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What turns a young athlete into a lifelong athlete? – TSRHC Sports Medicine

Various specialties have studied the characteristics that make a young athlete stick with his or her sport. From a psychological perspective, those who think sports are fun are more likely to continue to participate in sports and later, lead a healthier lifestyle that includes physical activity.

softballAround 12 or 13 years old, athletes progress to a more competitive sport environment and the pressures really start to grow. Winning, or being the best, becomes more important as elite team tryouts and college scholarship dreams come into play.

According to TSRHC Psychology Fellow and Sport Psychologist, Dr. Erica Force, this is the window of time where athletes begin to drop out of sports completely. “To keep our kids participating in physical activity for the long term, it’s important for parents to foster a positive and fun environment. Parents can do that by asking questions that focus on effort and hard work rather than only asking questions about results of the competition.”

Here are some ideas to help shift the conversation from negative to positive:

  • Be a good listener and offer encouragement regardless of the outcome of a game
  • Keep your own emotions under control
  • Ask about their experience while playing:
    • Did you put forth your best effort?
    • Did you have fun?
    • Did you help your team?
    • Were you a good sport?

For information about TSRHC’s Sports Medicine Center, please visit our website at tsrhc.org/sports. For information on TSRHC’s Psychology Department, please visit tsrhc.org/psychology.

Have you ever thought about how bones grow? – TSRHC Sports Medicine

We all know that our ears and nose have soft tissue called cartilage. But many don’t realize that this is also found in young bones. These areas are called growth centers and are filled with cartilage until those cells are replaced with bone. Like our ears, these areas in pediatric bones are soft and pliable. This increases the risk of damage from traumatic injuries, and even common orthopedic procedures.

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Some growth centers are called epiphyses, which typically lead to changes in the length of a bone. Tendons and muscles are connected to other growth centers called apophyses, which typically control the changes in the shape of a bone. The muscle pulling on these centers adds to the risk of injury. The growth centers “show up” and “go away” in x-rays in certain sequences. Pediatric orthopedic sports surgeons, like Dr. Philip Wilson and Dr. Henry Ellis, have studied how bones grow and how to assess how much growth is left by looking at x-rays. Many times, the most helpful x-ray is of the hand, where there are many growth centers to assess. With this expertise, they are able to offer the right treatment at the right time for young athletes with joint injuries.

According to Dr. Ellis, taking care of young athletes is very different than taking care of adults. He says, “We must take into consideration how much more growing an athlete will do, especially when managing fractures and complex knee ligament injuries.”

Decisions made in the early years of growth have the potential to impact knee alignment and leg symmetry years later. The risk of these complications is low with proper management by pediatric specialists.

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

TSRHC Welcomes New Hand Surgeon Dr. Christopher Stutz

Stutz - Whitecoat copyPediatric orthopedic hand surgeon Dr. Christopher M. Stutz has joined the staff of TSRHC, working with the team at the Charles E. Seay, Jr. Hand Center led by Dr. Marybeth Ezaki.

Stutz earned his medical degree from the University of Texas Health Science Center at Houston and completed an internship and residency at Vanderbilt University Medical Center in Nashville, Tenn. He was a hand and micro-vascular surgery fellow at Washington University and a congenital hand surgery fellow at TSRHC.

Stutz is an assistant professor of orthopedic surgery at UT Southwestern Medical Center and certified by the American Board of Orthopaedic Surgery. He is a member of the Pediatric Orthopaedic Society of North America and a candidate member of the American Society for Surgery of the Hand and the American Academy of Orthopaedic Surgery.

Read more about Stutz in his bio. Welcome to Scottish Rite Hospital!!

Researchers from TSRHC Find Clues Relating Scoliosis to Gender

Adolescent scoliosis, the spine-twisting condition that affects two to three percent of the population, has long mystified scientists. Scoliosis often runs in families, but until now, researchers haven’t been able to pinpoint a specific cause for the progressive deformity. However, thanks to a recent study conducted by Dr. Carol Wise of Texas Scottish Rite Hospital for Children (TSRHC), scientists are now one step closer to identifying a cause and hopefully a cure.

Different Types of Scoliosis

Scoliosis is classified in several ways. Children with congenital scoliosis are born with a vertebral defect that can eventually lead to a spine curvature of 50 percent or more. By contrast, children with neuromuscular scoliosis suffer a degenerative spinal condition that results from a neuromuscular condition such as cerebral palsy or spinal cord injury. In about 80-85 percent of all cases, doctors are unable to find the cause of scoliosis.

