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therapists to improve their tolera nce of activit y." E d u c a t i o n i s a n i n d i s p e n s a b l e pa r t of t he T hink SM A RT! prog ra m . Concussion specia lists from the Sports Medicine progra m offer free education at schools and sports events, as well as a six-week concussion wellness program at St. Cha rles Hospita l for patients a nd fa mily members. "A def initive way to prevent concus- sion does not exist," Dr. Queller says, "which ma kes it essentia l to know how to identify a concussion and understand the risks it poses to bra in hea lth." "The preseason concussion education our program provides is quite beneficia l because it helps ath letes a nd pa rents bet ter understa nd what to look for," Dr. Queller says. "Identif ying concus- sion is incredibly important. In 2019, it's ma rkedly less cha lleng ing to identif y a nd sta r t ma na g ing concussion tha n it used to be because people a re more educated about it a nd more willing to repor t symptoms." THERAPEUTIC OPTIONS FOR NONOPERATIVE INJURIES Ma ny spor ts injuries respond well to conser vative nonoperative treatment, such a s phy sica l t herapy, cor t i sone injections a nd activ it y modif ication. In addition to nonoperative treatments, S t . Ch a rle s Spor t s Med ici ne of fer s regener at ive me d ici ne, wh ich u se s platelet rich plasma , derived from the patients' ow n blood or bone ma rrow, t o fa ci l it a t e he a l i n g . R e gener a t ive medicine has a va riety of applications, according to Dr. Queller, including treat- ing tendonitis, osteoarthritis, chondra l injuries of the k nee, osteochondritis disseca ns a nd nonunion fractures. " To perform a platelet-rich plasma injection, which is one ty pe of regen- erative medicine, we draw a patient 's blood, spin it in a centrifuge, separate the platelets from the blood and inject the platelets into the area of concern," Dr. Queller says. "If we're ha r vesting b one m a r r ow, we take it from the pos- terior superior iliac spine and follow the s a m e p r o c e d u r e . Regenerative medi- cine seems to hasten recover y, a lthough a f ter a n injection, w e o f t e n h a v e t o l i m i t p a t i e n t s ' h i g h -i m p a c t a n d r ep e t it iv e a c t iv i- t i e s t o a l l o w t h e treatment to work. R egenerat ive med ici ne of fers more hea ling potentia l tha n rest or a cor ti- sone injection." EXTENSIVE SURGICAL EXPERTISE For patients whose injur ies require surgical treatment, board-certified and fellowship-trained orthopedic surgeons at St . Cha rles Spor t s Med ici ne a re adept at performing procedures to treat cartilage defects and soft-tissue tears from ankle to shoulder, including labral tears in the hip. These injuries are often the result of joint impingement and are common in individua ls younger than age 40, according to Michael Sileo, MD, FA AOS, Co-director of Sports Medicine at St. Charles Hospita l. Arthroscopic surgery is often the approach of choice for the best outcome. "During arthroscopic hip labral repair, we shave the bones in the joint to improve their fit and repair the damaged labrum," Dr. Sileo says. "That not only helps relieve short-term pain, but also preserves the long-term viability of the hip joint so patients can avoid replacement." In the knee, cartilage defects of varying size are common in young athletes, and St. Charles Sports Medicine orthopedic surgeons offer outpatient procedures to repair them. For sma ll defects, one option is to perform a microfracture procedure in which the surgeon, operat- ing arthroscopically, removes damaged cartilage and creates holes in the bone of the knee to form a clot that becomes the foundation for new cartilage growth. Another option is to perform an allograft Dr. Queller evaluates an athlete's joint and range of motion. Levinson performs the Y Balance test with an athlete. This proven reliable test analyzes dynamic balance, gathering composite scores in multiple directions, which will then be placed into a scientific algorithm. A percentage is calculated to determine the athlete's risk for injury. M D N E W S . C O M /// M D N E W S L O N G I S L A N D ■ 2 019 0 9