ONS Ranked Best

Don’t just take our word for it. 

For the second time this month, ONS specialists have been ranked among the best in their areas of expertise, this time they have been named “Best Doctors in the New York Metropolitan Area” by New York Magazine.  Published in the June issue, the magazine’s annual list of best doctors is compiled by Castle Connolly, a nationally recognized medical rating agency that uses peer reviews as part of its identification process.

Earlier this month, Connecticut Magazine published its list of the state’s best doctors based on results provided by researchers at Best Doctors®, a global benefits provider and medical information services company that uses a peer-to-peer polling method and proprietary balloting software for the selection process.

ONS Doctors Recognized as Best in the New York metropolitan area by New York  Magazine

Michael Clain, MD

Amory Fiore, MD

Jeffrey Heftler, MD

Paul Sethi, MD

Katherine Vadasdi, MD

Mark Vitale, MD

ONS Doctors Recognized as Best in Connecticut by Connecticut Magazine

Paul Apostolides, MD

Mark Camel, MD

Michael Clain, MD

James Cunningham, MD

Frank Ennis, MD

Amory Fiore, MD

Seth Miller MD

Paul Sethi, MD

Scott Simon, MD

Katherine Vadasdi, MD

Mark Vitale, MD

Trend: Outpatient Joint Replacement

Faster recovery and fewer risks of infection when recovery begins at home.

As elective surgeries resume in Connecticut and throughout the Northeast, patients are thinking about their risk for infection as never before. This is one of the reasons surgical candidates are trending toward outpatient procedures at independent ambulatory surgery centers and recovery in the comfort of home. Demand for outpatient joint replacement surgery, in particular, is on the rise. By some estimates, the number of hip and knee replacements surgeries done as a same-day procedure will increase by 50 percent in the next five years.

Total joint replacement surgeons Jonathan Berliner, M.D., and Kevin Choo, M.D. at Orthopaedic & Neurosurgery Specialists (ONS), a leading provider of orthopedic and spine care, have noticed a significant uptick in patients opting for the hip and knee replacement procedures that don’t require a hospital stay.

“Innovations over the past several years in anesthesia, surgical techniques and therapeutic approaches have allowed joint replacement procedures to safely transition to the outpatient setting,” said Jonathan Berliner, director of the ONS Outpatient Joint Replacement Center. “Factor in the benefits of conducting joint replacements in facilities dedicated to the care of orthopedics and spine patients separate from those being relied on to treat COVID-19 and it may become a better decision for the patient’s overall health and the system as a whole.”

Years ago, patients would often remain in the hospital for 3-5 days after total hip or knee replacement surgery. Today, hip or knee replacement surgery for an otherwise healthy patient can be safely performed at an outpatient facility followed by at-home nursing and physical therapy.

“Advances in anesthetic techniques that allow for improved pain control and a more rapid functional recovery have been an important factor in reducing the amount of time a patient needs to stay in a healthcare facility following a joint replacement procedure,” said Dr. Berliner.

A successful and smooth outpatient joint replacement surgical experience relies on detailed preoperative planning of post-operative care.  At ONS all patients are provided a clinical team to support the process that along with the doctor includes a case manager and physical therapist who engage with patients at each step in the process. Good candidates for outpatient joint replacement are motivated to recover at home, have a reliable support network, and are otherwise in good health.

“Continually improving the recovery process for my patients has become one of my greatest interests,” said Dr. Berliner. “Joint replacements can be a life changing event. The ability to eliminate joint pain and restore a patient’s desired activity level and quality of life is what makes my job so enjoyable. These patients are our family, friends and neighbors who have been waiting for more than two months to address a serious health need.  I think it is important they understand that we will continue to address their needs as safely as we can.”

If you are a current ONS patient, or are in-need of an orthopaedic evaluation or consultation, please visit https://onsmd.com/joint-replacement/outpatient/for more information about your options.

CT Magazines Best Doctors

Eleven ONS Physicians Recognized.Best Doctors ONS

We already knew our doctors are among the best, but it’s nice to be formally recognized once in a while.  In the June issue, Connecticut Magazine published its annual list of Best Doctors in Connecticut. We were thrilled to see so many ONS specialists named.

