Dr. Mark Galland

RALEIGH, N.C. – Dr. Mark Galland, a physician at Orthopaedic Specialists of North Carolina (OSNC) (www.orthonc.com), has been appointed as an adjunct clinical professor at Marietta College. In this position, Galland will be responsible for clinical instruction in orthopaedic surgery and sports medicine for the school and teaching their students at OSNC’s state-of-the-art orthopaedic sports medicine facility.

Marietta College is a private, coeducational, nonsectarian, undergraduate, residential, contemporary liberal arts school, which was founded in 1835. Located in Marietta, Ohio, the school boasts a student population of just more than 1,400 students. The Marietta College athletic program consists of 18 men’s and women’s teams including baseball, basketball, football, crew, cross country, soccer, softball, tennis, track, and volleyball, with nearly 400 student athletes.

Since joining Orthopaedic Specialists of North Carolina, Galland has focused on treating injured athletes. In addition to his role as adjunct clinical professor at Marietta College, he serves as a team physician and orthopaedic consultant to the Carolina Mudcats, the advanced A affiliate of the Cleveland Indians, as medical director of the Barton College athletic program, and as medical director and orthopaedic consultant to the Louisburg College athletic program. He also serves as the team physician and orthopaedic consultant to several local high schools.

QUOTES:

“I am honored to be named adjunct clinical professor at Marietta College,” said Galland. “I am looking forward to working with the students and athletes at the school, helping them begin their path to careers within orthopaedics and sports medicine.”

ABOUT DR. MARK GALLAND:

Dr. Mark Galland is an orthopaedic surgeon, sports medicine specialist and physician at Orthopaedic Specialists of North Carolina. Galland received his medical degree from Tulane University’s School of Medicine and completed his residency in the university’s Department of Orthopaedic Surgery. He began his career in orthopaedic surgery and sports medicine while serving in the United States Navy at a naval hospital at Camp Lejeune, N.C. There, he served as chief of orthopaedic surgery and was the recipient of numerous awards for both leadership and excellence in treating injuries common to sailors and marines. Since beginning with Orthopaedic Specialists of North Carolina, Galland has continued to treat injured athletes. He currently serves as a team physician and orthopaedic consultant to the Carolina Mudcats, the advanced A affiliate of the Cleveland Indians, as medical director of the Barton College athletic program, and as medical director and orthopaedic consultant to the Louisburg College athletic program. He also serves as the team physician and orthopaedic consultant to several local high schools.

RALEIGH, N.C. – Dr. Mark Galland, a physician at Orthopaedic Specialists of North Carolina (OSNC) (http://www.orthonc.com/galland.html), has been named the top Orthopaedic Surgeon in North Carolina by HealthTap, an online interactive health network. The award represents the highest recognition for orthopaedic surgeons in the network.

QUOTES:
“I am honored to be recognized as the Top Orthopedic Surgeon in the great state of North Carolina. It is even more special to know that my contributions, which I have never considered extraordinary, are recognized as noteworthy and special by my patients, their families and friends,” said Galland. “I truly enjoy serving my wonderful patients, and if anything I do can be considered special or worthy of praise, it is only because my patients are so. This award is a recognition and reflection of them.”

NEW MEDIA:
Dr. Mark Galland Blog

http://drmarkgalland.com

Dr. Mark Galland YouTube Channel

http://www.youtube.com/user/DrMarkGalland

ABOUT DR. MARK GALLAND:
Dr. Mark Galland is an orthopaedic surgeon, sports medicine specialist and physician at Orthopaedic Specialists of North Carolina. Galland received his medical degree from Tulane University’s School of Medicine and completed his residency in the university’s Department of Orthopaedic Surgery. He began his career in orthopaedic surgery and sports medicine while serving in the United States Navy at a naval hospital at Camp Lejeune, N.C. There, he served as chief of orthopaedic surgery and was the recipient of numerous awards for both leadership and excellence in treating injuries common to sailors and marines. Since beginning with Orthopaedic Specialists of North Carolina, Galland has continued to treat injured athletes. He currently serves as a team physician and orthopaedic consultant to the Carolina Mudcats, the High-A affiliate of the Cleveland Indians Major League Baseball team, and as medical director and orthopaedic consultant to the Louisburg College athletic program. He also serves as the team physician and orthopaedic consultant to several local high schools, as well as on the board of directors for the Trentini Foundation, a nonprofit scholarship organization. For more information, visit http://www.orthonc.com or http://drmarkgalland.com.

