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Move More, Hurt Less: Avoid These Common injuries · Meaningful Medicine with Novant Health

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  Carl (Host): Meaningful Medicine is a Novant Health Podcast bringing you
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  access to leading doctors who answer questions they wish you would ask.
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  From routine care to rare conditions, our physicians offer tips to navigate medical
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  decisions and build a healthier future.
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  I'm Carl Moroni, and today we're gonna be speaking with orthopedic surgeon Dr.
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  Edward Blocker, about staying active but doing it safely.
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  Doctor, welcome to the podcast.
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  Edward Blocker, MD: Yeah.
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  Thank you.
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  Carl (Host): Let's first start maybe by talking about tennis and
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  pickleball, which are popular ways for folks to exercise on the coast.
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  Are you seeing any common injuries with these sports?
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  Edward Blocker, MD: Yeah, I do.
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  as you said, it's a very, popular sport, especially pickleball, folks
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  moving into this area where, Large retirement community, everybody's,
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  moving down, becoming more active, and, getting into these popular sports.
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  And then unfortunately as a result, we're seeing, we see a fair number of injuries
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  from, unfortunately most of 'em aren't severe, but, with a few exceptions.
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  But,
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  Carl (Host): Yeah.
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  Edward Blocker, MD: especially has become real popular.
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  Carl (Host): and are there commonalities in the injuries you're seeing?
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  Elbows, knees?
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  Edward Blocker, MD: largely, upper extremity and ankle, kind of divide
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  things into two groups, the types of injuries, the fall or acute injuries,
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  And then the, the longer term, injuries we refer to as overuse injuries.
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  the fall injuries are a little bit more dramatic.
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  and, as you'd imagine typically, uh, falls on outstretch hands.
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  We call those foo fosh injuries, fall on outstretched hand, land on
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  your wrist and to stop your fall can result in a wrist fracture.
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  you're running up towards the net, stopping very fast, fall forward,
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  land with a good bit of force, so.
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  So fractures, fortunately Those are, are probably the minority, of the injuries.
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  Most of them tend to be overuse injuries that occur over, over just repetitive use.
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  Carl (Host): Sure.
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  Now you're based in coastal South Carolina, Beaufort, Hilton Head, which
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  are popular re for retirees and golfers.
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  what are some common golf injuries that you're seeing in patient's?
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  Edward Blocker, MD: as you'd probably expect, mostly upper extremity
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  injuries, especially shoulder.
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  and of course there's golfers elbow.
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  You can get tennis, elbow playing golf.
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  golfers elbow refers to.
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  the medical term is medial epicondylitis.
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  Uh, the medial side of the elbow is The inner side of your elbow.
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  that's, typically the, the muscle group that's involved with a, with a golf swing.
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  but the, opposite side of the elbow, the lateral side, which we typically
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  refer to as tennis elbow, uh, you're not exempt from that playing golf.
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  So we see a lot of that too.
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  these are.
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  As I mentioned earlier, would classify them as, as overuse injuries.
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  these muscle groups get used repetitively, with each golf swing.
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  can lead to tendonitis and irritation at the, where the tendons
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  originate from the, from the bones.
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  And, uh, there's some, oftentimes simple remedies for it.
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  But, And then shoulder injuries are, close behind, the elbows with
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  golf, but Those are the top two shoulder and shoulder and elbows
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  the most used, joints in that sport.
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  Carl (Host): Sure, And for some golfers like myself, you're a lot
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  more swings than the average golfer.
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  So more more chance for injury and to try to prevent injury.
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  I have to guess.
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  Warming up, stretching would probably be advised
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  Edward Blocker, MD: It is, and I recognize it's boring and
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  it's hard to make yourself do.
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  but it's not one of those things we just say do.
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  It really does make a big difference, stretching.
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  as unfortunately as we get older, tendons and ligaments become a little
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  bit less resilient, less, less elastic.
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  so if you have a fall or a a, twist or somehow stress, these ligaments,
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  when we're children and adolescents and even twenties and thirties, those
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  ligaments are more likely to stretch.
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  They're more elastic, and as we get older, they, they lose their elasticity.
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  They're more likely to, to tear.
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  And so stretching helps return that elasticity.
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  Stretching does a lot of things.
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  there's things you take for granted, like proprioception when you, when you.
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  Have your arm out in space.
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  You don't have to look.
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  to see where your hand is, to know where it is, and that's, that's a
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  function of, nerves that run through the ligaments and soft tissues of our joints.
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  So when you stretch, you're actually helping that feedback loop between
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  your brain and your, your extremities.
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  before you go into.
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  You play and, moving faster, your brain's sort of talking to your muscles.
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  Sometimes your brain gets ahead of the muscles these days.
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  so stretching kind of gets your nervous system in sync with your muscles and
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  your motors, your muscles, muscle groups, And also stretches the ligament so that
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  if you do take a tumble, you're more likely to stretch it than to tear it.
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  Carl (Host): Yeah.
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  And I suppose there, there's a, a better way to stretch or some ways are
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  better than other's for stretching.
