Dr. Carolyn Hettrich

Shoulder specialist, researcher joins UK Sports Medicine team

UK Orthopaedic Surgery & Sports Medicine welcomed shoulder specialist Dr. Carolyn Hettrich to the team earlier this summer. Hettrich will see patients, take care of UK athletes and conduct research.

Originally from Portland, Ore., Hettrich has studied and worked across the country. She completed her undergraduate studies in Los Angeles at Pomona College and went to medical school at the University of Washington. After graduating medical school, Hettrich completed a residency at the Hospital for Special Surgery in New York and a fellowship at Vanderbilt University. She has spent the past six years working in Iowa.

As a member of the team at UK Sports Medicine, Hettrich said she is looking forward to providing care for patients with shoulder disorders and conducting leading-edge research studies.

In fact, one of the reasons Hettrich decided to join UK HealthCare is because of UK’s emphasis on research.

“I’ll have the opportunity to do the research I’m interested in,” she said.

Hettrich’s research interests focus on three areas: clinical outcomes after shoulder surgery, computer modeling for shoulder replacement, and tendon and bone healing. Hettrich is the principal investigator on the largest prospective study in the world for shoulder instability surgery. The study has 950 patients currently enrolled and is operating at 12 sites nationwide.

Her research expertise meshes well with work already being done at UK Sports Medicine, particularly the work of Dr. Christian Lattermann. Hettrich and Lattermann are both part of the Multicenter Orthopaedic Outcomes Network (MOON) and share a mentor.

“We are very proud Dr. Hettrich joined UK Sports Medicine,” Lattermann said. “She brings an extraordinary expertise in shoulder-related, patient-centered translational research, which accelerates our efforts at UK to become a national leader in patient-related outcomes research.” Additionally, she is an outstanding shoulder surgeon, Lattermann said.

When she’s not conducting research, treating patients or working as a team physician for the UK football team, Hettrich is looking forward to continuing her advocacy work on behalf of her patients. Her master’s degree in public health focused on health policy gives her insight into how she can advocate for her patients and research funding.

Each year, on Research Capitol Hill Days, Hettrich takes patients to meet with congressional leaders in Washington D.C. to show the direct impact of research funding. Hettrich is especially interested in musculoskeletal research because musculoskeletal conditions affect half of the adult population in the U.S., with expenditures related to these conditions accounting for nearly 6 percent of the gross domestic product.


Next steps:

SMRI

Video: Take a tour of the Sports Medicine Research Institute

Lisa Cassis

Lisa Cassis, UK vice president for research

Written by Lisa Cassis, PhD, UK vice president for research.

The new UK Sports Medicine Research Institute, or SMRI, is a state-of-the-art, multidisciplinary facility that will allow UK researchers to study injury prevention and performance for professional and collegiate athletes, the tactical athletes of the U.S. military, and physically active people of all ages.

Watch the video below for an inside look at the equipment and technology that makes the SMRI such a unique and exciting endeavor.

The 10,000-square-foot facility, part of the UK Nutter Training Facility on campus, is spearheaded by the UK College of Health Sciences and is supported in part by a $4.2 million Department of Defense grant.

The SMRI is outfitted with sophisticated equipment to assess biomechanical, physiological, musculoskeletal and neurobehavioral health and is supported by a team of eight core faculty, staff and research assistants as well as 40 affiliate faculty.

A biomechanics laboratory conducts motion analysis studies using 14 cameras and a dual-force plate system in the floor, like the technology used to make video games and animated movies. Equipment shaped like a horse simulates realistic movement for jockeys and other equestrians.

A neurobehavioral lab uses virtual reality to assess visual acuity, reaction times and balance, which are critical measurements for concussion recovery. Other equipment is designed to measure oxygen consumption, workload and metabolic costs, physiological stress, and the influence of sleep deprivation and fatigue, all of which are important contributors to musculoskeletal strength, endurance, operational performance and injury risk.

The different branches of UK’s mission – education, research, service and care – converge in the work of the SMRI, and we look forward to the discoveries that will come out of this UK institute.