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MMI Public Relations
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In a recent message from Dr. Phalen of Wake Forest Chiropractic I found myself quite interested in some of his recent research on gluten/ grain consumption and I just wanted to take a minute to share. Dr. Phalen shared the following:

“I was asked recently to give a talk on the impact of gluten/grains on health and the opportunity gave me the push to get the info I’ve been trying to download to patients onto a one page algorithm (Grain Algorithm)…

I’ve seen my practice change significantly over the last 10 of my 21 years in practice. For a number of reasons; aging population, managed care, fewer PCP’s entering the field and unfortunately food industry practices — I’m seeing the need to help identify and refer for management conditions and disorders that seem to be accelerating in frequency.

Much of this seemed to trace back to gluten/grain consumption and the long term reaction to it…”

Dr. Shawn Phelan is a chiropractor practicing in Wake Forest, NC, treating neuro-musculoskeletal conditions with a focus on functional health care, food allergies and metabolic disorders. He works closely with primary care doctors and specialists in the management of his patients.

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“Patients treated for axial or radicular pain related to a spinal disorder reported less pain and disability after they quit smoking, in a new study.

The strong association between pain and smoking cessation was reported by older and younger patients alike.”

For more info Patients Who Quit Smoking Report Less Spine and Leg Pain

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Until now “researchers say that while cigarette smoking is one of the major causes of preventable disease, its effect on fracture healing and post-operative infection after long-bone fracture surgery hasn’t been well studied.”

However, this “study brings together the published data on the effects of smoking on long-bone fracture healing into a single meta-analysis with a large number of patients. We showed that smokers are at a higher risk of long bone fracture nonunion..”

For more info Fractures in Smokers Don’t Heal as Well or as Quickly as in Non-Smokers

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“Smokers may need more revisions and have more complications after total hip arthroplasty (THA), regardless of the number of pack-years smoked and whether or not they quit before their surgery, new research suggests.

‘A failed total hip arthroplasty can devastate and debilitate a patient’s health and finances…’

For more info Smokers May Have More Problems After Total Hip Arthroplasty

“Preparticipation screening of endurance athletes has gained interest during the past decade. Its main focus is to prevent sudden cardiac death (SCD) from unrecognised cardiac pathology, including hypertrophic cardiomyopathy (HCM) and arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) in individuals <40 years, and predominantly coronary artery disease in ≥40 years of age.[1–3]

If the results of clinical evaluation or preparticipation screening (including medical history, assessment of symptoms and signs and ECG) of athletes warrant further investigation, non-invasive imaging is typically used to identify the presence of structural heart disease.[4,5] The most frequently used imaging modality is echocardiography, which can accurately assess cardiac function and morphology, while being inexpensive, rapid and widely available."

For more info please see the complete article (from BJSM) posted below:

Head-to-head Comparison Between Echocardiography and Cardiac MRI in the Evaluation of the Athlete’s Heart

Niek H J Prakken, Arco J Teske, Maarten J Cramer, Arend Mosterd, Annieke C Bosker, Willem P Mali, Pieter A Doevendans, Birgitta K Velthuis

Apr 11, 2013

By Kerry Grens

NEW YORK (Reuters Health) Apr 11 – The aches and pains people suffer after exercising more than usual can be relieved just as well by more exercise as by massage, according to a new study.
“It’s a common belief that massage is better, but it isn’t better. Massage and exercise had the same benefits,” said Dr. Lars Andersen, the lead author of the study and a professor at the National Research Center for the Working Environment in Copenhagen.

Earlier research has shown that massage can offer some relief from work-out soreness.

To see how well light exercise compares, Dr. Andersen and his colleagues asked 20 women to do a shoulder exercise while hooked up to a resistance machine.

The women shrugged their shoulders while the machine applied resistance, which engaged the trapezius muscle between the neck and shoulders.

Two days later, the women came back to the lab with aching trapezius muscles. On average they rated their achiness as a five on a 10 point scale, up from 0.8 before they had done the shoulder work-out.

Then the women received a 10-minute massage on one shoulder and did a 10-minute exercise on the other shoulder. Some women got the massage first, while others did the exercise first.
The exercise again involved shoulder shrugs; this time the women gripped an elastic tube held down by their foot to give some resistance. (Hygenic Corporation, which makes the tubing used in the study, supported the study.)

