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Fri, 12 Mar 2021

Six Common Reasons for Back Pain

See Miller Ortho's spine doctors for your back pain.

Most of us will experience back pain at some point in our lives. Here are just a few of the common conditions that can be contributing to the pain:

1. Sprains and Strains

A strain is an injury to a muscle or tendon, and a sprain is the stretching or tearing of a ligament. These types of injuries usually happen from lifting a heavy object incorrectly, lifting and twisting, poor posture, accidents, or from sports injuries.

You may experience muscle spasms, lower back pain radiating into the buttocks, stiffness, and pain that intensifies with movement.  

2. Spinal Stenosis

Normal wear-and-tear as we age can lead to the narrowing of the spinal canal. Spinal stenosis occurs most often in the lower back and the neck. It puts pressure on the spinal nerves and cord which causes the pain. Most often, the symptoms include neck or back pain, cramps or weakness in the arm or leg, and pain going down the leg.

3. Disc Degeneration

Degenerative disc disease is the breakdown of the spinal discs that cushion the bones in the spine. Spinal discs are found between your vertebrae and over time they can deteriorate, shrink, or tear.  It’s technically not a disease, but a progressive condition that happens from aging, normal wear and tear, or from an injury.

Degenerative disc disease can cause back or neck pain, but many people do not experience pain. A disc in the neck area might cause neck or arm pain, while a disc located in the lower back might lead to pain in the back, buttocks, or leg. The pain may become more intense during movements such as bending over, reaching, or twisting.

4. Herniated Discs

A herniated disk is sometimes called a “slipped” or “ruptured” disc and can occur in the back or the neck leading to pain in these areas. The discs are shock absorbers and located in between the vertebrae. The disc becomes herniated when the soft (nucleus) center of it pushes through a tear in the rubbery exterior (annulus) of the disc. When the herniated disc bulges out toward the spinal canal, that pressure on those sensitive nerves causes pain. The most common symptoms include arm and leg pain, numbness, tingling, and muscle weakness.

5. Sacroiliac Joint Pain

There are two Sacroiliac (SI) joints in your lower back, sitting on each side of your spine. They carry the weight of your upper body when you stand or walk and shift that load to your legs. Like any other joint in the body, the SI joint can be injured and/or become degenerative. When this happens, you can feel pain in your buttock and sometimes in the lower back and legs. This is especially true while lifting, running, walking or even sleeping on the involved side. SI joint problem symptoms include lower back pain, pelvis or buttock pain, hip or groin pain, leg instability, or pain when you go from sitting to standing.

6. Sciatica

Sciatica is a condition where a protruding, or herniated, disc in your spine is pressing on nerves. This pinching creates inflammation and irritation, which leads to symptoms such as prickling, numbness, pain, and possibly weakness of the leg and foot. You may feel pain suddenly in your lower back or hip that goes to the back of your thigh and into your leg. Sometimes your feet and toes feel tingly and numb. You may even feel shooting, electrical pains up and down the back or the outside of your thighs and calves.

Address the Pain

These are just a few of the common reasons for back pain. Many back condition symptoms can be similar and it’s important to see a spine specialist if pain is keeping from enjoying your day-to-day life.

A spine specialist, like Dr. Ricart, can create a custom treatment plan for you to diagnose the issue, find methods to reduce your pain, and provide guidance on ways to prevent future back pain.

Contact us at 712-323-5333 to schedule your appointment with Dr. Ricart and get back to doing the things you enjoy!

Tue, 26 Jan 2021

Should I have my hip or knee surgery during COVID-19?

outpatient total joint replacement | Miller Orthopedic Specialists

This is a question and concern for many patients right now. First and foremost, your safety and wellbeing is our primary concern. Deciding to have surgery is a big decision in itself, but when you are in pain and missing out on your quality of life, it’s not necessary to delay it because of COVID-19.

It is still the perfect time to move forward with your joint replacement. If you delay, there is the possibility of increasing your symptoms and pain and perhaps further deterioration of the joints or weakened muscles that surround them. One of the ways to move forward more safely is with an outpatient joint replacement. Dr. Boese explains, “Staying out of the hospital is now more important than ever. Protect yourself and have your surgery in a facility where you don’t have to worry about COVID-19 or infections.”

