Preventing Gardening Injuries

For most of us who enjoy gardening, it is a relaxing, safe hobby.  However, every year we see many people who are needlessly injured in their backyards. Nationally more than 400,000 gardening injuries are seen in the ER every year.

By: Dr. Doron Ilan

For most of us who enjoy gardening, it is a relaxing, safe hobby.  However, every year we see many people who are needlessly injured in their backyards. Nationally more than 400,000 gardening injuries are seen in the ER every year. Back injuries, hand lacerations/puncture wounds, infections, overuse tendinitis, bug bites, and heat exhaustion are some of the more common medical conditions seen in recreational gardeners. Here are a few tips to keep you safe this spring and summer.

  • Warm up: One of the most common mistakes is to head straight to the shed and start lifting heavy bags of mulch, soil, and equipment. This can lead to back sprains and muscle strains.  Instead, first, take a 5-10 brisk walk to warm up the muscles, loosen the joints and get the heart rate up a bit.
  • Wear gloves: This will prevent most thorn punctures, blisters, lacerations, and bug bites. It will also protect your skin from pesticides, bacteria, and fungus (often live in soil). A small cut can lead to a major infection. A light long sleeve shirt and long socks or pants can’t hurt either.  Don’t forget the sunscreen and a hat.
  • Hydrate: It is very easy to spend hours gardening without drinking. Bring a bottle of water outside with you and sip regularly
  • Rotate your tasks: Avoid overuse repetitive stress injuries by not spending more than 10-15 minutes in a row doing the same motion. Make sure your gardening activities are varied so that the same muscles are not used repetitively.
  • Use proper equipment
  • Check your skin for ticks after you finish gardening for the day. Lyme disease and other tick-borne infections are very common in our area.

Following these tips can help minimize your risk, but of course, if you do sustain an injury make sure to get medical attention as soon as possible.  Have a great spring and summer — and enjoy your gardening!

If you do encounter an orthopedic injury while gardening, contact us today to find out what’s wrong and how we can help.

5 Simple Stretches for Sciatica

Sciatica can be a real pain in the back, among other things.

Also known as lumbar radiculopathy, sciatica (pronounced sci-at-ick-aa) is a term used to described a series of symptoms—most notably, pain—that occurs when the sciatic nerve is irritated. This large nerve runs from your lower back, past the buttocks and down each leg.

Sciatica is currently estimated to be the cause of low back pain in five to 10 percent of Americans.

What are some stretches to alleviate sciatica symptoms?

The beauty of creating a routine to manage your sciatic pain is that it also serves as a way to prevent sciatic pain and other symptoms from making a reappearance. In fact, though it may seem unlikely (or unpleasant), exercising actually helps to improve symptoms better than bed rest.

One of the forms of exercise to help relieve sciatica is performing stretches that externally rotate the hip. Here are five stretches that do just that:

  1. Reclining Pigeon Pose
    • While lying on your back, bring your right leg up to a right angle. Grip both hands behind the thigh and lock your fingers.
    • Lift your left leg and place your right ankle on top of the left knee.
    • Hold the position for a moment, then repeat with the other leg.
  2. Sitting Pigeon Pose (to be done once the reclining pigeon pose can be performed with ease)
    • Sit on the floor with your legs stretched out straight in front of you.
    • Bend your right leg, putting your right ankle on top of the left knee.
    • Lean forward and allow your upper body to reach toward your thigh.
    • Hold for 15 to 30 seconds.
    • Repeat on the opposite side.
  3. Knee to Opposite Shoulder
    • Lie on your back with your legs extended, and your feet stretched upward.
    • Bend your right leg and fasten your hands around the knee.
    • Lightly pull your right leg across your body toward your left shoulder. Hold it there for 30 seconds.
    • Push your knee so your leg returns to its starting position.
    • Repeat for a total of three reps, and then switch legs.
  4. Sitting Spinal Stretch
    • Sit on the ground with your legs stretched straight out with your feet arched upward.
    • Bend your right knee and place your foot flat on the floor on the outside of your opposite knee.
    • Place your left elbow on the outside of your right knee to help you gradually turn your body toward the right.
    • Hold for 30 seconds and repeat three times, then switch sides.
  5. Standing Hamstring Stretch
    • Place your right foot on a raised surface at or below your hip level. Flex your foot so your toes and leg are straight.
    • Bend your body forward slightly toward your foot (without feeling pain).
    • Release the hip of your raised leg downward as opposed to lifting it up. If you need help easing your hip down, loop a yoga strap or long exercise band over your right thigh and under your left foot.
    • Hold for at least 30 seconds, and then repeat on the other side.

