SPORTS MEDICINE MAGAZINE

SPORTS MEDICINE MAGAZINE

SPORTS MEDICINE MAGAZINE

SPORTS MEDICINE MAGAZINE

Athlete Success Story:w/ Brookwood alumCameron Faulkner

Athletic Heart:w/ Manfred Sandler, MD FACC

“Sports-Related Concussion”an article by Mathew W. Pombo, MD

Featuring:MVPs ofSports Medicine

The Team Approach to taking care of a team:with Tim SImmons, ATC,Coach Dave Hunter, & Snehal C. Dalal, MD

FALL 2011

The Team Behind the Team

ACL Tear:Career ending injury or bump in the roadw/ Gary A. Levengood, MD

Fall 2011Contents Page

Departments

Features

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Publisher | Kandace Walker-BundaLead Designer | Robert Walker-BundaMarketing/Advertising Sales | Sherri CloudContributing Photographers | Tim Song, Maggie McBrideCopy Editor | Megan GreerPrinting | Protech Printing and Graphics

-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 /// 3-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•Resurgens Orthopaedics - Scott G. Quisling, MD, C. Michael Morris, MD, &

Yvonne E. Satterwhite, MD /// 8 - 9•Southern Orthopaedic Specialists - Snehal C. Dalal, MD, & Brian E. Morgan, MD /// 10 - 11•Sports Medicine South - Gary A. Levengood, MD & Stephanie H. Hsu MD /// 12 - 13•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 /// 24

/// 25 GSMM AffiliateFootball Schedules

As 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 im-mediate 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.

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Letter from the Chairman of the Gwinnett Medical Center’s Sports Medicine CommitteeT. Scott Maughon, MD

Letter from the Manager of Gwinnett Medical Center’s Sports Medicine ProgramTim Simmons, MHA, ATC, LAT

Letter from the EditorGary A. Levengood, MD

Welcome and thank you for your interest in Gwinnett Medical Center’s Sports Med-icine 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 organiza-tions. 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 coun-ties through our passion and caring for patients. Our most important program attribute is the leadership provided by the professionals in-volved 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 pre-vent, manage and assess orthopedic or musculoskeletal injuries as well as facilitate access to advance medical care. This comprehensive system provides access to expedited and special-

ized 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 con-tinue 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.

Greetings, 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 medi-cine 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 pro-fessional sports team proud – in fact, many of the staff have actually worked alongside NFL teams. In addition to committing countless volunteer hours to educating fel-low 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.

“Gwinnett Medical Center – Duluth delivers more Sports Medicine Orthopaedic care than any other hospital in the state of Georgia.”

GSMM If you would like to submit an article or are interested in advertising opportunities in GSMM please contact Sherri Cloud atsherricloud@windstream.net or 6789072912

Be a

Contributor

Je

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, MD Jesse E. Seidman, MD

Orthopaedic Surgery & Sports Medicine

Dr. 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 Hospi-tal 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.

Common Sports Medicine procedures Dr. Seidman treats:•ACL Injuries•Meniscus Repair•Fractures•Rotator Cuff Repair

Dr. 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 suc-cessfully 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 pa-tient 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.

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 Center318 Tribble Gap RoadCumming, Georgia

Buford/South Hall County Office3929 Carter Road, Bldg. CBuford, Georgia

Duluth Office3540 Duluth Park LaneSuite 220Duluth, Georgia

For appointments call our scheduling coordinator at 770-271-9857 or go online to our website at www.academyorthopedics.com.

•Frozen Shoulder•Plantar Fasciitis•Arthroscopic Procedures

Our Surgery CenterAcademy Orthopedics Ambulatory Surgery Center

Our Locations

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Dr. Seidman is the exclusive team Orthopedic Surgeon for The Atlanta Sports Academy in Dawsonville, GA.

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Mark C. Cullen, MDOrthopaedic Surgery & Sports Medicine

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MDJ. Stephen Kroll, MDPrimary Care Sports Medicine

Mark C. Cullen, M.D. is a fellowship sports medicine trained ortho-paedic surgeon who has been in practice in Gwinnett County for the past 14 years. He received his B.S. in biology from Bucknell Uni-versity 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 through-out 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 involve-ment 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.