Outpatient Total Joint Replacement Surgery

Outpatient total joint replacement surgery is now more common and is often preferred for a minimally invasive alternative. At Miller Orthopedic Specialists, our physicians provide same-day total joint replacement surgeries at the Advanced Surgery Center. This facility does not treat those sick with COVID-19, and every precaution is taken to prevent the spread of the virus and ensure the facility remains a safe environment for patients and staff. Click here to read more about their specific safety measures.

What are the advantages of outpatient total joint replacements?
  • Avoid patients sick with Covid-19
  • Recovery is quicker
  • You can go home the day of your procedure
  • You can recover comfortably and safely in your own home
  • You’ll save money
  • Your risk of infection is reduced

Outpatient Same-Day Total Joint Replacement is what we do, and we’ve been successfully leading the way for several years in the Omaha and Council Bluffs area. Dr. Boese is a highly regarded surgeon, fellowship-trained at John Hopkins University, and is a recognized leader specializing in total joint replacements, specifically outpatient and minimally invasive hip and knee surgeries.

Schedule your appointment at one of our clinic locations to see if you are a candidate for outpatient total hip replacement surgery or total knee replacement surgery.

Fri, 04 Dec 2020

Winter Sports Injury Prevention Tips

Sports Medicine Physician | Miller Orthopedic Specialists

The weather may be getting colder, but many athletes are warmed up for winter sports. Injuries don’t have seasons, so it’s important to understand how to take care of your body to prevent them.

Skiing & Snowboarding

When you are speeding down a hill, there are all kinds of hazards. Your head, knees and arms are all at risk of injury during this activity. To help reduce your risks, follow safety tips including:

  • Make sure you have learned the proper form and technique
  • Ensure your gear is properly fit
  • Choose ski runs that match your ability
  • Drink lots of water and stay hydrated
  • Don’t push yourself if you are tired
  • Wear a helmet
  • Stretch before skiing
  • If you do begin to fall, go with the momentum of your fall and avoid using your arms to break your fall


As with skiing, sledding dangers are related to going at a high rate of speed down a hill. Most of the injuries that happen from sledding are from running into objects and falling off the sled. Concussion is the most common injury along with contusions and broken bones. A few sledding safety tips include:

  • Wear a helmet
  • Make sure your path is clear
  • Be sensible with your speed and the sledding location
  • Sit in a forward-facing position to control the steering – sledding head first is not a safe choice
  • In the evening, only sled in well-lit areas
  • Dress in layers for extra protection and warmth

Ice Hockey

Hockey is considered a collision sport. Injuries can happen from contact with other players, the stick, the puck and the boards. Injuries that can occur include sprains, strains, tears, fractures, dislocations, concussions, muscle pulls, broken teeth and spine injuries. With an extensive list of potential injuries, it is imperative to take precautions. Here are a few tips:

  • Ice hockey requires protective equipment, be sure that it fits properly and is not damaged
  • Have basic ice-skating skills mastered such as skating both forward and backward
  • Be in good physical condition at the start of hockey season
  • Always take the time to warm up and stretch
  • Stay hydrated and drink plenty of water
  • Understand the rules of ice hockey and play safe
  • Injuries should be assessed and treated as soon as possible
  • Avoid leading with your head if you are about to collide
  • Cool down and stretch after a game or practice to help reduce the risk of muscle pulls

Ice Skating

Ice skating is enjoyed by many in neighborhood rink outings to competitive figure skating. Ankle sprains and fractures, wrist injuries, head injuries and ACL tears are some of the frequently reported injuries in this sport. You can help increase your safety while ice skating by:

  • Making sure your skates fit properly
  • Stretch and warm up your muscles
  • Learn the correct form and pay attention to your balance and posture
  • Don’t attempt difficult tricks if you haven’t been trained
  • Be careful of chips in the ice and other hazards
  • Avoid putting your hands out when you’re falling to protect your hands and wrists
  • If you are not a strong ice skater, wear a helmet to protect your head

Although winter sports injuries are common, they are also preventable. Following safety principles like these will help you to prevent injuries and still have fun. Speak with a sports medicine physician if you’re injured or have any concerns about injuries or preventing them. Request an appointment online or call us at 712-323-5333.