Paul Apostolides, MD – Neurosurgery

Mark Camel, MD – Neurosurgery

Michael Clain, MD – Orthopedic Surgery

James Cunningham, MD – Orthopedic Surgery

Frank Ennis, MD – Orthopedic Surgery

Amory Fiore, MD – Neurosurgery

Seth Miller, MD – Orthopedic Surgery

Paul Sethi, MD – Orthopedic Surgery

Scott Simon, MD – Neurosurgery

Katherine Vadasdi, MD – Orthopedic Surgery

Mark Vitale, MD – Hand Surgery

ONS Webinar Series

New Live Speaker Events.

We are excited to kick off the ONS Live Webinar series, featuring ONS specialists’ discussions on interesting, health-related topics, followed by Q & A.. Click on the titles below at the appointed times to join any or all of our upcoming webinars, or copy to your calendar. Is there a topic of interest to you?  Send your suggestions to contact@onsmd.com and put Webinars in the subject line. Check the calendar on our website for future events. IOS users may need to download Microsoft Teams free app.

 

June 2    5:00 – 5:30 pm    

Treatments for Shoulder Pain
with Dr. Demetris Delos, sports medicine and shoulder specialist

June 3   5:00 – 5:30 pm    

The Healthy Student Athlete
with Dr. Marc Kowalsky, sports medicine specialist

June 4  9:30 – 10:00 am    

Is Outpatient Joint Replacement Right For You?
with Dr. Jonathan Berliner, total joint replacement specialist

June 9  5:00 – 5:30 pm    

Overcoming Neck Pain
with Dr. Heeren Makanji, orthopedic spine specialist

 

June 10  5:00 – 5:30 pm

Bunion Surgery: An Overview
with Dr. Michael Clain, foot and ankle specialist

June 11  12:00 – 1:00 pm
Understanding Knee Pain
with Dr. Kevin Choo, hip and knee replacement specialist

Honor for Dr. Berliner

Dr. Jonathan Berliner, director of the ONS Outpatient Joint Replacement Center, was named among the 2020 Rising Stars – 40 Under 40, by the Business Council of Westchester (BCW).

Dr. Berliner is a board certified orthopaedic surgeon and fellowship-trained specialist in hip and knee replacement. His expertise includes muscle sparing anterior hip replacement, minimally invasive total knee and partial knee replacement, complex revision total hip and total knee replacement, computer-assisted surgery, and trauma of the lower extremity.  Dr. Berliner joined ONS in 2017.

According to a statement released by the BCW, the Rising Stars program is modeled after the national business recognition program “40 under 40.” Rising Stars honorees were chosen based on professional and/or entrepreneurial accomplishments, professional and/or business affiliations, and demonstrated leadership skills.

“This year’s winners represent the very best and brightest of Westchester County’s up and coming young professionals from a tremendous cross-section of organizations and industries. We’re delighted to honor such an elite group,” said Rising Stars Chairman Joseph McCoy, Region Manager, Commercial Lending, SVP People’s United Bank.

The winners will be honored on September 2 at a location to be announced.

 

Back Pain Exercises

A SIMPLE ROUTINE THAT MAY MAKE ALL THE DIFFERENCE

If you are among the millions of Americans who experience persistent back pain, you may bet some relief by following the exercises demonstrated by ONS Stamford Physical Therapist, Liz Catalano, DPT.

Tennis Exercises

With tennis courts opening for singles play, Alicia Hirscht, DPT, SCS, director of physical therapy at ONS Stamford, has put together this video demonstration of exercises to strengthen the main muscle groups required to play the sport and help prevent tennis-related injuries.

ONS IS HERE FOR YOU

Beginning Monday, May 11, ONS will resume all office visits during regular business hours. Ambulatory surgeries  are scheduled to resume on Monday, May 18.

Throughout the past two months, ONS has maintained our commitment to patient and community health and safety. As our state leaders allow communities to reopen, ONS has strategically planned for the reinstatement of our elective office visits and ambulatory surgeries. 

We know this is a time of uncertainty. Our clinician-led team is acting purposefully and strategically to help you feel confident walking through our doors to receive the essential services you need, and to protect your safety before, during and after your visit.

ONS IS PROTECTING YOUR SAFETY AND ACCESS TO CARE

ONS is taking a physician-led and phased approach to safely treat patients with time-sensitive needs. This careful effort began with the introduction of ONS TeleHealth to keep patient care plans on track during Shelter in Place orders and the service is now expanding.

While we do not and have not treated any COVID-19 patients within our facilities, we are nonetheless enhancing our Safety & Access Protocols to support your overall wellness.