Steve Kroll, M.D. is the newest addition to Georgia Sports Medi-cine and Pediatric Orthopaedic Surgery. He is a West Virginia native who attended undergraduate school at West Virginia Univer-sity. 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.

…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 treat-ment of injuries in athletes is unparalleled, they also focus on the prevention of injuries. The physicians and their staff work with athletes and their fami-lies to develop individualized exercise and conditioning programs to assist in the prevention of injuries getting them back in game stronger than before.

Our Practice•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

Georgia Sports Medicine & Orthopaedic Surgery•6340 Sugarloaf Parkway Suite 375Duluth, GA. 30097 - 770.814.2223•3625 Braselton Highway Suite 206Dacula, GA 30019 - 770.814.2223

www.georgiasportsmedicine.com

Teams We Serve

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6340 Sugarloaf Parkway Suite 375 - Duluth, GA. 30097 - 770.814.22233625 Braselton Highway Suite 206 - Dacula, GA 30019 - 770.814.2223www.georgiasportsmedicine.com

Snehal C. Dalal, M.D. provides Orthopaedic care to patients in our Johns Creek and Gwinnett locations. As a Fellowship trained Or-thopaedic 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 inter-est, 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 com-pleted his fellowship training in shoulder, elbow and hand surgery in Mil-waukee 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 Law-renceville area. In his free time he enjoys running, tennis, skiing and trav-eling. Both he and his wife are avid college football fans.

Snehal C. Dalal, MDGeneral Orthopaedics,

& Hand and Upper Extremity

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The Strength of Experience Years of offering expert medical care with compas-sion and integrity have made Southern Orthopaedic Specialists one of the most distinctive and experi-enced orthopaedic specialty providers in the state. Our dedication to providing you exceptional ortho-paedic care is exemplified through our team of re-nowned physicians, experts in the treatment of trau-ma, diseases, and disorders of virtually every bone and joint in your body. Southern Orthopaedic Spe-cialists’ 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 of-fer 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.

Southern Orthopaedic Specialists•771 Old Norcross Road, Suite 390Lawrenceville GA 30046 - 678-957-0757•5955 State Bridge Road Suite 200Johns Creek GA 30097 - 678-205-4261

www.sos-atlanta.com

Our Practice

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Dr. 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 Roches-ter 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 partici-pant. He is an avid sports enthusiast who played basketball on both the high school and college levels. He is also involved in many com-munity, college and professional organizations. He has been an Or-thopaedic 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 volun-teered 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 sail-ing, windsurfing, water-skiing, playing the guitar and playing basketball

Brian E. Morgan, MDOrthopaedics, Sports Medicine &Arthroscopic Surgery.

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

Teams We Serve & Events We Cover

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

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Scott G. Quisling, MD

Yvonne E. Satterwhite, MD

Have 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 musculosk-eletal 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.

Our PracticeEXCELLENT CARE, EVERYWHERE:RESURGENS ORTHOPAEDICS

Residency:Georgia Baptist Medical Center; Atlanta, GAMedical Degree:University of Florida College of Medicine Fellowship:Sports Medicine; Lake Tahoe Orthopaedic InstituteCertifications:American Board of Orthopaedic Surgeons

C. Michael Morris, MDSports Medicine and Arthroscopy

Yvonne E. Satterwhite, MDGeneral Orthopaedics, Sports Medicine, Surgery of the Shoulder, Knee & Elbow, and Arthroscopic Surgery

Residency:Tulane University School of Medicine; New Orleans, LouisianaMedical Degree:Tulane University School of Medicine; New Orleans, LouisianaFellowship:James R. Andrews, M.D. & William G. Clancy, M.D.;Alabama Sports Medicine and Orthopaedic Center;Birmingham, Alabama; Sports MedicineCertifications:Board Certified, American Board of Orthopaedic SurgeonsCertificate of Added Qualification Orthopaedic Sports Medicine

