Behind the scenes at RODEOHOUSTON

f you live in or near Houston, March is the month you pull out your western gear and become a cowboy or cowgirl to celebrate the return of the Houston Livestock Show and Rodeo™. RodeoHouston® has it all – a BBQ cook-off, mutton bustin’ for the kiddos, bull riders, barrel racers and hit music stars.

While Houstonians enjoy the festivities for the entire month of March, the rodeo contestants come to town to compete for three days before moving on to the next rodeo. Sprains, strains, fractures, concussions – these are just a few of the injuries contestants risk when they enter the competition. To continue their sport, contestants need a team of health care professionals to back them up. That’s why Houston Methodist is proud to serve as the official health care provider for RodeoHouston.

In a typical night, the @RodeoHouston sports medicine team averages 60-70 treatments for the contestants. Click To Tweet

Houston Methodist coordinates the RodeoHouston sports medicine team with medical volunteers from across the city to ensure a multi-disciplinary team is available to care for contestants and their families. For the sports medicine team, the show starts long before you find your seat in NRG Stadium. A typical day in the RodeoHouston training room looks like this:

  • 9 a.m. – 12 p.m. – A physical therapist treats athletes and Rodeo staff (think Rodeo clowns and other support staff) for injuries sustained the night before or pre-existing injuries
  • 12:00 – 1:00 p.m. – Lunch break (eat while you can!)
  • 1:00 – 2:00 p.m. – Restock supplies (we go through a lot of tape and ice)
  • 2:00 – 4:00 p.m. – Prepare for the pre-event madness
  • 4:00 – 6:00 p.m. – The competitions usually start around 6 p.m., so between 4 and 6 p.m. is the madness.

In a typical night, we’ll average 60 to 70 treatments for the rodeo contestants. The cowboys and cowgirls come in to ice sore muscles, get therapy for aches and pains, tape their ankles, ask the primary care physician about a lingering health issue like a cold or get the surgeon’s opinion on a recurring shoulder problem. Our team also performs and reads x-rays on-site. 

At the same time, we’re treating the rodeo athletes’ family members. Many contestants travel with their spouses and children, so they need medical care while on the road, too. It may be the husband of a barrel racer with back pain or the son of a bull rider with an ear infection – the team can take care of them all. 

When the competition starts, the contestants know the same team of medical experts taking care of them in the training room will be standing by in case a ride doesn’t go their way. In the arena, two athletic trainers, two emergency medicine/trauma physicians, a team of paramedics and an orthopedic surgeon are ready to provide care if a rider is injured. In case of a concussion, we have neuropsychologist on call to provide an evaluation and treatment recommendations.

When the rodeo is over and the fans are waiting for the concert to begin, the training room is once again packed with athletes coming in to see the medical staff. While not all injuries that occur on the arena floor are serious, they can cause problems if left untreated before the next rodeo in the next town. 

The next day, the cycle repeats. Although the medical staff may change from day to day, we all have the same mission and provide the same level of care for each of the athletes and their family members.

After three days, the contestants move on to the next rodeo, and at the end of March, the medical staff will go back to their normal practices. So, if you’re heading to the rodeo, keep an eye out for the guys and gals in red vests. We’ll be there all night, every night, keeping the contestants at their best. Yeehaw!

How often do ACL tears happen to athletes?

How’s your fantasy football team doing? Lost any star players to an anterior cruciate ligament or ACL tear? St. Louis Rams quarterback Sam Bradford is out for a tear in his left knee for the second season in a row. Stephen Tulloch, a linebacker for the Detroit Lions, went down in week three with an ACL tear in his left knee.

ACL tears are common in football players and in professional, amateur and youth athletes in other contact sports with more than 250,000 occurring each year. An ACL tear is a season-ending injury, but does it signal the end of an athlete’s career? Not necessarily.

ACL tears affect 250,000 athletes each year Click To Tweet

So how often do athletes with ACL tears return to the sport they love? Dr. Joshua Harris, a Houston Methodist orthopedic surgeon, sought out to find just that. He matched athletes with ACL tears in the National Football League, National Basketball Association, National Hockey League, Major League Soccer and the X Games to athletes without tears based on age, experience and pre-tear performance.

“In addition to determining how often these athletes are able to return to sport after an ACL tear, our studies also revealed interesting patterns in ACL tears,” Dr. Harris said. “For example, we were able to determine which NBA playing positions had a harder time recovering and which knee was more susceptible to ACL tears in MLS players.”

National Hockey League

Athletes in the NHL had a return to sport rate of 97 percent – the highest rate of all major sports leagues. Left-handed shooters are more likely to tear their ACL, but all performed better after returning to the ice.

National Football League

Because the rates of ACL tears in the NFL are so high and specific offensive and defensive positions are unique in their cutting and pivoting demands on the knee, Dr. Harris and his team decided to narrow their research for this study to quarterbacks. The researchers found quarterbacks have a return to sport rate of 92 percent and, on average, played for five years after returning from an ACL tear, which proved ACL tears are not career-ending injuries for quarterbacks.


National Basketball Association

Dr. Harris found that 62 percent of ACL tears in the NBA occur in the second half, mostly in the fourth quarter of the game, possibly due to fatigue. Overall, NBA athletes have a high return to sport rate of 86 percent. Guards have the most difficult time returning to sport, while centers have the most predictable outcomes.

