The Risks of At-Home Exercise


If you are one of the many people using virtual exercise classes to stay fit while confined at home, you are putting yourself at risk for a strain, sprain, or inflammatory condition. That is the message ONS Sports Medicine Specialist, Dr. Katherine Vadasdi, delivered during a teleconference with members of the Women’s Business Council of Westchester.

“Whether you are exercising using an app or live streaming a yoga class from your favorite studio, injury prevention is more important than ever,” warned Dr. Vadasdi, “You don’t want to end up with tendinitis or other orthopedic problems at a time like this when it may be difficult to get treatment.”


Dr. Vadasdi, who is the director of the ONS Women’s Sports Medicine Center, noted that in times of stress, people should exercise in moderation and listen to their bodies, particularly if they are doing something new. “Now is not the time to push yourself.  If you feel any pain while doing an exercise, stop doing it.”

Before starting an at-home routine, Dr. Vadasdi advised finding programs that emphasize correct body positioning throughout each individual exercise. That guidance can help reduce the risk of developing inflammation in a joint, muscle or tendon from doing an exercise incorrectly.  Exercises available online from the American Academy of Orthopedic Surgeons (AAOS) was one source she recommended. When exercising inside the house, make sure there is enough clear space to do the activity without banging into a coffee table or tripping on a loose area rug.

Dr. Vadasdi noted that while it’s important to find ways to stay healthy and fit during quarantine, people should be equally focused on injury prevention.  “A hospital emergency room is the last place you want to be right now,” she said.

People who suffer a serious musculoskeletal injury who would otherwise seek treatment at an ER, can make an appointment to receive immediate orthopedic diagnosis and treatment at the ONS Greenwich office at 6 Greenwich Office Park.  Non-essential office visits have been temporarily suspended until the COVID-19 crisis is abated. As an added safety measure, all urgent patients, and visitors accompanying them, will be temperature screened upon arrival.  Call 203-869-1145  for an emergency orthopedic appointment.  Patients who wish to consult with an ONS physician on issues that are not truly urgent can schedule a telemedicine appointment by calling the same number.


New Hours and Policies

All Urgent Care Visits By Appointment Only

In response to the alarming rise in the number of coronavirus cases in our area, Orthopaedic & Neurosurgery Specialists (ONS), has designated all in-office appointments for patients who are truly in need of emergency orthopedic diagnosis and treatment. Those patients will be seen by appointment only at the Greenwich office at 6 Greenwich Office Park, on Monday through Saturday, from 12:00 PM to 4:00 PM. The practice suspended all non-essential office visits and elective surgeries in early March.

Safety is the Top Priority

Until the COVID-19 crisis abates, the new requirement for urgent care appointments reduces the risk of infection from a crowded waiting area and complies with social distancing guidelines. As an added safety precaution, patients and individuals who accompany them to the office, will be temperature screened upon arrival. If possible, adult patients are asked to come to his or her appointment alone.

“Ensuring the safety of patients is of paramount importance,” said James G. Cunningham, MD. “Prioritizing patients who are in serious need of emergency orthopedic care provides them with a safe alternative to a hospital ER.”

ONS TeleHealth

The new telemedicine service, ONS TeleHealth, further reduces patients’ risk of exposure while providing a continuity of care from a safe distance. ONS TeleHealth videoconferencing appointments to discuss such matters as X-ray and MRI test results, progress of a treatment plan, and other consultations, provides patients with remote access to a virtual face-to-face visit with an ONS physician from the safety and comfort of home. It also allows the physician to determine if a patient needs to schedule an immediate in-office visit for casting or diagnostic imaging tests. These services can be scheduled at the Greenwich office.​

Essential Physical Rehabilitation

ONS Physical Therapy is still available for individuals requiring essential physical rehabilitation at the Greenwich location and at the Stamford office, at 5 High Ridge Park, 3rd floor, on Monday – Friday from 12:00 PM – 4:00 PM.

In the current environment, Dr. Cunningham said that ONS is taking every possible precaution to protect the health and well-being of patients, staff and the wider community.