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

www.resurgens.com

Lawrenceville Office

Johns Creek Office

C. Michael Morris, MD

Scott G. Quisling, MDSports Medicine and Arthroscopic SurgeryJoint Replacement

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Associations:American Academy of Orthopaedic Surgeons

American Orthopaedic Society for Sports MedicineOlympic Sports Medicine Society

American Sports Medicine Fellowship SocietyMajor Accomplishments:

Head Team Physician Atlanta Beat 2000-20042002 Georgia Team Physician of the Year

U.S. Olympic Committee Medical Staff Physician, 1996, 1997, 19982011 Atlanta Magazine’s Top Doctors

Hospital Affiliations:Emory Johns Creek Hospital, Gwinnett Medical Center -

Duluth, Northside Forsyth Hospital

Associations:Georgia Orthopaedic Society

Atlanta Orthopaedic Society & American Society of Sports Medicine

Major Accomplishments:2006 Top Doc Gwinnett County

Hospital Affiliations:Gwinnett Medical Center

Residency:Georgia Baptist Medical CenterMedical Degree:University of Alabama School of MedicineCertifications:Board Certified, American Board of Orthopaedic SurgeonsSports Medicine Subspecialty Certificate in OrthopaedicSports Medicine

Associations:American Academy of Orthopaedic Surgeons

Arthroscopy Association of North AmericaGeorgia Orthopaedic SocietyAtlanta Orthopaedic Society

Major Accomplishments:2006 Top Doc Gwinnett County

Hospital Affiliations:Gwinnett Medical Center

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. Con-ceived by NASA, and approved by the FDA, the Alter-G is designed to reduce the weight impact on lower extremi-ties. 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 fur-ther injury. Both Sports Medicine Rehab facilities and pro-fessional sports associations strongly back the innovative machine. The Alter-G is continually used to facilitate re-habilitation 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 Direc-tor 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 re-habilitation program.”

Gary 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. Le-vengood 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 isthe 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 De-velopment program and formerly, he served as the Chief of Orthopedics atGwinnett Medical Center and as Team Physician for the Atlanta Silver-backs from 2000 – 2007. Dr. Levengood’s specialties include arthroscopic surgery, sports medi-cine, 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 na-tional men’s soccer team as their physician.

Gary A. Levengood, MDOrthopaedic Surgery & Sports Medicine

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Over 5 years ago, Dr. Levengood opened Sports Medicine South, LLC to offer his extensive experience, develop talent and passion for sports. The Sports Medicine South of-fice is located at 1900 Riverside Parkway in Lawrenceville, Georgia. The SMS office houses a highly specialized staff in-cluding Stephanie Hsu, MD; Diana Dean, PA-C; Harris Patel, PA-C, ATC; and a well-versed team of certified athletic train-ers. SMS also offers on-site physical therapy under the lead-ership of Curt Bazemore, PT, ATC. A number of specialized and technologically advanced services are offered at SMS, including: minimally invasive procedures, innovative ACL Reconstruction Procedures, ConforMIS, computerized surgi-cal navigation, total shoulder replacement and reconstructive surgery, elbow, pediatric sports medicine, Anti Gravity tread-mills, electrical stimulation, massage therapy.Dr. Levengood’s practice philosophy is stated in his tagline: We Get You Beyond Better. He and his entire staff are de-voted to providing the highest quality care in a comfortable setting to patients from all walks of life. “We don’t just get you better, we get you beyond better.” Dr. Levengood and his wife, Lisa, live in Gwinnett County and have four children. When he is not standing on the sidelines of a game or taking care of patients, he enjoys skiing, golf, tennis, fishing, and hunting.

Sports Medicine South •1900 Riverside Parkway Lawrenceville, GA 30043 -770.237.3475

www.sportsmedsouth.com

Our Practice

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Stephanie 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 ath-lete’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 Geor-gia 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 Medi-cal 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. pro-vided 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 shoul-der labral repair, and examination of the athlete’s elbow.