Next steps:

ultrasound-guided injections

Innovative pain-relief treatment allows woman to enjoy trip to Italy

Geri Maschio spent more than a year planning a girls trip to Italy, but pain in her hip threatened to keep her from getting on a plane and experiencing the cities she’d been dreaming about.

Maschio started experiencing pain in her hip two years earlier. She tried a variety of treatment options to find relief, but none fixed the issue. Unfortunately, physical therapy didn’t help, and Maschio needed a hip replacement.

She was referred by her primary care doctor to Dr. Jeffrey Selby, an orthopaedic surgeon at UK Orthopaedic Surgery & Sports Medicine.

By that time, Maschio’s pain had become too severe for her to continue without treatment. Hip replacements require about four to six weeks of recovery, but Maschio’s trip was quickly approaching, and she refused to forgo her long-planned vacation.

“I wasn’t going to be the person who bailed at the last minute – the trip was a year in the making,” she said.

Another route to pain relief

Luckily, Selby knew of another orthopaedic physician at UK who might be able to help. He referred her to Dr. Kyle Smoot, who suggested using ultrasound-guided injections to treat Maschio’s hip pain. The procedure required little recovery time and would allow Maschio to travel.

Ultrasound-guided injections are used to treat pain stemming from conditions like chronic tendinopathy, muscle tears and carpal tunnel. They’re used in a variety of joints – including the hip and knee – and can also be used diagnostically to identify and differentiate a patient’s pain.

Maschio felt prepared for the procedure, which was performed while she was awake and numbed, but wasn’t sure what the outcome would be.

“I trusted Dr. Smoot because I was totally confident seeing anyone Dr. Selby recommended,” she said. “And Dr. Smoot and the athletic trainer [Amy Waugh] were so kind when they explained everything to me.”

The day before her trip to Italy, Maschio had an appointment with Smoot to receive her injections. Recovery was simple, she said. She let the numbing medication wear off and then felt immediate relief from the pain that had threatened to keep her from going on the trip of a lifetime.

The very next day, Maschio got on the plane for an eight-hour trip. She spent 12 days in Italy walking five to seven miles a day – pain-free.

“I know I wouldn’t have made it on this trip without Dr. Smoot and Dr. Selby – I couldn’t have done it without them,” she said.


Next steps:

  • Learn more about UK Orthopaedic Surgery & Sports Medicine, which provides leading-edge treatment for a variety of injuries and conditions.
  • When Patty Lane was diagnosed with arthritis in her hip, she was told her time as a competitive triathlete was over. Not willing to give up on her dreams, Patty turned to UK Orthopaedic Surgery & Sports Medicine for a second opinion. Read Patty’s story.
massage

Massage might help those who can’t exercise, says UK research

An illness, an accident or even just getting older can limit a person’s ability to exercise. Rest is an essential component of healing, but it also atrophies muscles.

“People who are unable to exercise due to, for example, a recent surgery or illness, lose as much as 3 percent of their muscle mass per week,” said Esther Dupont-Versteegden of the UK College of Health Sciences. “That doesn’t sound like much, but it can make recovery much more difficult, especially for the elderly.”

Dupont-Versteegden and her College of Health Sciences colleague Tim Butterfield have been testing an inexpensive, noninvasive treatment that appears, in preliminary studies, to aid in the recovery of muscle mass and reduce muscle atrophy: massage.

“Our research proposes that massage may stave off atrophy, even if you aren’t able to get up and move around,” she says.

Massage mimics the effects of exercise

Proteins are the basic building blocks of all of the body’s tissues, especially muscle. The complicated metabolic process that turns protein into muscle, called protein synthesis, increases muscle cell size, which in turn strengthens muscle fibers. But one of the crucial ingredients for muscle growth is exercise.

“However, there are times and circumstances in which exercise is not possible, because of a severe illness or surgery, for example,” Dupont-Versteegden says.

According to Butterfield, it appears that massage mimics the effect of exercise by sending signals to the muscle to begin protein synthesis. And there’s perhaps an even more intriguing finding: Massaging one limb seems to confer benefits to its corresponding muscle on the other side as well.

“We’re not sure why yet, but if we could understand the mechanisms for this crossover effect, it could have real healing benefits for patients with wounds to one limb – for example, car accident victims or wounded soldiers,” Butterfield said.

