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Students learning how to treat injured athletes on the high school sports field

“We’re bringing together the student athletic trainers, the head school athletic trainers, Dignity Health athletic trainers, team physicians and emergency medical technicians, who would potentially take care of a high school athlete that is injured on the field of play,” said Dr. Matt Hansen, OrthoArizona sports medicine specialist.

All of these medical professionals and students are taking part in the second annual Field to Emergency Room event at Hamilton High School in Chandler.

They’re running through drills on how to work together when a student-athlete has injured his or her spine or other emergency situations on the sports field in the Gilbert Public Schools and the Chandler Unified School District.

“You could potentially take someone who has a bad injury and make it worse if we don’t treat them correctly,” Hansen said.

Hansen is the medical director of the sports medicine program in both school districts.

The program kicked off in Gilbert first and now Chandler this fall.

“Our sports medicine program between Dignity Health and OrthoArizona began about three years ago,” Hansen said. “We wanted to raise the level of care to something similar that you would have at a collegiate level.”

OrthoArizona physicians and Dignity Health athletic trainers work with the high school medical staff to make sure each student-athlete is given the best possible care. This includes hosting educational events like this one, providing sports physicals, being on the field during games and holding special office hours for student-athletes.

“It’s good for them to get hands on, so they understand the demands that we’re under when caring for that athlete,” Gary Cohen said. Cohen is with Dignity Health and is the head athletic trainer at Casteel High School in Chandler.

He likes the partnership with the orthopedic physicians and working with the student-athletes.

“They love having us on the sidelines and being able to identify things that might not be an injury necessarily, but we’re identifying that predisposed risk,” Cohen said.

“We’re getting an athletic trainer that is trained in all the latest techniques and protocols and putting them into the schools, so that all of these athletes at these schools have access to that trainer and those trainers are directing the athletes who are injured into our offices,” said Dr. Shelden Martin, OrthoArizona sports medicine specialist.

Martin is overseeing the Chandler sports medicine program. He believes the sports program they have put in place does much more than treat student-athletes’ injuries.

“Our job goes beyond fixing their injury surgically,” Martin said. “It’s counseling and coaching them, so to speak, and really setting their expectations and what to expect. You develop a bond in that relationship and that’s what it’s all about for us as the orthopedic surgeons.”

Student-athletes in Chandler getting new sports medicine services

“The job as a certified athletic trainer has changed tremendously since I started,” said Lance Michel, head athletic trainer at Hamilton High School in Chandler.

Michel has been at the high school for 17 years. He helps student-athletes get back to their sport after suffering an injury.

“They’re all working hard and they want to go out and compete and have fun,” Michel said.

Michel will be getting help this year from OrthoArizona and Dignity Health.

The two groups are providing sports medicine services at the five high schools and five junior high schools in the Chandler Unified School District.

OrthoArizona and Dignity Health have a similar program in the Gilbert Public Schools.

“The whole idea behind this program is elevating that level of care to the same level that we deliver to Division I universities or even the professional teams,” said Dr. Shelden Martin, OrthoArizona sports medicine specialist.

Martin will lead the sports medicine program team. He and four other physicians will be assigned to Hamilton, Basha, Casteel, Chandler and Perry high schools. Dignity Health will provide the athletic trainers.

“It involves not just the team physicians on the sidelines with the athletic trainer for all of the games, but it also involves a lot of education,” Martin said.

Education, sports physicals and prevention methods are just a few of the services they will offer.

“A lot of times these patients or athletes will have an injury and their parents don’t necessarily know where to take them,” Martin said. “Maybe they’re in a sport like cross country or volleyball that doesn’t necessarily have the athletic trainer at that game or practice and the injury doesn’t get recognized until the athlete gets home and their parents notice they’re limping.

“This program can help prevent that from happening,” Martin continued.

This includes offering a walk-in injury clinic at a new OrthoArizona location near the Dignity Health Chandler Regional Medical Center.

