Within these times of uncertainty, we at Northeast Orthopedics and Sports Medicine (NEOSM) are grounded more than ever in the principles of health care. It is our role always to prioritize the safety and well-being of our community, and to provide exceptional care with compassion and respect. This commitment is unwavering, and it is our promise to you. It is for that reason that our offices will remain open for patients requiring in-person visits, with the option of telemedicine visits for patients to be consulted from home.
As we all face the effects of COVID-19 (coronavirus) throughout our region, I would like to ensure you that NEOSM is taking the necessary precautionary measures to make certain all our patients are able to receive world-class orthopedic care in a safe manner. You can read more about the actions taken at this link.
On behalf of our dedicated physicians and staff, I’d like to thank you for trusting NEOSM for your care. Please continue to practice social distancing and disinfecting, so we may all protect not only ourselves but those most vulnerable around us.
As dedicated healthcare professionals, all of us at Northeast Orthopedics and Sports Medicine (NEOSM) are committed to the health and well-being of our patients, staff and community. During the current spread of the Coronavirus (COVID-19) in our area, our focus on safety is even more paramount. We have taken the following measures to ensure that all those in need of immediate orthopedic care are able to be consulted while limiting unnecessary exposure to others.
Visitor Policy:
All NEOSM offices are open for orthopedic appointments for patients who need to be seen in person. Priority scheduling (first hour of day) is available for older patients and those immunocompromised. Only the patient is permitted to enter our offices. If the patient requires assistance or a parent (for minors), the accompanying visitor must be in good health. All patients and visitors are required to wear a face-covering.
All visitors are pre-screened for any signs of illness or contact with coronavirus. Those who do not pass our pre-screening will be restricted from our office. All non-essential visitors are not permitted.
In-Office:
We are limiting the number of patients and staff in each office. In our waiting rooms, we have separated chairs to allow proper distancing and are providing the opportunity to wait in your car until your doctor is ready for your visit. We are also providing the option to fill out forms online prior to visiting and minimal wait times to see a doctor.
All staff are in proper Personal Protective Equipment (masks, etc) and all staff sanitized hands before and after each patient. All patient areas are wiped down/sanitized after each patient. Hand sanitizer is available throughout our offices for use.
Telemedicine Appointments (Virtual):
We are offering all patients the opportunity to consult with our physicians virtually through telemedicine appointments. Just call our office as you would to make a regular appointment and this option will be available. A web link will be sent to you to access the virtual appointment. All you need is either a smartphone, tablet or computer, with a camera and the microphone enabled. Telemedicine appointments are covered by insurance as a regular visit and all referrals, etc, would remain the same. Click here to learn more about Telemedicine.
We will continue to monitor the evolving situation and regulations in place during this time. We encourage you all to continue to practice social distancing, regular hand washing and sanitizing, and to remain up-to-date on and adhere to your local guidelines.
The rotator cuff is a group of 4 muscles and tendons around the shoulder joint. The shoulder joint, like the hip joint, is a ball-and-socket joint. But unlike the hip joint, the ball is not constrained by the shape of the socket. The result is that the shoulder joint is capable of a greater degree and freedom of motion. The rotator cuff acts as a dynamic stabilizer of the shoulder joint, keeping the ball relatively centered in the socket as the shoulder “rotates.”
The 4 rotator cuff muscles are:
Supraspinatus
Infraspinatus
Teres Minor
Subscapularis.
The rotator cuff is subject to stress and injury from a variety of sources, ranging from shoulder dislocation to degeneration that occurs over time from use.
Symptoms and Diagnosis of Rotator Cuff Problems
There are many different ways that the rotator cuff can cause problems. These problems may also involve other associated structures, like the biceps tendon. Neck disorders, such as herniated discs, may also cause symptoms of shoulder pain. Symptoms that patients experience related to rotator cuff problems include pain, stiffness, weakness, and clicking or popping when moving the shoulder. Rotator cuff problems may or may not be caused by an injury. In some cases there is pain and inflammation, but no structural damage. In other cases, there may be structural damage to the rotator cuff. Making an accurate diagnosis requires obtaining an accurate history, performing a physical examination, and usually obtaining some imaging studies. Plain X-rays are very useful initially. Advanced imaging, such as ultrasound or MRI, may also be recommended. Once an accurate diagnosis is made, an individualized treatment plan can be constructed.
Impingement Syndrome
The supraspinatus tendon of the rotator cuff lies at the top of the shoulder joint, directly below a projection of the shoulder blade, or scapula, called the acromion. When the arm is elevated overhead, the space between the acromion and the ball decreases, thereby putting more pressure on the supraspinatus tendon and the bursa that overlies it. This can frequently cause inflammation that is painful. This problem is called “Impingement Syndrome,” and is one of the most common causes of shoulder pain. Pain caused by inflammation of the rotator cuff is generally treated with therapeutic exercise, which may be done at home and/or under the direction of a physical therapist, and some form of anti-inflammatory medication. Cortisone injection may be required to alleviate pain, and in some cases, surgery may ultimately be necessary.
Image credit: rehabmypatient.com
Rotator Cuff Tears
In addition to causing pain from inflammation, the rotator cuff may also be damaged, or torn. Small, partial thickness tears of the rotator cuff are generally treated in a similar way to inflammation. A full-thickness tear, in which the tendon is detached completely from the bone, can range in size from small to massive, and is more likely to require surgery to repair. Rotator cuff repair surgery requires that the tendon be reattached to the bone. It can be performed with traditional open surgery, or with minimally invasive arthroscopic surgery. Recovery time varies, but usually requires at least 3 months, and physical therapy.
