Category Archives: Orthopedics

Darlene Oglesby

When it hurts to sit and it hurts to stand, Andrews can help

At just 50 years of age, Darlene Oglesby has suffered from tremendous hip pain. Many of the things we take for granted would typically leave her in tears. Sitting for a while would hurt, walking would hurt and even just getting out of bed would hurt.

That’s until she met with the doctors at Andrews Sports Medicine and Orthopaedic Center.

Andrews is typically known for being THE doctor for professional athletes, with former patients such as Michael Jordan, Tiger Woods, Peyton Manning, Derek Jeter, Charles Barkley, and Allen Iverson (just to name a few). However, Andrews does more than just help pro athletes, his practice offers the same expert care to “non-athletes” to help get us back in the game of life.

I have my active life back!!

Darlene Oglesby met with Dr. James Flanagan, one of the doctors on the Andrews team. He performed a total left hip replacement. Although a total hip replacement is a major procedure, Darlene Oglesby was able to walk again just two weeks after the surgery.

“The outcome was excellent!” she says, “Prior to surgery, I had very little quality of life. Now just two weeks after surgery, I have my active life back!! I am walking without a walker and I am able to do things that I could not do before!”

The surgery occurred mid-April and her results have been so overwhelmingly positive that she decided to have her other hip joint replaced.

“I went ahead and had the other hip replaced so I could have both hips back to better than ever!”

That was two weeks ago, and Darlene Oglesby is on her way to yet another speedy recovery.


To Stretch or Not to Stretch is the Question

stretching-part-iIs stretching before your workout a good idea? This question is being asked among athletes and doctors lately, thanks to interesting new research. The Journal of Strength and Conditioning Research and The Scandinavian Journal of Medicine and Science in Sports both featured studies that revealed that, contrary to popular belief, stretching can actually weaken an athlete before a workout.

The style of stretching in question in both studies? Static, in which stretches are held for several seconds without moving, as in a forward fold. Both studies found that dynamic stretching, which is more similar to a traditional “warm up” and involves moving the body to loosen and warm up muscles, is the preferred method.

For example, in the Journal of Strength and Conditioning Research study, participants felt 23 percent less stable after static stretching versus a dynamic warm-up.

UAB Orthopaedic Surgeon William Garth, MD, says that most experts believe that the warm-up, or dynamic stretching, contributes to beneficial flexibility, allowing the muscles to elongate properly before a workout, and agrees that holding stretches can be dangerous.

“Prolonged stretching of a cold muscle may place more stress on tendons and collagenous fibers throughout muscle and can cause micro- or macro-injury,” Garth says.

Kurt Thomas, head coach of UAB Track & Field, says that some stretching before a workout is acceptable, and that though research points away from traditional stretching, it’s important to warm your body up before you exercise, whether you are lifting weights or running.

“It doesn’t have to be intense, as long as you’re getting the body moving and the blood flowing.”

Thomas says that getting the muscles warm whether it is swinging your legs side to side, jumping jacks or any kind of movement. Even jogging for a mile or two then stopping to stretch, and continue running is a great way to stretch out cold muscles and get them warm.

“If your muscle is already cold and you start stretching hard, you could pull a muscle or injure some sort of muscle or tendon before you even get started, so I recommend light static stretching if you are feeling a little bit tight.”

Thomas says that jogging for a mile or two, then stopping to briefly stretch before continuing to run is more ideal, because the body is warm and better able to stretch.



Can a knee to the spine help ease debilitating back pain?

back-painjpg-ae13505518fc735cA doctor here is injecting the cells of knee cartilage from young donors directly into the spinal discs of people with back pain to see if it will regenerate the aging discs that may be causing the pain.

Dr. Bradly Goodman at Alabama Orthopedic, Spine & Sports Medicine Associates is leading the only Alabama study site, part of a national clinical trial, to evaluate a biological agent called NuQu, made up of young cartilage cells.

“What’s exciting about this is it’s getting down to the cellular level and regenerating tissue,” said Goodman, a doctor who specializes in physical medicine and rehabilitation.

