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Sports-Related Conditions We Treat

Our sports medicine experts in the Department of Orthopaedic Surgery are leaders in their field and treat a range of sports injuries and related conditions. Here is how we approach some of the most common sports-related problems.

 

Foot and Ankle Conditions

  • Our sports medicine team offers expertise in repairing full and partial Achilles tendon tears (tears in the fibers connecting the calf muscles to the heel bone).

    Some patients benefit from surgery to repair a fully ruptured Achilles tendon. The goal of the surgery is to stitch the tendon back together. However, in some cases, the damaged part (or the entire tendon) needs to be removed and replaced with tissues taken from another area of the foot.

    Nonsurgical treatment for Achilles tendon rupture focuses on allowing the tendon to heal naturally while it’s immobilized in a boot. Early functional weight-bearing is a key part of Achilles tendon rehabilitation.

    Our foot and ankle specialists:

  • Our physicians treat a wide range of ankle fractures, including fractures of the tibia, fibula and talus. They are also trained in treating complex, multipart fractures and related ankle cartilage damage, as well as ligament injuries and avulsion fractures that occur when a bone pulls off from a ligament attachment site.

    Not all ankle fractures require surgery. Treatment depends on the location and number of fractures and whether the ankle is stable after injury. An X-ray stress test can determine the stability — whether the broken bones are in alignment. Nonsurgical treatment for stable fractures typically includes immobilizing the ankle in a cast, brace or boot.

    Most unstable ankle fractures, and occasionally stable ankle fractures, can benefit from surgery. Surgery to repair a broken ankle usually includes aligning the bones, followed by internal fixation (connecting the bones with screws, plates or wires).

    Our team works closely with foot and ankle physical therapists for pre-surgery and post-surgery rehabilitation.

    Our foot and ankle specialists:

 

Hip and Knee Conditions

  • Our sports medicine experts offer personalized treatment and return-to-sport plans for athletes with ACL tears. The ACL is one of the most common knee ligaments to be injured, especially among female athletes. Tears may occur during sudden, twisting movements of the knee.

    Treatment ranges from bracing and physical therapy to surgery, depending on the patient’s knee stability and desired activity level. If the patient chooses to have ACL reconstruction surgery, the surgeon will replace the damaged ligament with a tendon, which is called a graft. This may be an autograft (using a tendon from the patient’s knee) or an allograft (using a donor tendon). When possible, our specialists perform the procedure arthroscopically, placing the graft through a small hole in the knee.

    ACL surgery was once considered too risky for children because they are still growing. Our specialists use new minimally invasive techniques to repair or replace knee ligaments with low risk to children and teens.

    For nonhealing ACL injuries, percutaneous needle tenotomy may also be an option to promote the body’s healing response.

    Our knee specialists:

    Patient Resources:

  • Our physicians treat many athletes with hip (femoroacetabular) impingement — pinching of the ball of the hip joint against the cup of the hip. We also treat related damage to the labrum — the cartilage that surrounds the hip socket — which can lead to stiffness, pain and arthritis in the hip.

    Hip impingement occurs due to abnormal shape of the bones in the hip joint. For many people, it is thought, the abnormal shape has been present since birth. It is often seen in young athletes who play sports that require much twisting of the hip or squatting.

    While hip impingement can be treated using nonsurgical methods, surgery may be needed to repair or remove the damaged tissue around the hip joint. Surgery is often performed arthroscopically by making several small incisions.

    Our sports medicine hip specialist:

  • Our sports medicine experts treat many injuries to the labrum (the ring of cartilage on the socket of a joint), including labral tears of the hip. The severity of the tear ranges from frays at the edges to sections ripped away from the socket bone. The injuries are often caused by overuse, trauma or abnormalities in bone structure.  

    Nonsurgical treatments focus on symptom management and prevention of further damage. The treatments include rest, activity modification, medications, temporary pain relief injections and physical therapy.  

