Hip arthroscopy is a modern minimally invasive surgical technique that can be used to treat various conditions affecting the hip joint.  It has revolutionized our ability to diagnose and treat painful conditions of the hip that affect young active individuals and athletes. Often the pain results from an injury or overuse during athletic activity, and persists despite some conservative treatments.  Some of these conditions include hip impingement, snapping hip syndromes, labrum tears, cartilage injury and loose bodies. Recent studies indicate that some of these conditions can precipitate the early development of arthritis.

Previously these conditions were poorly understood and surgical treatment involved large incisions and dissections which often resulted in significant down-time and soft tissue injury, necessitating prolonged recovery and rehabilitation. Currently hip arthroscopy can be performed on an outpatient basis and can allow for a quicker return to symptom-free function.

If you are a young or middle-aged active individual and are experiencing hip pain, or painful catching or popping sensations after an injury, or discomfort with prolonged sitting or activity, you may benefit from an evaluation by an orthopedic surgeon with specialty training in hip arthroscopy.

Alexander M. Aboka, MD, MPH, of Virginia Orthopaedic & Spine Specialists is a fellowship trained orthopaedic surgeon specializing in sports medicine, arthroscopy, and shoulder and knee reconstructive surgery. He completed an orthopaedic sports medicine fellowship at the Cincinnati Sports Medicine & Orthopaedic Center in Cincinnati, Ohio. He has provided sports medicine coverage at a variety of levels with high profile teams, including the University of New Mexico Lobos and the NFL’s Cincinnati Bengals. To schedule a consultation with Dr. Aboka, please contact us online or call our office directly at 757.215.3789.

+ Read more of Dr. Aboka’s blogs on sports medicine and orthopaedic health topics!

Head injuries are a big problem for young athletes, who may be more vulnerable for up to a year after having a concussion, according to new research in the journal Pediatrics. That means students and their parents may have to think hard about when it’s safe to return to play.

When faced with the choice of benching their high-risk athletes, most parents would probably take the risk and re-enroll their child in sports. But we still don’t know if one year is what it takes to protect kids’ brains.

According to a study that tracked 235 patients, aged 11 to 22, who came to the emergency room at Boston Children’s with a concussion, patients who had had a concussion in the year before being injured again had symptoms for almost three times as long as those with a first concussion, 35 days compared to 12 days. In the study, those aged 13 and over were more likely to have a long recovery time.

Headaches and other concussion symptoms can make it impossible for students to do schoolwork. Patients are often told not to read, use computers or watch TV.

Any athlete suspected of having a concussion should be removed from play immediately, according to guidelines issued earlier this year by the American Academy of Neurology. The goal is to reduce a second hit to a recovering brain. It’s important that concussed children get close follow-up care (preferably from a board-certified sports medicine specialist) and make decisions based on what’s best for each child’s circumstances.

+ Learn about In Motion’s Concussion Management Program, with ImPACT Neurocognitive Testing.

Primary Care Sports Medicine Doctors
Our primary care sports medicine doctors focus on managing the overall health of the people with active lifestyles, including annual physical exams, immunizations, and preventative health care. They also diagnose and provide non-surgical treatment of sports-related or sports-like injuries. Our experts treat concussed athletes of every size, shape, age and ability.

Shoulder pain can be a disabling condition affecting individuals of all walks of life, and limiting their ability to perform many normal daily activities. In many instances it is caused by an injury or an overuse event that leads to localize tissue injury an inflammation.  Conservative treatment, including  rest, physical therapy and oral medication has proven successful in the management of most minor shoulder pain.

It’s important however to be aware that pain and other shoulder symptoms can be a sign of a problem that requires prompt evaluation and treatment by a shoulder specialist.  Be mindful of pain that persists for a long time and does not get better with oral pain medication. Also of concern should be pain that is prominent at night and wakes you up. Any limitation in range of motion due to stiffness and/or weakness is not normal, and significant grinding and rubbing sensations warrant an evaluation.  A sudden inability to reach out or overhead, and inability to maintain the arm overhead is of significant concern, especially after a fall or other injury.

Some painful shoulder conditions like impingement and frozen shoulder respond well to conservative treatment with rest, physical therapy and oral medications.  Others like chronic tendinitis and advanced arthritis do well with surgery. Acute large rotator cuff tears require prompt surgical fixation to restore shoulder function.

It is important to pay attention to the signals your body is sending. An evaluation by a specialty trained shoulder surgeon is critical in the early diagnosis and effective treatment of most of these conditions.  When surgery is necessary, modern arthroscopic techniques now make it possible to perform minimally invasive work with very good outcomes and quick recovery, and return to normal function.

