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Bryce’s Treatment is a Home Run

Bryce’s Treatment is a Home Run

by | Sep 30, 2024 | Sports Medicine

Header image courtesy of Eddie Kelly/ProLook.

When an injury threatened to keep Bryce off the baseball field for nine months, he and his family turned to Scottish Rite for Children to get him back in the game.

Bryce has always loved baseball. “I’ve been playing baseball pretty much ever since I could walk and get a ball in my hand,” he says. His mother, Johnette, first saw glimpses of Bryce’s outstanding athletic ability when he was 4. “When the other team was batting, it didn’t matter where Bryce was playing, he would go all over the field to get the ball,” she says. “He was kind of like a one-man-team.” Bryce started pitching when he was 8, and Johnette saw a drive and a passion that were unlike what she saw in other young athletes. When Bryce became a teenager, he played on select baseball teams, and he spent several summers traveling for games. Bryce’s drive and determination paid off his freshman year at McKinney High School when he made the varsity baseball team.

Like many star athletes, Bryce played several sports, and enjoyed football when he wasn’t playing baseball. Sport diversification can help prevent injuries caused by overuse, but unfortunately contact injuries are harder to prevent. In his junior year, he and his team had made it to the second round of the playoffs. During practice, to get ready for the big game, Bryce went for a block and, after contact, felt his arm go completely numb. “I thought it was just some bumps and a bruise because it’s football,” says Bryce. “So, I played that second round, and played every snap on offense and felt fine, but it turns out, it wasn’t too great.” The day after the game, he and a friend went to the baseball field to throw the ball around, but Bryce quickly realized that there was a problem. “I couldn’t even throw the ball five feet, because it was hurting so bad,” he says. 

Bryce had sustained a labral injury to his shoulder, which likely occurred when he subluxated (shoulder almost dislocated) or possibly dislocated (shoulder completely out of the socket) his shoulder. When the shoulder joint is injured this way, it can cause damage to the structures around the joint, including the labrum. The labrum is a ring of cartilage around the socket part of the ball and socket joint of the shoulder. When torn, the labrum is commonly thought to need surgery, but not always. 

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Initially, Bryce was told that surgery was necessary in order to return to sports and may take as long as nine months. This news devastated Bryce, so when his parents returned, they turned to the Scottish Rite for Children Orthopedic and Sports Medicine Center for another opinion. Pediatric orthopedic surgeon Henry B. Ellis, M.D., reviewed Bryce’s files and MRI, and felt that they could get him back to baseball with physical therapy instead of surgery. He felt with proper rehabilitation (physical therapy) and allowing enough time to allow the labrum to heal, Bryce could avoid a surgery and possibly be back to baseball sooner. However, this did mean that Bryce would have to give his shoulder enough time to heal before throwing a ball again.

Though encouraged by the option to avoid surgery, Bryce remembers being a little shocked at how difficult physical therapy was from the start. “It kind of killed my confidence a little bit and frustrated me, because I’ve always played a lot of sports and I always want to be the best that I can be. But once I saw improvement in how my body and my shoulder felt, I finally started getting back my confidence, so it was good.” Scottish Rite coordinated with the McKinney High School athletic trainers on a program to get Bryce back on the field as soon as possible.

Bryce was cleared to play in February, right before the team began preparing for the upcoming season. After all the hard work he had put into building back his shoulder, he was very excited to be with his team again. They were glad to have him back too – in Bryce’s first week back, he hit three home runs. Things were going great until COVID-19 forced an early end to the season. “All this is a little different,” says Bryce. “It’s like a curveball being thrown at us. But you just have to adapt and be able to adjust and focus on what you are there for.”

Bryce has complete confidence in his shoulder now. “I feel like I can do anything and everything that I’ve always been capable of doing,” he says. “If it wasn’t for Scottish Rite, I wouldn’t be where I am now.” Bryce recently verbally committed to play baseball at Northeast Community College in Mount Pleasant, Texas, and plans to continue his journey to Major League of Baseball.

Bryce is very grateful to Dr. Ellis. When others were recommending surgery, Ellis presented the pros and cons of a nonoperative plan. Bryce says he learned a lot from his experience. “When you go through hard times, you always have to keep your head straight and focus on the main goal, because you are going to go through ups and downs, but you just have to focus on the end result, and that was big for me. Not focusing on the negatives, but on getting back to where I needed to be.”

 

Has your child been seen in the Sports Medicine clinic here? Fill out this form to tell us about your MVP. 