    If the hip labral tear is severe, or if the patient is still in pain after trying nonsurgical options, arthroscopic surgery or open surgery may be needed to repair the tear.

    Our sports medicine hip specialist:

  • Meniscus tears are among the most common knee injuries our sports medicine specialists treat. Treatment ranges from icing, bracing and pain medications to surgery, depending on the symptoms and the type of tear. When possible, our specialists perform meniscus tear surgery arthroscopically by making small cuts in the knee.

    A common type of surgery for a meniscus tear is a partial meniscectomy, during which a surgeon trims off the torn part of the meniscus and preserves as much of the intact meniscus tissue as possible.

    In some cases, depending on the type of tear and the condition of the meniscus, the torn part can be stitched back together. This procedure is more common for younger patients.

    After surgery, rehabilitation exercises help the patient regain range of motion and strengthen the muscles supporting the knee joint.

    Our knee specialists:

    Patient Resources:

  • Our pediatric experts have experience treating young athletes who have Osgood-Schlatter disease, sometimes referred to as growing pains.  

    The treatment for Osgood-Schlatter disease and related knee pain typically includes taking time off from the activity that makes the pain worse, applying ice and taking anti-inflammatory medications. Injury prevention techniques, including proper warm-ups and taking rest days, can help reduce the likelihood of overuse injuries. Surgery is rarely needed for Osgood-Schlatter disease.

    Our pediatric knee specialist:

  • Our sports medicine specialists treat a variety of patellar conditions, including patellar instability.

    When the kneecap (patella) moves or slides out of the small groove at the end of the thighbone, it is considered unstable. A patellar dislocation or subluxation (partial dislocation) can usually be diagnosed by a physical exam, but X-rays and an MRI may also be required.

    Treatment varies depending on the condition’s severity and the patient’s health status and activity level. It includes nonsurgical treatments (rehabilitation and bracing) and surgical treatments to realign the bones or tighten the tendons that hold the kneecap in place.

    Our knee specialists:

  • A patellar tendon rupture is one of the many knee injuries that our sports medicine specialists treat. A rupture occurs when the tendon is completely torn and separated from the kneecap, often as the result of a fall or during the landing from a jump.

    If the patient has been diagnosed with a patellar tendon rupture, our orthopaedic surgeons can offer a treatment plan that may include surgery to re-attach the tendon to the kneecap.

    Our knee specialists:

  • Treatment of patellofemoral pain syndrome usually includes avoiding any activity, sport or exercise that makes the knee pain worse, taking anti-inflammatory medications and, for some patients, wearing soft braces. Surgery is rarely needed.

    Our knee specialists:

 

Shoulder and Elbow Conditions

 

Other Conditions

  • Popping and cracking in joints such as fingers and knees could be caused by ligaments stretching and releasing or by the compression of nitrogen bubbles in the spaces of the joints.

    Usually, joint cracking and popping does not need to be treated. These sounds are normal and may become more frequent with age. However, if cracking and popping in the joints is accompanied by swelling and pain, this may be a sign of a more severe condition and should be evaluated by an orthopaedic physician.

  • Our sports medicine physicians and physical therapists are experts in treating soft-tissue injuries such as muscle strains or “pulled” muscles.

    If you believe you have experienced a pulled muscle, you should immediately stop the activity that caused the strain and apply ice to the injured area.

    A severe muscle strain will cause swelling and bruising and can even make the person unable to move the limb. However, most muscle strains can be treated at home and do not require medical intervention.

    The risk of muscle strains can be reduced by taking time to warm up and stretch muscles before any type of physical activity, including walking. Muscle strains occur more often in cold, inflexible muscles.

 

Johns Hopkins Hip Preservation Clinic

Our experts at the Johns Hopkins Hip Preservation Clinic offer minimally invasive treatments for hip pain due to hip labral tears, impingement and similar conditions that don’t require a hip replacement. Schedule a consultation with our hip preservation specialist Alex Johnson, M.D., in our Bethesda clinic: 240-762-5100.

 
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