Mon, 26 Oct 2020

The Benefits of a Partial Knee Replacement

Partial Knee Replacement Surgery: Orthopedic Knee Surgery by Miller Orthopedic Specialists

Arthritis in the knee can cause pain and make everyday activities more difficult. There are a range of treatment options, but if the arthritis is limited to just one area of the knee, a partial knee replacement is a minimally invasive option to consider. Partial knee replacement is also called a unicompartmental knee replacement and essentially means that only a portion of the knee is replaced or resurfaced.

Partial knee replacement is a surgery that replaces only one of the parts of the knee. Your knee is divided into three major compartments:


  • Medial (the inside part)
  • Lateral (the outside part)
  • Patellofemoral (the front of the knee)

This procedure uses smaller incisions to remove the damaged tissue and bone in the knee joint. The areas are replaced with a prosthetic or resurfaced, which leaves healthy parts of the joint preserved. Because only the damaged compartment is replaced, the healthy cartilage and bone in the rest of the knee are left alone. This means that a patient will usually spend less time recovering and return to normal activities sooner than with a total knee replacement.

If your knee pain continues after taking anti-inflammatories, maintaining a healthy weight, and trying other non-surgical treatments, you may want to consider a partial knee replacement. What are some of the benefits of a partial knee replacement over total knee replacement?

  • Recovering more quickly
  • Less pain during recovery
  • Can feel more natural than a total knee replacement
  • Less blood and bone loss
  • Smaller scar

A few of the important considerations for whether you may be a good candidate include having an intact ACL, a sufficient range of knee motion, damage to only one compartment, and a stable knee. The minimally invasive partial knee replacement is ideal for patients with severe arthritis of the knee that have not found relief with standard non-surgical treatments. A thorough evaluation with an orthopedic surgeon will ultimately determine whether you are a good candidate for a partial knee replacement.

Recovery from a partial knee replacement takes approximately six weeks, including rehabilitation exercises to help maintain your range of motion and restore your strength. You will begin putting weight on your knee immediately after surgery and may need a walker, cane, or crutches until you become comfortable enough to walk. During this time, you will also continue to see your orthopedic surgeon for follow-up visits.

If you have joint pain or arthritis and want to return to your active lifestyle, we are here to help. Our specialists work with you to diagnose, treat, and answer your questions and get you back doing the things you love. It’s quality of life! Request an appointment online or call us at 712-323-5333.

Thu, 01 Oct 2020

What is Regenerative Medicine?

Regenerative Medicine by Miller Orthopedic Doctors

Regenerative medicine is an emerging procedure that promotes healing at the cellular level. Our bodies can do incredible things and this treatment encourages faster healing, repairs tissue, reduces pain and speeds recovery time after injury or surgery. The process involves replacing or regenerating cells, tissues and organs for treating medical conditions.

Regenerative medicine stimulates the patient’s body to repair and heal. Stem cell therapy is a type of regenerative medicine that can grow and develop many different types of cells in your body. With a stem cell injection, the area treated can receive healing properties for damaged tissue, tendons, ligaments, cartilage and bone. Let’s explore more about this newer medical therapy.

Stem cells are used for treating all kinds of conditions, but just some of the orthopedic conditions include:

What are some of the benefits of this type of treatment?

A Less Painful Treatment Option

Regenerative medicine targets tissue in the exact place to provide the greatest help. During healing, you will feel far less pain than you would from an injury and surgery. The risk of complications from this procedure is low. The pain typically subsides in three days or less, and is usually well tolerated. The risk of infection is very low, but is not non-existent.

Faster Healing Time

The growth factors used in regenerative medicine help kickstart the process, leading to faster healing. Healing is boosted by concentrating and precisely targeting cells to where they’re needed most. Orthopedic Doctors, like Dr. Larose and Dr. Atteberry, perform these injections directly into the area of injury or damage. While recovery time varies by person, many patients start to feel better and see improvement within 1-3 months. Every patient is different and the amount of damage before the procedure can impact how quickly one recovers.

Other benefits include:

  • Customized treatments to fit your needs
  • Supports long term healing
  • Prolongs the need for potential surgery
  • Simple and quick procedure
  • Safe for your body

What are the treatment types and how do they work?

Platelet-Rich Plasma (PRP) – PRP is a concentration of platelets and growth factors created from a small amount of your own blood. Platelets are concentrated down to a cellular level. Outside of the bloodstream these platelets become activated and release important proteins to help increase growth levels and improved signaling of recruitment cells. This procedure is usually done in less than half an hour.

