ONS’ New Partnership

Orthopaedic & Neurosurgery Specialists (ONS), the leading provider of multi-specialty orthopedic and neurosurgery services in Connecticut and Westchester, announced today a growth capital investment from Kohlberg & Company, L.L.C. (“Kohlberg”), a leading private equity firm headquartered in New York. Kohlberg is partnering with ONS to continue expanding its extensive offering of clinical care capabilities and ancillary services while serving a broader base of patients in the Tri-State area.

ONS, headquartered in Greenwich, Connecticut, is a multi-specialty physician group with three locations in Greenwich, Stamford, and Harrison. The Company’s clinical offering covers a wide range of sub-specialties including orthopedic, sports medicine, joint replacement, neurosurgery, physiatry and ancillary services such as physical therapy and MRI. ONS partners operate an ambulatory surgery center and an urgent care center, providing the highest quality of care through a full continuum of care.

Seth Miller, MD, Co-Founder and Executive Committee member of ONS, remarked, “We are incredibly excited to partner with Kohlberg and to pursue the next chapter of the Company’s growth. Kohlberg brings extensive industry experience and financial resources with a proven track record of investing in leading healthcare services companies.” Mark Camel, MD, Co-Founder and Executive Committee member of ONS, stated, “We believe Kohlberg will be the ideal partner to help implement our plans for strategic growth and to expand our clinical model to better serve our patients today and going forward.”

“ONS is a clear market leader in orthopedic services with an unparalleled reputation for providing best-in-class patient care and delivering industry-leading clinical outcomes,” commented Robert A. Cucuel, Operating Partner of Kohlberg. “We are thrilled to partner with ONS, and we look forward to supporting ONS’ continued expansion as well as their unwavering commitment to delivering the highest-quality patient care.”

About Kohlberg & Company, L.L.C.

Kohlberg & Company, LLC (“Kohlberg”) is a leading private equity firm headquartered in Mount Kisco, New York. Since its inception in 1987, Kohlberg has organized eight private equity funds, through which it has raised over $7.5 billion of committed equity capital. Over its 32-year history, Kohlberg has completed 76 platform investments and nearly 200 add-on acquisitions, with an aggregate transaction value of over $15 billion.

For more information visit: www.kohlberg.com.

Jumping for Joy with New Knees


No one expects the pain of arthritis to affect a thirty-something adult, but that’s what Westchester middle school teacher, Mallory Chinn, was faced with.  For 5 years, Mallory tried every non-operative treatment available to ease the worsening pain in her knees. Some treatments would work for a while. Others did not work at all. By the time Mallory turned 40, her pain was debilitating. She had trouble walking and climbing stairs, and missed out on family activities such as bike rides and hikes in the woods.

“I was pretty much immobilized,” recalled Mallory, now 43.  The defining moment came one day when her youngest child, then 7 years old, ran ahead of her.  “When I tried to chase up the hill after him, I was stopped in my tracks by an excruciating stab in my knee.  I thought ‘this is ridiculous. How can I be so young and not mobile?”

By this time, Mallory’s arthritis was severe, often referred to as bone-on-bone. She looked ahead to the life she wanted to have going forward and it didn’t include constant pain and physical limitations.

“I wanted to be able to live an active life and keep up with my kids, so I decided to go for it,” she said of her decision to undergo a double knee replacement procedure.


On August 11, 2017, Dr. Demetris Delos of ONS performed the surgery at Greenwich Hospital. The procedure went according to plan. However, as anyone who has recovered from a knee replacement can attest, the road to recovery is a slow, challenging process that requires months of rehabilitation.

Following surgery, Mallory recuperated for a few weeks at an in-patient rehabilitation facility.  Upon release, she went to a number of local physical therapy centers to continue her rehab program. Time after time, she was disappointed by the therapists’ indifference to her concerns and pain. As soon as Mallory learned that ONS had a state-of-the-art physical therapy center at the Harrison office, she made an appointment. At ONS, she found the physical therapists were kind and highly-skilled at helping joint replacement patients get moving again.


