Give Young Athletes a Break

ConcussionFor many of today’s young athletes, summer break includes a sports camp providing concentrated training in their specialized sport. But according to ONS Sports Medicine Specialist, Dr. Marc Kowalsky, early sports specialization is the last thing they should be doing with their free time.

“There is an increasing body of evidence indicating that early sports specialization does more harm than good. In fact, it seems that it actually decreases the potential for success in the sport in the long term,” he said.

Dr. Kowalsky said children who specialize in a single sport before the age of 13 don’t develop the protective neuromuscular patterns that help prevent stress to a single area of the body.  Because young athletes are less likely to perform technical repetitive skills properly, these children are more prone to overuse injuries that can sideline them later in life.

“The risk of injury doubles for children involved in excessive organized play at early ages over children who participate in an appropriate amount of free play,” Dr. Kowalsky noted.

Children who undergo early sports specialization are also at an increased risk for psychological burnout. Overtime it can manifest as mood disturbances, social isolation, and eating disorders. “These kids often drop out of the sport altogether as they get older,” he said.

Despite popular belief, early specialization does not guarantee elite performance later in life. A study of elite adult athletes at amateur and pro levels revealed that elite success did not require exclusive participation in a single sport until their high school years. Instead, top players participated in multiple sports in the preceding years, developing important movement patterns that made them stronger over time.

“Sports diversification actually increases overall athleticism, and the chance of a young athlete achieving elite status,” Dr. Kowalsky said.

The trend toward early youth sports specialization is relatively new. Twenty years ago, young athletes typically played a particular sport only during a given season (i.e. football in the fall, baseball in the spring, swimming in the summer), and most kids rested from competitive sports for a season or during the summer.

The surge in throwing injuries, stress fractures, and other overuse injuries in younger athletes reflects the physical pressures affecting today’s young athletic bodies.  A recent study found that high school athletes who had trained in one sport for more than 8 months in a year were more likely to report a history of overuse knee and hip injuries, than those who played a variety of sports throughout the year or played sports at less intense levels.

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.

Thankfully, these injuries are relatively easy to treat when recognized early, with a period rest and activity modification.  All too often, however, 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 more significant structural damage to an affected area. Therefore, it can require lengthier rehabilitation and sometimes surgery.

What’s more, repetitive activities such as throwing or running can lead to changes in the development of growing bones and joints. For instance, significant amounts of pitching during adolescence can change the rotation and shape of the shoulder.

“The musculature and bones of the developing thrower are not prepared for the excessive numbers of pitches they throw in a game,” said Dr. Kowalsky. This in part has contributed to an epidemic of young athletes suffering ulnar collateral ligament (UCL) injuries, which sometimes requires the so-called Tommy John Surgery.

The solution is simple but that doesn’t mean it is easy.  Dr. Kowalsky recommends the following practices for kids younger than 13 years:

  • Make time for unstructured play

  • Keep the ratio of weekly hours of organized sport to free play below 2:1.

  • Weekly hours of sports participation should not exceed a child’s age, or total of 16 hours in teen players.

  • Athletes of all ages should participate in some sort of supervised strength and conditioning program.

But he admits, in today’s competitive environment implementation of these steps can be easier said than done.  Parents and coaches should keep in mind that the ultimate goal is to make sure their children remain injury-free so they can maximize enjoyment and success in their sport of choice.

 

Lifelong Athlete Stays That Way, Thanks to ONS

Jeffrey B. Mendell has been active his entire life and he plans to remain that way for as long as he can.

At 64, the athletic Bedford resident and real estate developer still plows down mountain moguls in Colorado several times a year, bikes more than 50 miles per week along the backcountry roads of Greenwich and Bedford, and plays 50+ rounds of golf each season.

“I just love being active outdoors,” he said.

Over the years, however, Jeff’s intense athletic pursuits have taken a toll on his body.  In each instance, he turned to the specialists at Orthopaedic & Neurosurgery Specialists (ONS) to repair his injuries. “I’ve had two rotator cuff surgeries, meniscus surgeries on both knees and on the first ski day of 2016 I caught an edge and broke my wrist,” he explains.  “I know I’m going to have to slow down at some point…. but I’m just not ready to yet.”