Stephanie H. Hsu, MDOrthopaedic Surgery, Shoulder, Elbow & Sports Medicine

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 Re-hab 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 Geor-gia; one of the machines is housed in the Physical Therapy De-partment 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.”

Alter-G - the anti-gravity treadmill

Teams We Serve

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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. Con-ceived by NASA, and approved by the FDA, the Alter-G is designed to reduce the weight impact on lower extremi-ties. 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 fur-ther injury. Both Sports Medicine Rehab facilities and pro-fessional sports associations strongly back the innovative machine. The Alter-G is continually used to facilitate re-habilitation 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 Direc-tor 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 re-habilitation program.”

Dr. Maughon is a native of Atlanta, having graduated from Lakeside High School in 1977. He earned his BS in biology from the Universi-ty of Georgia in 1982 and was awarded his medical degree from The Medi-cal 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 In-stitute under Drs. James Andrews and William Clancy. Dr. Maughon spe-cializes 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 commu-nity 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 Foot-ball 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.

T. Scott Maughon, MDArthroscopic Knee and

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The Sports Medicine & Orthopaedic Institute of Gwinnett is one of the oldest orthopaedic prac-tices in Gwinnett County. Founded in 1992 by Dr. Maughon, the practice has been in existence for al-most 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 pos-sible working condition; returning you to the free-dom 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 dedi-cated 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.

The Sports Medicine & Orthopaedic Institute of Gwinnett•3855 Pleasant Hill Road, Suite 470 Duluth, GA 30096 - 770.813.8888•24 Amhurst Drive Winder, GA 30680 - 678.425.0113

www.gwinnettsportsmedicine.com

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Dr. Pombo is an orthopaedic surgeon, speaker, author, and re-searcher. He is a native of Gwinnett County and former star soccer player at Duluth High School. He attended the Georgia In-stitute 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 rec-reational athletes. He has served as a Team Physician for the Pitts-burgh 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 imple-menting 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.DArthroscopic Knee and Shoulder Surgery &Sports Concussion Specialist

Teams & Events We Serve

Kyle Petty Charity Ride

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Gwinnett Medical Center’s

Sports Medicine Program

• 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.

Our program delivers traditional sports medicine services un-der the direction of the Gwinnett Medical Center affiliated physicians. We also have contracts for private EMS and emergen-cy 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

•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

The Athletic Training Services Program

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.

Leaders can make a difference. As the leading sports medicine program in Georgia, Gwinnett Medical Center-Duluth pro-vides innovative care to its athletic communities. In 2005, the pro-gram 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 ath-letic 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-educat-ed and highly-trained medical professionals in the nation. The sports medicine program’s vision is to provide injury preven-tion, immediate care and rehabilitation services of excellence to the community. The program currently provides certified athletic train-ers in different capacities such as high schools, professional teams and recreational leagues. The program provides comprehensive on-site medical coverage, concussion management through the Im-PACT 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 Gwin-net Gladiators, premier youth recreational leagues such as the At-lanta Fire United Soccer Association, the Greater Gwinnett Baseball League, Gwinnett lacrosse and hockey leagues, the Gwinnett Foot-ball League, the Gwinnett Touchdown Club All-Star game, and the Geor-gia 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 sub-stantially 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:

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Heat IllnessEnvironmental stress can adversely affect an athlete’s perfor-mance and in some instances pose an emergent health threat. Exertional heat illnesses are very serious conditions that consist of a three level spectrum in result of exposure or overexposure to hot environments. These progressive levels include exercise as-sociated heat cramps, heat exhaustion, and exertional heat stroke. Symptoms include painful muscle cramps of the arms, legs, and/or stomach usually combined with excessive sweating with thirst, headache, weakness, dizziness, nausea, increased pulse and respi-ration, seizures, and mental confusion. Death can occur in severe instances. These injuries are preventable. Treatment for heat exhaustion includes identifying early symp-toms, stopping or modifying the activity, rapid cooling, and mov-ing to a cooler environment. Rehydration with water or a sports drink is the foundation of treatment. If nausea or vomiting pre-vents an individual from drinking enough water, intravenous flu-ids may be required. Any rapid deterioration in health or mental status can be an emergency where 911 activation is imperative. Activity in hot environments can overwhelm the body’s ability to cool itself and cause heat related injuries. The body cools itself by sweating and allowing that sweat to evaporate. This requires enough fluid in the body to make sweat, air circulating across the skin, and low air humidity to allow that sweat to evaporate. This process is your body’s way of cooling itself.