“Everyone made it a happy, safe place to heal. I actually looked forward to going to therapy because it felt like I was a part of a big family,” she said. Mallory praised the therapists and PT Techs and the integrated care she received.  Once when there was a concern about one of her wounds, the therapist, Robert Spatz, PT, reached out to Dr. Delos and received a reply within a minute.

“Dr. Delos and the Physician Assistants were always there if I had questions or needed a prescription refill.  Whenever Dr. Delos was at the Harrison office, he always came over to PT to see how I was doing,” she said.  When it came time to come off the narcotics, Dr. Alex Levchenko, an ONS physiatrist, introduced Mallory to alternative pain management strategies.  “I didn’t even know ONS had doctors that could do that,” she said.

Mallory was particularly impressed by the amount of time Spatz, who is also the director of PT at that office, spent working with her.

“In other places, I’d see the therapist for a minute and then I’d be handed over to a tech for the rest of the hour.  Robert always gave me a big chunk of his time,” she said.  “He was respectful of my tolerance and goals. He went out of his way to educate me about each step of the recovery process.”

Mallory went to PT three times a week until she “graduated” in December of that year. She was strong and stable enough to continue her strengthening using a tailor-made workout she could do at the gym.


Since then, Mallory has fully reclaimed mobility in her life and enjoys activities with her friends and family.  She has hiked in the mountains of Colorado, and can spend an entire day walking around New York City.  At a summer camp last year, Mallory led a group of 30 girls through a physically challenging Ninja Race course.  In May, Mallory picked up a jump rope during her school’s Wellness Week, and got hopping.  “I wasn’t the bounciest person out there, but I could never have done it before my knee replacements.”

Although Mallory is completely recovered, she has had occasions to visit ONS.  She brought her husband to the Harrison office when he needed treatment for back pain. She was back again when her daughter sustained an athletic injury. Each time, she has been welcomed with the same kindness she first experienced during her time there. “I tell everyone that ONS is the best.  I’ve sent family members and friends there. I wouldn’t even think of going anywhere else,” she said.

Take your first step toward an active life.   Schedule an appointment online with an ONS total joint replacement specialist or call 203-869-1145.

Female Athlete Triad Syndrome

By Katherine Vadasdi, MD, director of the ONS Women’s Sports Medicine Center


It is well known the students of all ages benefit from sports and exercise. However, when girls and young women become too intense with training and overly restrictive with their diet, their health may be at serious risk.

Relative energy deficiency syndrome (RED-S), more commonly known as Female Athlete Triad Syndrome, occurs from a gross imbalance between the nutritional needs of a maturing female body and the amount of energy that is expended during sports or exercise.  Triad refers to three resulting conditions: disordered eating, amenorrhea, or the cessation of menstruation, and osteoporosis.

Many girls who develop this disorder try to lose or maintain a low body weight to improve their athletic performance.  Sadly, the opposite is more likely to happen.  Athletes with RED-S become more easily fatigued and their concentration is diminished.  If a girl doesn’t have enough fat on her body,  the muscles will be starved to supply energy to the body, making them weaker.

At a time in life when girls should be building bone mass that will support them throughout life, girls with RED-S have lower levels of estrogen. When combined with poor nutrition,  her bones to become thin and possibly deformed. Girls with early onset osteoporosis are more vulnerable to season-ending stress fractures, broken bones and other injuries. Internal organs, including the heart, also suffer.

Intense exercise and caloric restriction can decrease the hormones that regulate the menstrual cycle. This may compromise her reproductive system later in life.

Schedule an appointment with an ONS women’s sport medicine specialist or call (203) 869-1145


The girls at greatest risk for developing RED-S tend to participate in sports that classify athletes by weight, or those where there is a perceived advantage in appearing thin. Low self-esteem, a tendency toward perfectionism, and stress from school, peers or at home are compounding risk factors.


Because RED-S has physical and psychological factors, the most effective treatment is a team effort among doctors, coaches parents, nutritionists and professional counselors.

If you suspect someone you know is at risk for female athlete triad syndrome, it is important for her to see a sports medicine specialist who can recognize the signs of the disorder.  Left untreated, the toll on her body will have lasting effects that in extreme cases, can lead to death.

