Dr. Mark Galland Discusses Youth Pitching, Use of the Curve Ball and Matt Harvey

Written by admin on August 27, 2013 – 8:36 pm -

Dr Mark Galland – Youth Pitching

ABOUT DR. MARK GALLAND:
Mark Galland, M.D. is an orthopaedic surgeon, sports medicine specialist and physician at Orthopaedic Specialists of North Carolina. He currently serves as a team physician and orthopaedic consultant to the Carolina Mudcats, the advanced A affiliate of the Cleveland Indians, medical director and orthopaedic consultant to the Louisburg College Athletic Program, medical director of the Barton College athletic program, adjunct clinical professor at Marietta College and team physician and Orthopaedic consultant to several area high schools.


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Sports & Health: Guidelines for Young Pitchers

Written by admin on April 15, 2013 – 7:54 am -

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.


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“It’s Not Funny”

Written by admin on March 8, 2013 – 12:24 pm -

Have you ever hit your “funny bone”? You know that spot on the elbow that causes a stabbing pain/ tingling (parathesia) down into your forearm and hand. In fact, when you hit the inner side of your elbow the sensation is anything but funny, right? The temporary tingling, stabbing pain, and inability to move wrist/ fingers comes from an ulnar nerve contusion (bruise), not an injury to the bone.

The ulnar nerve runs through an area in the elbow called the cubital tunnel, and when the elbow is flexed this area opens up so that the nerve is stretched and minimally protected by soft tissue. The nerve lies on top of bone, and is only protected from the outside by your skin in this position, therefore most ulnar nerve contusions will occur when the elbow is flexed instead of extended.

This nerve innervates muscles that move the forearm, wrist and fingers, while also providing sensation to the inner forearm, pinky side of the palm, and palmar aspects of the medial fourth and fifth digits (inside of ring and pinky fingers).

Ulnar nerve contusions may result in symptoms of varying duration, but usually things will return to normal with time. Icing the area should be done with caution (due to the superficial nature of the nerve), anti-inflammatories may be helpful, and upon return to activity one may wish to invest in padding for the area.

The ulnar nerve (at the elbow) can also be irritated in patients with medial epicondylitis, ulnar collateral ligament injuries, ulnar nerve entrapment, elbow fractures/ dislocations, or in some cases people have been known to experience a subluxation of the nerve.

Mary Sult (LAT, ATC) is a Certified Athletic Trainer at Orthopaedic Specialists of North Carolina. Mary regularly provides outreach services to Bunn High School (Bunn, NC). OSNC’s Sports Medicine staff also works with other schools and sports organizations in Franklin, Granville, Wake, and Vance counties. For more information please visit www.orthonc.com.


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“Injections for tennis elbow: Sometimes they work, sometimes they don’t.”

Written by admin on January 9, 2013 – 8:45 am -

NEW YORK (Reuters Health) Sep 27 – Among the variety of injections that have been tested for lateral epicondylitis – tennis elbow – it remains unclear which ones work and which ones don’t, a new systematic review concludes.

Tennis elbow affects 1% to 3% of the population and peaks between the ages of 45 and 54 years. Injection therapies have included glucocorticoids, platelet-rich plasma (PRP), autologous blood, prolotherapy, hyaluronic acid, botulinum toxin, polidocanol, and glycosaminoglycan polysulfate.

In an effort to determine which injection therapies work best, Dr. Robin Christensen from Copenhagen University Hospital, Frederiksberg, Denmark and colleagues conducted a systematic review of 17 randomized controlled trials that evaluated eight different injection therapies in 1,381 patients.

They considered only two outcomes: change in pain intensity and adverse events (including the number of adverse events leading to withdrawal).

Glucocorticoid, polidocanol, and glycosaminoglycan polysulfate proved to be no better than placebo in relieving pain of tennis elbow, according to the report online September 12 in the American Journal of Sports Medicine.

Botulinum toxin was marginally effective compared with placebo but was associated with significant side effects (transient paresis and weakness). Moreover, all trials of botulinum toxin had high or unclear risk of bias.

Autologous blood, PRP, prolotherapy, and hyaluronic acid were all significantly more effective than placebo, but only prolotherapy was significantly better than placebo after excluding results from trials with high or unclear bias.

Transient pain after injection was common in all the trials, but there were no withdrawals due to adverse events and no serious adverse events.

Overall, only three of the trials (18%) were judged to be low risk of bias.

The researchers conclude, “Our systematic review and network meta-analysis found a paucity of evidence from unbiased trials on which to base treatment recommendations regarding injection therapies for lateral epicondylitis.”

“Further high-quality trials are needed and should have an adequate sample size, valid inclusion criteria, including confirmation of the diagnosis with imaging, and valid and reliable patient-relevant outcome measures,” they add.


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I don’t play tennis, how do I have “tennis elbow”?

Written by admin on January 7, 2013 – 8:52 am -

You don’t have to be Serena Williams or Roger Federer to be diagnosed with “tennis elbow”. You may be surprised to learn that most of my patients with this condition have never played tennis, even once! Tennis elbow, or lateral epicondylitis, is the progressive degeneration of the tendons that attach the forearm muscles to the outside of the elbow.

