Dislocated Elbow

The elbow, being a true hinge joint, is one of the most stable joints in the body. It is formed by the articulation of the humerus, radius, and ulna. Dislocations of the elbow are rare, however, there seems to have been a few more elbow dislocations lately. It takes a very large force to dislocate the elbow, and most dislocations occur in the posterior (backwards) direction. If you do not like to look at pictures of injuries, I would advise you not to scroll down any further. But, if you do and would like to learn, take a look at the pictures and video.

This injury occurred this summer during the NBA playoffs. Rando, the injured player, got tangled up with Wade. As he landed, he put his arm out to brace his fall, and the force from the ground caused the resulting elbow dislocation.
This injury occurred during the 2008 Bejing Olympics. The weightlifter was attempting to lift a very large amount of weight, and the force from the barbell caused the forearm to be forced posteriorly (backwards) in relation to the upper arm.

This injury occurred last week during the Oregon-California game, and was very similar to the basketball injury. The running back was being tackled and when he attempted to brace his fall, he dislocated his elbow. Once a physician reduces the dislocation, it is possible to make a fairly quick return to play (except for the weight lifter) while wearing an elbow brace to stabilize the joint. This must be treated as a serious injury, because there are many nerves and blood vessels that run behind the elbow that could be damaged by the dislocation.

Motor Milestones

We have been discussing infant reflexes, spontaneous movements, and motor milestones in motor development the past few classes. Since Cameron is now 6 months, I thought I would post pictures of him achieving these milestones. I will do another post once he turns 12 months in order to show the next stage of milestones he will progress through.

Spontaneous arm and leg movements

Lifting head

Smiling

Lifting head and shoulders, rolling over

Reaching and grabbing feet

Smiling some more

Sitting with support
Reaching and grasping

Sitting with slight support

Dangerous situation

If you keep up with the NFL, then you know that Peyton Manning just had his third neck surgery in the past two years. This one was more serious than the first, and involved removing the disc between two of his cervical (neck) vertebrae, which will allow the two bones to fuse together. If you look at the picture above, you can see the nerve roots coming out of the side of the spinal cord, and the herniated disc is pressing, or impinging on the nerve root. These nerve roots carry motor signals from the brain down to the muscles, telling them when to contract and relax, and they also carry sensory information, such as touch, temperature, and pain, up to the brain. When the disc impinges on the nerve root, it disrupts these signals, causing muscle weakness (because the signal has trouble getting to the muscle), pain, discomfort, etc. Peyton's first two surgeries were less invasive and attempted to increase the space for the nerve root to pass through. The first surgery allowed him to play last year, but he began having many of the above symptoms after the season concluded so he had a second surgery in May. As Peyton prepared for this season, he was still having some of these symptoms, including weakness in his triceps muscle. This muscle extends the elbow and is crucial for a quarterback attempting 40 to 50 passes a game. Cervical nerve root seven innervates the triceps, so this leads me to believe his problem was the disc between the sixth and seventh cervical vertebrae. The doctors say Peyton should regain full function and be able to play football again. However, the risk of future injury is greater, and when you are dealing with the neck, it is an especially delicate situation. Peyton is only 35 years old, and hopefully has a long life ahead of him. I am not sure it is worth the risk to continue to play football if it could jeopardize his quality of life. But, that is his decision.

Motor Development

One of the classes I am teaching this semester is Motor Development, and I have such an invaluable resource to use this semester. That would be Cameron, my almost five month old son. I was working on some future lectures and came across his two month ultrasound picture from a year ago (above). I've also attached a recent picture of him (below) to show just how much he has grown and developed in a year. It will be fun and interesting to watch and track his growth and development as I teach about it this semester.

Difference in Response Latency of the Peroneus Longus

This month, I (along with my co-author Dr. Weimar) had an article published in the Journal of Sport Rehabilitation. The study examined the peroneus longus muscle, which is found on the outside of the lower leg and is the main muscle that can help prevent an ankle sprain when a person rolls his or her ankle. We reported that when you invert (roll) your ankle, it takes the muscle of the dominant leg longer to respond than the muscle of the nondominant leg. This increase in response time for the dominant leg could potentially lead to a greater number of ankle sprains of the dominant ankle versus the nondominant ankle. I am currently conducting a research study to investigate this further. The primary goal of my research is to understand the factors leading to ankle sprains and eventually develop protocols to help reduce the number of ankle sprains. If you want to read the whole article, you can check it out at this link. I also had to attach a four month picture of Cameron. He is continuing to grow at a rapid rate and is doing well. And yes, he is wearing an Auburn outfit because I do have two degrees from Auburn.

NATA 2011

This Wednesday, I went down to New Orleans for the 2011 National Athletic Trainers Association Annual Meeting and Symposium. I presented some research on ankle sprains and was able to attend a few other sessions. Overall it was a good experience. I received some positive feedback on my research, was able to catch up with some old friends, and see what other types of research related to athletic training is being conducted. It was, however, the first night I had spent away from Cameron since he was born, and that was tough. I was sure glad to get back to Hattiesburg on Wednesday and see him!!

Mechanical Analysis of Human Movement

This summer, I am teaching a new course called "Mechanical Analysis of Human Movement." It is basically a Clinical Biomechanics course designed for our students that plan on pursing a career in a health related profession or a graduate degree in exercise science. The students will learn how to apply biomechanics to evaluate movement, injury, disorders, etc. The class is taught over a three week period, and we just completed our first week. The students are doing very well and I am confident that they will be able to learn about Inverse Dynamics, which is a graduate level skill, by the end of the semester. I will provide an update on the class as well as inverse dynamics at the end of the semester. Also, I would be remiss if I didn't post an updated picture of Cameron. He is seven and a half weeks old and growing fast!! We just wish that he would sleep a little more.