Skier’s Thumb

You don’t have to be a skier to suffer skier’s thumb, according to hand, wrist and elbow specialist David Wei, MD at ONS.

Along with other skiing-related injuries such as concussions, torn knee ligaments and shoulder dislocations, injuries to a skier’s thumb are one of the most common conditions Dr. Wei and the other specialists at the ONS Hand & Upper Extremity Center see during ski season.

While not as serious or debilitating as the other skiing calamities, skier’s thumb can be extremely painful and can limit the ability to perform many common daily tasks such as grasping or opening jars, pinching your fingers to pick up something or writing with a pen.  And it’s a stubborn injury. It can take 4 – 6 weeks to heal and sometimes longer.

What is Skier’s Thumb?Skier's Thumb

Skier’s thumb occurs when one of the two main ligaments that support the thumb, the ulnar collateral ligament, is abruptly stretched beyond its limits. It is typically referred to as skier’s thumb because it commonly results when a skier falls with an outstretched hand while holding a ski pole. But, this condition can occur in other contact sports where the thumb is vulnerable to injury, such as football, rugby, or lacrosse. Most often, the ligament is strained when the thumb is jammed backwards and out to the side, but strains can occur on any side of the thumb.  Although skier’s thumb is typically caused by a single accident, repetitive gripping and twisting motions can create a painful chronic condition.

Symptoms of Skier’s Thumb

The most common symptoms of skier’s thumb include swelling, throbbing pain, and decreased range of motion. Bruising can appear a few days after the incident.

  • Pain is at the base of the thumb, usually at the side of the web space between the thmb and index finger
  • Swelling is usually at the base of the thumb
  • Pain, weakness or difficulty gripping using the thumb and index finger
  • Bruising along the inside of the thumb
  • Pain moving the thumb

Treating Skier’s Thumb

Moderate, partial ligament injuries may be managed with ice compression, anti-inflammatory medication and immobilization using a splint.  However, Dr. Wei, notes, “If the thumb is unstable during physical exam, an MRI can help determine if a special lesion, known as a Stener lesion, is present.  If this is the case, surgery may then be required for proper healing of the ligament and stability of the joint.”  Surgery may also be necessary if the ligament suffered a complete tear and is very unstable.

During recovery from this injury, either with nonoperative or operative treatment, a certified hand therapists may be called in to help rebuild strength and mobility to the thumb.

Preventing Skier’s Thumb

There is no single precaution that can be taken to prevent thumb injury . For skiers, many experts suggest keeping the hands outside of the straps at the top of the poles so that the poles are easy to drop during a fall.

 

 

 

The Dangers of Sports Specialization

Every young athlete dreams of the pride and exhilaration of hitting the game winning home run, or scoring the goal that clinches the championship.  In today’s competitive sports environment, youth are under more pressure than ever to train harder and longer to excel in their sport, often with debilitating consequences, writes sports medicine specialist and orthopedic surgeon, Demetris Delos, MD in the latest issue of The Magazine for Greenwich Hospital.Sports Medicine Discussion

The greatest shift in youth sports in the last generation has been the trend toward sports specialization and year-round training. Twenty years ago, young athletes typically played a particular sport only during that sport’s season (i.e. football in the fall, baseball in the spring and summer), and most kids sat out a season or a summer.  Today’s young competitors don’t seem to enjoy that luxury.  Unfortunately, this has also led to a surge of sport specific injuries.

A recent study at the Departments of Kinesiology, Orthopedics and Rehabilitation at the University of Wisconsin-Madison, for instance, found that high school athletes who trained in one sport for more than 8 months were more likely to report a history of overuse knee and hip injuries, than those who had played a variety of sports throughout the year or played sports at less intense levels.

The results of this study reflect what orthopedists have noticed in the last decade with the increasing number of kids showing up in our offices with throwing injuries, torn knee cartilage and stress fractures.