For that reason, patients in need of emergency ortho care who have cold or flu-like symptoms, have travelled within 14 days, or are under a directed quarantine or who have a household member under quarantine, must seek treatment at a hospital ER.

Patients can speak to an ONS representative at 203-869-1145 to learn which appointment is appropriate for their condition, or learn more about the temporary changes in policy, hours, locations and the new telemedicine service on our website.

ONS TeleHealth


For your convenience and the safety of all our patients and staff during this unprecedented healthcare Telemedicinecrisis, ONS is pleased to now offer ONS TeleHealth.


ONS TeleHealth provides patients with remote access to an ONS physician for matters that do not require an in-office visit. Using a computer, tablet or phone, appointments for post-operative assessments, review of X-ray and MRI testing, and evaluation of treatment progress can be conducted through videoconferencing, without in-person contact.  It also helps your doctor to determine if you condition requires an in-person office visit or test.

Call our office at 203-869-1145 to find out if you are a candidate for a virtual appointment. If a telemedicine visit is appropriate for you, our experienced staff can help you get started.

Read more about ONS TeleHealth


At ONS, patient safety and well-being has always been our first priority. In light of recent concerns about the outbreak of the coronavirus (COVID-19), patients should be assured that we employ the highest standards of safety and infection control protocols.  We are actively monitoring developments and news regarding local outbreaks and will take further action if necessary.

For the safety of our patients and our staff, please reschedule your appointment if you are experiencing a cold or flu-like symptoms. Be advised that if you arrive at an ONS office exhibiting symptoms of an illness, you may be asked to reschedule your appointment.

In addition, we ask patients who have recently travelled to the following countries to wait 14 days after their return to schedule any appointments:

  • China, Japan, South Korea, Iran
  • The following regions of Italy
    • ​Lombardy
    • Veneto
    • Liguria
    • Emilia-Romagna

While the best way to prevent illness is to avoid exposure, the CDC recommends a list of precautions, including:

  • Avoid close contact (within 6 feet) with people who are sick.
  • Wash your hands frequently.
  • Avoid touching your eyes, nose and mouth.
  • Stay home if you are sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash. If a tissue is not available, sneeze or cough into your elbow.
  • Read more about the CDC’s virus prevention recommendations.

Please visit our website for updates.

Dr. Delos on Sodium Imbalance


Endurance events have increased in popularity over the last decade. However, as more and more athletes participate in these types of competitions, the risk of sodium imbalance during and after Electrolyte Supplementsraces should be given more attention.

Many athletes turn to electrolyte supplements to stay hydrated and improve performance. Yet a recent study involving ultra-marathoners, published in the Clinical Journal of Sports Medicine, reports that popular electrolyte supplements do not necessarily protect against hypernatremia, an increase in sodium levels, which is associated with dehydration.  Moreover, drinking too much of them may contribute to an extreme decrease in sodium levels, a condition known as exercise-associated hyponatremia (EAH). EAH is far more likely to result in serious complications, even death.

Moreover, the risk for sodium imbalances (both hyper and hyponatremia) and associated race-induced illnesses is particularly high if the race is taking place in hot climate and among those who have not properly trained for the event, who were heavy at the time of the event, and/or those who took longer to complete the event that majority of the other participants.

Along with proper training and conditioning, the study suggests that the best protection against dehydration or over-hydrations is to drink during the race only when you feel thirsty, not at pre-set regular intervals, which can dangerously dilute the body’s salt levels and lead to EAH.

Dr. Vadasdi On Air Live

ONS Sports Medicine Specialist  Interviewed During Hockey Game BroadcastKatherine Vadasdi, MD, with Rob Burnett

Katherine Vadasdi, MD, director of the ONS Women’s Sports Medicine Center discussed her speciality on air live with Rob Burnett on Thursday night, February 13.  The interview took place at the Dorothy Hamill Rink in Greenwich during the first and second periods of the Greenwich High School Varsity Hockey game against New Canaan. It was broadcast through the LocalLive Network. streaming service.

