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ACL Reconstruction for Very Young Athletes – TSRHC Sports Medicine

At one time, orthopedic surgeons believed that waiting for surgery until an athlete was fully-grown was ideal for kids who had torn their anterior cruciate ligament (ACL). Henry Ellis, M.D. and Philip Wilson, M.D. have extensively studied the effects of waiting to reconstruct a torn ACL. They have found it’s not always best for some patients. Without a healthy ACL, one of the primary stabilizers for the knee, other tissues inside the joint are at risk for damage.

footballTo determine the right course of care for a very young athlete, our first step is to estimate the number of years of growth left in the knee joint. We do this by looking at the growth plates in an x-ray of the hand to determine the patient’s “bone age.” Only with the “bone age” can, the best treatment plan can be put in place for optimal outcomes.

Scott, now 13 years old, had his ACL reconstructed by Dr. Ellis, a TSRHC pediatric orthopedic surgeon, when he was 10. In athletes like him, with several years left to grow, the surgeon must carefully protect the growth plates. This way, the knee is stabilized, but the legs can continue to grow normally. If adult procedures are incorrectly used on young knees, the legs may end up different lengths or the injured leg may become bowed.

Now, Scott is back in action on the football field with no complaints and no concerns.  Good luck to Scott and the Bulldogs!

To learn more about growth plates, check out Dr. Ellis’ comments in an earlier post, “Have you ever thought about how bones grow?”

For information about pediatric sports medicine and surgical options, please visit our website at scottishrite.org/sports.

Things to Know About Scoliosis Screening

As kids go back to school, many of them are being screened for scoliosis. Here is some information that you should know about the process:

  • What is Scoliosis? Scoliosis is a progressive condition causing the spine to curve or twist into a “C” or “S” shape.
  • What Causes Scoliosis? The most common form of scoliosis is idiopathic, meaning there is no known cause. Despite some popular beliefs, scoliosis does not result from carrying heavy items, athletic activity, sleeping/standing postures, or minor lower limb length discrepancies. Researchers at TSRHC identified the first genes associated with idiopathic scoliosis and hope the discovery will one day lead to identifying the cause of the spinal curvature
  • How is it diagnosed? Scoliosis usually occurs in early adolescence (5th – 9th grade), becoming more noticeable during a growth spurt. The child’s physician or school nurse will screen for scoliosis by having the child perform the Adam’s Forward Bend Test to look for any unevenness or abnormalities in the shoulders, ribcage or back. They can also screen using a device called the scoliometer or by taking an X-Ray.
  • Treatment: If your child has been told they have a curvature in the spine, their physician or school nurse can refer them to a healthcare provider such as Texas Scottish Rite Hospital for Children. From there, the physician will find the proper treatment method for your child.
    • Note: Approximately 5% of the patients referred to TSRHC will need treatment:
      • 3% – need surgery
      • 2% – need a brace
      • 45% – need observation
      • 50% – are determined not to have scoliosis and are released from care

Watch the following video from our Assistant Chief of Staff Dr. Karl Rathjen:

Patient Shares Lessons Learned in Moving Speech About “Happiness”

What is happiness? TSRHC patient Anika, age 18, of Lewisville, has been winning awards for her thought provoking take on the subject.

Screen Shot 2015-08-19 at 11.12.41 AMIn the latest triumph for her dramatic speech, “Happy,” the Lewisville High School senior competed in the National Speech and Debate Association’s annual National Tournament that was held in Dallas this summer. Anika was one of only two North Texas students to qualify in the Original Oratory category.

Earlier this year, she delivered the speech, which cites studies and other published observations about happiness, to TSRHC’s orthopedic staff.

Six years ago, Anika moved with her family from Bangladesh “for a better life,” she says, including medical care at TSRHC. She has cerebral palsy and has been treated at the hospital for related orthopedic conditions. The speech begins with Anika’s observation that from birth, the people closest to us “are blessing our futures with happiness and prosperity.” But what shape does that happiness take? She ponders whether what makes us happy is success, money, the latest technology and other “new ways of living easy” or a deeper inner satisfaction.

Anika’s own sense of happiness was shaken by a personal tragedy she outlines in the speech. “Step back, smell the roses, hug a little,” she says in closing. “And remember, it’s never too late to be happy.”


Triathlons for young athletes: Three times the fun – TSRHC Sports Medicine

Did you know that triathlons were “born” in the United States in the 1970’s? This relatively new phenomenon in sports has evolved to attract younger and younger athletes over the years.

UntitledThirteen year-old Caitlin, a prior patient of Shane Miller, M.D. and multi-sport athlete, is gearing up for her third triathlon. She certainly won’t be the youngest at the upcoming North Texas Kids Triathlon in Arlington. The event will include athletes as young as five years old.