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  Would you recommend that golfers kind of get some stretching advice or, or
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  what's the best way for athletes to find out the best ways to stretch?
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  Edward Blocker, MD: Slow and easy.
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  I mean trainers and physical therapists are experts in that and they can
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  show you 15 different ways to do it.
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  But if, but the biggest thing is if, if that's gonna be a
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  rate limiting step to somebody.
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  Just doing it.
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  Just, if you're running, getting ready to go on the pickleball court,
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  stretching your hamstrings, you can walk up to a tree, or the hood of your car.
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  we've all seen runners doing that beforehand.
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  That'll stretch out your.
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  Your gastroc or your your calf muscles.
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  and you know, of course stretching your arms and, and shoulders and elbows.
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  basically you're just moving your, your, your arms and subsequently ligaments
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  and all the directions that they go to, put the ligaments that support
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  them under a little bit of tension.
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  course, YouTube's a good friend too.
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  If you YouTube stretching, stretching exercises before pickleball, it'll, it'll
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  tell you 10 different things you can do.
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  But the biggest thing is make it simple.
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  it doesn't have to take too long.
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  if it's too long and too complicated, you won't do it.
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  So, just a, a short but concise and well focused stretching exercise regimen
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  before you go out on the quarter.
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  And the one of the golf course would be, time well spent.
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  Carl (Host): Yeah.
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  Great, great advice.
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  there certainly are sudden injuries like fractures and things that happen.
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  And then as you mentioned, kind of overuse injuries, things that happen over time.
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  why is it so important not to delay orthopedic care from these
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  repetitive motion injuries?
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  Edward Blocker, MD: Well, they can sort of self perpetuate.
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  So, you know, I don't, I wouldn't, I wouldn't want to convey that it
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  every little egg campaign you've gotta go in for, but the one, the
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  ones that seem to be hanging around, and not getting better, or maybe.
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  if it's interfering with what you're doing, if you're going out and if
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  the side of your elbow hurts when you play pickleball and, and it doesn't
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  get better after the, a few days and you go back on the court and it seems
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  to hurt a little bit worse And then a little bit worse the next time, then,
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  and it is, then those things can set.
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  you know, amplify and get worse.
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  And in the, And the early on in the, in the course of these, repetitive use
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  injuries, it's oftentimes very simple to get it stopped, on the treatment.
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  Algorithm of options from least to most surgery being at the most obviously
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  invasive, complex end, And then simply rest at the, at the easier end.
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  as something lasts longer, you're more likely to have to march up the, treatment
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  level of complexity towards surgery.
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  So, the sooner you can, get things turned around and headed in the
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  right direction, the, the better.
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  and early on that.
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  Simple.
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  Usually simply involves, you know, adding, stretching, or maybe an anti-inflammatory.
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  Carl (Host): Yeah, as you kind of mentioned it, people should have a kind of
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  sense of their body to know when it's kind of an acre pain they can work through.
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  And when something feels a lot different and they know now,
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  now it's time to get some help.
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  Edward Blocker, MD: Exactly.
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  I tell patient's all the time, listen to your body.
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  It'll tell you.
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  when to seek advice or if, You know, sometimes we're grown up with
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  the adage of, no pain, no gain.
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  But, but at this point, at this point, sometimes it's best to, it's not giving
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  in if it's a consistent pain that's there, especially if it's limiting your
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  activities or, you know, a certain, swing, that it happens every time and you
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  notice you're losing power because of it.
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  It is probably asking for help
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  Carl (Host): as you mentioned a minute ago, there's a a range of, of, of
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  treatments that might be needed from this physical therapy to, to surgery.
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  Maybe you could talk a little bit about the, the steps of that and, and
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  when it comes to surgery, the kind of things that that one might expect
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  if they go down the surgical route.
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  Edward Blocker, MD: Yeah.
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  So, the beginning treatments of, of most of these things begins with, some
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  stretching, just picking tennis elbow as an example, and it's, This is applicable
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  to, to most of the other maladies, tennis elbows, uh, inflammation of the ligaments
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  on the outer side of your elbow, and simply, uh, stretching those muscle
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  group in the beginnings, stretching those muscle groups, so that they're not.
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  so tight from the origin of the muscle off of the bone.
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  it helps again, return it for elasticity, maybe addition of
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  an anti-inflammatory, an oral anti-inflammatory like Advil or Aleve.
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  Of course, as long as there's no other medical reasons not to take those.
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  step above That is, is oftentimes a cortisone injection.
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  That's a.
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  that's also an anti-inflammatory, but it's a steroid anti-inflammatory, and
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  it, and it goes, you know, right to the source as opposed to a medicine
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  that goes everywhere systemically.
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  physical therapy sometimes for i'll, I'll oftentimes give patient's
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  exercises to do in the office.
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  Instruct them in the office And what they can do at home.
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  oftentimes adding in anti-inflammatory.
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  See them back if it's still hurting, good percentage of those patient's
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  don't need that follow-up appointment 'cause it's better and they've
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  returned to play, but they have the appointment if it's not better.
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  Plan B is oftentimes that cortisone shot I mentioned, or
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  sometimes formal physical therapy.