ONS SAFETY AND ACCESS PROTOCOLS

SAFETY

·         Temperature & Symptom Screening – All patients and staff will be screened for potential COVID-19 symptoms prior to appointments and again upon arrival at any of our facilities.

·         Socially Distanced Waiting Room – Our waiting room will be open and will be rearranged to enforce social distancing measures for patients and staff.

·         Parking Lot Waiting – As an alternative to our waiting room, we are encouraging patients to wait in their car until their appointment begins.

·         Mask, Glove & PPE Use – We will use the proper PPE for all appointments in addition to following CDC reuse and preservation protocols.

·         Enhanced Cleaning & Sterilization – All common spaces, procedure rooms, equipment and more will undergo strict sanitization measures.

ACCESS

·         Pre-Visit Registration – You will have the opportunity to reduce time spent in our lobby and reception area by completing necessary registration documents prior to your visit.

·         ONS TeleHealth – Our new telehealth portal, ONS TeleHealth, continues to connect patients, physicians and therapists for virtual appointments and care sessions. Visit https://onsmd.com/telehealth/ for more information.

·         Online Self-Scheduling – ONS patients are now able to schedule TeleHealth appointments online through our self-scheduling program. You can handle your scheduling needs at any time of day that is convenient for you.

ONS Safety & Access Protocols are in place so that you can feel comfortable and confident returning to the providers you know and trust. We are here for you and can’t wait to see you … even if it will be from behind a face mask.

We also know you are going to have questions and that’s a good thing. We want to answer them. Call (203) 869-1145 or visit www.onsmed.com.

Golf Injury Prevention

Now that golf courses are starting to open, golfers may want to head out to the links to make up for time lost in quarantine.  Not so fast, writes ONS Physical Therapist, Matt Dunning, DPT, who advises golfers to make sure they are physically primed for the demands the sport takes on different parts of the body. 

He’s shared some insightful information detailing the physical exertion that occurs while playing golf and how to avoid common golf injuries.

Golf is a full body exercise for three hours or more.  During that time, the golf swing transfers energy from the feet through the legs, up the spine, through the arms and to the club.  Physical issues and pain can arise due to problems at any point along that kinetic chain.  Pre-existing physical issues can put limitations on the ability to swing soundly and play consistently and at the desired level.

A good golf training program must include leg and core strengthening and stretching as well as upper body work to ensure the entire body moves in correct alignment. 

THE BODY AND GOLFGolf swing

A good golf training program must include leg and core strengthening and stretching as well as upper body work to ensure the entire body moves in correct alignment. 

Golf injuries occur if the body is not conditioned to go through the motions effortlessly.  A comprehensive training program should promote:

  • Ankle /calf flexibility
  • Knee bend and rapid straightening during swing
  • Hip and lower back rotation
  • Shoulder rotation, elbow bending and straightening
  • Neck flexibility, strength and stability

WHAT CAN GO WRONG

Any one of the following issues can and will impact your ability to swing a golf club properly and consistently.

  • Joint pain and stiffness  
  • Muscle tightness
  • Limited hip rotation
  • Decreased balance
  • Weakness and decreased stability

COMMON GOLF INJURIES

Neck and Back: Muscle strain, overuse, limited range of motion, weakness, disc dysfunction

Shoulder: Bursitis, rotator cuff tendonitis, biceps tendonitis

Elbow: Medial or  lateral epicondylitis (Golfer’s or Tennis elbow), forearm tightness

Wrist: Carpal Tunnel Syndrome

Knee:  Pain due to OA, meniscus injury

Ankle: Sprain, weakness

HOW COMMON ARE COMMON GOLF INJURIES?

Back pain / injury

Most common area of injuries, affecting 15-34% of amateur golfers

Upper extremity pain

Affects 13-20% of amateur golfers

Knee pain

Affects about 3-18% of all golfers

STRETCHES FOR FLEXIBILITY

Daily stretching and exercise will reduce the risk of repetitive motion injuries common to golfers. Stretching and staying mobile during the round of golf helps to maintain flexibility for safe play throughout the game. 

Download this Golf Stretching Program

These muscles, in particular, should not be tight.

