Notice of Data Security Incident

February 9, 2024

Northeast Orthopedics and Sports Medicine, PLLC (“Northeast Orthopedics”) is providing notification of a recent incident. On November 22, 2023, we observed unusual activity on our computer network and immediately began an investigation into the nature and scope of the event with the assistance of third party forensic specialists. On December 29, 2023 the investigation identified potential unauthorized access to certain data on our network.

We determined that the information potentially impacted may have included information related to patients of Northeast Orthopedics, including name, Social Security number, drivers license information, payment information, date of birth, medical record information, health insurance information, and treatment and diagnosis information. We are mailing notice letters to potentially impacted individuals with more information regarding this incident. If you have questions about this incident, or the letter you received, please call the dedicated line we are setting up to address questions about this incident. This line will be available in the coming week, and this notice will be updated with the call in information once available.

In response to this incident, we also worked with third-party specialists to re-secure our network, implement additional precautions, and we are reviewing our policies and procedures related to data protection.

In general, we encourage individuals to remain vigilant against incidents of identity theft and fraud by reviewing credit reports/account statements and explanation of benefits forms for suspicious activity and to detect errors. Under U.S. law, individuals are entitled to one free credit report annually from each of the three major credit reporting bureaus, TransUnion, Experian, and Equifax. To order your free credit report, visit www.annualcreditreport.com or call 1-877-322-8228.

Individuals have the right to place an initial or extended “fraud alert” on a credit file at no cost. If individuals are a victim of identity theft, they are entitled to an extended fraud alert lasting seven years. As an alternative to a fraud alert, they have the right to place a “credit freeze” on a credit report. The credit freeze is designed to prevent credit, loans, and services from being approved without consent. Pursuant to federal law, individuals cannot be charged to place or lift a credit freeze on your credit report. 

Should individuals wish to place a fraud alert or credit freeze, please contact the three major credit reporting bureaus listed below:

TransUnion

1-800-680-7289 

transunion.com     

P.O. Box 2000  

Chester, PA 19016  

Experian

1-888-397-3742      

experian.com

P.O. Box 9554   

Allen, TX 75013

Equifax

1-888-298-0045

equifax.com

P.O. Box 105069

Atlanta, GA 30348

Individuals can further educate themselves regarding identity theft, fraud alerts, credit freezes, and the steps to protect their personal information by contacting the credit reporting bureaus, the Federal Trade Commission (FTC), or their state Attorney General. The FTC also encourages those who discover that their information has been misused to file a complaint with them. The FTC may be reached at 600 Pennsylvania Ave. NW, Washington, D.C. 20580; www.identitytheft.gov; 1-877-ID-THEFT (1-877-438-4338); and TTY: 1-866-653-4261. Instances of known or suspected identity theft should also be reported to law enforcement, the state Attorney General, and the FTC.

Breach Hotline Help Center: 888-324-1031

Keeping Tennis and Golfer’s Elbow at Arm’s Length

By: Dr. Barry S. Kraushaar

Tennis Elbow and Golfer’s Elbow are names for similar tendon injuries that occur at the tendon attachments on the outer (lateral) and inner (medial) sides of the elbow joint. If you have pain on or near the points of bone that serve as the origins of the muscles of the forearm, you may have this diagnosis. The forearm muscles, which give power to your grip, attach to these anchoring points called epicondyles. They can tear off of the bone or within their fibers. Tendons are injured throughout our lives, but they usually heal themselves, making it rare to need medical help. When a tendon attachment to your elbow tears and fails to heal it can be Tennis or Golfer’s Elbow.

TENNIS ELBOW is an injury at the outer (lateral) bony prominence of the elbow. You can have this diagnosis even if you do not play tennis, but the name comes from the observation that tennis players get it as part of the sport. This is because the grip of a long tennis racquet and the wrist motions of the tennis swing put strain on the muscles which originate at the lateral epicondyle. Expert tennis players rarely get tennis elbow because they have powerful forearms and good swing mechanics. If you have the wrong grip size, string tension, timing (late swing), racquet type, or stroke mechanics (wrist motion), you are at risk for Tennis Elbow. In fact, any type of forearm overuse can cause tennis elbow, and the treatment options, described below, are the same.

GOLFER’S ELBOW refers to pain on the inner, medial side of the elbow. In this sport, the problem is caused by the combined effect of the long club length being gripped by the trailing arm (the right arm in a right-handed swing) as the club-head strikes the ground, such as in the rough, the sand or when taking a divot to get under the ball. The forearm is driving forward as the hand is held back, causing strain in the muscles that control the wrist. The damage occurs at the tendinous origin on the inner side of the elbow. Ironically, golfers can also get Tennis Elbow, because the leading arm sees strain on the outer, lateral side during the same movement.