“This walk-in injury clinic from 7 to 8 a.m. every day, MondayFriday, is perfect for that scenario because now those parents will know that there is a place they can take them where they will be getting appropriate diagnosis and treatment by orthopedic surgeons,” Martin said.

These are sports medicine services that can be a game changer.

“It’s great to have that accessibility because, once again, sports don’t stop,” Michel said.

“It’s 100 mph full throttle all the time and they [OrthoArizona and Dignity Health] understand the commitment that it takes and that’s what I like about it.

“From what I can see, we’re going to have a great relationship,” Michel said.

Soccer player coming back strong after ACL injury

“Raph Colasito has been spending a lot of time at the Foothills Sports Medicine Gilbert Mesa location.

He and owner/treating physical therapist Matt MidKiff have been working on strengthening his right knee.

“We did a treatment called augmented soft tissue mobilization,” Midkiff said. “[This is] a tool-assisted method with what are called wash out tools and that allows us to break up scar tissue.”

Colasito tore his ACL during a tournament with his club team SC Del Sol in February.

“Beginning of the second half, I went to tackle at midfield and as I was driving and getting away from the person I wanted from, him and his teammate sandwiched me and one of the players came across my knee and then my knee came out and as I was falling I heard three pops,” Colasito said.

“He presented with me a little bit late and so he already had a little bit of stiffness and so we did what is called pre-rehab and we worked on his range of motion before surgery,” said OrthoArizona sports medicine specialist Dr. Shelden Martin. “It’s always better to have good range of motion, good quadriceps control and normal gait before go in and do an ACL reconstruction.”

Martin did Colasito’s surgery in April.

“A lot of times it’s an issue of educating these patients and athletes about the recovery period and understanding this is kind of a year out of their life,” Martin said.

The doctor and Midkiff have been working together to help Colasito recover from his injury.

“The first six weeks after surgery are really just controlling swelling and getting range of motion back,” Martin said. “After that it’s really working on getting that quad muscle to start and getting back its strength and its bulk and that takes many months.

“When you get to three months is when we start progressing to running and four months and beyond is more sports-specific activities like jumping, cutting, twisting, pivoting and training in three planes of front to back, side to side, up and down,” Martin continued.

The 18-year-old is more than four months out from his surgery.

“Once they get passed that four-month time frame, it’s kind of as strong as it will be,” Midkiff said. “The bone is healed around the grafts and ultimately we can start to challenge the knee with difficult and more lateral and rotational patterns.”

Colasito is working hard to not only get back to the sport that has been part of his life since he was 3 years old, he wants the opportunity to try out for the Division I men’s soccer team at Grand Canyon University in the spring.

He will be a freshman in the fall.

“Before this I wanted to rush into things, but with all the people who I know that have torn their ACL, they said take your time and that’s helped me with my patience a lot,” Colasito said.

Patience and a never-give-up attitude can go a long way.

“I hope when they see this that it pushes them to stay focused and there is always a way,” Colasito said.

3rd Annual ACL Injury Prevention Clinic

Watch the recap from my ACL Clinic for young athletes, coaches and trainers and learn more about ACL injury prevention. The event was in partnership with the Arizona Rattlers, Spooner Physical Therapy and Don Joy.

Also watch a showcase with Spooner Physical Therapy the exercises performed on the field at the 3rd Annual ACL Injury Prevention Clinic.

ACL awareness for high school athletes

“I do ACL surgery for a living, but obviously we have an interest in educating the community and if we can prevent an athlete from being injured that’s certainly our preference to do that,” said OrthoArizona sports medicine specialist Shelden Martin.

Martin is also the head team physician for the Arizona Rattlers.

He tries to bring awareness to this condition with his annual Rattlers ACL Injury Prevention Clinic at the Talking Stick Resort Arena.

Valley student-athletes, coaches, physical therapists and athletic trainers got a chance to listen to Martin’s presentation and learn how exercises from the Spooner Physical Therapy crew can help in preventing ACL injuries.

“This is the patient population that has the highest rate of ACL injuries,” Martin said. “Football players, soccer players and really that young female category between the ages of 15 to 25, they’re the most vulnerable.”