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  I'll send people to therapy for two reasons.
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  one to learn the right exercises.
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  Two to make sure you do 'em.
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  So, I would probably have to have an appointment with a
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  therapist to make sure I do it.
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  if you have a lot of discipline and you know, they write exercises,
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  you can do it on your own at home.
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  But that kind of third level might be actually going to formal physical
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  therapy and there's always additional stretches they can show you.
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  And then when we get to, if, if all the failing, all of that, which fortunately
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  is a, we're getting into a m much smaller percentage of patient's now.
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  You know, end, end up at this surgical level and surgery, is very reliable
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  way to cure all these maladies.
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  We're, we're in a good place with this and.
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  There's a lot of arthroscopic techniques now and min more, uh, minimally
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  invasive, procedures we can do.
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  It's still a long rehab.
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  The, the, the recovery after surgery, is always longer than people want it to be.
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  The human body is.
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  it's still healing at the same rate.
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  It always has.
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  we've come up with better procedures, but the healing time is still slower.
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  so, average, 6, 8, sometimes 12 weeks of, of recuperation after these surgeries.
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  So that's another reason to deal with it early rather than late.
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  Carl (Host): Yeah.
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  The technology that you've probably seen over your career, has developed
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  and, you're probably able to do things now that maybe you weren't, when
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  you, you started, has that had a big impact on, uh, this kind of work?
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  Edward Blocker, MD: Yeah, it has, especially in the world of joints.
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  I never thought I would be talking to patient's about
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  robots, but, uh, here we are.
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  We're, uh, and, and even ai, we use AI daily in the office.
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  AI is getting integrated into our robotic surgeries.
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  so yeah, there's things that, you know, my grandfather was an orthopedist.
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  I don't think.
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  He saw this coming.
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  but uh.
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  Carl (Host): Amazing stuff.
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  kind of, to that point, but are there still misconceptions or, maybe common
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  questions that you get from patient's?
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  Edward Blocker, MD: Yeah, probably one of those that I hear the most may
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  not be totally applicable to, sports injuries and such, but a lot of times
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  people feel like they should, have a joint replacement, for instance now,
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  because they might need it later.
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  But the, the indication for a.
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  For a joint replacement, a hip or a knee or these days even
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  ankles and, shoulders is pain.
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  So, I tell people all the time, you know, your joint will tell you
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  if it's time for something like that, And that This is applicable
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  to a lot of things in orthopedics.
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  So if it's, not to that level.
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  you know, we're all gonna be older later, but, um, surgery now
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  for symptoms that don't warrant it, I don't think's a good idea.
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  You may never reach those symptom levels.
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  We're all gonna be older, but, it'd be kinda like, our car tires are gonna have
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  more mileage on 'em later too, but you wouldn't change 'em at, at 15,000 miles.
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  so I think that's, that's probably one of the biggest things I hear.
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  That's a, you know, misconception that people have.
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  Carl (Host): Well, doctors, we prepare to close.
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  Maybe you could talk a little bit about what got you into
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  orthopedics and sports medicine.
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  I know you mentioned your grandfather, uh, was an orthopedic surgeon, but
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  what, what drew you to the specialty besides the family connection?
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  Edward Blocker, MD: Yeah.
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  I've always liked using my hands since I was a young, young kid.
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  One of my other one grandfather was an orthopedist.
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  The other was a, was a carpenter.
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  I worked with him and, and, had a farm and, And farms.
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  You fix things all the time.
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  Plus he built houses.
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  So I worked with him at a very early age and really enjoyed using my hands.
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  Things that were broken that, that we would fix, was very gratifying.
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  My other grandfather was an orthopedist, and when I realized that that's kind
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  of a glorified carpentry, and you actually have the added satisfaction
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  of, helping people, feel better, it was, uh, just, I figured out at, at seven
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  years old, that's what I wanted to do.
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  Carl (Host): I suppose the, the carpenters may be using robots
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  too to do their work these days.
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  Edward Blocker, MD: They are CNC machines.
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  They're, uh, a lot of similarities.
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  And, uh, in some cases I, I think some of the carpentry procedures might be
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  harder than what we do, but, uh, but it's all, it's uh, it's all hand eye.
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  and best thing I like about orthopedics is it's, uh, not, not just hands
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  on, but it's a lot of common sense.
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  Carl (Host): Yeah.
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  Very good.
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  Well, I'm sure, uh, podcast hosts will be done by robot someday soon, but I'm
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  glad today was not and I was able to have this conversation with you, Dr.
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  Edward Blocker, orthopedic surgeon.
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  Uh, a lot of great advice.
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  We appreciate it.
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  Edward Blocker, MD: Sure enjoyed it.
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  Thanks.
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  Good
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  talking to you.
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  Carl (Host): Good talking to you as well.
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  And if you enjoyed this podcast, please share it on your social
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  channels and explore our entire podcast library for other topics of interest.
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  To find a physician, visit novant health.org.
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  For more health and wellness information from our experts,
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  visit healthy headlines.org.
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  I'm Carl Moroni, This is Meaningful Medicine.
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  Thanks for listening.