New Games: 7 Tips for Transitioning From Winter Sports to Spring Sports

Spring sports and winter sports are similar: They require strength, speed, skill, agility and sweat. But while they both depend on these attributes, they have their own preparations and demands.

From playing surfaces to equipment to the stresses incurred by varying body parts, these changing needs require a winter-to-spring transition for athletes and fitness enthusiasts. This is particularly critical for younger athletes whose bones and joints are still developing, and who may be inexperienced at switching between sports seasons.

Safely transitioning sports is often a matter of experience. Many athletes—from recreational to professional—have learned through trial and error how to adapt to their activity, both for athletic improvement and injury prevention.

Below are some of the techniques they have used and you can use to make the smoothest transition possible between spring sports and winter sports:

1. Get a pre-season physical

Many sports require a pre-season physical for youth athletes as a rule of participation, but everyone should consider having a check-up. This will help to identify any potential health or injury risk, and in so doing, ensure you are ready to play.

2. Have a lesson or two

If you’re new to the spring sport or just rusty, consider investing in a lesson or two from a professional, such as a coach or a trainer. This will start you off on the right foot as proper technique aids both good performance and injury prevention.

3. Build up to the activity

Ideally, you want to do some pre-season conditioning and preparation relative to your spring sport. However, that conditioning can also be acquired by slowly acclimating to your new activity. If you’re not in shape in general, the best approach is to partake in some form of fitness prior to the season.

4. Invest in the proper equipment

Different sports mean different gear. Make sure you get the best gear for your spring activity. That includes sports equipment and attire. Constantly improving technology has resulted in clothing made of the most advanced sports performance fabrics.

5. Break in your equipment

Whether it is new shoes or getting accustomed to a racquet or glove, avoid discomfort such as blisters or foot and ankle problems by ensuring your gear is fully ready to use.

6. Remember general sports principles

Switching from one sport to another is no reason to change good habits. You can also use the new season to acquire them:

  • Always warm up and cool down
  • Drink plenty of fluids (but don’t overhydrate)
  • Don’t overdo your activity
  • Rest/recover between sessions

6. Protect your skin outside

Spring means enjoying the outdoors. An under-considered aspect of outdoor sports is the need for skin protection. Whether you’re young or older, whether it’s sunny or cloudy (the sun’s rays come through the clouds), apply sunscreen early and often, particularly if you perspire. Make sure children do so, as well. Now is a good time to educate them on skin safety.

Come to the Sports Medicine Specialists

If sports-related injuries do occur, our physicians at Northeast Orthopedics and Sports Medicine have years of experience in effectively treating all orthopedic conditions. Our multidisciplinary approach to care ensures that patients receive the customized treatment they need to get back in the game.

For more information on sports medicine or to schedule an appointment with one of our sports medicine specialists, contact us today.

The Multipurpose, Multigenerational Benefits of Strength Training

Once upon a time, people got strong with the lifting, bending and squatting of regular physical labor. This was true whether people worked in the kitchen, the fields or the factory. Today, in a sense, we make up for the lack of physical labor with strength training.

Strength training is a tremendous asset. Experts from multiple fields highly recommend it, and they attest to the proven benefits of this training for everyone from youth to seniors. For young people, it can protect them from sports injuries and also establish good lifelong habits. And for the older, it can help counter the natural loss of muscle mass.

Strength Training Defined

Strength training is a method of improving muscular strength by an increased ability to resist force. This resistance stimulates muscle strength. Strength training can be done with a person’s own body weight (e.g., push-ups, squats, lunges), free weights or machines, all of which stimulate muscle strength. Strength training builds anaerobic conditioning and contributes to coordination and balance.

The benefits of strength training are numerous. Strength training:

  • Enhances daily activities and task performance, by lessening the risk of falls
  • Enhances exercise/sports ability and performance by improving strength, speed, power and endurance
  • Prevents exercise/sports injuries by protecting bones and joints, improving alignment and balancing the strength of lesser-used muscles
  • Promotes weight management, burning calories while increasing metabolism
  • Strengthens bones as stress increases bone mass

Now that the major “why’s” of strength training are established, below are tips to optimize your efforts:

  1. Talk to your doctor. Generally, it is a good idea to consult your doctor before undertaking any exercise program.
  2. Welcome the work. Strength training is meant to be challenging; that’s why it works! So create the conditions that will assure your success.
  3. Consider a coach. Whether building or refreshing a program, an expert coach or trainer can be an important asset, even for just a session or two.
  4. Make it doable. Chose a place, time and type of program that will realistically work for you. A regular, consistent routine is the key goal.
  5. Practice proper habits. Form, breathing, rest between sets … It is important to adhere to proper technique.
  6. Work your way up. Strength training should progress. While you want to start easy, and not overdo it, don’t stick with the same routine indefinitely. It should get more difficult.
  7. Warm up. Warming up raises your body temperature and sends blood to the muscles to prepare for your session. This means a more efficient workout.
  8. Cool down. Winding down with a gradual recovery helps your heart rate and blood pressure return to normal, which can help prevent muscle soreness and/or stiffness.

