Michael L Gross, MD  
Male, 64
Hackensack,Westwood, NJ

Specialties: orthopedic surgery, sports medicine

Interests: Orthopedics, Knee and Shoulder Arthroscopy
Active Orthopedics & Sports Medicine
Hackensack, NJ
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Oct 09, 2011 - 7 comments

Acupuncture and Sports Medicine
More and more injured athletes are turning to alternative medicine to treat their aches, pains, sprains and strains.  Chief among these modalities is acupuncture. Acupuncture has a very successful record with sports injuries.  More and more professional sports teams have put acupuncturists on their medical staff to accelerate healing and to resolve stubborn injuries. .Acupuncture remains one of the primary means of quick healing for the martial arts. Specific acupuncture styles and techniques were developed to stop pain and dramatically increase recovery time. This tradition continues today and its use has expanded into competitive athletic and sports that result in every type of injury. Acupuncture is used effectively to reduce the pain and inflammation of sports injuries.  It has also been shown to increase range of motion and accelerate healing time.  Acupuncture can benefit athletes at any level, in all phases of injury: to prevent, to treat acute pain, swelling and spasms, and to address conditions that make athletes vulnerable to re-injury.  In terms of modern western medicine, studies have shown that acupuncture increases blood circulation to specific areas of the body, which not only promotes healing of sports injuries but could also boost athletic performance.
The January 2008 issue of the Clinical Journal of Sports Medicine observed the effects of acupuncture on cyclists.  Participants were divided into three groups that either received acupuncture, sham acupuncture or no acupuncture prior to periods of high-intensity cycling.  The study revealed that the group who received acupuncture that adhered to the principles of Traditional Chinese Medicine had a higher performance scores and rode faster than their counterparts.
A study conducted at the Beijing University of Traditional Chinese Medicine in which athletes received acupuncture after running three miles revealed quicker heart rate recovery than those in the control group.
Recently, a Johns Hopkins University study found that people with chronic tendinitis or arthritis who had 20-minute acupuncture sessions twice a week for 6 weeks had less pain and disability than people who only thought they were receiving acupuncture, but were receiving placebo treatments where the needles didn't penetrate the skin.
Additionally, a 2008 study in the Journal of Alternative and Complementary Medicine found that participants who received acupuncture therapy for muscle soreness 24 and 48 hours after they exercised to exhaustion reported significantly less pain than people who didn't receive the treatment.
In the most basic explanation,the underlying premise of acupuncture lies in understanding the energetic system of the body, which consists of Chi.
Chi is the energy which circulates throughout the body and is responsible for the proper balanced and harmonious functioning of all of the organs and processes of the body. When the Chi or energy becomes blocked or deficient, or travels in the incorrect direction, then disease is the result.
By strategically placing the acupuncture needles in different points along the meridians or energy conduits of the body, the acupuncturist is able to direct the flow of this Chi, to unblock the meridian of “stuck” energy, or to control the increase or decrease or balance of Chi throughout the body.  This is not unlike unclogging an artery that delivers blood and nutrients to the heart to prevent a heart attack.
In modern western terminology, there are several theories which might explain acupuncture's effectiveness for pain control. One such theory postulates that the acupuncture needles trigger the release of endorphins, or neuro-chemicals in the brain, which are responsible for the feeling of well-being.
