Fall 2011 - Sports Medicine South

FALL 2011
SPORTS MEDICINE MAGAZINE
The Team Behind
the Team
The Team
SPORTS
MEDICINE MAGAZINE
Approach to
taking care
of a team:
with Tim SImmons, ATC,
Coach Dave Hunter, &
Snehal C. Dalal, MD
Athlete
Success
SPORTS
Story:
w/ Brookwood alum
Cameron Faulkner
MEDICINE MAGAZINE
Athletic
Heart:
w/ Manfred Sandler, MD FACC
ACL Tear:
SPORTS
Career ending injuryMEDICINE MAGAZINE
or bump in the road
w/ Gary A. Levengood, MD
“Sports-Related Concussion”
an article by Mathew W. Pombo, MD
Featu
rin
MVPs g:
of
Sport
s
Medic
ine
Fall 2011
Contents Page
Departments
-Editor’s Note /// Gary A. Levengood, MD ///
2
-Letter from the Chairman of SMC /// T. Scott Maughon, MD ///
2
-Letter from the Manager of SMP /// Tim Simmons MHA, ATC, LAT ///
-MVPs of Sports Medicine ///
4 - 17
•Academy Orthopaedics - Jesse E. Seidman, MD ///
4-5
•Georgia Sports Medicine - Mark C. Cullen, MD & J. Stephen Kroll, MD ///
///
6-7
25
GSMM
Affiliate
Football Schedules
•Resurgens Orthopaedics - Scott G. Quisling, MD, C. Michael Morris, MD, &
Yvonne E. Satterwhite, MD ///
3
8-9
10 - 11
•Sports Medicine South - Gary A. Levengood, MD & Stephanie H. Hsu MD /// 12 - 13
•Southern Orthopaedic Specialists - Snehal C. Dalal, MD, & Brian E. Morgan, MD ///
•The Sports Medicine and Orthopaedic Institute of Gwinnett - T. Scott Maughon, MD &
Mathew W. Pombo, M.D ///
14 - 15
-Gwinnett Medical Center’s Sports Medicine Program ///
16 - 17
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-ACL Tear /// Gary A. Levengood, MD ///
18
-Heat Illness /// Tim Simmons MHA, ATC, LAT ///
19
-The Team Approach to taking care of a team /// Tim Simmons MHA, ATC, LAT,
Dave Hunter, and Snehal C. Dalal, MD ///
21
-Athletic Heart /// Manfred Sandler, MD FACC ///
22
-Sports-Related Concussion /// Mathew W. Pombo, MD ///
23
-Athlete Success Story /// with Cameron Faulkner - Brookwood ///
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Letter
from the
Editor
Gary A. Levengood, MD
Greetings,
“Gwinnett Medical Center –
Duluth delivers more Sports
Medicine Orthopaedic care
than any other hospital in
the state of Georgia.”
With great enthusiasm and anticipation, I present to you
the first edition of Gwinnett Sports Medicine Magazine.
In its Fall 2011 debut issue, GSMM features all of our
Gwinnett Sports Medicine Team. Between its covers,
you will meet the physicians, trainers and administrators
who allow us to deliver safe and effective sports medicine in Gwinnett. Additionally, the magazine is filled
with articles, authored by our members, highlighting the
best practices in “taking care of a team!”
We are blessed at Gwinnett Medical Center – Duluth to
have some of the most sought-after physicians not just in
Georgia, but throughout the entire Southeastern region.
Each Orthopaedic and Sports Medicine physician team
member is highly skilled, equipped with an extensive
training background and outstanding medical credentials.
Their expertise allows the team to deliver top quality,
cutting edge care on the field and in the operating room.
The GSM team also includes an outstanding group of
athletic trainers with resumes that would make any professional sports team proud – in fact, many of the staff
have actually worked alongside NFL teams. In addition
to committing countless volunteer hours to educating fellow physicians, paramedical staff and the community on
the latest techniques and advances in Sports Medicine,
GSM physicians serve as team doctors for sporting teams
ranging from professional level to Little League.
Gwinnett Medical Center – Duluth delivers more Sports Medicine Orthopaedic care than any
other hospital in the state of Georgia. When the inevitable happens and an athlete is injured,
our GSM physicians and trainers offer the finest medical care and rehabilitation services
available, returning athletes to top-notch physical condition as quickly and safely as possible.
Our goal is to provide to all of our patients safe, top-notch medical care and rehabilitation.
As members of GSMM team, we look forward to continuously enriching the community
with Sports Medicine knowledge and best practices. Please give us your feedback so that we can
further tailor the magazine to fit your needs in the future – Sports Medicine is truly our labor of love.
Be a
GSMM
Contributor
2 GSMM
If you would like to submit an article or are
interested in advertising opportunities
in GSMM please contact Sherri Cloud at
[email protected] or 6789072912
Letter from the
Chairman of the Gwinnett Medical Center’s
Sports Medicine Committee
A
T. Scott Maughon, MD
s Chairman of the Gwinnett Medical Center Sports Medicine Committee, I am proud
to say that over the last 18 years, here in Gwinnett, we have been able to provide
many advances in sports medicine to the athletes of Gwinnett County.
When the program was first established back in 1992, there were very few physicians on
the sidelines at high school football games in Gwinnett County. Now , we have essentially
placed a doctor on the sidelines of every home field at the majority of the high schools in
Gwinnett County, as well as extending into North Fulton County. This translates into immediate evaluation and treatment of any high school student that requires attention while on
the playing field. In addition to doctors, certified athletic trainers, provided for by Gwinnett
Medical Center, have been placed on the field and in the training rooms. These trainers have
extended experience in treating injuries both on and off the field.
With the introduction of the ImPACT Program throughout the county for the past four
years, also provided by Gwinnett Health Center, this has helped protect the student athletes
from potentially life threatening second impact which may have otherwise gone undetected.
Another program provided by the Sports Medicine Program called Friday Night Lights has
also been implemented. When there is a questionable fracture, the respective team physician
and trainer are able to send the athlete to the hospital and bypass the emergency room that will
be fast tracked into radiology where an x-ray can be provided with minimal wait.
It is through these programs and others that provide a student athlete with the safety and
care they deserve. These developments and others are what keep me excited and enthusiastic about the future of sports medicine and healthcare
in Gwinnett County and surrounding areas and make us proud to be a part of the Sports Medicine Program at Gwinnett Medical Center. If you
would like to know more about us, please refer to the Gwinnett Sports Medicine website, as well as your individual team physician websites.
Letter from the
Manager of Gwinnett Medical Center’s
Sports Medicine Program
W
Tim Simmons, MHA, ATC, LAT
elcome and thank you for your interest in Gwinnett Medical Center’s Sports Medicine Program. We are proud of our program, its reputation, and the impact we
are having in our community. This is most evident in the program’s success and
seen in its growth.
We currently employ over 30 certified athletic trainers and provide services to 46 organizations. This success is attributed to the sports medicine vision and mission driven by unique
core values. We have set the standard in sports medicine for Gwinnett and surrounding counties through our passion and caring for patients.
Our most important program attribute is the leadership provided by the professionals involved in our program. Our award-winning fellowship-trained physicians, specialists and
staff are some of the most well-educated and highly-trained medical professionals in the
nation. Not only are they the true backbone of what makes us the leading sports medicine
program in the state, their commitment, drive, and constant support are what allow us to
provide the best care possible.
Our community program delivers traditional sports medicine services under the direction
of the Gwinnett Medical Center affiliated physicians. The GMC certified athletic trainers
work closely with coaches, parents, and chiefly the GMC affiliated team physicians to prevent, manage and assess orthopedic or musculoskeletal injuries as well as facilitate access to
advance medical care. This comprehensive system provides access to expedited and specialized care while supporting the ongoing needs athletes often require.
Our goals are high, our commitment to serving our athletic community is our passion, and our leadership is unparalleled! Our vision is to continue progressing access to appropriate care, enjoying what we do, and being the best at it. Thank you for your continued support and interest
in our program.
GSMM 3
Jesse E. Seidman, MD
4 GSMM
Jesse E. Seidman, MD
Orthopaedic Surgery & Sports Medicine
Our Surgery Center
Academy Orthopedics Ambulatory Surgery Center
D
r. Seidman performs many outpatient surgeries in our very own Ambulatory Surgery Center (ASC)
located at our Cumming office. Academy Orthopedics opened the ASC in 2001. The ASC has successfully treated over 10,000 patients for their outpatient orthopedic surgical procedures. The ASC is an
alternative for those that prefer not to have their outpatient surgery performed at a hospital saving the patient additional costs, as well as having a reduction in risk for infection. We pride ourselves on the personal
attention and calming atmosphere that helps decrease the stress of having surgery. The ASC also provides a
private family waiting room for those anxiously awaiting their loved-ones return from surgery. Dr. Seidman
also performs surgery at Gwinnett Medical Center and Northside Hospital/Forsyth.
