Watch Now: Rotator Cuff Injuries & Treatment

NEOSM’s Dr. Jason Fond sat down with Nyack Hospital to talk Rotator Cuff injuries and treatment. Check out the video for his expert presentation.

Click on the video below to watch the presentation.

To schedule a consultation with the experts at Northeast Orthopedics and Sports Medicine, give a call to one of our conveniently located offices.

When the Bones are Good: 5 Keys to Bone Health

You often hear “the bones are good” when people talk about the value of a house. It’s to say the structure is sound, that it can stand up to what it may face, that it can protect those who live there. Well, the same goes for when the actual bones in your body are healthy. They can protect you from falls and fractures, and support all the functions of your body.

Let’s talk about those bones. Did you know your skeleton rebuilds itself as we age? That right, about every 10 years, our bones regenerate where new bone tissue replaces the old. As we age, though, the amount of new bone can decrease, resulting in bone loss which leads to weaker bones, increasing the risk for fractures. Thankfully, there are proactive measures we can take to better balance the process and protect our bones.  

Understand your risks for bone loss

Many individual factors can affect bone density, namely age, family history, weight and related health issues. Age: The older you get the more bone loss is projected to occur. Women, in particular, experience rapid loss following menopause, putting them at risk for osteoporosis. Family History: Bone mass is determined by our genes, so it’s important for this and other reasons to have a good understanding of your family medical history. Weight: Overweight adults are at higher risk for falls which can lead to bone breaks, and being underweight can increase bone loss and risk of fractures. Health Issues: If you have diabetes, an autoimmune disease, or are taking medications that are known to cause bone loss, be sure to discuss your risks with your doctor.

Nutrition

The right combination of vitamins and nutrients is needed to promote healthy bones. We hear much about the importance of calcium for bone health, which is for good reason. Calcium is stored in our bones. When our body does not have enough to function, it will steal some from its storage in, you guessed it, the bones. So load up on green leafy vegetables and dairy products, and try supplements if you need increase your daily dosage. And grab some water instead of soda, specifically, since they decrease calcium absorption. Vitamin D is also super important, as it helps our bodies absorb calcium from our diets and build those strong bones. It’s hard to get enough Vitamin D through food, so look for supplements or help your body make some by sitting in some good sunlight – just don’t forget the sunscreen!

Exercise

Committing to regular physical activity is a key component to a healthy lifestyle and the benefits extend to bone health. Weight-bearing activity helps your bones become stronger and can slow down bone loss after menopause. Brisk walks, dancing, tennis, jump roping, even hopscotch! Exercise in all forms is good for your skeleton. Also, as you grow stronger and gain balance through activity, you decrease your risk of falls leading to fractures. So get out there and keep moving!

Lifestyle & Environment

We all know smoking and heavy alcohol use are no good for your overall health, so it is no surprise that both can reduce bone mass. In fact, nicotine actually suppresses bone-forming cells. There may also be other everyday risks right under your nose. Tripping hazards and obstacles can lead to accidental falls, so be sure fix that loose step or tuck that computer cord away, for instance. And adding safety features around the house, like a grip bar in the tub for instance, is never a bad idea.

Consult with your doctor

If you are at risk for bone loss, be sure to consult with your physician. A bone density test may be in order to determine if prescription medicine may be necessary to help protect and build up bone tissue. It’s better to be proactive, than try to make up for severe bone loss down the road.

We hope that with this guidance, you can make your bone health a priority. The specialists at NEOSM are here to answer any questions you have in your journey.

Source: American Academy of Orthopedic Surgeons/orthoinfo.org

Tiger Woods’ Injuries: Defining Terms and Procedures

The recent news of Tiger Woods’ horrific car accident has been startling. Watching the images of the aftermath, we see how serious the incident and the injuries sustained by the golf great are. While news outlets have been reporting on details of the necessary emergency orthopedic surgery, fans are growing more and more concerned, so we thought it would be helpful to provide some expert insight into the meaning of some common terms and procedures being reported.

