William Moore of College Park HS returns from shoulder surgery

William Moore knew something was wrong last December when he got up from the mat and his shoulder felt misplaced.  It wasn’t the pain you feel when your shoulder totally separates or when a ligament tears.

This pain was subtle at first and then the soreness began to increase.  Something wasn’t right.

“I wrestled with the pain for about 2 weeks before we decided to have it checked out,” says Moore, a junior on the College Park wrestling team.

Dr. Brandt Lipscomb of The Fondren Group of The Woodlands quickly discovered that Moore had sustained a torn glenoid labrum of the left shoulder.

The labrum in the shoulder is a cartilage disc attached to the socket of the shoulder that aids in maintaining shoulder stability.

Common symptoms for a labrum tear of the shoulder are deep aches within the joint, feeling of the shoulder popping out of the joint, and feeling the shoulder pop or click within certain movements.

After surgery Moore decided to rehabilitate his injury at TEKTONIC Athletic Development and Rehabilitation, a department of St. Luke’s The Woodlands Hospital.

“The trauma that occurred when William hit the mat with his arm extended out to the side was most likely the cause of his labrum tear,” said Andy Arthur PT, DPT, OCS, STC, CSCS of TEKTONIC Sports Medicine

“We were able to recognize the issue early and begin his rehabilitation treatment in very aggressive manner without jeopardizing the repair.”

Moore is expected to be released from rehabilitation in only 4 months after surgery.

“With labrum tears you have to be careful not to have the athlete return to sport too quickly,” adds Arthur.

“It is common for athletes to feel no pain during rehab, return to their respective sports, and then continue to have pain due to their joint not being back to fully strength.”

Arthur credits the streamlined progression of St. Luke’s The Woodlands Hospital’s sports medicine rehabilitation program and Moore’s dedication for having such a positive outcome.

“William’s progression was enhanced by the immediate recognition of the injury by Dr. Lipscomb, his arthroscopic surgical skills to reduce recovery time, having a specialized sports rehabilitation facility in TEKTONIC, and having an athlete who is dedicated to his return, works hard, and follows the treatment plan.”

Moore is looking forward to the spring freestyle wrestling competition organized by The Woodlands High School wrestling team.

“I feel very fortunate to have rehabilitated my injury through the TEKTONIC Sports facility so I can compete this spring,” says Moore.

“Dr. Arthur was extremely helpful in getting me back where I need to be to compete.”

William Moore graduates in the spring of 2013 and is looking to attend Texas A&M University or the United States Military Academy at West Point.

Of particular concern is the athlete whose symptoms persist beyond 3 to 5 days post-injury. Concussions can produce many symptoms, often resulting in physical (headaches, dizziness), cognitive (poor concentration, memory) and behaviorial changes (irritability, mood swings). These symptoms have the potential to not only impact the student’s day to day functioning, but also their performance in the classroom.

If symptom reduction is not evident within a few days, or severity of symptoms is of concern (see side bar – Grade 2 and 3), an MRI along with a neurological exam is recommended to rule out more serious intracranial pathology (skull fracture, hematoma, parenchymal lesion).

SIDE BAR
The severity of concussion is graded on a three-point scale and is used as a basis for treatment decisions.

Grade 1 No loss of consciousness, transient confusion, and other symptoms that resolve within 15 minutes
Grade 2 No loss of consciousness, transient confusion and other symptoms that require more than 15 minutes to resolve
Grade 3 Loss of consciousness for any period

Functional MRI [FMRI] images of a high school football player with a functionally observed impairment in the absence of a diagnosed concussion.  Depleted brain activity of frontal lobe.  From left to right: Preseason, In-Season 1, In-Season 2.  Reduced brain activity of the frontal lobe.  Photo courtesy of The Purdue Acute Neural Injury Consortium.

Integrated care among school staff and healthcare providers who are specialists in concussion management becomes critical for student athletes who are dealing with the symptoms of Post Concussion Syndrome that affect their ability to perform well academically, socially and physically.

Neuropsychological assessment has proven critical to the safe management of the concussed athlete, particularly with ensuring timely recovery and to prevent cumulative neuropsychological effects from a second concussion.