Treatment

There are many additional reasons for tendon injuries about the elbow, usually involving pulling or twisting motions during exertion. It can happen from low level stresses or big motions. From an orthopedic view, the approach is to identify the causes and help the patient adjust activities to allow the tendons to heal themselves.  This may involve a period of partial or complete rest from the aggravating activity. It may involve different equipment or technique. During a flare-up, you may benefit by using a brace. If you wear a wrist brace it may help the elbow by limiting the motions that are traumatizing the injured tendon. A tennis elbow strap is different, as it works by re-directing forces coming up the forearm and deflecting the pulling effect on the tendon origin. Pills, such as non-steroidal anti-inflammatory drugs (NSAIDS like ibuprofen) or analgesics (acetaminophen, Tylenol) may temporarily help the symptoms, but they do not cure tendon injuries. Similarly, a steroid (cortisone) injection may relieve pain for now, but the chemical may damage tendon, and after a few months the problem can come back even worse. Sometimes, a small injection is used as part of a bigger plan.

The most effective and lasting way to manage Tennis or Golfer’s Elbow is to perform exercises to strengthen the forearm. Since the elbow is injured, the exercises need to be rehabilitation type, which is different than fitness exercise. Doctors often prescribe Physical Therapy because a therapist should know the gradually increasing exercises that achieve the goal of lasting recovery without a setback. While many videos exist online, there is no substitute for personal guidance. Once you learn these exercise you can do them yourself. 

Other non-operative treatments exist but are less commonly used. One promising intervention is Stem Cell Injection Therapy. Currently, this technique involves having your blood drawn and spun in a centrifuge. The provider injects a small volume of your own special stem-cells back into you at the site of the pain, and you grow new tendon in the damage zone. Stem cells can also be harvested from your fat or marrow. The use of Stem Cells is usually not covered by insurance, and the statistics of success are still not high enough for many people to be willing to pay out of pocket (costs hundreds to thousands of dollars).  Ask your doctor if you want to know the current trends.

Ultimately, surgery may be necessary for tendon injury at the elbow. There is a minimally invasive technique that requires a brief, light period of sedation and/or local anesthetic injection. The doctor introduces a special needle through your skin over the injured area and activates a device that either causes the tip of the needle to heat up and melt the damaged tendon, or it injects a pressurized water jet into the tendon to break up the scar tissue and cause the tendon to react by developing scar tissue to replace the damaged area. During this process, the surgeon may also use stem cells, described above.

The open surgical technique for Tennis or Golfer’s Elbow is well established and has an excellent success rate. The operation is not usually very long, involves little or no risk to nerves and vessels, and recovers rather quickly, although you may need a period of protection and rehabilitation afterward to give the tendon a chance to heal and the muscle groups time to recover. Basically, the surgeon opens the tendon and removes the bad scar tissue, the tendon is given a chance to grow fresh tissue in the place of the old, painful region, which is usually right where the pain was. In my practice, fewer than ten percent of patients with Tennis or Golfer’s Elbow go to surgery, and nearly every patient reports real improvement from the intervention. Return to sports and full activities is possible in most cases.

Summary

If you think you have Tennis or Golfer’s Elbow, try to identify the causes and address them yourself. Try to gently strengthen your muscled without overdoing it. Consider a brace and careful usage of medicines, if you can do so safely. If you do need orthopedic care, you may be discussing physical therapy and the other treatments described above. Know that if you have to go to surgery, the options in most cases are likely to be effective. Hopefully, you can continue to enjoy your active lifestyle, doing what you need or want to do. The specialists at NEOSM are there to help along the way.

6 Signs You Should See an Orthopedic

“Should I get this checked out?” That’s the question most of us ask ourselves when we’ve suffered an injury or have been experiencing some ongoing discomfort. It’s hard to know what you can let heal on its own and what needs the attention of a specialist. Consider, though, that waiting on treatment can create deeper issues and complications. To help, our orthopedics are sharing the tell-tale signs that it’s time for them to take a look.

Pain, Swelling, Discoloration, Loss of Motion Lasting More Than 48 Hours

Things don’t feel or look normal, and they don’t seem to be getting better.

Deformity 

Your joint or extremity is looking deformed, for instance a finger that is now crooked.

Locked Joint 

You have lost range of motion in a joint, such as your elbow, shoulder or knee.

Any Bone or Joint Injury with Broken Skin 

An open wound or break in the skin is visible in the area of the injured bone.

Over-the-counter Pain Medication Not Providing Relief

You’ve tried Tylenol or ibuprofen, but your pain has not been reduced to a tolerable level.

Unable to Bear Weight 

Standing or walking is painful, or nearly impossible

Any of the symptoms above could be a sign of a serious orthopedic issue that could get worse if not treated. If you think you, or someone you know, is in need of a consultation, reach out for an appointment with one of our highly trained specialists today. 

Is Knuckle Cracking Bad?