Better health for Kentuckians of all ages

Their initial work is promising enough to earn a five-year, $2.1 million grant from the National Center for Complementary & Integrative Health. The research grant will further their study in conjunction with Benjamin Miller and Karyn Hamilton, both researchers at Colorado State University.

Dr. Scott Lephart, dean of the UK College of Health Sciences, says that Dupont-Versteegden’s and Butterfield’s work demonstrates how research can uncover new, cost-effective ways to improve health for Kentuckians of all ages.

“The loss of skeletal muscle mass and the inability to recover from atrophy are major contributors to disability and a major factor in the elderly’s loss of independence,” Lephart said. “This work exemplifies our college’s commitment to optimizing health for Kentuckians of all ages and beyond.”


Next steps:

Dr. Patrick O'Donnell

Oncologist Patrick O’Donnell on why he has the world’s best job

Making the RoundsWe sat down with Dr. Patrick O’Donnell, an orthopaedic oncologist at the UK Markey Cancer Center, for our latest installment of Making the Rounds, a blog series that introduces you to the providers at UK HealthCare. Dr. O’Donnell specializes in treating bone cancer and also does reconstructive orthopaedic surgeries. 

How did you become interested in orthopaedic oncology?

I actually went into medicine with an interest in doing oncology, and I always knew I wanted to be a doctor. I had some interaction with cancer patients when I was a really young kid, and I just found it fascinating that your body could attack itself.

It got me interested in medicine, so I went to medical school saying, “I’m going to be an oncologist.” But then I did a surgical rotation and I loved it. I loved having a problem and then a surgery and then a solution. And then I ended up really liking the reconstruction, the big surgeries of orthopaedic oncology. I’ve got the best job in the world.

What kinds of conditions do you treat?

I specialize in orthopaedic oncology and reconstructive orthopaedics. I treat a lot of different types of cancers. I treat soft tissue sarcomas, bone sarcomas, bone tumors that are not cancerous tumors, and then I treat a lot of metastatic disease to bone – the so-called “bone cancer.”

Bone cancers that start in the bone are called sarcomas, and sarcomas are the rarest type of human cancer. They’re also one of the most aggressive types of human cancer. I treat both types of bone tumors – those that have started outside the bone and tumors that have spread inside the bone.

Tell us about your interest in rock climbing.

I’ve always really liked rock climbing, and Kentucky is like the world mecca of rock climbing. An hour away is the Red River Gorge, and there are over 3,000 documented climbing routes. Recently in Lexington, we’ve gotten a new climbing gym, which has been great.

I got reinvigorated with rock climbing when my daughter had a birthday party at the gym. I went and just got completely excited, and my kids got into it. And now it’s the way that I blow off steam when I’m not at the hospital. I’ve got a great group of friends that I climb with.

What’s your favorite food?

I really like Indian food mostly because I don’t get it very often, so when I do get it, it’s a big treat. My wife, she can’t do curry, she can’t do Indian food, so the only time I get Indian food is when I’m by myself.

What does your ideal weekend look like?

A weekend when I’m not working, I get to spend a lot of time with my family. My son and I will play baseball. My daughter is a really good swimmer, so we’ll get to go to a swim meet. And then we really like going out to dinner and trying all the different places in Lexington.

So, an ideal weekend would be a little bit of baseball, a little bit of swimming and going out to dinner at a new restaurant.


Watch our interview with Dr. O’Donnell, where he discusses how his experience treating patients with bone cancers has expanded treatment options for other patients with orthopaedic problems.


Next steps:

  • July is Sarcoma Awareness Month. Learn more about Markey’s Musculoskeletal Oncology team, which is nationally recognized for expertise in the diagnosis and treatment of bone tumors, soft tissue sarcomas and metastatic diseases of bone.
  • One of Dr. O’Donnell’s patients is a well-known member of the Big Blue Nation – former UK basketball player Todd Svoboda. When Todd was diagnosed with bone cancer, he turned to Markey and Dr. O’Donnell for help. Read Todd’s story.
muscle soreness

How to reduce muscle soreness after exercise

Written by Laurie Blunk, an athletic trainer at UK Orthopaedic Surgery & Sports Medicine.