Jeff said he thoroughly researched the best orthopedic surgeons in the NY area when he suffered his first injury several years ago. He consulted with orthopedic surgeons in New York City and, on a friend’s recommendation, he checked out Dr. Paul Sethi’s qualifications on the ONS website, www.onsmd.com.  Jeff was immediately impressed.  “I watched videos of Dr. Sethi speaking at medical conferences about complex knee and shoulder surgeries. I was attracted to both his intelligence and surgical experience. We met at ONS and after a thorough discussion, I was convinced that he was an especially talented surgeon and the right doctor for me.”

Dr. Sethi performed a very sophisticated procedure to repair Jeff’s severely damaged right rotator cuff and torn bicep tendon. This injury happened in a high speed fall while skiing. The procedure included the use of a synthetic patch to reattach the rotator cuff to the bone. The outcome was flawless. From that point on, Jeff has turned to ONS physicians and physical therapists to help him recover from his sports injuries.

“I’ve had outstanding outcomes from the surgeries I’ve had with the ONS team,” he said. “I send my family to ONS when they get hurt and I tell all my friends to go there when they suffer an orthopedic injury.  Personally, I wouldn’t consider going anywhere else.”

ONS PT Patient Returns to Doing What She Loves Most

Old Greenwich artist, Felicity Kostakis, first noticed the pain in her right elbow while playing tennis. Over the course of a year, the pain invaded her day to day activities to the point that lifting clothing from the washer or taking a jar from the kitchen cabinet was excruciating. “I began to do everything with my left hand,” Felicity recalled.

Even more worrisome, it interfered with her ability to paint. “I was so scared it was the end. Painting is what I do every day. It’s what I love,” she said.

Not knowing what was wrong and fearing the worst, Felicity made an appointment with sports medicine specialist, Dr. Katherine Vadasdi, director of the ONS Women’s Sports Medicine Center.

“Dr. Vadasdi was amazing and so kind. With a digital x-ray machine right there in the office, I had everything done in the same appointment. It was so easy,” she said.  Dr. Vadasdi determined that Felicity had lateral epicondylitis, commonly known as tennis elbow, probably due to Felicity’s renewed enthusiasm for the sport.  During the consultation, Dr. Vadasdi helped Felicity purchase the proper elbow braces from an online source, and prescribed a program of physical therapy to get her better.

As a mother of two and art teacher, the time commitment needed for physical therapy seemed daunting. Yet, when she was able to get an appointment right away with Tanya Kalyuzhny, DPT, MDT, the director of physical therapy at the ONS Greenwich office, Felicity was immediately confident the time would be well spent.

“I could tell that Tanya was very knowledgeable and experienced from the get go,” Felicity explained. “Every time she treated me, she talked me through the entire process, so I knew what she was doing, what I needed to do, and why it was important. “

Treatment began with laser therapy and light weight bearing exercises and eventually involved advanced therapies such as Graston technique and dry needling.

“It was really a pleasure to go there. Everyone was so supportive, the front desk staff, the PT technicians and the therapists. They were always involved with what I was doing. I never felt like I was forgotten or ignored,” she explained. When Tanya announced that Felicity had “graduated” and didn’t need therapy anymore, Felicity was surprised at the void she felt in her life.

“I built a real friendship with Tanya,” she said. “It’s funny to say, but overall it was a pleasurable experience. I recommend ONS to everyone. We are so lucky to have their offices right here in our own backyard. “

These days, Felicity is back doing what she loves most. Painting canvases large and small, teaching art classes at Greenwich Academy and privately, and spending time with her husband and two sons. And she’s anxious to start swinging the tennis racket once the warm weather finally arrives.

Biceps and Shoulder Pain

People with shoulder pain often assume they’ve injured their rotator cuff, but sometimes that is not the only culprit. Shoulder specialist and orthopedic surgeon Dr. Marc Kowalsky of ONS notes that an injury to the tendon of the biceps, the prominent muscle in the upper arm that made Popeye and spinach famous, can cause shoulder pain and other uncomfortable symptoms such as clicking or popping.

“The biceps tendon is an often-misunderstood structure of the shoulder and arm,” said Dr. Kowalsky. “We now know that damage to that tendon is often the primary cause of shoulder pain in active people.”

Anatomically, the biceps muscle has two tendons, called heads, that attach it from the elbow to the shoulder. The tendon of the short head attaches to a bone on the shoulder blade outside of the joint. The long head, usually the source of the pain, takes a circuitous path into the shoulder joint. It then attaches to the top of the socket and the glenoid labrum.

