Take steps to avoid soccer injuries

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The right gear, including shin guards and non-absorbant soccer balls, can help prevent injuries. / SA  Read more:

With the buzz surrounding the U.S. soccer team’s trip to the World Cup in summer 2010, soccer experts predicted the sport would experience a surge in popularity among youth.

More soccer players means more chances for soccer injuries – something parents might not anticipate when they sign their children up for a team.

Nationally, more than 477,500 soccer-related injuries are treated each year, according to the American Academy of Orthopaedic Surgeons.

“It’s not as dangerous as some of the high-contact sports, but the thing about soccer is a lot of the injuries that we see are preventable,” says Randall Marx, orthopedic foot and ankle surgeon with the San Antonio Orthopaedic Group. “Simple preparation goes a long way. It’s easier to prevent injuries than it is to treat them.”

The most common injuries Marx sees are ankle sprains, contusions on the lower legs, tendonitis and plantar fasciitis. Pulled muscles, torn ligaments and broken bones also can occur.

Here’s what the experts suggest to prevent soccer injuries:

Get strong: Twisting injuries and ligament tears can happen when players are moving quickly in one direction and try to stop and change directions by planting their feet, but their muscles aren’t strong enough to withstand that force, says John DeWitt, a staff coach with the youth development system for the Houston Dynamo major-league soccer club. Strengthening muscles can protect against that type of injury.

Get smart: Kids can learn to avoid some dangerous situations. “If I’ve got the ball and I see a defender running at me really fast, getting ready to slide, then probably there’s going to be contact between my foot and their foot,” DeWitt says. “If I recognize that early, I can avoid that by jumping or changing direction.”

Get warm: Have kids warm up thoroughly because cold muscles are more prone to injury.

FIFA’s Medical Assessment and Research Centre developed a soccer warm-up called the 11+ made up of running, strength, balance and plyometric exercises, or exercises using jumping movements, which was shown to reduce injuries by up to half if performed correctly and regularly. Download videos, posters and cards at

Get the right gear: Make sure kids are wearing properly fitted shin guards to protect the lower legs, Marx says.

Shoes with cleats for good traction are a must to prevent ankle sprains. When playing in the cold, youths should dress in layers so they shed extra clothes as they warm up.

Get the field prepared: Inspect the playing surface in case there are holes in the field, which can cause a sprained ankle, Marx says. Soccer goals should be padded in case of contact and secured and stable so they don’t tip over.

Choose balls made of synthetic, nonabsorbent material, rather than leather, which can absorb water and become heavier, causing injuries.

Get a plan: Know how to administer first aid for minor injuries and have an emergency plan in place in case kids need immediate medical treatment for possible concussions, fractures or dislocations, advises the American Academy of Orthopaedic Surgeons.

Get prepared: “What we always tell our players is there are three important parts of being an athlete,” DeWitt says. “It’s training, nutrition and rest. When you … stop doing one of those three things, performance drops and injury rates increase.”

Some Tips for Staying Healthy as Soccer Season Begins

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Many kids today are playing soccer, not football … so more soccer  injuries are coming through the door at the bone doc’s office.

Dr. Randall Marx of the San Antonio Orthopaedic Group, the region’s leading orthopaedic practice, is learning a lot more about soccer simply by treating all of the soccer injuries now coming through his door.

“We see more overuse type injuries with soccer and more high impact injuries with football.”

Like most Texans, Marx grew up with football … but soccer is the sport for the younger generations.

“People are more familiar with football, and the equipment that goes with it and the injuries associated with it.”

Marx has some tips to avoid injury:

“The athletes should prepare themselves by hydrating, they should wear multiple layers, since it’s cold weather they should have layers that they can remove as the warm up, they also need to warm up and stretch and they also need to wear shin guards and cleats.”

Hips, knees thighs and calves should be play ready and warmed up … cold muscles are much more prone to injury.

He says most patients limp in with ankle sprains.

“Contusions to the lower extremity, this can be prevented with shin guards; we see shin splints in athletes that play too aggressively without progressing their activities over time.

“Lots of ankle sprains limping into the office as well as tendonitis .. and occassionally a broken bone. when pain is lingering and severe that’s the time to see the doctor. There are some 480,000 soccer injuries a year.

New Therapy Uses Patient’s Own Blood to Treat Certain Injuries

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(SAN ANTONIO) January 11, 2011 — A new therapy which uses a patient’s own blood instead of steroid drugs is continuing to yield promising results and can have powerful, localized effects in reducing pain in patients with recurring joint, neck, and back pain and various spinal conditions. What’s more is that it has no notable side effects.