Professional level injuries

 The growing corps of young adolescents and pre-adolescent baseball pitchers is now throwing excessive numbers of pitches during an unusually high number of innings for immature arm muscles. This has led to an epidemic of young athletes suffering ulnar collateral ligament (UCL) injuries, requiring the so-called Tommy John Surgery. Tommy John was a left handed pitcher for the Los Angeles Dodgers in the 1970’s, who was the first baseball player to undergo UCL reconstruction surgery.  His successful recovery and return to achieve a record of 288 career victories.

Anterior cruciate ligament (ACL) tears in youth athletes are also increasing at an alarming rate. While ACL tears are not so closely related to a particular sport statistic the way  UCL injuries are tied to pitch count, clearly the rapid rise of sports that involve running and sudden pivoting – think soccer, lacrosse, football, basketball and rugby – increases the likelihood of season ending ACL tears and reconstructive surgery.

Overuse injuries

Unlike ACL injuries, which can be dramatic on-field experiences with players being helped off the field, the vast majority of injuries associated with excessive specialization and training are overuse injuries. Overuse injuries develop slowly over time, starting perhaps as a mild twinge before progressing into relentless, often debilitating pain.  Ironically, these injuries are relatively easy to treat with a period rest and activity modification.  All too often, players, their coaches and, sadly, parents, are often reluctant to have the athlete sit out a few practices and games.  Left untreated, overuse injuries can lead to tears in the muscles and tendons of the affected area, which require a lengthier rehabilitation and sometimes surgery.

Overuse injuries are typically sport specific. In baseball, the upper extremity is most often affected.  With Little league shoulder, the growth place of the humerus (arm bone) becomes inflamed by the repetitive motion of throwing with excessive force.  Similarly, Little league elbow involves injury to the growth plate along the inner portion of the elbow.

In the lower extremity, overuse injuries of the knee and ankle are very common. Osgood Schlatter and Jumper’s knee are injuries to the growth plate of the knee that can be a frustrating source of pain. These injuries are typically associated with repetitive impact activities (running, jumping, etc.) as seen in basketball, soccer and track.  In the ankle, Sever’s disease can lead to pain in the back of the heel.

How can we prevent injuries?

The solution is simple but that doesn’t mean it is easy. Rest and activity modification can be difficult to execute in the middle of the season when the athlete is invested in playing and when parents have already invested much time and money to the sport.

Nevertheless, it is incumbent upon parents to insist their child rest to give the body the opportunity to heal before more serious injury occurs. If a week or two of rest doesn’t resolve the condition, the young athlete should be evaluated by an orthopedist or sports medicine specialist.

Repetitive activities such as throwing or running can lead to changes in the development of growing bones and joints. It has been known for some time now that significant amounts of pitching during adolescence can change the rotation and shape of the shoulder.

Moreover, there is a growing body of evidence indicating certain sports played excessively during adolescence are associated with the development of femoroacetabular impingement syndrome (hip impingement), which can lead to hip problems often requiring surgery in adulthood.

In addition, numerous studies have shown that exposure in youth to a range of different sports that utilize different muscle groups and mechanical skills lead to the greater overall athleticism and better athletes.

Tips to Prevent Injuries from Running

Prevent Running Injuries
Proper fitting running shoes can help prevent injury

Do you have pain when you go running?

There can be many causes for the aches and pains associated with running, but sometimes it is as simple as wearing the wrong running shoe. Improperly fitting sport shoes can lead to a variety of painful foot, ankle, knee and hip conditions, according the ONS Sports Medicine specialist Katherine B. Vadasdi, MD.

“The best running shoe is one that keeps the foot in a neutral position, so it’s important to know if your feet are neutral when you stand or run, or if they are pronated (roll to the inner side of the foot) or supinated (roll to the outside of the foot),” said Dr. Vadasdi.  In general, people whose feet have low arches tend to pronate, while people with high arches tend to supinate. Today there are dozens models of sports shoes that are specifically designed to support each of these conditions, knowing your foot’s anatomy will help you make the right decision.

The other thing you have to consider is the type of running that you do, which determines the level of cushioning and stability you will need. For instance, trail runners need a shoe that offers more stability for the rugged terrain, while a marathon runner may need a training shoe with more cushion. An athlete training for shorter distances may use a track shoe or racing flat.knee and

Past injuries should also be taken into consideration when making your selection. If you’ve had plantar fasciitis, for instance, an over-the-counter insert may help put your foot in a more neutral position. If you’ve had hamstring tendinitis or tightness in your calves, you should opt for a greater heel to toe incline – called an offset.

