Swimming – The Ultimate Exercise

The way we workout is a personal choice. Some people love running out on an open path, others can bike all day long, some swear by their Pilates class, while Zumba may be the first choice for others. Since it’s a preference, is it possible to crown the best exercise out there? We say ‘yes!’ and that the #1 choice for physical exercise is… swimming! Let us tell you why and we’re sure you’ll agree.

Open for All Fitness Levels

Aside from knowing how, there is no barrier of entry to begin a swimming regimen. Since it’s a self-paced exercise, you control the level of difficulty, speed and effort according to your ability.

Low Impact

Exercises on dry land can be hard on your joints. Think about the shock your ankles, knees and hips have to absorb each time you step while running. In a pool, there is no impact on your joints and, in fact, the buoyancy the water provides lightens your body weight load, allowing you to carry yourself easier and further.

Muscle Building

The resistance provided by the water is just enough to build muscle strength. Stronger bodies lead to healthier bones and better balance, reducing the risk of falls and fractures. You can also increase intensity by using webbed aquatic gloves.  

Cardiovascular Strength

Swimming is not only a muscle building exercise, but also stellar for heart health. As you build on endurance during your swims, your heart rate increases building on your cardiovascular strength. A stronger heart means less fatigue during daily activities and less risk of cardiac conditions.

Little to No Equipment

Once you have access to a pool, what more do you actually need – just a suit and goggles. That’s it! No special shoes, no fancy bike or other contraptions.

So, have we convinced you that swimming is the #1 exercise choice? Even if not, we hope you’ll consider adding some laps to your fitness regimen for all the reasons above. If you do, let us know! We’d love to hear your thoughts.

5 Tips to Shop for the Right Athletic Shoe

In order to avoid injury in a sport, it’s important to have the right gear. Football players wear pads right? And softball players wear batting helmets? Well almost all sports require the right athletic shoe.  Injuries related to inadequate foot gear can range from blisters and ankle issues to knee and hip pain. But how do you go about finding the right shoe? Here are tips to take with you on your shopping trip for the perfect gear for your feet.

1 – Find a Specialty Store

The first step in finding the right shoe is finding a shop that specializes in the activity you are looking to do so you can benefit from their expertise. For example, if you are looking for a running shoe, your best bet is visiting a running store. The sales professionals are not only more knowledgeable on the best fit for you, but the stores themselves usually have a treadmill to test out the sneakers.

2 – Save Your Trip for the End of the Day

If you were to try new shoes on first thing in the morning, they’ll likely be uncomfortable by nighttime. That’s because, as the day wears on, our feet naturally swell. So the end of the day the best time for that shopping trip for new shoes.

3 – Come Prepared

It seems simple, but many people forget this step: bring the same socks you would normally wear with your athletic shoe. Any sock thinner or thicker that what you plan to regularly wear is going to affect your fit.

4 – Check Your Fit

Once you’ve arrived to the shop and start trying on athletic shoes, how do you know if it’s the right fit? Think Toe, Heel, Feet. Look for ½ an inch of space between your longest toe and the front of the shoe, with room enough to wiggle your toes. Take some steps and make sure your heel isn’t slipping in and out of the shoe at all, otherwise you can count on blisters. And make sure to try the shoes on both feet as many of us have differences in width and even length between our left and our right.

5 – Take Them for a Spin

Take your time moving around the shop to test how comfortable the athletic shoes are. Try to mimic some of the moves you’ll be doing, like jumping for basketball. Understand the return policy of the store as well, as you may have the opportunity to test your new shoes outside the store. Some specialty stores have generous policies, allowing you to return used sneakers if they don’t work out within a month.

With these tips in mind, we’re sure you’ll find the perfect shoe to match your activity and avoid unnecessary injuries. Have more questions? Feel free to contact us at monteortho.org/contact-us.

What is Tommy John surgery? (And why the name?)

If you follow sports, baseball in particular, you may have heard of a star player being out for Tommy John surgery. No, there isn’t a part of the elbow named “Tommy John” – the surgery is a reconstruction of the ulnar collateral ligament (UCL) and a baseball player named Tommy John was the first to undergo the procedure successfully, thus the common name. So what causes the injury that necessitates this type of operation? To answer, it’s important to understand the anatomy of the elbow and the function of the UCL.

Source: OrthoInfo

As shown in the diagram, the ulnar collateral ligament (UCL) attaches the upper arm (humerus) to the forearm (ulna). The UCL stabilizes movement of the elbow when throwing, but the more stress it endures through repetitive motion or force, the greater the risk of the ligament deteriorating. That is why UCL tears are particularly common in baseball pitchers, who contort their elbows in a series of different angles during a single hard throw, then repeat these motions over and over. 