Scoliosis Genetics Research

PAX1 Gene: Girls vs. Boys

Because scoliosis often affects members of the same family, researchers suspect that genetic factors play a role in its development. When Wise and her team investigated a gene that influences early spinal development called PAX1, they made an astonishing discovery: Boys with scoliosis don’t manifest PAX1 genetic markers for the disease, but girls with the diagnosis do. In fact, most boys – those with scoliosis and those without – harbor no markers for the condition in their PAX1 genes.

This significant finding suggests that gender differences buried within the PAX1 gene could contribute to the development of scoliosis in girls. It also suggests that, for boys, other genetic factors might play a part in the condition’s development. TSRHC’s findings support the notion that scoliosis doesn’t have one “blanket” cause; different children suffer from the deformity for different reasons. Wise’s data has validated researchers’ urgent need to probe gender-specific links to the disease.

scoliosis cause researchNext Steps

Ideally, doctors will use Wise’s results to evaluate female patients’ PAX1 markers and catch scoliosis in its earliest phase before surgery becomes necessary. According to the Scoliosis Research Society, children with a curvature of 50 percent often need spinal fusion surgery, a treatment process that takes four weeks or more to heal.

Similarly, scientists now know that the PAX1 gene isn’t a useful tool when it comes to predicting scoliosis in boys. Researchers can now move on to the investigation of other possible genetic culprits with confidence.

Scoliosis No More

For nearly a century, TSRHC physicians and staff have worked shoulder to better understand orthopedic conditions in children. Thanks to the work of Wise and her team, scoliosis specialists across the globe have taken a giant step forward. It is hoped that prevention measures will eventually flourish, and that scoliosis will become as obsolete as polio, the measles, and chicken pox.

5 Signs Your Injured Athlete May Need a Little Extra Help

Imagine being a 16-year-old athlete, with your whole future ahead of you. You spend all your time playing, thinking and dreaming about soccer. Then, your season abruptly comes to an end with a ligament injury and your doctor tells you there’s no soccer for 6 months, at best.

UntitledOur Sports Medicine team knows this scenario all too well. We see athletes of all kinds encounter this, and six months later, they are back on the field. They often express disappointment and anxiety early in the cycle, but their drive to conquer rehabilitation and return to sports wins in the end.

Unfortunately, we also see some athletes that can’t quite get past that anxiety about returning to sports. “If there are any additional stressors at home or school, injury recovery can be a difficult process,” according to Dr. Sandy Roland, TSRHC’s Director of Psychology. She says that being a teenager is tough, but dealing with a life-changing sports injury on top of underlying stressors like depression, family tension, or tough social environments can be too much for some to handle.

Dr. Roland works closely with the sports medicine team to identify concerning signs and symptoms in our injured athletes. Though it’s only a small part of the care we provide, it’s a critical component to pediatric sports medicine. It’s another way we are taking care of the whole athlete, and not just the injury.

Parents, you should ask your child’s medical provider for help if you notice changes in any of these:

  • Sleep patterns
  • Decreased attention or concentration in school
  • Worsening grades
  • Socialization patterns like less time with friends
  • Mood

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

 

Winter: the Dolphin with the Prosthetic Tail

wintertail copyA few of our staff members attended the Association of Children’s Orthotic-Prosthetic Clinics (ACPOC) annual conference in Clearwater Beach, FL earlier this month. ACPOC is an association of interdisciplinary professionals who are involved in providing prosthetic-orthotic care for children with limb loss or orthopedic disabilities.  We participated in the conference by presenting two clinical papers, which were very well received and encouraged valuable discussion. The hospital was even specially recognized by ACPOC for our attendance to the conference as a team!

Despite the long hours at the conference, Amanda Brown from Prosthetics and Orthotics and Jesse Kowalski from Physical Therapy managed to squeeze in some time to spend an afternoon at the Clearwater Beach Aquarium. This special aquarium is home to Winter, the famous dolphin. Winter is the only known dolphin in the world missing her tail, and was featured on the big screen in Dolphin Tales.

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Like many of our patients, Winter has scoliosis and kyphosis, which has caused her to wear a prosthetic tail. She wears her prosthetic device during physical therapy sessions to help decrease the progression of the curvature of her spine, and has to do other types of stretching and exercise too. Her prosthesis helps keep her healthy and happy so she can do what dolphins do best… play!