With athletes this young competing, it’s good to know the medical team of Texas Scottish Rite Hospital for Children sports medicine experts, led by Dr. Miller, have already begun discussing race-day logistics and confirming safety plans for young athletes, like Caitlin.

Next to safety for the athletes, Dr. Miller says the top priority for kids participating in distance events, like The North Texas Kids Triathlon, is for them to have fun. Caitlin tells us, this event meets the mark. From the pre-event pep rally to the post event celebration, there is no shortage of fun. The September 20th event co-presented by Texas Scottish Rite Hospital for Children Sports Medicine and Academy Sports is sure to be a great day.

Good luck to all the young triathletes!

If your young athlete is interested in participating, find more information and register here.

For information about TSRHC’s Center for Excellence in Sports Medicine, please visit our website at scottishritehospital.org/sports.

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Celebrating the Gift of Gratitude – TSRHC Celebrates 20 Years of Treasure Street

TSRHC’s signature event was started 20 years ago by a family with one goal – giving back.

On a crisp spring evening in 1996, Dallas residents Dee and Dodge Carter gathered close friends and family around their dining table with a mission in mind. They were exploring ways to give back to TSRHC’s Tuberous Sclerosis Complex clinic, where their daughter, Nicole, was being treated. That intimate brainstorming session led to a small gathering at the hospital later that year, where guests donated a “treasure” to be auctioned on behalf 
of the clinic. Treasure Street was formed and would ultimately become the hospital’s signature fundraising event, benefiting all TSRHC patients. This year hospital friends, patients and staff celebrate the event’s 20th anniversary and perhaps the greatest treasure of all — the gift of gratitude.

October 23, 1993, a date Dee can rattle off like her phone number. It was the day 11-month-old Nicole was diagnosed with Tuberous Sclerosis Complex (TSC), a rare genetic disorder that causes noncancerous (benign) tumors to form in the vital organs of the body, primarily the brain, heart, kidney, skin and lungs.

“We were at Children’s Medical Center when the doctor gave us the diagnosis,” Dee recalls. “He let us process it a little bit and then told us about the TSC clinic at Scottish Rite and said, ‘You need to get her over there.’ ”

The first Treasure Street was held in 1996 and this group has been there from the beginning. L to R: TSRHC President/CEO Robert L. Walker and his wife, Pat; Dee and Dodge Carter; TSRHC Trustee Harold Carter and his wife, Bitsy; Margaret and Syd Carter; Lark Montgomery and her husband, TSRHC President Emeritus and Foundation Executive Chairman J. C. Montgomery, Jr.

Mauricio Delgado, M.D., TSRHC director of Neurology, founded the hospital’s TSC clinic in 1990, along with former Children’s and TSRHC neurologist E. Steve Roach, M.D. Although pediatric orthopedics is the specialty, TSRHC treats certain related neurological disorders. The hospital’s TSC clinic was one of the first clinics of its kind in the country and has served as a national model for those that followed.

“The complexity of this disorder led us to organize 
a dedicated TSC clinic where we could gather relevant clinical information through a standardized approach,” explains Delgado, who became Nicole’s physician.

The clinic played a key role in creating a national database of TSC patients, which is overseen by a national organization called the Tuberous Sclerosis Alliance.

The hospital’s TSC clinic also conducted a landmark study with the University of Texas Medical School at Houston, which isolated two causative genes associated with the condition.

“The financial support from Treasure Street played a critical role in our genetic testing,” says Steven Sparagana, M.D., who joined TSRHC in 1994 and became director of the TSC clinic in 2001. “Now we know the mechanism by which the disease occurs.”

In TSC, that mechanism is a mutation, or change, in one of two genes, TSC1 or TSC2. When either of these genes carries a mutation, it is unable to inform the body how to grow correctly, which affects proper development and function in children with TSC.

“This condition is complex and it exhibits differently in every patient,” Sparagana explains. “An accurate diagnosis is key and from there, finding a cure remains our ultimate goal.”

“There’s so much that we’ve come to know about the disease, but there’s still so much that is unknown,” Dodge explains. “There’s a huge level of comfort in knowing that you’re with the experts at Scottish Rite, because it’s not just the patients the hospital cares for, it’s the families as well.”

Funds from Treasure Street continue to meet the needs of the TSC clinic, in addition to supporting the hospital as a whole. Twenty years, thousands of guests and $11 million in gross proceeds later, the event has exceeded 
all expectations.

“We never dreamed it would come this far,” Dee says. “We’re so grateful for the generosity of the community and our friends. The success of the event speaks to them, and to the hospital. It’s touched so many lives.”

The Carters explain that Treasure Street is a celebration of the hospital and those who support it, like Dee and Dodge’s parents.