  • Hamstring – back of the thigh
  • Piriformis – deep muscle of the buttocks
  • Quadriceps – front of the thigh
  • Quadratus Lumborum and Latissimus – along your side from the hip to the armpit
  • Wrist flexors/extensors – forearm
  • Pectoralis muscles – chest
  • Upper Trapezius /Levator scapula – neck muscles

SAFETY TIPS 

  • Stretch or exercise at home before leaving for the course to save time and ensure proper ability to perform.  Fight the urge to bounce or stretch quickly, hold each stretch for 15-20 seconds at a comfortable position
  • At the course, a quick stretch with the club, prior to lining up the first tee
  • Stretch from time to time while other players playing through their shots
  • Give yourself opportunities to walk more if using a cart, to keep muscles loose and increase circulation
  • If sore after the round of golf, use ice to reduce inflammation at the elbow, shoulder, knee

 

Managing Back & Neck Pain

Amanda Rausch, PTA, offers advice for dealing with back and neck pain while at home.

pain in the backDuring this time of lock down, many people are finding themselves in a more sedentary lifestyle than they lived before the COVID-19 outbreak. After many weeks of confinement and immobility, they may start to experience restricted movement and stiffness that can easily lead to back and neck pain. That’s why it is so important to intersperse periods of movement throughout the day. The more you move, the better your body mechanics and posture, and the more control you will have over neck and back pain.

PAIN OVERVIEW

Eight out of ten people will suffer from some form of pain at some point in their life. Pain is the body’s way of protecting itself and alerting you to the fact that something is wrong. Back and neck pain can range from a mild, dull, annoying ache, to persistent, severe, disabling pain. Spine pain can restrict your mobility and interfere with your normal functioning and quality of life.

Pain in your back or neck area can be acute, meaning it comes on suddenly and intensely, lasting for a few days to a couple weeks. Chronic pain tends to increase over time, lasting for weeks, months, or even years. This type of pain can be continuous or intermittent. Consult with your healthcare provider or an ONS spine specialist if you experience persistent or increasing pain for more than few weeks.

UNDERSTANDING SPINE PAINspine anatomy

Anatomy of the Spine

The spine has natural curves creating an “S” shape. These curves allow the spine to act like a coiled spring to absorb shock, maintain balance, and facilitate full range of motion through the spinal column.

The muscles that support and maintain the spinal column fall into two groups, lexors and extensors. The flexor muscles are on the front side of the spine and include the abdominals. The extensor muscles are in the back of the spine.

Both groups perform different functions for the spine. Flexors allow you to bend forward and flex. They also assist when you lift objects to stabilize the low back. Extensors allow you to stand up straight and they assist with lifting objects as well. When both muscle groups work together, they stabilize the spine.

SOME CAUSES OF BACK AND NECK PAIN

Even with today’s technology, the exact cause of back and neck pain is difficult to determine. In most cases, the cause includes any of the following:

  • Overuse, strenuous activity, or improper use, such as repetitive or heavy lifting
  • Poor muscle tone
  • Muscle tension or spasm
  • Sprain or strain
  • Ligament or muscle tears
  • Trauma, injury, or fractures
  • Infection
  • Abnormal growth, such as a tumor or bone spur
  • Obesity, which places increased pressure on your spine, and discs
  • Joint problems, such as arthritis
  • Smoking
  • Dehydration
  • Protruding or herniated (slipped) disk and pinched nerve
  • Osteoporosis and compression fractures
  • Congenital (present at birth) abnormalities of your vertebrae and bones
  • Abdominal problems
  • Degeneration of vertebrae, often caused by stresses on the muscles and ligaments that support your spine, or the effects of aging
  • Emotions: Stress, Depression, Anxiety, etc.

SYMPTOMS ASSOCIATED WITH PAIN IN THE BACK 

Symptoms associated with back pain may include:

  • Dull, burning, or sharp pain in the back.  The pain can be confined to a single spot or cover a large area
  • Leg numbness or tingling above or below your knee from any side
  • Stiffness or achiness that occurs anywhere along your spine (from your neck to your tailbone)
  • Sharp, shooting pain that radiates from your low back to your buttocks, down the back of your thigh, and into your calf and toes
  • Consistent ache in the middle or lower part of your back, especially after standing or sitting for an extended period

Loss of bladder and bowel control, with weakness in both legs, are symptoms of a serious condition that requires immediate medical attention.