By: Doron Ilan, MD

Between 25-50% of people will crack their knuckles at some point.  In some of these people it becomes habitual. Parents across the world have been telling their kids (and spouses) “Don’t crack your knuckles. You are going to get arthritis!” Is this true? What is actually happening when someone cracks their knuckles? 

What happens when you crack your knuckles?

Our knuckle joints (metacarpo-phalangeal joints) are synovial joints. Meaning there are two cartilage covered bones that meet each other and are surrounded by a joint capsule which contains synovial fluid (lubricant). When our joints move normally the synovial fluid lubricates the ultra-smooth cartilage and the bones glide silently over each other. When someone pops their knuckle, the pressure exerted on the joint and synovial fluid forces dissolved gases out of the synovial fluid. This creates what is called a cavitation bubble. This forms very quickly and explosively. This cavitation bubble then pops. It is believed that the sound of knuckle cracking is due to the formation or popping of the cavitation bubble. This would be similar to either the opening of a champagne bottle (sound caused by formation of the bubbles) or popping bubble wrap (sound caused by popping the bubble). To this day, we are still not 100% sure which one it is. The thing we are sure about is that knuckle popping is not due to bone rubbing on bone or tendons popping.

Are all sounds coming from a joint due to gases?

No. In arthritis (loss of cartilage) you can get a crunching sound called crepitus as bone rubs on bone. Some people have loose joints and the joint can sublux or partially dislocate. A tendon can shift over a moving joint and cause a pop or clunk. A torn labrum (hip or shoulder) or meniscus (knee) can also cause popping in a joint. Note:  If you have pain associated with any noise from a joint you should consult your doctor.   

Is knuckle cracking bad for you? Does it cause arthritis?

This may come as a shocker to parents everywhere but there is no evidence that knuckle cracking is bad for you or causes arthritis. It is certainly annoying and there have been case reports where people tried to crack their knuckles with such force that they caused a sprain or fracture, but despite multiple studies it appears that routine knuckle cracking is safe. There was even one doctor (Donald Unger) who decided to do a study on himself. He cracked the knuckles on one of his hands for 50 years while not cracking the other. He found no difference between the two hands in the end.  

So go ahead and crack your knuckles.  Just don’t do it around me. 

For more from the experts at Northeast Orthopedics and Sports Medicine, feel free to contact us for a consultation.

Rise in eSports Injuries: What every gamer needs to know

Everyone knows a gamer, and chances are, it’s you. With over 164 million video game players in the US and three quarters of American households having at least one gamer, that’s a statement we can make pretty confidently.

The incredible growth of the eSports industry has cemented it as one of the biggest forms of entertainment around the world. Live gaming events bring in viewers in the hundreds of millions, and some colleges are even setting up gaming teams and offering eSports scholarships. But like any other sport, there are physical demands to achieve success as a formidable opponent.

The fact that many gamers are in a sitting position for 5-10+ hours each day while repeating the same motions with their wrists and hands is leading to an increase in cases of musculoskeletal conditions, particularly in pediatric patients.

What are common conditions associated with gaming and how can they be prevented and treated?

Common Conditions

Orthopedic surgeons, Sports Medicine professionals and Hand specialists are seeing an increase of the following conditions within the gaming community.

  • Tendonitis of the forearm muscles
  • Carpal tunnel syndrome
  • “Gamers thumb” (De Quervain’s Tenosynovitis)
  • Ulnar nerve irritation
  • Upper back and neck muscle pain
  • Poor posture, core weakness
  • Obesity and poor balance
  • Sciatica
  • Eye strain

Preventing Injury

Being sidelined due to injury can make your average gamer disgruntled, but for serious players on the eSports scene, it can mean the loss of huge winnings in major events. That’s why prevention is key to be able to complete at the highest level. Here are some tips:

Limit play time

  • The less you put yourself at risk of injury the better. Limit play time and take multiple breaks during a long gaming session. Parents and caregivers should determine an appropriate daily limit for video games for their children, and encourage alternative physical activity throughout the day.

Evaluate your set up

  • Make sure the equipment you use is as ergonomic as possible. This includes your chair, desk, keyboard and mouse. Blue light glasses can help with eye strain.

Exercise

  • Build core strength to support proper posture. Stretching loosens the muscles to reduce risk of kyphosis (rounding of the back). Stretch your wrists, fingers and thumbs before playing and during breaks. Go on walks, runs, swim or engage in other sports.  It is important in all sports (even eSports) to cross train. 

Don’t play through pain

  • Continuing to play video games while in pain will make the condition worsen and take longer to heal.

Treatment

Some serious conditions caused by continuous gaming may require surgery, but most can be treated through a combination of activity modification, ergonomic adjustments, physical and occupational therapy, massage, devices/braces and medical injections or prescriptions.

