Dr. Galland Featured in American Council on Exercise Article

Written by admin on July 8, 2013 – 4:10 pm -

Dr. Mark Galland was recently featured in an article published by the American Council on Exercise, titled “Muscular Imbalances Increase Your Client’s Risk for Injury.” In the article, Galland provides insight on muscular imbalances, their causes and how exercise helps prevent them.

To read the full article, visit:


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Posted in Health and Fitness, Injury Prevention, Sports Medicine | No Comments »

Prevention of Anterior Cruciate Ligament Injury in Athletes

Written by admin on June 9, 2013 – 7:16 pm -

A Review
Thomas Trojian, MD, Lindsay DiStefano, PhD, ATCDisclosures

Clin J Sport Med. 2013;23(2):120-121.

Abstract and Introduction

Sadoghi P, von Keudell A, Vavken P. Effectiveness of anterior cruciate ligament injury prevention training programs. J Bone Joint Surg Am. 2012;94:769–776.

Objective: To investigate whether anterior cruciate ligament (ACL) prevention programs reduce risk of injury in athletes, and which prevention program is most effective, by means of a review of the literature and meta-analysis of the results.

Data Sources: PubMed, MEDLINE, EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials databases were searched online using the terms anterior cruciate ligament, knee, injury, prevention, and control. The reference lists of relevant studies were searched for further trials.

Study Selection: Prospective controlled studies of humans, in any language, that reported on proprioceptive neuromuscular training techniques for ACL injury prevention compared with usual training programs were selected if they reported clinical outcomes and had an attrition rate of <20%. Three independent reviewers selected the studies and resolved differences by consensus. After duplicates were eliminated, the search identified 723 reports. Eight studies met the selection criteria.

Data Extraction: Details of the study design, participant characteristics, the intervention, the number of ACL injuries at follow-up, the duration of follow-up, and the sport played were extracted. Study quality was scored 0 to 3, according to use of randomization and blinding and adequacy of follow-up of participants. Pooled risk ratios (RRs) were calculated in random-effects models.

Main Results: Participants in the studies were predominantly women or girls who played soccer, basketball, or volleyball. The interventions included proprioceptive neuromuscular training and agility skills as well as strength, flexibility, and cardiovascular training, done either preseason or for 30 days to 12 weeks during the season. With 1 exception, the results of the interventions were positive, with the number needed to treat to prevent 1 ACL injury varying from 5 to 187 in those 7 studies. The pooled RR favoring the interventions was 0.38 (95% confidence interval [CI], 0.20–0.72). This included 34 ACL injuries among the 3905 intervention participants and 181 ACL injuries among the 6703 control participants. The pooled RR among female athletes was 0.48 (95% CI, 0.26–0.89) and among male athletes was 0.15 (95% CI, 0.08–0.28). The mean quality score for the studies was poor (mean, 1 point; 95% CI, 0.43–1.57 points). No variable such as type of intervention, timing of the program, or length of the program was clearly related to effectiveness.

Conclusions: Neuromuscular-focused exercise training programs to prevent ACL injuries were effective among both female and male athletes. Despite the poor methodological quality of the studies, the results were consistent.

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Posted in Knee, Sports Medicine | No Comments »

Dr. Mark Galland Discusses Injury Prevention Baseball For Amateur Athletes

Written by admin on February 21, 2013 – 8:08 am -

Dr. Mark Galland has announced the release of a podcast discussing prevention of common youth baseball injuries. In the podcast, Galland provides his expert opinion on some of the most common injuries associated with baseball: from little leaguer’s elbow to torn labrums and everything in between, and gives advice to parents, coaches and athletes on safety techniques for injury prevention.

“To prevent injury when playing baseball as a young athlete, the most important thing is to resist the temptation to achieve short term success at the expense of the long term goals of the athlete,” said Galland. “Too often I see that in the pressure to win we sacrifice the athlete, the baseball player or the pitcher that this child could be when he or she reach collegiate or professional levels.”

To listen to the podcast, click here: Injury Prevention In Youth Baseball

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“Athletic trainers are valuable health care professionals.”

Written by admin on January 18, 2013 – 12:56 pm -

Call it what you do – January 18, 2013

“Athletic trainers have fought for years to be recognized and have the approriate regulations in place to protect the public. Hard work has gone into making sure that it accurately reflects what we do for the public.

Let’s remember and remind people that we do athletic training. Within that is a number of things. We do injury prevention, diagnosis, injury management and treatment, rehabilitation, administration and professional development. What do we not do?

We do not do medicine. We work under a physician and we are in the sports medicine field. We are not board certified. We ARE certified by the Board of Certification. We are not performing physical therapy. We are very skilled at performing rehabilitation. We are not water boys/girls. We do promote the benefits of hydration and other ways to prevent heat illness. We are not equipment managers, but we are skilled at fitting equipment properly and making sure that appropriate checks are in place to ensure the safety of athletes. We do not coach or do personal training, but work with coaches and strength coaches to protect athletes and optimize a person’s plan. We are not the “trainer.” The appropriate title, and the one that you can use, is athletic trainer.

Be proud of what you do and be accurate in how you explain it. Do not let someone else define your profession. Define it for them. The law is there to protect what we do. Know your practice act. Read it. If you don’t understand it then ask someone to explain it. Don’t practice with an idea of what you think is your practice act. Know it. If you travel to another state then you need to know that practice act. Can you practice there? These are important things that many ATs neglect to pay attention to and it gets them in trouble. Know your practice act.