When you try a new exercise, lift heavier weights or run steeper hills, your muscles experience strain and micro-tearing at the cellular level, which can cause them to become sore.

Thankfully, there are ways to prevent and treat muscle soreness. Foam rolling, stretching and eating foods with anti-inflammatory properties can help reduce pain, alleviate discomfort and get you back to your favorite exercise.

Make sure to stretch

Stretching is an important recovery step in reducing muscle soreness and preventing injuries. Muscles can’t react to changes in exercise or intensity effectively when they are tight, but stretching before you work out can help muscles move more effectively.

Static stretching, or holding a stretch without movement, can be done before exercise, but is most important after activity.

Kinetic stretching, or warming up muscles with movement, is also beneficial. Your muscles will get the most benefit when you combine kinetic stretching with static stretching.

Roll it out

Foam rolling has become a popular recovery technique. Foam rolling consists of using a cylindrical tool, called a foam roller, and body weight to massage muscles.

Foam rolling can be helpful when combined with stretching because it breaks up adhesions in the soft tissue around the muscle, allowing for a better and deeper stretch.

Consider using a foam roller both before and after exercise for different reasons. Rolling out before can help break up adhesions, and rolling out after acts as a form of self-massage, which has been shown to aid in muscle recovery.

Targeting large muscle groups with the foam roller, like your leg muscles (quads, hamstrings, calves, glutes etc.) offers the most benefit. Foam rollers can also be used on the large muscles of the back. If you have muscle soreness from the previous day’s exercise, you can foam roll on subsequent days to help alleviate muscle soreness.

It is recommended to foam roll soon after activity and every 24 hours thereafter to reduce soreness.

Food for recovery

Diet also plays a role in recovery. Tomatoes, olive oil, green leafy vegetables, nuts, fatty fish like salmon and tuna, and fruits (especially berries) have anti-inflammatory properties that help reduce muscle soreness. Try working these healthy foods into your diet to help alleviate pain after exercise.

Don’t let muscle soreness deter you from trying a new workout. Just be sure recovery through stretching, foam rolling and a healthy diet are also part of your routine.


Next steps:

Dr. Rasesh Desai

Inspired by his sister, Rasesh Desai decided to become a doctor

Making the RoundsIn our latest Making the Rounds interview, we sat down with Dr. Rasesh Desai, an orthopaedic surgeon with UK Orthopaedic Surgery & Sports Medicine who works at The Medical Center at Bowling Green. Dr. Desai sees patients of all ages and specializes in joint replacement surgery, spine surgery and pediatric orthopaedic surgery. 

What kinds of patients do you see?

I see patients from all age groups – from newborns to adults. I’m in a unique position because of my variety of fellowship training. I’m fellowship-trained in spine surgery and joint replacement surgery, and it gives me an opportunity to see the patient as a whole person.

Sometimes a patient comes to your office with leg pain, hip pain or knee pain, and then you find out their actual problem is coming from the spine. Or sometimes it might be vice versa, where patients come in with back problems. But we find out the back problem is mainly the result of hip or knee arthritis.

Tell us about UK’s partnership with The Medical Center at Bowling Green

The UK orthopadic department has an agreement with The Medical Center at Bowling Green to provide orthopaedic service in this community. The main purpose of this affiliation is to provide the same level of care that you would get at a bigger hospital, right here in a smaller community.

What inspired you to get into medicine?

I saw my elder sister go into the medicine field, and it always inspired me to see her, how she treated her patients. You know, when you are a kid, when you are growing up, you go to the doctor when you are sick and they get you better and back to your life, and that always fascinated me.

During medical school, I worked with an orthopaedic surgeon. I saw the patients coming to the hospital with broken bones and severe pain, with arthritis, or not able to walk. And then getting them back on their feet was immensely satisfying, and that inspired me to become an orthopaedic surgeon.

What does your ideal weekend look like?

My ideal weekend is to be able to spend some time with my family and my 3-year-old son. Get him out to the park and play with him, because I don’t get much time to do that during the week. I also like to spend some time with friends and their families. Go out, watch a movie and maybe watch some sports on TV.