Alexander M. Aboka, MD, MPH, of Virginia Orthopaedic & Spine Specialists is a fellowship trained orthopaedic surgeon specializing in sports medicine, arthroscopy, and shoulder and knee reconstructive surgery. He completed an orthopaedic sports medicine fellowship at the Cincinnati Sports Medicine & Orthopaedic Center in Cincinnati, Ohio. He has provided sports medicine coverage at a variety of levels with high profile teams, including the University of New Mexico Lobos and the NFL’s Cincinnati Bengals. To schedule a consultation with Dr. Aboka, please contact us online or call our office directly at 757.215.3789.

Instead of suffering from chronic conditions like frozen shoulder syndrome and migraines, some Hampton Roads residents have found another source of relief: massage. A trip to the massage therapist once or twice a month can help ease headaches and promote blood flow for better healing of aches and pains.

While many people still enjoy massage for pure relaxation, the demand for therapeutic massage is growing fast. Clients of all ages are seeking it out for relief from a long list of ailments including: back pain, headaches, osteoarthritis, sports injuries, fibromyalgia, whiplash, anxiety, depression and chemotherapy side effects. Research evidence of benefits of manual therapy have been building, and more doctors also are recommending massage as a complement or add-on to traditional medicine and physical therapy.

According to a 2012 survey by the American Massage Therapy Association, 75 percent of people who’d had a massage in the past year cited a medical (43 percent) or stress-related (32 percent) reason rather than pampering (11 percent). That survey also found 87 percent of people considered massage beneficial to overall health; 89 percent called it effective for pain relief.

All massage boosts the circulation of oxygen-rich blood, but there are many different types and variations within each. “Swedish massage” typically refers to gentler sessions while “Deep tissue massages” involves deeper strokes to target chronic muscle tension or knots. Sports massages and prenatal massages are also popular options.

At Bon Secours In Motion Physical Therapy and Sports Performance, massages are often a part of treatment plans and may help reduce pain and fatigue. Our team also works with a variety of active, athletic individuals, people with overuse joint injuries, and neck, shoulder and back soreness, as well as those with aches and pains from too much sitting, often at a computer.

Doctors might not recommend massage for certain patients, including people prone to blood clots. Contact us today to learn if you can benefit from a session with a certified massage therapist.

Summer is a great time to fire up the grill. But, as all grill masters know, it’s not all about the meat! Spice up any cookout by adding fruits and vegetables to the menu – and the grill!

Fruits and vegetables serve up a variety of vitamins and nutrients. Here are four ways to incorporate healthy foods into your bbq:

1. Try a Kabob – Throw a kabob of color onto the grill with marinated vegetables like red or yellow bell peppers, mushrooms, eggplant, cherry tomatoes and onions. Simply brush the vegetables with olive oil and your favorite spices and grill over medium heat, turning until marked and tender (about 12 to 15 minutes, and 8 to 10 minutes for cherry tomatoes and pre-boiled potatoes).
2. Give Portabellos Some Love – Whether you’re a vegetarian or an avid meat lover, a grilled, marinated Portobello burger is a tasty alternative. Marinate and grill mushrooms, gill sides up, over medium-low heat with the grill covered until they are marked and softened (about 15 minutes). Flip and grill until cooked through, being careful not to char the gills, (1 to 2 minutes).
3. Fire Up Fruit – For a flavorful dessert, try fruit kabobs with pineapple slices or peach halves. Grill on low heat until the fruit is hot and slightly golden. Serve them on top of low-fat frozen yogurt or angel food cake.
4. Grill Some Watermelon – Another tasty option – grilled watermelon! Since watermelon is primarily made up of water, when you put it on the grill some of the water evaporates, leaving an intense watermelon flavor. Grilling watermelon slices only takes about 30 seconds on each side.

As a final note for those of us trying to eat healthier this summer, try to choose lean cuts of beef, pork, chicken or fish for your meals. As you grill, keep raw meat and poultry (and raw meat juices) separate from ready-to-eat foods, including fruits and vegetables. This means using separate plates, cooking utensils and cutting boards.

To learn more about safe grilling and eating right all summer long, visit www.eatright.org and consult a registered dietitian nutritionist.

+ Find a registered dietitian in Hampton Roads.

+ Learn more about In Motion’s Nutrition and Weight Loss Programs!

Tennis elbow is a common condition that affects individuals from different walks of life. You don’t have to be a tennis player to suffer from persistent and intractable pain on the outside of the elbow – in fact, normal activities of daily living like keyboarding and swinging a hammer can lead to elbow pain. (Of course, it is commonly associated with sports like tennis.)

In the majority of cases conservative treatment of elbow pain (with anti-inflammatory medication, physical therapy, bracing, and steroid injections) leads to complete resolution of symptoms. In some cases, however, surgery is needed to address symptoms that do not improve.

