So I’m back in the emergency room with a little girl who looks like her forearm is going to fall off the rest of her upper extremity. People love trampolines. Yet somehow the only time I seem to hear the word trampoline is when someone’s been hurt. I’m not the only one who’d vaporize them on site. The American Academy of Pediatrics recommends that trampolines never be used at home or in outdoor playgrounds because these injuries include head and neck contusions, fractures, strains and sprains, among other injuries.
So my patient had a (posteriorly) dislocated elbow, meaning she fell off the trampoline, landing on the back of the extended upper arm, pushing the upper arm bone (the humerus) in front of the elbow and forearm. This is how that looks.
So for the joy of bouncing on a trampoline, the child had to be put asleep so the elbow could be replaced into the appropriate position. This procedure is fraught with potential for complications, including a broken bone on the way back, as well as damage to the local nerves and arteries (brachial artery, median and ulnar nerves), which can become entrapped during the effort to relocate the bone into the elbow joint. Some limitation in fully bending the arm up and down (flexion and extension) is common after a dislocation, especially if prompt orthopedic and physical therapy follow-up isn’t obtained. This really is a high price to pay for the privilege of bouncing up and down. So if you’re going to allow your kids to play on a trampoline, here are two tips shown to reduce injuries.
Find one of those nets that enclose the trampoline, and make sure the frame and hooks are completely covered with padding. This is meant to protect against getting impaled, scratched or thrown from the trampoline.
Keep the trampoline away from anything else, including trees and rocks. This works even better if the trampoline is enclosed as previously mentioned.
We’re in the middle of summer, which for many of us means a lot of golf (at least on the weekends). You should be aware that golf-related injuries continue to be on the rise. I’m not talking about the struck by lightning, hit by a golf ball or club, driving your cart into the adjacent lake or being bit by a crocodile variety. I’m talking about overuse of specific parts of your body that are involved in the golf swing. 80% of golf-related injuries are reportedly due to such overuse considerations. It’s also estimated that 40% of amateurs and 60% of professionals will experience an injury related to such overuse. It should be intuitive and is certainly true that the risk for such injuries increase with age. Here are the three most common sets of golf injuries in amateurs (professionals have slightly different injury patterns and frequencies). I’ll also address how they occur and what you can do to prevent them. Keep it in the short grass. 1. Lumbar Strain/Development of Low Back Pain: We spend so much time learning to extend the club, coil and uncoil while swinging a golf club about 100 MPH (some of us, myself included, at an ever faster rate; professionals average speeds of approximately 120 MPH). The very premise of doing this for three and a half to five and a half hours at a time (shame on you, slow golfers!) is not the most natural consideration based on our bodies’ design. Studies of professionals show that about 1/3 of them have experienced significant low back pain of at least two weeks’ duration. And they know what they’re doing!
What to do? This may be close to blasphemy to many golfers, but studies show that not carrying your golf bag (i.e. using a caddy or a golf cart) cuts the rate of golf injuries in half. That’s not saying don’t walk! Even the pros don’t carry their own bags. A second consideration (or perhaps it should be first) is learning proper technique. Additionally, flexibility training that increases the range of motion of the lumbar spine and extension and rotation of the lead hip (left hip in right-handed golfers) should decrease low back pain. Personally, I’ve had great success with golf-tailored stretching exercises and modified yoga techniques. Try it. The only thing you have to lose is the pain and maybe a few strokes.
2. Elbow Injuries – Medial and Lateral Epicondylitis: Consider these the plague of the hacker. Both conditions are inflammatory problems involving tendons of the elbow. Medial epicondylitis is known as ‘golfer’s elbow’, although it occurs in other sports such as bowling, lifting weights and sports involving throwing. It’s typically associated with those times that you (excuse me, your playing partners…) hit the ground before the hitting the ball, and you feel that shiver in your elbow. Lateral epicondylitis is known as ‘tennis elbow’, although golfers may be affected on the lateral side as well. This typically occurs when you over-involve your right hand in your swing; eventually the overuse will produce inflammation in that tendon. Similar conditions exist in the wrist as well.
What to do? Get better, for starters! Proper swing mechanics reduce the incidence of both golfer’s and tennis elbow. Additionally, good health (including an exercise regimen inclusive of strength training and stretching) and pre-round stretching maneuvers help to reduce the likelihood of these conditions presenting during your round. Additionally, if the situation becomes truly painful, typical treatments include recommendations to rest, use ice and anti-inflammatory medications, and to immobilize the involved area.
3. Shoulder Injuries – Failure to have proper mechanics also rears its ugly head and affects the lead shoulder in golfers. Strains, bursitis, tendonitis and eventually arthritis are all frequently seen problems in golfers.
What to do? Again, it’s about prevention, strengthening and stretching the muscles and tendons in and around your rotator cuff and developing good technique that reduces undue strain on your areas being called into action during the swing.
If I had one tip to give you, I’d recommend that you always take at least 10 minutes before your round to stretch. Doing so will reduce your injury risk by half. Yet, only 10-20% of golfers actually consistently do this. Jumping from a cramped car to swinging a golf club 100 MPH is a formula for disaster. If I had one piece of advice to give you, it’s simply to discover an exercise regimen that includes strengthening (muscles and core), flexibility and cardiovascular considerations. Obviously, the second would be to get lessons, which by itself will improve your risk profile. I hope this information proves to be of some use to you. I welcome any questions or comments.