Girls can be protected from developing this serious condition if they are empowered to set realistic expectations for themselves. Moreover, they need to be educated about the healthy nutritional and hydration requirements for their level of daily activity. They should also understand the importance of sleep and rest to allow the body to recover. Stress management techniques such as meditation, yoga or other calming activities will help them build healthy coping skills that will be useful for a lifetime.

Schedule an appointment with an ONS women’s sport medicine specialist or call (203) 869-1145

NY Magazine 2019 Best Docs

Best Doctors NY Metro

Congratulations to the five ONS physicians who are included in the New York Magazine 2019 Best Doctor issue, now on newsstands!

The New York Magazine Best Doctor issue recognizes medical specialists in the NY metro area who have been ranked above others in their area of expertise. Published annually, the list of leading physicians is culled from the database of the medical research and information company, Castle Connolly Medical Ltd.

Best Doctors in Neurosurgery


 Best Doctors in Orthopedic Surgery

Best Doctors in Physical Medicine and Rehabilitation




Castle Connolly conducts annual peer-review surveys across the country to compile regional and national lists of top doctors. The Top Doctors: New York Metro Area database, for instance, reflects those physicians whom Castle Connolly has determined to be among the top 10 percent in the region.  In January, 15 ONS specialists appeared in Moffly Media magazines, Top Doctors in Fairfield County, which also relied on Castle Connolly data.

ONS Urgent Ortho Care in Stamford

Following last month’s successful launch of ONS Urgent Ortho Care (OUOC) during business hours at the ONS Harrison, NY office, ONS has introduced walk-in, daytime hours for emergency musculoskeletal treatments at its offices in Stamford, CT at 5 High Ridge Road, 3rd floor. ONS is in network with all major insurances.


As with OUOC in Harrison, Stamford area residents now have a fast, cost-effective and convenient alternative to the long waits and expense that can accompany a trip to a hospital emergency department for treatment of sprains, fractures or other musculoskeletal injuries. 

During the hours of 8:00 am through 5:00 pm, patients with injuries to a bone, joint, ligament, muscle or nerve can receive immediate treatment from the region’s leading orthopedic and spine professionals in Stamford.

According to ONS President, Seth Miller, MD, the addition of the daytime ONS Urgent Ortho Care services in Stamford now provides residents in and around Stamford with convenient access to emergency orthopedic care, day and night.

“We have found that patients prefer the high standard of specialized orthopedic care that ONS delivers, where and when they need it most,” said Dr. Miller.  


After hours, walk-in care has been available at ONS Greenwich, 6 Greenwich Office Park, for nearly one year. In Greenwich, no appointment is necessary from Monday through Friday from 5:00 – 8: 00 pm and from 12:00 through 4:00 pm on Saturdays. 




Dr. Kowalsky at Int’l Rugby Tournament

Dr. Kowalsky Team DoctorDr. Marc Kowalsky will be in Alicante, Spain this week as team physician for the Northeast Rugby Academy Men’s U23 team, who will compete in the 33rd Annual Costa Blanca Rugby Sevens Tournament.  The Northeast Academy Men’s U23 team will compete in the Elite division along with teams from Europe, Africa, and South America, including several national Sevens teams.

Sevens games are more fast moving and free flowing than a regular union rugby match.  A union game of 15s rugby, when there are 15 men on the pitch, lasts 80 minutes. Sevens, on the other hand, with 7 players on the pitch, has 7 minute halves, with a 2 minute half-time. In Sevens, players who have been subbed out are allowed to go back into the game.

Dr. Kowalsky has served as medical director for this organization since November, 2018.  Northeast Academy is the official USA Rugby National Development Academy for the identification and development of athletes from the northeast region for participation in the USA Rugby national teams and the USA Olympic rugby teams.  Dr. Kowalsky is also team physician for the USA Rugby national team, the Eagles.

ONS adds Urgent Ortho Care hours in Harrison


Orthopaedic & Neurosurgery Specialists (ONS) has launched walk-in emergency orthopedic services during weekday business hours at its office at 500 Mamaroneck Avenue in Harrison, NY.  No appointment is necessary.


