Detroit Tigers Jose Iglesias Out With Stress Fractures — Why?  Dr. Bicos talks Stress Fractures…

Spring is in the air. The snow is melting, and as we wrap up the basketball March Madness, the only thing left is opening day of baseball – hot dogs, peanuts and popcorn, the crack of the bat. But the Tigers will be without Jose Iglesias for the ENTIRE 2014 season due to stress fractures in his legs! How can this be? What are stress fractures and are they that bad that he cannot play the entire season?

Let’s go back to March 31, 2013, almost one year ago, in the first half on an Elite Eight matchup between Louisville and Duke during the NCAA tournament in Indianapolis, IN. A player by the name of Kevin Ware attempted to block a 3 point shot, landed awkwardly, and broke his shin bone in half on prime time TV. Not only did he break his leg in half, but the bone came protruding out of his skin.

Massive traumatic sports injuries like that, after just landing from a jump, are almost always caused by a stress fracture or a stress reaction to the bone. It is as if the bone is “hanging on by a thread” and it just takes that one awkward maneuver for the whole thing to go.

This is why Jose Iglesias is benched for the entire season and basically has to do non-weightbearing conditioning (i.e. he can’t put weight on both his legs) for the next 3 – 6 months. Stress fractures are real, stress fractures are dangerous, and stress fractures can lead to devastating injuries.

How do stress fractures happen?

A stress fracture is the last part of a chain of injuries that can happen to a bone. Most of the time, we never reach a stress fracture because the body tells us that it is in pain, so we limit our activities. It is in situations where we do not listen to our body and ignore the pain, that the injury progress down the pathway that leads to a real fracture.

Our bones are alive, and even though they don’t look like they do much except support our body, they are constantly being replaced by new bone. When we are very young, that new bone growth adds to our height, but when we stop growing, our bones need to be maintained. There is a constant balance between the body removing old bone and replacing it with new bone. That is why we are better than machines – we can technically heal ourselves with new bone or skin, while machine parts can only wear out.

As we place stress on our body, you can think of it as wearing down some bone. That is actually healthy for our bodies, because we put down new bone in response to stress. Hence, we recommend an active lifestyle as one of the preventers of osteoporosis (or brittle bones). But…and this is important…you can do too much damage to the body so that the body can’t keep up with the amount that it has to repair. This is technically the beginning of the chain of events that lead to a stress fracture. The chain of events has many “checkpoints” that our body builds in. There is pain to let us know that we have done too much. There is swelling also to let us know that we have done too much. But if we disregard these clues, bad things can happen.

The chain of events is broken down to normal bone, painful bone, stress reaction, and stress fracture.

If you ever have a chance to look at an old foundation of a house, you see cracks. The cracks are usually small enough that the house does not collapse. The smaller cracks are the same as a stress reaction on a microscopic level. There are certain situations that the cracks develop into a size where part of the house actually collapses – this is a stress fracture.

A stress fracture of the shin bone.  (Red arrow points to stress fracture)

A stress fracture of the shin bone. (Red arrow points to stress fracture)

What is the treatment for a stress fracture?

REST!!! What a stress fracture or even the precursor to a stress fracture is telling us is that the balance between making new bone and taking new bone away is off. The easiest way to correct that balance is rest. Often times, this is the hardest thing for athletes to do, because they are either in season, training in the off-season, or competing in too many sports. I routinely hear the words, “I can’t take any time off because…”, and the excuses are many, ranging from “If I take time off I will lose my position”, “If I take time off I will be kicked off the team”, or “If I take time off I will fall behind the other kids”.

But my point of view is that if you do not take time off you can end up with a catastrophic injury like Kevin Ware, where you have your shin bone sticking out of your skin. These injuries are not made up, they are real.

Your sporting career is not a sprint, it is a marathon. And from that standpoint, you need to give your body adequate time to heal.

Even though Jose Iglesias has stress fractures in both legs, what is he doing? Resting!!

One can say that he has already made it in his profession and that as a high school kid there is even more to prove, but if the pain you have is not letting you reach your true potential, then you are not doing your self any favors.

Bottom line?

Seek out someone who understands athletes and what the pressures are that they face. This is typically a fellowship trained sports medicine physician, such as the ones found at Performance Orthopedics. From there, listen to what they say, because the only thing we want to see is for you to get back in the game, what ever your game may be.

Catch Dr. Bicos on BCTV!

Dr. Bicos does an interview with The Community House on his upcoming shoulder lecture in April.

You can catch the show this week:

Tuesday at 7:30pm
Wednesday at 8pm
Friday at 2pm

Comcast Customers:
In Bloomfield Hills and Bloomfield Township BCTV is on Channel 15. In Birmingham, Beverly Hills, Franklin and Bingham Farms BCTV is on Channel 18.