Our Locations
Academy Orthopedics has 3 locations to better serve our patients.
Dr. Seidman treats patients at all three of these North Georgia locations.
Cumming Office and Ambulatory Surgery Center
318 Tribble Gap Road
Cumming, Georgia
D
r. Seidman is a board certified orthopedic surgeon. He joined Academy Orthopedics in 1995. He attended college
and medical school at the State University of New York and received his post-graduate training at Mt. Sinai Hospital in New York at the State University of New York in Stony Brook. He completed his Fellowship in Sports Medicine
at the Lahey Clinic in Burlington, Massachusetts. Dr. Seidman was born and raised in New York. He came to Atlanta
in 1992 and practiced in Dekalb and Gwinnett counties prior to joining Academy Orthopedics. He has presented papers
at orthopedic meetings and has been published in some of the major orthopedic journals. He brings to our practice his
expertise in sports injuries, shoulder surgery, and general orthopedic surgery. Dr. Seidman has expertise in both foot and
ankle surgery and total joint replacement surgery. Dr. Seidman is a Partner in Education.
Academy Orthopedics takes great pride in providing quality care for patients of all ages. Our board certified physicians
treat many different types of orthopedic problems which include general orthopedic care for sprains, fractures, torn
ligaments, back problems, and any other musculoskeletal problems. Our physicians are here to help you with any pain
or discomfort you may be having. We offer non-surgical as well as surgical procedures.
Buford/South Hall County Office
3929 Carter Road, Bldg. C
Buford, Georgia
Duluth Office
3540 Duluth Park Lane
Suite 220
Duluth, Georgia
For appointments call
our scheduling coordinator
at 770-271-9857 or go online
to our website at
www.academyorthopedics.com.
Common Sports Medicine procedures Dr. Seidman treats:
•ACL Injuries
•Meniscus Repair
•Fractures
•Rotator Cuff Repair
•Frozen Shoulder
•Plantar Fasciitis
•Arthroscopic Procedures
Dr. Seidman is the exclusive team Orthopedic Surgeon
for The Atlanta Sports Academy in Dawsonville, GA.
GSMM 5
6 GSMM
•6340 Sugarloaf Parkway Suite 375
Duluth, GA. 30097 - 770.814.2223
•3625 Braselton Highway Suite 206
Dacula, GA 30019 - 770.814.2223
Mark C. Cullen, MD
Orthopaedic Surgery & Sports Medicine
J. Stephen Kroll, MD
Primary Care Sports Medicine
www.georgiasportsmedicine.com
M
ark C. Cullen, M.D. is a fellowship sports medicine trained orthopaedic surgeon who has been in practice in Gwinnett County for
the past 14 years. He received his B.S. in biology from Bucknell University in Lewisburg, PA and received his medical degree from Temple
University School of Medicine in Philadelphia, PA. He completed his
Orthopaedic Residency at the University of Cincinnati Medical Center
Department of Orthopaedic Surgery and a Sports Medicine Fellowship
at the prestigious Cincinnati Sports Medicine Center under the direction
of Dr. Frank Noyes. He specializes in arthroscopic knee and shoulder
surgery and has developed a specialized program for the care of youth
and high school athletes.
Dr. Cullen, a former athlete himself, can be seen on the sidelines throughout the years at many Gwinnett County sporting events and practices.
He currently serves as team physician for North Gwinnett High School,
Dacula High School, Lanier High School and St. Pius High School. He
also serves as team physician for Atlanta Cheer and Dance and Ultimate
Gymnastics. Dr. Cullen has been named Sports Medicine Person of the
Year by the Southeastern Athletic Trainers Association for his involvement with youth sports. Dr. Cullen is a member of AOSSM and AANA.
Dr. Cullen is married and has four children. In his free time he enjoys
spending time with his family and sports of all kinds.
Teams We Serve
•North Gwinnett High School
•Dacula High School
•Lanier High School
•Hebron Christian Academy
•St. Pius X High School
•Georgia Force Home School
Football
•Cheer and Dance Atlanta
•Thunder AAA Hockey
•Atlanta Phoenix Hockey Club
•MAYLA Lacrosse
•Team Crease Lacrosse
•Hotlanta Lacrosse
•Ultimate Gymnastics
S
teve Kroll, M.D. is the newest addition to Georgia Sports Medicine and Pediatric Orthopaedic Surgery. He is a West Virginia
native who attended undergraduate school at West Virginia University. He worked as a strength and conditioning coach at West Virginia
for two years before attending medical school. He attended medical
school and completed his residency in Pediatrics at West Virginia
University School of Medicine. He completed advance fellowship
training in Sports Medicine at the University of South Carolina.
While there he served as one of the assistant team physicians for the
USC Gamecocks, Benedict College, as well as multiple local high
school programs.
His addition to the practice provides a team approach similar to that
utilized by universities and professional sport teams for specialized
non operative and operative care of Orthopaedic and sports related
injuries. His pediatric training will assist our practice to expand our
role as a local leader in the care of youth and high school athletes.
He is a member of the American Academy of Pediatrics and the
American Medical Society for Sports Medicine.
Our Practice
…Dedicated to Getting
You Back in the Game
Georgia Sports Medicine is an orthopaedic surgery practice that specializes
in sports medicine, arthroscopic surgery, and pediatric orthopaedic surgery.
Georgia Sports Medicine provides high level operative and non operative
care for athletes of all ages, levels and abilities. The physicians and staff at
Georgia Sports Medicine strive to keep athletes active and work hard to get
them back to their desired activities as quickly as possible. The office staff
is dedicated and committed to superior patient care making them one of the
best orthopaedic practices in Gwinnett County.
A list of services include: orthopaedic surgery, pediatric orthopaedic surgery,
sports medicine, concussion testing, sports physicals, physical therapy, injury
prevention, conditioning programs, and ACL prevention.
Georgia Sports Medicine wants to keep you in the game. While their treatment of injuries in athletes is unparalleled, they also focus on the prevention
of injuries. The physicians and their staff work with athletes and their families to develop individualized exercise and conditioning programs to assist
in the prevention of injuries getting them back in game stronger than before.
www.georgiasportsmedicine.com
6340 Sugarloaf Parkway Suite 375 - Duluth, GA. 30097 - 770.814.2223
3625 Braselton Highway Suite 206 - Dacula, GA 30019 - 770.814.2223
J. Stephen Kroll, MD
Mark C. Cullen, MD
Georgia Sports Medicine
& Orthopaedic Surgery
GSMM 7
•771 Old Norcross Road, Suite 390
Lawrenceville GA 30046 - 678-957-0757
•5955 State Bridge Road Suite 200
Johns Creek GA 30097 - 678-205-4261
www.sos-atlanta.com
General Orthopaedics,
& Hand and Upper Extremity
S
nehal C. Dalal, M.D. provides Orthopaedic care to patients in our
Johns Creek and Gwinnett locations. As a Fellowship trained Orthopaedic surgeon, his practice includes general orthopaedics and sports
medicine, with an emphasis in hand and upper extremity, including elbow
and shoulder arthroscopy and reconstruction. Dr. Dalal has special interest, training and experience in the diagnosis and treatment of employment
injuries.
Dr. Dalal graduated from Case Western Reserve University in Cleveland,
Ohio with a Bachelor of Science degree in biomedical engineering. He
received his Doctor of Medicine degree from The Ohio State University
College of Medicine and Public Health and completed his residency in
Orthopaedic surgery at the Medical College of Wisconsin. Dr. Dalal completed his fellowship training in shoulder, elbow and hand surgery in Milwaukee as well as conducted research on rotator cuff injuries and elbow
trauma as part of the Milwaukee Combined Upper Extremity fellowship.
He currently serves as team physician for Duluth High School and Central
Gwinnett High School.
Dr. Dalal, and his wife Falguni and their two daughters live in the Lawrenceville area. In his free time he enjoys running, tennis, skiing and traveling. Both he and his wife are avid college football fans.
Brian E. Morgan, MD
Orthopaedics, Sports Medicine &
Arthroscopic Surgery.
D
r. Morgan is a second generation physician and now walks the
same halls at Gwinnett Medical Center as his father, Claude
Morgan, M.D., a 30 year emergency room veteran. He received his
undergraduate degree from Swarthmore College near Philadelphia,
and his medical degree from Duke University School of Medicine.