Nearly everyone, as they age, suffers from some degree of degeneration of their spinal discs, Goodman said. The discs gradually lose their ability to act as shock absorbers between the spine’s vertebra. Because spinal discs have poor blood supply, regeneration is a challenge in a part of the body designed for stability and mobility, he said.

“We are asking a lot of the cells we inject to allow them to survive,” he said.

Back pain is still a mystery in many regards, Goodman said. Doctors don’t know why some people with degenerative discs have persistent pain and others do not. But the NuQu treatment is exciting because it addresses what could be considered the key to the problem — the discs.

“To make the disc go back to normal is certainly appealing from a biologic perspective,” he said.

Current therapies for back pain include surgery, anti-inflammatory medications, physical therapy and injections of cortisone and/or anesthetic agents.

The NuQu procedure takes place in an outpatient surgery center with some light sedation. An x-ray machine helps the doctor guide a thin needle into the disc to inject the knee cartilage cells. The patient can go home about an hour later.

Those interested in participating in the study can call Alabama Orthopedic, Spine & Sports Medicine Associates at 205-833-2228 or call 855-893-NuQu (6878).

Participants may receive either an injection of NuQu or sterile saline solution as a placebo.

Participants may qualify if they are at least 21, have had back pain for six months or more, are not severely overweight and never had lower back surgery.



Local doctors concerned about safety at new Birmingham area trampoline park


The Birmingham area’s new extreme trampoline park, which has drawn thousands of jumpers since its opening six weeks ago, is also creating concern among some members of the local medical community.

Dr. Bob Wolf and Dr. Ken Jaffe, surgeons at Alabama Orthopaedic Center in Homewood, said they are alarmed at the amount and severity of the injuries they have seen among patients who were hurt at AirWalk Trampoline Arena, located off U.S. 280 in the Greystone area.

In the past couple of weeks, Wolf said he has operated on two patients who were injured at the park. One had severe fractures in both legs and another had a severe knee dislocation.

The patients included a healthy, active middle-aged person and a healthy, athletic younger person, he said.

Wolf, who has been practicing since 1999, said he sees a lot of sports injuries, particularly football, but these go beyond what’s typical for contact sports.

“The injuries I have treated are types you would ordinarily see in a severe motor vehicle accident,” Wolf said. “These are devastating, limb-threatening injuries.”

Jaffe said he has personally treated three or four patients with injuries sustained at AirWalk, including sprains and minor fractures. But he and Wolf say they have compared notes with colleagues at other practices who have also seen more significant injuries

“As a physician, I feel it’s almost our obligation to let the public know, there’s another side to this,” said Jaffe, who has been practicing for 25 years.

Jaffe said he wonders if the problem is isolated in the Birmingham area because the park is new, if this is an industrywide issue and if anything can be done to make the park safer.

Case Lawrence, AirWalk’s developer, said there have been a few leg and foot fractures at the facility, and that is true of all trampoline parks across the country.

But, he added, it’s important to remember that there have been almost 20,000 jumpers so far at AirWalk.

The incident rate at AirWalk and his other parks is better than the national rate, which is at 0.02 percent, he said.

“When you have such a large volume of jumpers coming through statistics dictate that you are bound to have injuries,” Lawrence wrote in an email. “But I would posit that it is safe or safer than any other active sport. How many injuries would you project if you had 20,000 people play full court basketball? We make daily efforts to increasingly make the park safer and to train patrons and staff how to use the facility in the safest way.”

Lawrence notes that the set-up of the facility — essentially a floor of trampolines — means there’s no where to fall off, like a typical backyard trampoline.

There’s also a list of rules for jumpers — no double-jumping or gainers, for example — and staff members wearing black-and-white-striped referee shirts monitor the crowd.

The Birmingham area facility, a 16,000-square-foot space located at 7010 Champion Blvd., is outfitted with nearly 8,000 square feet of trampolines, a trampoline dodgeball stadium and Olympic foam pits with more than 25,000 foam cubes.

It is open to jumpers of all ages. Activities include birthday parties, slumber parties, open jump times for everyone and designated jump times for specific ages.