These injuries may ensue when an athlete is not properly hydrat-ed or acclimatized, is exposed to extreme heat or has prolonged exposure, has on heavy clothing or equipment, has had a previous heat injury, has used alcohol, certain dietary supplements includ-ing caffeine, over the counter drugs or prescription drugs, and is fatigued or not rested. Key ways to prevent heat injuries are proper hydration, hydration monitoring systems before and after activity such as weighing, adequate rest to activity cycles, ade-quate acclimatization, correct uniforms/equipment, environmen-tal monitoring systems, and a pre-participation activity medical screening. Proper hydration is a process that begins 24 to 48 hours prior to activities in hot or high humidity environments. Gradual accli-matization is the most effective method of avoiding heat stress. A good pre-season conditioning program started prior to the begin-ning of strenuous activity in the heat is recommended and a pre-activity medical screening is essential. All activity in high weath-er environments should include progressive exposure in the first 10 to 14 days of activity with abundant access to frequent liquids. It is the policy of the Gwinnett Medical Center Athletic Training Services to inspect, oversee and evaluate all hot weather related athletic and training activities to provide the greatest degree of in-herent safety at athletic sites where it provides services. The goal is to maximize care while minimizing or eliminating these injuries.

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You’re out playing a soccer game, a ten-nis 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 tol-erable. 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 Cruci-ate 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.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 inju-ries, 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 con-tinued 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.

ACLTear:Career ending injury or bump in the road

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/// By: Gary Levengood, MD

/// By: Tim Simmons, MHA, ATC, LAT

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The Team Approach to taking care of a team

A certified athletic trainer (ATC) is a highly educated and skilled professional specializing in the prevention, treatment and rehabilita-tion 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

The 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.

The Coach/// By: Dave Hunter

Former Head Football Coach & Athletic Director at Brookwood High School

The Trainer/// By: Tim Simmons, MHA, ATC, LATSports Medicine Program Manager at Gwinnett Medical Center

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The 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 medi-cine. 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, preparticipa-tion 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.

The Doctor/// By: Snehal C. Dalal, MDGeneral Orthopaedics & Sports Medicine at Southern Orthopaedic Specialists

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Dr. 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 appre-ciation of all Gwinnett High School Football coaches. Proceeds from the tournament fund sponsorships for deserving Gwinnett County foot-ball players from each of the partici-pating teams. This year, SMS host-ed 31 teams: 20 Gwinnett County Schools and 11 teams of sponsors, and raised over $23,000 to support community high school players.

2nd Annual Gwinnett Football Fellowship Golf Tournament

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 condi-tions 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 re-ceived a medical kit as well as a medical field guide, courtesy of Gwinnett Medi-cal Center. This event was held at Duluth High School, with parents representing teams across Gwinnett County.

6th Annual Gwinnett Football League Parent Trainer’s Clinic

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Happening atWhat’s

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Happening atWhat’s

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Sports-RelatedConcussion /// by: Mathew W. Pombo, MD

There is an epidemic in our midst of which most of us are un-aware. Untold numbers of young people are suffering con-cussions 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 im-mediate and long-term effects of sports related concussions. The purpose of this editorial is to outline where we have come in con-cussion 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. Symp-toms of a concussion may include headache, amnesia, nausea, diz-ziness, confusion, irritability, visual symptoms, and mental fog-giness 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 neurocog-nitive 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 func-tion has returned to baseline. Establishing a return to baseline is

The 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 differ-ence 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.