ONS Ortho Urgent Care provides patients with a fast, cost effective and convenient alternative to hospital emergency room visits in the event of a sudden, acute musculoskeletal injury.  During the hours of 8:00 am through 5:00 pm, patients with injuries to a bone, joint, ligament, muscle or nerve can receive immediate treatment from the region’s leading orthopedic and spine professionals. ONS is in network with all major insurances.


By offering daytime hours to emergency patients, ONS is expanding on the success of the after hours. Further, walk-in urgent orthopedic care that has been available at the ONS office in Greenwich at 6 Greenwich Office Park in Greenwich since June 2018. ONS Urgent Care in Greenwich is available from Monday through Friday from 5:00 – 8: 00 pm and from 12:00 through 4:00 pm on Saturdays. 

According to ONS President, Seth Miller, MD, the introduction of the daytime ONS Urgent Ortho Care services in Harrison provides patients with the convenience of emergency care options, day and night.

“Accidents can happen to anyone at any time,” said Dr. Miller, “With ONS Urgent Ortho Care available during the day in Harrison and after hours in Greenwich, ONS is continuing its mission to provide patients with convenient, specialty care where and when they need it most.”

Dr. Sethi Teaches in India


Dr. Paul Sethi was one of the distinguished surgeons who joined an international faculty at the 4th Ganga Operative Arthroscopy Course (GOAC) 2019, at Ganga Hospital in Coimbatore, India. The educational event ran from March 22 – 24 and drew more than 500 surgeons from across India. Dr. Sethi delivered lectures on shoulder and knee arthroscopy and performed surgeries that were simultaneously broadcast live to three packed lecture halls.


Arthroscopy is a minimally-invasive procedure that allows orthopedic surgeons to look inside a damaged joint for diagnosis and treatment.  During the procedure, the surgeon will make a small incision and insert an arthroscope. It is a tiny television camera and fiber optic light that magnify the structures inside the joint.  The camera projects an image of the joint on a screen, which allows the surgeon to assess the damage and type of surgery, if any, is needed.  If a surgical repair is determined, the surgeon will use special small tools to correct the injury.  In some cases, this may involve cutting or shaving bone, for instance, or anchoring torn tissue to the bone. shoulder and knee surgery spectators

Depending on the severity of the condition and treatment required, the surgery can be done in a hospital or at an ambulatory surgical facility.Dr. Sethi at Arthroscopy Course











Another Achievement Award for Dr. Sethi

Congratulations to Dr. Paul Sethi who received the prestigious 2019 Achievement Award from the American Academy of Orthopaedic Surgeons (AAOS) for his many contributions to education, research and advocacy in both AAOS endeavors as well as elsewhere in the profession of orthopaedic surgery.

In addition to being an outstanding orthopedic surgeon and Castle Connolly Top Doctor in America, Dr. Sethi is president of the ONS Foundation for Clinical Research and Education (ONSF). Dr. Sethi’s research has recently included clinical study of the use of a long lasting analgesic, Exparel, during surgery to reduce the need for opioids to control post surgical pain; 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.

Sports and Longevity: The Ball is in Your Court

It has become well known that an active lifestyle plays an important role in a person’s health and well-being.  But is one physical activity more beneficial than another? A group of Danish  researchers conducted a study to find out. The answer was yes.

The study was based on 25 years of data collected from 8,577 participants in the Copenhagen City Heart Study, sponsored by the Danish Heart Foundation.  Among the study group, 12 percent reported a sedentary lifestyle with no physical activity, while 66 percent participated in at least one type of physical activity.

When compared to the sedentary group, sports that were associated with the greatest gains in life expectancy involved interval bursts of exercise. It engaged large muscle groups along with full body movements, according to study author and cardiologist Peter Schnohr, MD, DMSc of Frederiksberg Hospital in Copenhagen. Dr. Schnohr and six co-authors published the report in Mayo Clinic Proceedings.

Activities associated with the longest life expectancy were racket sports. On average tennis players lived 9.7 years longer than the sedentary group and badminton players gained 6.2 years. Following was soccer (4.7 years), cycling (3.7 years), swimming (3.4 years), jogging (3.2 years), strength and toning or calisthenics (3.1 years) and health club activities (1.5 years.)