“They’ve been with us from the beginning,” Dee says. Her mother, Bitsy, and father, Harold, a TSRHC trustee, are active on the Treasure Street board, as are Dodge’s parents, Margaret and Syd. Dee and Dodge are also grateful for the involvement of friends like longtime event board members Kammy and Andy Fleck.

“Part of the joy now is that we have a host committee that is comprised of our kids,” Dodge says. “So, the families involved in this event have gone full circle and now we’re establishing a foundation for the future.”

“It’s the little things we’re grateful for, too,” Dee says. “Nicole has never been afraid to go to Scottish Rite and that means so much, to bring your child to a place where they aren’t afraid to be.”

It’s that gratitude for the small things that has culminated in big things, like celebrating the 20th anniversary of Treasure Street this fall on Thursday, Oct. 15. There will be fabulous food, live music and, of course, treasures to bid on at both silent and live auctions. But as the Carters know firsthand, there are some treasures upon which you cannot put a price.

“What can you do for an institution like Scottish 
Rite that does everything it can to help your child?” Dodge asks. “You can’t repay that. But our goal from the beginning has been to tell people about the hospital and it’s a story we feel blessed to tell.”

**This article was featured as the cover story of our Rite Up magazine.

Waiting until August to prepare for fall football in Texas is a mistake for young athletes – TSRHC Sports Medicine

Dr. Shane Miller, TSRHC sports medicine pediatrician, warns parents about the serious risks of returning to Texas football poorly prepared.

football“Though heat illness prevention practices have greatly improved in Texas schools, I worry about the kids that sit on the couch all summer playing video games in the air-conditioning. They show up to pre-season training out of shape and poorly prepared for the heat,” he says.

To manage heat from the environment and from activities, the body must be in balance. Most athletes need guidance from adults to make good choices throughout the year, especially in the summer.

Tips for parents and coaches who want to reduce the risk of heat-related illnesses in young athletes in all sports:

  • Encourage healthy sleep habits
  • Keep healthy food options in the house
  • Limit consumption of caffeinated and sugary beverages
  • Encourage drinking water throughout the day
  • Encourage physical activity throughout the summer
  • Encourage acclimating to the heat BEFORE training begins
  • Notify athletic trainers of fever or changes in medical history

Screen Shot 2015-08-06 at 10.45.16 AMAdditionally, coaches can help reduce the risk of heat-related illnesses with these tips:

  • Encourage frequent and adequate rest and water breaks, every 15 – 30 minutes
  • Know the signs and symptoms of heat illness
  • Insist on proper conditioning, it takes 10-14 days to adapt to heat
  • Avoid practice from 12:00 – 4:00 pm when the Texas sun is most intense
  • Follow league guidelines for practice schedules
  • Respond to temperature and humidity warnings

To learn more about proper hydration for young athletes, see our PDF. For information about TSRHC’s Center for Excellence in Sports Medicine, please visit our website at scottishritehospital.org/sports.



Crayon Club Membership Drive until August 28

Screen Shot 2015-08-04 at 1.31.58 PMHave you been thinking about joining Crayon Club? Now is the time! Crayon Club provides opportunities to create friendships, network and connect with others interested in making a positive impact in their community. Check out the following three membership levels to find the one that is right for you. These gifts help underwrite patient care, research, medical equipment and building renovations at TSRHC:

  • RED CRAYON: $40: Let your passion for TSRHC patients shine through! This level includes…
    • Reduced ticket price for each annual Crayon Club event (4 per year)
    • Crayon Club koozie
  •  BLUE CRAYON: $130: Contribute to life changing care for TSRHC patients! This level includes…
    • One ticket for each annual Crayon Club event (4 per year)
    • Crayon Club t-shirt
  •  GREEN CRAYON: $220: Be part of the new generation of TSRHC philanthropists! This level includes…
    • One ticket for each annual Crayon Club event (4 per year)
    • Recognition at Crayon Club events
    • Crayon Club t-shirt and koozie

Join Today!

* Discounted rates are available until midnight on August 22, 2015.
** Your contribution is tax deductible to the full extent of the law. Goods or services will be provided in exchange for part of your donation.


We’re Moving… the TSRHC Sports Medicine Practice!

Screen Shot 2015-07-28 at 2.11.22 PMTexas Scottish Rite Hospital for Children has served more than 225,000 patients since first opening its doors in 1921, and is growing faster than ever before!

Due to rapid expansion and the demand to serve more patient families in the northern area of the DFW Metroplex, the TSRHC Sports Medicine Center will be moving to its new location at 7000 West Plano Parkway in Plano, Texas.

This larger space will allow more patients access to the outstanding care they deserve from leading surgical and non-operative pediatric orthopedic specialists.