“Our goal is to get all those athletes out on the field,” said Torrey Foster, Spooner Physical Therapy Scottsdale clinical director. “When we look at the reason it gets so much attention is the duration it takes to get back can be anywhere from six months to a year that’s a long time.”

“This is a dedication that’s constant to be working hard for that amount of time and to make sure that your doing that to perform well to minimize risk of injury again,” Foster continued.

Spooner Physical Therapy is another partner in the ACL injury prevention clinic with OrthoArizona

“Many people miss out on hitting all three planes of motion when it comes to the training,” Foster said. “The exercises that we do to prevent an ACL injury are the exercises to some degree at different levels that we do for rehabilitation as well.”

The three planes of motion Foster is talking about are sagittal (front to back), frontal (side to side) and transverse (rotational movements).

Doing this during training can increase an individuals range of motion and prevent injuries.

“This is the first time I’ve had a chance to be in a room with the professional and understand precisely what’s going on, ask questions, ask follow-up questions and learn current research and of course now, I’m more zeroed in on the preventive side,” said Excel Soccer Academy coach Corbett Hess.

Hess plans on bringing some of what he learned at the clinic into his teams’ warm-ups.

“We’re not going to be able to do all of those things in a particular night, but over the course of a training curriculum that we’re hitting all three of those planes and making sure that we’re doing what we can as coaches to protect our athletes,” Hess said.

The student-athletes not only got a chance to learn about preventing ACL injuries, the clinic included a tour of the arena and watching the Rattlers in action.

“These athletes want to play sports,” Martin said. “They don’t understand what the ACL is and why it’s torn. I think increasing that awareness and education can potentially help these kids decrease injury rates.”

Contact Dr. Martin if interested in having an ACL Injury Prevention Clinic at your school or club organization.

Females prone to ACL injury

Members Of Female High School Soccer Playing MatchThe words “You have an anterior cruciate ligament (ACL) injury” are ones that no athlete wants to hear, but it does happen.

In fact, more than 200,000 ACL injuries take place in the United States every year.

The knee injury can occur during sports when an athlete makes contact with another player or in a non-contact situation by how they land from a jump or plant their foot.

Some athletes will hear or feel a popping sound in their knee and immediate symptoms include pain, swelling and not being able to walk.

Research shows that female athletes are also more likely to tear their ACL than a male.

“In the 12- to 18-year-old age category, some sources state that females are eight times more likely to tear their ACL than a male,” said Dr. Shelden Martin with OrthoArizona.
Martin said it also depends on the sport.

“The sports with the highest rate of ACL injuries for females are basketball and soccer.” Martin said. “We don’t have solid data to prove our suspicions, but intuitively we believe that there are a number of biological and anatomical factors that predispose females to having higher rates of ACL tears than males.”

One factor is that females have a wider pelvis than males.

“This creates a greater angle of the femur as it approaches the knee, creating an increased valgus alignment at the knee, or a more “knock-knee” alignment,” Martin said. “We know the greater the valgus angle, the greater the risk for an ACL injury.”

The second factor is the width of the gap inside the knee between the two ends of the femur bone called the condyles. This gap, called the intercondylar notch, where the ACL ligament travels, tends to be narrower in females and could cause impingement on the ligament during extremes of motion, leading to injury.

“The intercondylar notch is seen to be quite narrow in many female patients at the time of ACL reconstruction surgery,” Martin said. “One of the important steps of the surgery is to widen this notch prior to passing the graft to allow appropriate space for the graft.”

Martin said females have hormonal factors that can contribute to ACL injury.

“Estrogen causes ligament laxity, or relaxation, and females have higher estrogen levels than males,” Martin said. “If they have more ligamentous laxity, they’re going to be more prone to tearing their ACL.”

Additionally, females also tend to have weaker hamstrings and hip abductors compared to males, which can lead to improper landing technique when striking the ground landing from a jump. This can place the knee in a more vulnerable position for an ACL injury.