Autologous Conditioned Plasma (ACP) – A small amount of your blood is collected and goes through a rapid spinning process that separates and concentrates platelets. The main difference between this and PRP is that the platelets get spun down and concentrated further with ACP using the Arthex Angel System. The process takes place in less than an hour.

Amniotic Fluid (AF) – AF is a protein-rich fluid with proven regenerative potential. Amnion contains growth factors and proteins essential to healing that reduce scar formation, reduce inflammation, and support soft tissue regeneration. This fluid has a complex range of growth factors and anti-inflammatory properties that are injected into your body. 

Bone Marrow Concentrate (BMC) – BMC is a concentration of stem cells, platelets and growth factors created from your own bone marrow. Increased levels of growth factors can improve signaling and recruitment of cells for faster healing. Local anesthesia is applied and some bone marrow is removed. It is then filtered down to retrieve the stem cells. Then, the stem cells get injected in or around the location of the injured joint or tissue.

To find out if regenerative medicine treatments are right for you, make an appointment with an orthopedic specialist at Miller Orthopedic today.

Mon, 31 Aug 2020

Have You Been Shrugging Off Your Shoulder Pain?

Shoulder pain can make everyday activities challenging and unbearable. The shoulder is made up of several joints, tendons and muscles that allow a wide range of movement. Because of this, it can be hurt by a variety of conditions.

Here are some common reasons for shoulder pain:

Rotator Cuff Injuries 
The Rotator Cuff is a group of muscles and tendons that surround the shoulder joint, keeping the head of the upper arm bone firmly within the shallow socket of the shoulder. A rotator cuff injury can cause a dull ache in the shoulder, which often worsens when you try to sleep on the involved side. A torn rotator cuff is a common shoulder injury that can be caused from repeated movements while playing sports, performing a job function or doing common household chores, such as yard work.

Shoulder Arthritis
The most common type of shoulder arthritis is Osteoarthritis. It is also known as “wear-and-tear” arthritis and damages the smooth outer covering of bone. As the cartilage wears away, the protective space between the bones is reduced. The bones of the joint rub against each other causing pain. Other less common forms of shoulder arthritis include Rheumatoid Arthritis, Posttraumatic Arthritis and Rotator Cuff Tear Arthropathy.

Shoulder Bursitis
Bursae are tiny, fluid filled sacs found inside each of your shoulders. They provide cushion and reduce friction between muscles and the bone. When a bursa sac is inflamed or irritated, it can cause bursitis. It usually happens from repeated pressure or using the joint too much. The most common symptom of this condition is pain, but the joint may also be stiff and swollen.

Shoulder Dislocation
The shoulder joint is the body’s most mobile joint. It can turn in many directions, but this also makes the shoulder an easy joint to dislocate.

A dislocation happens when the ball pops out of your socket. A dislocation can be partial, or a complete dislocation means it is all the way out of the socket. A common type of shoulder dislocation is when the shoulder slips forward, when the upper arm bone is moved forward and out of its socket.

Shoulder Separation
A shoulder separation involves the AC joint (acromioclavicular joint). The AC joint is where the collarbone meets the highest point of the shoulder blade. The most common cause for a separation of the AC joint is from a fall directly onto the shoulder, injuring the ligaments surrounding the AC joint. If the force is severe, the ligaments attaching to the underside of the clavicle are torn and causes the separation of the collarbone and the shoulder blade.

Frozen Shoulder
Frozen shoulder happens when the connective tissue lining the shoulder joint thickens and becomes inflamed. It causes pain and stiffness in the shoulder and the shoulder may become more difficult to move. The risk of developing frozen shoulder increases when recovering from a medical condition or procedure that prevents you from moving your arm.

A shoulder fracture is a partial or total crack to one of the shoulder’s main bones, clavicle, scapula, or humerus. A fracture of any of these shoulder bones can greatly impair your mobility and cause severe pain. Shoulder fractures happen as a result of trauma or injury to the shoulder from a fall, sports, car accident or any direct blow to the shoulder.

Contact Us

Shoulder pain can occur from a variety of issues, but arthritis, injury, and repetitive motion are leading causes of many of these conditions. Keeping your shoulders healthy and getting a proper diagnosis is important. Our highly experienced orthopedic physicians are experts at diagnosing and treating the full range of shoulder issues. Contact us today with any shoulder trouble you are having. 