Some common injuries and diagnoses that fall under usual treatment of Sports Medicine specialists include: medial & lateral epicondylitis, frozen shoulder, plantar fascitis, acute olecranon bursitis, acromioclavicular joint separation, rotator cuff tendonitis, osteoarthritis of all joints, bicepital tenosynovitis, lumbar disc herniations,  patellofemoral syndrome, Osgood Schlatters syndrome, ankle sprains, shin splints,musle contusions and others.  In addition, acupuncture can be a valuable aid in relieving post operative pain and inflammation after surgical treatment for sports medicine, or is used as an adjunct to tradional physical therapy. The key here is that eastern and western medicine can be used together, and that in doing so they will give a better result.
Acupuncture is an effective treatment for Sports Injuries because it reduces pain, increases range of motion, increases recovery and healing time, and strengthens weakened parts of the body. These effects are accomplished during treatment because acupuncture:
• decreases inflammation
• reduces swelling
• relaxes muscles and relieves spasms
• decreases bruising
• lowers the body’s pain response
• improves local blood circulation to increase delivery of nutrients and removal of noxious elements
Acute injuries need to be properly assessed before any type of treatment can begin. Most musculoskeletal sports medicine injuries are evaluated by an orthopedist before treatment begins. When necessary, xrays and MRI can be used to reach an accurated diagnosed.  As traditonal treatment progresses Acupuncture proceeds along a parallel track. Acupuncture should then begin as soon after an injury as possible for the best results. Acupuncture treatment is also started with a full evaluation and examination.
Acupuncturists classify acute injuries as Excess conditions. In other words, there is an excess physical response (too much pain) or an excess biochemical reaction (too much inflammation or swelling). If Acupuncture treatment is given soon after an injury occurs, this encourages the body to correct this excess in a rapid fashion. An improvement is usually noticed after one or two treatments. If an injury is not very severe, 3-4 treatments can resolves the condition.
Right after an acute sports injury happens it is helpful not to forget the acronym RICE. Each letter stands for one of the four steps to follow immediately after an injury: Rest, Ice, Compression and Elevation. This will help quicken recovery and provide short term relief. Remember, Acupuncture is not a substitute, but an addition to traditional treatments that work.
Chronic injuries also need to be properly assessed before any type of treatment begins. It is important to determine if there is an underlying structural cause for a lingering injury such as a loss of cartilage, formation of scar tissue or degenerative damage of any kind. Once the complete underlying framework of the injury is understood, an acupuncture treatment plan can be devised to address both the main symptoms and their causes. This may include acupuncture treatments, Chinese herbal formulas, stretches and exercises, diet modifications and the use of liniments or balms. Corrective exercises can be provided in conjunction with a physical therapist or athletic trainer. Again, traditional western medicine is used side by side with acupuncture.
Acupuncturists classify chronic sports injuries as Deficient conditions. Deficiency refers to a weakness or lack. Over time, unresolved sports injuries lead to areas losing strength, flexibility and stability. Instead of focusing on removing excesses, acupuncture for chronic conditions focuses on invigorating and strengthening specific parts of the body. This is done while also decreasing the pain that commonly accompanies most chronic sports injuries.
It is more difficult to generalize the length of treatment for chronic conditions.  Even so, a person should notice a positive change in his/her specific condition within 8 to 10 treatments, although many chronic injuries respond quickly to acupuncture. After which, an accurate prognosis for complete resolution of the problem can be given.
Acupuncture and Sports Medicine are ideal team mates.  Many Acute sports injuries result in pain caused by inflammation and swelling. Acupuncture is the perfect modality for treatment without risk of harmful side effects. When surgery is necessary, acupuncture can reduce pain, increase healing, and reduce down time. For chronic injuries, acupuncture can not only reduce symptoms, but can aid in the resolution of the underlying causes. By increasing strength, flexibility, and range of motion, performance is ultimately improved.

