What is a Sports Medicine Provider, and Can I See One?

You may be asking yourself what is a Sports Medicine provider? To be honest with you, I only found out the difference between sports medicine and general orthopedics in my last semester of Nurse Practitioner school. Because of this, I want to provide more insight into the differences so that you can be educated and empowered in choosing an orthopedic specialist that best fits your needs.

Sports Medicine is a specialty underneath the orthopedics umbrella. Just like you can see specialists who see only hips, shoulders and knees, foot and ankle, or the spine, you can see a sports medicine specialist. Dr. Clarke Holmes and I are Orthopedic Sports Medicine Providers. What might differentiate a sports medicine provider from a general or specialty orthopedist? Here are few key points:

1.      One stop shop: Sports Medicine Providers see orthopedic conditions from the top of your head (concussions) to the tip of your toes, and everything in between

2.      Conservative treatment options versus jumping right into surgery: Dr. Holmes and I will always be transparent with our patients if surgery is the best option, but why not try utilizing all the nonsurgical options first if surgery is not necessary?

3.      We are experts in minimally-invasive procedures that can either prevent surgery or be an alternative to surgery: For example, Platelet Rich Plasma (PRP) injections are very successfully used for partial tendon tears and osteoarthritis of numerous joints. See our PRP blogs or check out our social media posts to learn more about PRP.

4.      Improved accuracy of our injections by utilizing musculoskeletal (MSK) ultrasound guidance. Ultrasound is becoming a mainstay in the sports medicine world, and we’ve used MSK ultrasound for over a decade. We also use this daily to diagnose tendon tears, bursitis, joint swelling and ganglion cysts.

5.      Holistic treatment: We care about the patient as a whole person and do not see them as just a body part, a diagnosis or a potential surgery.  We develop a plan of action with the  patient that considers what activities they like to do, their occupation, weight, nutrition, mental health and any other contributors to formulate an individualized treatment plan.

6.      YOU DO NOT HAVE TO BE AN ATHLETE TO SEE A SPORTS MEDICINE PROVIDER. Yes, we experts in treating athletes ranging from the youth to the professional ranks, but we also treat those who do not consider themselves an athlete. In addition, we see patients of all ages and all activity levels. One of my favorite things to treat is arthritis, even in those who do not exercise and just want their pain to decrease and daily function/activities to improve.

Hopefully this has provided clarification on the differences between a sports medicine orthopedic specialist and a other types of orthopedists. As always, let us know if we can be a resource to you!

Taylor Moore, NP

BEING PROACTIVE, NOT REACTIVE, WHEN IT COMES TO PLATELET RICH PLASMA (PRP) INJECTIONS

I am a 28 year-old nurse practitioner and former competitive athlete, and I am strongly considering getting platelet-rich plasma (PRP) injections for my knees. Why? For one, as a provider, I have witnessed many improved patient outcomes. Two, this procedure is safe, has relatively no side effects, and is minimally-invasive. Lastly, we are seeing that by being proactive with PRP versus reactive when symptoms are present shows even further benefit.

After many years of intense volleyball training, games, and working out without any downtime throughout the year, I developed bilateral knee pain. Although I have no x-ray evidence of osteoarthritis at this time, based on my symptoms, there is no doubt I have cartilage damage. Because of this, I feel that PRP injections, in addition to other conservative treatments I’ve used, will boost the longevity of my knees. 

PRP helps soft tissue, joint, and cartilage pathology. It is a great way to use your own body’s healing system to improve musculoskeletal problems, and there is minimal risk because it uses your own blood. 

What’s our process?

1. Obtain blood from a vein.

2. Spin it in a centrifugation system in our office. This separates the components of the blood and concentrates the platelets.