Andersen’s group found that, compared to the shoulder that wasn’t getting any attention, massage and exercise each helped diminish muscle soreness.

The effect peaked 10 minutes after each treatment, with women reporting a reduction in their pain of 0.8 points after the warm up exercise and 0.7 points after the massage.

“It’s a moderate change,” said Dr. Andersen, whose study appeared March 21st in the Journal of Strength and Conditioning Research.

He said he expects that athletes would notice the difference, however.

“I think that for athletes…by reducing soreness then they’re able to perform better, but we didn’t measure this. But if you are sore your movements are very stiff,” he said.

Dr. Andersen would like to see future studies track whether warming up the muscles to relieve soreness does indeed impact how well athletes perform.

It’s not clear how massage or exercise would relieve soreness, but Brumitt said that it’s thought that they help to clear out metabolic byproducts associated with tissue damage.

Andersen recommends that people try light exercise to ease their pain. The effect is moderate, and only offers temporary relief, but the benefit of using exercise, Dr. Andersen said, is that it doesn’t require a trained therapist or travel time.

“If people go out and exercise and get sore they can find some relief in just warming up the muscles,” he said.

SOURCES:

Medscape News

Journal of Strength and Conditioning Research 2013. – Abstract

Andersen, Lars L. PhD; Jay, Kenneth MSc; Andersen, Christoffer H. PhD; Jakobsen, Markus D. MSc; Sundstrup, Emil MSc; Topp, Robert RN, PhD; Behm, David G. PhD

“This paper is a revision and update of the recommendations developed following the 1st (Vienna 2001), 2nd (Prague 2004) and 3rd (Zurich 2008) International Consensus Conferences on Concussion in Sport …

The new 2012 Zurich Consensus statement is designed to build on the principles outlined in the previous documents and to develop further conceptual understanding of this problem …

While agreement exists pertaining to principal messages conveyed within this document, the authors acknowledge that the science of concussion is evolving, and therefore management and return to play (RTP) decisions remain in the realm of clinical judgement on an individualised basis…

This consensus paper is broken into a number of sections

1. A summary of concussion and its management, with updates from the previous meetings;

2. Background information about the consensus meeting process;

3. A summary of the specific consensus questions discussed at this meeting;

4. The Consensus paper should be read in conjunction with the SCAT3 assessment tool, the Child SCAT3 and the CRT (designed for lay use).

Please read the following for more information/ details:
Consensus Statement on Concussion in Sport – BJSM

“At a press conference held at the American Academy of Neurology’s (AAN’s) 2013 Annual Meeting, the release of new AAN guidelines for the evaluation and management of sports-related concussion (SRC) were announced. The recommendations update the 1997 AAN sports concussion practice parameter and were published online in Neurology on March 18, 2013.[1] The new guidelines attempt to address uncertainty and inconsistency in the management of concussion and mild traumatic brain injury (TBI) by addressing 4 clinical questions:

1. For athletes, what factors increase or decrease concussion risk?

2a. For athletes suspected of having sustained concussion, what diagnostic tools are useful in identifying those with concussion?

2b. For athletes suspected of having sustained concussion, what diagnostic tools are useful in identifying those at increased risk for severe or prolonged early impairments, neurologic catastrophe, or chronic neurobehavioral impairment?

3. For athletes with concussion, what clinical factors are useful in identifying those at increased risk for severe or prolonged early postconcussion impairments, neurologic catastrophe, recurrent concussions, or chronic neurobehavioral impairment?

4. For athletes with concussion, what interventions enhance recovery, reduce the risk for recurrent concussion, or diminish long-term sequelae?

The new AAN recommendations — divided into preparticipation counseling; assessment, diagnosis, and management of suspected concussion; and management of diagnosed concussion — were nicely summarized at the press event by lead authors Christopher C. Giza, MD, and Jeffrey S. Kutcher, MD. However, some areas of the guideline are open to interpretation, particularly when it comes to deciding when it is acceptable to allow an athlete with a suspected concussion to return to play. The following summary serves as a guide to the new report, highlighting the major recommendations and providing additional clarification based on comments from Drs. Giza and Kutcher…”

Please read the following for more information/ details:
New Concussion Guidelines – An Analysis

Cary, NC – It’s that “Field of Dreams” time of year and many young baseball players dream of throwing a perfect game and becoming the team “Ace.” The path to greatness begins much earlier and requires learning proper mechanics and maintaining pitching fitness.