Traditional open surgical techniques are successful, but leave behind large incisions and more trauma to the soft tissues. That’s can make recovery slower and outcomes less than optimal.

New Arthroscopic Tennis Elbow Surgery

The latest minimally invasive advances allow us to perform tennis elbow surgery arthroscopically – with a quick resolution of symptoms, fast recovery, and early return to activity and sport. From a cosmetic standpoint arthroscopy produces minimal scars compared to  open techniques which results in a prominent scar on the outside of the elbow.

Perhaps most importantly, the arthroscopic approach still enables elbow surgeons to evaluate the inside of the elbow joint and effectively address problems like arthritis or lose bodies.

If you are dealing with unremitting pain around the elbow and you are considering  surgery it is important to obtain an evaluation by an orthopedic surgeon who specializes in elbow arthroscopy and sports medicine. Contact VOSS today to determine if arthroscopic tennis elbow surgery is right for you 757.673.5680.

About Dr. Alexander Aboka
Alexander M. Aboka, MD, MPH, is an orthopaedic surgeon specializing in sports medicine, arthroscopy, minimally invasive ACL reconstruction, reverse total shoulder replacement, hip labrum tear repair, and shoulder and knee reconstructive surgery. He holds a doctor of medicine degree from the University of Pittsburgh School of Medicine and a master in public health degree from the University of Pittsburgh School of Public Health — both in Pittsburgh, Pa.r. Aboka completed his orthopaedic surgery residency at the University of New Mexico in Albuquerque, N.M. In addition, he completed an orthopaedic sports medicine fellowship at the Cincinnati Sports Medicine & Orthopaedic Center in Cincinnati, Ohio, with advanced training in sports medicine, modern arthroscopy, and shoulder and knee reconstructive surgery. He speaks English and Spanish.

For more information about our sports medicine program, or to schedule an evaluation with Dr. Aboka, our fellowship trained arthroscopic shoulder surgery specialist, please call us today at 757.673.5680.

The Bon Secours Maryview Center for Physical Rehabilitation was recently featured in an article from The Catholic Health Association of the United States discussing the use of “mobility courtyards” in rehabilitation.

Mobility courtyards are used by therapists to help patients re-learn how to walk on a variety of surfaces – thereby reducing their risk of a fall. It’s considered an important part of building skills for daily living.

At Maryview’s inpatient Center for Physical Rehabilitation, therapy patients practice walking on different uneven surfaces, including cement and gravel, grass and mulch, and steps. Working with therapists, patients navigate up inclines, down ramps and around obstacles. It was designed for in-patient rehabilitation and has a variety of surfaces and grades, a small bridge to walk over, ramps and curb cuts.

Find out who qualifies for inpatient rehabilitation services.

“Usually a patient’s goal is to get home,” says John DaVanzo, Maryview’s director of rehabilitation services. Mobility courtyards allow patients to practice ways they can be safe in their home environment, or how adaptive devices or new techniques and skills can be used to compensate in the case of permanent disability. When learning a skill, “it takes a lot of practice to get it into muscle memory,” DaVanzo says.

While the walled courtyards are landscaped and welcoming, the garden features are practical, not ornamental. Therapists help patients work in the garden to maximize the abilities and esteem of the patient and family and foster a healthy reintegration into the community. A car body located inside, beyond the courtyard, allows patients to practice getting in and out of all four doors and loading and unloading items from the trunk.

Benedictine facilities with the mobility courtyards have a goal of a 5 percent reduction in the numbers of patients discharged from those skilled nursing facilities who later have a fall resulting in an emergency room visit, hospital stay, readmission to a skilled nursing facility, or death.

Source: “Rehab patients master varied terrain in mobility courtyards”

+ Learn about Bon Secours’ state of the art inpatient physical rehabilitation unit.

+ View the Maryview mobility garden.

Repairing rotator cuff tears can present a challenge for patients and orthopaedic specialists. Nonoperative treatments for active individuals can result in significant impairment in daily function and quality-of-life, so the preferred treatment is often surgical repair.

Advances in Arthroscopic Rotator Cuff Repair Surgery

The latest advancement in rotator cuff repair has been the development of an entirely arthroscopic technique to repair torn muscles with minimal disruption to the tissues. This arthroscopic approach allows shoulder surgeons to achieve a very secure fix of the torn tendons while also minimizing the presence of irritating suture knots in the articular spaces of the shoulder. Research shows us that this approach allows for optimal results, quick healing, and a better return to full function after rehabilitation.