SYMPTOMS ASSOCIATED WITH NECK PAIN

  • Headaches, Migraines
  • Shoulder pain
  • Arm numbness or tingling than can radiate part way down the arm or all the way to the finger tips
  • Sharp shooting pains or a dull ache in your neck that can radiate the length of the neck or down the upper back

BACK AND NECK PAIN SELF-TREATMENT

If you experience acute back or neck pain, it may simply improve with some rest. Over-the-counter medicines can also help with the discomfort. It may seem counter intuitive, but you should try to move gently during this time to avoid stiffness and lose mobility. It becomes more difficult to decrease pain when you stop moving for too long.

If you have acute or chronic pain of your back and neck, there are several remedies you can try that may help. These include:

  • Hot or cold packs; for better results it’s best to alternate hot and cold. However, wait for the affected area to return to your normal body temperature before alternating packs
  • Specific exercises to strengthen muscles and ease pain, such as stretching, extending and flexing
  • Mild aerobic exercise such as walking at a normal pace
  • Certain anti-inflammatory medications or muscle relaxants may be used, with your Doctor’s supervision

MANAGING PAIN IN THE BACK AND NECK

Acute back pain usually resolves on its own. Acetaminophen, such as Tylenol®, or ibuprofen, such as Aleve®,will decrease the pain and help you rest. Surgery and special exercises are generally not used with acute pain.

For severe, disabling, or chronic back and neck pain, a physical therapist can develop a program designed specifically to meet your needs and lifestyle goals. The type of program will depend on the type and severity of your pain, injury, or disease.

The goal of back and neck rehabilitation is to help you manage the pain, return to your highest level of functioning and independence possible, while improving your overall quality of life. The focus of physical therapy is to relieve pain and improve mobility (movement). Surgery is always the last option for treatment of pain relief.

To help reach these goals, back and neck rehabilitation programs can include the following:

  • Exercise programs to improve range of motion, increase muscle strength, improve flexibility and mobility, and increase endurance
  • Help with obtaining assistive devices that promote independence
  • Patient and family education
  • Pain management techniques (breathing exercises and mindful awareness)
  • Gait (walking) and movement retraining
  • Stress management
  • Ergonomic assessments and work-related injury prevention programs
  • Body Mechanics and Posture training
  • Proper lifting techniques: avoid heavy lifting; when you do lift something, bend your legs, keep your back straight, and then slowly lift your body and the object
  • Ergonomics for telephone and computer use and other equipment
  • Correct posture while sitting, standing, and sleeping

BREATHING AND MINDFULNESS EXERCISES

back pain exerciseIt’s always important to remember to breath when doing exercises especially when having pain. I always suggest starting with breathing exercises before doing any other physical exercises. It will help you build a better tolerance when going for a walk or doing the neck or back exercises. You can do these exercises laying down or sitting. It’s important to have your back be fully supported while seated or your spine  straight when laying down.

You may be self-conscious if you are new to these types of exercises, but it’s important to be fully relaxed.  Allow your stomach to expand and contract without resistance for best results. Try to visualize your breathing cycle and how it affects your body while completing these exercises.

BREATHING BEST PRACTICE

When first starting to work on breathing exercises, you can either place one hand on your chest and one on your stomach or you can place both hands on your stomach, whichever is most comfortable for you.

With any exercise, if you start to feel pain going down the arm or leg stop immediately and rest.

Posture and Transfers

If you have increased pain in the back or neck, supporting the spine is very important with transfers and with posture.

Getting out of Bed: The proper transfer is the log roll. Turn to the side without rotating or twisting the spine then put legs over the edge before pushing yourself up.

Bed positioning– If you sleep on your back, support your neck with a neck pillow and place a second pillow under your knees to support your low back.  If you tend to sleep on your side, use a neck pillow to support your neck and place a second pillow between your knees. This helps to relieve the pressure from your hips and low back.

Proper workstation postureSitting posture: Working or reading while sitting. You want your computer screen at comfortable eye level and keyboard lowered to comfortable level using an extra keyboard if needed to keep straight neutral posture. When reading, don’t slouch and hold the book higher to eye level.

When looking at your phone, keep in mind that for every inch that your head flexes forward, you add 10 lbs of pressure to your neck. The pressure from the head going forward leads to compression on the nerves in the back of the neck and can start causing pain down the neck and into the arms and upper back.  Looking at your phone for long periods can also contribute to disc degeneration and neck arthritis.

 

Avoiding Shoulder Pain

Peter Falla, ATC/L, of ONS Physical Therapy in Greenwich, shares tips to avoid shoulder pain during the COVID-19  lock down.