What’s your favorite movie?

I like all of the X-Men movies!


Check out our video interview with Dr. Desai, where he tells us more about working in Bowling Green and why teamwork makes a world of difference in patients’ recovery.


Next steps:

UK Sports Medicine Research Institute

New UK Sports Medicine Research Institute focuses on injury prevention, athlete performance

UK celebrated on Tuesday the opening of the new UK Sports Medicine Research Institute (SMRI), spearheaded by the UK College of Health Sciences and supported in part by a grant from the U.S. Department of Defense.

The 10,000-square-foot facility, part of the UK Nutter Training Facility on campus, will conduct research into injury prevention and performance optimization for professional and collegiate athletes, the tactical athletes of the U.S. military, and physically active people of all ages in Kentucky and beyond.

“Our research and scholarly endeavors offer the brightest hope for transformation and change for our Commonwealth and the broader world we serve,” UK President Dr. Eli Capilouto said. “This sentiment fuels the work of this university, and it fuels the work of the Sports Medicine Research Institute.”

Capilouto held the institute up as an example of the university’s efforts to collaborate across disciplines in addressing the challenges and disparities that face the Commonwealth, noting that seven UK colleges are involved in the work of the SMRI, in addition to personnel from UK HealthCare.

There is no similar facility within 400 miles of Lexington.

State-of-the-art technology

The SMRI is outfitted with sophisticated equipment to assess biomechanical, physiological, musculoskeletal and neurocognitive health. It’s supported by a team of eight core faculty, staff, and research assistants and 40 affiliate faculty. In addition to its Lexington location, SMRI operates a facility in Camp Lejeune, N.C., where its team works directly with MARSOC – the Marine Corps Forces Special Operations Command.

A biomechanics laboratory conducts motion analysis studies using 14 cameras and a dual-force plate system in the floor, similar to the technology used to make video games and animated movies. Equipment shaped like a horse simulates realistic movement for jockeys and other equestrians.

There is also a neurocognitive lab that uses virtual reality to assess visual acuity, reaction times and balance, which are critical measurements for concussion recovery.

Other equipment is designed to measure oxygen consumption, workload and metabolic costs, physiological stress, and the influence of sleep deprivation/fatigue, all of which are important contributors to musculoskeletal strength, endurance, operational performance and injury risk.

Dr. Scott Lephart, dean of the UK College of Health Sciences and founder of the SMRI, leads the $4.2 million Department of Defense grant that helped launch the institute. He said that the military can adapt from lessons learned in athletics and vice-versa.

“The elite warriors of the U.S. military are expected to be at peak performance in extremely dangerous and unpredictable situations, and there’s no room – either financially or personally – for them to sustain a preventable injury,” said Lephart, who is also UK Endowed Chair of Orthopaedic Research. “Our research with athletes both military and civilian is mutually beneficial, and it will result in strategies for injury prevention and performance for every walk of life.”

Impacts in education, health

University of Kentucky Provost Tim Tracy emphasized that the SMRI serves an educational need, in addition to its missions in research and clinical care, noting that the program provides educational experiences for both undergraduate and graduate students across the university.

“With this emphasis on collaboration, the different branches of UK’s mission – education, research, service and care – converge in the work of the SMRI,” he said.

Dr. Michael Karpf, UK executive vice president for health affairs, predicts that SMRI’s impact will extend far beyond the realms of tactical warriors and professional athletes.

“SMRI is a powerful merger of research, outreach and collaboration, enhancing UK HealthCare’s efforts to address chronic disease and poor health in Kentucky,” Karpf said.

UK Director of Athletics Mitch Barnhart noted that the SMRI was not just a valuable resource for UK athletes, but for professional and youth athletes across Kentucky and nationally.

“This is yet another example of the power of partnership on our campus,” Barnhart said. “By working together, we are creating cutting-edge resources for athletes both here at UK and beyond. The efforts of the SMRI will help minimize injury and maximize athletic performance in sports ranging from football to NASCAR and from basketball to horse racing.”

UK Sports Medicine Research Institute

Leaders from UK, UK HealthCare and UK Athletics came together to celebrate the opening of the SMRI.