When you get a new pair of running shoes, gradually introduce them into your routine, using them only two times in the first week or two alternating with your previous pair, and then gradually increase the numbers of days that you run in them. It can be difficult to determine if your running shoes are at the root of your pain, but in general, if you develop a new pain or discomfort shortly after switching running shoes, stop using them until the pain is resolved. Consult a physician if the pain persists for more than a week.

Shoulder and Elbow Throwing Injuries Rise for Young Athletes

Surge in Elbow and Shoulder Injuries for Youth Involved in Throwing Activities.

Young male baseball player

For youth involved in repetitive throwing activities, there is an epidemic of elbow and shoulder injuries, usually due to overuse, poor training, improper throwing mechanics, and fatigue, according to sports medicine physician, Demetris Delos, MD, who specializes in shoulder and knee conditions.

The dreaded injury to the ulnar collateral ligament (UCL)  is usually caused by excessive pitching. If the UCL is injured, it can sometimes be difficult to repair or rehabilitate and may require the so-called Tommy John procedure in order to return to competitive pitching. The surgery is named after Tommy John, the first baseball pitcher to undergo successful UCL reconstruction surgery in the 1970’s.

Other common throwing-related injuries include Little League shoulder, which occurs when the growth plate of the humerus (arm bone) becomes inflamed by the excessive forces produced by repetitive throwing. Similarly, Little League elbow involves injury to the growth plate along the inner portion of the elbow.

In addition to acute injuries, repetitive activities such as throwing can lead to physical changes in the development of growing bones and joints. Significant amounts of pitching during adolescence can change the rotation and shape of the shoulder which may leave the player vulnerable to shoulder injury and arthritis in adulthood.

Studies show that children and adolescents who pitch competitively for more than 8 months in a year are the most prone to injury. Throwing more than 80 pitches per game, a fastball that consistently exceeds 85 mph, or pitching while fatigued are also risk factors for injury.

According to one study, pitchers who pitched more than 100 innings in a calendar year were 3.5 times more likely to sustain serious injuries requiring elbow or shoulder surgery or retire due to the injury. This is why USA Baseball and Major League Baseball now recommend that youth pitchers of all ages and abilities take a minimum four month break from overhead throwing, with at least two months off consecutively.

However, athletes and their parents should be reassured that numerous studies have shown that kids who are exposed to a range of sports that utilize different muscle groups and mechanical skills have greater overall success in athletics than those who specialize early on. In addition, they are less prone to injury and burnout than those who focus on a single sport exclusively.

Chocolate and Athletic Performance

Portrait Of Fitness Mature Man Eating A Energy Bar Of Chocolate

Can chocolate improve athletic performance?  Some researchers say it can.

Here’s one more study to suggest that indulging in chocolate and physical fitness are not mutually exclusive.  Past research has indicated that flavanols in cocoa beans have antioxidant effects the can help lower blood pressure, improve vascular function and reduce the cell damage involved in heart disease.  Now, research published in The Journal of the International Society of Sports Nutrition puts forward the notion that one of the flavanols in the cocoa bean and dark chocolate, epicatechin, can increase the production of nitric oxide in the body. Nitric oxide causes blood vessels to dilate and reduces oxygen consumption, which in turn seems to increase athletic performance.

Nitric acid is also a bi-product of nitrates in beetroot juice, which is popular among elite athletes because it enhances their endurance.  A  postgraduate research student from Kingston University in London, Rishikesh Kankesh Patel, wanted to know if dark chocolate could provide similar benefits.  His supervised study involved nine amateur cyclists who were put into two groups after establishing a baseline in fitness levels. For two weeks, the cyclists  replaced a daily snack with 1.5 ounces of chocolate, with one group consuming dark chocolate, the other  white chocolate. Following the two weeks, the participants performed  moderate cycling exercises and time trials while researchers measured their heart rates and oxygen consumption. The riders then took a week-long break from eating the sweet, then switched chocolate types and repeated the two-week trial and exercises tests.