A World of Expertise, Locally Grown

By Manny Mendoza

When TSRHC hosted the World Hand Symposium, orthopedic physicians from
 19 countries flocked to the hospital to learn about the latest treatments for upper limb disorders. Why Scottish Rite Hospital?

It’s home to two of the world’s preeminent pediatric hand surgeons, consistently ranks as one of the top pediatric orthopedic facilities in America and is renowned for its groundbreaking research.

flowerSuch locally grown leadership from the TSRHC medical staff plants seeds that encourage ideas and innovations to bloom across the globe, cultivating a brighter future for children with orthopedic conditions in the United States and abroad.

In addition to traveling from overseas to attend medical conferences put on by the hospital, doctors come to TSRHC
 to train with its superior medical team. Last year alone, physicians came from 39 countries. They also wrangle for spots in the world-class fellowship programs at TSRHC, taking some of the hospital’s expertise back home with them. They come here because Scottish Rite Hospital’s commitment to the highest standards has put it on the world stage of pediatric orthopedic care.

And the world has taken notice. In addition to international representatives from the medical community, more than 300 current patients from nearly 60 countries travel to TSRHC to benefit from the hospital’s expert treatment. “We are a destination,” says Chief of Staff Daniel J. Sucato, M.D., M.S. “We help set the standard.”

Sucato’s predecessor, now Chief of Staff Emeritus John A. “Tony” Herring, got the international ball rolling in the 1980s when he began visiting countries such as China and Russia, teaching their doctors the Scottish Rite way and treating their patients with TSRHC’s superior know-how. Last year alone, TSRHC physicians and researchers lectured in 15 countries in addition to training medical personnel across the U.S.

The hospital’s training of domestic and foreign physicians results in better care of children with orthopedic conditions around the world, while also spreading TSRHC’s philosophy of providing superior treatment to children regardless of their family’s ability to pay.

How sought after is the hospital’s expertise? More than 160 physicians, or more than 10 percent of the pediatric orthopedic surgeons in North America, completed their advanced instruction in TSRHC fellowship programs. Internationally, Scottish Rite Hospital fellows have come from 21 countries, representing every continent but Antarctica, with many going on to assume leadership roles at medical institutions in their home countries.

The reach of TSRHC’s research team is equally broad. As a major medical research center, the hospital directs international studies such as leading the International Perthes Study Groupa team of physicians from the U.S. and eight other countries who came together to discover new approaches to Perthes disease, a hip disorder.

In addition, the hospital develops innovative treatments that lead to better outcomes for children with pediatric orthopedic disorders. For example, when the TSRH Spinal System for correcting spinal deformities was introduced, it was the most widely used treatment of its kind internationally. The hospital has also established itself as a global leader in limb lengthening and reconstruction, building on the work of Russian physician Gavril A. Ilizarov. Improving on his original frame, TSRHC orthopedists and researchers have created a series of patented limb-lengthening devices recognized around the world.

The impact of Scottish Rite Hospital’s leadership on the direction of pediatric orthopedics is evident through the high-ranking positions TSRHC physicians hold in esteemed medical associations. Chief Medical Officer
 B. Stephens Richards, M.D., recently led the Scoliosis Research Society (SRS). In addition, Richards and Herring are former presidents 
of the Pediatric Orthopaedic Society of North America (POSNA), whose archive is housed at TSRHC. Assistant Chief of Staff Lori A. Karol, M.D., is president-elect of POSNA. She will become the first woman to assume the role of president at POSNA’s annual meeting in May.

With its international influence and dedication to education and collaboration, TSRHC has blossomed from its Texas roots into one of the most respected pediatric orthopedic institutions in the world. In that thriving spirit, TSRHC is constantly growing, evolving and reaching skyward, so that children – no matter where they are – can, too.

**This article was feature as the cover story of our Rite Up Magazine – 2015, Issue 1. View an e-mag version for more stories from this issue.

Assistant Chief of Staff Dr. Lori A. Karol Becomes First Woman to Lead POSNA

Dr. Lori KarolDr. Lori A. Karol, assistant chief of staff at Texas Scottish Rite Hospital for Children (TSRHC) and professor of orthopedic surgery at UT Southwestern Medical Center, will become the first woman president of the Pediatric Orthopaedic Society of North America (POSNA) on Friday at the organization’s annual meeting in Atlanta.

