Good Connections

Dr. Blane Crandall was doing all the right things. He stayed active and worked out several times a week, steadily increasing his strength. He even played golf at least once a month. But the 55-year-old obstetrician and gynecologist couldn't have guessed that a hidden joint problem would stop him in his tracks.

"I was lifting weights, doing overhead presses,"

he says. "And my rotator cuff tendon separated and dropped-boom-just like that."

After waiting a few days, he still couldn't lift his arm. That's when he sought the help of Dr. Leon Mead, an orthopedic surgeon at Gulfcoast Orthopaedic Specialists, who is dual-fellowship-trained in joint replacement and

sports medicine.

"The thing about athletic injuries is that the same type of injury that can occur in an older athlete can occur in a young athlete," Mead says. "It just can happen a little more easily as we get older." He says that for adults, other responsibilities tend to take the place of daily sports activity, resulting in the "weekend warrior" syndrome-a sure-fire prescription for injury.

"They try to go out and make up for a week's worth of inactivity in two days," Mead says. "With the combination of a sudden burst of activity and overall de-conditioning, older tendons, ligaments and cartilage tend to give way."

At any age, bone health and joint flexibility are key to keeping any level of athlete injury-free. In sports, that means not only working on sports-specific training, but cross-training and stretching as well, says Dr. Abbott Kagan, a Fort Myers orthopedic surgeon who is the physician for several professional and amateur sports teams in Southwest Florida.

"I've taken care of the Boston Red Sox for the past 15 years, and as I've seen players throughout the organization from when I first started until now, their athletes are so much more flexible," says Kagan. "The reason is they work not only on conditioning but on flexibility. You can improve your flexibility, but you have to do it on a regular basis. You have to do it every day."

That means more sessions during the week to avoid pulling a hamstring while running the bases during the Sunday-afternoon softball game or throwing a back out on the golf course. "Particularly in golf, you see a lot of people who have back problems because the golf swing is tough," Kagan says. "It's tough for young people and it's even tougher for older people who already have some spine stiffness. The way to prevent those types of problems is to take lessons and use proper form."

But for Crandall, who was exercising regularly, injury came from another-

and not uncommon-source: a congenital shoulder impingement, worsened by the repetitive motion of his weightlifting.

"[Mead] knew what the diagnosis was as soon as he finished his examination," Crandall says. An MRI and X-rays confirmed that, indeed, Crandall's rotator cuff had been severely damaged and surgery would be required to repair it.

"[Mead] was able to put the tendons back together and clean up the joint. He shaved off all the bony [protrusions] that were rubbing on the tendon," says Crandall.

Diagnosis and treatment have advanced significantly for bone- and joint-related injuries in recent years. "Some of our diagnostic testing is so much better than what we had in the past," says Kagan. "We get a much better idea of what the problem is and we know how to treat it better."

Advanced MRI technology allows for faster diagnosis, and Kagan says new ultrasound technology can stimulate bone growth and reduce healing time. Some surgeons, like Mead, are performing partial knee and entire hip replacement surgery through minimally invasive arthroscopic procedures that are easier on patients.

"There's no question that there's a huge difference between patients who receive a minimally invasive procedure and those who don't," Mead says. "For the aging athlete, that's good news as well, because with a joint replacement, there's a lot of things you can still do, sports-wise."

Fifteen weeks after the injury, Crandall is easing back into his fitness routine, which now includes swimming, some weightlifting and running. He is looking forward to getting back on the golf course with his repaired shoulder.

"I think I will actually play better," he says. "I will have a much better shoulder because he took care of the impingement that was limiting my range of motion."