Appointment Icon

St. Luke's Emergency Department

First Available Time :

Jones Regional Medical Center Urgent Care - Anamosa

1795 Highway 64 East
Anamosa, IA 52205

Current Estimated Wait:
Closed

UnityPoint Clinic - Express (Lindale)

153 Collins Road Northeast
Cedar Rapids, IA 52402

Current Estimated Wait:
Closed

UnityPoint Clinic - Express (Peck's Landing)

1940 Blairs Ferry Rd.
Hiawatha, IA 52233

Current Estimated Wait:
Closed

UnityPoint Clinic Urgent Care - Marion

2992 7th Avenue
Marion, IA 52302

Current Estimated Wait:
Closed

UnityPoint Clinic Urgent Care - Westside

2375 Edgewood Road Southwest
Cedar Rapids, IA 52404

Current Estimated Wait:
Closed


Ep. 136 - LiveWell Talk On...Sports Injuries and Treatment (Kris Sehr)

episode 136

Ep. 136 - LiveWell Talk On...Sports Injuries and Treatment

   Subscribe so you never miss an episode!

   Apple Podcasts | Google Podcasts | Spotify | Pandora | iHeart Radio |   
   Google Play Music | Stitcher TuneIn SoundCloud 


Host: Dr. Dustin Arnold, chief medical officer, UnityPoint Health - St. Luke's Hospital

Guest: Kris Sehr, PT, ATC, sr. physical therapist, St. Luke's Therapy Plus

Dr. Arnold:
This is LiveWell Talk On...Sports Injuries and Treatment. I'm Dr. Dustin Arnold, chief medical officer at St. Luke's Hospital - UnityPoint Health. Joining me today is Kris Sehr, senior physical therapist with St. Luke's Therapy Plus and also a certified athletic trainer, to discuss sports injuries, treatment, prevention, and anything else that should come up. Welcome, Kris.

Kris Sehr:
Thank you.

Dr. Arnold:
Also we should start off saying that you're also an alumni of the Harvard of the Midwest, also known as Coe College.

Kris Sehr:
Absolutely.

Dr. Arnold:
Yeah, so we just referred to it as the Harvard of the Midwest on the podcast. So it's that time of year for sports injuries, well let me back up. It's always that time of year. I mean, this is an all year long thing, not just as school starts. But what are the most common injuries that you see at Therapy Plus?

Kris Sehr:
It depends on contact versus non-contact sport, there's a big difference. This time of year, we see with football and volleyball ankle sprains, nice strains a lot. Non-contact injuries, swimming, gymnastics tend to see more tendonitis. Stress fractures, maybe with cross-country. So it depends on the sport, but yeah, it is kind of all year round.

Dr. Arnold:
Yeah. You know, I think before we started to record we were talking about how particularly teenagers are kind of impatient. And they want to get back into the fray as soon as, you know, that acute pain is gone. Could you kind of speak to over-training and even if it's a "strain," the recovery process and how long it takes? It can be an estimate, but I think it's important to stress that it's not instantaneous.

Kris Sehr:
No it's not. Teenagers do heal quickly, but you're absolutely right, they are impatient. A lot of times, especially if it's their first injury, they think it's the end of the world if they're going to have to miss a game. And I like to stress with them, missing a little bit of time may overall mean that you miss less time. Because if you get it healed completely and healed correctly to begin with, it's probably not going to come back and bug you later. Versus getting back too soon, can sometimes cause more long-term problems.

Dr. Arnold:
Are there certain conditions or scenarios that make a student athlete or athletes more susceptible?

Kris Sehr:
One of the things that has changed over the course of my career is early specialization. More kids just playing one sport year round really increases your risk of injury. Years ago, you played volleyball during volleyball season, basketball, track, and you didn't necessarily play those sports when it wasn't that season. And now we see a lot of, soccer is kind of a year round thing, even basketball. You know, kids are playing club and high school. So that really increases that risk if you're not changing sports.