According to the American Journal of Sports Medicine Second-Impact Syndrome (SIS) can result where an individual sustains a second head injury before the symptoms from the first head injury have been resolved.

This often results in brain damage and in rare occasions death.

“This is a very serious consequence of not having the first concussion diagnosed or treated,” says Michael Knox Ph.D., neuropsychologist with St. Luke’s The Woodlands Hospital Concussion Center and Director of Neuropsychology of the Greater Houston Neurosurgery Center.

“We need to see a full and complete recovery from the first concussion before we put the student back into a situation where a possible second concussion can occur.”

A neuropsychologist can determine the nature of the cognitive, emotional and behavioral difficulties, assess the impact of symptoms on everyday life, ability to function effectively, monitor change over time and assist in the development of a rehabilitation program or course of treatment. Classroom based accommodations and support at school with teachers and coaching staff is an important part of the treatment plan.

Dr. Knox puts a tremendous amount of emphasis on the parent’s actions towards seeking treatments for their children

“The (neuropsychological) treatment process for a concussion does not have to begin immediately at impact,” says Knox. “But the sooner I get involved with the patient the sooner I can help guide the treatment. I seek to monitor the athletes symptoms, provide treatment and functional recommendations, and getting the athlete back to sport as quickly as I can. I am also very concerned about making their teachers aware of any subtle changes in thinking so we can avoid any difficulties in the classroom.”

In instances where the athlete continues to be limited by symptoms of headaches, blurred vision, dizziness and balance problems, vestibular rehabilitation along with a regulated exercise program specific to the athlete’s functional status with continued re-assessment may be prescribed.

Seeking treatment at a Concussion Center where medical treatment from first diagnosis to final release is integrated and streamlined between concussion management specialists can save the patient precious resources of time and money.

For more information about how to access services of The Concussion Center at St. Luke’s The Woodlands Hospital, contact Tektonic at 936-266-3130 or visit our website at www.stlukeswoodlands.com/tektonic

How grafts are shaping sports medicine

Allograft procedures of the shoulder promote successful outcomes from surgeries. These type of surgeries are being performed at St. Luke's The Woodlands Hospital

St. Luke’s The Woodlands Hospital |

Arthroscopy and the technique of minimally invasive surgery was first introduced to the medical community as early as 1917 as an alternative to the often barbaric open surgery techniques of earlier times.

Many surgeries procedures performed during those times involved heavy blood loss, more pain, and long inpatient recovery using older techniques.

Complications were not uncommon.

“The medical community has come a long way with treating shoulder ailments in the last 30 years,” says Dr. Andrew Arthur PT, DPT, OCS, STC, CSCS and Director of Clinical Services and Human Performance for TEKTONIC Sports, a department of St. Luke’s The Woodlands Hospital.

“We are traveling into new and exciting realms of sports medicine that are bringing new ways of delivering care for injured athletes.”

Orthopedic surgeon Marc Labbe’ MD of St. Luke’s The Woodlands Hospital has recently brought significant attention to the sports medicine community by delivering a new treatment for rotator cuff tears.

Using a surgical procedure called a “4 Corner Graft Augmentation” Labbe’ has pioneered a more reliable process to repair large and massive rotator cuff tears.

Labbe’s procedure involves anchoring a soft tissue graft through small arthroscopic incisions on each corner of a normal rotator cuff repair.  Hence a “4 Corner” structure.

“With this graft procedure we are able to literally patch the injured area of the shoulder together as you would a torn piece of clothing,” says Labbe’ Board Certified of the American Board of Orthopedic Surgery and a partner at The Bone and Joint Clinic of Houston in The Woodlands. 

Dr. Marc Labbe' of St. Luke's The Woodlands Hospital is a pioneer in the 4 Corner Graft surgical procedure of the shoulder

“We are able to stitch the graft on top of the repaired area to add additional repair strength and healing properties.”

New research confirms the patching process delivers an 85% success rate for full healing, compared with only a 40% rate for rotator cuff repairs without the grafting technique.

“This type of 4 corner graft technique should be considered for individuals who have experienced a large or massive tear of the rotator cuff which can occur with trauma,” says Labbe’.

“We are better able to treat situations where severely degenerative tissue occurs such as in overuse injuries and also in revision situations where an athlete is returning for a second surgery,” says Labbe’.