Dr. Karol is a staff orthopedic surgeon at TSRHC and medical director of Performance Improvement and the Movement Science Laboratory at the hospital. In 2011, she won the Arthur Huene Memorial Award from POSNA for published research on clubfoot. She has been the group’s president-elect for 2014-15 and takes over the presidency from Dr. Gregory A. Mencia, director of pediatric orthopedics at Monroe Carell Jr. Children’s Hospital at Vanderbilt in Nashville, Tenn.

Dr. Karol earned her undergraduate and medical degrees from the University of Michigan and completed her fellowship in pediatric orthopedics and scoliosis at TSRHC in 1991. She joined the hospital in 1994. Dr. Karol is the third TSRHC surgeon to lead POSNA. Dr. J.A. “Tony” Herring, chief of staff emeritus, and Dr. B. Stephens “Steve” Richards, chief medical officer, are past presidents.

“I am immensely honored to be selected to serve as president of POSNA this year, and even more so to serve as the first woman president of our organization,” Dr. Karol said. “When I trained as an orthopedic surgeon, I was the only woman in my program for many years. Now, 40 percent of our newest members are female. POSNA has always been very open and accepting of diversity in its members. I hope my election as president will help open up leadership positions to the young women physicians who are now training in residency programs or are newly in practice. As the mother of three daughters, I want them to have the opportunity to serve as leaders in their careers some day.”

“Dr. Karol is a world class surgeon who cares deeply about the children she treats,” said TSRHC Chief of Staff Dr. Daniel J. Sucato. “Her patient care, teaching and research have improved countless children’s lives and her leadership in the field of pediatric orthopedics is a great example for other physicians to follow. She will make a great POSNA president.”

Dr. Karol is one of almost a dozen TSRHC physicians making presentations at the POSNA annual meeting being held at the Marriott Marquis in Atlanta from Wednesday, April 29, to Saturday, May 2. With more than 1,200 members, POSNA is the preeminent organization for orthopedic surgeons who care for children in the United States and Canada. Its mission is to improve the lives of children through expert orthopedic care.

“We are very active in education of orthopedic surgeons, in advocacy for our pediatric orthopedic patients and in research to better the treatment outcomes for the children we care for,” Dr. Karol said.

Congratulations, Dr. Karol!

Luke Waites Center for Dyslexia and Learning Disorders Awarded Luminary Award

UntitledCongratulations to TSRHC’s outstanding Luke Waites Center for Dyslexia and Learning Disorders. They are the recipients of the SMU Simmons Luminary Award for 2015. The Luminary Award honors those who have made an exceptional commitment to improving lives through education. This was a tremendously special award for the hospital and for the dyslexia department, who was recognized for all the transformative work they perform for children with learning differences. The breakthroughs they have made have not only benefited the children of Scottish Rite, but have changed the lives children all over the world. TSRHC could not be more proud of the outstanding work done by the dyslexia department and is honored to be recognized by SMU with this prestigious award.

For more information, view video below:

 

TSRHC Leads the Way with Magnetic Spinal Rod System

TSRHC physicians recently performed the hospital’s first noninvasive adjustment of an implanted spinal rod system using groundbreaking magnetic technology. This system is designed to minimize the progression of specific cases of early-onset scoliosis. This revolutionary device is called MAGEC (MAGnetic Expansion Control) System®, distributed by Ellipse Technologies, Inc.

Daniel J. Sucato, M.D., M.S., TSRHC chief of staff, with TSRHC patient Viviana, age 7, of Austin, after her adjustment.

Daniel J. Sucato, M.D., M.S., TSRHC chief of staff, with TSRHC patient Viviana, age 7, of Austin, after her adjustment.

The FDA cleared the system for commercial use earlier this year. It
 is composed of an implantable rod and an External Remote Controller (ERC). After the MAGEC rod has been implanted, a physician simply places a “MAGEC wand,” or locator, over the patient’s spine. The wand locates the magnet on the implanted rod and allows the physician to make a noninvasive adjustment. An X-ray or ultrasound of the spine is then used to confirm the procedure’s success.

Thus, adjustments that once required a patient to undergo anesthesia, surgery and recovery are now performed in the clinic in a matter of minutes.

The frequency of such sessions 
is customized to meet the needs of each patient until the desired result is achieved. TSRHC is excited to be at the forefront of institutions in the U.S. providing patients with this revolutionary, nonsurgical adjustment technology.

 

**This article was featured in the 2014 Rite Up Volume 3 Magazine. Read more from the magazine online