Dr. Arnold:
Yeah. I think there's a really good softball pitcher that's not playing for school ball and just doing clubs. You're right. You know, we both have kids that age and the club scene is pretty big. You know, that goes into the next question, the recovery and the over-training for this. Because I think the kids are just going all the time. On an average week, how much should an athlete—What is the optimal training schedule and rest cycle for an athlete?

Kris Sehr:
The American Academy of Pediatrics recommends one to two days of rest per week and one to two months per year. And I definitely have seen over-training injuries. And I would say a lot of your athletes between club and high school sports are not, probably not even taking a day a week. Much less a month or two a year.

Dr. Arnold:
Yeah. As I said, my youngest daughter had an injury and she had to sit out six weeks and you would've thought we canceled Christmas. You know, and just constantly asked when she can get back into it. Which you respect that, you know, I think that's fun. Like you said, it's fun to treat those patients and interact with them, but it's also mind numbing at times, how often they ask you to get back in the fray when they haven't done that. So the most common injuries, could you take us through for the most common injuries, what they are, and then talk about the old ice, compression, elevation? And whether or not ice or heat.

Kris Sehr:
Yeah. That's old, but still absolutely applicable. Always ice. We tell people ice for the first 72 hours. For the most part for athletes, you're going to keep icing. If you're looking at a six week old muscle strain, you might do some heat before you start activity. But ice is probably the easiest, biggest thing you can do to kind of prevent that injury from increasing in severity. The price, P-R-I-C-E: protection, rest, ice, compression, elevation. This is still the best protocol you can follow initially. You know, and getting that swelling down makes a big difference on an ankle sprain, knee strain.

Dr. Arnold:
What is the injury that's the most difficult to recover from?

Kris Sehr:
Concussion probably, which could be a whole podcast of its own. You know, a lot of the stuff we see is acute injuries. And so they resolve pretty quickly. You know, you're talking two or three weeks. Once you get into an ACL tear, you know, those are six to nine months if you end up with surgery. So for the acute stuff, I'd say three to four weeks.

Dr. Arnold:
I guess I would—from my experience, not personally, but observationally—it seems like a hamstring injury if not treated early on well and rested to recover, can be one that can just plague a player all season.

Kris Sehr:
Absolutely. Those can be real finicky. And you can think that they're doing pretty well, and then you go back to the sport and they're real prone to re-tweaking.

Dr. Arnold:
So if I'm an athletic trainer or a parent coach, when should I send that player to the urgent care or the emergency room with the exception of, let's just take concussions out of that. Because that should be a pretty low threshold to have them evaluated. But when should I think that they need an x-ray or they need to be seen by a physician or care needs to be escalated?

Kris Sehr:
If they can't weight bear on a leg or a severe limp, probably an x-ray is a good idea. Also depends a little, if there was like a specific blow, a specific trauma. You know, if a football player lands on somebody else's ankle at a weird position that probably warrants an x-ray. General soreness, where there wasn't like a really specific trauma, you know, you could ice for a day or two if it's not getting better. Like I said, for the most part, kids heal pretty quick. So after a couple of days if it's not improving, probably warrants a trip. I think it makes a little difference too if the school has an athletic trainer or a qualified person to evaluate it. That's helpful too, because then they can make that call.

Dr. Arnold:
You know, being the team physician for Coe, the Harvard of the Midwest, I've seen more concussions from soccer players than I do football players. Now, part of that might be reporting them or just the lack of protection that a soccer player has. And it's a fairly physical sport. And but I definitely see more soccer players with concussions.

Kris Sehr:
I definitely see sports other than football. I think football has taken a little bit of a bad rap in the concussion game, partly with the NFL publicizing incidences that people have down the road. Girls actually more commonly get concussions than boys, if you look statistically. I had a son that played four years of high school football and never got a concussion. Daughter that played basketball and had two. So I have seen more in soccer. I had a cheerleader that had a concussion, so it can not be just football.