Full Thickness Rotator Cuff Tears
Full thickness rotator cuff tears increase in size over time, and patients do not always have symptoms as this occurs. When a rotator cuff tears gets larger, the mechanics of how the shoulder joint moves changes, putting more stress on the cartilage surfaces in the joint. This may eventually cause the development of arthritis in the joint, which can itself be painful and disabling. If a patient has a large chronic rotator cuff tear that has caused arthritis in the joint, several treatment options exist. Physical therapy may help restore range of motion and strength. Medications can alleviate pain when needed. There are several types of injections that can be performed, including cortisone, for relief of symptoms. Hyaluronic acid, or “gel” injections, can also be used for symptomatic relief. These are more commonly used for the treatment of osteoarthritis of the knee. Other injections, such as platelet-rich-plasma (“PRP”) and stem cell injections are currently considered experimental for treatment of rotator cuff disorders and arthritis. The last resort for treatment of this problem is a type of shoulder replacement called a reverse total shoulder replacement.
At Northeast Orthopedics and Sports Medicine, our physicians have the knowledge and experience to diagnose and treat the full spectrum of rotator cuff disorders, using the most advanced and minimally invasive techniques, including an array of non-surgical treatments. If you think you have a rotator cuff problem, schedule a consultation with one of our talented physicians for an evaluation and treatment plan today.
With generous contributions from our staff and physicians, Northeast Orthopedics and Sports Medicine is proud to have donated an incredible amount toys and pantry items in support of the East Ramapo Central School District (ERCSD) Family Center. Donations will be distributed to those in our community in need this holiday season. A big THANK YOU to all for making this season a bit brighter for our neighbors!
Northeast Orthopedics and Sports Medicine is beyond proud to announce that twelve of our physicians have been named Top Doctors by Hudson Valley magazine. Congratulations to our doctors for this recognition of their commitment to exceptional care!
October is Breast Cancer Awareness Month and NEOSM is proud to celebrate survivors, bring awareness to early detection and support research efforts to find a cure.
On October 18th, our staff participated in our ‘Pink for Hope’ day by proudly wearing pink and contributing to the American Cancer Society. We’re so thankful for their show of support!
Together, we stand behind all the mothers, daughters, sisters & friends who are survivors or soon-to-be survivors!
Tennis and golf are two of the most popular sports, especially amongst adults. As enjoyable as they are to play, overuse can lead to pain of the elbow, commonly called Tennis or Golfer’s Elbow. Both tennis and golfer’s elbow are very common and affect both men and women, mostly between the ages of 40 to 50 but can occur at any age. It can also arise from activities not related to sports, such as household chores or work that requires repetitive gripping, like painting, but can also occur form a traumatic injury, such as a blow to the elbow.
Symptoms
Pain with activities such as lifting, gripping and grasping that starts in the elbow but often radiates down the forearm to the hand.
Diagnosis and Treatment
The diagnosis of tennis or golfer’s elbow is usually made clinically by a thorough history and physical examination by your doctor. Sometimes your doctor may order different images such as X-Rays or MRIs to rule out other conditions.
Prevention and Treatment
Activity Modification
If the pain is from playing tennis or golf it is often recommended that you be evaluated by a tennis or golf professional to make sure you are using proper equipment and have proper technique.
Rest & Ice
It may be necessary to stop the aggravating activity all together, for a period of time to allow the soft tissues to heal. Try to avoid heavy lifting, pushing, pulling or repeated hand shaking. Using two hands for heavier lifting can help protect the injured arm. Apply ice 2 to 3 times a day for 15 to 20 minutes at a time when the condition first starts or after actively using the arm to help diminish the inflammation.
Stretching
Stretching can help with tendonitis by keeping muscles and tendons flexible and preventing stiffness. It can also help break down scar tissue that may have formed.
Physical/Occupational Therapy
Therapy can help in many ways. Initial treatment is aimed at diminishing inflammation and stiffness while subsequent treatment helps strengthen forearm muscles, which can help prevent future episodes from occurring.
Medications
If there are no medical contra-indications, over-the-counter pain medication, like Advil, Aleve or aspirin, can be taken to help reduce inflammation and pain.
Bracing
The counter-force brace is a padded strap that can be worn on the forearm, just below the elbow. By putting gentle pressure on the muscles, tension is released on the tendon. Bracing can be used for treatment and can be used to prevent recurrence in the future by wearing for all activities that put a lot of stress on the arm.
Cortisone Injections
Cortisone injections usually reduce the pain in the arm for an extended period of time but do not always diminish the time it takes for the elbow to fully heal.
Platelet Rich Plasma (PRP)
PRP is a procedure where blood is withdrawn and then is processed to concentrate the platelets so they can be re-injected into the area of tendonitis. This procedure can usually be done in the office. This is a newer technique and research on this treatment modality continues.
Surgery
Surgery is the last resort. If conservative treatment fails and symptoms have been present for at least a year then surgery can relieve the pain. The aim of surgery is to remove degenerated or worn out tissue from the tendon and release tension on the tendon. Symptoms can take several months to fully resolve and a small percentage of people may still have some symptoms, even after surgery.
Prognosis
Most cases of tennis and golfer’s elbow will resolve with conservative care but can take a long time to fully resolve.
If you have been suffering from symptoms of golf or tennis elbow, schedule a consultation with one of our talented physicians for an evaluation and treatment plan.
Once again, NEOSM has had the honor to support the amazing team at the East Ramapo Central School District Family Resource Center by providing school supplies and backpacks for the children of our community. Our physicians and employees contributed a countless number of back-to-school basics that are necessary for the students in our area to succeed. We wish all of them a wonderful year full of learning!
A special THANK YOU to the ERCSD Family Resource Center for all that they do throughout the year!