Nine Steps to Healthy Bones

Apr 27, 2011 - 2 comments

Osteoporosis is a major public health threat for an estimated 44 million Americans, or 55 percent of the people 50 years of age and older. In the U.S. today, 10 million individuals are estimated to already have the disease and almost 34 million more are estimated to have low bone mass, placing them at increased risk for osteoporosis. While osteoporosis is often thought of as an older person's disease, it can strike at any age.

Osteoporosis is a disease in which bones become fragile and more likely to break.  If not prevented or if left untreated, osteoporosis can progress painlessly until a bone breaks. These broken bones, also known as fragility fractures, occur typically in the hip, spine, and wrist.  The US Surgeon General has identified osteoporosis and fragility fractures as major public health problems.

Osteoporosis has no symptoms. You notice no pain or change as the bone becomes thinner, although the risk of breaking a bone increases as the bone becomes less dense.  A bone mineral density (BMD) test is usually done to see whether you have osteoporosis. The most accurate test of BMD is dual-energy X-ray absorptiometry (DEXA), although there are other methods. DEXA is a form of X-ray that can detect as little as 2% of bone loss per year. A standard X-ray is not useful in diagnosing osteoporosis because it is not sensitive enough to detect small amounts of bone loss or minor changes in bone density.

Many men don't think they are at risk for osteoporosis, since these are commonly considered to be conditions of older women. Because men have a higher peak bone mineral density than women at middle age, osteoporosis tends to happen at an older age in men. But aside from the hormonal change in women as they go through menopause, the risk factors are risks for men as well as women. Men are also at risk if they have low levels of the hormone testosterone.

Your bones don't reach their greatest density until you are about 30 years old, so for children and people younger than 30, anything that helps increase bone density will have long-term benefits. If you're older than 30, it's still not too late to make these lifestyle changes. A balanced diet and regular exercise will help slow the loss of bone density, delay osteopenia and osteoporosis, and delay or prevent osteoporosis.

1.  Maximize calcium intake.  Most recommendations are for 1000 milligrams of calcium per day for both men and women.  According to the NIH, after age 50, both men and women should increase their intake to 1200 milligrams.  Dairy products contain calcium, so do broccoli, almonds, and sardines.  Calcium supplements are also useful.  Discuss these with your doctor or pharmacist before starting.

2.  Increase Vitamin D intake.  Once calcium is ingested, vitamin D is essential to help your body absorb it and utilize it.  For both men and women, the recommended daily intake of vitamin D is between 400 and 800 international units.  This can usually be met with a balanced diet.  However supplements are available.

3.  Exercise Regularly.  To improve and maintain bone density a combination of regular low impact, weight bearing exercise and resistance exercises works best.  Weight bearing exercise includes walking, jogging and even dancing.  If you are fit, and your doctor approves, jogging, tennis, basketball, or jumping rope are all weight bearing exercises, but are not low impact.  Low impact activities include walking, elliptical or stepper routines, and cycling.  Resistance exercises use weights or elastic bands to increase the work as you move against gravity.  Body weight also provides resistance, so push-ups, pull-ups, and toe raises can be a good place to start.  Be sure to start slowly, and increase slowly to avoid injury.  A functional exercise program that increases balance and agility is your

4.  Play Outside.  Exposure to sunlight on the skin allows the body to manufacture vitamin D3 from cholesterol.  As little as 15 minutes a day of moderate sunlight is enough to provide enough vitamin D to meet the most people’s needs.  Humans make 90 percent of our vitamin D naturally from sunlight exposure to our skin – specifically, from ultraviolet B exposure to the skin, which naturally initiates the conversion of cholesterol in the skin to vitamin D3.  It is not possible for the body to over produce Vitamin D in this manner. Excess production is metabolized away.  However, exposure to ultraviolet rays to the point of burning is not advised.  If one regularly avoids sunlight exposure, it may be necessary to supplement with at least 5,000 units (IU) of vitamin D daily. To obtain this amount from milk one would need to consume 50 glasses. With a multivitamin more than 10 tablets would be necessary. Neither is advisable.
The skin produces approximately 20,000 IU vitamin D in response 20–30 minutes summer sun exposure—100 times more than the US government's recommendation of 200 IU per day!

5.  Avoid excessive alcohol.  Moderating alcohol intake has a direct effect on bone strength.  Drinking heavily increases calcium absorption from bone and decreases bone density and strength.  Excessive drinking also leads to falls which can be a cause of fragility fractures.  Carbonated colas also promote absorption of calcium from bone.  Excessive cola consumption should also be avoided.

6.  Stop Smoking.  Smoking is toxic to your bones.  It appears to increase the rate of bone loss when bone density is compared in smokers versus non-smokers.  In addition, the effects appear to build up over time.  Quitting smoking will halt and partially erase the effects of cigarettes on the bone over time.  However, it will not eliminate them completely; therefore, the best advice is not to start.

7.  Speak to your doctor.  Your doctor can evaluate your family history and current lifestyle to identify risk factors for osteoporosis.  Current medications or other medications may increase your risk of osteoporosis. Evaluation of your diet and nutritional counseling can help to insure to the proper intake of calcium and Vitamin D necessary to maintain bone health.  Bone Mineral Density testing can be arranged to identify problems and their severity, to institute the appropriate level of treatment.

