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Sports Injuries

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.

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.

How to stay safe when playing sports?

When the time comes for a young athlete to play their sport, there are a variety of things that need to be done before they take the field.

One of those is making sure they have the right equipment.

“Wearing the proper equipment is essential to help prevent injury,” said Dr. Shelden Martin with OrthoArizona. “This applies to all sports, from organized contact sports like football to recreational solo activities like mountain biking.”

According to a recent Health Day article, one of those recreational activities was skateboarding. In 2011, skateboarding accidents accounted for more than 78,000 trips to the emergency room.

“I don’t think people think about injuries when being active, and particularly how prevalent injuries are, especially in organized sports like football or soccer,” Martin said.

Common injuries that Martin sees affecting young people vary from sport to sport, but in general include strains, sprains, fractures and torn ligaments.

“You can see injury in almost any activity whether competing in organized sports or just participating in solo activity,” Martin said. “Fortunately, most of the minor injuries I see don’t typically require surgery.

“However, more severe injuries like fractures and ligament tears, in general, will require surgery,” the doctor continued.

Martin believes educating young people about wearing the proper equipment is a step in the right direction when it comes to preventing trips to the emergency room.

“It’s important to properly check your equipment before use to ensure it is in proper working order,” Martin said. “For instance, you should make sure you don’t have cracks in your helmets, pads, or guards.”

While supervised sports typically have coaches, athletic trainers, and equipment managers keeping an eye on the equipment, Martin believes parents can play a big part in the non-group sports.

“Parents should help their youth athletes and educate them about properly checking equipment and making sure everything is up to date and in good working condition prior to use,” Martin said.

Young athletes and baseball injuries

pitcher delivers a fastballIf you drive by any park across the country, you will probably see athletes throwing a baseball around.

It’s a sport more and more young athletes are playing year-round, and that means it comes with its share of injuries.

According to two recent studies, young baseball players feel pressure from parents or coaches to play despite arm pain. Additionally, most pitchers’ parents are unaware that safe pitching guidelines exist.

“When these young athletes pitch too many games a week and throw too many pitches during a game, or play in multiple leagues, it’s going to cause overuse injuries,” said Dr. Shelden Martin with OrthoArizona. “I see a lot of these patients in my office between ages 10 to 18 because they’re overusing their arms, causing shoulder and elbow pain.

“They’re not allowing enough time for their body to rest and recover,” Martin continued.

Rest is one of the best things a young athlete can do when they feel pain.

“By playing through pain, these athletes are causing further injury, typically to the cartilage growth plates in the shoulder and elbow. At some point, if they continue to play through that pain and just keep pushing it to the point where they can’t throw, they can cause serious injury.

Martin went on to say, “Although these athletes rarely require surgery, their recovery period can be prolonged by playing through pain and not seeking medical intervention.”

“What is especially helpful for baseball pitchers while recovering from injury is getting them into sports performance therapy to focus on their pitching mechanics, core training and strengthening” Martin said. “This ensures that they have appropriate throwing form and pitching mechanics which leads to longevity in baseball.”

“If they have poor throwing form and mechanics, they’re not going to last long in baseball,” he continued.

Martin said educating parents and athletes on the guidelines to safe pitching is an important step to decreasing rates of player overuse injuries.

“Dr. James Andrews, founder of American Sports Medicine Institute in Birmingham, Alabama, has been a leader in this area in terms of trying to educate parents, athletes, coaches and trainers about what is safe,” Martin said.

Pitch Smart is a program that has implemented guidelines for safe pitch counts and appropriate rest between outings for youth athletes.

“There are very well defined parameters in terms of how many pitches a pitcher may throw based on the age of the athlete,” Martin said. “The younger they are, the less pitches they should be throwing per outing and the less frequently they should be pitching.”

These guidelines can help put parents at ease.

“The majority of parents want the best for their kids and they want to do the right thing,” Martin said. “Once I see these athletes in my office with the parents and educate both the athlete and the parents, usually the parents even want to error on the side of making their child rest longer than they might need to because they care about them.”

Martin has additional advice for young baseball players.