The therapy is called PRP, or Platelet Rich Plasma, and in some cases offers an alternative to surgery and cortisone injections. Dr. Ephraim Brenman is The San Antonio Orthopaedic Group’s PRP specialist. His special interests include non-surgical spine care, spinal injections, pain management and electrodiagnostic medicine.

Platelet Rich Plasma (PRP) treatments involve the use of a patient’s own blood to create a plasma mixture with a high concentration of platelets which contains many all-natural healing factors including adult stem cells. During the 30-minute procedure, a tube of a patient’s blood is put into a centrifuge and spun, producing concentrated platelets. The platelets contain growth factors that accelerate tissue repair and regeneration.

The platelets then are injected into the injury site using ultrasound imaging as a guide to inject the PRP into the target tissue, simulating internal bleeding from a tendon injury simulating a patient’s own body’s natural healing agents – instead of drugs — to accelerate healing and to more quickly repair a chronic injury.

Most traditional treatments focus on reducing inflammation with medications or steroid injections. PRP accelerates tendon repair by increasing the body’s own healing agents at the injured area. Benefits of PRP include a shorter recovery time. No steroid drugs are used and no surgery is required.

The therapy was introduced in the 1970s for surgical uses in hospitals. It didn’t enter sports medicine until a decade ago. The treatment gained notice in 2008 after Pittsburgh receiver Hines Ward used it on his sprained right knee to help him play in the Steelers’ Super Bowl win over Arizona. The therapy is still very new and in some cases it’s longterm benefits are still to be determined, but Brenman says, “There are good studies in the works, and in the introduced to the area where a person is experiencing pain.

Dr. Brenman joined The San Antonio Orthopaedic® group in September of 2009. His special interests include non-surgical spine care, spinal injections, pain management & electrodiagnostic medicine. 

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The San Antonio Orthopaedic Group was established in 1947 for the purpose of providing the highest quality of orthopedic, medical, and surgical care to the regional San Antonio community, surrounding areas, and beyond. Its board certified surgeons are experienced, skilled, and subspecialty trained to care for and treat the full range of musculoskeletal disorders, diseases, and injuries to the human body in the areas of adult reconstructive, arthroscopic surgery, hand foot and ankle, spine, sports, trauma and general orthopedics. 

People On the Move – Christian A. Woodbury, M.D.

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Printed through the SABJ

Hand and wrist specialist, Christian A. Woodbury, M.D., has joined The San Antonio Orthopaedic Group, where he will treat orthopaedic conditions of the hand, wrist, and elbow and will see patients of all ages. Woodbury will see patients at the group’s Medical Center, Westover Hills and Southeast locations.

Halloween Celebration for Patients

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Patients who have to get physical therapy instead of celebrating Halloween this year were given a special treat Friday.  The San Antonio Orthopedic Group each year decorates its offices with Halloween or other scenes, right down to the exam tables.  Doctors challenge all 300 staff members to come up with the best costumes and décor. 

CEO Chris Kean said she toured all seven locations of the group’s medical offices, from Topperwein to Westover Hills, to judge the contest.

Kean: “The most impressive floor that we went to was our physical therapy department and they actually won the group award.  They were “Patellica,” which is a knock-off to Metallica, since they are physical therapists and they care of knees and patella injuries.  They produced a rock band show for our patients and they performed a couple times throughout the day.”

Kean said the event started several years ago when one of the principals of the company told the doctors, nurses and staff – “no costume, no paycheck” and since then has grown to an annual event that improves morale among staff and patients they treat.

The San Antonio Orthopaedic Group Joins National Effort to STOP Sports Injuries

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(SAN ANTONIO) October 15, 2010 – The incidence of youth sports injuries has increased at an alarming rate and now account for an estimated two million injuries, 500,000 doctor visits and 30,000 hospitalizations every year, according to the Centers for Disease Control and Prevention (CDC). The CDC also says that nearly 30 million children and adolescents participate in youth sports and nearly 3.5 million children under the age of 14 receive medical treatment for sports injuries each year. Most importantly, perhaps, the CDC says that more than half of all sports injuries in children are preventable.

The increase in injuries is linked to two different factors; the first being the increased participation of children playing sports at younger and younger ages, and the second involves those who participate in year-round play.

In September of this year, The San Antonio Orthopaedic Group and, joined with a national coalition of health care providers to promote an awareness campaign called the Sports Trauma and Overuse Prevention or STOP Sports Injuries.

The national program was created in early 2007 by the American Orthopaedic Society for Sports Medicine). Nationally, campaign partners include the, the American Academy of Orthopaedic Surgeons, the American Academy of Pediatrics, and the National Athletic Trainers Association American Association. The program focuses on prevention and education for coaches, parents, health providers and student athletes.