Wed, 29 Jul 2020

Did You Throw Your Back Out? Understanding Lower Back Pain

Tips to decrease back pain from orthopedic doctor


It is estimated that 80 percent of adults will experience back pain at some point in their lives. “Throwing your back out” is a phrase that’s used to describe pain and discomfort in the lower back. It can refer to many conditions but is often used to describe back spasms and muscle sprains from overexertion or incorrect form while lifting heaving objects. Less commonly, it can refer to a herniated disc or broken vertebrae.

What are some of the symptoms experienced by “throwing out your back?”

  • Back stiffness
  • Difficulty moving and limited range of motion in your back
  • Intense and sharp back pain
  • Muscle spasms

When you experience these symptoms, there are simple things you can do to help relieve your pain:  

  • Get some rest, but not for too long.
    • Sitting still for too long can make the problem worse.
    • Don’t lie down for more than a few hours at a time.
    • Try to return to your normal daily activities as soon as you are able.
  • Cold and heat therapies can provide some relief.
    • An ice pack on your back for short periods of time can aid in reducing pain and swelling.
    • Applying heat to the area with a shower, bath, or heating pad can help relax the tense muscles and reduce inflammation.
  • Try pain relievers.
    • Over-the-counter anti-inflammatory medications such as ibuprofen should provide some relief.
  • If the injury or pain persists it’s time to see a spine specialist like Dr. Pedro Ricart.

What else can you do to prevent future back injuries and treat your spine better?

  • You can lower your chances of throwing your back out by maintaining a healthy lifestyle.
    • Maintain a healthy weight. Carrying extra weight can put a strain on your back.
    • Having a strong back and core muscles can help reduce the likelihood you’ll throw out your back.
    • Quit smoking. Smoking cigarettes is linked to back pain.
  • When lifting heavy objects, bend at your knees and lift with your legs.
  • Wear protective equipment like a weightlifting belt or back brace that provides extra support.
  • Warm-up before exercising.
  • Try to avoid high heels, as they can cause back problems.
  • Maintain good posture. Sit upright and stand straight. Hunching over will strain your back and put you at risk for further injury.

Spine specialists create a customized treatment plan for diagnosing the issue, finding methods to reduce pain, and giving suggestions on other ways to prevent some future back pain. If back pain is causing you problems, contact us to schedule your appointment with Dr. Ricart and get back to doing the things you enjoy! 

Thu, 25 Jun 2020

The Importance of ACL Injury Prevention

The ACL, anterior cruciate ligament, is a band in the knee that connects the femur to the tibia. It helps keep the joint stable as you walk, run, jump and make other leg movements. It is also one of the most commonly torn ligaments in the body. Injuries of the ACL often require surgery and rehabilitation, which can be damaging for students’ and professional athletes’ careers, and this is the reason why it is so important to focus on ACL injury prevention.

The ACL can be injured in several ways such as:

  • Suddenly stopping and changing direction quickly
  • Slowing down while running
  • Landing from a jump incorrectly
  • Direct contact or collision

A torn ACL is one of the most frequently reported sports-related injuries orthopedic surgeons see. Some of the sports where ACL injuries can often occur are soccer, football, tennis, basketball, volleyball and gymnastics. When an ACL injury happens, you might hear a “popping” noise that’s followed by pain and swelling. After this happens, the knee can be unstable and movement can cause wear and tear on the cushioning cartilage (meniscus) of your knee.

ACL injuries often require some sort of surgical repair and a minimum of six months to a year of rehabilitation. Having a focus on ACL injury prevention is crucial. Many ACL injuries can be prevented by strengthening the muscles around the knees, along with exercises to help increase balance, flexibility, core strength and stability. Having proper technique and form during sports and physical activities are key.

Here are a few tips to keep in mind for helping with ACL injury prevention:

  • Stretch and warm-up prior to the activity
  • Practice proper landing after jumps with your knees directly over your feet
  • Crouch and bend at your knees and hips when you pivot
  • Focus on strengthening your hamstrings, quadriceps, hips and thighs

Working with physical therapy specialists, like Joshua Bintz, PT, DPT, and Amanda Askey, PTA, is a good place to start for assessing how you can best modify movements to prevent ACL injuries. Therapists and clinicians can identify and target weak muscle and provide ways to improve strength and assist in preventing injuries.

Contact us today for more information or to schedule your appointment.

