Every year in the United States, it is estimated that more than 40 million people play amateur sports, such as baseball, softball, basketball, and soccer. In many cases, the first time these players pick up a bat or ball is on game day, and this can cause problems. Since there is very little conditioning and many of these players are not as young as they used to be, their muscles, tendons, and ligaments are vulnerable to injuries

When this occurs, some find themselves in the waiting room of Dr. Cori Grantham. She is an orthopedic sports medicine physician in Plano, a former athlete and a participating physician at the Texas Health Spine & Orthopedic Center referral line. Dr. Grantham shared her insights about some common sports injuries and new, high-tech treatments.

The Most Common Injuries for Weekend Warriors

Baseball and softball leagues, for both men and women, are extremely popular, with dozens of games scheduled for every night of the week during the summer season. With these many players competing, many in less-than-optimal condition, the incidence of minor injuries is to be expected. However, serious injuries are also experienced by these amateur athletes.

“Most of the shoulder injuries we treat come from athletes competing in baseball and softball,” Dr. Grantham said, “and these are usually the result of improper mechanics. Overtime, these players begin to wear out their rotator cuff, which is the tendon that enables rotation of the shoulder. Biceps are also prone to overuse injuries in these sports.

“Knees get most of the injuries in the court sports, such as basketball, and field sports, such as soccer. These injuries are usually the result of quick cutting on the field or court. The anterior cruciate ligament (ACL)is the stabilizing ligament in the knee and tears in the area are also more prominent in these quick-cutting sports. There is also the possibility of patella (kneecap) dislocation.”

 Replacement Procedures

Replacing injured or worn out joints has become highly sophisticated, especially in the hands of a surgeon like Dr. Grantham.“For shoulders, there are two replacement procedures,” she said. “The standard replacement surgery is used when arthritis has occurred from wear and tear on the shoulder. With this procedure, the patient still has use of their original ligaments and tendons but the arthritic joint is removed and replaced with an artificial joint. This eliminates the bone-on-bone grinding in the shoulder.

“For shoulders, there are two replacement procedures,” she said. “The standard replacement surgery is used when arthritis has occurred from wear and tear on the shoulder. With this procedure, the patient still has use of their original ligaments and tendons but the arthritic joint is removed and replaced with an artificial joint. This eliminates the bone-on-bone grinding in the shoulder.

“The second type of shoulder procedure is used when the patient doesn’t have good use of their shoulder due to chronic rotator cuff tears. This type of patient doesn’t have use of their ligaments and tendons and this keeps them from being able to use their arms. This procedure is called a ‘reverse procedure’ and it changes the dynamics and force on the shoulder just enough to bypass the injured rotator cuff. This allows the patient to use those big muscles – the deltoid, latissimus dorsi (lats) and pectoral – that are located around the shoulder to have a functional shoulder again.”

“This is a complicated surgery because the shoulder is a complex joint,” she said. “It is one of the only ones that has 360 degrees of motion and has 22 muscles around it that makes it work. It has a lot of moving parts. There are a lot of factors to consider, and it takes a great deal of balance to keep it working properly.”

Innovations in Treating Knee Cartilage Injuries

Weekend athletes will sometimes damage the cartilage of the knee and this can be challenging for treatment.

“We only get one set of cartilage, or padding, in our joints,” Dr. Grantham said. “Once that wears down, or we have other issues with it, there is no way to bring back one’s native cartilage. Once it’s gone, it’s gone. This is why we try to protect and preserve the cartilage.

“If someone has experienced a loss in cartilage, we try to get something similar to the natural cartilage. We are very aggressive with cartilage injuries, particularly in younger athletes, because we want them to keep as much padding as possible.”

Medical literature has recently noted groundbreaking research being conducted in Israel where artificial scaffolding is used to generate new cartilage. This is scheduled to be tested in Europe in 2017. Dr. Grantham was asked if there are any cartilage replacement procedures available in the U.S.

“Actually, we have several procedures that have been approved by the FDA,” she said. “One method involves taking the patient’s own cartilage cells and growing that cartilage in a lab. When we get those cells back, we can use them as a ‘patch’ for the area that is damaged. It’s not an exact match, but it is the closest we can get to the native cartilage.

“We also have some similar products to those being tested in Europe, which take cartilage and bone grafts that we then put in place of the injured area. Again, this is not an exact match, but it gives the patient some padding in the area where cartilage has been lost.”

Are these procedures covered by standard health insurance?

“Yes, these procedures are usually covered by health insurance,” she said. “It can sometimes be a challenge to get the insurance companies to recognize this, but they are covered by most insurance.”

Engineering and Medicine

Medical procedures such as the use of artificial joints, reverse procedures, and cartilage scaffolding are engineering concepts that have been adapted to medicine. Dr. Grantham readily agrees.

“Those of us in orthopedics are very much ‘carpenters’ of the body,” she said. “We use engineering and physics in order to make the body work properly. When we are putting in a metal replacement, it’s very much like putting in a new part in a machine. All of these replacements must adhere to the same mechanical principles as the body in order to make them work.”

Physicians who are members of the referral program practice independently and are not employees or agents of THSOC.