8.  Medications.  Although there is no cure for osteoporosis, currently bisphosphonates (alendronate, ibandronate and risedronate), calcitonin, estrogens, parathyroid hormone and raloxifene are approved by the US Food and Drug Administration (FDA) for the prevention and/or treatment of osteoporosis.  Like all medications, these drugs each have specific risks and benefits. There may also be possible interactions with drugs you are currently taking.  This should be carefully discussed with your doctor and your pharmacist.

9.  Start young.  Since most adults don not reach their peak bone density until age thirty, early habits are the most important.  The higher the bone density before it reaches its peak, the better.  Children should learn early to eat a diet adequate in calcium, to maintain high levels of activity, and to get enough time outdoors in the sunshine.  Needless to say, children should be taught not to smoke and to avoid excessive alcohol.  

10 Tips to Avoid Ski Injuries this Winter

Mar 02, 2011 - 1 comments

Winter is still with us, just look out the window and there is certainly no doubt of that.  While you may have already hit the slopes, it is never too late to think about safety.  Skiing is a high speed sport that requires strength, endurance, balance, skill, and co-ordination. Muscles involved are the quadriceps, hamstrings, gluteals, abdominals, upper body and especially the core.
At highest risk for injury, are the joints of the lower limbs, which bear the brunt of the forces passing through the body while skiing. The knee joint is the most vulnerable joint while skiing, with the ankle joint, the wrist, thumb and shoulder being the other joints commonly injured. Improvement in ski boots and bindings protect the foot, ankle and the tibia from injury. Unfortunately, this results in the even greater ground forces being transmitted to the semi-flexed knee. While overall injury rates for skiing continue to drop, knee injuries, particularly to the anterior cruciate ligament (ACL) are on the rise.
Skiing is generally considered to be a sport with a high injury risk. Although, recent advances in design of equipment, as well as technique, has resulted in a drastic reduction of risk. However, injuries to the anterior cruciate ligament of the knee, and spinal injuries, continue to occur at an alarming rate. Thumb injuries are also a common occurrence.  When you are injured, seek medical attention; but the best treatment is to avoid injury altogether.
Presented here are 10 easy ways to prevent injuries while you’re out on the mountain:
1. Prepare for a ski trip with a conditioning program
A physical conditioning program is very important for avoiding injuries on the ski slopes. Physical conditioning is vital for improved muscular strength, endurance, co-ordination, and reflexes. Skiers should start doing exercises about a month and a half to two months prior to heading for the ski resorts. Some good exercises, to help prepare for the slopes include those which use similar motions. Swimming, bicycling and rowing use similar muscles and build endurance, as well as strength. Exercises which strengthen the thigh muscles are also helpful,.  Most important are exercises to build core strength and balance.  Don’t try to ski yourself into shape
2. Stretching is important
Stretching improves your flexibility, another key ingredient in avoiding a ski injury. When you stretch, combine both dry land stretching and ski stretches with your skis and boots on once you are out on the mountain.  Concentrate on stretching your legs and core, but don’t forget your upper body as well. Don’t forget to stretch when you get off the lift and are at the top of the mountain.  A few minutes of stretching before you turn back down the mountain, could be the best investment you make all season!
3. Choose the proper Equipment
Skiers using incorrectly adjusted skis and bindings are eight times more likely to sustain an injury.  Consider ski conditions, your ability, and your experience when choosing which skis to buy.  Buy skis and ski bindings together to ensure a proper fit. Choose skis based on your ability, the type of skiing you plan to do and your weight. Get measured by a professional to ensure a good fit.  Skis now are shorter and more shaped like an hourglass than in the past. If you’re still hanging on to your sentimental favorites, this is the year to update.  Choose poles that fit your height. To find the right size pole, stand in your ski boots and hold the pole upside down to the ground. Place your hand under the basket (the round piece at the bottom of the pole) and touch your thumb to the basket. Your arm and the pole should create a 90 degree angle. If the angle is more than 90 degrees, you need a longer pole. If the angle measures less than 90 degrees, your pole should be shorter.  Purchase boots for skiing that fit snugly and offer proper support based on your skiing ability. Novice skiers generally wear "soft" boots that allow for slower skiing while advanced skiers choose stiffer boots that offer agility and work well with speed.  Find ski goggles that provide protection from ultraviolet rays, wind and sun glare.  If you already have all the equipment you need, make sure it is well maintained, and in even better shape than you are!
4. Take a rest  
The highest risk of accident is after 3pm on the third day of your ski trip. This is because muscle fatigue reaches its peak 48 hours after you start your vacation.  In general, recreational skiers on a skiing holiday should follow the rule of three: after two days of skiing, the muscles of the lower limb are fatigued and therefore less able to protect against injuries. The rule of three thus recommends a stop no later than 3 pm each day, skiing not more than 3000m each day, and taking the third day off.
Don’t just rely on the rule of three. If you do feel tired while skiing or snowboarding, it’s important to listen to your body and take breaks as necessary. If you’re on the trail, pull off to the side—never stop in the middle, below a jump or blind rollover. If you can, head to the closest lodge for water and a snack, and rest for a little while before heading back out.
If you’ve really overdone it on the slopes in the morning, don’t overdo it and push yourself to ski all day. There’s nothing wrong with quitting a little early if it helps prevent a serious injury. Go get a massage or use the hot tub to soothe those tired muscles instead. Besides, there are fewer people in the resort hot tub in the mid-afternoon anyway.