Patel and his team, noted that after consuming dark chocolate, the athletes used less oxygen when cycling at a moderate pace and out-distanced their white chocolate eating counterparts in a 2-minute time trial.  While the results appear promising, more research with a larger study group is needed to determine such factors as the optimal quantity to consume, the time period in which to consume it, and the duration of benefits.

If those questions can be answered, however, dark chocolate may offer a tastier training tool to athletes who find beetroot juice too bitter to palate, and to anyone else looking for a good excuse to each chocolate.

ONS Surgeon Named Doctor of Distinction

Paul Sethi, MD, was named one of Fairfield County’s Doctors of Distinction by Westfair Communications.

Dr. Sethi, a sports medicine specialist and orthopedic surgeon at ONS, will be presented with the Cutting Edge Award  at the annual Fairfield County Doctors of Distinction Awards ceremony on Tuesday, May 3.  Dr. Sethi has received this recognition from Westfair Communications for his ongoing research into improving orthopedic surgical procedures  and help in creating international orthopedic surgical standards.  Doctors of Distinction

As President of the  ONS Foundation for Clinical Research and Education, Dr. Sethi’s research has recently included the establishment of  better methods for surgical skin preparation (cleaning) to lower the risk of surgical infection; development of a new technique to repair chronic or weakened biceps tendons; and the evaluation of surgical needles in tendon surgery to establish international guidelines on needle use. Additionally, Dr. Sethi has recently contributed a textbook chapter on shoulder fractures, and two chapters on treating elbow injuries in throwing athletes.

Learn more about Dr. Sethi’s outstanding career here.

 

ONS Surgeon Demetris Delos, MD Speaks about Knee and Shoulder Conditions on Health IQ

Demetris Delos, MD
Demetris Delos, MD

ONS orthopaedic surgeon Demetris Delos, MD, was a featured guest on Pleasantville Community Television’s series, Health IQ, hosted by Dr. Alan Siegel of ProClinix. During the fascinating thirty-minute interview, Dr. Delos, a specialist in knee and shoulder conditions, spoke in detail about common cartilage, ligament and tendon injuries. Age, gender and type of activity can play a role in a person’s susceptibility to orthopedic problems, he said. Using models and computer generated images, Dr. Delos described the non-surgical and surgical options to repair or replace damaged tissue and joints.  Functional and strength training, he stressed, are key for injury prevention and rehabilitation. Dr. Delos also provided a glimpse into future treatments including the development of synthetic tissue products and the advances in biologic medicine which uses biomedical materials such as blood, platelets and stem cells to treat pain and complex, often chronic conditions of the musculoskeletal system.

 

 

 

PRP: A step forward in regenerative medicine

Dr Kessel
Dr. Tamar Kessel, physiatrist, with a C-arm

Dr. Kessel is a physiatrist who specializes in non-operative treatments of musculoskeletal injuries and has an interest in the use of ultrasound to target medications to the precise location of tissue damage. One procedure that optimizes on ultrasound technology is the new and progressive treatment in regenerative medicine, PRP (Platelet Rich Plasma). Utilizing therapeutic injections, like PRP, has been shown to be safer and to greatly improve treatment results.  The treatment has even received significant attention from the media and has been used by members of the New York Giants along with other NFL players and elite athletes. Dr. Kessel is committed to providing the highest quality medical care and achieving the best outcomes for her patients.

PRP is a new treatment in regenerative medicine that uses the patient’s own blood and platelets to promote healing and helps the body optimize on its own natural processes. The patient’s own blood is drawn then placed in a centrifuge machine that separates the blood, leaving the platelet rich plasma ready to be removed. Afterwards, the PRP is placed right into the area of damage using ultrasound. Most people benefit from one injection but depending on the severity of the damage, it could take up to three. This method can help heal injuries including tendon/ligament injuries (Achilles Tendonitis), tennis elbow, cartilage loss, arthritis, and small tears (rotator cuff tears and meniscal injuries).

Note: Because PRP is given in the hopes of optimizing the initial inflammatory response of healing, anti-inflammatory medications should likely be stopped at the time of PRP treatment. Please consult your physician before any procedure.