He completed his orthopaedic residency at the University of Rochester in Rochester, New York. Dr. Morgan completed a sports medicine
fellowship at The Hughston Clinic in Columbus, Georgia, where he
also did research in elbow arthroscopy.
Dr. Morgan’s special interest in sports medicine began as a participant. He is an avid sports enthusiast who played basketball on both
the high school and college levels. He is also involved in many community, college and professional organizations. He has been an Orthopaedic consultant for the Valdosta State University Football team,
Columbus State University Men and Women’s Basketball Teams and
the Rochester Americans AHL Hockey Team. Dr. Morgan has volunteered as a team physician for several area high schools, soccer teams
and currently serves as team physician for the Gwinnett Gladiators
Professional Hockey Team and Mill Creek High School.
Dr. Morgan resides in the Atlanta area an in his free time enjoys sailing, windsurfing, water-skiing, playing the guitar and playing basketball
Teams We Serve & Events We Cover
Our Practice
The Strength of Experience
Years of offering expert medical care with compassion and integrity have made Southern Orthopaedic
Specialists one of the most distinctive and experienced orthopaedic specialty providers in the state.
Our dedication to providing you exceptional orthopaedic care is exemplified through our team of renowned physicians, experts in the treatment of trauma, diseases, and disorders of virtually every bone
and joint in your body. Southern Orthopaedic Specialists’ physicians are subspecialty trained in hand
and upper extremity, hip, knee, foot and ankle, spine,
sports medicine, total joint and non-operative spine
treatment and care. To augment this care we also offer MRI testing, Physical Therapy and a comprehensive
program to treat work related injuries.
To ensure our patients receive the best treatment and
care available, our physicians are fellowship trained in specialty orthopaedics, which means they have received advanced
training in their respective fields. With the support of our patient-friendly staff, you can be assured that the physicians at
Southern Orthopaedic Specialists will dedicate their medical experience and expertise to making your life better.
This is what we do.
8 GSMM
Snehal C. Dalal, MD
Dalal:
•Duluth High School Team Physician
•Central Gwinnett High School Team Physician
•Chick-fil-A Bowl Sideline Physician
•Chick-fil-A College Kick-Off Sideline Physician
•Atlanta Tennis Championships Assistant Medical Director
•Atlanta Silverbacks Assistant Team Physician
•PGA Championships Medical Provider
•Gwinnett Sports Commission Official Sports Medicine Provider
Morgan:
•Gwinnett Gladiators Team Physician
•Mill Creek High School Team Orthopaedic Surgeon
•Atlanta Tennis Championships Tournament Physician
•Chick-fil-A Bowl Sideline Physician
•Chick-fil-A College Kick Off Sideline Physician
•Gwinnett Sports Commission Official Sports Medicine Provider
•Georgia Force Assistant Team Physician- 2003-2007
•LPGA Chick-fil-A Charity Championships Medical Provider
•UGA Hockey Team - Medical Provider
Brian E. Morgan, MD
Snehal C. Dalal, MD
Southern Orthopaedic Specialists
GSMM 9
C. Michael Morris, MD
Resurgens Orthopaedics
•758 Old Norcross Road, Suite 100
Lawrenceville, GA 30046 - 770.962.4300
•6335 Hospital Parkway, Suite 302
Johns Creek, GA 30097 - 404.575.4500
C. Michael Morris, MD
Sports Medicine and Arthroscopy
Residency:
www.resurgens.com
Associations:
Georgia Baptist Medical Center
American Academy of Orthopaedic Surgeons
Arthroscopy Association of North America
Georgia Orthopaedic Society
Atlanta Orthopaedic Society
Medical Degree:
University of Alabama School of Medicine
Certifications:
Major Accomplishments:
Board Certified, American Board of Orthopaedic Surgeons
Sports Medicine Subspecialty Certificate in Orthopaedic
Sports Medicine
2006 Top Doc Gwinnett County
Hospital Affiliations:
Gwinnett Medical Center
Scott G. Quisling, MD
Scott G. Quisling, MD
Sports Medicine and Arthroscopic Surgery
Joint Replacement
Residency:
Associations:
Georgia Baptist Medical Center; Atlanta, GA
Georgia Orthopaedic Society
Atlanta Orthopaedic Society &
American Society of Sports Medicine
Medical Degree:
University of Florida College of Medicine
Major Accomplishments:
Fellowship:
2006 Top Doc Gwinnett County
Sports Medicine; Lake Tahoe Orthopaedic Institute
Hospital Affiliations:
Certifications:
Gwinnett Medical Center
American Board of Orthopaedic Surgeons
Yvonne E. Satterwhite, MD
Our Practice
EXCELLENT CARE, EVERYWHERE:
RESURGENS ORTHOPAEDICS
H
ave you ever felt “something pop” while running. Or have you ever had trouble moving your
shoulder after the big game. Or perhaps you have a pain that just doesn’t go away. If you relate
to these all-too-common complaints, you are not alone.
Thanks to Resurgens Orthopaedics, however, athletes can get back on the field quickly and safely. In
addition to providing sports medicine and treatment for injured athletes, Resurgens Orthopaedics offers
a full range of orthopaedic services at 21 offices around Metro Atlanta, including state-of-the-art facilities
in Johns Creek and Lawrenceville, GA.
With 99 physicians, Resurgens provides specialized expertise and broad experience in the areas of
sports medicine, joint replacement, neck and back surgery, foot and ankle surgery, non-operative spine
care, general orthopaedics, hand surgery, shoulder and elbow surgery, arthroscopic surgery, epidural
steroid injection, and trauma care. Resurgens provides comprehensive musculoskeletal care in a single
location, from injury diagnosis and treatment to rehabilitation services. Resurgens is helping Georgians
get back on their feet, back to work, and to living their lives to the fullest. When the need for musculoskeletal care arises, patients can trust they are getting the finest care available. Go ahead and take a closer
look at Resurgens to uncover capabilities and standards for orthopaedic care that may not be found in
any other practice. Resurgens strives to be the leader in orthopaedic care.
10 GSMM
Yvonne E. Satterwhite, MD
General Orthopaedics, Sports Medicine, Surgery of
the Shoulder, Knee & Elbow, and Arthroscopic Surgery
Residency:
Lawrenceville Office
Tulane University School of Medicine; New Orleans, Louisiana
Medical Degree:
Tulane University School of Medicine; New Orleans, Louisiana
Fellowship:
James R. Andrews, M.D. & William G. Clancy, M.D.;
Alabama Sports Medicine and Orthopaedic Center;
Birmingham, Alabama; Sports Medicine
Certifications:
Board Certified, American Board of Orthopaedic Surgeons
Certificate of Added Qualification Orthopaedic Sports Medicine
Johns Creek Office
Associations:
American Academy of Orthopaedic Surgeons
American Orthopaedic Society for Sports Medicine
Olympic Sports Medicine Society
American Sports Medicine Fellowship Society
Major Accomplishments:
Head Team Physician Atlanta Beat 2000-2004
2002 Georgia Team Physician of the Year
U.S. Olympic Committee Medical Staff Physician, 1996, 1997, 1998
2011 Atlanta Magazine’s Top Doctors
Hospital Affiliations:
Emory Johns Creek Hospital, Gwinnett Medical Center Duluth, Northside Forsyth Hospital
GSMM 11
•1900 Riverside Parkway
Lawrenceville, GA 30043 -770.237.3475
www.sportsmedsouth.com
Gary A. Levengood, MD
Orthopaedic Surgery & Sports Medicine
G
ary A. Levengood, M.D., is the Founder and President of Sports
Medicine South, LLC. Board certified in Orthopaedic Surgery and
Sports Medicine by the American Board of Orthopedic Surgeons, Dr. Levengood completed a Sports Medicine fellowship at The Hughston Clinic
in Columbus, Georgia, where he specialized in Arthroscopic Surgery and
Sports Medicine. He also holds membership in the American Academy of
Orthopedic Surgeons.
Dr. Levengood’s interest in sports medicine began as an active participant
and coach. A former professional soccer player with the Georgia Generals,
he holds a United States Soccer Federation B coaching license and has
coached at the youth, amateur and collegiate levels. Dr. Gary Levengood is
the current Team Physician of the Georgia Force, a professional arena
football team and the Atlanta Blackhawks FC Soccer team; he is also the
Medical Director for the Georgia State Soccer Association’s Olympic Development program and formerly, he served as the Chief of Orthopedics at
Gwinnett Medical Center and as Team Physician for the Atlanta Silverbacks from 2000 – 2007.
Dr. Levengood’s specialties include arthroscopic surgery, sports medicine, and joint arthroplasty. In addition, he supports the local community
by serving as Team Physician for Brookwood High School, Norcross High
School, Mountain View High School, and Medical Director of Gwinnett
Gymnastics Center. He has also traveled internationally with the U-17 national men’s soccer team as their physician.