Interestingly, length of time engaged in an activity didn’t increase life expectancy.  For example, people who used gym equipment like treadmills, stair climbers and stationary bikes had the shortest lifespan benefit even though they worked out an average of 2.5 hours per week. In contrast, tennis players who played an average 1.7 hours per week had the greatest gains.  Moreover, sports that involved social interaction, whether team sports or sports with partners and opponents, were associated with the greatest improvements in longevity. However, because this is an observational study, the authors caution that the relationship between certain sports and longevity warrants further investigation.  People who don’t play tennis or badminton shouldn’t lost heart, though.  Noted Sports ONS Medicine Specialist, Dr. Marc Kowalsky, “The best exercise is the one you actually do.”

ONS Adds Joint Replacement Case Manager

Tori Kroll, RN, is known to many ONS physicians and staffers from her former position. She was the coordinator for joint and spine programs at Greenwich Hospital.  Tori worked in various departments at the hospital for 38 years, and it was there that she developed her love of orthopedics and helping orthopedic patients.

“This is a dream job for me,” she said of joining ONS.

In this newly created role, Tori will provide joint replacement patients with a full continuum of personalized care from the time a surgery is scheduled through the initial months of recovery.  Further, the position provides many advantages to patients, including a direct line for any questions or concerns.  In addition, Tori may visit patients’ homes to evaluate post-op safety and arrange for supportive equipment, if needed. She may also coordinate post surgical at-home care or a stay at a skilled-care facilities of preferred providers.

“It’s all about achieving the best outcomes,” said Tori. “By establishing a close relationship with patients, we can fully prepare them for every level of the procedure and after.”

ONS Urgent Ortho Care now in Greenwich

If you’ve ever experienced a long wait in an emergency department when you’ve suffered a sudden sprain or broken bone, you will appreciate the new orthopedic urgent care service that ONS launched on Monday, June 18.

ONS Urgent Ortho Care offers after-hours emergency orthopedic care at the ONS Greenwich office at 6 Greenwich Office Park, between the hours of 5:00 pm and 8:00 pm, Monday through Friday and Saturday from 12 – 4:00 pm.  No appointment is necessary.

“Orthopedic injuries can happen to anyone at any time,” said Seth Miller, MD, president of ONS. “ONS Urgent Ortho Care gives patients a fast, convenient and less costly alternative to a visit to an emergency room.  Patients can walk in and be seen right away by a professional orthopedic team who are trained to deliver state-of-the-art-care for musculoskeletal injuries.”   Studies show that sprains and fractures rank among the top ten reasons for a visit to an emergency department.

“ONS Urgent Ortho Care is a continuation of our mission to provide our surrounding communities with the highest standard of specialized orthopedic and spine care,” Dr. Miller said.  ONS is in network with all major insurances.

Further, ONS currently offers same day appointments during business hours for patients who experience a sudden, acute musculoskeletal injury between 8:00 am and 5:00 pm, Monday through Friday.  Patients can request same day appointments by calling 203-869-1145.

With 25 sub-specialty trained physicians in orthopedics, neurosurgery, sports medicine and physical medicine and rehabilitation, ONS has been the one of the most comprehensive and advanced practice of its kind in the region for more than 20 years. ONS has offices in Greenwich and Stamford, CT and Harrison, NY which offer a state-of the-art medical facility, onsite physical therapy centers, digital x-ray and MRI.  Note: ONS Urgent Ortho Care is currently available at the Greenwich office only.

An All-Star Comeback

When Greenwich High School senior, Alex Mozian, accepts his diploma in June, he will be celebrating the culmination of a remarkable year as Greenwich High School’s hockey star.  After leading the Cardinals to the finals of the state championship, the 18-year senior was awarded team MVP as well as the Division 1 MVP and 1st Team All State by the CT State Hockey Coaches Association, among many other honors.  What’s even more impressive about the young athlete’s accomplishments during his final year on the ice as a Cardinal is the fact that he was sidelined during his junior year for the entire season after sustaining consecutive injuries, any one of which could have ended his career.

“Before the injuries, Alex was getting noticed by college scouts.  He was also selected for the USA hockey regional showcase camp, where college recruiters check out the talent,” explained Joe Mozian, Alex’s father. “Junior year should have been his year.”