Keeping Players in the Game

Dr. Vadasdi and Rob also discussed the success of former Greenwich High Cardinal player and ONS patient, Alex Mozian, who has gone on to be an All Star in hockey’s Junior League and is currently under consideration by a number Division 1 recruiters.

When Alex was a junior at Greenwich High School, he suffered four consecutive injuries, any of which could have ended his dreams of playing pro hockey.  Dr. Vadasdi  repaired Alex’s badly damaged. Dr. Vadasdi gave Alex credit for his determination to do whatever it took to safely recover as quickly as possible to get back on the ice.

Following the interview, Alex appears in an ONS commercial and credits the doctors at ONS for keeping his dream alive.

You can watch Dr. Vadasdi’s interview at 37:40 into the stream.



Tim Corvino, MD, Appointed CEO

ONS Chief Executive Officer, Tim CorvinoONS is pleased to announce the appointment of Tim Corvino, M.D., as Chief Executive Officer (CEO), effective March 1.

“Tim Corvino’s experience as an executive, as well as a physician will be a tremendous asset to ONS. As CEO, he will be invaluable in guiding the next chapter in the life of this organization that is centered around growth, while continuing a commitment to providing exceptional patient care,” said Seth R. Miller, M.D., a founding partner of ONS.

A graduate of Greenwich High School, Corvino gained a first-hand understanding of the healthcare needs of the region at every level, from a summer job in the Greenwich Hospital cafeteria to serving as an attending Emergency Medicine physician at Stamford Hospital. Corvino’s father, Frank Corvino, served as the president of Greenwich Hospital for 23 years before retiring in 2014.

Most recently, Corvino served as Chief Operating Officer of Covenant Physician Partners, where he prepared the company for the significant growth that occurred during his tenure. Corvino helped to build the infrastructure needed to evolve the company into a physician services organization that now serves 19 states through more than 60 physician partnerships. Prior to Covenant, he served as President, Integrated Acute Care for U.S. Acute Care Solutions, the nation’s leading physician-owned provider of integrated acute care services for 6 million patients annually.

“ONS’ physician founders have built a leading organization that’s highly successful and known for excellent clinical care, and I am honored to be part of the team,” said Tim Corvino, M.D., CEO of ONS. “As a physician and someone with strong ties to the Greenwich area, I care deeply about the clinical excellence we provide our patients, and I’m excited to be back in the community as ONS charts our next era of growth. I look forward to working with the physicians, employees and community to further enhance the ONS legacy.”

Under Corvino’s leadership, ONS will focus on growing its regional footprint and expanding the number of communities served through partnerships with like-minded musculoskeletal physicians, while also upholding the superior quality of care that ONS has always delivered to the community.

“ONS has built a legacy of delivering excellent care and exceptional patient experience through a highly personalized approach,” said Mark Camel, M.D., a founding partner of ONS. “Tim understands the truly unique model on which we’ve built our successful practice, as well as the healthcare needs and expectations of our community.”

Through the ONS team approach, patients receive the highest standard of care from the expertise of 26 fellowship-trained physicians who work together to produce the best possible outcomes. With state-of-the-art physical therapy centers, digital imaging and MRI, ONS provides patients with a fully integrated care model. ONS also offers urgent ortho care services and its partners operate an ambulatory surgery center.

Throughout his career, Tim’s passion for addressing the needs of patients and physicians has been ever-present and he continuously strives to bring innovative solutions to the many challenges of healthcare today.

Meditation and the Mainstream


What do tennis star Novak Djokavic, comedian Jerry Seinfeld and singer/songwriter Sheryl Crow have in common? Meditation. They have used meditation to manage stress and maintain focus on achieving their goals.  But you don’t need to be a celebrity to have it work for you.

Studies from the National Institutes of Health and the David Lynch Foundation have found the practice of meditation has benefited at-risk inner-city youth and military personnel dealing with PTSD.  One study of high school seniors showed a noticeable improvement in test performance among the students who had meditated before the taking test versus those who did not. There is evidence that meditating can be useful in chronic pain management as well.