5. Take a lesson
From the novice to the most experienced expert, an hour with an instructor at the start of your trip can be a good idea, and a great way to prevent injuries.  A qualified ski instructor can help you improve your skills, so that you can safely ski more challenging terrain.  Bad habits learned early on, are difficult to resolve on your own, and a good instructor can identify them and help correct them.  Proper form and technique are essential to avoid injuries.  It is important to choose ski runs that you can ski on successfully. If you select a run that is too difficult for your level of expertise, you are more likely to suffer an accident. Ask the ski instructor to describe the various runs so that you have a clear idea of what to expect, and what level of expertise is required. If you are skiing in unfamiliar terrain, an instructor can help identify the runs that are most appropriate for you, and also point out potential rough spots.
6. Don’t Drink and Ski
Don't drink alcohol at lunch or on the slopes. Most ski accidents happen in the afternoon. The effects of muscle fatigue—less strength and control—are increased by the consumption of alcohol. Contrary to popular belief, more relaxation is not always a benefit to your skiing.  Avoid alcohol while on the slopes.  Save the drink for après ski by a fire in the lodge
7. Dress well
When buying skiwear, look for fabric that is water and wind-resistant. Look for wind flaps to shield zippers, snug cuffs at wrists and ankles, collars that can be snuggled up to the chin and drawstrings that can be adjusted for comfort and keep wind out. Be sure to buy quality clothing and products. Dress in layers. Layering allows you to accommodate your body's constantly changing temperature. For example, dress in polypropylene underwear (top and bottoms), which feels good next to the skin, dries quickly, absorbs sweat and keeps you warm. Wear a turtleneck, sweater and jacket. Be prepared. Mother Nature has a mind of her own. Bring a headband or hat with you to the slopes, 60 percent of heat-loss is through the head. Wear gloves or mittens (mittens are usually better for those susceptible to cold hands).
8. Wear a Helmet.
Recent research has shown that the use of helmet reduces the incidence of any head injury by 30 to 50 percent, but that the decrease in head injuries is generally limited to the less serious injuries such as scalp lacerations, mild concussions (Grade I) and contusions to the head, as opposed to more serious injuries such as concussions greater than Grade II, skull fractures, closed head injuries and the like. There has been no significant reduction in fatalities over the past nine seasons even as the use of helmets overall has increased to 57 percent overall usage among skiers and snowboarders, and to as much as 43 percent within the population at greatest risk—experienced young adult male skiers and snowboarders. This trend emphasizes the importance of not increasing risk-taking behavior simply because you are wearing a helmet.   It is important that any helmet be properly fitted and that it not uncomfortably restrict your vision or hearing. Read the helmet manufacturer's information and learn about what level of protection a particular helmet will provide. All models are not the same and do not provide the same level of protection.
9. Fall Correctly
You are going to fall; falling while skiing is inevitable.  Since you are going to fall eventually, learn to fall correctly.  In a fall, keep your arms forward and your hands over your skis if possible. Keep your arms away from your body, don’t keep them tucked in.  Don’t fully straighten your legs when you fall - try and keep them bent.  After a fall, don’t try to get up until you have stopped moving.  
10. Ski Smart, Be Aware.
Observe the National Ski Areas Association Code listed below and share with other skiers the responsibility for a great skiing experience.
Always stay in control.
People ahead of you have the right of way.
Stop in a safe place for you and others.
Whenever starting downhill or merging, look uphill and yield.
Use devices to help prevent runaway equipment.
Observe signs and warnings, and keep off closed trails.
Know how to use the lifts safely.