The San Antonio Orthopaedic Group is one of the area’s largest orthopaedic practices and the only local healthcare group to be an official supporter of this national program.

Our goal is to reach as many local parents, students, teachers, coaches, booster clubs and athletic directors as we can in order to help keep our kids safe. Our message is simple. The old adage, “No pain, no gain,” used with prior generations of athletes has changed to, “Listen to your body’s warning signals.” And everyone involved with youth sports can play a role.

The San Antonio Orthopaedic Group is dedicated to your health and supports the initiatives of the STOP program. Everyone involved with youth sports injuries can play a role in preventing injuries.

If you are a healthcare provider, student athlete, coach or parent, we encourage you to Take the Pledge to do YOUR part and participate in the movement by going to the link at visiting the TSAOG Website. Visitors to this site can learn more about the program, view podcasts, and discover injury prevention tips for the following sports and conditions:

  • Baseball
  • Basketball
  • Cheerleading
  • Dance
  • Football
  • Gymnastics
  • Running
  • Soccer
  • Softball
  • Swimming
  • Tennis
  • Volleyball
  • Heat illness
  • Concussion
  • Overuse injury

For immediate diagnosis and treatment of an athletic injury, we welcome walk-ins at the OrthoNow Urgent Care Clinic located at The Orthopaedic Institute near Jones-Maltsberger and 281. You may also schedule an appointment by calling 210.804.5424. The OrthoNow Urgent Care Clinic offers extended hours and accepts most insurance plans.

If you wish to speak with one of our Sports Medicine Institute physicians regarding specific questions on the STOP program, you may visit the “Our Physicians” section of website for contact information at

Dr. Brad Tolin is an orthopaedic surgeon with The San Antonio Orthopaedic Group. He specializes in arthroscopic and reconstructive surgery of the shoulder and knee, total knee and joint replacement; cartilage restoration procedures; and sports medicine.

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The San Antonio Orthopaedic Group was established in 1947 for the purpose of providing the highest quality of orthopedic, medical, and surgical care to the regional San Antonio community, surrounding areas, and beyond. Its board certified surgeons are experienced, skilled, and subspecialty trained to care for and treat the full range of musculoskeletal disorders, diseases, and injuries to the human body in the areas of adult reconstructive, arthroscopic surgery, hand foot and ankle, spine, sports, trauma and general orthopedics. 

Orthopaedic surgeons working to stem the rising tide of sports injuries

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Two San Antonio businesses are joining a national coalition that is seeking to reduce the number of youth sports injuries.

The San Antonio Orthopaedic Group and online youth sports magazine are teaming up to promote the Sports Trauma and Overuse Prevention or STOP Sports Injuries campaign locally. STOP Sports Injuries was created in early 2007 by the American Orthopaedic Society for Sports Medicine. Since then, local groups throughout the country have been signing on as partners.

The campaign provides information on how to reduce injuries as well as info on how playing safe and smart can actually enhance and extend a child’s athletic career. Across the United States, youth sports injuries have been growing. According to the Centers for Disease Control and Prevention, nearly 30 million children and adolescents are participating in youth sports and nearly 3.5 million children under the age of 14 receive some sort of medical treatment for sports injuries each year. An estimated half of these injuries are preventable.

Officials with San Antonio Orthopaedic Group and say their goal is to reach as many local parents, students, teachers, coaches, booster clubs and athletic directors with better tips on how to keep young athletes safe.

“Youth sports injuries are a problem that we all can do something about,” says Brad Tolin, sports medicine surgeon with the San Antonio Orthopaedic Group. “Youth sports injuries are linked to two different factors. The first is the increased participation of children playing sports at younger and younger ages, and the second involves those who participate in year-round play. The old adage ‘No pain, no gain,’ used with prior generations of athletes needs to be tempered, with a shift to one that says, ‘listen to your body’s warning signals.’ ”

The San Antonio Orthopaedic Group will provide tip sheets and articles on sports injuries on its Web site and at the company’s seven clinics. also will post information on its site. has covered 130 high schools from San Antonio to Eagle Pass, from Beeville to Burnet and from Shiner to Cotulla since 2001.

All contents of this site © American City Business Journals Inc. All rights reserved.

San Antonio orthopaedic surgeon to deliver Kessel Lecture at international congress

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Local orthopaedic surgeon Dr. Stephen Burkhart will be in Edinburgh, Scotland this week, at the invitation of the International Congress on Shoulder and Elbow Surgery (ICSES), to deliver the prestigious Kessel Lecture.

The International Congress is unique in that it showcases the latest views of thought leaders involved in shoulder and elbow surgery throughout the world, and it takes place only once every three years.

At the Congress there are instructional updates, symposia and workshops by the top surgeons in the shoulder and elbow world, and the Kessel Lecture is the cornerstone presentation of the entire Congress.