Originally presumed to be an inflammatory condition, “tendonitis,” it is now well accepted that true tendonitis is only rarely present. The term “tennis elbow” originates in the high prevalence of the malady in tennis players. Players experience pain when grasping the racquet with backhand strokes being most problematic, but any grasping activity, even non-athletic, may be associated with pain. Primarily an overuse injury, racquet sports athletes, as well as painters, carpenters, and mechanics, are prone to developing tennis elbow.

Symptoms of tennis elbow include pain localized on the outside of the elbow, weak grip strength, and pain with specific motions (picking up a gallon of milk, turning a door knob, or holding a cup of coffee).

There are surgical and non surgical treatment options for tennis elbow. Non surgical options include: oral or topical anti-inflammatory medication, braces designed to change the angle of action of the tendon, lessen pressure at its boney insertion and decrease pain, exercises to stretch and strengthen the muscles and steroid injections directly into the tendon. Initially, rest, particularly avoiding those motions that cause the most pain are ideal. Once symptoms subside, stretching and strengthening the elbow will help prevent further damage to the tendon. We have recently enjoyed success with a promising emerging technique, Platelet Rich Plasma (PRP), injections directly into the failing tendon. Surgical treatment is an outpatient procedure in which the surgeon removes the defective tendon. The recovery time from surgery is a few weeks before normal subsistence level activities can be performed painlessly and 10-12 weeks before sport and weight activities can be resumed.

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 you can follow him on twitter: @drmarkgalland.

Kate Anderson, ATC/LAT is a post-graduate fellow at GOSM, Galland Orthopaedic and Sports Medicine. Follow her on twitter @kattethegreatt.


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Dr. Mark Galland Releases Podcast On Tommy John Elbow Ligament Reconstruction

Written by admin on July 18, 2012 – 6:58 am -

RALEIGH, N.C. – Dr. Mark Galland, a physician at Orthopaedic Specialists of North Carolina (OSNC) (http://www.orthonc.com/galland.html), has announced the release of a podcast on Tommy John elbow ligament reconstruction, a frequently-discussed topic in the sports world. In the podcast, Galland discusses the type of injury that requires Tommy John elbow ligament reconstruction, what type of athletes typically undergo the surgery, how the surgery works and what to expect during the recovery process. Dr. Galland serves as the team physician and orthopaedic consultant to the Carolina Mudcats, as medical director and orthopaedic consultant to the Louisburg College athletic program and as the team physician and orthopaedic consultant to several local high schools. The podcast can be found at: http://drmarkgalland.com/?p=187&preview=true

QUOTES:

“Tommy John Elbow ligament reconstruction is a common procedure that athletes undergo, particularly throwing athletes,” said Galland. “We want to make information about this surgery easier to obtain, so that more people are aware of how it works and can take advantage of the procedure.

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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Dr. Galland Releases Podcast On Tommy John Elbow Ligament Reconstruction

Written by admin on July 10, 2012 – 5:56 am -

Dr. Galland has released a podcast on Tommy John elbow ligament reconstruction, a frequently-discussed topic in the sports world. In the podcast, Galland discusses the type of injury that requires Tommy John elbow ligament reconstruction, what type of athletes typically undergo the surgery, how the surgery works and what to expect during the recovery process.

To listen to the podcast, click here: Tommy John Elbow Ligament Reconstruction EDITED


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Tommy John Surgery Gives New Life to Tired Arms

Written by admin on May 18, 2012 – 4:08 pm -

Every season, baseball fans lament the loss of some of their favorite pitchers to elbow injury. It is so common an occurrence that it is no longer a surprise – many fans seem to expect that one or more of their favorites will eventually fall prey to “Tommy John.” The doctors call it a UCLR – ulnar collateral ligament reconstruction. Baseball players and fans call it Tommy John surgery, named after the Los Angeles Dodgers pitcher for whom the procedure was first performed in 1974. It is one of the most significant advancements in sports medicine.  Read more about how this arm saving procedure has saved careers and allowed both men and boys to live their dreams.  http://www.orthonc.com/articles/Fixing_Pitches_Revised.pdf

 


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Red Sox Crawford Elects Rehab for Elbow injury

Written by admin on April 27, 2012 – 11:34 am -

Boston Red Sox CF Carl Crawford recently sought a second opinion on his aching elbow.  The diagnosis of a partial tear of the UCL (“tommy john ligament”) was confirmed by Dr James Andrews.  Details surrounding the the onset of the injury are unclear, but reports confirm that an MRI and 2 medical opinions concur on the diagnosis.  Although traditionally, treatment of UCLs has favored surgery over rehab, recently many baseball subspecialists have elected a more conservative approach for partial tears.  Apparently Crawford has been treated with a PRP injection and a course of rehab.  Generally this requires 3 months of activity restriction and rehabilitation.  Long-term results for non-operative treatment are mixed, and PRP is an emerging technology, so Bosox fans will cross their fingers and hope for a speedy return of their Left Fielder.  For more info on PRP injections http://www.orthonc.com/news-updates/what-prp-therapy.


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