Next steps:

Watch: UK researcher discusses his work to improve jockey health, safety

As a researcher in the UK College of Health Sciences, Carl Mattacola spearheads the Equine Jockey/Rider Injury Prevention Initiative, a first step toward building a medical model for jockeys that is similar to the care offered to athletes in other sports, including hockey, NASCAR racing and football. The initiative aims to provide jockeys with proper management, biomechanical assessments and injury prevention.

“A horse race is a pretty high powered event. … You have to be strong and balanced to maintain control of this 1,000-pound horse going about 30 miles per hour,” Mattacola said. “We spend most of our time focused on the horse, but the rider is an athlete, too, and he or she can benefit from the expertise that we have to offer.”

Watch this episode of “Five Questions” to learn more about Mattacola’s efforts to improve the health and safety of jockeys and other riders. Mattacola also talked about his history with horses and what he enjoys most about being a health educator.


Next steps:

In the latest edition of Making the Rounds, Dr. Scott Mair discusses always wanting to be a doctor, his hobbies and why he enjoys living in Lexington.

A passion for sports led Dr. Scott Mair to orthopaedic surgery

Making the RoundsWe sat down with Dr. Scott Mair, an orthopaedic surgeon at UK Orthopaedic Surgery & Sports Medicine, for our latest installment of Making the Rounds, a blog series that introduces you to some of our providers at UK HealthCare. Dr. Mair specializes in shoulder and knee arthroscopy and shoulder reconstruction.

How did you first become interested in medicine?

I grew up in Rochester, Minn., and everybody there is a doctor, basically. My dad was a pediatrician. I didn’t know there was anything else to do. I’m kind of kidding, but there are an unbelievable number of doctors there, per capita, just because the Mayo Clinic’s there and it’s a small town. So obviously I knew a lot of doctors, and they seemed to like what they did.

Why did you decide to specialize in orthopaedics?

It had more to do with my love of sports. I wasn’t a spectacular athlete, but I played a lot of sports, and I enjoyed being around sports. So when I would hear about team doctors, it seemed like a good fit. I get to work with several of the UK teams, which is a lot of fun.

What types of injuries do you treat?

Mostly what I see is shoulder problems. Probably about 80 percent of my practice is shoulder things. A lot of young athletes with stability problems, and then older people who have rotator cuff problems. But I see all kinds of other, different shoulder abnormalities, too.

What should patients know about rehab after surgery?

People think rehab is something where they have to push through the pain and do everything they’re supposed to do – which, in certain surgeries or certain rehabs, is important. But a lot of times, it’s almost the opposite, where once people start feeling well, we’ve got to slow them down because some things take months to heal.

For a lot of my younger patients especially, after a couple of months when we’ve stabilized their shoulder, they feel like they’re good as new, and they start doing things they’re not supposed to do before they’re healed. So half my time I spend trying to slow people down while they’re healing up after surgery instead of pushing them along, like you do in some surgeries.

What do you do in your spare time?

I have four daughters, so most of the time I’m doing things with them. I used to play a lot of golf, but they’re not much into that, so I spend a lot of time chasing them around for their sports and things. They range from age 12 to 20 now.

Describe your ideal weekend. 

I’d be at a UK basketball game and hanging out with my family after that, doing something with our friends. Maybe go fishing.

What do you like most about living in Lexington?

I’ve been here about 18 years and I think it’s a fun place. There’s a lot to do, it’s easy to get to big cities, but it’s not such a big place that you can’t get around where you need to go. And it’s got friendly people.

What’s your favorite movie?

I like some of the old-school movies like Caddyshack and Fletch. Those are probably still my favorites.


Check out our video interview with Dr. Scott Mair below, where he talks about why working with the student-athletes at UK is so rewarding.


Next steps:

  • Learn more about UK Orthopaedic Surgery & Sports Medicine, which provides leading-edge treatment for a variety of injuries and conditions.
  • When Patty Lane was diagnosed with arthritis in her hip, she was told her time as a competitive triathlete was over. That’s when she turned to UK Orthopaedic Surgery & Sports Medicine for a second opinion. Read Patty’s story.