So, hit the gym, the park or the living room. The beauty of strength training is that you can craft a program that’s doable anywhere. And the rewards are great!

Preparing for Preseason Training: A Guide to Getting Back on the Field Safely

It won’t be long before crisp weather, falling leaves and cheers from the stadium are upon us. Autumn is fast approaching, which means that preseason training for the season’s traditional sports—such as football and soccer—is just around the corner.

The question is: After spending the summer relaxing, how do you properly prepare for preseason to avoid being injured before everything officially kicks off?

The answer: adequate preparation.

That said, here are some tips to help you gear up for the brisk but brutal preseason training awaiting you:

Go for a physical

Having a physical before preseason starts ensures that you’re healthy and ready to play. If something hurts, have it checked out by a physician. Failure to do so could result in serious injury later on during the season.

Get your body moving

Master the art of fundamental moving patterns, such as squatting, jumping and kicking. This creates a solid foundation for your body to build upon. Agility, flexibility and strength do not develop overnight. The sooner you start, the sooner you’ll see results. For example, try alternating intervals of hard sprints with light jogging. This will teach your body proper balance and endurance for running longer distances (which will come in handy when you have to motor down the field).

If you’re not sure where to begin, talk to your physician or coach to learn suitable training techniques.

Take care of your body

Eat well, sleep well and keep consistently hydrated before, during and after preseason training. Pack on the fruits, veggies and lean meats. Make sure you get eight to 10 hours of solid shut-eye. Keep water on you—and in you—at all times to avoid dehydration.

Remember: A well-balanced body is a well-performing body.

Assess, assess, assess

Get assessed by a trained professional—such as a strength/conditioning coach or physical therapist—to ensure your body is balanced with functional movement. If imbalance or dysfunction occurs, a professional can give you the proper techniques you need to correct the problem before it leads to injury.

On a similar note, make sure that all sports equipment fits well (including footwear); ill-fitted equipment can result in accidental injury during the season.

By following these tips, you’re sure to kick start a safe and fantastic season, on and off the field.


Come to the Sports Specialists 

At Northeast Orthopedics and Sports Medicine (NEOSM), our team of orthopedic physicians specializes in all aspects of sports medicine, including comprehensive diagnosis, treatment and preventive care of sports-related injuries. As a practice, we are committed to utilizing the latest advancements to ensure patients receive the highest quality of care possible.

Swimming and Cupping: Is Michael Phelps Onto Something?

Michael Phelps entered the pool deck at the Rio Olympics, stripped down for competition, and characteristically slapped his arms and shoulders immediately before his race. But the eyes of the world were on something even more conspicuous than the time clock and his medal count. Those millions of viewers noticed bruises the size of baseballs decorating his strong shoulders. The marks might have led one to think his bouquet of medals smacked him.

But the bruises Phelps sported come from cupping, or suction cup therapy, a training modality that Phelps has used in his routine for the past couple of years. Cupping is an ancient therapy that has been around for thousands of years, originally practiced by Chinese, Egyptian and Middle Eastern cultures. Cupping’s origins were to pull toxins out of snakebites and infections. In the case of athletes in contemporary times, however, it is used to promote blood flow, relieving pain and swelling. In turn, this leads to an easing of muscle soreness. Outside of sports, cupping is also used to alleviate acne, shingles, breathing problems, arthritis, congestion, asthma and the common cold, among other conditions.

In an article on, the author contends that although the benefits of suction cup therapy for swimmers are not yet scientifically proven, athletes and therapists report the following advantages:

  • Improved blood flow
  • Improved flow of lymphatic system
  • Improved muscle flexibility
  • Pain relief
  • Reduced inflammation
  • Relief from tight muscles
  • Stress relief

How does cupping work?

Trainers (or therapists) heat or pump air into glass (or sometimes silicone) cups in order to create suction on the skin and pull it away from the underlying muscles. The cups remain on the skin for five to 10 minutes. Initially, the process results in a tight feeling and may be uncomfortable when the cups are pulled off the skin. Others find the procedure pleasurable, like a deep massage. The resulting cupping marks (e.g., Phelps’ bruises) heal in a few days to a week.