Instead, Alex faced the daunting task of recovering and rebuilding his strength to get back on the ice as quickly as he could, working with a team of ONS specialists and physical therapists to help get him there.

Alex’s troubles began in December, 2016, when the skate of an opposing player lacerated Alex’s lower right leg.  Alex collapsed on the ice and was taken to the nearest hospital emergency department where the injury was stitched up. Once at home, the pain and swelling increased hourly. It became apparent to parents and player that something more serious had occurred.  Alex was able to see ONS foot and ankle orthopedic surgeon, Sean Peden, MD, the next morning.

Based on the nature of the cut and Alex’s inability to lift up his leg, Dr. Peden determined that a critical tendon had ruptured – the anterior tibial tendon. This tendon is responsible for lifting the foot during activities. A prompt MRI was obtained which confirmed the diagnosis.

“The tendon was completely severed and had retracted, meaning the cut edges had separated from each other significantly,” said Dr. Peden. Knowing how important return to play was to Alex, Dr. Peden performed a procedure that would allow him to maintain strength as much as possible to support a quicker recovery. He was in a cast for just 2 weeks.

Alex showed the same determination off the ice as he so regularly did on the ice.  When he wasn’t working on post-surgical rehabilitation with his ONS physical therapist, Courtney Kirellis, to regain strength and mobility in his lower leg, Alex focused on building his upper body and core strength.

Remarkably, Alex was back on the ice by mid-March, and scored a hat trick and an assist at his first game in April, which was a national championship game.  The family’s excitement was short lived, however. During his third game back, Alex suffered a knee-on-knee collision with an opponent that resulted in a lateral meniscus tear to his left knee.  Once again, the Mozian family turned to ONS.

“After the fantastic experience we had with Alex’s first surgery, Alex insisted that he wanted to go back to ONS,” said Joe. “We had every confidence he would get the best care there.”

“Everyone at ONS made me feel like I was their most important patient.  I felt like they were working with me so I could achieve my goals,” Alex explained.

Sports medicine physician and knee specialist, Dr. Katherine Vadasdi, surgically repaired the injury.  The procedure went without a hitch, but Alex was in for the long haul with physical therapy rehabilitation. Not only did he miss the rest of the Nationals tournament, he had to sit out the US hockey showcase, and all the spring and summer showcase tournaments for colleges.

Understandably, the second injury took an emotional toll on the young athlete, as he watched his peers get accepted to college teams. But with Courtney’s help, Alex regained his strength and determination to stay active and ready to play. On his own, Alex lifted weights in his basement and practiced shooting 100 pucks a day while standing on one leg – the leg Dr. Peden had repaired.

“Alex was an ideal patient,” said Dr. Vadasdi, “He did everything in his power to stay strong and positive throughout a tough healing process.

Alex was cleared to skate in August, and when the school year began that fall, he was ready to reach out to recruiters.  Then, the unthinkable happened.  A freak collision with an opponent brought Alex crashing to the ice with the hockey stick still in his hand.  The injury?  A broken scaphoid bone in his right wrist, a particularly difficult bone to repair.  While most upper extremity fractures take about 6 weeks to heal, scaphoid fractures typically take at least 12 weeks and sometimes as long as 6 months to heal.

This time Alex trusted the skilled hands of ONS’s Dr. Mark Vitale, an award-winning hand and wrist surgeon. Dr. Vitale understood how desperately Alex wanted to get back on the ice, and surgically inserted a tiny compression screw to stimulate healing.

“The surgery was personalized to Alex to allow for early range of motion and durable protection to the bone in the earlier healing periods, which is much more important to a high level athlete looking for rapid return to play,” explained Dr. Vitale.

Alex returned to the ice in October stronger and better than ever, scoring a season high 60 goals and assists to lead the Greenwich Cardinals to the state finals for the first time since 2014. And while Alex is sad to leave behind his Cardinals teammates when he graduates in June, his career will continue. Alex’s story and his post-surgical successes of the past season caught the attention of a number of coaches from elite prep schools. As a result he will pursue a post-graduate year at The Hotchkiss School, starting in the fall and his dream of playing NCAA hockey still alive.