Major League Soccer

While most injuries in Major League Soccer athletes are non-contact injuries, these players tend to have more ACL tears in their left knee and have a 77 percent chance of returning to the field after an ACL tear.

“Because of the cutting and pivoting nature of soccer, MLS players may have more ACL tears in the leg they plant with,” Dr. Harris said. “The majority of soccer players kick with their right and plant with their left, which may explain why they tend to have more ACL tears in their left knee.”

X Games

Dr. Harris and his team looked specifically at skiers and snowboarders. Skiers tend to have more tears in their left knee and had an 87 percent chance of returning to their sport. Snowboarders had a 70 percent return to sport rate and won more medals after recovering from an ACL tear.

“This injury can happen to anyone,” Dr. Harris explained. “Researching ACL tears in athletes helps all of our patients because we are able to evaluate treatments and bring the best solutions back to our practice.”

Rethinking osteoarthritis

My knee pain started in my late 20s. I was overweight and the pain didn’t exactly encourage me to keep moving. Now, more than a decade later, the osteoarthritis (OA) in my knees is much worse. Other than pain and stiffness, it is the grinding that bothers me the most. I know that I will probably need a knee replacement eventually.

When you have OA, your joints ache. You feel stiff. Your knees creak and squeak like an unoiled Tin Man. Your hips tell you when it’s going to rain, and the pain is deep and consuming.

The term “arthritis” characterizes more than 100 different rheumatic diseases and conditions ranging from Lyme disease to autoimmune diseases such as lupus. When most people refer to arthritis, they are usually referring to OA, the most common form of arthritis, which affects 27 million people and is the leading cause of disability in the United States.

Osteoarthritis (OA) affects 27 million Americans. OA deteriorates cartilage, joint lining, ligaments and bone.

Don’t be fooled into thinking that OA only affects seniors. When it comes to this disease, it affects people of all ages.

Also known as the wear-and-tear form of arthritis, OA is a degenerative joint disease that affects cartilage, joint lining, ligaments and bone. It can cause joint pain, swelling, tenderness and stiffness, and can restrict joint mobility. It commonly affects joints at the ends of the finger and thumb, also in the knees, hips, hands, neck and back.

Who gets it?

OA has many contributing factors beyond wear and tear that determines who get the disease and when:

  • Age: OA is a disease often associated with aging because over time, many seniors develop the disease because time has a way of wearing away the cartilage in the joints
  • Gender: After age 55, women are more likely than men to have OA
  • Genes: OA in the hands, in particular, is more closely associated with genetics. Also, certain genetic defects in cartilage can lead to OA
  • Injury and Overuse: Activities that impact and cause injury to the joints, such as playing sports, or soft tissue injury, such as ACL tears, can increase chances of developing OA, even at a young age. Also, jobs that require repetitive motion and heavy lifting can increase the odds of developing OA
  • Weight: Being overweight or obese can cause significant wear and tear on the weight-bearing joints especially in the knees, hips, ankles and feet
Osteoarthritis affects 27 million people and is the leading cause of disability Click To Tweet

Treating osteoarthritis

It is better to treat OA early because the pain and damage to the affected joint can progress over time. Treatment options, which depend on the severity of the joint damage, include taking anti-inflammatory medications, reducing body weight, exercise to strengthen muscles that support the joint, arthroscopy and as a final option — joint replacement surgery.

To learn more about treating osteoarthritis and joint replacement options, visit Houston Methodist Orthopedics & Sports Medicine online.

5 signs you may need a knee replacement

More than 600,000 knee replacements are performed each year in the United States, and an aging population will continue to drive that number up. If knee pain is affecting your daily life, it might be time to ask your physician about a knee replacement.

Before you take another pain reliever, consider these five signs from Dr. Stephen Incavo, an orthopedic surgeon at Houston Methodist, that suggest it’s time for a knee replacement.

Sign #1: Decrease in activity level or quality of life

Knee pain should not affect your daily routine or prevent you from enjoying your favorite activities. If you experience in a decrease in activity level or quality of life, talk to your doctor.

Sign #2: Pain and/or stiffness at night

If you dread the evening because your knees begin to stiffen up or become painful, you might be a good candidate for a knee replacement.

“Some patients will only have knee pain or stiffness at night, so they think they don’t need a knee replacement. It isn’t normal to be unable to sleep at night due to knee pain.”

More than 600,000 knee replacements are performed each year in the United States Click To Tweet

Sign #3: Non-surgical options no longer help

In some cases, your physician may recommend trying non-surgical options, such as physical therapy or anti-inflammatory medicine, to provide pain relief. If the non-surgical treatment doesn’t help or stops helping, don’t hesitate to go back for a visit.

“Don’t wait too long after non-surgical options stop helping to come back in. The goal is to get you back to a happy, pain-free life, but you have to tell your doctor when something isn’t working for you.”

Sign #4: Future prognosis is not good

For many, your knee pain slowly erodes activity level or quality of life. But if the condition of your knee will continue to worsen, why wait? 

“So many patients with arthritis know they will eventually need a knee replacement, but think they aren’t ready for it yet. But think about your current situation. Ask yourself if you want to enjoy your present years or wait until you’re older and potentially lose all mobility.”

Sign #5: The first replacement has not helped

Unfortunately, not all knee replacements function properly and may require a revision surgery to correct the problem. 

Reviewed by Dr. Stephen Incavo