Alter-G - the anti-gravity treadmill
T
he Anti-Gravity Treadmill, more formally known as the
Alter-G, does exactly what its name eludes to by creating
a walking environment similar to that of the Moon. Conceived
by NASA, and approved by the FDA, the Alter-G is designed to
reduce the weight impact on lower extremities. By utilizing air
pressure, the Alter-G has the ability to take off as much eighty
percent of your own body weight, allowing patients to walk, jog,
or run without pain or further injury. Both Sports Medicine Rehab facilities and professional sports associations strongly back
the innovative machine. The Alter-G is continually used to facilitate
rehabilitation to patients and athletes with hip, knee, ankle, and foot injuries.
The technically advanced machine, although in high demand, is
hard to find. There are only a few Alter- G’s found across Georgia; one of the machines is housed in the Physical Therapy Department of Sports Medicine South in Lawrenceville, GA. Curt
Bazemore, PT and SMS’s Director of Rehabilitation sums it up as, “The capabilities of the Alter-G facilitate a significant
improvement in the quality of care for our patients and to the progression of their rehabilitation program.”
Teams We Serve
Stephanie H. Hsu, MD
Orthopaedic Surgery, Shoulder, Elbow
& Sports Medicine
S
tephanie H. Hsu, M.D. is a fresh addition to the Sports Medicine
South family. With her interest and specialized training in both
adult and adolescent sports medicine, shoulder surgery, and the athlete’s elbow, Dr. Hsu easily complements the SMS practice mission. As a native Georgian, Dr. Hsu grew up playing competitive softball
and tennis in Roswell and attended Chattahoochee High School. She
graduated early, with honors, in Mechanical Engineering from Georgia Tech. After completing her undergrad studies, Dr. Hsu attended
medical school at the Medical College of Georgia, then pursued a
master’s degree in Mechanical Engineering and Biomechanics at the
University of Southern California to expand her understanding of
surgical implant design. Dr. Hsu then traveled across the country to Boston, to complete her
orthopedic surgery residency at Tufts University-New England Medical Center. Prior to joining Sports Medicine South, Dr.Hsu completed
the prestigious Shoulder, Elbow and Sports Medicine fellowship at
Columbia University in New York City. While in New York, Dr. provided care for collegiate and professional athletes under the direction
of Columbia University and New York Yankees team physicians.
Additionally, Dr. Hsu has published research in prestigious journals,
and has authored book chapters and teaching videos covering topics
including total and reverse shoulder arthroplasty, arthroscopic shoulder labral repair, and examination of the athlete’s elbow.
O
Our Practice
Stephanie H. Hsu, MD
Gary A. Levengood, MD
12 GSMM
Sports Medicine South
ver 5 years ago, Dr. Levengood opened Sports Medicine
The Anti-Gravity Treadmill, more formally known as the
South, LLC to offer his extensive experience, develop
Alter-G, does exactly what its name eludes to by creating
talent and passion for sports. The Sports Medicine South ofa walking environment similar to that of the Moon. Confice is located at 1900 Riverside Parkway in Lawrenceville,
ceived by NASA, and approved by the FDA, the Alter-G
Georgia. The SMS office houses a highly specialized staff inis designed to reduce the weight impact on lower extremicluding Stephanie Hsu, MD; Diana Dean, PA-C; Harris Patel,
ties. By utilizing air pressure, the Alter-G has the ability to
PA-C, ATC; and a well-versed team of certified athletic traintake off as much eighty percent of your own body weight,
ers. SMS also offers on-site physical therapy under the leadallowing patients to walk, jog, or run without pain or furership of Curt Bazemore, PT, ATC. A number of specialized
ther injury. Both Sports Medicine Rehab facilities and proand technologically advanced services are offered at SMS,
fessional sports associations strongly back the innovative
including: minimally invasive procedures, innovative ACL
machine. The Alter-G is continually used to facilitate reReconstruction Procedures, ConforMIS, computerized surgihabilitation to patients and athletes with hip, knee, ankle,
cal navigation, total shoulder replacement and reconstructive
and foot injuries.
surgery, elbow, pediatric sports medicine, Anti Gravity treadThe technically advanced machine, although in high
mills, electrical stimulation, massage therapy.
demand, is hard to find. There are only a few Alter-G’s
Dr. Levengood’s practice philosophy is stated in his tagline:
found across Georgia; one of the machines is housed in the
We Get You Beyond Better. He and his entire staff are dePhysical Therapy Department of Sports Medicine South in
voted to providing the highest quality care in a comfortable
Lawrenceville, GA. Curt Bazemore, PT and SMS’s Direcsetting to patients from all walks of life. “We don’t just get
tor of Rehabilitation sums it up as, “The capabilities of the
you better, we get you beyond better.” Dr. Levengood and his
Alter-G facilitate a significant improvement in the quality
wife, Lisa, live in Gwinnett County and have four children.
of care for our patients and to the progression of their reWhen he is not standing on the sidelines of a game or taking
habilitation program.”
care of patients, he enjoys skiing, golf, tennis, fishing, and
hunting.
GSMM 13
•3855 Pleasant Hill Road, Suite 470
Duluth, GA 30096 - 770.813.8888
•24 Amhurst Drive
Winder, GA 30680 - 678.425.0113
www.gwinnettsportsmedicine.com
T. Scott Maughon, MD
Arthroscopic Knee and
Shoulder Surgery
D
r. Maughon is a native of Atlanta, having graduated from Lakeside
High School in 1977. He earned his BS in biology from the University of Georgia in 1982 and was awarded his medical degree from The Medical College of Georgia in 1986. He completed his orthopaedic residency
in Atlanta at Georgia Baptist Medical Center and completed his Sports
Medicine Fellowship in 1992 at the famed Alabama Sports Medicine Institute under Drs. James Andrews and William Clancy. Dr. Maughon specializes in arthroscopic knee and shoulder surgery, fracture care and total
knee replacements.
Dr. Maughon prides himself on being an orthopaedist who enjoys taking
care of his community. He has been a vital part of the Gwinnett community and hospital system and currently serves as Chairman of the Sports
Medicine Committee at the Gwinnett Medical Center Duluth Campus.
He has given many hours of service to the Gwinnett County community
through his education talks and affiliation with the Gwinnett Youth Football League. He has provided sports coverage to many of the area high
schools and is currently the team physician for Northview High School. In
August 2011 he served as the Official Medical Provider for the 2011 PGA
Championship.
Dr. Maughon is married with two children. He enjoys serving in his
church and coaching his own children in their sporting events.
Our Practice
The Sports Medicine & Orthopaedic Institute of
Gwinnett is one of the oldest orthopaedic practices in Gwinnett County. Founded in 1992 by Dr.
Maughon, the practice has been in existence for almost 20 years. Drs. Maughon and Pombo are board
certified orthopaedic surgeons who are Fellowship
Trained in Sports Medicine, Shoulder Surgery, and
Arthroscopy and are dedicated to helping you keep
your body’s musculoskeletal system in the best possible working condition; returning you to the freedom of an active pain free lifestyle at any age.
The mission of Drs. Maughon and Pombo and
their staff is to provide quality healthcare to each
individual patient. By providing the most advanced
technology and levels of expertise, they are dedicated to fill the orthopaedic and surgical needs of
each patient. It is the goal of Dr. Maughon and Dr.
Pombo, as well as their staff, to effectively support
and care for all patients as they strive to maintain a
healthy quality of life.
Teams & Events We Ser ve
Kyle Petty Charity Ride
Mathew W. Pombo, M.D
Arthroscopic Knee and Shoulder Surgery &
Sports Concussion Specialist
D
r. Pombo is an orthopaedic surgeon, speaker, author, and researcher. He is a native of Gwinnett County and former star
soccer player at Duluth High School. He attended the Georgia Institute of Technology and received his Doctor of Medicine from the
Medical College of Georgia graduating with honors as a member of
the prestigious Alpha Omega Alpha honors society. He completed
his orthopaedic training at Wake Forest University and his Sports
Medicine Fellowship at the world renowned University of Pittsburgh
Center for Sports Medicine. Dr. Pombo is highly trained in joint
preservation in the aging athlete and specializes in arthroscopic and
reconstructive procedures of the knee and shoulder. He also performs
ankle and elbow surgery, provides fracture care and a variety of total
joint replacements. He is the only orthopaedic surgeon in the State
of Georgia that is Fellowship Trained in Concussion Injuries and the
ImPACT Program.