3. We take the plasma that has platelets that are rich in growth factors to create the PRP injectable solution.

4. The PRP is then injected under ultrasound guidance in the targeted area.

When injecting the PRP solution to the targeted area, it creates an espresso shot-like effect for your body’s growth factors and repair cells to travel to this area. The main goal is to help repair the damaged area, decrease pain, and improve function. Keep in mind that this is a slow and methodical approach that can take up to 6 months to see maximum benefits. Sometimes more than one PRP injection is needed. How long does PRP last? It varies based on the severity of the patient’s condition, a patient’s activity level, and incorporation of other conservative treatments. Cost can vary per practice. We typical charge $800-$950 (*subject to change) depending on how many locations we are injecting and which centrifugation system we use. Keep in mind that PRP injections are NOT stem cell injections. 

My goal with this blog is to change the thought process that PRP injections should only be used reactively to treat orthopedic conditions and their accompanying symptoms to one instead that utilizes PRP in a proactive approach to slowly repair and stabilize conditions. 

So, why haven’t I had PRP injections in my knees already? Honestly, the only thing holding me back is my nervousness when it comes to needles. 

Interested to see if PRP injections would be helpful for you? We would love to have a consult with you to discuss these in detail! 

Taylor Moore, FNP

Impact Sports Medicine and Orthopedics

Why Does an Orthopedic Practice Care About a Patient's Weight?

Let’s talk weight. It’s not a fun topic to talk about, but necessary in the medical field. A poll taken earlier this year showed that 48% of Americans admit they have gained weight since the beginning of the Covid outbreak.

Why is this important to orthopedic providers? Weight is a contributor to orthopedic pain. Let me give you an example: there are two patients of the same age and gender with equal severity of knee arthritis. One maintains a healthy weight level, and the other has had a 10 lb. weight gain. For every one pound you’re overweight, there’s an estimated extra four pounds of force on the joints. Therefore, even though they have the same degree of arthritis, it is likely that the overweight patient is struggling more with flares of pain and dysfunction due to that extra 40 lbs. of force going through the knees. 

Not only does maintaining a healthy weight help orthopedic pain, it helps fight against high blood pressure, high cholesterol, diabetes, cardiovascular disease, sleep apnea and other sleep disturbances, gallbladder and liver disease, and mental disorders. Overall, a healthy weight has significant health benefits. 

All that being said, losing weight and maintaining a healthy weight isn’t easy, especially when life gets busy. We fall into routines, and it just never seems like there’s enough time in the day. Many people get caught up in the numbers on the scale. If monitoring this is motivational for you, keep stepping on the scale. If weighing yourself is discouraging, use other tools such as how are your clothes fitting, whether you feel better, and are you holding yourself accountable to feeding your body the fuel foods it needs while moving your body more. 

Weight management is 80% eating habits and 20% exercise, and impacting each of these is one huge factor: your overall mental approach to both. Let’s break down each. 

Eating Habits 

Wouldn’t it be nice if we could lose weight while frequently eating foods like sweets and pasta. That would be AMAZING. Unfortunately, that’s not reality. But it doesn’t mean you can’t eat the deemed “unhealthy foods,” or that healthy foods can’t taste good. Another factor to consider is that eating healthier tends to be more expensive.

-limit unhealthy foods and then control the portion sizes when you do splurge. Another good tip is if you know you’re going out for that pizza for dinner, eat healthier for breakfast and lunch. 

-use a free calorie tracking app such as MyFitness Pal. The amount of calories needed depends on age, size, height, gender, and activity level. A calorie deficit is needed to lose weight, but that doesn’t mean you have to always be hungry. It’s all about the foods you choose! Eat foods that keep you full and choose healthy snacks in between. 

-intermittent fasting doesn’t work for everyone. If you’re interested, try fasting from 8 p.m. until 12 p.m. the next day. Black coffee and water are still acceptable to drink during this time. 

-drink plenty of water. The amount will be different from everyone. Drinking an excess amount of water can drop your body’s sodium levels, so don’t go overboard. 

-be mentally prepared on how to approach that dreaded spiral when opportunities to consume unhealthy food present themselves and then have the mental fortitude to decline the temptations.

-don’t go to the grocery store when you’re hungry. This increases the likelihood of buying unhealthy foods. We all know if it’s in the house, it will get eaten. 