ONS on Spring Training

An article by  Tanya Kalyuzhny, DPT, MDT, director of physical therapy at ONS in Greenwich, was published recently in the Greenwich Sentinel.   Greenwich Physical Therapy

In Spring Training is Not Just for Pros, Tanya stresses the importance of building strength and flexibility before staring up seasonal activities to avoid many of the painful injuries that can crop up.  In the March 16 issue, she writes:

If you’re like me, you’re chomping at the bit for spring to arrive so you can tie up your sport shoes and head out in the sun with your racquet or golf club in hand.

Not so fast!

If you haven’t been using the muscles necessary for your sport in the past few months, you’ll need to start slowly and make sure you have the strength and conditioning needed to play before the season is underway.

A simple pre-season program using light weights or an exercise band can help protect against back strain, arm pain and worse. Start with daily stretching exercises, held for a minute, and move on to two sets of weight bearing or resistance exercises of 15 repetitions three to four times a week.


Common golf and tennis injuries are usually the result of muscle strain and fatigue, muscular imbalance, overuse, or any combination of the three. As with any physical activity, core muscle strengthening is essential to train your pelvis, lower back, hips and abs to work together to give you power, better balance and stability. Without core strength, the muscles in your back, neck and extremities will be strained taking you through your motions.

Beyond the core, your shoulders need to be ready for the demands of the repeated overhead, rotating motions required in tennis and golf. Conditioning that area is not only important to prevent tendinitis and rotator cuff problems, weakness in the joint’s surrounding muscles can also lead to pain elsewhere in your arm when smaller muscles are forced to overcompensate.

To avoid painful shoulder injuries, it’s important to strengthen the peri-scapular (shoulder blade) muscles as well as the four muscles that make up the rotator cuff. The rotator cuff helps stabilize the upper arm within the shoulder socket and manage the speed of your swing and follow through.

You can strengthen and increase flexibility in this region of your body by using light weights or an exercise band.

In general, exercises that involve the internal and external rotation of the shoulder are good for the rotator cuff. You can work on external rotation by alternating arms to rotate the band away from your body, starting with your arms waist level and forearms parallel to the floor.

For internal rotation exercise, tie your band to a door knob and hold it in one hand across your shoulder. Start with your arm bent at 90 degrees as though you are waving hello, and slowly stretch the band downward until your forearm is parallel to the ground. Slowly return to your starting position and switch arms.

It’s also important to keep your pectoral muscles and those in the back of your shoulder supple. A corner stretch is great for the pecs. Lean into a corner of a room with each of your forearms resting on the adjacent walls and hold the stretch.

Cross body stretches, achieved by moving your extended arm across your chest, will help prevent and reduce any tightness that may occur in the back of the shoulder.

These exercises will also help reduce the risk of elbow conditions such as tendinitis and golf and tennis elbow. Elbow injuries can occur because the wrist muscles, which originate in the wrist but attach at the elbow, become overused or lack proper strength to match the demand of each sport.

Exercises to help thwart this from happening involve wrist flexion and extension while holding a light weight. First, sit while you hold a weight, palm facing down. Raise the weight by pulling the hand upward, bending at the wrist. Next, rotate your arm so the palm of your hand is facing the ceiling and bend your wrist to move the weight upward.

Common sports-related lower extremity injuries, including calf strains and ankle sprains, can be avoided if the musculature is strong enough to support the acceleration and deceleration involved in walking, running and jumping. Ankles are particularly vulnerable to quick changes in direction. Single leg balance exercises are the best way to protect against ankle and calf issues. Try standing on one leg on a balance board, standing on one leg with your eyes closed, or standing on one leg on a pillow. Single leg heel lifts from the edge of a step, and slowly lowering the heels below the step are also good calf exercises.

When you do head out to the court or the greens, start slowly and be sure to warm up. Don’t play an 18-hole round of golf without a few days swinging at the driving range. Immediately before play, start with 5-10 min warm up with a light jog or walking briskly in place. When you finish for the day, cool down and gently stretch your muscles.