Athletic trainers are valuable health care professionals. We have a specific and important skill set. Your skills are unmatched in the health care field. This is why we are sought after professionals. People want our skill set. Do not let others try to minimize your impact. Do not let others define what athletic training is. Do not let yourself improperly defining what you do. You are an athletic trainer.”


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See What You Hit

Written by admin on September 24, 2012 – 9:41 am -

Football is one of the most dangerous and violent sports. Though it has been considered the classic “contact sport,” it is more accurate to say it is the ultimate “collision sport.” While concussions currently garner the media spotlight, injuries to the neck and spine are ignored– until disaster strikes. Recently, defensive backs at Catawba and Tulane Universities both suffered severe cervical spine injuries. Last season, at Rutgers University, Eric LeGrand was injured while making a tackle, and he remains paralyzed from the neck down.

The cervical spine is comprised of the first 7 spinal vertebrae. The nerves that exit the cervical spine are vital to both basic and sophisticated body functions including respiration and movement. Cervical spine injuries typically result from an axial load, which is a force that originates at the top of the head and continues longitudinally down the spine. “Spearing” is the term used for a tackle in which the player leads with the head, and the top of the head makes initial contact with the opponent. This type of tackle has been banned in the NFL to ensure the safety of NFL athletes as well as the young players that emulate them. Roger Goodell, commissioner of the NFL, has said that football needs a “culture change” in order to become a safer sport at all levels. Rules changes are welcome, but to decrease the prevalence of these injuries, It is perhaps more important that coaches, parents, and players be educated in proper tackling technique. The NFL has joined with USA Football, the governing body of youth football, to form the “Heads Up Football” initiative to teach proper tackling technique and increase awareness of head and neck injuries. According to Heads Up “The right way of tackling begins with ‘the breakdown’: feet set, hands sunken, the arc of the back straight and the knees bent. The head is up at all times.” A player must always be able to “see what you hit.” If you can’t, your technique is incorrect.

Given the inherent danger of participation in football, it is important to have a well-coordinated medical team present at every game. These medical professionals include the athletic trainers, first responders, team doctors and EMS. Fortunately, these teams were present on the sidelines at Catawba, Tulane, and Rutgers, their skilled, rapid, and coordinated efforts were essential in achieving the best outcomes.

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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Posted in Spine (Neck & Back), Sports Medicine | No Comments »

Injuries and Preventative Measures for Young Soccer Athletes

Written by admin on September 13, 2012 – 5:35 am -

Soccer is the most popular sport in the world with up to 230 million amateur participants. In the U.S. alone 3 million are registered in either high school or youth programs with an estimated growth of 21.8% annually.

As a result, soccer-related orthopedic injuries are more and more common. In 2006 alone, the CPSC (The US Consumer Product Safety Commission) estimated 186,000 soccer-related injuries. Up to 45% of those injuries reported occurred in athletes ages 15 years or younger.

The lower extremity is the most common location of injury. The ankle is the most common area injured, followed closely by the knee. In addition, Sever’s disease is perhaps the most common over-use injury seen in younger soccer athletes.

Sever’s disease, or calcaneal apophysitis, typically occurs in physically active youth between the ages of 8 to 15. The name sounds bad, but it is really not serious. Not really a “disease,” it is an inflammatory response at the growth plate of the heel bone where the Achilles tendon attaches. For soccer athletes, it usually results from excessive running on hard surfaces (not every pitch is covered in soft cushiony grass, too often the field is hard-packed earth) in cleats lacking proper fit, heel or arch support. Common symptoms include pain at the back of the heel and a limp that are aggravated during running. In severe cases, the pain may also be present with walking. As with many overuse injuries, the best treatment is to dramatically decrease activity. Severe cases may warrant complete non-weight-bearing for a period of time. Additional measures include rest of the injured area, providing a heel lift or heel cup for support, and stretching the calf and hamstring muscles 2-3 times per day. Prevention of Sever’s disease requires maintenance of flexibility of the calf and hamstring muscles, wearing well-fitted shoes that allow proper support throughout the entire foot, and adoption of a reasonable training regime that will not allow extensive amounts of vigorous activity for young developing athletes (particularly during growth spurts).

While Sever’s disease is among the most common soccer-related injuries, there are a number of other conditions to which soccer players are prone. Ankle and knee injuries account for over half of all injuries in soccer athletes regardless of the age. The major concern for all parents and athletes is the complete rupture of the anterior cruciate ligament (ACL) in the knee. Fear not, mom and dad! Help is on the way. A recent study published in the American Journal of Sports Medicine reported that the implementation of an injury prevention program resulted in 21% fewer injuries. Proper warm-up and cool-down, taping unstable joints, and exercises designed to improve the core stability, coordination, reaction time, and endurance were all incorporated into the training regime. The researchers also included a process of educating the coaches on proper training and the promotion of fair play.

While athletic participation will always carry the inherent risk of injury, Taking the proper steps towards injury care and prevention can be the difference between staying healthy and missing a number of games or even an entire season.

Orthopaedic Specialists of North Carolina partner with a number of youth athletic organizations in the greater Raleigh area. Dr. Mark Galland and his colleagues at OSNC are specialists in orthopedic surgery and sports medicine and are eager to assist any and all young athletes injured on the playing field. For immediate needs, our Wakefield and Knightdale locations have an urgent care clinic open 7 days a week from 9:00am to 9:00pm, no appointment needed.

Article by Dr. Mark Galland with Matt Rongstad, ATC/LAT

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Wrist Taping with Jen Hall

Written by admin on March 24, 2010 – 10:46 am -

Jen Hall teaches the United Volleyball 15 National Team how to best tape their wrists to prevent injury. Want to learn the best way to tape up your wrists? Watch the video below:

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