As with any other tendon in the shoulder, the biceps can develop tendonitis and tears. It can be a result of repetitive, strenuous overhead activities. Pain from biceps tendonitis or partial tearing typically occurs over the front of the shoulder. It radiates toward the biceps muscle. If the biceps tendon fully tears or ruptures, patients may notice bruising and a cosmetic deformity as the muscle descends and becomes more prominent, in what is known as a “Popeye sign”. Lastly, you can affect the biceps tendon by instability, particularly in certain overhead athletes including swimmers. Biceps instability can also occur in association with a particular tear of the rotator cuff tendon in the front of the shoulder. When this happens, pain is caused because the biceps has slipped from its bony groove of the upper humerus (head of the arm bone).

Moreover, most patients with tendonitis, a partial, or complete rupture of the long head of biceps can be treated conservatively. You can use a combination of ice, anti-inflammatory medication, physical therapy, and corticosteroid injection, said Dr. Kowalsky. Although the cosmetic deformity from a complete rupture will persist, once the pain from the acute rupture improves, strength and overall function of the shoulder should return to normal. If conservative measures fail to relieve symptoms from biceps problems, surgery may be recommended.  If you experience shoulder pain, consult with a fellowship-trained shoulder  specialist at ONS. 

The Well-Balanced Student Athlete

Watch the panel presentation, The Well-Balanced Athlete,  delivered by ONS physicians at Byram Hills High School in Armonk, NY on February 13, 2018.  Sports medicine experts Dr. Marc Kowalsky and Dr. Demetris Delos were joined by sports psychologist Dr. Alex Diaz, to address such issues as injury prevention, the dangers of sports specialization, sleep and nutritional requirements, and the importance of mindfulness training.  The school’s television station recorded the 90-minute program. If you would like to see the presentation live, the panel will be addressing the Briarcliff Manor school district coaches, parents and students at the Briarcliff Middle School Auditorium on Tuesday, March 13 beginning at 7:00 pm.  There will be time for Q & A at the end of the presentation.  You can also view the PowerPoint presentations given by Dr. Delos and Dr. Kowalsky.

Tips for Running in Winter

Like it or not, winter is here. Whether you’re training for an endurance race or just a dedicated runner, New England winters are particularlyWinter running challenging to one’s safety and resolve. According to Alicia Hirscht, DPT, SCS, CSCS, director of physical therapy at ONS/Stamford, snowy pathways and icy sidewalks, reduced daylight and frigid temperatures all present real risks for those who are willing to brave winter weather conditions to get in their run. But there are a few sensible precautions you can take to stay safe and warm.

LAYER UP

“Experts agree that the trick to staying warm while you’re out in the cold is to layer, but not too much,” Hirscht said. Even though it’s cold outside, your body will generate enough heat to perspire, so it’s important to wear moisture-wicking inner layers to help your body stay warm and dry. Your outer layer should be made from a material like Gore-Tex which lets out the heat while also protecting you against the wind. When deciding how many layers to add, Hirscht suggested that you dress to feel a little chilly when your first step outside. “You will warm up as you get going,” she said. Bearing in mind that everyone’s tolerance to cold is different, in general, if the temperature is below 40, you’ll want two layers beneath your jacket – a light weight base layer and a light fleece top or vest.

We lose as much as 30 percent of our body heat through our hands, feet and head. A hat and running gloves or mittens are essential, again those made of wicking materials are the best. If your hands are particularly sensitive to the cold, Hirscht advised slipping disposable heat packs into your gloves or mittens. If you local running store doesn’t keep them in stock, you can usually find them in a ski shop.

Sometimes it’s impossible to avoid running in slush, but you can keep your feet warm and dry if you forgo light, mesh covered running shoes in favor of sturdier versions with breathable, waterproof uppers. If you don’t feel like buying winter trainers, treat your current shoes with a waterproof spray. If your feet are prone to blister, putting a balm on your feet will keep your toes and heels dry and minimize the friction between soggy socks and shoes.

Some people have difficulty breathing when they exercise in extremely cold weather, especially those with asthma or exercise-induced asthma. If you are breathing heavily, the winter air may induce bronchoconstriction due to the air’s dryness and extreme cold. That’s why Hirscht and other experts recommend slower, endurance runs in the winter instead of high velocity sprints. If cold air affects your breathing, consider wearing a thin, skier’s face mask or waterproof gaiter, or wrap a lightweight scarf across your mouth and nose. Breathing through the nose instead of the mouth will also help reduce the impact of bursts of cold air in your lungs.