Many of us have recently set goals to take advantage of downtime during isolation from coronavirus.  We have pledged to improve eating habits, get on track with our exercise routines, and even check off some household projects that have been hanging over our heads.  Additionally, stay-at-home orders have many of us working and schooling from home, presenting a whole new set of challenges including less than optimal workstation setups. Any and all of these situations can put you at risk for a shoulder injury.

Outlined below are steps you can take to help prevent or perhaps improve, pain in and around the shoulder.

Watch Your Posture!Poor work posture

Pay attention to your posture while using your laptop to work from home.  Fight the urge to sit cross-legged on the couch during long bouts of keyboarding, reading, or video conferencing.  Sitting in this position promotes a slouched thoracic spine and a forward head posture that stresses soft tissue structures in the neck, shoulders, and back, often leading to pain in these areas.

Instead, keep your feet on the ground, engage your core muscles to support your back, and do all that you can to elevate the height of the screen so that you are not looking down for long periods.  Activating certain muscles to maintain good posture can be considered a workout.  Over time it will become easier to do and also easier to notice when you are in a poor sitting position.  Check out this link for more detailed information: ONS Workstation Ergonomics

Be Careful with Home Exercises

Home exercise injuryThere are many home workouts circulating now that are tailored to people sheltering at home to avoid infection.  Evaluate these workouts carefully before starting.  Instructions for your body position during the exercises should be clear and make sure the program is issued by reputable sources.

Do not deviate too greatly from the workouts your body is familiar with.  New stressors and movements can be beneficial in some situations, however, this is not a time to develop a new injury or aggravate an old one.

Exercise-Related Shoulder Pain

When patients present to our physical therapy clinics with exercise-related shoulder pain, there are usually some common denominators we uncover in their exercise history.  Previous injury notwithstanding, one of the most common causes of acute shoulder pain occurs when an  individual increases the level of activity too quickly.  When starting an exercise plan at home, select a program that gradually increases the activity in a methodical manner to avoid over-straining the shoulder girdle.

Another exercise-related shoulder pain results from performing repetitive exercises that irritate the soft tissue surrounding the ball and socket joint in the shoulder, or the rotator cuff, which is a group of muscles that stabilise the joint and allow the arm to be raised overhead.

Common Culprits

One of the classic complaints patients have is shoulder pain when raising their arm fully overhead.  In the context of someone active in the gym, or with home-based weight training, certain exercises can be detrimental to your shoulder.  Overhead presses, dips, and push-ups are the top three exercises that may lead to shoulder pain.  If the shoulder muscles that stabilize the scapula (shoulder blade) are not strong, an individual may perform the exercise using improper mechanics at the shoulder joint, causing inflammation and discomfort.  Discontinue any exercise that causes discomfort during the movement.  Strengthening the same muscles can be done effectively with lifting the arms no higher than the shoulders.

Push-ups and dips are two exercises that, if done too deeply, (elbow angle >90°) can overload the ligaments of the shoulder joint, leading to pain.  Perform these exercises slowly and through a comfortable range of motion, avoiding the extreme ranges that uncomfortably stretch the front portion of the shoulder.  Lastly, when performing upper-body resistance training, remember to warm up adequately and incorporate some light stretches to prepare the shoulder for the demands it will encounter.

Go Easy On The To-Do List

Finding ways to stay busy and productive during these trying times has resulted in many of us tackling projects around the house that we normally have little time to do. Some of us find ourselves undertaking one project after another, which is great for one’s sense of pride and accomplishment, but it may take a toll on the shoulder or low-back.  Work slowly when faced with projects that require lifting, digging, or sustained overhead work.  If you feel any shoulder discomfort, space out the work and take breaks as needed to do other less strenuous tasks.  If the pain persists, put that project on the back burner until you’ve consulted with a physician or physical therapist.

General Instructions

The takeaway here is that you should have a plan in place to minimize stress to your shoulders and total body through careful exercise selection, good body mechanics, and a gradual, progressive approach to all types of strenuous work you undertake.

There are some useful general strengthening and stretching exercises included in the following link; RANGE OF MOTION EXERCISES.  As always, check with your doctor before beginning any new exercise routine.