In addition to Michael Phelps and a number of other swimmers who displayed evidence of cupping in Rio, the U.S. men’s gymnastics team also uses the system. The American gymnast Alexander Naddour spoke about the procedure in his Rio interviews, mentioning that he regularly employs cupping, even using a do-it-yourself method.

Is cupping effective?

Several small studies have generated mixed results. One review compiled in 2012 of 135 cupping studies determined that the technique might have some benefits, particularly in the case of alleviating muscle tension. However, the review pointed out that most of those studies had basic flaws.

A recent New York Times Wellness blog quotes Leonid Kalichman, an Israeli academic who co-authored a review of cupping. He mentioned it is possible that those who undergo cupping experience a placebo effect. However, he endorses the possible physiological effect, as well. He speculates that it may be the case that cupping triggers a process that produces cytokines, small proteins that play a role in the immune response.

In any event, experts say the procedure is relatively safe. The only potential side effects include:

  • Burns
  • Bruises
  • Mild discomfort
  • Skin infection

Michael Phelps may have grabbed the Rio headlines, but the first buzz among contemporary world-class swimmers who employ cupping dates back to when Australian Olympic gold medalist Grant Hackett sported cupping welts on his back at the 2004 Games. American multi-time Olympic medalists Natalie Coughlin and Nathan Adrian have also sported cupping bruises. Cupping is growing in popularity in swimming circles, such as its recent adoption by prominent college swim programs.

So, is cupping worth a try? If Michael Phelps does it, it’s guaranteed there will be followers. After all, who can argue with history? He has a record 28 Olympic medals, including 23 golds…and counting!


At Northeast Orthopedics and Sports Medicine (NEOSM), our sports medicine specialists provide outstanding care and medical support for sports-related injuries. We can help athletes of all ages and activity levels develop a customized treatment plan. For more information or to schedule an appointment, contact us today.

What Happened to My Ankle? How to Tell the Difference Between a Break and a Sprain

With the warm weather enticing you to join the outdoors and frolic through summer, injuries are bound to happen, even to your unsuspecting ankles. From seasonal sports to harmless gardening, an ankle injury can emerge from any number of situations, including:

  • A motor vehicle accident
  • Tripping over something or falling awkwardly
  • Twisting, rolling or rotating the ankle in an uncomfortable way

When an unsuspecting ankle injury occurs, knowing what kind of ankle injury will play a pivotal role in getting you back on your feet. To determine whether your ankle is broken/fractured or sprained depends upon whether you damaged the bone or the tissue. Let’s decipher how to tell the two apart…

Sprain Versus Fracture

 Ankle Sprain: When a sprain occurs, one or more of the ligaments in the ankle become severely overstretched or even torn. (A ligament is a fibrous tissue that helps hold the ankle together.) 

Ankle Fracture: A fracture is a break in a bone. With regards to the ankle, the bones that make up the top ankle joint are typically the most prone to fracture. These include the shinbone (tibia), the anklebone (talus) and the bone of the lower leg (fibula). 

With definitions in tow, determining which ankle injury you’ve suffered can be tricky at best. Here are a couple of questions to consider after injury has occurred:

  • Does the pain seem to radiate from the soft tissues surrounding the ankle but not over the bone? It’s probably a sprain.
  • Is the pain over the anklebone? That may be an indication of a break.
  • Are you unable to put pressure on it or walk? It is possible that the ankle is broken.

If the injury is still unclear or if you are hesitant to rush to the doctor, it may not hurt to carefully observe and lightly treat the injury utilizing the R.I.C.E. method of treatment and assessment:

  • Rest the ankle
  • Ice the ankle to reduce swelling and pain
  • Compress the ankle with an air cast or bandage wrap to stabilize and immobilize the ankle
  • Elevate the ankle until it’s level with the heart to help decrease pain and swelling

If, after two to four days of the R.I.C.E. method, you still have a hard time moving or putting pressure on the ankle, a visit to an orthopedist is in order. This is also true if dark blisters or bruises have developed. Once the orthopedist diagnoses the injury, treatment can begin.