STAY VISIBLE

It’s up to you to make sure that you stand out to distracted drivers and or those whose vision is compromised by snow, glare or shadows in dim light. It’s best to have bright, reflective outer clothing or accessories such as reflective wrist bands or clip-on lights to make yourself more noticeable, particularly if your route takes you off the sidewalks and into the road.

HYDRATE

While we do sweat while running in the cold weather, we typically do not feel as thirsty to replenish those fluids as we do when running in warmer weather. Be mindful of this and remember to hydrate both before, during and after your workout. “As with any cardiovascular exercise, remember to continue drinking until you urinate after your exercise, and that the color of your urine is a pale yellow, not dark, cloudy or brown,” Hirscht said. For runners, the general guideline is to drink 16 ounces of water or sports drink before your run. Ideally, you should take in between 5 and 12 ounces of fluid every 15 – 20 minutes during your run, and another 8 ounces within 30 minutes after you stop.

BE SMART

If you are out on a particularly windy day, avoid getting a chill by facing the wind at the beginning of your run so it will be at your back when you make your sweaty return to home. If the temperature is at or below 0 degrees, or the wind chill is below minus 20, be smart and work out at the gym to avoid the chance of frostbite.

Regardless of the season, you should participate in a training program that consists of strengthening and stretching to avoid the types of injuries that can plague runners. This twice weekly program should include exercises for your core, hips, hamstrings and calves. Here are some injury prevention exercises for runners.

An Added Level of Safety to Young Athletes

THE ORTHO ACCESS PROGRAM AT ONS OFFERS AN ADDED LEVEL OF SAFETY TO YOUNG ATHLETES WHO ARE INJURED ON THE FIELD. 

If you missed yesterday’s  Well column in The New York Timesit focused on the lack of national safety standards to protect student athletes from crippling or fatal injuries.  Individual states and theinjured on the field schools within them, for the most part, haven’t yet adopted injury prevention and treatment policies or procedures for children who play organized or league sports either. The responsibility is all too often left to coaches and parents to assess what measures to take when a young athlete is injured and when they can return to play. 500 student athletes died last year due to poor decisions made immediately following injury, according to the article. The ORTHO ACCESS program at ONS is designed to add an extra layer of medical support and injury prevention education for coaches, athletes, and parents. During the first critical moments after a player is hurt,  ONS ORTHO ACCESS sports medicine physicians helps to determine the best immediate course of action to take. Read  more.

 

 

The Importance of Injury Prevention: Don’t Become a Statistic

QUALITY OF LIFE, ACTIVITY AND PRODUCTIVITY ARE AFFECTED BY PAINFUL ORTHOPEDIC CONDITIONS. 

One in two Americans over the age of 18 and nearly three out of four age 65 and older have a musculoskeletal condition costing an estimated $213 billion each year in treatment, cadolori articolari 1re and lost wages, according to a report by the United States Bone and Joint Initiative (USBJI), The Impact of Musculoskeletal Disorders on Americans: Opportunities for Action.

The study finds that the quality of life, activity and productivity of an estimated 126.6 million American adults are affected by painful conditions and disorders affecting the bones, joints and muscles, a number which is comparable to the total percentage of Americans living with chronic lung or heart conditions. Among children, musculoskeletal conditions are surpassed only by respiratory infections as a cause of missed school days.

The report states that arthritis and related conditions top the list of orthopedic ailments (51.8 million adults) followed by back and neck pain (75.7 million combined). With an aging population, the number of people faced with musculoskeletal discomfort can be expected to greatly increase.

Fortunately, advances in diagnostic and treatment technologies, such as those that are available from the sub-specialists at ONS, can provide patients with pain relief and a safe return to mobility. However, the report underscores the importance of injury prevention strategies for individuals of all ages and the need for prompt treatment when injuries occur and orthopedic conditions first appear. With top orthopedists, neurosurgeons, physical therapists and physiatrists, ONS is committed to finding non-surgical options as the first line of treatment. Only 10 percent of ONS patients require surgery.