In athletes, meditating is useful for stress reduction and improved concentration.  Nervous energy and self-questioning thoughts are replaced with a focus toward achievement.  What’s more, meditation has been shown to reduce the recovery time from many common sports injuries.


How does it work? Meditation relaxes the brain and helps the mind filter out the noise and emotions of stress.   However, for many people, quieting the mind is easier said than done.  If you try sitting still with your eyes closed for just five minutes, focusing only on your breathing, you’ll notice how quickly thoughts will vie for your attention.  When you notice your focus has shifted to those thoughts, immediately return your attention to your breath.  With daily practice, intrusive thoughts will interfere less, or disappear entirely, and your ability to maintain your focus will increase.

Mindful meditation, transcendental meditations, other approaches, and meditation apps, make it easier than ever to give it a try and find the practice that works best for you.  Ideally, meditations should last for 10 – 20 minutes, once or twice daily, depending on the method you choose.  If you are crunched for time, five minutes of resting your mind is better than nothing.

ONS: Fairfield’s Top Doctors

ONS is proud to announce that 16 physicians from the practice have been named

2020 Top Doctors in Fairfield County by Castle Connolly Medical Ltd., a respected national medical data research company. Fifteen of the designees have received this accolade for several consecutive years.  However, physiatrist Christopher Sahler, MD, joins the elite roster after becoming eligible for nomination in 2019.  David Nocek, MD, who retired last year, received the designation as well.


The Castle Connolly Top Doctors are nominated by their peers for talent and expertise in their medical specialties.  A Castle Connolly physician-directed research team then reviews the credentials of each nominee. They give special scrutiny to medical education, training, board certification, hospital appointments, administrative posts, professional achievements, years in practice and reputation, according to the organization’s website.

Moffly Media published the results of the annual survey in the January issues of Greenwich Magazine, Stamford Magazine and New Canaan/Darien Magazine. As in past years, ONS has the most physicians ranked than any other practice.


In the field of Orthopedic Surgery, the following physicians and Dr. Nocek were singled out as the best in Fairfield:

Elsewhere, Mark Vitale, MD was recognized as Fairfield’s Top Hand Surgeon.

The entire ONS Spine Center team was identified as the best in neurosurgery: Paul Apostolides, MD; Mark Camel, MD; Amory Fiore, MD, and Scott Simon, MD.

Along with Dr. Sahler, Jeffrey Heftler, MD, at the ONS Interventional Sports and Spine Center, was ranked on top in the category of Physical Medicine and Rehabilitation.


Tips for Safe Skiing

Skiing can be one of the most enjoyable winter activities and is a great sport the entire family can enjoy.  But nothing can ruin a great day outdoors (or even the next 6-12 months) like a serious Ski Injury Prevention injury such as the dreaded anterior cruciate ligament (ACL) tear.

Skiers are at greatest risk to strain the ACL to the point of tearing in several ways: when they try to recover from a fall with their body weight in back of the skis; if they don’t land a jump correctly; or if improperly set ski bindings don’t release during a critical moment. ACL tears usually require surgery and a lengthy recuperation to repair.  In short, it’s an injury you want to avoid at all cost.

It almost goes without saying that proper fitting equipment, adequate rest, hydration, sleep and weather-appropriate, moisture-wicking attire are essential elements of injury prevention.

Physical preparation is also key.  Ideally, you started a conditioning program at least two or three months before your ski trip to build strength and stability in your core and lower body.  If you didn’t get around to it, or if this is your first trip of the season, it’s worth considering the following safety tips from ONS Sports Medicine Specialist, Dr. Demetris Delos.