Work Before Play – Strength & Conditioning

All young athletes should perform off-season strengthening and conditioning. Even If your youngster has become a one-sport athlete, focusing solely on baseball, he should not actually play year round.

Year-round play (11-12 months straight) has been associated with increased incidences of both minor and severe injuries. Even minor injuries can derail training and development, and put your athlete behind other players once practices and games begin.

Work with your athlete’s coach to determine what training and strengthening drills should be done, and strictly follow that program.

Pitchers Need 3 Months Off

Young pitchers need a three-month rest period from baseball each year. This means three months without any games, drills and practices; however, athletes should continue to follow their off-season training program.

Because adolescent players are still growing and developing, they must be careful to avoid over-training. Taking time off, while it can be disappointing, is critical to the long-term health and success of any athlete.

Lower the Pitch Count

Younger pitchers should have lower pitch counts. Pitchers as young as seven and eight years old should pitch no more than 50 pitches each game, with the number of maximum pitches per game increasing until players are 17 or 18, when pitches are capped at 105 per game.

A pitcher might think he feels up to pitching more than the recommended number of pitches during a game, but by failing to follow the guidelines he will likely find himself injured or overly sore.

Mechanics Prevent Injury

Pay strict attention to the proper mechanics of pitching. This will involve working with your athlete’s coach, and more specifically, his pitching coach, to ensure that he is using proper form and techniques.

It is critical to learn how to perform each pitch properly. Developing proper habits early can prevent future injury.

Age- Specific Pitches

Learning different pitches is age-specific. Fastballs and change-ups are to be learned and used exclusively early in a pitcher’s career.

As tempting as it might be for an elementary school-aged pitcher, the curveball should not be used earlier than age 12. A slider should not be attempted until age 16.

It is important to consult your athlete’s coach and trainer before serious training begins, so that they can also be involved. Your child’s physician can also be a valuable resource in helping you know when learning new pitches and skills is appropriate.

Play Ball!

For a long-lasting baseball career, these are important guidelines to follow and will make a critical difference in young athletes’ health and ability to excel in the sport.

Story by Dr. Mark Galland, a Board Certified Orthopaedic Surgeon specializing in sports medicine, practicing at Orthopaedic Specialists of North Carolina in Wake Forest and North Raleigh. Photo by Greg Westfall.

The above article was published on April 11, 2013 in Cary Citizen.

The arrival of spring’s warmer weather brings with it the desire to get more active. We are spending more time on the tennis courts, the golf course, the ball field, etc., providing opportunities to burn some energy and have fun … but unfortunately, being active also carries with it a risk of accidents and injury.

The ankle sprain is one of the most common injuries sustained by athletes and non-athletes alike. Simply stated, the “sprain” is a stretching or tearing of the lateral (outside) ligaments of the ankle: anterior talofibular ligament (ATFL), the calcaneofibular ligament (CFL), and the posterior talofibular ligament (PTFL). One or all of these ligaments may be damaged in a sprained ankle, and though uncommon, other ankle ligaments may also be damaged. The classic mechanism of such an injury is “rolling,” or inverting, the ankle after landing on another player’s foot or stepping on an uneven playing surface. This inversion mechanism of injury causes the ligaments to stretch, partially tear, or completely rupture. Very severe injury or repeated injury may ultimately result in chronic ankle instability. This results in decreased function of the ankle joint and becomes quite a nuisance for competitive athletes.

The primary treatment in both acute and chronic cases begins with external stabilization using ankle braces. This is combined with a rigorous rehabilitation program guided by a physical therapist. When conservative treatment measures fail and instability of the ankle becomes a daily issue, surgical intervention may be considered. The Broström procedure is primarily used to repair the ATFL; however, the CFL (and even more rarely, the PTFL) may be repaired during the procedure as well. By repairing these damaged ligaments, proper ankle mechanics and function are restored. The ultimate goal is to restore the ankle to its pre-injury state. The procedure has a 90% success rate, and athletes usually return to play within three-four months.

Recovery time after the surgery may vary depending on each patient’s response. Typically, there is a six-week period of time when the ligaments are allowed to heal. During these six weeks, the patient will be non-weight bearing or limited weight bearing status (in a boot) and only allowed to do light range of motion activities. After the initial six-week healing time, physical therapy is introduced to help regain proper ankle strength, range of motion, proprioception, and restoring a normal gait (walking without a limp). Returning to high level activities may take up to six months; however, it may be sooner depending on each individual.