In his invitation letter to Dr. Burkhart, Professor W. Angus Wallace, president of this year’s organizing committee, called the committee’s selection of Dr. Burkhart, “unanimous,” and a “very fitting tribute to [Burkhart’s] most distinguished career in our specialty.”

Every three years ICSES is held in a different host city around the world. The first meeting was organized by Prof. Lipmann Kessell in London in 1980. Kessel was a successful surgeon based in London, and Emeritus Professor of Orthopaedics at the University of London.

Kessel is credited with organizing the first international conference on surgery of the shoulder in London in 1980. This conference is considered a landmark in defining shoulder surgery as a separate clinical entity.

Burkhart’s lecture, Expanding the Frontiers of Shoulder Surgery, takes a look at what he calls both the “challenging and exhilarating role that technology has had and will continue to have on shoulder surgery.” And Burkhart should know about technology and medicine.

The San Antonio based surgeon is credited as one of the first orthopedic surgeons in the world to use a technology known as athroscopy for the treatment of specific shoulder injuries. Arthroscopy is a surgical procedure orthopaedic surgeons use to visualize, diagnose, and treat problems inside a joint.

Burkhart said he was “humbled” by the invitation to speak to this prestigious international group. He said, “This is the largest assemblage of the top shoulder surgeons from around the world, all of whom are highly respected in the field, and it occurs only once every three years.” He continued, “This is the greatest professional honor of my career.”

Chris Kean: Chief Operating Officer, The San Antonio Orthopaedic Group

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Earlier this year, The San Antonio Orthopaedic Group decided to create its own weight-loss reality show. It launched the, “TSAOG Biggest Loser Fitness Competition.” Participants paid $20 each and were awarded a range of prizes for certain achievements.

Out of 287 employees, the program had 26 participants, 24 which stayed to see the program through. “We lost a total of 265.3 pounds,” says Chris Kean, chief operating officer.

But the group is not stopping there.

“Developing incentives like weight-loss programs are a cost-effective way to motivate our employees to improve their health and well-being, which we believe is the cornerstone to building a successful business,” say Kean. “Bottom line, healthy employees are happy employees and we will continue to invest in developing programs that have proven success, like the ones we have developed over the past few years.”

This fall, the Orthapaedic Group will also partner with Spectrum and the Virgin HealthMiles program to offer participants incentives for physical activity.

“Having our employees track their results with fun competition is a great way to promote our culture of healthy living,” Kean says. “We are excited about this partnership and look forward to seeing our results.”

Local Docs: Kids Are Overdoing Sports

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alarming increase in pediatric sports injuries called a ‘silent epidemic’

By Jim Forsyth

Tuesday, March 16, 2010


The number of childhood and teenaged sports injuries is skyrocketing to the point where orthopaedic surgeons call it a ‘silent epidemic,’ and they say it is due to the ‘alarming trend’ of young kids participating in sports year round, 1200 WOAI news reports.  

“It is certain something that we are seeing more frequently in the office nowadays,” says Dr. Casey Taber with the San Antonio Orthopaedic Group, the state’s leading practice for research and treatment into bone, muscular, and musculoskeletal injuries. 

 “They are using their bodies more than they probably should.”  

Doctors worry that overuse and traumatic joint and extremity injuries among adolescents are setting them up for a ‘lifetime of chronic pain.’ 

A report released at the annual meeting of the American Academy of Orthopaedic Surgeons this past weekend suggests ‘mandated downtimes’ for young athletes.  

“More adolescents are participating in year-round sports without seasonal breaks,” the report says. “They are playing on multiple teams simultaneously. This increased exposure means there will continue to be growing numbers of significant musculoskeletal injuries, both traumatic and chronic overuse.”  

Dr. Taber sees it in his clinic, and he doesn’t like what he sees. 

 “You are starting to see some injuries nowadays that we didn’t see years ago,” Dr. Taber says.  

He says more and more, he encounters adolescents who are participating in year-round sports, and occasionally in several sports at once. 

“They are using their bodies more than they probably should,” he said.  “The only way to prevent that is to back off to some degree.” 

He says parents need to be aware that even young, strong, and physically fit young people can suffer chronic injuries by overuse. 

The report says ‘everyone wants to get to the top,’ but adds, “we have to look at this and say, are we pushing kids too hard?  We cannot wait for kids to reach the college level to modify their training, because by that time, it could be too late.’ 

Orthopaedic surgeons point out that college and pro sports governing bodies regulate how much practice, when practice can begin, and how many sports people can participate in, but frequently, there is none of that regulation at the grade school and high school level, where the potential for lifelong damage is the greatest.


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