Tips to Prevent Back Injury from Shoveling Snow

If the local forecasts are to be believed, many of us will be doing a fair amount of snow shoveling this weekend. Before you bundle up and head out, though, Dr. Jeffery Heftler, an interventional pain Blog-shoveling show 300 pxspecialist at Orthopedic and Neurosurgery Specialists (ONS) in Greenwich and Stamford, has a few words of advice to protect your back from strain and injury.

“The most important thing is to stay ahead of the accumulation of snow. It’s much easier on your back to shovel after every few inches has fallen than to wait and lift heavier loads of snow for a longer period of time,” he advises. Waiting can make the task even harder if the snow melts and then freezes over. Dr. Heftler also recommends investing in so called “push shovels” that are specially designed for pushing the snow aside while shovels with bent handles can help ease the tension on back and shoulders.

Without a doubt, Dr. Heftler sees more patients with back pain following a large snow storm. One reason, he suggests, is that people tend to think of shoveling snow as a nuisance and chore, when in fact it is an intense and strenuous exercise. “All too often, people who are generally inactive underestimate the physical challenge involved in clearing snow. Even someone in good shape can strain their back from the rotation of lifting the snow and throwing it over their shoulder,”   he says.

To protect your back, it’s best to take a few moments to warm up your muscles before going out in the cold. When shoveling, maintain the correct posture and technique to minimize the pressure on your weaker back muscles. Avoid rounding your lower back, for instance. Instead, go through the motions with a straight back leaning forward and your knees slightly bent. Use your core, hips and hamstrings to provide strength and stability instead of relying on your back and shoulder muscles to do the heavy lifting.

People with pre-existing back conditions are most vulnerable to shoveling related injuries and should avoid the activity altogether. “Even if you have to hire someone to clear the snow for you, it will pay for itself in terms of avoiding pain and days lost from work and winter sports,” Heftler says.

If you do experience pain while shoveling, Dr. Heftler says to stop, go inside and rest in a comfortable position until the discomfort passes. He recommends anti-inflammatory medications such as Advil or Aleve, and using ice or heat directly on the area where the pain is most acute. If the pain is severe and persists through the next day, consult with a physician.

USA Rugby National Team Physician Marc Kowalsky, MD: Injury Prevention Strategy

Kowalsky MD World Rugby 2015 Pacific Nations CupONS Orthopedic Surgeon, Marc Kowalsky, MD, USA Rugby National Team physician returned from the Pacific Nations Cup this week.

“The USA Rugby National Team lost to Samoa in the first round of the Pacific Nations Cup, 21-16 at Avaya Stadium in San Jose, California. This match was a preview of the match-up between these two teams in pool play for the Rugby World Cup this fall. While the Samoans, ranked 9th in the world they jumped out to an early lead in the first half. The Eagles battled valiantly in the second half, but fell short of victory by only five points.” (more about the game)

Dr. Kowalsky traveled with the team during their week of preparation, and served as team physician for the match. The Eagles contended with a tough Samoan team, known for their physical style of play. Fortunately, neither team sustained catastrophic injuries during the match.

Now back in Connecticut, Dr. Kowalsky looks forward to the fall season of high school, collegiate, and men’s rugby, passing along to athletes these tips for injury prevention strategy:

  1. Adequate nutrition and hydration are imperative not only to optimize performance, but also to avoid overuse injuries during training and competition.
  2. A supervised strength and conditioning program is essential.
  3. Athletes must respond early to symptoms of impending injury when possible, and seek the care of their training staff and team physician.

Dr. Kowalsky is not only team physician for USA Rugby National Team but also for Iona College Rugby Football club and White Plains Rugby Football Club.

USA Rugby National Team Doctor from ONS

March 27, 2014; Atlanta, Georgia, USA; USA Men's Eagles training session before the second leg of the Rugby World Cup 2015 qualifier game against Uruguay at Life University
KOWALSKY, MD: March 27, 2014; Atlanta, Georgia, USA; USA Men’s Eagles training session before the second leg of the Rugby World Cup 2015 qualifier game against Uruguay at Life University

Rugby is one of the fastest growing sports in the United States, with a 33% annual increase in participation among youth athletes. In part, the popularity of rugby in the US can be attributed to an increased visibility of the sport at the high school and collegiate levels, and the recent success of the USA Rugby National Team. The US fields a “7s” and a “15s” team, characterized by the number of players on the field during competition. The 7s team recently qualified for participation in the 2016 Rio Olympics. This will be the first time the sport is featured in Olympic competition since 1924. The 15s team, otherwise known as the Eagles, is currently ranked 16th in the world, and qualified to compete this fall at the 2015 Rugby World Cup in England.