The recovery time for this type of injury is different for every patient. It can be anywhere from six months to a year.

“The return to play rate, depending on the study you read, is somewhere in the range of 75 to 95 percent,” Martin said. “We have a high rate of getting these athletes back, but we still have significant room for improvement.”

So how can we prevent ACL injuries?

Martin believes females and males potentially can decrease their risk for an ACL injury by proper training, using certain exercises to help keep their muscles strong around the knees, thighs and hips.

“As athletes continue to become stronger and faster with more advanced training techniques, we continue to see increasing rates of ACL injuries,” Martin said. “It’s, therefore, critical that athletes at all levels implement specific exercises and training techniques into their preseason and offseason regimens to do all they can to decrease their risk of an ACL injury.”

The doctor has an ACL Injury Prevention Clinic he uses to teach young and professional athletes.

“We take these athletes through an educational session that gives them the basic information about the ACL and then teaches them training programs utilizing different types of preventive exercises,” Martin said.

While there is not enough data out there yet to determine if these ACL prevention techniques are working, Martin believes it’s still important to implement.

“I think the ACL Injury Prevention Clinic educates athletes about one of the most common and devastating injuries an athlete can sustain,” Martin said. “Our hope is that this clinic will give these athletes an awareness of this injury and tools to hopefully prevent an ACL injury.”

If interested in having Martin conduct an ACL Injury Prevention Clinic at your school or sports club organization, contact Dr. Martin.

Phoenix Orthopedic Surgeon Shelden Martin Receives ABOS Subspecialty Certificate in Orthopaedic Sports Medicine

The American Board of Orthopaedic Surgery (ABOS) has granted the Subspecialty Certificate in Orthopaedic Sports Medicine to Phoenix orthopedic surgeon Shelden Martin, MD, of OrthoArizona – Arizona Orthopaedic Associates.

The certificate is bestowed upon board-certified orthopedic surgeons who have demonstrated qualifications in sports medicine beyond those expected of other board-certified orthopedic surgeons. Those who receive the certificate must have additional training in sports medicine, have a practice characterized by a majority of cases in sports medicine and have contributed to the field.

“Throughout the years, I’ve dedicated my career to sports medicine,” Martin said. “Earning my Subspecialty Certificate in Orthopaedic Sports Medicine is a reflection of my experience and focus in the field. I’m honored to have my work in sports medicine recognized by The American Board of Orthopaedic Surgery.”

To receive a Subspecialty Certificate in Orthopaedic Sports Medicine, orthopedic surgeons must meet specific criteria, including completing a one-year Accreditation Council for Graduate Medical Education (ACGME) fellowship and submitting a case list of at least 115 operative cases, 75 of which must involve arthroscopy, and 10 non-operative cases.

Those who receive the ABOS Subspecialty Certificate in Orthopaedic Sports Medicine must also pass a four-hour examination that evaluates each surgeon’s cognitive knowledge relevant to sports medicine.

As an experienced OrthoArizona – Arizona Orthopaedic Associates surgeon, Martin has distinguished himself in the field, serving as head team physician for the Arizona Rattlers and associate team physician for the Arizona Diamondbacks, the Arizona Coyotes and the Chicago White Sox. He is also team physician for Desert Vista High School, Veritas Preparatory Academy and Neptune Swim Club.

“We’re happy to congratulate Dr. Martin on this outstanding achievement,” said David Ott, MD, president of OrthoArizona – Arizona Orthopaedic Associates. “He’s a dedicated surgeon whose work in sports medicine brings distinction to our team of experienced orthopedic surgeons.”

Martin graduated from Georgetown University, completed his orthopedic residency at Loyola University and his fellowship in sports medicine at OrthoCarolina. He specializes in complex arthroscopic surgery, including ligament reconstruction, cartilage transplants, shoulder and elbow joint replacements, and reverse shoulder replacements.

Overuse injuries in throwing athletes

The baseball season is in full swing across the Valley.

Young athletes are hitting the fields to perfect their skills, but sometimes they can get hurt.