High-Energy Trauma/Fracture

Injuries sustained where a large amount of energy or force are at play are considered high-energy traumas. Accidents involving a moving vehicle, like in the case of Tiger Woods, or a fall from a significant height are examples. These traumas result in more complex injuries that generally involve more tissue damage.

Open Fracture

An open fracture, historically known as a compound fracture, is a fracture in which the bone has broken through the skin of the area at the time of injury. Because the wound is open, there may be contamination at the fracture site that increases the risk of infection. Severity of the injury depends on the degree of contamination and extent of damage to soft tissues such as muscles, tendons, nerves, and blood vessels. Open fractures should always considered an emergency and treated immediately due to the increased risk of infection.

Use of Rods, Plates and Screws

When a fracture cannot be adequately treated with conservative measures, such as setting the bone and casting or splinting, surgery is indicated. In the case of open fractures, surgery is necessary to clean the area to minimize the risk of infection. Fractures treated in this way usually need to be stabilized with metal hardware, such as rods, plates and screws. This is called internal fixation. Nails or rods are inserted into the center of long bones, such as the tibia, for stabilization. These are most often used for fractures near the middle of long bones. Some fractures may require a plate and screws to hold the bones in place while they heal. In some cases, wires or pins are utilized to treat fractures in smaller bones. Depending on the case, pins and wires are usually removed once the bone has healed adequately. Rods, plates and screws are often not removed.

Compartment Syndrome

Fractures can cause bleeding and severe swelling, which can create excessive pressure within muscle compartments. If this occurs, this pressure can cause damage to muscle and other soft tissue within that compartment, which may be irreversible. This is called compartment syndrome. If this occurs, emergency surgery must be done to prevent this tissue damage. If not properly treated, this problem may lead to amputation. Treating this requires a procedure called fasciotomy, during which surgeons incise the covering of muscles (called fascia) to relieve the pressure from the injury. This release is commonly achieved through large incisions, which may heal together once swelling is reduced or may require skin grafting. Sometimes fasciotomy is performed if the injury is felt to have a high risk for developing compartment syndrome.

Until more information is released about the specifics of Tiger Woods’ injuries and treatment, it is hard to speculate on what his recovery will look like. The focus now is on successful healing from surgery and combating any complications, should they arise. Traumatic injuries are devastating to those who have had the unfortunate experience. We hope through the support of his family and all his fans, Tiger Woods will make a full and healthy recovery. We wish him all the best in his journey.

To learn more about the orthopedic trauma specialists in our practice, visit our NEOSM physician profiles.

Preparing Your Home for Knee Replacement

Knee replacement surgery can really be life-changing. Eventually, majority of patients are able to resume daily activities with considerable less pain and discomfort. Before and immediately after surgery, it’s important to follow your physician’s instructions carefully to avoid unnecessary setbacks. One key direction from our surgeons is to create a home environment focused around healing and recovery before your scheduled procedure to help set you up for success. The American Academy of Orthopedic Surgeons recommends you consider the following to prepare your home for your return.

Arrange for help at home from a family member, friend or caregiver for days or weeks after surgery.

Clear or arrange furniture so you can easily make your way with a cane, walker or crutches.

Plan for avoiding stairs. Consider moving your sleeping quarters downstairs, if you are able.

Remove any tripping hazards. Throw rugs or area rugs, electrical cords and clutter, for example, can be dangerous during recovery.

Make sure you have a good chair with a high seat and a footstool for elevation.

Have a shower chair and gripping bar set up in the bathroom.

Set up a “recovery center” – an area where everything you need most often are at your fingertips, like a table by your chair with your medications, tissues, water pitcher, phone, etc.

These simple planning steps not only provide a safe environment for your recovery, but they also grant you a huge amount of peace-of-mind, which you’ll appreciate once you are discharged.

If you have any questions about these tips, or knee replacement surgery in general, give us a call, the specialist at Northeast Orthopedics and Sports Medicine would be happy to provide answers.

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.