AT&T/U-verse Customers:
In Bloomfield Hills, Bloomfield Township, Birmingham, Beverly Hills, Franklin and Bingham Farms BCTV is on Channel 99.

WOW! Customers:
In Birmingham, Beverly Hills, Franklin and Bingham Farms BCTV is on Channel 18. BCTV is not available to Bloomfield Customers on WOW!

Sports Medicine Conference 2014 Registration – Sports Medicine from Head to Toe

The 11th Annual Sports Medicine Conference is Saturday, May 3rd, 2014 at William Beaumount Hospital Royal Oak Campus in the AB West Auditorium of the Administration building. Conference doors will open at 8:00am and presentations will begin at 8:30am and continue until 1:00pm. Our conference is free of charge, and continuing education units (CEU’s) are offered for those in attendance. All attendees are encouraged to register prior to the conference so that we provide adequate services for everyone who attends. Thank you!

For more information, click here.

Register Now!

Dr Bicos talks about shoulder pain on Bloomfield Community TV!

Dr Bicos talks about his upcoming lecture at The Community House. His lecture is set for April. Please visit The Community House website to register for his talk!

Please see the BCTV video for his interview on this topic.

“Dunk Out” Injuries This Basketball Season

For more information, contact:
Dr. Joseph Guettler
Performance Orthopedics
248-988-8085

For Immediate Release
3/1/2014

‘Dunk-Out’ Injuries this Basketball Season
Dr. Guettler provide pointers to prevent basketball injuries

Photo: Kirby Lee/Image of Sport-US PRESSWIRE

Photo: Kirby Lee/Image of Sport-US PRESSWIRE

Royal Oak, MI—Whether participating in recreational outdoor games, playing on a school team or competing professionally, basketball is one of America’s most popular sport pastimes. With more than 28 million people of all ages taking part each year in this high-impact, extremely charged sport, the potential risk for injury is great. The American Academy of Orthopaedic Surgeons (AAOS) urges players to heed appropriate safety precautions and condition properly to minimize potential musculoskeletal injuries.

According to the U.S. Consumer Product Safety Commission, in 2011 more than 1.4 million people were treated in doctors’ offices, clinics and emergency rooms for basketball-related injuries. Among the most frequent are wrist or finger sprains and fractures, and twisting and impact injuries to the foot, ankle and knee.

“The majority of basketball injuries result from overuse, improper conditioning and trauma,” stated Dr. Joseph Guettler, Orthopedic Sports Medicine Surgeon with William Beaumont Hospital. “To avoid injury, it is important to stretch properly and participate in conditioning programs, such as cardiovascular training, core (abdominal area) strengthening and flexibility exercises.”

As part of the AAOS Prevent Injuries America! ® Campaign, orthopaedic surgeons would rather prevent injuries than treat them. Consider the Academy’s basketball safety tips:
Wear appropriate equipment. Shoes should fit snugly and offer support. Ankle braces can reduce the incidence of ankle sprains in patients with a history of injury (this should be discussed with your doctor); protective knee and elbow pads can protect players from bruises and abrasions. Consider wearing a mouth guard. Do not wear jewelry or chew gum while playing. Other helpful equipment may include eye protection, ankle braces or sports tape.

Ensure a safe play environment. Outdoor courts should be free of rocks, holes and other hazards. Players should avoid playing on outdoor courts that do not have appropriate lighting. Indoor courts should be clean, free of debris and have good traction. Baskets and boundary lines should not be too close to walls, bleachers, fountains or other structures. Basket goal posts, and the walls behind them, should be padded.

Maintain fitness throughout the year. Ideally, players should maintain an exercise and training regimen during the basketball season, and throughout the year.

Warm up before play. Consistent warm up and stretching exercises may reduce injuries. Warm up with jumping jacks, stationary cycling, or running or walking in place for three to five minutes. This should be followed by slow and gentle stretching, holding each stretch for 20-30 seconds. Stretches should focus on the legs, spine, and shoulders. A player should also stretch after their practices or games.

Safe Return to Play. An injured player’s symptoms must be completely gone before returning to play. The player must have no pain, no swelling, full range of motion, and normal strength and should be cleared by the appropriate medical provider.

Stay hydrated. Even mild levels of dehydration can hurt athletic performance. Ideally, players should drink 24-ounces of non-caffeinated fluid two hours before exercise, and additional 8-ounces of fluid or sports drink immediately before play. While playing, break for an 8-ounce cup of water every 20 minutes.

Use proper passing and play techniques. Practice good technique. For example, when you jump for the ball, land on a bent knee rather than a straight knee. Play only your position and know where other players are on the court to reduce the chance of collisions. Do not hold, block, push, charge, or trip opponents. Use proper techniques for passing and scoring, and most importantly, don’t forget sportsmanship!