Movement Science – Breaking Down Movements in Young Baseball Players

Movement Science – Breaking Down Movements in Young Baseball Players

by | Oct 27, 2023 | Sports Medicine

As part of SAFE (Sports-specific Assessment and Functional Evaluation), our team is developing sport-specific protocols for the use of motion capture technology in sports medicine that are being used across the country. There are only a handful of sports that have received attention in the motion capture world, and those are typically performance-based models. The models that our team are creating evaluate foundational movements to help us predict injuries and improve return to play protocols. To do this, we will need to record a great deal of data from a large number of athletes.

For the past two summers, our Movement Science Lab team in Frisco has collected data sets on our baseball program participants and some other volunteers. Though we are just getting started on the total number of athletes to test, we are making great progress on tweaking the protocol and looking at preliminary results to understand where to go next. Here are a few things that we are looking at in the study:

Trunk mobility – specifically in the thoracic spine. We’ve identified the best way to capture the mobility of the upper spine. We believe that tightness there may affect the stress on the shoulder during throwing.

 
Motion throughout the body while throwing. Because our movement science lab is spacious, with 14-camera motion capture system, we can monitor joint angles, speed and forces throughout the body during high velocity pitching. We believe some movements are directly related to the development of elbow and shoulder injuries, particularly when there is a high volume of throws without rest.

 
Single leg stability with motion. Most sports require movement of the legs, and most of the time, only one leg is in contact with the ground. We are measuring the differences from side to side and between athletes to identify asymmetry in static and dynamic single leg movements. We believe asymmetry is a factor for increased injury risk in all athletes.

 
Leader of the project and assistant director of the Movement Science Lab in Frisco, Sophia Ulman, Ph.D., says, “Early results from this study are helping us to establish an evidence-based return to play decision-making model.” Many have heard of functional testing or return to play testing for athletes returning to sport after a significant knee surgery, such as an ACL reconstruction. This new upper extremity program is much needed in the pediatric sports medicine community. As we continue to collect information about healthy athletes, we will use the results to continue to modify the upper extremity return to play program. This is an example of where our clinical teams of physicians, physician assistants and physical therapists collaborate with our research team to make changes that impact athletes today.

We are continuing to work on this baseball project and invite healthy young athletes to help us. We schedule testing dates periodically and would be happy to send you the calendar to sign up or work with your team to find a date to do testing together.

To learn more about Movement Science, please call 469-515-7160 or email MSL.Frisco@tsrh.org. 

It’s a Whole New Game: Bridge Program Helps Young Baseball Players

It’s a Whole New Game: Bridge Program Helps Young Baseball Players

by | Feb 5, 2021 | Sports Medicine

When a child or adolescent baseball player completes physical therapy for an elbow or other injury, his needs still look different from those of their peers. Bridge Program Coordinator Ian Wright, P.T., D.P.T., CSCS, USAW, answered the five “W’s” about what a bridge program can do for these athletes.

Who should participate in a bridge program?
Growing muscles, joints, and bones in boys and girls are at an increased risk of injuries from improper training and repetitive activities that occur in baseball and other sports. After recovery from an injury and discharge from physical therapy, all athletes would benefit from a strength and conditioning program to balance sport-specific training sessions. An athlete with a current injury should not start a bridge program without activity clearance from the medical provider.

What is a bridge program?
A bridge program is a series of group training classes led by a certified strength and conditioning coach. The coach evaluates the athlete’s movement patterns and provides instruction while supervising specific exercises with proper repetitions, resistance, and rest. Activities range from general strength and conditioning to sport simulation activities that are age- and task appropriate for each athletes. Education to complement the physical activities includes nutrition and hydration information for young athletes.

When is a bridge program appropriate?
A bridge program is most effective when it closely follows rehabilitation closely. Because poor movement patterns are associated with growth and increased injury risk, an ongoing or periodic conditioning program provides value to the young athlete at any point. The instructor must have a solid understanding and commitment to off-season periodization. Periodization is selecting the appropriate type of intensity of training based on the sports season.

For example, for baseball players, three seasons are considered:

  1. Off-Season: August – November
  2. Pre-Season: December – February
  3. In-Season: March – July

Periodization becomes more difficult when athletes participate in a single sport year-round which is also associated with an increased risk of injury.

Where can an athlete participate in a bridge program? 
The program should be implemented in a setting where there is access to equipment for the young athlete to train in a safe environment. For example, an at-home exercise program may have limitations for the athlete because they do not have enough space to perform their activities with the needed equipment. Additionally, proper supervision is important, both the ratio of participants to instructors and the qualifications of the instructors must be considered.