Orthopaedic & Neurosurgery Specialists have a long-standing tradition of providing orthopedic care for young rugby players. ONS doctors have served as team physicians for the Greenwich High School rugby team, one of the strongest high school teams in the country. Currently, orthopedic surgeon and sports medicine specialist Dr. Marc Kowalsky is the team physician for the USA Rugby National Team. Having played rugby himself at Dartmouth College he understands the game from a medical and player’s perspective. He also serves as team physician for the Iona College Rugby Team and the White Plains Rugby Football Club.

“Injuries that are typically encountered in rugby encompass the entire spectrum of injuries treated in any collision sport.  As with American Football, there has been a significant increase in attention to concussion and traumatic brain injury in the sport. World Rugby, the governing body of international rugby, and USA Rugby, have devoted a significant amount of time, energy, and resources to optimize the prevention, detection and care of concussion and traumatic brain injury among rugby players.

Two of the important measures to prevent concussion from occurring are, avoiding contact in the sport at a young age, and proper instruction about safe tackling as contact is introduced.  At the elite level, techniques for safe tackling are certainly reinforced. From the perspective of the medical team, all members of the USA Rugby medical staff are required to complete the IRB Level 2 Immediate Care in Rugby Course to prepare for the management of catastrophic injuries during training and competition.  Physicians and trainers are additionally required to complete extensive training in the assessment and management of concussion in particular. 

Another key tool is a baseline neurocognitive exam to measure an athlete’s cognitive function, or the ability to process information. All players complete neurocognitive testing once they join the team, to establish baseline values for each athlete, which become important in the assessment of an athlete who may have sustained a concussion.”

Rugby,calcioWorld Rugby and USA Rugby continue to improve the medical team’s ability to assess injured athletes during competition. Clear guidelines have been established to guide treatment and determine an athlete’s ability to return to play.  All of these measures will be in place as the USA Rugby National Team prepares for competition in the Pacific Nation’s Cup, July 18, 2015. Dr. Kowalsky will accompany the team and serve as team physician.

ONS Stamford: Off to a Great Start

ONS_Stamford
5 High Ridge Park, 3rd floor, Stamford, CT 06905

On the evening of June 22, 2015, Orthopedic & Neurosurgery Specialists (ONS) held a grand opening celebration of a second ONS location at 5 High Ridge Park in Stamford, CT. The event was a first look at the new facility for the public, complete with informative stations about injury prevention, exercise tips and sports medicine stations with medical models and video presentations. Throughout the evening, around 200 guests toured the office, and learned about injuries and treatments of the foot and ankle, hand and wrist, shoulder and elbow, hip and knee, spine and Platelet Rich Plasma treatment. ONS physicians were available to answer questions. ONS Physical Therapy showcased injury prevention exercises for tennis, golf and running. Local businesses participated in the evening as guests enjoyed food and beverage and displays and a drawing of exciting prizes. The ONS physicians, clinicians and staff members were pleased with the opportunity to meet and greet the Stamford community! To learn more about our new Stamford office please visit https://onsmd.com/ons-stamford/.

An Arthritic Reality Check

Arthritis affects more than 52 million adults in the United States and is the most common cause of disability,” according to the CDC. The pain from arthritis can set the stage for a decline in physical activity and make it difficult to prevent chronic health problems. Unfortunately, some who suffer from this ailment stop their activity and become depressed from thoughts of the mobility they once had.

Solutions for Knee Pain ArticleJane E. Brody, author of the “Keep  Moving to Stay a Step Ahead of Arthritis” article in The New York Times recently attempted to relate to those suffering from arthritis by speaking of her own battle with having to put down the tennis racket after decades of enjoying the sport, and her story did not end there. Two years after that, she had joint replacement surgery, picked up an assortment of other activities that successfully replaced tennis as a main source of activity. Therefore, encouraging others to do the same and not succumb to the depression that can sometimes come in hand with arthritis.