Overuse injuries in throwing athletes are something doctors across the country are treating a lot of these days.

Dr. Shelden Martin with OrthoArizona talked about a few of those injuries and how to get young players back out on the baseball field.

The first condition that Martin sees is something called Little League Shoulder.

“This is a condition caused by repetitive stress that goes through the cartilage growth plate in the upper part of the humerus bone,” Martin said. “The cartilage growth plate is the weak link of the system and receives all of the stress.”

Little League Shoulder is commonly seen in pitchers and throwing athletes.

“It can cause pain, stiffness in the shoulder and lead to decreased throwing velocity,” Martin said. “The patients are also usually tender when I push on the upper part of their arm.”

Martin can diagnose this condition during a physical exam in his office and with an X-ray.

“The X-ray may show an abnormality at the growth plate,” Martin said.

When it comes to treating Little League Shoulder, rest and physical therapy can usually resolve the problem.

The next injury that Martin sees in pitchers and throwing athletes is something called Glenohumeral Internal Rotation Deficit.

“In order to throw a baseball at 90mph, the pitcher has to be able to fully externally rotate their arm at their shoulder,” Martin said. “So they undergo adaptations where they gain more external rotation but it’s at the cost of losing internal rotation.

“Overall the net arch of their shoulder rotation decreases and causes pain, stiffness and decreased throwing velocity,” Martin continued.

Once diagnosed the treatment strategy involves stretching exercises.

“The athletes will perform sleeper stretches to work on regaining that internal rotation and stretching out the posterior capsule in the shoulder which tightens up overtime,” Martin said.

The last condition is Little League Elbow.

“The athletes feel pain on the inside part of the arm,” Martin said. “ What is happening is there is stress going through the growth plate in the end of the humerus bone just above the elbow joint.

Martin sees Little League Elbow in ages 12 to 16 as well as older individuals.

“After the growth plates have closed and the athletes continue down the route of throwing excessively and repetitive use, this can lead to what is called a Tommy John injury,” Martin said.

Surgery is an option to repair the injured elbow ligament in this instance.

Younger athletes can be treated for Little League Elbow with rest and physical therapy to work on their throwing mechanics and core strengthening.

For more information visit Dr. Martin’s injury prevention section.

Injury prevention tips to keep you out on the pickleball court

Pickleball is one of the fastest growing sports in the U.S. It combines many elements of tennis, badminton and ping-pong.

Athletes of all ages and skill levels play this game, but like any sport, injuries can occur.

“Those types of injuries tend to be sprains and strains, tendonitis type problems, rotator cuff tendonitis, tennis elbow, Achilles tendonitis and a lot of these athletes also have arthritis in their knees and shoulders as well,” said Dr. Shelden Martin with OrthoArizona.

Martin was talking to athletes about injury prevention at the USA Pickleball Association Nationals Tournament in Casa Grande.

“Stretching before you go play a game is a good idea,” Martin said. “Warm up can be up to 15 minutes of just getting your heart rate elevated, breathing rate up, and blood flow into your muscles, so you’re not prone to tearing a muscle or tearing a tendon or ligament.”

Stretching and making sure you go see a doctor when symptoms from an injury don’t go away is key to getting back to your sport.

“If this is an injury, pain or strain that is continuing to give you symptoms up to a week, then it’s probably time to get it checked out,” Martin said “It’s our job to be able to keep these athletes active and hopefully most times they won’t need surgery, but if they do that’s our goal with surgery to try and allow them to continue being active.”

Pickleball player Jan Brannan has had her fair share of injuries since picking up the sport four years ago in Houston, Texas.

“As I tell people, I sprained, strained and broke everything I owned that first year,” Brannan said.

She may have had a lot of aches and pains, but Brannan takes care of her injuries so she can get back on the court.

“I think it’s wonderful he’s willing to give of his time to come out and help people prevent injury and answer the questions we have, because a lot of people don’t have access to medical people,” Brannan said.

“I look at it as education being the main benefit for us going out into the community at these different events,” Martin said.