Athletic Heart/// By: Manfred Sandler, MD FACC

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HCM Grey zone of LV thickness Athlete’s Heart

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Unusual patterns of LVH LV cavity < 45 mmLV cavity > 55 mmLA enlargementBizarre EKG patternsAbnormal LV filling Female genderThickness with deconditioningFamily history of HCMMax. VO2 >50ml/kg/min

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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 par-ticipation as well as state-of-the-art surgical and non-surgical musculoskeletal interventions. Conference speakers shared their expertise in concise didac-tic presentations and an emphasis on hands-on demonstrations including physical examination techniques of major joints. This conference is designed specifically for family practice physicians, in-ternists, pediatricians, physician assistants and nurse practitioners. We had approximately 90 attendees.

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critical to prevent repetitive head trauma during a vulnerable pe-riod 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 ef-fective than current practices. There are five concussion recommendations that need to be ap-preciated 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 concussion2: An individual sustaining a concussion should cease any ac-tivity that leads to an increase in concussion symptoms (e.g. headaches, dizziness, nausea, etc.)3: School attendance and activity may need to be modified4: Neurocognitive testing/ImPACT is an important compo-nent 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 concus-sion management has evolved rapidly over the past several years and has become a more individually-driven management proto-col formulated through scientific evidence and research across the world. This injury is one with devastating immediate and long-term consequences that are all preventable through education and establishing concussion awareness in our youth and their parents.

Strength training results in increased LV wall thick-ness and a decreased diastolic function. No changes occurred in the RV. The wall increased in thickness between 13-16 mm. Normal wall thickness is ap-proximately 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 ath-letes and may be unhelpful in terms of specificity and sensitivity in differentiating athletes heart from any other pathology for instance coronary artery dis-ease or HCM. However in HCM voltages are usu-ally 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 ob-structive HCM and athletic heart please refer to the table below for some helpful distinguishing criteria.

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Sports Medicine Update for the Primary Care Physician:

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 Liga-ment (ACL) in my sophomore year. This occurred during spring football practice and I went through surgery and rehabilitation during baseball sea-son. 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 sur-gery. 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.

What happened, how did you get injured? Both of my injuries to my knee and shoulder occurred during spring prac-tice 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.

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 shoul-der, 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 condi-tioning 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!

AthleteSuccessStory

Cameron FaulknerBrookwood High School - 2011Fullback/Linebacker

24 GSMM

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nomination with a brief

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to our publisher at:

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North GwinnettBulldogs - Black, Red & White8/20 At McEachern(GD)(D)8/27 TBD9/3 St. Augustine, Fla9/16 At Collins Hill9/23 Meadowcreek10/7 At Norcross10/14 Mountain View10/21 Mill Creek10/28 At Duluth11/4 Peachtree Ridge

NorthviewTitans - Navy & Silver8/26 Meadowcreek9/2 At Duluth9/9 At South Cobb9/16 Newton9/23 Alpharetta9/30 At North Forsyth10/7 At West Forsyth10/14 Milton10/21 Roswell11/4 At Centennial

Peachtree RidgeLions - Royal Blue & White8/20 At Walton(GD)9/2 At Roswell9/9 Newnan9/16 At Meadowcreek9/23 Mountain View10/7 At Collins Hill10/14 Norcross10/21 Duluth10/28 At Mill Creek11/4 At North Gwinnett

Providence Christian AcademyRed, Navy & White8/25 At Loganville Christian9/1 At George Walton Academy9/17 At Holy Spirit Prep9/24 At Community Christian9/29 At Young American Christian10/6 At Creekside Christian School10/13 At Hebron Christian10/20 Playoffs10/27 League Championship

LanierLonghorns - Orange, White & Black9/2 Hapeville9/9 At Mountain View9/23 At Union County10/21 At River Ridge

Mill CreekHawks - Cardinal, Vegas Gold & Navy8/26 At Dacula9/2 At Alpharetta9/9 Cherokee9/16 At Mountain View9/23 Norcross10/7 At Meadowcreek10/14 Collins Hill10/21 At North Gwinnett10/28 Peachtree Ridge11/4 Duluth