Dr. Pombo works extensively with collegiate, high school, and recreational athletes. He has served as a Team Physician for the Pittsburgh Steelers, the Pittsburgh Penguins, the University of Pittsburgh,
Wake Forest University, and Chip Ganassi Racing. He is currently
head team physician for Berkmar, John’s Creek, and Chattahoochee
High Schools and is on the medical team for the annual Kyle Petty
Charity Ride Across America. He has played a vital role in implementing a system wide concussion prevention program in the Gwinnett
County School System.
Dr. Pombo is married and has two sons. In his spare time he enjoys spending time with his family and often can be
found racing cars at local race tracks across the country with his younger brother.
Mathew W. Pombo, M.D
T. Scott Maughon, MD
14 GSMM
The Sports Medicine &
Orthopaedic Institute of Gwinnett
The Anti-Gravity Treadmill, more formally known as the
Alter-G, does exactly what its name eludes to by creating
a walking environment similar to that of the Moon. Conceived by NASA, and approved by the FDA, the Alter-G
is designed to reduce the weight impact on lower extremities. By utilizing air pressure, the Alter-G has the ability to
take off as much eighty percent of your own body weight,
allowing patients to walk, jog, or run without pain or further injury. Both Sports Medicine Rehab facilities and professional sports associations strongly back the innovative
machine. The Alter-G is continually used to facilitate rehabilitation to patients and athletes with hip, knee, ankle,
and foot injuries.
The technically advanced machine, although in high
demand, is hard to find. There are only a few Alter-G’s
found across Georgia; one of the machines is housed in the
Physical Therapy Department of Sports Medicine South in
Lawrenceville, GA. Curt Bazemore, PT and SMS’s Director of Rehabilitation sums it up as, “The capabilities of the
Alter-G facilitate a significant improvement in the quality
of care for our patients and to the progression of their rehabilitation program.”
GSMM 15
Gwinnett Medical Center’s
L
The Athletic Training Services Program
S p o r t s M e d i c i n e P r o g ra m
eaders can make a difference. As the leading sports medicine
program in Georgia, Gwinnett Medical Center-Duluth provides innovative care to its athletic communities. In 2005, the program was established with the goal of implementing a county-wide
sports medicine model to provide comprehensive sports medicine
services. The goal to promote and provide the highest-level of athletic care for its community has driven the program to be the leader
in sports medicine. The award-winning physicians, specialists and
staff at Gwinnett Medical Center are some of the most well-educated and highly-trained medical professionals in the nation.
The sports medicine program’s vision is to provide injury prevention, immediate care and rehabilitation services of excellence to the
community. The program currently provides certified athletic trainers in different capacities such as high schools, professional teams
and recreational leagues. The program provides comprehensive
on-site medical coverage, concussion management through the ImPACT program, injury prevention programs and education events.
Since 2005, the program has provided sports medicine services to
1.5 million athletes participating in 46 different organizations.
The program presently delivers services for public and private schools
in both Gwinnett and North Fulton, the Georgia Force, the Gwinnet Gladiators, premier youth recreational leagues such as the Atlanta Fire United Soccer Association, the Greater Gwinnett Baseball
League, Gwinnett lacrosse and hockey leagues, the Gwinnett Football League, the Gwinnett Touchdown Club All-Star game, and the Georgia High School Association. Gwinnett Medical Center is also the official
healthcare provider for the Gwinnett Braves and the Atlanta Tennis
Championships.
The program’s mission includes four central areas of focus for the
future. First, it will provide easy access to sports medicine services.
Second, it will incorporate a philosophy that will inspire a high value
on health, wellness and prevention through provision of services.
Third, it will help injured persons return to their respective activities
as soon as medically possible. Finally, the program is designed to substantially reduce the chance of injury for those it provides services.
The Sports Medicine Program at GMC-Duluth strives continually for
improvement and is committed to helping all athletes prevent injury,
heal, manage pain and get back in the game as quickly as possible.
TM
The GMC sports medicine program values that set them apart include:
• Integrated View of Health:
We believe health is multidimensional: physical, mental, emotional, environmental, social and spiritual.
• Community-Based Collaboration:
We embrace working collaboratively—with customers, schools, and local providers—using the strengths
of a multidisciplinary approach.
• Accessibility and Responsiveness:
We promote equity and inclusion and believe everyone should receive the highest quality care.
We are committed to providing programs and services that are economically, physically and culturally
accessible and responsive to the changing needs of our communities.
• Social Responsibility and Stewardship:
We protect the long-term wellbeing of our community by responsibly using and developing the resources
entrusted to us and promoting environmental awareness, superior global thinking, and local action.
• Vibrant Work Culture:
We celebrate the contributions of our staff and embrace diversity of ideas, backgrounds and experiences.
We encourage teamwork and innovation, and support a learning environment that helps staff succeed in
their jobs and develop their careers.
16 GSMM
O
ur program delivers traditional sports medicine services under the direction of the Gwinnett Medical Center affiliated
physicians. We also have contracts for private EMS and emergency transport, emergency action plans for athletic venues, access
processes with the GMC emergency and imaging departments,
and facilitate access to necessary support services.
ATC Team:
•Tim Simmons, Manager, Sports Medicine Program
•Kristin Moore, Coordinator, ATC Services
•Kim Winn – Johns Creek
•Jay Pearson - Brookwood
•Mindy Simmons - Duluth
•Sarah Bailey - Central
•Cristina Vega - Brookwood
•Eddie Knox – Mountain View
•Tovan Willey - Berkmar
•Rick Flateau - Northview
•Tangela McCorkle - Chattahoochee
•Susanne Tucker – Atlanta Fire United
•Sam Hadaway – Providence Christian Academy
This unique system provides access to expedited and specialized
care while supporting the ongoing needs athletes require.
The ATCs work closely with coaches and the Gwinnett Medical
Center affiliated team physicians to prevent, manage and assess
orthopedic or musculoskeletal injuries and to facilitate access to
advance medical care.
•Dani Ellis – Gwinnett Gladiators
•Kristen Wilkey - Norcross
•Jennifer Duff – Norcross
•Crystal Frazier – Peachtree Ridge
•Brian Struck – Georgia Force
•James Williams – Part Time Support Staff
•Harris Patel - Part Time Support Staff
•Stephanie Griggs - Part Time Support Staff
•Kelly Bilbrey - Part Time Support Staff
•Kent Qualls - Part Time Support Staff
•Dinika Johnson - Part Time Support Staff
•Laura Trkovsky - Part Time Support Staff
•Doug Wardy - Part Time Support Staff
GSMM 17
ACL
Tear:
Career ending injury
or bump in the road
/// By: Gary Levengood, MD
Y
ou’re out playing a soccer game, a tennis match, or maybe even down hill skiing
when all of a sudden you lose your balance
and feel a “pop” in your knee. For a moment, the
pain is excruciating, but then it becomes more tolerable. However, your knee starts to swell and it is
painful to walk on. So, you are helped off the field,
court, or get a sled ride down the mountain. Unfortunately, you have just joined the nearly 200,000 others who will tear their Anterior
Cruciate Ligament (ACL) this year.
With a general increase in organized sports and year round training, games and tournaments, it is not surprising that the exposures and
risks for ACL injuries has increased as well. If you are female athlete (especially those participating in soccer, basketball or gymnastics)
your risk of injuring your ACL is 2 – 10 times greater than your male counterparts, and the numbers are growing! With the advent of Title
IX legislation and the rise in opportunities for female athletic participation, a whole new number of athletes have become at risk of injury.
ANATOMY
The ACL is one of the four principle ligaments which help to stabilize the knee. The ACL is anterior or in front of the Posterior Cruciate Ligament (PCL) and crosses it from inside to outside. The other two major ligaments are the Medial Collateral Ligament (MCL)
on the inside part of the knee, and the Lateral Collateral Ligament (LCL) on the outside part of the knee. The ACL functions to prevent
the Tibia (shin bone) from being pulled off the Femur (thigh bone). The quadriceps (thigh) muscles in front help to extend the knee and
the Hamstring muscles in back help to flex or bend the knee. The hamstrings are vital as they actively help to prevent the quads from
pulling the tibia off the femur.
Heat Illness
/// By: Tim Simmons, MHA, ATC, LAT
E
These injuries may ensue when an athlete is not properly hydratnvironmental stress can adversely affect an athlete’s perfored or acclimatized, is exposed to extreme heat or has prolonged
mance and in some instances pose an emergent health threat.