Fri, 22 May 2020

Outpatient Knee Replacement Surgery and the Benefits

Knee Replacement Surgery | Miller Orthopedic Surgeons

Outpatient knee replacement is a great way to get a patient in and out of the hospital on the same day. Not everyone qualifies or prefers this method, but many do. Outpatient total knee replacement is becoming more and more common of a surgery. Many, however, do not know what to expect with an outpatient procedure and therefore just stick to inpatient. Outpatient procedures do have their benefits, so it is important to be informed. A good orthopedic surgeon, such as total joint specialist Kent Boese, MD, can help you decide the best option for your knee replacement.

Total knee replacements (also called total knee arthroplasty), both inpatient and outpatient, are very similar. The biggest difference is in where post-op recovery is spent and the length of a hospital stay. The process of a total knee replacement is the removal of damaged bone or cartilage and the insertion of a prosthesis. The healthy bone and cartilage are resurfaced to help with the support of the implant. So, after the removal of the damaged bone and cartilage, the new joint is fused into place. This procedure is intended to reduce pain and increase the mobility of the patient. The goal is an improved quality of life.

Some Benefits to outpatient total knee replacement:

  • Lower infection rates
  • Recover in the comfort of own home
  • More Convenient
  • Cheaper

Outpatient surgery is an option because of less invasive surgical techniques, less blood loss, better pain control, and better anesthesia practices than were previously available. This allows people to be up and walking shortly after surgery. This is not a procedure that is appropriate for everyone, but through careful discussion with a fellowship-trained, Board Certified Surgeon, such as Dr. Kent Boese, a proper diagnosis and treatment plan can be decided.

 Many people will ask the same question about newer procedures, is it Safe?

Many different studies have found that in the proper candidate, outpatient is just as safe as inpatient knee replacement surgery. A lot of it comes down to ensuring the surgeon is a skilled, trained surgeon. Overall, most studies do not find a major increase of risk from inpatient to outpatient. It is important to address any concerns or complications before or after the surgery with the surgeon or nurse navigators to ensure a better outcome and recovery for the patient.

One important thing to note about outpatient procedures is they can turn into an inpatient procedure if needed. This means that after surgery if something is questionable in the post-op evaluation, the surgeon can request the patient to stay overnight to be monitored. This helps resolve unforeseen complications that may have arisen. The patient will have a careful evaluation to be cleared for discharge to be sent home, but even once they get home, it is extra important that the patient have someone around to help monitor them in the case of complications. Communication is very important throughout the entire process.

A nurse navigator is there to help both in and outpatient knee replacement patients. The nurse is there to guide the patient through any problems or questions that might arise before or after surgery. The nurse is there to help put the patient’s mind at ease while helping monitor their recovery status for all knee replacements.

One important thing to note when choosing outpatient surgery is that it is extra important for the home to be prepared prior to the surgery. Because there is less immediate supervision following the surgery, the patient needs to be sure to eliminate potential causes of slips, trips and falls in the home.

There are risks involved with all knee replacements, but there are also so many benefits to people being able to walk around and be more mobile than they have been in years. Outpatient knee replacements have patients up and walking by that afternoon and on their way to recovery. Choose a surgeon that can help prepare you, educate you, and get you back out doing the things you love.

If knee pain is keeping you from doing the hobbies you love then it’s time to schedule an appointment. We are here to help you, give us a call 712-323-5333 (Council Bluffs) or 402-991-9958 (Omaha) or click here to request an appointment.

Fri, 01 May 2020

Return of the Athlete

Athletes and Injuries: Returning to Sports After COVID-19

Whether you’re a coach, parent of an athlete, or an athlete yourself, life without sports is tough. Sports fill so many roles in our lives. Beyond just filling up our schedules, sports are often a primary social source for people, an outlet for stress and energy, a source of self-esteem and accomplishment. In the past several weeks, many of those roles have been taken away from us; and while it’s all for very good reasons, it doesn’t make it any easier. But for most athletes, sports will resume. Kids will go back to their clubs, high schools will turn the lights on the field, weekend warriors will step onto the court once more. Many of us are looking forward to that day, but how are we preparing, especially those involved in highly organized and competitive sports at the AAU, high school, collegiate, and professional levels?