Skiing can be a fun and healthy pastime.  Taking the time and making the effort to prepare, trying to observe a few simple rules, and being smart enough to know when you’ve done enough, can make all the difference.  Some injuries are unavoidable, but most can be prevented.  Hopefully, your next itinerary won’t include a visit to the ER.  But if you do have bad luck, follow up and get the proper care when you return home.  

Dr. Michael Gross, the founder and director of Active Orthopedics and Sports Medicine P.A., www.activeorthopedics.com , is the section chief for sports medicine and the orthopedic director for the center for sports medicine at Hackensack University Medical Center.  Dr. Gross is the co-founder and medical director of the Active Center for Health and Wellness, a unique facility promoting health through a combination of services including personal training, nutrition counseling, massage therapy, acupuncture, and Bio-identical Hormone Replacement Therapy www.activecenterforhealthandwellness.com

What is Sports Medicine? Five questions

Jan 31, 2011 - 11 comments

The terms “sports medicine” and “sports medicine doctor” are commonly used by athletes, coaches, trainers, patients, and even other doctors.  However, it is really fairly unclear as to exactly what these, and quite a few other terms are referring to.  Listed below are the five most common questions, and their answers, in hopes of giving you some guidance through the maze of sports medicine.

1. What is Sports Medicine?
Sports Medicine is the branch of medicine that is concerned with the treatment of injuries or illness resulting from athletic or recreational activities. Sports Medicine involves the prevention and treatment of injuries to athletes and other physically active people, as well as the use of exercise for recovery from non-sports injuries. Orthopedic (musculoskeletal system) surgeons (MDs) often specialize in sports medicine. The phrase “sports medicine” is not specific to one career/profession.  Instead, it encompasses a group of professionals from various disciplines whose focus is the health of an athlete. Athletes can be all ages and play on all different levels (youth, high school, collegiate, recreational, and professional).
Orthopedic sports medicine is a specific area in the sports medicine family that is concerned with the investigation, preservation, and restoration by medical, surgical, and rehabilitative means to all structures of the musculoskeletal system affected by athletic activity. While sports medicine originally began as an offshoot of several broader fields, designed to treat athletes in a way that allowed early, safe and efficient return to the playing field, the techniques and principles of sports medicine and now being brought back to general medicine. These methods are now being used to bring workers back to work, or simply to restore function to athletes and non athletes alike, to allow for efficient return to the activities of daily living.

2. What is a Sports Medicine Physician?
A Sports Medicine physician is a doctor with specialized training who promotes lifelong fitness and wellness, and encourages prevention of illness and injury. This physician helps the patient maximize function and minimize disability and time away from sports, work, or school.
He or she is a leader of the sports medicine team, which also includes specialty physicians and surgeons, athletic trainers, physical therapists, coaches, parents, other personnel, and, of course, the athlete.
After completing residency, they obtain 1-2 years of additional training in sports medicine through accredited fellowship (subspecialty) programs in Sports Medicine. Physicians, who are board certified in their specialty, such as Orthopedic Surgery, are then eligible to take a subspecialty qualification examination in Sports Medicine. Additional forums, which add to the expertise of a Sports Medicine Physician, include continuing education in sports medicine, and membership and participation in sports medicine societies. Many specialties including general medicine, family practice, physical medicine and rehabilitation, and of course, orthopedic surgery, offer advanced training and subspecialty certification in sports medicine. Each specialty brings its own expertise to the field.