Exertional heat illnesses are very serious conditions that consist
exposure, has on heavy clothing or equipment, has had a previous
heat injury, has used alcohol, certain dietary supplements includof a three level spectrum in result of exposure or overexposure to
ing caffeine, over the counter drugs or prescription drugs, and
hot environments. These progressive levels include exercise asis fatigued or not rested. Key ways to prevent heat injuries are
sociated heat cramps, heat exhaustion, and exertional heat stroke.
proper hydration, hydration monitoring systems before and after
Symptoms include painful muscle cramps of the arms, legs, and/
or stomach usually combined with excessive sweating with thirst,
activity such as weighing, adequate rest to activity cycles, adequate acclimatization, correct uniforms/equipment, environmenheadache, weakness, dizziness, nausea, increased pulse and respital monitoring systems, and a pre-participation activity medical
ration, seizures, and mental confusion. Death can occur in severe
screening.
instances. These injuries are preventable.
Proper hydration is a process that begins 24 to 48 hours prior to
Treatment for heat exhaustion includes identifying early sympactivities in hot or high humidity environments. Gradual acclitoms, stopping or modifying the activity, rapid cooling, and movmatization is the most effective method of avoiding heat stress. A
ing to a cooler environment. Rehydration with water or a sports
drink is the foundation of treatment. If nausea or vomiting pregood pre-season conditioning program started prior to the beginning of strenuous activity in the heat is recommended and a prevents an individual from drinking enough water, intravenous fluactivity medical screening is essential. All activity in high weathids may be required. Any rapid deterioration in health or mental
er environments should include progressive exposure in the first
status can be an emergency where 911 activation is imperative.
10 to 14 days of activity with abundant access to frequent liquids.
Activity in hot environments can overwhelm the body’s ability
It is the policy of the Gwinnett Medical Center Athletic Training
to cool itself and cause heat related injuries. The body cools itself
Services to inspect, oversee and evaluate all hot weather related
by sweating and allowing that sweat to evaporate. This requires
athletic and training activities to provide the greatest degree of inenough fluid in the body to make sweat, air circulating across the
herent safety at athletic sites where it provides services. The goal
skin, and low air humidity to allow that sweat to evaporate. This
B:8.875 in
is to maximize care while minimizing or eliminating these injuries.
process is your body’s way of cooling itself.
T:8.375 in
S:7.625 in
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RISKS
The probability of tearing your ACL is increased if you are involved in a contact or collision sport that includes cutting, twisting and
jumping. However, it is important to note that non-contact ACL injuries (where no one hits you) are responsible for 70% of these injuries, where direct contact accounts for only 30%. Again, female athletes have an increased incidence of non-contact ACL injuries than
do male athletes (up to 10%).
PREVENTION
Unfortunately, ACL injuries have become a major part of athletics. In particular, female soccer players have a reported 4-6 times greater
risk of ACL injury than the male athlete and over 30,000 ACL injuries are reported every year with an estimated healthcare cost of over
720 million dollars. In response, over the past several years, many programs have been developed, designed and promoted to reduce the
risk of ACL Injury. Results from this focus on proper athletic development have returned a reduced rate of injury in as much as 75% for
athletes in a specifically designed program. (Boone 2007)
A properly designed training program should consist of nine basic components: evaluation, movement preparation, plyometrics, core
strengthening, weak point training, integrated strength training, multi-directional speed training, footwork, and proper recovery drills.
TREATMENT
The treatment for ACL injuries can be either non-operative or operative. Non-operative treatment consists of supervised physical
therapy, activity (sport) modification and bracing. However, many initial non-operative treatments end up requiring surgery due to continued instability and/or further injury. The operative treatment of ACL injuries has progressed significantly over the past 20 years. The
recognition of anatomic landmarks and new techniques has allowed the surgeon to better replicate the ACL’s anatomic and isometric
position. Single and double bundle ACL’s performed in this fashion show less residual instability and easier rehabilitation. Due to these
new arthroscopic techniques, better graft selection and improved postoperative rehabilitation, an increased number of athletes have been
able to return to their chosen sport more quickly and safely than ever before. If surgery is chosen it is performed in an outpatient setting.
Recovery times to return to sport depend on many factors and can vary from 3 – 8 months with aggressive rehabilitation.
SUMMARY
ACL injuries are increasing due to increased sport participation and continued year round training. Prevention programs are available
and have proven to reduce risks of injury by up to 75%. If necessary, surgery has a extremely high rate of success if performed by an
experienced Orthopedic Surgeon who performs 50 or more ACL’s a year coupled with an aggressive rehabilitation plan supervised by
an experienced physical therapist and/or certified athletic trainer.
18 GSMM
www.euflexxa.com
What’s
Happening at
2nd Annual
Gwinnett Football
Fellowship
Golf Tournament
GMC...
D
r. Levengood and the Sports
Medicine South team were
proud to put on the 2nd Annual
Gwinnett Football Fellowship Golf
Tournament on July 11th, 2011. Each
year the SMS Golf Tournament is
put on in support of the Gwinnett
Touchdown Club and in appreciation of all Gwinnett High School
Football coaches. Proceeds from
the tournament fund sponsorships
for deserving Gwinnett County football players from each of the participating teams. This year, SMS hosted 31 teams: 20 Gwinnett County
Schools and 11 teams of sponsors,
and raised over $23,000 to support
community high school players.
MEDS_adGSMM_0711.qxd:MEDS_adGSMM_0711E
7/28/11
10:23 AM Page 1
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The Team
Approach
to taking care of a team
The Trainer
/// By: Tim Simmons, MHA, ATC, LAT
A
Sports Medicine Program Manager at Gwinnett Medical Center
certified athletic trainer (ATC) is a highly educated and skilled professional specializing in the prevention, treatment and rehabilitation of injuries. In cooperation with physicians and other allied health personnel, the ATC functions as an integral member of the
athletic healthcare team in high schools, colleges, sports medicine clinics, professional sports programs, industrial settings and other
healthcare environments. An ATC acts as a gatekeeper or liaison in administering or directing appropriate medical care between athletes, their
organizations, and the proper medical professional.
Specifically, a certified athletic trainer’s
role encompasses six domains:
• Athletic Injury Prevention and Risk Management
• Recognition, Evaluation and Assessment of Injuries and Illnesses
• Immediate Care of Injuries
• Treatment, Rehabilitation and Reconditioning
• Health Care Organization and Administration
• Professional Development and Responsibility
T
The Coach
/// By: Dave Hunter
Former Head Football Coach & Athletic Director at Brookwood High School
he responsibility in taking the BEST care of players rest with the Coach, Team Doctor, and Athletic Trainer. The Coach must be aware
of the players physical condition, be educated to the latest safety procedures and be pro-active in his training and practice methods. The
Coach, Team Doctor, and Athletic Trainer must be in concert and must design a master plan for player care and safety. This plan should
include out of season and in season training calendars and a proper nutrition guide as well as the “latest” in preventive care.
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The Doctor
/// By: Snehal C. Dalal, MD
T
General Orthopaedics & Sports Medicine at Southern Orthopaedic Specialists
he Team Physician is a medical doctor who is proficient in musculoskeletal injuries and medical conditions that are related to sports.
The physician is specially trained and board certified in a sports specialty and the majority of their practice is in the field of sports medicine. Most importantly, the physician must be willing to commit the time and effort to care for the athlete and the team. In addition, the
team physician must develop and maintain a current knowledge base of the sport he/she is taking responsibility. In the off season, protocols
are developed in conjunction with the coaches, athletic trainers, and other allied health professionals regarding injury prevention, preparticipation physicals, and in- or off-season treatments to keep the athletes game ready. During the season, the team doctor must be “side-line ready”:
actively observe the sporting event, assess and manage game day injuries and determine an athlete’s safe return to play.
What’s
Happening at
GMC...
6th Annual Gwinnett Football League
Parent Trainer’s Clinic
Tim Simmons, Manager of Sports Medicine Program, reports a record turnout
at the 6th annual Gwinnett Football League Parent Trainer’s Clinic on August
6th. The several hundred people in attendance learned to recognize conditions that required care and got hands on experience doing basic taping
as well as first aid. They also benefitted from on field emergency scenarios.
Topics covered included: Youth Cardiac issues, Concussions, Head and
Neck injuries, Heat injuries, Sprains, Strains and Fractures. Attendees received a medical kit as well as a medical field guide, courtesy of Gwinnett Medical Center.
This event was held at Duluth High School, with parents representing teams
across Gwinnett County.
GSMM 21
Athletic Heart
/// By: Manfred Sandler, MD FACC
T
he phenomenon “athletic heart” needs to be differentiated from the potential life threatening
condition hypertrophic cardiomyopathy (HCM). The latter is responsible for approximately
50% of sudden cardiac death in athletes’ below the age of 35 years.