Treatment for a Sprained Ankle

Treatment for a sprained ankle depends on the severity of the injury, which can be graded as mild (Grade I), moderate (Grade II) or severe (Grade III):

  • Mild sprains are typically healed utilizing the R.I.C.E. method combined with range of motion, strengthening and stretching exercises
  • Moderate sprains are also treated with the R.I.C.E. method, but for a longer period of time. A physician may use a soft cast or a splint to immobilize the ankle and prescribe range of motion, strengthening and stretching exercises. Physical therapy may also be suggested to restore full motion and use of the ankle
  • Severe sprains are a full tear or rupture of a ligament. When this occurs, the ankle must be fully immobilized and requires a longer period of physical therapy. In some cases, surgery may be required to repair the tear 

Treatment for a Broken Ankle

Fractures may be treated surgically or non-surgically depending on the injury. If the ankle is stable, only one bone is broken and the bones aren’t out of place, the ankle may simply be immobilized with a splint or cast.

However, if the ankle is unstable, surgery is required to reinforce it. During the procedure, a metal plate and screws are used to hold the bones in place. Then, the ankle is positioned in a splint. Once the swelling goes down, a cast is utilized for several weeks as the ankle heals.

It is important to remember that, regardless of whether you suspect a sprain or a break, if often requires an orthopedist to accurately diagnose your condition.


Comprehensive Ankle Care in New York 

At NEOSM, our physicians have years of experience in effectively treating all orthopedic conditions and injuries, including those of the foot and ankle. Our multidisciplinary approach to care ensures that patients receive the customized treatment they need to get moving again.

For more information on ankle injury or to schedule an appointment with one of our specialists, contact NEOSM today.

The Low-Down on Little League Elbow

With baseball season officially upon us, injuries are inevitable. (Much like allergies.) In fact, doctors see an increase in elbow conditions among young baseball players during this time. One of the most common elbow conditions is medial epicondylar apophysitis, generally known as Little League elbow.

What is Little League elbow?

Little League elbow is categorized as an overuse injury (injury sustained to a part of the body from a repeated action) that affects a growth plate found on the inside of the elbow. Growth plates are easily injured on children. Damage to growth plates can result in the improper or misshapen growth of the bone.

Who gets Little League elbow?

Little League elbow is most frequently found in pitchers but has also been seen in outfielders, infielders and catchers. It typically occurs in children between the ages of 8 and 15, and may even be seen in adolescents as old as 17 (if the bones haven’t finished growing).

This condition is directly linked to a certain number of throws each week, including games and practice time. The general guidelines are as follows:

  • 75 pitches a week for 8 to 10 year-olds
  • 100 for 11 to 12 year-olds
  • 125 for 13 years and above

The injury typically occurs when a child exceeds the number of throws for his/her age range. Little League elbow is especially prominent in baseball players who participate in the sport year-round, as well as those who play for more than one team.

What are the symptoms of Little League elbow?

A child should stop playing immediately if any of the following symptoms appear during or after a game/practice:

  • Aching or sharp pain on the inside of the elbow
  • Locking of the elbow joint
  • Restricted range of motion
  • Swelling of the elbow

How is Little League elbow treated?

In the majority of cases, Little League elbow can be effectively managed with conservative treatment, which is done in three stages:

Rest. It is initially recommended that all throwing activities cease and the elbow be allowed to rest. Ice and nonsteroidal anti-inflammatory medication (i.e., Aleve®) can help relieve swelling and pain.

Rehabilitation. Your child’s doctor may recommend physical therapy exercises to help heal the injury and prevent it from reoccurring. This may include range of motion and strength exercises for the forearm, upper arm, back and shoulder.

Return to play. Children may return to playing when the pain is completely gone and they have full range of motion. This should include a gradual change over time from non-throwing positions (such as a designated hitter) to full throwing positions, like pitching.

As a treatment, surgery is rarely necessary. In such cases, it is only designed for girls over 12 and boys over 14. Depending on the type of injury the child sustains, surgery may include:

  • Bone grafting to replace missing bone from the elbow
  • Reattaching a ligament
  • Removing loose bone fragments that tore away from the growth plate due to a detached ligament or tendon

How can Little League Elbow be prevented?

Though there is no 100 percent guarantee that Little League elbow can be prevented, a child’s risk may be reduced considerably by taking the following precautions:

  • Always warm up before throwing
  • Avoid certain types of throws, such as curve balls and breaking pitches until the age of 14. (With these types of throws, it is difficult to successfully execute the spin the ball requires. Children compensate for their inability to hold the ball properly, resulting in awkward twisting of the arm and elbow)
  • Count pitches to ensure a safe range (the coach should count, too)
  • Avoid playing other full-throwing positions on pitching days
  • Stop playing if pain occurs and see a doctor as soon as possible
  • Rest for a solid 24 to 48 hours after playing, including practice

For information on Little League elbow or other overuse injuries, or to schedule an appointment with one of our sports medicine specialists, contact Northeast Orthopedics and Sports Medicine today.