How sprains are treated today

Thomas Grogan, MD Orthopedic Surgeon, discusses how a recent study shows that conventional wisdom to treat sprains with rest, ice, compression, and elevation is now known to not be the best method
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How sprains are treated today

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Things are changing a little bit overtime. When I was in high school especially, or college, if you sprained your ankle, the key was to stay off of it. We gave everybody crutches, we put an ice bandage on and really kept them off the extremity. As it turns out, some great studies were done in New York City on high school basketball players really show us that may not be the case. In reality what they did they looked at high school basketball players – and they had two group of kids – one group with health insurance and one had no health insurance. The kids with health insurance missed 28 days of their sport and, you know, the kids with no insurance missed only 4 days of their sports, because they have to move. So now, we’re changing. Now what we want to do is encourage motion. And to help that along we devised these functional braces – braces that kids can wear inside their tennis shoes in a sprained ankle and functional braces for the wrist or elbow that allow them to move but be protected, so they don’t go too far. And in this way they seem to return to sport almost immediately. So things are continuing to change overtime, but right now, I always tell my patients, “Motion is your friend. You want to move.” One of the interesting questions is, “Do I ice or do I use heat to really help the sprain?” Well, that’s changing too – now our mantra these days is, “Ice is okay for pain, but really heat heals.” Heat increases blood flow and really blood flow leads to healing. We used to have this old saying, “RICE. Rest. Ice. Compress. And elevate,” is how we took care of an injury. Now we kind of know three of those four are simply wrong. So compression still works, but really we want to move, we want to encourage blood flow. And so motion, again, and heat are two main factors to encourage healing.

Thomas Grogan, MD Orthopedic Surgeon, discusses how a recent study shows that conventional wisdom to treat sprains with rest, ice, compression, and elevation is now known to not be the best method

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Thomas Grogan, MD

Orthopedic Surgeon

Dr. Grogan is a practicing pediatric orthopedist in Santa Monica, California. He has seen over 40,000 patients in his practice alone. Dr. Grogan graduated cum laude from Princeton University with a degree in Biology and received his medical degree from the University of Cincinnati College of Medicine.  Dr. Grogan’s orthopedic training has included an orthopedic residency at UCLA plus several orthopedic fellowships in pediatric orthopedics, trauma, and NIH sponsored joint replacement surgery. Following his orthopedic training he returned to Los Angeles, spending six years at Shriner’s Hospital for Crippled Children, including serving as Assistant Chief in 1996 and 1997. In addition to his clinical practice, he spent several years involved in managed care consulting as an orthopedic surgeon and has developed special expertise in this area. He has collaborated with the American Academy of Orthopedic Surgeons in the development of a handbook and audiotape entitled, Health Care Reform and Managed Care: A Guidebook for Orthopedic Surgeons. In addition, he has served as the lead faculty member for the AAOS for their 1995, 12 city educational seminar, “Taking Charge: Managed Care Contracting for Orthopaedic Surgeons” and as a faculty member for the AAOS’s 1996 seminar series entitled, “Winning at Risk: The Interplay of Cost, Quality, and Access in Orthopaedic Practice”.  He most recently served as a faculty member for the AAOS’s 2009, 2010, 2011 and 2012 seminars, “Practice Management Symposium for Practicing Orthopaedic Surgeons’. He is currently chairman of the Practice Management Committee for the American Academy of Orthopaedic Surgeons and a member of their Council on Education. He is a member of Alpha Omega Alpha, Honor Medical Society, the Sigma XI Scientific Research Society, California Orthopaedic Association (COA), the Pediatric Orthopaedic Society of North America (POSNA), the American Academy of Orthopaedic Surgeons (AAOS), and is a diplomate of the American Board of Orthopaedic Surgery.

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