The modern science of grafting (replacing) human tissue within the confines of sports medicine evolved with the groundbreaking surgery in 1974 of ulnar collateral ligament reconstruction.

Looking to expand his career Los Angeles Dodgers Pitcher Tommy John would take the extraordinary steps to have a tendon from another part of his body replace the injured ligament of his left medial elbow.

Dodgers team physician Dr. Frank Jobe would perform the surgery that would catapult both individuals into history as medical and sports icons.

“From a science standpoint it is quite exciting to see the next evolution of surgical techniques that Dr. Labbe’ is bringing,” says Arthur.

“We are literally witnessing the newest sciences of skin grafting and how they are replacing the old sciences when it comes to tissue repair and regeneration and how that translates to the field of play.”

“With the 2 fold increase in successful surgeries only means that athletes are now able to win in the rehabilitation clinic.”

Not to be downplayed with surgical procedures is the importance of continuing physical therapy after the surgery is complete.

“Even with new surgical techniques to improve graft strength and healing rates, it is important for athletes to undergo a thorough evaluation by a sports physical therapist,” adds Arthur, one of only 3 therapist in the state of Texas with the prestigious Sports Therapy Certification (STC).

“Rehabilitation for the surgery is just the beginning”.

“At Tektonic we evaluate all movement problems including joint mobility, range of motion, strength and biomechanics to make sure that the athlete makes a full recovery and is able to return to their sport safely.”

For an accumpanying video podcast of this article with Dr. Marc Labbe’ of St. Luke’s The Woodlands Hospital and Dr. Andrew Arthur of TEKTONIC Athletic Development and Rehabilitation visit TektonicSports.com/blog.

Follow TEKTONIC Athletic Development and Rehabilitation on Twitter @TektonicSports.

Check Twitter Feed @TektonicSports #NorthHoustonVype for real time info.

Pick up your VYPE North Magazine at Tektonic Sports

Tektonic Sports of St. Luke’s The Woodlands Hospital, St. Luke’s The Woodlands Hospital campus, Medical Arts Center (MAC) II Building at 17350 St. Luke’s Way, Suite 390, The Woodlands, Tx. Intersection of I-45 and Hwy 242.
(Spring ISD, DeCaney HS, Westfield HS, Oak Ridge HS)

AfterShocks Sports Equipment, 19786 Hwy 105 W, Ste 170, Montgomery, Tx., 77356 (Located in The Colannades At Lake Conroe Shopping District)

Rico’s Mexican Grill The Woodlands, 314 Sawdust Rd., The Woodlands, Tx., 77380

Rico’s Mexican Grill Magnolia, 33418 Egypt Lane (Next to Home Depot), Magnolia, TX 77354-2759

Steel City Pizzeria, 501 Sawdust Ave, Spring Tx., 77380(The Woodlands HS, College Park HS, Oak Ridge High HS, The Woodlands Christian Academy HS, John Cooper HS, Lonestar Community College)

Phils Roadhouse, 501 Liberty St Montgomery, TX 77356

(Montgomery HS, Conroe HS, Willis HS, Magnolia HS, Magnolia West HS)

Dr. Eric Pack DPM, Sadler Clinic, 508 Medical Center Blvd, Conroe, Tx., 77304

Dr. Jennifer Chilek, Stone Creek Family Medicine, 19782 Highway 105 West Suite 111, Montgomery, TX 77356

HEB Grocery Store North Woodlands, 3601 FM 1488, The Woodlands, Tx., 77384

TEKTONIC Athletic Development and Rehabilitation is a department of St. Luke’s The Woodlands Hospital.

Emily Garza has played through the pain.  She has played with torn ligaments on her right thumb and a fractured left thumb.  Her right throwing shoulder has also been injured through the rigors of athletics.

Being a catcher does not afford one the luxury of comfort and tranquility in the sport of softball.  Foul tips to the hands, collisions at the plate, endless squatting, and the south Texas heat all contribute to the charm of sports’ busiest receiver.

Garza recently recovered from a partially torn meniscus of her right knee, suffered at a national softball tournament in the summer of 2011.  Garza was playing for the Select Texas Hawks softball team of Spring Klein.