The reality is that the majority of people dealing with arthritis do not fully understand what they are capable of. Less than 10% of participants with arthritic knees in a 10-year study met the national guidelines of doing two and a half hours of moderate physical activity a week. Yes, you read that correctly, a week! It gets better though. Participants did notice a significant improvement of function when the amount of activity per week was increased. Additional weight on the body creates unnecessary stress on the major joints as well, leaving a 10% decrease in weight able to make a noticeable difference. With this fact a recommendation of starter exercises were mentioned, including walking laps in a swimming pool and then increasing activity as the muscles gain strength.

For more insightful tips, come to Dr. Delos’ talk about “Solutions for Knee Pain in Active Patients with Arthritis” tonight! The program is free and open to the public! Registration Requested. Aside from the talk, please consult your physician if this article has hit home and/or your quality of life is not what it once was; ONS provides excellent service and care for those in need, proudly keeping up-to-date with developments in the field.

ONS is Expanding!

Stamford announcment art.smWe are excited to announce that ONS will open an expanded, state-of-the-art office and physical therapy facility at 5 High Ridge Park in North Stamford in June. Construction began in January and is expected to be completed by the end of May.

The Stamford location will offer a team of physicians and clinical staff dedicated to that office. Some of our other surgeons from Greenwich will also maintain a schedule to see patients in Stamford on a weekly basis. In addition to the doctors’ office, the site will feature a state-of-the-art physical therapy facility outfitted with the latest equipment in an aesthetically comfortable and healing environment.

The new facility is being added in order to accommodate ONS’s growing patient population in the Stamford, New Canaan, Darien and surrounding communities. “Many of our patients come from the Stamford area. Now they can receive the excellent level of orthopedic and neurosurgical care they count on without having to drive to Greenwich,” explained Dr. Seth Miller. In house x-ray and a fully integrated electronic medical records system will make the ONS Stamford office a convenient choice for patients in that area.

Collaborative Solutions for Safety in Sport 2015

Gloria Cohen, MD
Gloria Cohen, MD

ONS specialists are on a mission to spread the word about health! Gloria Cohen, MD participated in the first Collaborative Solutions for Safety in Sport Meeting at the NFL Headquarters in New York City on March 26-27 with more than 20 other members of the AMSSM (American Medical Society for Sports Medicine); an organization of sports medicine physicians in multiple fields dedicated to education, research, and advocacy.

The meeting was strongly influenced by the “2013 Inter-Association Task Force for Preventing Sudden Death in Secondary School Athletic Programs: Best Practice Recommendations” giving it a focus on safety and health issues at the secondary sports level. Speakers encouraged best practices and protocols and this fit perfectly with Cohen’s belief in a comprehensive approach to prevention and treatment of injury. They concerned the establishment with heat-related illnesses, cardiac conditions (use of AEDs), head and neck injuries and the overarching need for emergency action plans in all high schools. ONS would like to thank the participants for understanding how important preventative care is.

Aside from the talk Dr. Cohen is not only a recognized authority in sports medicine, she is a successful competitive runner who has qualified twice for the New York Marathon. She has also held the title as head team physician for the Canadian National Olympic Cycling Team for 14 years while still enjoying off-road and road cycling herself. All in all, we are incredibly proud to have her on our team.

Who is Tommy John and why did he have surgery?

Putting On White GlovesWhat is Tommy John surgery? Dr. Sethi and Yu Darvish of the Texas Rangers know. It is when an individual undergoes the reconstruction of a torn ulnar collateral ligament. Dr. Paul Sethi of ONS is a disciple of Dr. Frank Jobe, the man who did an ulnar collateral graft in Tommy John’s elbow in ’74 and so created the most famous baseball-medical connection since Lou Gehrig’s disease (also known as, ALS).

Another person to know in this field is Dr.Glenn Fleisig, a man who is well versed in this topic and has made a career out of arm injuries. He was recently interviewed in an article about the Tommy John surgery after a presentation at MIT Sloan Sports Analytics Conference about his collaborative study with Stan Conte of the Los Angeles Dodgers.

The research in the study noted that the Tommy John surgery is becoming more common, as more pitchers had the surgery in 2014 than in the 90’s combined. Although the success rate of the surgery is high, 20 percent of pitchers never regain a full level of performance even after PT. Other topics covered in the interview include:

  • What causes tears and the surgeries that follow

  • Whether it is the arm speed or the pitcher has his forearm cocked that far back

  • How long should we expect a pitcher to be out after TJ nowadays

  • Overuse of the ligament

  • Risk Factors and more

Read the Grantland article in order to enjoy the full interview about the Tommy John surgery.