The two main advances in arthroscopic rotator cuff repair that allow orthopaedic surgeons to optimize our patient outcomes are:

• Knotless Anchor Technology – Traditional rotator cuff surgeries rely on suture knots to help strengthen torn tendons. In some cases, these knots would sometimes irritate a patient’s joint after surgery – leading to revision surgery for optimal shoulder movement. The latest knotless anchor technology allows sports medicine surgeons to minimize the need for revision surgery by to address prominent irritating knots that arive after arthroscopic rotator cuff surgery.
• Use of Bioabsorbable Materials – Bioabsorbable materials give should surgeons the opportunity to perform very robust rotator cuff repairs with multiple implants without leaving multiple foreign bodies in the shoulder for the long term. Since these materials are absorbed into the body, patients who undergo these procedures have minimized risk of complications or irritation in the shoulder in the future.

Given these advancements, nonoperative treatment of rotator cuff tears has now become the rare exception rather than the rule.

Remember, if you develop pain and difficulty with mobility after a shoulder injury and significant weakness, it is imperative that you visit with a fellowship trained arthroscopic shoulder surgeon for evaluation.

About Dr. Alexander Aboka
Alexander M. Aboka, MD, MPH, is an orthopaedic surgeon specializing in sports medicine, arthroscopy, minimally invasive ACL reconstruction, reverse total shoulder replacement, hip labrum tear repair, and shoulder and knee reconstructive surgery. He completed an orthopaedic sports medicine fellowship at the Cincinnati Sports Medicine & Orthopaedic Center in Cincinnati, Ohio, with advanced training in sports medicine, modern arthroscopy, and shoulder and knee reconstructive surgery. He speaks English and Spanish.

For more information about our sports medicine program, or to schedule an evaluation with Dr. Aboka, our fellowship trained arthroscopic shoulder surgery specialist, please call Virginia Orthopaedic & Spine Specialists (VOSS) today at 757.673.5680.

An ACL tear can be a disastrous injury for any athlete or active individual. When physical therapy efforts fail to help patients control pain and regain freedom of motion, surgery can be the only option for individuals trying to get back into the activity or sport they love.

Luckily, tremendous advances have been made in our understanding of ACL injury and treatment over the past two decades.

For any active individual the preferred treatment for an ACL tear is an ACL reconstruction surgery. At Virginia Orthopaedic & Spine Specialists, our surgical team is on the cutting edge of this kind of repair.

Using a minimally invasive approach, our sports medicine surgeon is able to place a reconstructed ACL graft inside the correct position in the knee to restore atomic knee joint function. This procedure is commonly called “All-Inside ACL reconstruction.”

This new arthroscopically-assisted technique is performed by placing the ACL graft in bone sockets in the knee joint, which allows an orthopaedic surgeon to avoid drilling long bone tunnels.  When the outer hard shell of the bone is preserved, patients experience less pain. Less pain means a quicker functional recovery.

The Benefits of “All-Inside” ACL Reconstruction

The benefits of this approach are significant – especially for active patients. Among those who are candidates for this surgery we see:

• Less post-operative pain
• Quicker recovery of lost strength
• Accelerated rehabilitation

The cosmetic benefits of this approach are also incredibly significant. Since no external instrumentation is applied during the procedure, this surgery can be performed with smaller incisions – resulting in less scarring.

Am I a Candidate for “All-Inside” ACL Reconstruction

Although the benefits of this minimally invasive ACL reconstruction surgery are substantial and the surgery can be performed on most individuals, certain patients may not be candidates for this minimally invasive approach. Your eligibility is based on your individual activity level and functional demands and should be determined by a qualified orthopaedic surgeon.

If you’re interested in this surgical treatment option, it’s important to consult with a fellowship trained sports medicine, and arthroscopic knee specialist to determine if the all inside ACL reconstruction is the best treatment option for you.

+ Learn more about knee pain treatment options at VOSS.

Virginia Orthopaedic and Spine Specialists is a natural choice for those with an ACL injury in western Hampton Roads who want to get up on their feet and back in the game as quickly as possible.

For more information about our sports medicine program, or to schedule an evaluation with Dr. Alexander Aboka, a minimally invasive ACL reconstruction surgery specialist, please call us today at 757.215.3789.

Knee pain is a growing complaint that physical therapists and orthopaedic surgeons are tackling as millions of aging Americans struggle to stay active.

The most common cause of knee pain is osteoarthritis, a joint disease that results in the degeneration of the cartilage between bones in the knee joint. As cartilage is lost due to accelerated wear and tear, bones in the knee rub against each other and cause damage to the joint – and pain. The most common treatment regiment for osteoarthritis is anti-inflammatory medication (like Tylenol and aspirin), weight loss to help relieve stress on the joint and physical therapy to help strengthen the supporting muscles in the knee.