“The injury was from a collision at the plate of our national tournament,” says Garza, a 2011 1st Team All-District catcher as a freshman for the Magnolia Lady Bulldogs.

“I knew my knee was hurt right after the collision,” said Garza.

“My coach (Dick Haskell of the Texas Hawks) basically told me to shut it down for the rest of the summer.”

Garza decided to rehabilitate her injury at TEKTONIC Athletic Development and Rehabilitation, a department of St. Luke’s The Woodlands Hospital.   TEKTONIC specializes in Athletic Development, Sports Physical Therapy, and Human Performance.

Being able to strengthen the affected area of the joint through specialized joint mobilization afforded Garza the luxury of returning to her sport with a full recovery.

“The meniscus is a passive stabilizer for the knee, which means that it is not able to increase and decrease tension like the active stabilizers,” says Dr. Andrew

Arthur PT, DPT, STC,CSCS, OTC and Director of Clinical Services and Human Performance for TEKTONIC Sports.

“In order to restore the knee back to it’s original function, we initially focus on joint mobility, soft tissue flexibility and strength of the supporting structures.”

Although smaller in size compared to most catchers, Garza’s athletic ability provides her the ability to move quickly behind the plate.  A necessity for keeping runners honest on the base paths.

“The deep squat position is more difficult to stabilize, so it is much more important for catchers to train their stability,” says Arthur, himself a former collegiate pitcher in baseball.

“At TEKTONIC we have had good results with a well balanced lower extremity strengthening program, stability exercises specific to the cather’s movements and especially training joint stability in their deep squat.

TEKTONIC Athletic Development and Rehabilitation offers a comprehensive Sports Performance training program to compliment its rehabilitation services, the only facility in North Houston to offers such services simultaneously.

“My knee feels as well as it did before the injury,” says Garza, looking to become a seasoned sophomore leader for coach Renee Bialis’s squad.

“I’m right at 100% compared to before the injury..”

For more information on TEKTONIC Athletic Development and Rehabilitation visit StLukesWoodlands.com/Tektonic or call (936) 266-3130.

Also designed for athletes recovering from injuries the Sports Physical Therapy department and Athletic Development department are led by staff members well geared in the sport of baseball.

Dr. Andrew Arthur, DPT, PT, OCS, STC, CSCS is a former collegiate pitcher who knows the difficulties of playing through arm pain and is one of only 3 physical therapist in the state of Texas to earn the prestegious Sports Therapy Certification.

Jay Pierson, MS, ATC, LAT, CSCS, PES has worked in the Detroit Tigers and St. Louis Cardinals organization in a training capacity and earned a Master of Science degree in Sports Physiology from Texas A&M University at College Station.

TEKTONIC Athletic Development and Rehabilitation is a department of St. Luke’s The Woodlands Hospital. For more information about TEKTONIC’S Sports Performance programs and its Sports Physical Therapy clinic call (936) 266-3130.

Houston Memorial's Mason Stewart is a Division 1 Football Prospect who recently trained at the TEKTONIC Sports Facility.

Recent All District honors includes many athletes who have trained at the TEKTONIC Sports facility of St. Luke’s The Woodlands Hospital

TEKTONIC Athletic Development and Rehabilitation would like to congratulate our alumni athletes on all of their recent success with high school post season honors:

Brionne Smith, Sr., Decaney High School, 1st Team All District Volleyball 14-5A.

Emily Phillips, Sr., The Woodlands High School, 1st Team All District Volleyball 14-5A.  Committed to Colorado College.

Maddie Slater, Jr., The Woodlands High School, 1st Team All District Volleyball 14-5A.  Committed to Northwestern University.

Hannah Bullock, Sr., Oak Ridge High School, 1st Team All District Volleyball 14-5A.

Taylor Erwin, Sr., College Park High School, 2nd Team All District Volleyball 14-5A.  Committed to Emory University.

Mason Stewart, Sr., Houston Memorial High School, 1st Team All District, 19-5A.

TEKTONIC Sports is a department of St. Luke’s The Woodlands Hospital.  For the latest in Athletic Development, Sports Physical Therapy and Human Performance visitTektonicSports.com/blog andStLukesWoodlands.com/Tektonic.