Symptoms

There are different signs that you may have an injury of the UCL. These include:

  • A sudden ‘pop’ sensation in your elbow
  • Pain when in a throwing motion
  • Limited ability to throw
  • Tingling in the hand or fingers
  • Weakened grip strength

Treatment

Once non-surgical options have been exhausted, like physical therapy, rest or medication, your orthopedic may recommend surgery. Thankfully, since Tommy John first had his surgery, countless athletes have benefited from UCL repair or reconstruction surgery to get them back on the mound. During the operation, an orthopedic surgeon will either repair the tear in the ligament or reconstruct using a donor tendon from elsewhere in the body to graft a new ligament. Rates of return to sports 9 months after surgery are high for this type of treatment – 85%-95% of throwing athletes returning.

If you are experiencing any of the symptoms outlined above, remember, ignoring the issue can lead to further complications. The team of specialists at NEOSM are here to help you overcome your injuries and make the most out of life. Reach out to us anytime for a consultation.

How to Train Like an Olympian

Inspiration is all around us. Watching the winter Olympics, there’s plenty of athletic inspiration to feast our eyes on. Yes, we may not have the time or natural talent to compete at the highest level of sport. But what we’ll find when taking a look at the training habits of the elite athlete, is that there’s a lot we can apply to our everyday physical goals.

TRAINING LIKE AN ATHLETE

Training Team

The professional athlete doesn’t train alone. There’s a team in place to help advise, encourage and support the athlete. Build your team! Consult with your primary physician before you start a new exercise program and stay current with your physicals. Stay on top of unusual aches and pains before they progress into serious issues by reaching out to one of the skilled specialists at Northeast Orthopedics. Bring a friend along to your workouts to help you stay accountable. Reach out to others with the same athletic goals as you on social media and join a community. Your team is out there waiting to support your journey.

Diet/Hydration

When you’re an athlete in training, your body needs a lot of fuel. That’s why diet is so important. Fuel your body with enough carbs to provide energy and protein to support muscle growth. And don’t forget the importance of hydration. Aim for drinking half your body weight in ounces per day. If you’re new to consuming a lot of water, start at a tolerable level and build up your intake each week.

Strength Training

You may think strength training is only for sports that require a lot of power, but building muscle strength is key for endurance sports as well. Strong muscles create an overall structure that is less prone to injury. For the non-professional athlete, a strong frame makes you less vulnerable to falls and related injuries.

Rest/Recovery

Every professional athlete knows the importance of rest/recovery days. Taking a break from intense training allows the body the opportunity to heal and make the next training session more effective. At home, rest days can look like a leisure walk instead of a HITT cardio class, or some simple yoga flows rather than hitting the weights hard.

Sleep

We’ve all experienced sleepless nights and the feeling of uselessness the following day. Imagine being sleep deprived and expecting your body to perform at an Olympic level. It’s a recipe for injuries to occur. That’s why top athletes prioritize sleep, and so should you. Restfulness isn’t something your body would like to have, it’s something it needs in order to allow healing and restoration.

Your level of training may not mirror that of an Olympian, but the formula is there for your success. And, as always, the providers of NEOSM are there to support you all the way!

The Rise of One-Sport Injuries

As a parent, it’s easy to go “all-in” on a sport your child really enjoys or excels in. But studies are showing that playing the same sport for three or more seasons of the year is resulting in a spike in overuse injuries in young athletes. While sudden trauma injuries are immediately apparent, overuse injuries appear gradually and can be easy to miss. What can you do to prevent serious injury if your son or daughter has become a “one-sport” athlete and how do you spot trouble? The American Academy of Orthopaedic Surgeons (AAOS) and the American Orthopaedic Society for Sports Medicine (AOSSM) have created The One-SportTM campaign to answer that question and to guide parents and coaches.

Preventing Injuries

Following the guidelines below will help kids get the most out of their sport while reducing risk of injury.

PHYSICAL – It’s a good idea to have your child visit their doctor for a physical before their season starts to screen for, diagnose and treat any conditions.

WARM UP & COOL DOWN – Gradually increasing the heart rate before exercise and allowing a gradual decrease after is important. During warm up and cool down, give a proper amount of time to stretch muscles gently.

HYDRATE– Taking a water break at least every 30 minutes (or more often depending on weather and activity) is key to preventing cramps and muscle spasms.

PROPER EQUIPMENT – Always use proper equipment when participating in a sport. Be sure all gear fit well, are in good condition and are checked on a weekly basis.