Why should young baseball players participate in a strength and conditioning program?
Physical therapy typically focuses on the specific impairment or limitations caused by the injury or condition. Though sports-focused therapists integrate total body treatment throughout, the sessions may end long before the body is back to normal. Most home exercise programs revolve around continued, supervised resistance training. Young athletes have limited access to well-trained instructors that consider total body conditioning, growth and development, skill acquisition, seasonal periodization, and individualized effective strengthening prescription. When left on their own, athletes are at an increased risk of a new injury or re-injury when they return to sport specific regimens of practice, games, tournaments, coaching clinics, and self-guided training.

Scottish Rite for Children in Frisco is offering training classes to former patients, Contact our Therapy Services team at 469-515-7150 or bridgeprogram@tsrh.org.

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

Common Injuries in Volleyball: Recognize Them and Reduce the Risks

Common Injuries in Volleyball: Recognize Them and Reduce the Risks

by | Jan 28, 2021 | Sports Medicine

Sports medicine physician Jane S. Chung, M.D., has a special interest in caring for young female athletes. She worked to let coaches and parents of young volleyball players know about injury risk and prevention in the sport.

Download the Volleyball Safety Sheet to share with parents of teammates and coaches.

Like many sports, volleyball comes with some inherent risks. This popular, fast-paced, explosive-natured sport requires players to react quickly, swiftly generate power from the legs and arms and perform movements repeatedly. Year-round, intense competition adds to the challenges for preventing overuse injuries and burnout. However, strategic rest periods and following appropriate safety recommendations can help decrease injury risk and help keep these athletes on the court.

COMMON PROBLEMS FOR VOLLEYBALL PLAYERS

Knee Pain and Injuries
Pain in the front of the knee is a common complaint from growing, active females. A proper strength and conditioning program can help prevent this discomfort and improve the alignment of both hips and knees for more power in squatting and jumping. Activity-related pain should not be ignored. Landing awkwardly from a jump can cause sprains and tears to ligaments and other soft tissue in the knee. A swollen knee after an injury warrants removal from play and an evaluation.

Finger Injuries
Blocking high-speed hits and setting the ball can put the fingers at risk of being jammed, fractured or dislocated. While jammed fingers typically heal with rest and ice, they can sometimes cause injury to ligaments and cartilage, which may require closer evaluation. If you are unsure or if pain and swelling do not subside with rest, it is best to have a medical evaluation.

Ankle Injuries
Ankle injuries are common in many sports, including volleyball, and typically occur while changing direction or landing on another player’s foot after a jump. Mild ankle sprains are often treated with RICE (Rest, Ice, Compression and Elevation). Repeated sprains, more severe sprains or an inability to bear weight may require an X-ray, evaluation and rehabilitation.

Shoulder Pain
The repetitive overhead motion of serving and hitting the ball can lead to pain in and around an athlete’s shoulder. Without ample recovery time, the tissue cannot adapt to the stress, and the muscle, tendon, bone or cartilage can be damaged. If pain persists after resting the injury for a couple of days, it is best to have a medical evaluation. For further information on shoulder pain, please visit Sports Medicine

Concussions
Liberos seem to be at the greatest risk of concussions in volleyball, but a hit or fall can happen to any player. An athlete with any symptoms or change in behavior, thinking, or physical functioning after a blow to the head or body should be suspected of having a concussion. This athlete should be removed from play immediately, even if there was not a loss of consciousness. The athlete should not return to play the same day as the injury and should have a medical evaluation.

Groin Injuries
Defensive moves require rapid changes in direction and speed, which can cause the adductor muscle group (inner thigh) to become overstretched. Pain from a muscle strain to this group may occur suddenly or over time. A medical evaluation is appropriate if the condition persists or occurs repeatedly.

Low Back Pain
Back pain that persists or does not get better with rest should not be ignored. Promptly addressing it can keep it from worsening. Overuse injuries such as a stress fracture (spondylolysis) in the lower back can develop from repeated hyperextension common in volleyball. Studies have found that volleyball players with a history of ankle sprains may be at a higher risk of low back pain. Strength and conditioning programs that include core training will help to prevent back pain.

TIPS TO HELP PREVENT INJURIES IN VOLLEYBALL

Play Smart and Be Aware of the Environment 

All coaches want their players to hustle, but it is equally important to make smart plays.

Communicate
Volleyball is truly a team sport where one athlete cannot shine without the others.

Pre-Participation Evaluation (PPE) 
A PPE is an essential first step in injury prevention.

Dynamic Warm-Up
A dynamic warm-up involves continuous movement in preparation for competition or practice.

Stay Hydrated
Whether, indoors and outdoors, an athlete’s performance can be impacted by even mild dehydration.

Rest
Take a day or two off from volleyball each week to let the shoulder rest even if there are no symptoms.

Wear Appropriate Gear
Athletes should wear properly sized shoes that are tied correctly and are appropriate for the playing surface.

Learn more about pediatric sports medicine.