3. Do Sports Medicine Physicians only treat competitive athletes?
No, Sports Medicine Physicians are ideal physicians for the non-athlete as well, and are excellent resources for the individual who wishes to become active or begin an exercise program. For the "weekend warrior" or "industrial athlete" who experiences an injury, the same expertise used for the competitive athlete can be applied to return the individual as quickly as possible to full function.  Most sports medicine physicians treat non athletes as well.  In doing so, they adapt the techniques and protocols that allow for athletes to regain a high level of function, to achieve the same goal for non-athletes in the normal daily lives.  From a worker injured on the job, to a stay at home mother hurt while playing with her kids, any patient can benefit from the application of sports medicine techniques to their problems.

4. What are the most common Sports Medicine Injuries?
Most Sports Medicine injuries fall into one of two categories: acute and chronic, or overuse. Acute injuries occur suddenly and are the result of a collision, a fall, or a simple twist. Chronic, or overuse, injuries are the results of repetitive stress placed upon a single body part. When repetitive stresses are increased too rapidly or with too much intensity and the body is not adequately prepared, an injury occurs.  When looking at the most common injuries, some of them are acute, and some are overuse. The seven most common sports injuries in order are:
• Ankle sprain
• Groin pull
• Hamstring strain
• Shin splints
• Knee injury: ACL tear
• Knee injury: Patellofemoral Syndrome
• Knee injury:  meniscus (cartilage) tear
• Tennis elbow:  lateral epicondylitis
• Shoulder injury:  Rotator cuff tear
• Shoulder injury:  AC separation
• Shoulder injury:  Dislocation

5. Does a Sports Medicine Orthopedist only treat injuries?
While a great deal of a sports medicine specialist’s time is spent treating injuries in athletes and non-athletes alike, much of the time is also spent on other responsibilities.  Much of the focus of sports medicine is on injury prevention.  Another large area of concern is the area of conditioning and optimizing performance.  Educating and coordinating coaches, athletes and the other members of the sports medicine team is also the responsibility of the sports physician.   Family doctors on the team often deal other issues such as cardiac evaluations, skin conditions, infections and asthma, but orthopedic sports doctors generally limit their scope to musculoskeletal problems.
Orthopedic sports medicine specialists…
• Condition and train athletes.
• Provide fitness advice relating to athletic performance.
• Give advice on athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on athletes’ short- and long-term health and performance.
• Coordinate medical care within athletic team settings, including other health care professionals, such as athletic trainers, physical therapists, and non-orthopedic physicians.
• Conduct on-the-field evaluation and management of illnesses and injuries.
Orthopedic sports medicine specialists have knowledge of…
• Soft tissue biomechanics, injury healing, and repair.
• Treatment options, both surgical and non-surgical, as they relate to sports-specific injuries and competition.
• Principles and techniques of rehabilitation that enable the athlete to return to competition as quickly and safely as possible.
• Knowledge of athletic equipment and orthotic devices (braces, foot supports, etc.) and their use in prevention and management of athletic injuries.

After an athletic injury, initial care often consists of Rest, Ice, Compression, and Elevation.  After a short time if the pain or swelling persist, or there is an inability to return to sports or regular activity, it is probably time to see the doctor.  With the information provided, hopefully the choice of which doctor see will not be as confusing.

Dr. Michael L. Gross, the founder and director of Active Orthopedics and Sports Medicine P.A., www.ActiveOrthopedics.com , is the section chief for sports medicine and the orthopedic director for the center for sports medicine at Hackensack University Medical Center.  Recognizing the importance of nutrition and alternative health in both sports medicine and overall wellness, The Active Group, LLC has added the Active Center for Health and Wellness,  www.activecenterforhealthandwellness.com which features one on one fitness training, diet coaching, massage therapy, bio-identical hormone replacement therapy, anti-aging and preventative medicine, and aesthetic medical services.