But while supporters of trampoline parks say they provide good exercise and fun, safety concerns are growing as more open around the U.S.

There have been a number of lawsuits in the wake of trampoline park injuries, CNN reported last summer.

In January, a Seattle area trampoline park, which has fought dozens of lawsuits from people who have been injured, filed for Chapter 11 bankruptcy protection.According to its website, Sky High Sports Bellevue says it will be closed for the immediate future.

There’s also a Facebook page, Think Before You Bounce, which says its mission is to make indoor trampoline parks safer through awareness, regulation and design.

Amid it all, the parks continue to grow in popularity. According to Lawrence, there are nearly 50 trampoline parks currently operating in the U.S., for a total annual revenue of almost $100 million.

He has opened similar parks in Fresno, Calif.; Raleigh-Durham, N.C.; Albuquerque, N.M.; and Richmond, Va.

Later this year, additional parks are planned in Knoxville, Tenn.; Tulsa, Okla.; Baton Rouge, La.; Virginia Beach, Va.; and Greenville, S.C.



Youth Sports – Play it Safe

Back-to-school also means back to the locker room, football field, and gym for many students—38 million each year, according to Safe Kids USA. And while participating in team and individual sports is a great way for kids and young adults to hone healthy habits, injuries can occur. The Centers for Disease Control estimates that as many as 3.8 million athletes suffer concussions every year in the United States. Discover answers to common questions about concussions from the Concussion Clinic at Children’s of Alabama.



  1. What is a concussion? A concussion is a brain injury caused by a hard hit.
  2. What are the ramifications of a concussion? The effect of a concussion on the developing and adolescent brain is unknown, but athletes who have had a single concussion are much more likely to suffer subsequent concussions. Younger athletes may also take longer than college and professional athletes to recover from concussion.
  3. Which sports have the highest rate of concussion? Sports with the highest rates of concussion include football and hockey, though significant numbers occur in other sports, including lacrosse, soccer, and basketball.
  4. What are the signs of a concussion? Most concussions are associated with symptoms like headaches, confusion, nausea, dizziness, and blurred vision.
  5. Do concussions cause a loss of consciousness? While concussions can result in a loss of consciousness, 90% of them do not.
  6. What should you do if you suspect a concussion? When a concussion is suspected, it is most important to immediately remove the athlete from the playing field and have him/her assessed by an experienced athletic trainer or on-field physician. Young athletes who return to play before their symptoms are assessed are at higher risk for significant brain injury.
  7. What should an athlete do before returning to sports after experiencing a concussion?Athletes should not return to play the same day of injury, and instead should follow the following stages. Each stage should comprise 24 hours, and the athlete should return to stage 1 if symptoms recur. Resistance training should only be added in later stages, and medical clearance should be given before the athlete returns to play.
    1. Rest until asymptomatic (physical and mental rest)
    2. Light aerobic exercise (e.g. stationary cycle)
    3. Sport-specific exercise
    4. Non-contact training drills (start light resistance training)
    5. Full contact training after medical clearance
    6. Return to competition (game play)


Learn more about the Concussion Clinic at Children’s of Alabama.

Source: UAB

Dr. Geoffrey Conner Talks Ankle Sprains and Breaks

Dr. Geoffrey Connor Talks Ankle Sprains and Breaks

Don’t wait until it’s too late to treat that ankle injury.


While ankle sprains and fractures occur most commonly in athletes, these injuries can also affect anyone engaging in physical activity. Dr. Geoffrey Connor, MD, orthopedic surgeon at D1 Sports Medicine, advises how you can best treat an ankle injury.


Remember R.I.C.E. “The initial treatment for a sprain or break is called RICE, which stands for Rest, Ice, Compression and Elevation,” says Connor.


-Rest: “Get to a stable location as soon as possible, putting as little weight or stress on the injured area as possible.”

-Ice: “Put ice on the affected area.” Experts say for the first 24-48 hours, you should apply ice packs every two hours for about 15 minutes.

-Compression: “Compress the area with either a wrap or ankle brace if you have one handy.” Connor says even a towel wrapped with ice will work fine.

-Elevation: “Make sure you elevate the foot above your heart to reduce swelling.”