Many athletes, whether recreational or competitive, are attempting to stay in shape somehow: home workouts from coaches, streaming videos to the living room, or just getting creative with what you have available are all good options. But what if it’s not enough? What are the risks of returning to whatever field, court, or pitch on which you find yourself after not having practiced in your typical routine or intensity for several weeks? In a recent article on SI.com, Brian Burnsed discussed what we’ve seen in the past from situations that can be compared to our current experience with restrictions related to COVID-19:

“… athletes’ muscles and ligaments will need adequate time to recalibrate to their sports’ demands. After the 2011 NFL lockout that kept players away from team medical personnel and strength and conditioning coaches for four months, Achilles tendon tears leapt from an average of eight per season to 12 in training camp and the preseason alone, according to a study done that year. Similarly, a 2012 report found that NBA injury rates jumped after the league’s 2011 lockout, including a rash of ACL tears among stars like Derrick Rose, Ricky Rubio and Baron Davis. Nine players tore ACLs in the two years after the lockout, a figure that dropped to an average of a little more than two per year in subsequent seasons.” 1

ACL and Achilles injuries nearly always require a surgical repair and then a minimum of six months of rehabilitation, often closer to one-year. Any increase in risk to an injury like this should prompt many athletes to re-evaluate their training regimen and coaches to reconsider their practice and workout schedules for the first few weeks of practice with these athletes. Between limited offseason training, shortened pre-season practices, and potential alterations to competition schedules, few athletes will return to their respective sports under normal circumstances.

So, what can we do to minimize this risk of injury associated with extended time off?

  • Athletes
    • Do everything you can to stay in shape. Listen to your coaches and trainers. Try to maintain a sleep schedule. Eat well: poor quality protein = poor quality muscle. Go online and see what professional athletes are doing to workout. Use whatever random things you can find to load your body and maximize intensity.
    • Understand what this will look like: you normally work out at least five days per week in a high intensity and structured program – now say you’re working out three days a week at your own discretion. Most studies show a notable drop off in strength after three weeks of detraining. Maybe you can extend that number out a bit longer because you are doing something a few days a week, but we can all likely agree you will have some loss after eight or more weeks of isolation. Not only will you have strength loss, but muscle memory loss as well. It sounds silly, but your muscles will forget how to coordinate to jump/cut/sprint efficiently. So now you show up to practice and you’re weaker and uncoordinated. You fatigue a bit earlier in practice than you normally would, you get into a situation that requires max effort but your form is sloppy and your power fades, you plant your foot in the ground… That’s when injuries are most common and we didn’t even talk about the effects of detraining on ligaments, bones, etc.
  • Parents
    • Help your kids and encourage them to do the things listed above. That may look different in each house, but do what you can.
    • Keep an eye on your athletes as they return to sports. If they’re showing signs of pain or injury, talk to them about it. The likelihood is greater that an athlete may try to hide an injury because they’re already behind or there’s less time to earn that starting spot.
    • Don’t get stressed or upset if your athlete gets subbed out of a game more frequently or for longer stretches. The coach may be taking precautions to not overuse/overwork them early in the season.
  • Coaches:
    • I have seen many posts on social media encouraging athletes to do all they can to keep up their fitness. Keep contacting and pushing your athletes with this. Especially encourage high speed and high intensity training in athletes whose sports demand cutting, acceleration/deceleration, and jumping. (soccer, basketball, football, volleyball). These sports already carry an increased risk of injuries like ACL tears and these movements must be performed frequently to maintain proper mechanics, endurance, and muscle memory.
    • Realize your athletes will not return at the point they left off. In some way, even if it’s small, athletes will be behind where they normally would be at the beginning of the season. Their nutrition, sleep, and workouts have all been affected during this time and may mean you have to ease them in a bit more than usual.
  • Fans
    • We all want sports back, but realize these athletes will need time to prepare the right way. Give them time. Once things start to trend back to whatever normal might look like in the future, sports will not and should not instantly resume. Otherwise, you might see your favorite player sidelined for the next year or possibly their career.

The time will come, sports will return, you’ll be able to go back to the gym, but no one should expect it to be business as usual. In the coming articles, we will look at other areas of fitness beyond sports including running, weight management, and more.

Sources Cited:

  • Burnsed, Brian. “What Does the Coronavirus Do to an Athlete’s Body?” Sports Illustrated, Maven, 6 Apr. 2020, www.si.com/more-sports/2020/04/06/effects-of-coronavirus-on-athletes-bodies.



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