Unfortunately, ankle injuries are a common result of today’s active lifestyles. If you happen to fall victim to an ankle injury and traditional treatments just don’t seem to help, remember that there are other alternatives available, and the Broström procedure may be the answer for you.

Dr. Mark Galland is a Board Certified Orthopaedic Surgeon specializing in sports medicine, practicing in Wake Forest and North Raleigh. He serves as team physician and Orthopaedic consultant to the Carolina Mudcats, High-A Affiliate of the Cleveland Indians of Major League Baseball, as well as several area high schools and colleges. Dr. Galland can be reached at 919-562-9410 or by visiting www.orthonc.com or www.drmarkgalland.com, or on Twitter @drmarkgalland.

Matt Rongstad, ATC/LAT is a post-graduate fellow of the GOSM program at OSNC.

The above article was published in Circa Magazine (April-May-June 2013).

You stepped in a hole, landed on another person’s foot, tripped on a root, or simply took an awkward step. We’ve all done it – that is, “tweaked” our ankle and assumed it must be just a simple ankle sprain. You push through the pain limping for awhile, waiting, expecting your ankle to return to normal. The swelling slowly reduces, but the bruising worsens until you cannot take a step without intense pain. Unfortunately, a more significant injury is present. How do you know when an injury isn’t just an ankle sprain, but rather an injury that could prove an impediment to your active lifestyle?

Many conditions can, initially at least, be confused with a simple ankle sprain. Fractures are the most common, and can involve bones of the ankle or nearby portions of the foot. Most frequently injured are the malleoli – the ankle bones that protrude the most, each resembling a small golf ball on each side of the ankle. Another common fracture site is the talus, which lies between the malleoli. Last, and technically not an actual bone of the ankle, is the fifth metatarsal that connects to your pinky toe; it is a part of the midfoot, but is often injured by a similar mechanism as other ankle injuries. Perhaps the most serious soft tissue injury of the ankle is the now-infamous high ankle sprain. This is an injury to the ligaments that connect the two lower leg bones, the tibia and fibula, together at the ankle. This often requires surgical correction, or at the very least, immobilization and restricted weight-bearing for several weeks.

Clinicians have a variety of tools available to make the correct diagnosis. The Ottawa Ankle Rules is one such tool that is particularly important in the athletic setting – on the court and on the field, and is routinely used to determine when an x-ray is necessary. The rules are somewhat technical in nature, but can be easily summarized as any direct tenderness of an ankle or foot bone, combined with the inability to walk four steps, indicate the need for medical attention. As in all cases, the rules are generalized and one should seek medical attention for any injury that one deems serious. The true inability to bear weight is a red flag that should dictate the need to seek professional medical attention.

The initial treatment for all of these injuries is immediate use of R.I.C.E. (Rest – Ice – Compression – Elevation) and should be continued for at least three days to decrease pain, swelling, and bruising. A physician skilled and experienced in treating sports injuries should be consulted as soon as possible. Sports medicine specialists are usually orthopaedic surgeons with additional training or certification in sports medicine. These physicians frequently care for a number of athletic programs and teams, and are well versed in the diagnosis and treatment of a variety of athletic injuries.

Preventing these injuries is always preferred to treating them, but is not always possible. Select footwear appropriate for the sport or activity. It must fit well, providing support and stability to the foot and ankle. If a history of multiple ankle sprains is present – a sign of underlying ankle instability – it is good practice to employ ankle taping or to wear lace-up ankle braces during activity. Perhaps most important is maximizing strength, endurance, and balance, which are best obtained with sport-specific drills performed as a part of a supervised rehabilitation program.

Ruby Floyd is a senior athletic training student at Western Carolina University, studying this semester at the GOSM program.

Dr. Mark Galland is a Board Certified orthopaedic surgeon specializing in sports medicine, practicing in Wake Forest and North Raleigh. He serves as team physician and orthopaedic consultant to the Carolina Mudcats, High-A Affiliate of the Cleveland Indians of Major League Baseball, as well as several area high schools and colleges. He can be reached at 919-562-9410 or by visiting www.orthonc.com or www.drmarkgalland.com, or on Twitter @drmarkgalland.

Above article published in Circa Magazine (January-February-March 2013, p. 46)