If you or someone you know is experiencing a gaming-related injury, the specialists at Northeast Orthopedics and Sports Medicine are skilled in providing the custom treatment plan you need to get back to the sport you love. Reach out to one of our offices to make your appointment today.

Hit the Pavement, Avoid Injury

With the weather turning warmer and warmer, the joy of taking an outdoor run is here. Taking in the fresh spring air and hitting the pavement or trail has never felt more freeing. Before venturing out, though, be sure to think ‘safety first’ in order to enjoy those runs well into the summer and fall. Here are some important precautions to follow from Healthline.com*:

  • Don’t wear headphones when running on roads. You need to be able to hear traffic around you and remain aware of your surroundings.
  • Run against traffic.
  • Follow all rules of the road. Look both ways before crossing a street.
  • Run in well-lit, safe areas. Wear reflective gear in the early morning or evening hours.
  • Bring water with you when you run, or run on a route with water available, so you can stay hydrated as you train.
  • Carry identification with you when you run. Tell a friend, roommate, or family member where you’re going.
  • Run with a family member or dog, when possible.
  • Wear sunscreen when running outdoors.
  • Run in loose, comfortable clothing and appropriate running shoes.
  • Switch out your running shoes every 300 to 500 miles.
  • Warm up before running and stretch afterward.
  • Cross-train once or twice per week to mix up your routine and keep your muscles challenged.

Should you find yourself in the unfortunately position of having an injury, be sure to pay attention to your body. Rest and seek medical attention if necessary. The skilled physicians at Northeast Orthopedics and Sports Medicine are here to provide treatment and get you back out on the road. Find the office nearest to you at neosmteam.com/locations.

*Source: https://www.healthline.com/health/average-mile-time#precautions

NEOSM Resumes Elective Surgery

We’re pleased to share that restrictions on elective surgery in our area have been lifted and all NEOSM surgical locations are now cleared for surgery. The team of skilled orthopedic surgeons at NEOSM are prepared to provide the surgical needs of our patients while maintaining the highest level of safety precautions.

Scheduling surgery

  • If you had a surgery scheduled and it was postponed, the NEOSM team will be contacting you to reschedule your procedure.
  • If you have recently seen one of our doctors and were indicated for surgery but did not schedule, please call your doctor’s surgery coordinator to schedule your procedure.
  • If you believe you need surgery, but have not scheduled a date previously, please call one of our offices for an appointment.

Please feel free to contact us with any questions.

Sincerely,

Northeast Orthopedics & Sports Medicine

6 Helpful Tips to Stay Active at Home

The benefits of physical activity are undeniable. Consistent exercise helps reduce your health risks,
strengthen your bones and muscles, and even reduce feelings of anxiety. With many gyms and exercise facilities currently closed, here are a few easy tips to help you stay active from home.

  • Set an intention for the day
    When you rise in the morning, set your goal for physical activity for the day. However big or small, identifying what exactly you’d like to accomplish will make it more likely for you to achieve it. It could be as simple as “I will take the dog for a 20-minute walk”, or more challenging like committing to a 40-minute workout. It’s up to you, just let yourself know and plan your day accordingly.
  • Take advantage of free resources
    If you have WiFi, you have access to a huge library of workouts for all fitness levels. YouTube is a great resource, and many home workout apps are offering free content, like Peloton, Nike and Planet Fitness. And it’s always free to go outside! Adding some fresh air to your physical activity helps clear your mind and connects you to the world around you.
  • Find a partner
    It’s easier to achieve your goals if you have a partner to motivate you and keep you accountable.
    Maybe someone in your home can join you on your walks, or you can text your friend your morning goals and have them check in on you. Any way you choose, having support makes all the difference.
  • Practice safety
    Aside from safe social distancing practices, make sure you take all the necessary safety precautions during your activity, like wearing your helmet during your bike ride, warming up your muscles before your workout and practicing good form when lifting heavyweights. You’ll hear many workout instructors advise you to substitute hand-held weights with household items. If you do, make sure to choose wisely and avoid items that could slip your grasp and cause an injury. Simply, be careful and move smartly to minimize your risks.
  • Don’t ignore an injury
    Be mindful not to aggravate a potential injury further. It’s common to feel muscle fatigue and soreness after a strenuous workout, but if you are experiencing acute pain or pain that won’t go away, you may need to be evaluated. The physicians at NEOSM are available for telemedicine appointments and our offices are open for necessary in-person visits. Don’t wait for an injury to get worse – we can accommodate same-day or next-day appointments, just call any of our offices to schedule.
  • Be kind to yourself
    The motivation you have today may not be the motivation you had yesterday and that’s ok! Be kind to yourself and commit to even the smallest amount of physical activity to help get your blood flowing. You never know, once you get moving, you may feel inspired to do more!

We hope these tips have inspired you to set your activity goals and get moving. Stay safe and stay healthy.