Mountain ViewBears - Black & Vegas Gold8/26 At Central Gwinnett9/2 At Archer9/9 Lanier9/16 Mill Creek9/23 At Peachtree Ridge10/7 Duluth10/14 At North Gwinnett10/21 At Collins Hill10/28 Meadowcreek11/4 Norcross

NorcrossBlue Devils - Blue, White & Silver8/18 Dacula9/2 At Parkview9/9 Roswell9/16 Duluth9/23 At Mill Creek10/7 North Gwinnett10/14 At Peachtree Ridge10/21 At Meadowcreek10/28 Collins Hill11/4 At Mountain View

DuluthWildcats - Purple, White & Black8/26 Archer9/2 Northview9/9 At Alpharetta9/16 At Norcross9/23 Collins Hill10/7 At Mountain View10/14 Meadowcreek10/21 At Peachtree Ridge10/28 North Gwinnett11/4 At Mill Creek

GraysonRams - Hunter Grn, Gold & Navy8/20 At Kell(GD)(D)8/27 At TBA(N. Gw.)(D)9/9 At Archer9/16 Berkmar9/30 At Shiloh10/7 Dacula10/14 At Parkview10/21 South Gwinnett10/28 Brookwood11/4 At Central Gwinnett

Johns CreekGladiators - Cardinal & Vegas Gold8/26 Rome9/2 At Sequoyah9/9 Cass9/16 At Woodland9/23 At Creekview9/30 At Chattahoochee10/7 Lambert10/21 At South Forsyth10/28 Northwest Whitfield11/4 Forsyth Central

Hebron Christian AcademyLions - Crimson, Gold & White8/26 At Prince Ave. Christ.9/2 At Southside Christ., SC9/9 Athens Christian9/16 At G. Walton Academy9/23 Lakeview Academy10/1 At Baconton10/7 GA Military College10/21 At N. Cobb Christian10/28 Cross Keys11/4 Towns County

Central GwinnettBlack Knights - Black & Gold8/26 Mountain View9/2 At Chapel Hill9/9 At Berkmar9/16 South Gwinnett9/23 Brookwood9/30 At Dacula10/7 Parkview10/14 At Archer10/28 At Shiloh11/4 Grayson

ChattahoocheeCougars - Blue, Gold & White9/2 Lambert9/9 At Forsyth Central9/16 At Creekview9/23 Northwest Whitfield9/30 Johns Creek10/7 Cartersville10/14 Sequoyah10/21 Cass10/27 At South Forsyth11/4 At Rome

Collins HillEagles - Green, Silver & White8/26 At Roswell9/2 At Brookwood9/9 At M. L. King(HS)9/16 North Gwinnett9/23 At Duluth10/7 Peachtree Ridge10/14 At Mill Creek10/21 Mountain View10/28 At Norcross11/4 Meadowcreek

DaculaFalcons - Blue, Gold & White8/18 At Norcross8/26 Mill Creek9/9 Brookwood9/23 At Shiloh9/30 Central Gwinnett10/7 At Grayson10/14 At South Gwinnett10/21 Archer10/28 At Berkmar11/4 Parkview

ArcherTigers - Red, Silver & White8/26 At Duluth9/2 Mountain View9/9 Grayson9/16 At Brookwood9/23 At Berkmar10/7 Shiloh10/14 Central Gwinnett10/21 At Dacula10/28 At Parkview11/4 South Gwinnett

BerkmarPatriots - Red, White & Blue8/26 Etowah9/2 At Meadowcreek9/9 Central Gwinnett9/16 At Grayson9/23 Archer9/30 At Parkview10/7 At South Gwinnett10/21 Shiloh10/28 Dacula11/4 At Brookwood

BrookwoodBroncos - Maroon & Gold8/20 At Lassiter(GD)(D)9/2 Collins Hill9/9 At Dacula9/16 Archer9/23 At Central Gwinnett9/30 South Gwinnett10/14 At Shiloh10/21 Parkview10/28 At Grayson11/4 Berkmar

GSMMAffiliateFootball Schedules

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