GRADUAL TRAINING INCREASE & INSTRUCTION – You wouldn’t jump in the deep end at your first swim lesson for the same reason you shouldn’t train to extremes from the start. Allow your child to gradually increase the intensity of their training as their skills and strength grow. Look to coaches and trainers for guidance on correct form and appropriate exercises suited to your athlete’s ability.

BREAKS AND REST – The most important lesson to teach kids during training is how to listen to their bodies and take a break when necessary. Until they learn how, adults should encourage scheduled rests during training or competition, plus rest days during the week to allow their bodies to recover.

Spotting Trouble

Don’t miss the signs of overuse. Early action can prevent long term effects on performance or quality of life. Take action if you notice any of the following:

  • Isolated pain when using a body part
  • Sleep disruptions
  • Preference to put weight on one side of the body rather than another
  • Numbness or tingling in extremities
  • Headaches during or after training or competition
  • Stiffness in joints or muscles
  • Unusual weakness
  • Presence of blisters or irritate skin

If you see the presence of any of these signs, call one of our orthopedic and sports medicine specialists as soon as possible. With early evaluation and intervention, you can prevent injuries that can have life-long implications.

For more information on The One-SportTM campaign, visit www.stopsportsinjuries.org.

5 Signs Your Child May Be Overtraining

When watching young athletes in motion, it’s easy to think they have a boundless cache of energy and stamina. So daily practices, rigorous game schedules and continued training shouldn’t be a problem, right? Actually, no. Overtraining can actually deteriorate an athlete’s performance. With more and more children committing to one sport year-round, risks of burnout and injury increase. Here are signs of overtraining and tips to help make your child a healthy life-long athlete.

Five Signs of Overtraining

  • Fatigue
  • Lack of interest in practice or competition
  • Mood or personality changes
  • Persistent pain in muscles or joints
  • Decrease in sport performance

Protecting Your Athlete

Time to Heal:

Include 1 to 2 rest days from sport training or competition per week to allow muscles and body to heal.

Quality Rest:

Get plenty of sleep per night to send your body into restoration mode.

Variety of Activity:

Participate in a variety of sports to prevent overuse injuries.

Scheduled Time Off:

Every 2 or 3 months, take a longer break from structured practice or games of a single sport. During this time, focus on maintaining strength and stamina in different ways.

Learn to Listen:

Teach your athlete to always listen to their body and understand cues of burnout or injury.

See a Specialist:

Add a NEOSM Sports Medicine specialists to your team. Our physicians are ready to work with your athlete to help them perform at their peak level while avoiding unnecessary injury.

For more information, or to schedule a consultation, contact us today.

What Everyone Needs To Know For A Safe Pool Season

There’s really nothing better than taking a dip in a cool pool on a long, hot summer day.  With a nice swim, we can relax, exercise or just have fun with friends. We wouldn’t want anyone to miss out on a good time – or, more importantly, suffer a serious injury – so we’re sharing some easy-to-follow tips to think about next time you’re planning a day poolside.

Before You Plunge

Before you get into a pool, it’s important to evaluate first and foremost if you actually should. Ask yourself: Am I alone? Do I not see a lifeguard present? Is the weather report calling for lightning? Have I consumed alcohol? Am I too tired or too overheated? If you can answer ‘yes’ to any of these questions, reconsider.

Know Your Depths

Make sure you know how deep the water is. Look out for depth indicators throughout the pool, as depths can vary in different sections. NEVER dive in shallow water and always check depth markers before you go in headfirst. More on diving in our next section. If you are an inexperienced swimmer, avoid depths where you cannot stand comfortably with your head above water.

Diving

It bears repeating: NEVER DIVE IN SHALLOW WATER. Serious spinal cord injuries, including paralysis of all four limbs, can and do occur. Never dive headfirst in above ground pools or water that is murky and where you can’t see the bottom. Dive only off the end of a diving board and swim away from the diving area immediately to avoid the next diver.

Pool Deck

If you sit by a pool with children long enough, you’re sure to hear a lifeguard or parent yell “Don’t run!” at least once. It’s for good reason. The area around a pool will naturally be wet, creating a slick surface that is easy to slip on. Add in flimsy flip flops or bare feet and running, and chances of a fall increase. So walk carefully. Also, if swimming at night, make sure the area is well lit to avoid any hazards for trips or falls.  

Swimming for Fitness

If swimming is your go-to for aerobic exercise, you’ve made a great choice. It’s an activity that can be continued as you age, is gentle on your joints and is simply a great workout. As with any form of exercise, injuries can occur, so make sure to warm-up your body before you start, stretch often and include weight bearing exercises in your program to strengthen your shoulders and back.

With these basic guidelines, you’re sure to have a summer full of poolside fun, hopefully injury-free. However, should you encounter an issue, as always, the specialists at NEOSM are here to help.

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.