Dr. Arnold:
Yeah, absolutely. You had said earlier that concussions are probably one of the most difficult ones to recover because you don't have—there's not a measurement, there's not a test you can run to say, okay, we're out of the clear. And I think over the years, we've become appropriately more conservative in returning to play. What is the process following a concussion that you evaluate someone and make the decision that perhaps they already returned to play?

Kris Sehr:
From the athletic training side, there's a lot of pretty specific layout. You need to be able to ride the exercise bike symptom-free before you progress to the next sports specific drills. And then you need to be able to be headache free 24 hours to progress back to practice. And then 24 hours being able to practice with no symptoms, which would be headaches, sick to your stomach, sensitivity to light. And that gets to be some technical stuff, because as we touched on, kids don't necessarily want to be injured. If I'm looking at an ankle sprain, I can tell if it's black and blue, if it's swollen.

Dr. Arnold:
Right, right.

Kris Sehr:
Concussions, there's nothing you can touch or visibly see. And those are tricky. Some of the things you're looking at with concussion symptoms, moodiness. Well, I had teenagers at home. How many times are they moody? You know, there's some tough things like that. Is this from the concussion, or is this just a typical teenager? Sleepiness. Again, sometime that's not uncommon with teenagers.

Dr. Arnold:
Correct, that is so true. They have, I can't think of the name of the test, but they are trying to refine a blood test. Kind of like a troponin for your heart, to signify if you've had some brain damage. So that wouldn't probably be a benefit in the short-term, but that would be nice to have that test prior to returning.

Kris Sehr:
Yes, it would for sure be nice to have something objective. I mean, there are some objective things, dizziness, sensitivity to light. The impact test is a short-term recall of letters or words. And then can you recall it 15 minutes later? So there's some stuff they can show the direction you're headed, but that's the one area I would definitely be conservative in.

Dr. Arnold:
I don't know about you, but my biggest fear always is that second impact. It's really not the first, it's not the concussion that happens. It's them returning to play and getting hit again very early after the first one.

Kris Sehr:
Yes. And that "soon" can be three to four weeks before the brain is really fully recovered. I grew up old school where if you knew which side of the ball to line up on, you were going back in. And that's challenging because I think that there's coaches and parents and teachers that that's what they're familiar with. And when you tell a kid, you know, three to four weeks before you're going to go back for contact, that doesn't usually go over real big. But certainly it's beneficial to be sure you're completely recovered.

Dr. Arnold:
Yeah. I think it's always tough because three to four weeks in an eight/nine week season is pretty disappointing to the parents and the patients, et cetera.

Kris Sehr:
Three to four weeks to a teenager is a lifetime.

Dr. Arnold:
Absolutely. A weekend is a lifetime for a teenager. Last question. Why did you choose physical therapy?

Kris Sehr:
I actually got into it from kind of the sports end. My best friend had an ACL tear when we freshmen in high school. And so I saw a little bit of it and thought it was pretty cool. And then I got into athletic training when I was at Coe and loved that side of it. So the sports medicine side is my professional love.

Dr. Arnold:
Well just for full disclosure, Kris and I were at Coe at the same time and she was my athletic trainer for playing football. So we know she's good.

Kris Sehr:
That should give me a lot of credibility.

Dr. Arnold:
That should, absolutely. Hey Kris, thanks for taking time and joining me. This has been great information. Once again, this was Kris Sehr, senior physical therapist and certified athletic trainer at St. Luke's Therapy Plus. For more information visit UnityPoint.org.

Thank you for listening to LiveWell Talk On. If you enjoyed this episode, don't forget to subscribe. And if you want to spread the word, please give us a five-star review and tell your family, friends, neighbors, strangers about our podcast. We're available on Apple podcast, Spotify, Pandora, or wherever you get your podcasts. Until next time, be well.