Sprain or Break? “It can be hard to differentiate because they’re so similar,” says Connor. A sprain will likely cause tenderness below the outer anklebone, toward the foot, while a fracture or break will cause point-tenderness directly on the bone. “After a 24-hour period, if the swelling is getting worse or you’re unable to put weight on the foot, that’s a telltale sign it’s a fracture or break.”


When should I see a doctor? If you’re ever in doubt about the severity of your ankle injury, it’s best to go see a doctor as soon as possible, says Connor. “If there is concern in participation of any kind, it’s better to have it checked out and get the ‘all-clear’ before going back to sports activity or heavy-duty work.”


There’s a short recovery period for fractures. “The typical time frame after an ankle is fractured is to expect healing in about 12 weeks before being back at full strength,” says Connor. He estimates only about 6 weeks of immobilization in a cast, splint or boot with limited or protected weight using crutches.


You can expect to then progress into slight weight bearing and activity with a reduced level of support for the next 6 weeks. “During that time period, you’re doing physical therapy to strengthen the ankle and increase the range of motion.”


Chronic ankle sprains may require surgery. “If we find that rehabilitation, physical therapy exercises and bracing are not working to prevent repetitive sprains, there is a procedure we can do, called the brostrom procedure, that strengthens or tightens the ligaments,” says Connor. Think of it like slack in a fishing line—the line must be reeled in tight to be effective. “That’s essentially what we do: take the ligament and surgically shorten and thicken it, so that it can do its job again.”


By Sloane Hudson

To learn more about Dr. Geoffrey Connor, click here.

To learn more about D1 Sports Medicine, click here.

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Ultrasounds Now Your Heel’s Best Friend

How Dr. Francisco Caycedo can use a specialized ultrasound to watch a foot in action and heal that elusive heel pain.


“Everybody during their life has an episode of low back pain and at least one episode of heel pain,” says Francisco Caycedo, MD, an orthopedic surgeon with OrthoSports Associates at St. Vincent’s in Birmingham.


What’s the problem? Until now, finding the cause of heel pain could be hit and miss. “There’s all kinds of different tissue in the heel,” explains Dr. Caycedo. “We were limited by technology in how to find the cause of the pain. We had to do some guessing.”


Make a joyful sound. But now, a special ultrasound offers an ideal diagnostic tool for elusive heel pain. “The machine produces sounds of certain wavelengths, different from cardiac or obstetric ultrasounds, so when it hits bone or tendon it gives you a particular image,” says Dr. Caycedo. “It’s an amazing quality of picture.”


You can see your foot in motion. For the first time, this ultrasound allows orthopedic surgeons — and you — to see exactly what’s going on in your foot as you move it. And even in color. “It’s a dynamic image,” says Dr. Caycedo. “With this kind of technology, we can see new formation of vessels, where fluid is collecting, how the tendons are moving, almost everything.”


Spotting Achilles tendonitis. The most common heel pain comes from the tendons. “With the ultrasound, we can now see whether the Achilles tendon has a partial rupture or full rupture right in our office without having to do surgery,” says Dr. Caycedo. This is a major diagnostic breakthrough for patients and surgeons, because while the treatment for partial rupture is rest, a full rupture can’t heal without surgery.


A look inside. The ability to clearly see the tendons in real time makes the ultrasound a potent part of the treatment of heel pain, as well. “If you have inflammation around the tendon, you need to put the injection where it is inflamed or it doesn’t help,” says Dr. Caycedo. “Used to be the only way to see exactly where the injection was needed was to do open surgery, but now we can see with ultrasound even if you move while we do the injection. The difference is so subtle between the tissues around the tendon and the tendon itself, you have to have something to guide you.”


Helps with nerves. The other major source of heel pain comes from damaged or trapped nerves. “With ultrasound, we can see the shape of the nerve, even as it’s surrounded by tendons and the sheath of fascia,” says Dr. Caycedo. “There’s a lot of live information given to us with these devices.”

by Jane Ehrhardt

To read more about Dr. Francisco Caycedo, click here.

For more on OrthoSports Associates, click here.

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