“Maximizing Your Child’s Athletic Potential” Success

Delos_Houston_
Dr. Delos with Allan Houston

Last Thursday’s talk on “Maximizing Your Child’s Athletic Potential” was a success. A big thank you goes out to the Junior League of Greenwich for making it possible with their focus on improving the community and empowering others to further health and education! Ultimately they brought together the perfect combination of experts to inform the public about the youth and the sports they love.

Dr. Delos, of ONS and Greenwich Hospital, was a panel speaker at this event. He specializes in sports medicine and arthroscopic treatment of knee and shoulder disorders. Before ONS, Dr. Delos was the Assistant NFL Team Physician for the New York Giants and was team physician for a number of local high school and college athletes.

Other panel members consisted of Andy Barr, Director of Performance and Rehab for the New York Knicks, Mubarak “Bar” Malik, Head of Strength and Conditioning for the New York Knicks, and Allan Houston, one of NBA’s all-time greatest long range shooters and Olympic gold medalist, as the moderator. Each participant reinforced the importance of parents taking interest in the development of their young athlete and properly guiding them to the path of success. Parents attending this event were very attentive, and came prepared with questions.

Conversations covered the fundamental topics, like proper sleep habits and nutrition. For example, a young athlete’s nutrition should increase in relation to the amount of activity they experience daily. This may be common knowledge to an adult but for an adolescent, proper amounts of sleep and good nutrition that balances the amount of activity should be added to their routine.

Aside from the basic topics of discussion, there was a myth to be busted as well; to find out the details of the myth and for more information about the questions that were asked at the event, please read the article written by the Greenwich Freepress.

Delos_Group_2
Photography credit goes to the Delos family, thank you!

ONS Success Story: William McHale

William McHale TestimonialWilliam McHale started off as many other athletes did, full of energy and feeling invincible. As we all know, that feeling of invincibility is only a feeling. In the 7th grade, young William broke his ankle playing football; fortunately he was then referred to Dr. Paul Sethi.

Dr. Sethi considers all of the athlete’s needs which helps set the stage for a successful and timely recovery period and translates into an ideal patient-doctor experience.  When McHale got older, he started as a linebacker in 30 consecutive games between his sophomore and senior years at  Yale University. During his senior year though, the labrums in both of his shoulders tore. Time was of the essence if he wanted to recover in time for his Pro Day in front of NFL Scouts. Who did he contact? None other than our very own Dr. Sethi.

The MRIs originally taken of the injury did not reveal the full extent of the damage but Dr. Sethi corrected all issues encountered during the surgery. After the procedure, William was scheduled to go to physical therapy multiple times a week and overall, it took about six to seven months for a full recovery. Since then, William has not had any other issues regarding his shoulders.

Where is William McHale now? He played to his full potential on Pro Day, was invited to Minicamp with the New Orleans Saints, and just returned from playing football in France; congratulations!

The Fragile Feet: A Ballerina Story (Part I)

Ballerina
Ballerina in en pointe position

Dr. Peden of ONS and Greenwich Hospital is an orthopedic surgeon specializing in foot and ankle surgery and treatments for adult foot conditions as well as youth sports injuries in field athletes, gymnasts and ballet dancers. He shares a two-part blog about conditions to be aware of for ballet dancers and gymnasts.

Ballet dancers feet are much like a musician’s handsthey earn a living with them. In addition to putting an amazing amount of stress on their feet, they also are often well below an ideal body weight – either because of the stress of an enormous amount of training or because of unrealistic expectations placed on them by the ballet community. This leads to several different and often unique foot and ankle conditions.