-limit eating out or if you do eat out, make healthier choices. 

-incorporate color into every meal, as more color often means more fruits and vegetables. 

-eat when you are hungry, not necessarily simply because it’s meal time, and stop when you are full. 

-if you want to follow or need the accountability through a weight management program, consider Weight Watchers or Noom.

-if you overeat at a meal, move on and don’t shame yourself.

-fueling your body with healthy food choices can also help combat full body inflammation. Here is a link to one of our favorite resources on anti-inflammatory foods that we like to share with our patients. 

https://www.drweil.com/diet-nutrition/anti-inflammatory-diet-pyramid/dr-weils-anti-inflammatory-food-pyramid/

*Eating habits are not a “one plan fits all”*

Exercise

Our biggest tip is to just keep moving! Find an activity that gets you moving and that you enjoy physically and mentally. At least 3-4 times a week. Choose an activity that gets your heart rate up and cross train with strengthening. You don’t have to spend hours in the gym. 

-set a timer every hour at work to get up and walk around. Take a walk during your lunch break. 

-get a sit-to-stand desk and alternate every 30 minutes to 1 hour. “Sitting is the new smoking.”

-find a routine and stick to it. Choose a few different activities you can alternate. 

Finally, here are the main keys to successful weight management: consistency, maintaining a positive mindset, positive reflection, smart food choices while also allowing yourself to eat what you want in moderation, and get moving. It’s definitely not easy, but the overall improvement in your physical or mental health will be well worth it. 

If you have found success in losing or maintaining a healthy weight, let us know what helped you!

Taylor Moore, FNP-C

Impact Sports Medicine and Orthopedics

What is a Nurse Practitioner?

I have had the pleasure to meet and take care of many of our awesome patients since I joined Impact Sports Medicine in August 2020. However, questions still occasionally arise about what my role is at Impact.

What is a Nurse Practitioner?

You may hear the following interchangeable terms: Nurse Practitioner, NP, Mid-level, Advanced Practice Registered Nurse (APRN). Nurse Practitioners are trained to assess patient needs, order and interpret imaging and laboratory tests, diagnose conditions, formulate and prescribe treatment plans, and provide patient education. There are many different Nurse Practitioner Specialty degrees. You commonly see NPs in inpatient and outpatient settings, primary care, and specialist offices, occupational health, the health department, and more!

Are a Nurse Practitioner and a Nurse the same thing?

No, these are not the same roles and have different scopes of practice. A nurse assists providers and has an associates or bachelors degree, whereas an NP requires at least a masters degree and special training through an NP educational program.

Nurse Practitioners function as a provider just like a Medical Doctor (M.D.). In Tennessee, all Nurse Practitioners are required to be under the supervision of a Medical Doctor.

What is the difference between a Nurse Practitioner (NP) and a Physician Assistant (PA)?

These two roles function very similarly with tiny nuances. Both are considered mid-level roles. A Nurse Practitioner is required to be a Registered Nurse (RN) before advancing their training to become an NP.

What is my role at Impact Sports Medicine and Orthopedics?

I see patients independently of, and at times along side, Dr Holmes. This means I can assess and examine patients, interpret imaging and labs, prescribe medications, diagnose conditions, provide treatment plans, perform ultrasound guided injections, and provide education to patients. Overall, think of me as a provider extension of Dr. Holmes.

What else do I want you to know about me as an NP?

Although you will see me independently, Dr. Holmes and I work as a team. This means I discuss patient cases and my decisions with him, and always have him review x-ray and MRI images as well. I want patients to know he is involved in their care, even if you don’t see him directly. Yet, have confidence that I will deliver safe, compassionate, and competent care to get our patients better! I work with my patients as a team to devise decisions that are tailored to each individual, their conditions, and their needs.

Hopefully this provides more clarity on what a Nurse Practitioner is and my role at Impact Sports Medicine and Orthopedics. Looking forward to providing care to y’all in the future!

Taylor Moore, FNP-C

Instagram: @taylormoore_nashvillenp

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