If You Develop Shoulder Pain

If you are experiencing shoulder pain that is slow to improve or may even worsen, refrain from strenuous upper body exercise and household work until you can be properly evaluated by an ONS orthopedic shoulder specialist.  Due to the COVID-19 pandemic, ONS has limited office visits to urgent orthopedic and spine injuries, by appointment only. Patient evaluations and consultations with ONS specialists are available to all patients online through ONS Telehealth.  Call 203-869-114 to make an appointment or you can schedule your  telehealth visit at any time using our new self-scheduling feature.

ONS Launches Self-Scheduling

A New Convenience for Patients

ONS has introduced a fast and convenient way for patients to schedule a Telehealth appointment with an Self-scheduling pageONS physician or physical therapist. The new self-scheduling feature allows patients to make an appointment online from wherever they are, night or day, with a few simple clicks.

Patients only need to go to the Request An Appointment or the Telehealth page of the ONS website, then select the Telehealth Self-Schedule tab, to select a physician, by name or specialty, at a televisit time and date that is most convenient.

“ONS remains committed to patient-centered care. Self-scheduling and Telehealth further that goal because they provide patients with easy and safe access to our physicians,” said ONS shoulder surgeon, Dr. Seth Miller.

 

ONS Team Published

Results from a groundbreaking study led by ONS surgeon, Dr. Paul Sethi, president of the ONS Foundation for Clinical Research and Education, have been published in Arthroscopy, Sports Medicine and Rehabilitation.  The article, “Opioid Use After Knee Arthroscopy,” discussed the findings of research conducted on patients between March 2018 – March 2019 that studied patient consumption of opiate medication after arthroscopic surgery.

“There is very little published data on how to prescribe pain medication after orthopedic procedures. Given the lack of guidelines, patients are often overprescribed medication out of concern that we may leave them in pain,” said Dr. Sethi

The research team found that 90 % of patients needed 5 or less Oxycodone 5 mg tablets, and that close to 75 % did not take any opiate medication after surgery. This contrasts the expert panel guidelines of 12-30 pills.

“This study provides evidence based guidelines on how to prescribe opiate medication after knee arthroscopy, ” Dr. Sethi said. “Orthopedic surgeons need to continue to lead the charge on reducing opiate dependence after surgery.  This reduction in medication prescribed can translate directly in fewer excess medications prescribed and reduces the risk misused or diverted medication.”

The article was co-authored by ONS knee specialists Dr. Tim Greene and Dr. Katherine Vadasdi, among others.

Read the article.

Dr. Clain on Achilles Tendonitis

A VIDEO DISCUSSION ABOUT A COMMON ANKLE INJURY

Do you suffer from pain or tenderness at the back of your ankle?  You may have Achilles Tendonitis.  In this video, ONS orthopaedic foot and ankle surgeon discusses the causes and treatments for this condition.  You can also read more about it here.

ONS Helps Lighten to Load at GH

ONS Physician Volunteers Help Greenwich Hospital Cope with COVID-19ONS Surgeons

It can’t be said enough. The true heroes of the COVID-19 crisis are the hospital physicians , the physician assistants, nurses and all other healthcare workers on the front line caring for coronavirus patients day in and day out. Long before the pandemic hit the area, the orthopedic and spine specialists at ONS, worked together with the hospital staff as healthcare partners caring for patients with orthopedic and spine injuries. It was only natural they’d want to ease the burden however they could.

“Well before the onset of this pandemic, Greenwich Hospital provided invaluable care to our orthopedic and spine patients,” said orthopedic surgeon, Dr. Marc Kowalsky . “They are our colleagues, our neighbors, and in many cases, they or their families have been our patients. Our contributions to their efforts in caring for COVID-19 patients are small in comparison, but we want to help lighten their load even if it’s just a little bit.”

BASIC MEDICINE

The ONS orthopedic surgeons have been tapping into basic skills they learned during residency training years ago.  During two or three volunteer shifts each week, the doctors have been assisting internal medicine physicians with the evaluation and admission of Covid-19 patients and others in the emergency department, in addition to treating musculoskeletal conditions while on call.

“Our role is very similar to that of a medical intern.  We provide support to free up the hospital doctors so they can deliver direct care to more coronavirus patients more quickly,” noted Dr. Berliner.

The ONS group says they’ll continue to assist in whatever way is meaningful to the hospital doctors, but they are looking forward to the day this crisis dwindles and they can go back to focusing on what they’re trained to do —  providing relief to people suffering musculoskeletal pain and impairment.