One fairly unique foot and ankle condition in ballet is caused by the en pointe position. In this position an enormous amount of strain is put on the dancer’s great toe, as it is essentially holding up the entire body weight through a small joint. The main flexor tendon of the toe, called the flexor hallicus longus – normally quite small, takes over the job of the largest tendon in the body, the Achilles. The flexor hallicus longus hypertrophies well in compensation for its new job, but unfortunately this tendon is forced through a tight tunnel in the back of the ankle. When it gets too large it will get pinched in the posterior ankle joint. Patients develop painful irritation of the bones and soft tissues in the posterior ankle. An extra bone in the posterior ankle called the os trigonum, which present in about 10% of all people, can be become very painful and irritated in many ballerinas. This constellation of problems is called posterior impingement of the ankle, and it is noticed by the patient as a vague deep pain in the posterior part of the ankle, in front of the Achilles, that is felt with plantarflexion, the position of pointing the foot and toes downward.

Ballet dancers suffer from numerous other problems of the foot & ankle, many of which are not unique. One of the less glamorous problems they deal with are corns, calluses, and blisters. These are necessary adaptations to allow a high level dancer to compete.

Similar to posterior impingement, which arises from dancers spending an inordinate amount of time and stress in an extreme position at the ankle, ballet dancers will develop anterior impingement at the ankle. This comes from repetitive forceful dorsiflexion – pulling the foot and toes upward, toward the shin. Landing from jumps and deep knee bends exacerbate this problem. Pain is felt in the anterior ankle.

Treatment for the above condition is customized to the patient. Often a minor activity modification, or period of rest, can dramatically improve the symptoms. Unfortunately, rest is not easy to come by in the competitive living of a gymnast. Many dancers will treat the symptoms with a combination of anti-inflammatory medications and occasional steroid injections in the region of maximal tenderness. Surgery is a last resort option for any ballerina – when symptoms persist for many months and are limiting, despite all other efforts. Surgery is typically very successful in these patients and can be done with arthroscopic or minimally invasive techniques.

The most common orthopaedic injury of all is also very common amongst ballet dancers: the lateral (traditional) ankle sprain. The mainstay of treatment for ankle sprains is rest, ice, compression, and elevation – mnemonic RICE. A short period of rest and immobilization (1-2 weeks) is followed by aggressive physical therapy, with strengthening of the muscles that stabilize the ankle. Recent research has pointed to improved short and long-term outcomes when early motion and weight bearing is initiated. There is promising early research on the role of stem cell injections – harvested from the patient’s own blood or bone marrow – in the setting of an acute ankle sprain. This is a technique we will offer for the highest level athletes and dancers in certain situations, understanding that the research data on this intervention is still in development.

… to be continued in the next segment, The Fragile Feet: A Gymnast Story (Part II)

Want to learn even more? Dr. Peden will be giving a seminar on “Solutions for Foot and Ankle Pain: Beyond a Foot Massage.”  The program is free and open to the public. Registration Requested. Call (203) 863-4277 or register online at www.greenhosp.org.

ONS Physiatrist, Christopher Sahler, MD on post New York City Marathon Tips for Runners

Christopher Sahler, MD
Christopher Sahler, MD

Christopher S. Sahler, MD of ONS is an interventional physiatrists specializing in sports medicine. His focus is non-operative treatment of musculoskeletal injuries, restoring proper function, reducing pain and promoting active lifestyles.

“Each year 50,000 people participate in the NYC marathon. If you are in that group and completed the race this past weekend, congratulations! It is an exciting accomplishment that you will remember for the rest of your life.

Now that the race is over, there are a few key points to remember that will help to maximize your recovery and minimize pain. Many athletes experience worsening soreness over the following days after the race. This is known as delayed onset muscle soreness and typically is most painful 48-72 hours later. After the race, your body is in a depleted state so it is important to take in plenty of water and healthy food. A combination of complex carbohydrates and protein help the muscles to repair themselves and re-build their energy stores. It is also recommended that you perform light, short duration activities such as walking, gentle jogging, biking, swimming etc. This helps to increase blood flow to the muscles and tissues that need the nutrients the most and helps to wash away the built up metabolic byproducts such as lactic acid. Gentle stretching and soaking in a warm bath may also help loosen up the muscles. Depending on your previous activity level, it is important to give your body time off before re-starting any intense exercise routines. Most runners should take at least one month off.

Congratulations again on the race!”