Prevent overuse injuries. Because many young athletes focus on just one sport and train year-round, doctors are seeing an increase in overuse injuries. The AAOS has partnered with STOP Sports Injuries to help educate parents, coaches, and athletes on how to prevent sports injuries. STOP Sports Injuries recommends limiting the number of teams in which your child is playing on in one season. In addition, do not let your child play one sport year round; taking regular breaks and playing other sports is essential to skill development

Performance Orthopedics – Keeping you in the game, whatever your game may be!

Avoid Getting Sidelined This Winter

For Immediate Release
2/19/14

Avoid Getting Sidelined This Winter
Orthopaedic surgeon provides tips to prevent winter sports injuries

Bloomfield Hills, MI ⎯ At the sight of the first snowfall, kids and adults alike are eager to enjoy the variety of winter sports available. Hours of recreation are spent on activities ranging from sledding, snow skiing and tobogganing to ice hockey, ice skating and snow boarding. But according to the American Academy of Orthopaedic Surgeons, if the proper precautions are not taken to ensure warmth and safety, severe injuries can occur.

Winter sports injuries get a lot of attention at hospital emergency rooms, doctors’ offices and clinics. According to the U.S Consumer Product Safety Commission, more than 310,000 people were treated in hospitals, doctors’ offices and emergency rooms in 2012 for winter sports-related injuries. Specifically:
• more than 40,000 injuries were caused by sledding;
• 97,713 by snowboarding;
• 119,715, snow skiing; and,
• nearly 53,000 by ice skating.

“Countless numbers of winter sports injuries happen at the end of the day, when people overexert themselves to finish that one last run before the day’s end,” explained Dr. James Bicos, Orthopedic Sports Medicine Surgeon with William Beaumont Hospital. “A majority of these injuries can easily be prevented if participants prepare for their sport by keeping in good physical condition, staying alert and stopping when they are tired or in pain.”

The American Academy of Orthopaedic Surgeons urges children and adults to follow the tips below for preventing winter sports injuries:

Sledding
Numerous sledding injuries are caused by collisions at the end of sledding paths and/or sledding in improper positions. Click here to read a detailed list of safety tips to help reduce these injuries.

Snowboarding and Skiing
Many snowboarding and skiing injuries can be avoided by utilizing appropriate equipment, ensuring a safe environment and following all rules of these sports. Click here to read a full list of snowboarding and skiing safety tips.

General winter sports safety tips:
• Consider participating with a partner. If possible, skiers and snowboarders should stay with a partner and within sight of each other. Also, make sure someone who is not participating is aware of your plans and probable whereabouts before heading outdoors.
• Check the weather for snow and ice conditions prior to heading outdoors. Pay attention to warnings about upcoming storms and severe drops in temperature. Make adjustments for icy conditions, deep snow powder, wet snow, and adverse weather conditions.
• Dress for the occasion. Wear several layers of light, loose and water- and wind-resistant clothing for warmth and protection. Also wear appropriate protective gear, including goggles, helmets, gloves and padding and check that all equipment, such as ski and snowboard bindings, is kept in good working order.
• Warm up thoroughly before playing and exercising. Cold muscles, tendons and ligaments are vulnerable to injury. It’s important to warm up by taking it easy on the first few runs.
• Know and abide by all rules of the sport in which you are participating. Take a lesson (or several) from a qualified instructor, especially in sports like skiing and snowboarding.
• Always carry a cell phone in case of an emergency.

Click here to read more safety tips.

More tips:
Winter sports safety

For more information, contact:
Dr. James Bicos
Performance Orthopedics
248-988-8085

Dr. Bicos to talk on shoulder pain at The Community House

Come attend a free lecture on Shoulder Pain — It’s Common Causes and Treatments by Dr. Bicos at The Community House in Birmingham, MI, on Wednesday, April 23rd from 6:30 – 8:30 PM.

Dr. Bicos will discuss the anatomy of the shoulder in terms you can understand, the most common tests that help us diagnose your shoulder pain, and the 5 most common causes of shoulder pain with their treatment options.

Be prepared when you go and see your physician on the questions to ask!

Dr. Bicos is a board certified Orthopedic Surgeon who specializes in cartilage restoration, shoulder injuries (rotator cuff, shoulder replacement, dislocations), and sports related knee injuries.

He is on staff at William Beaumont Hospital with the Department of Orthopedics. Dr. Bicos is the team orthopedic physician for the USA Gymnastics Team and was named Top 10 Sports Surgeons by Sports Illustrated Magazine in 2012.

You can register by calling 248-644-5832 or by visiting The Community House website.

You can also see the TCH flyer below…

Dr. Bicos talks on the 5 most common causes of shoulder pain.

Dr. Bicos talks on the 5 most common causes of shoulder pain.