My last piece of advice is to have a professional evaluate your technique and equipment. An improper grip, ill-fitting racket or club, and/or faulty body mechanics can lead to an injury no matter how fit you are.



Another Award for Dr. Sethi


Congratulations to ONS orthopedic surgeon, Dr. Paul Sethi, who has earned the 2018 AAOS Achievement Award again this year from the American Academy of Orthopaedic Surgeons.  The AAOS Award recognizes members for their active volunteer efforts and their contributions to education, research and advocacy in the profession of orthopedic surgery. Dr. Sethi received this prestigious award in 2017 as well.

A sports medicine, shoulder and knee specialist, Dr. Sethi is also a leading research physician who speaks at academic and instructional medical conferences in the US and abroad. His research on surgical advances for the shoulder, elbow and knee is regularly published in leading medical journals including the Journal for Shoulder and Elbow Surgery, Arthroscopy, and the Journal of American Academy for Orthopaedic Surgery. He also collaborates with outside companies for education and research purposes and to develop medical procedures on the shoulder, elbow and knee. He is a member of the prestigious American Shoulder and Elbow Society and American Academy of Orthopedic Surgeons.

As President of the ONS Foundation for Clinical Research and Education,  Dr. Sethi’s research has recently included clinical study of the use of a long lasting analgesic, Exparel, during surgery. This will reduce the need for opioids to control post-surgical pain; 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.

Synthetic Cartilage Implants


ONS orthopedic foot and ankle surgeon, Dr. Mark Yakavonis, was a guest today on Healthy Frontiersa White Plains community television program hosted by Dr. Louis Bisogni.  Dr. Yakavonis discussed a significant new development in the treatment of big toe arthritis that has the future potential to alleviate arthritis pain in larger joints in the body. Dr. Yakavonis and Michael Clain, MD, also of ONS, are among the few orthopedic foot and ankle surgeons in the country who offer this option to their patients.

The new synthetic cartilage implant was approved as a treatment for painful arthritis in the joint of the big toe in July, 2016, but  Dr. Yakavonis explained that it has been a highly effective treatment in Canada, Europe and Brazil since 2002.  The implant, called Cartiva, is made of saline and a bio-compatible polymer that is similar in consistency to a contact lens and is the size and shape of a No. 2 pencil eraser.  The surgical procedure takes about 30 minutes to complete. The implant is inserted through a tiny incision between the bones metatarsophalangeal or MTP joint, where the natural cartilage has worn away.

Dr. Yakavonis named a few benefits for patients over conventional treatments. For instance, unlike the metal materials used in traditional MTP joint replacement, this implant is different. The implant is tolerated by the body’s immune system. This will reduce the risk of inflammation or rejection.  And it’s unlike fusion surgery, which fuses the two bones in the big toe together to eliminate the painful bone-on-bone rubbing. This product is flexible and allows for the return of full range of motion in the joint.

Recovery from the implant surgery is relatively easy, when compared to other foot surgical procedures.  Following the ambulatory procedure, patients are sent home with their foot in a soft wrap.  While patients should rest with the foot on a pillow as much as possible while the toe heals, they are able to put some weight on the foot for balance when walking.  There is no need for crutches or a scooter to get around.

According to Dr. Yakavonis, this type of implant his being researched for use in larger joints such as the knee. Down the road, he said, the potential for arthritis relief for joints all over the body is limitless. It is good news for the nearly 54 million people in the United States who are suffering from some form of arthritis.

Dr. Yakavonis said neither he nor ONS has any commercial interest in this product. “It’s just an amazing option to relieve my patients from pain and I am thrilled to be able to offer it to them.”

Further, Healthy Frontiers airs on White Plains Channel 76 and Verizon Channel 45. It will air on Thursdays at 6:30 pm and Friday’s at 10:30 am.  This segment should begin broadcasting next week.

ONS Sports medicine specialists Dr. Marc Kowalsky and Dr. Katherine Vadasdi have each been guests on the program in the past, along with hand and wrist surgeon Dr. Wei, hip and knee replacement specialist Dr. Jonathan Berliner.  Watch those interviews.

Dr. Louis Bisogni is the head chiropractor for the New York Yankees and has private practices in White Plains and Somers, NY.