“The best advice I give to them is to cross train and don’t play the same sport year round,” Martin said. “We see more super specialize athletes now that play only one sport year round, especially in the warm weather states like Florida, California and Arizona.”

“You can play another sport during one season to give your body a break from using the same muscles continuously without rest, thus decreasing the risk of overuse injury.”

“You’re going to have more longevity in a sport with less risk of injury by cross training and playing multiple sports,” Martin continued.

For more information, please contact Dr. Martin at

Platelet-Rich Plasma (PRP) Therapy Offers an Alternative

Physical exercise can be rough on joints, whether you’re a professional athlete or a recreational jogger. An active lifestyle can sometimes result in natural wear and tear in the form of tendonitis, ACL or MCL tears, or an increased risk of osteoarthritis. Surgery, while a solution to these physical ailments, can still interfere with a person’s athletic lifestyle due to potentially long recovery times and the risk of infection or other complications, leaving injured athletes with less-than-favorable solutions to their ailments.

Platelet-Rich Plasma (PRP) therapy offers a safe, more affordable alternative to orthopedic surgery. With a shorter recovery time and minimal invasiveness, PRP therapy is now a viable option for injured athletes looking to get healthy and back on their feet as soon as possible.

Typically when the body suffers an injury, it sends a rush of blood to the site of the wound in order to start a natural healing process. However, blood has more limited access to particularly ligamentous regions like joints, making recovery for these areas much more difficult.

With PRP therapy, the procedure sends plasma-rich platelets to the joint injury to allow for rebuilding ligaments and expedited healing. The therapy entails the injection of the injured athlete’s centrifuged blood into the joint in question. The procedure takes less than an hour and leaves little to no room for infection or complication due to lack of incision and the use of the patient’s own blood.

PRP therapy offers a more comfortable, less invasive alternative to orthopedic surgery. The procedure is less expensive than typical surgery and shaves several weeks off a patient’s rehabilitation or recovery time. PRP therapy is a smart option for all individuals suffering from joint pain, be it from vigorous activity or osteoarthritis.

Understanding Reverse Total Shoulder Replacement

In certain patients with shoulder arthritis, a total shoulder replacement does not suffice. Conventional total shoulder replacements are adequate for patients with shoulder arthritis, but in cases where patients have shoulder arthritis with large rotator cuff tears, known as rotator cuff tear arthropathy, a reverse total shoulder replacement is necessary.

A reverse total shoulder replacement is a revolutionary new technology that was initially developed in Europe and FDA approved in the U.S. in 2004.  This device essentially switches the  internal components of a traditional shoulder replacement, which consists of a metal ball attached to a metal stem that is inserted into the humerus and a plastic liner implanted into the scapula which forms the socket of the shoulder ball and socket joint.  The rotator cuff tendons balance the ball against the socket during arm motion.

In patients that have large rotator cuff tears and therefore dysfunctional rotator cuff tendons, a standard shoulder replacement cannot be utilized.  The reverse shoulder replacement consists of a plastic liner on top of the metal stem in the humerus, and a metal hemisphere screwed to the socket.  This device relies on the deltoid muscle to compress the humerus against the hemispherical glenosphere, which acts as a fulcrum to provide arm motion.

Ideal candidates for this procedure are elderly patients who have had untreated rotator cuff tears or previous failed rotator cuff surgeries and developed arthritis, previous failed shoulder replacement surgeries, or patients that sustain severe shoulder fractures.

With appropriate postoperative physical therapy, the surgery successfully increases mobility and decreases pain.

Dr. Martin uses the latest nonoperative and surgical treatments for a wide range of shoulder, elbow, knee and sports related injuries. With the most advanced treatments, Dr. Martin is able to get you back to activity as soon as possible.

Schedule a visit with Dr. Shelden Martin today by calling (480) 685-2850.

Phoenix Orthopedic Surgeon Dr. Martin Featured on Debut “Health 2 Fit” TV Show

Phoenix Orthopedic Surgeon Dr. Shelden Martin was a guest on the debut episode of “Health 2 Fit” on AZTV on Oct. 5. If you missed it, here’s a chance to see it again.