colors, they knew that she was ready. Julia performed well in the USAG Development Camp in October and is continuing to compete pain-free!

Although COVID-19 slowed everything down for a while, it did show young athletes how taking time off can be beneficial. “In the gymnastics culture, people always think that you shouldn’t take any time off, but the pandemic showed us that if you miss some time and if you do it right, you can come right back and avoid injury,” says Heather. “In some cases, girls came back stronger in their core, which made them stronger gymnasts.”

Young athletes often feel like they have to play through the pain, so they don’t let their team or coaches down. Both Julia and Heather encourage other young athletes to speak up when something doesn’t feel right. “Talk to your coaches about it and tell them what’s happening,” says Julia. “Make sure that they know, so they don’t push too hard because you don’t want to hurt yourself.” Injuries may be treated quickly early on, but if athletes continue to practice and compete at a high level, it may become much worse, taking them out of their sport much longer. “Missing practice to go to Physical Therapy, does not mean you are falling behind or not getting stronger,” says Heather. “You are actually getting even stronger by going through physical therapy.”

Today, Julia continues her exercises to help prevent future injuries, and she is using everything that she has learned through this experience to help her fulfill her dream of competing in the Olympics!