Opening September 21, 2015

The Sports Medicine practice will begin seeing new patients and current families in the new Plano location beginning September 21, 2015. The Sports Medicine staff provides specialized treatment for sports-related pediatric orthopedic conditions and concussions. In addition, they offer sports injury prevention and educational information for young and growing athletes.

Under the direction of Assistant Chief of Staff Philip Wilson, M.D., alongside Henry B. Ellis, Jr., M.D. and Shane Miller, M.D., the TSRHC Center for Excellence in Sports Medicine is actively involved in research regarding the etiology, treatment and prevention of pediatric sports injuries and joint problems. This leading edge Sports Medicine practice will be the primary focus of the new location, with other Scottish Rite Hospital clinics to follow later this year.

Permanent Second Location

More plans are underway for a permanent north campus home, which will be located on 40 acres at the northeast corner of Lebanon Road and the Dallas North Tollway in Frisco. This second location will be an extension of the original Dallas campus.

Groundbreaking for the Frisco location is anticipated soon, with hope for completion of the new campus in 2017.

Becoming a Patient

Texas Scottish Rite Hospital’s Center for Excellence in Sports Medicine is unique in that it receives self-referrals, as well as referrals from primary care and specialty physicians. To make an appointment, call 469-515-7100 or sign up through the online form.

Is water enough for your young athlete today? – TSRHC Sports Medicine

Water is the “go-to” drink to keep young and growing athletes hydrated for optimal performance. However, sometimes water just isn’t enough to replace electrolytes lost through sweating.

If your young athlete answers yes to any of these questions, he or she may need more than water:

  • Are you going to be playing in a high–intensity activity, lasting longer than an hour?
  • Do you feel salt on your skin after activity?
  • Do you see salt on your clothes after activity?
  • Are you going to be participating in back–to–back events or tournaments?
  • Are you going to be playing in hot or humid conditions, either indoors or outdoors?
  • Do you have a hard time drinking extra fluids on practice and game days?

UntitledAll of these are reasons to supplement a water hydration plan with sports drinks or salty snacks. Incorporating these throughout the day ensures optimal safety, health and performance during each practice and game.

The sodium in these items helps to keep water in the body, replaces lost electrolytes and also stimulates thirst. Thirst encourages the athlete to drink more fluids than he or she may do naturally.

Here are some suggestions to have on hand:

  • Sports drinks
  • Broth-based soups
  • Vegetable or tomato juice
  • Pretzels or salty crackers
  • Pickles
  • String cheese
  • Yogurt

Talk with your young athlete about when to reach for these salty snacks; enjoying them too often can lead to other problems. Your child’s pediatrician or sports dietitian can help design a nutrition plan that’s right for your young athlete.

To learn more about the best ways to hydrate, take a look at our PDF on hydration for young athletes.

For information about TSRHC’s Center for Excellence in Sports Medicine, please visit our website at tsrhc.org/sports.

KidSwing golf tournaments complete successful 13th year

About 300 young philanthropists participated in this year’s KidSwing golf tournaments, raising more than $83,000 for Texas Scottish Rite Hospital for Children. That brings the total generated for the hospital since the event was launched in 2003 to more than $1.8 million.

KidSwing Junior Committee

KidSwing is unique in that the kids themselves raise money by asking their friends and family to sponsor them. The idea came from 10-year-old patient Ben Sater, who founded the event as a way to give back to the hospital that had taken such good care of him.

Over the years, KidSwing has grown from one tournament to four. The latest, called the Scottish Rite Shootout, is aimed at 16- to 18-year-olds. Held this month for the first time, at Topgolf Dallas, it joins three earlier tournaments for 5- to 15-year-olds: KidSwing Dallas at Brookhaven Country Club, KidSwing McKinney at Stonebridge Ranch Country Club and KidSwing Trophy Club at Trophy Club Country Club.

A junior committee oversees KidSwing. New committee members this year include Michael Brunski, 9, of Allen; Caden Hansen, 8, of Southlake; Blake Littleton, 12, of Frisco; Aubrey Morris, 12, of Irving; Gage Sherwinski, 11, of Allen; and Randy St. Clair and Rusty St. Clair, both 14, of Plano.

Sponsors include GEICO, the Ryan Foundation, Janet and Joe Tydlaska and Topgolf ($10,000 each); Barbi and Scott Cohen, J. Small Investments, the Mary Kay Family Foundation and Stonebridge Orthodontics ($5,000 each); Davaco, Cinemark and the Freedom Foundation ($2,500 each); and Anonymous, Archer Western, Capital One Bank, Green Bank, Sandy Nachman, Truman W. Smith Children’s Care Center and Veritex Community Bank ($1,000 each).

Proceeds from this year’s KidSwing benefit the hospital’s bebionic hand technology program.

See more photos on TSRHC’s Events Facebook page.