Dr. Sahler will present “Exercise as Treatment for Chronic Pain.” Learn how exercise can be used as a safe and effective treatment for chronic pain conditions. This free health seminar will be in the Noble Conference room at Greenwich Hospital Tuesday, December 2 at 6:00 p.m.  To register call 203-863-4277 or register online at https://www.greenhosp.org/CREG/ClassDetails.aspx?sid=1&ClassID=5348

 

ONS Orthopedic Surgeon Seth Miller, MD, Elected to Join Elite Medical Society

Seth Miller, MD
ONS Orthopaedic Surgeon, Seth Miller, MD

At the October Closed Meeting of the American Shoulder and Elbow Surgeons (ASES), held in Pinehurst, NC, ONS (Orthopaedic and Neurosurgery Specialists) orthopedic surgeon Dr. Seth Miller was elected to join the ASES organization.  “Membership in ASES is a privilege and an honor” said Dr. Jim Cunningham, ONS Vice President. Membership in American Shoulder and Elbow Surgeons is by invitation only. Only experienced orthopedic surgeons who have completed a fellowship in shoulder surgery, elbow surgery, and/or sports medicine are considered for membership.

Dr. Miller, in his 25th year in practice at ONS in Greenwich, has ascended quickly in his career being recognized with such a national honor.  Candidates must meet strict academic and clinical requirements to become members of ASES.

“ASES is a remarkable collection of like-minded surgeons, and researchers who, through their collaboration and the sharing of techniques and outcomes, work together to solve the most complicated and pressing shoulder and elbow disorders. Founded on the premise that by such sharing of ideas we can determine the most efficient, cost effective, high quality shoulder and elbow care” said Dr. Robert Bell, ASES President.

The American Shoulder and Elbow Surgeons was created to enhance the study of Conditions_shouldershoulder and elbow surgery and to foster advances in the field, serving as an educational body responsible for scientific programs and advances.  The Mission of the ASES is to support the ethical practice of evidence-based, high quality, cost-effective, shoulder and elbow care.

The society global impact on quality shoulder and elbow care is achieved through leadership, medical education, scientific research, and patient advocacy. Congratulations to Dr. Miller on becoming an Associate Member of the society.

ONS is an advanced multi-specialty orthopedic and neurosurgery practice serving patients throughout Fairfield and Westchester Counties and the New York Metropolitan area. ONS physicians provide expertise in the full spectrum of musculoskeletal conditions and injuries, sports medicine, minimally invasive orthopedic, spine and brain surgery, joint replacement and trauma. For more information, visit www.onsmd.com, or call (203) 869-1145.

Orthopaedic Surgeon and Sports Medicine Specialist Dr. Demetris Delos on NY Giants Victor Cruz’s Injury

Dr. Delos served as Assistant NFL Team Physician for the New York Football Giants and

Demetris Delos, MD
Demetris Delos, MD

team physician for local high school and college athletes. His practice is focused on sports medicine and arthroscopic treatment of knee and shoulder disorders including knee preservation surgery, shoulder instability and rotator cuff repair. Upon hearing about the NY Giants’ Wide Receiver Victor Cruz’s knee injury, we reached out to Dr. Delos to give us insight on Victor’s type of injury. Dr. Delos said:

“Victor Cruz sustained a devastating injury to his knee last night, an injury that will cost him the rest of the season. While attempting to catch a ball in the end zone, he tore the patellar tendon in his right knee. The patellar tendon is a structure that attaches the kneecap (patella) to the shinbone (tibia). When the patellar tendon is torn, the player cannot straighten (extend) his knee and obviously cannot perform at the high level expected in the NFL.

Patellar tendon ruptures are relatively uncommon injuries that occur in otherwise healthy players without any predisposing factors. The mechanism of injury is typically eccentric overload (forcibly bending the knee while the quadricep is firing).

Studies of NFL players with this injury report that the vast majority are able to return to NFL level play after surgery and extensive rehabilitation. Let’s wish Victor a speedy recovery so we can watch him salsa in the end zone again!”

For more information on knee injuries, visit Our Specialties page.