The differentiation from a clinical perspective can be using basic modalities starting from taking
a thorough history and doing a thorough cardiac examination. Clearly a family history of sudden
cardiac death, cardiomyopathy or Marfans Syndrome should warrant more extensive testing in any
athlete wanting to participate in sport. Any history of syncope or frequent dizziness, palpitations
or exertional chest pain requires closer attention. Finally auscultation of a murmur of questionable
significance should trigger an echocardiogram for better clinical diagnosis.
Changes seen in an athlete’s heart occur either with endurance /dynamic aerobic or isometric
static power exercise. This results in complex responses which are evidenced on physiological and
morphological level. These changes ultimately lead to increased cardiac output, stroke volume,
maximum oxygen consumption and arteriovenous oxygen difference.
Morphological changes usually result in increases in left ventricular mass or left ventricular hypertrophy (LVH). The histological difference in LVH arising from exercise is that the myocardial cells are usually symmetric as opposed to eccentric and disorganized as seen in HCM.
There appears to be different responses of cardiac muscle to either endurance sport (for example rowing) versus isometric/strength training
(for example weight lifting). Endurance training induces left (LV) and right (RV) ventricular dilatation and enhanced LV and RV diastolic function.
Strength training results in increased LV wall thickness and a decreased diastolic function. No changes
occurred in the RV. The wall increased in thickness
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between 13-16 mm. Normal wall thickness is approximately 12 mm.
These changes also seem to be dependent on body
surface area and therefore are less pronounced in females.
The EKG may show a wide range in changes in athletes and may be unhelpful in terms of specificity
and sensitivity in differentiating athletes heart from
any other pathology for instance coronary artery disease or HCM. However in HCM voltages are usually greater, Q waves and T wave inversion are more
prominent.
If one looks at the diastolic function of the heart
utilizing echocardiography there appears to be more
definitive ways to diagnosing HCM even in patients
with only mild or no LVH. One utilizes mitral valve
inflow patterns as well as tissue doppler. The latter is
determined my measuring the velocity that the mitral
annulus moves in both systole and diastole.
Finally in athletes with LVH of between 13-16 mm
falling into a grey zone of diagnosis between non obstructive HCM and athletic heart please refer to the
table below for some helpful distinguishing criteria.
TM
TAKING YOU BEYOND RECOVERY
Weoffer
offer Physical
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PhysicalTherapy,
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22 GSMM
ATHENS
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MARIETTA CENTRAL
(404) 367-2086
ATLANTA
(404) 367-2095
MARIETTA EAST
(404) 367-2085
HCM Grey zone of LV thickness
+
+
+
+
+
+
+
-
Unusual patterns of LVH
LV cavity < 45 mm
LV cavity > 55 mm
LA enlargement
Bizarre EKG patterns
Abnormal LV filling
Female gender
Thickness with deconditioning
Family history of HCM
Max. VO2 >50ml/kg/min
Athlete’s
Heart
-
+
+
+
Sports-Related
Concussion
/// by: Mathew W. Pombo, MD
T
here is an epidemic in our midst of which most of us are unaware. Untold numbers of young people are suffering concussions at an alarming rate. According to the American Medical
Association two million sports-related concussions happen each
year, and 85% of these head injuries go unrecognized. The public,
as well as the medical community, have failed to appreciate the
consequences of this problem and have been unaware of the immediate and long-term effects of sports related concussions. The
purpose of this editorial is to outline where we have come in concussion management and why things have had to change.
A concussion is a short-lived loss of brain function that is due to
head trauma that does not require a loss of consciousness. Symptoms of a concussion may include headache, amnesia, nausea, dizziness, confusion, irritability, visual symptoms, and mental fogginess to name a few. Physical signs include poor concentration,
emotional changes, slurred speech, and even personality changes.
Many of these symptoms mimic those of migraine headaches and
these athletes may even be diagnosed with migraines, when they
in fact have post-traumatic headaches. A big change in the last 10
years has been the awareness that cognitive strains such as school,
testing, etc. may worsen concussion symptoms. Often times an
athlete that sustains a concussion over the weekend may only have
a mild intermittent headache until Monday at school where he/she
may have an acute worsening of symptoms. Due to the brain’s
cognitive dysfunction, there is increasing evidence showing the
effect a concussion has on a student-athletes ability to perform
academically in the classroom during their recovery.
In Gwinnett, we are fortunate to provide computerized neurocognitive testing to every high school athlete through the Gwinnett
Medical Center’s Sports Medicine Program. The ImPACT test is a
computer based neurocognitive test battery that each athlete takes
during preseason to provide a baseline brain function score for that
particular athlete. If they sustain a concussion during their sport
season, the ImPACT program is utilized to follow their cognitive
function over time through repetitive testing. The ImPACT test
provides objective data as to when the injured athletes brain function has returned to baseline. Establishing a return to baseline is
What’s
Happening at
GMC...
critical to prevent repetitive head trauma during a vulnerable period of recovery that can lead to Second Impact Syndrome (sudden
death from sudden brain swelling) or more long term effects such
as Post Concussive Syndrome. Most concussions take 2-4 weeks
in high school athletes to heal and 90% of high school athletes
have returned to play after 4 weeks of recovery. Old treatment
guidelines had athletes returning to play after 1 week for grade 1/
first time concussions. New research has shown that only 40% of
athletes return to baseline neurocognitive function after 2 weeks.
Current literature has proven traditional concussion grading scales
and return to play guidelines to lack evidence basis and be less effective than current practices.
There are five concussion recommendations that need to be appreciated by the public and the medical community in addition to
treating each concussion individually:
1: No adolescent should continue to play or return to a game
after sustaining a concussion
2: An individual sustaining a concussion should cease any activity that leads to an increase in concussion symptoms (e.g.
headaches, dizziness, nausea, etc.)
3:
4:
School attendance and activity may need to be modified
Neurocognitive testing/ImPACT is an important component of concussion management.
5: No athlete should return to contact sports/activities until
they are symptom free, both at rest and with exercise, and
have normal neurocognitive testing/ImPACT.
In conclusion, a Sports-Related Concussion is a traumatic brain
injury and should be taken seriously. The field of sports concussion management has evolved rapidly over the past several years
and has become a more individually-driven management protocol formulated through scientific evidence and research across the
world. This injury is one with devastating immediate and longterm consequences that are all preventable through education and
establishing concussion awareness in our youth and their parents.
Sports Medicine Update for the
Primary Care Physician:
This educational activity held on Saturday May 21, 2011 on the campus of
the Philadelphia College of Osteopathic Medicine Georgia Campus featured
leading experts who shared the latest in orthopaedic and sports medicine
topics, including information on diagnosis and treatment modalities for sports
injuries. Presentations addressed primary care concerns affecting sports participation as well as state-of-the-art surgical and non-surgical musculoskeletal
interventions. Conference speakers shared their expertise in concise didactic presentations and an emphasis on hands-on demonstrations including
physical examination techniques of major joints.
This conference is designed specifically for family practice physicians, internists, pediatricians, physician assistants and nurse practitioners. We had
approximately 90 attendees.
GSMM 23
Athlete
Success
Story
What sport do you play and for how long have you been playing?
I play football and have since I was in 1st grade.
Tell us about your sports career at Brookwood?
I played both football and baseball until I tore my Anterior Cruciate Ligament (ACL) in my sophomore year. This occurred during spring football
practice and I went through surgery and rehabilitation during baseball season. This made me have to choose to concentrate on football only. I got
back out on the football field towards the end of my sophomore year for
the last couple games after 7 hard months of rehabilitation. Going into my
junior year and first year on Varsity I went into spring practice and again
had a huge injury and tore my shoulder up pretty bad. I dislocated my
shoulder and tore my labral cartilage in my shoulder which required surgery. Through diligent rehabilitation I got back on the field and started at
linebacker and defensive end along with all special teams my junior year.
I worked out all offseason strengthening my muscles and coming together
with my team. Senior year approached and I stayed healthy this time and
was feeling great. I was moved to fullback and together with my team we
earned the region title and then won the State Championship! It felt great
to be healthy and contributing and to put Brookwood back on the football
map in the state of Georgia. I had a great year and am very determined to
keep my body healthy at the next level.