To set up your Initial Athletic Assessment or for further questions about off-season sport specific training contact TEKTONIC Atheltic Development and Rehabilitation at (936) 266-3130.

The TEKTONIC off season throwing program is designed for pitchers and position players

The long baseball and softball season is finally over.  You have played in as many as 80 games and if you are a baseball pitcher you have thrown over 10,000 pitches including bullpen sessions and side work.  Your arm has been through the ringer and if you are fortunate you have experienced limited or no arm pain or injury.

Consider yourself lucky.

Position players for baseball and softball are overlooked in the dynamics of throwing injuries but are as much at risk for ulnar collateral ligament (UCL) and rotator cuff tears as their pitching counterparts.

If your shoulder and elbow joints are not properly trained going into your upcoming season you are just as likely to injure your throwing arm during the season.

PREPARING FOR THE SEASON

“Rotator cuff strengthening along with scapular stabilization exercises are essential training elements for baseball and softball players pre-season and in-season,” says Jay Pierson, Athletic Development Coach of TEKTONIC Athletic Development and Rehabilitation, a department of St. Luke’s The Woodlands Hospital.

Pierson, who is a Certified and Licensed Athletic Trainer (ATC, LAT), has developed professional baseball players in the St. Louis Cardinals and Detroit Tigers organizations.  He also has extensive training in the athletic department at Texas A&M College Station where he received his MS degree in Sports Physiology.

Pierson is also a Performance Enhancement Specialist through the National Academy of Sports Medicine and a Certified Strength and Conditioning Specialist (CSCS) through the National Strength and Conditioning Association.

“Often times injuries occur due to fatigue of the shoulder girdle during competition or the cumulative fatigue over a long season,” says Pierson.

“Proper conditioning is required to maintain the strength and stability necessary to avoid injury.  This all must be done while maintaining adequate shoulder range of motion.”

A common mistake athletes make for shoulder-centric sports such as baseball and softball is the over training of the shoulder region.

This is done with the mindset of building muscle mass to the upper arm, but often times leads to undesired results.

The over development of the joint through heavy weights and high volume exercises often leads to inflexibility which takes away from needed range of motion and depletes arm speed, the life blood of the “strong arm”.

“We concentrate on building arm strength and correcting any limitations we see from our state of the art bio-mechanics lab,”  says Pierson.

“Having the ability to break down the 4 phases of the throwing motion with our Performance Lab technology and see how the kinetic chain is being affected is a big advantage for us.”

“We break down the wind up, cocking, acceleration, and deceleration phases for pitchers and position players.”

News Years Day is the barometer and compass for new stars to start the clock to shine.

LONG TOSS vs STRENGTH TRAINING

Most area coaches suggest that high school baseball and softball players recuperate during the month of November with little or no throwing.  Early December is the typical start time for pitchers and position players to work on their arm speed and conditioning.

“TEKTONIC incorporates a progressive long toss program along with a structured strength and conditioning program designed specifically for throwers,” says Pierson.

“Our goal is to have your arm in peak condition when the season starts.”

Houston baseball and softball seasons begin in early February with the Texas UIL high school playoffs ending in early June.  Summer select seasons begin shortly thereafter  with leagues running deep into late September.

For more information about off season training for baseball and softball contact TEKTONIC Athletic Development and Rehabilitation at (936) 266-3130 or email jjames@sleh.com.

For live Internet broadcasts of local high school sporting events log into TektonicSports.com     

The 4 phase of throwing. Clockwise 1. Wind up 2. Cocking 3. Acceleration 4. Deceleration (Courtesy Primal Pictures)

The Legends of the Fall Northside continues December 15 with the latest on the best athletes and stories north of Hwy 1960.

On The Cover

Kylie Randall of Magnolia High School.

Zach Wright of College Park High School.

Rachel Harvey of Montgomery High School.

Garrett Hope of The Woodlands High School.

Inside Feature Stories:

Nicole Iadamarco of The Woodlands returns from injury.

Jesse Jones becomes Magnolias All Time Leading Scorer.

Pick up your issue of the VYPE Magazine North Side supplement at TEKTONIC Athletic Development and Rehabilitation a department of St. Luke’s The Woodlands Hospital.