ONS SPONSORS NEWS 12 SCHOLAR ATHLETE AWARD

Orthopaedic-NeurosurgerySpecialists

October 2014 – June 2015, NEWS 12 CONNECTICUT will introduce and recognize a local area high school student athlete by featuring the student and their school during the NEWS 12 CONNECTICUT SCHOLAR ATHLETE weekly segment sponsored by ONS. Students who excel in both academics and athletics are nominated by coaches and athletic directors with extracurricular activities and leadership qualities noted. At the end of each academic year, scholarships are awarded to three NEWS 12 CONNECTICUT Scholar Athletes.

Watch NEWS 12 CONNECTICUT on Mondays 5 p.m. to midnight to catch the stories of the nominees. Cross-channel airing will run on CNBC, ESPN, ESPN2, MSG-TV, NBCS-TV or visit <NEWS 12 Sports online>.

Missed a segment? Links to our NEWS12 SCHOLAR ATHLETES are listed below:
Matt Doyle
Jamie Kockenmeister
Olivia Haskell
Simon Whiteman
Ali Weiner
Lars Pederson
Hannah Caldwell
Elizabeth Miller
Dugald Shannon

Train Right, Run Free! ONS Physical Therapist Alicia Hirscht Shows Us how to Train for a Marathon

The ONS Foundation’s Annual 5K Run/Walk is coming up this Sunday, September 21st in Old Greenwich! ONS supporters, staff and former patients will participate in this fun-filled event. It would be great to see you all come down and enjoy a nice morning jog. Some of you may be casual joggers, others might want to participate in the local race circuit, or you might be training for the NYC Marathon.

ONS Senior Clinical Specialist Alicia Hirsch
ONS Senior Clinical Specialist Alicia Hirsch

Whether you are a casual runner, training for the marathon, or just someone who supports local causes with a 5K run…all runners are at risk of developing injuries if they are not training properly. A question I ask all my runners in the clinic is, “What else do you do for training, besides running?” More often than not, the answer is, “nothing” or “I stretch sometimes.”  What many runners do not know is that research has shown an effective leg and core strengthening program can reduce the incidence of hip, knee and ankle pain.

A proper program needs to have exercises specific for running: weight bearing on one leg, focused on shock absorbing muscle groups, and emphasizing hip and core strength. Many runners feel that stretching in their training can help prevent injury. However, many injuries occur because of inherent muscle weakness, not necessarily because of tightness.  To address this weakness, incorporate the exercises below into your routine: 3 times per week. Good luck with your training!

 

Hamstring Curls with the Ball:

1. Lie on your back with your legs up on a ball.

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2. Lift your hips, bend your knees and roll the ball in towards your buttocks.

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3. Roll the ball back out and lower your hips.

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One Legged Bridges:

1. Lie on your back with one knee bent, the other straight in the air.

IMG_3241

2. Pushing through the bent knee, lift your hips off the ground. Lower back down.

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Repeat: 3 sets of 15 reps on each leg.

 

 

 

 

 


Sideplanks:

1. Lie on your side, heels in line with your shoulders.

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2. Supporting yourself on your elbow, lift your body off the ground. Lower back down, repeat:

 

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3. Lower back down, repeat:

 

 

 

Hip Dips:

 1. Stand on your left leg only.

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2. Let your trunk bend forward while extending your right leg straight back. Let your arms fall freely, keep your left knee slightly bent. Keep your stomach muscles tight and your back in neutral, bend through your hip.

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3. Return to start position, repeat: 2 sets of 15 reps on each leg.

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One Legged Heel Raises:

1. Stand off the edge of a step, letting your heel hang below the step.

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2. Push up onto your toes. Lower back down slowly.

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Repeat: 3 sets of 15 reps on each leg.


Lateral Squats:

1. Stand sideways on a step.

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2. Sit your hips back and bend your knee, lowering your opposite leg to the ground. Do not let your knee fall inward and do not let it bend past your toes.

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3. Lift back up and repeat: 2 sets of 15 reps


Orthopaedic and Neurosurgery Specialists PC (ONS)
is an advanced multi-specialty orthopedic and neurosurgery practice in Greenwich, CT. ONS physicians provide expertise in sports medicine, minimally invasive orthopaedic, spine and brain surgery, joint replacement and trauma. For more information, please visit www.onsmd.com.