GSMM
Archer
Tigers - Red, Silver & White
At Duluth
8/26
9/2
Mountain View
Grayson
9/9
At Brookwood
9/16
At Berkmar
9/23
10/7
Shiloh
10/14
Central Gwinnett
At Dacula
10/21
10/28
At Parkview
South Gwinnett
11/4
Berkmar
Patriots - Red, White & Blue
Etowah
8/26
At Meadowcreek
9/2
Central Gwinnett
9/9
At Grayson
9/16
Archer
9/23
9/30
At Parkview
At South Gwinnett
10/7
Shiloh
10/21
10/28
Dacula
At Brookwood
11/4
Brookwood
Broncos - Maroon & Gold
At Lassiter(GD)(D)
8/20
9/2
Collins Hill
9/9
At Dacula
9/16
Archer
At Central Gwinnett
9/23
South Gwinnett
9/30
At Shiloh
10/14
10/21
Parkview
At Grayson
10/28
Berkmar
11/4
Central Gwinnett
Black Knights - Black & Gold
8/26
Mountain View
At Chapel Hill
9/2
9/9
At Berkmar
9/16
South Gwinnett
9/23
Brookwood
9/30
At Dacula
Parkview
10/7
10/14
At Archer
10/28
At Shiloh
11/4
Grayson
Chattahoochee
Cougars - Blue, Gold & White
9/2
Lambert
At Forsyth Central
9/9
9/16
At Creekview
9/23
Northwest Whitfield
9/30
Johns Creek
10/7
Cartersville
Sequoyah
10/14
10/21
Cass
10/27
At South Forsyth
11/4
At Rome
Collins Hill
Eagles - Green, Silver & White
8/26
At Roswell
At Brookwood
9/2
9/9
At M. L. King(HS)
9/16
North Gwinnett
9/23
At Duluth
10/7
Peachtree Ridge
At Mill Creek
10/14
10/21
Mountain View
10/28
At Norcross
11/4
Meadowcreek
Dacula
Falcons - Blue, Gold & White
8/18
At Norcross
Mill Creek
8/26
9/9
Brookwood
9/23
At Shiloh
9/30
Central Gwinnett
10/7
At Grayson
At South Gwinnett
10/14
10/21
Archer
10/28
At Berkmar
11/4
Parkview
Duluth
Wildcats - Purple, White & Black
8/26
Archer
Northview
9/2
9/9
At Alpharetta
At Norcross
9/16
9/23
Collins Hill
10/7
At Mountain View
10/14
Meadowcreek
10/21
At Peachtree Ridge
North Gwinnett
10/28
11/4
At Mill Creek
Grayson
Rams - Hunter Grn, Gold & Navy
8/20
At Kell(GD)(D)
At TBA(N. Gw.)(D)
8/27
9/9
At Archer
Berkmar
9/16
9/30
At Shiloh
10/7
Dacula
At Parkview
10/14
10/21
South Gwinnett
10/28
Brookwood
11/4
At Central Gwinnett
Hebron Christian Academy
Lions - Crimson, Gold & White
8/26
At Prince Ave. Christ.
At Southside Christ., SC
9/2
9/9
Athens Christian
9/16
At G. Walton Academy
9/23
Lakeview Academy
10/1
At Baconton
GA Military College
10/7
10/21
At N. Cobb Christian
10/28
Cross Keys
11/4
Towns County
Johns Creek
Gladiators - Cardinal & Vegas Gold
8/26
Rome
At Sequoyah
9/2
9/9
Cass
At Woodland
9/16
9/23
At Creekview
9/30
At Chattahoochee
Lambert
10/7
10/21
At South Forsyth
Northwest Whitfield
10/28
11/4
Forsyth Central
Lanier
Longhorns - Orange, White &
Black
9/2
Hapeville
9/9
At Mountain View
9/23
At Union County
10/21
At River Ridge
Mill Creek
Hawks - Cardinal, Vegas Gold & Navy
8/26
At Dacula
9/2
At Alpharetta
9/9
Cherokee
9/16
At Mountain View
9/23
Norcross
10/7
At Meadowcreek
10/14
Collins Hill
10/21
At North Gwinnett
10/28
Peachtree Ridge
11/4
Duluth
Mountain View
Bears - Black & Vegas Gold
8/26
At Central Gwinnett
9/2
At Archer
9/9
Lanier
Mill Creek
9/16
9/23
At Peachtree Ridge
10/7
Duluth
10/14
At North Gwinnett
10/21
At Collins Hill
10/28
Meadowcreek
11/4
Norcross
Norcross
Blue Devils - Blue, White & Silver
8/18
Dacula
9/2
At Parkview
9/9
Roswell
9/16
Duluth
9/23
At Mill Creek
10/7
North Gwinnett
10/14
At Peachtree Ridge
10/21
At Meadowcreek
10/28
Collins Hill
11/4
At Mountain View
North Gwinnett
Bulldogs - Black, Red & White
8/20
At McEachern(GD)(D)
8/27
TBD
9/3
St. Augustine, Fla
9/16
At Collins Hill
9/23
Meadowcreek
10/7
At Norcross
10/14
Mountain View
10/21
Mill Creek
10/28
At Duluth
11/4
Peachtree Ridge
Northview
Titans - Navy & Silver
8/26
Meadowcreek
9/2
At Duluth
9/9
At South Cobb
9/16
Newton
9/23
Alpharetta
9/30
At North Forsyth
10/7
At West Forsyth
10/14
Milton
10/21
Roswell
11/4
At Centennial
Peachtree Ridge
Lions - Royal Blue & White
8/20
At Walton(GD)
9/2
At Roswell
9/9
Newnan
9/16
At Meadowcreek
9/23
Mountain View
10/7
At Collins Hill
10/14
Norcross
10/21
Duluth
10/28
At Mill Creek
11/4
At North Gwinnett
Providence Christian Academy
Red, Navy & White
8/25
At Loganville Christian
9/1
At George Walton Academy
9/17
At Holy Spirit Prep
9/24
At Community Christian
9/29
At Young American Christian
10/6
At Creekside Christian School
10/13
At Hebron Christian
10/20
Playoffs
10/27
League Championship
Affiliate
Football
Schedules
What happened, how did you get injured?
Both of my injuries to my knee and shoulder occurred during spring practice of my Sophomore and Junior year.
Where did you go for treatment?
I was treated by Dr. Gary Levengood at Sports Medicine South, who is our team
doctor. He is always on the sidelines at all the games. I did physical therapy with
Curt Bazemore at Sports Medicine South along with our Brookwood High school
trainer Jay Pearson, ATC with Gwinnett Medical Center. Jay, who has been the
athletic trainer at Brookwood for 10 years did a great job of making sure I stuck
with all my training and coached me through my strengthening workouts. It was
great that I could do most of my rehabilitation at school and not have to miss a
bunch of class time.
How did you hear about your doctor?
Dr. Levengood is a legend, He has been Brookwood’s team doctor for 15
years and he is always available for us. He is always on the sideline for
something like 185 consecutive games, or coming to see us in the training
room. He and our trainer Jay make a great team.
Cameron Faulkner
Brookwood High School - 2011
Fullback/Linebacker
/// Do you have an
Athlete Success Story?
If so, please send your
nomination with a brief
description of the story
to our publisher at:
[email protected]
24 GSMM
What makes him different from other doctors you have seen?
He cares more about how you feel ...He tells you the truth about your
condition. I feel confident he’s the best and knew he would get me back
on the field as quick and as safely as possible as he has done for so many
professional and high school athletes.
What did he do for you?
He reconstructed my ACL and then the next year reconstructed my shoulder, two years back to back. Through all of it he was very reassuring and
encouraged me to continue to work hard to achieve my goals.
Why was therapy so important to getting you back in the game?
If you don’t take therapy seriously you are not going to have a chance to
perform at a high level and you can end up back in the same spot you were
when you injured it.
Are you recovered? What are your plans for the future?
I am fully recovered and am going to play college football on scholarship
at Bethel University in Tennessee. I want to play football as long as I can
and then carry over my hard work ethic into being a strength and conditioning coach/ nutritionist for a college weight lifting program. I’d like to
thank Dr. Levengood, Jay Pearson, and Curt Bazemore and the team at
Sports Medicine South for helping me return to football and achieve all
my goals. Go Broncos!
GSMM 25
GET BACK IN THE ACTION.
Choose Atlanta’s sports medicine specialists.
Sports injuries can unexpectedly take you out of the game.
That’s why the Sports Medicine Program at Gwinnett Medical
Center–Duluth is dedicated to helping all athletes prevent
injury, heal and manage pain.
With Atlanta’s most experienced team of sports medicine
specialists, we help thousands of professional and everyday
athletes spend less time on the sidelines. Our convenient
surgical, imaging and rehabilitation facilities ensure we
get athletes back to full strength faster.
For a free physician referral, call 678-312-5000 or visit us on
the web at gwinnettsportsmed.com.
THE OFFICIAL HEALTHCARE PROVIDER FOR THE GWINNETT BRAVES, GEORGIA FORCE, GWINNETT GLADIATORS AND THE ATLANTA TENNIS CHAMPIONSHIPS