  1. Warm up: Some light stretching slope-side before you step into your skis can be helpful to stimulate the muscles that will play an important role in a day of skiing.  For example, try a few simple leg exercises such as leg circles and leg lifts to the sides, back and front of your body while engaging your core.  Mini squats, trunk twists and 30 seconds of quad and hip flexor stretches will also help with flexibility.
  2. Acclimate: Take a few runs on an easy trail to put your mind and body rhythm in sync before you attempt more difficult terrain.
  3. Cool down: When you break for lunch and at the end of the day, stretching (preferably by maintaining a certain pose for 15-20 seconds at a time, and repeating that for 3-5 repetitions) can loosen up the muscles and prepare them for the necessary recovery process.
  4. Know Your Limits: Ski at your level. Don’t think about tackling a mogul-filled Double Black Diamond if blue runs are the height of your comfort zone. Ignore pressure from more accomplished friends or significant others.
  5. Know When to Quit: Most skiers know that the risk of injury increases in the afternoon or early evening as fatigue sets in. So, if you’re feeling fatigued but want to do one last run, DON’T.
  6. Respect Nature: The risk of injury increases when visibility is decreased by late afternoon shadows, during snowfall, and when ski conditions become very icy or very soft. When these factors are present, consider easier runs or call it a day.


Your ONS Visit

A visit to the doctor can be stressful for many people, particularly if you are in pain.  There are forms to fill out, questions to ask, diagnostic tests to undergo and information to absorb. The staff at ONS is committed to providing a seamless, comfortable experience for every patient.  You can make it even easier and the time spent with your physician more productive by taking a few simple steps to prepare ahead of time.


  • Complete Forms in Advance of Your Appointment.Medical forms

    Your medical history provides important information to your doctor about your overall health. After making an appointment, you will receive an email or text with a secure link to all the necessary forms online. Filling out the required forms prior to your office visit will reduce the amount of time you will be sitting in our reception area.

    • If you prefer to complete the forms at ONS, plan to arrive 30 minutes before your appointment. You cannot be taken to an exam room until all forms have been completed. You will need to bring the following information with you:
      • The name of your primary care physician and referring physician, if you have come by referral.
      • A list of all your medications, dosages and frequency, including vitamins and herbal supplements.
  • Bring Important Medical Reports to Your Appointment.

    If you have previously had diagnostic testing related to your symptoms, such as X-rays or MRIs, bring copies of the reports to your appointment. This may help your physician diagnose your problem and develop your individual treatment plan.

  • Create a Symptom Log.

    To the best of your ability, create a timeline starting with the onset of symptoms and any activity that may have contributed to your condition. Your physician will want to know of the progression of symptoms and any activities that worsen or improve them.  Be sure to include treatments you have previously tried.

  • Make a List and Take Notes.

    Compile a list of all your questions about your condition and treatment options, so your physician can address your concerns.  Be sure to take notes during the appointment. They will be useful as reference when you get home.

  • Call if You Will Be Late.

    Please give us a call if you know you will be late for your appointment. We may be able to hold your appointment or will reschedule for another time or day.


Dr. Berliner Appointed Director

ONS Appoints Joint Replacement Specialist to Head the ONS Outpatient Joint Replacement CenterDr. Berliner

Orthopaedic & Neurosurgery Specialists (ONS) announced today the appointment of orthopedic surgeon and joint replacement specialist, Jonathan Berliner, MD, to the new position of Director of the ONS Outpatient Joint Replacement Center.

Dr. Berliner joined ONS in 2017. He is a fellowship-trained specialist in hip and knee joint replacement and revision surgeries, with an expertise in 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.

With a medical degree from the New York University School of Medicine, Dr. Berliner completed his residency in orthopedic surgery at the University of California, San Francisco (UCSF), followed by a fellowship in hip and knee replacement at Hospital for Special Surgery in New York City.

“ONS has been in the forefront of the trend toward outpatient joint procedures,” said ONS Medical Director, James Cunningham, MD. “Dr. Berliner has been an integral part of that effort. Under his leadership, patients can trust ONS to stay ahead of the curve in providing the best research-based options available. “

ONS makes this appointment at a time when the national trend for outpatient joint procedures is growing exponentially.  Currently, more than one million ambulatory joint replacement surgeries are performed annually in the United States.  That number is predicted to jump by 90 percent in the next decade.

At Home Recovery Gains Favor

The movement toward ambulatory joint replacement surgery is fueled by advances in minimally invasive surgical techniques and pain management protocols, and a younger demographic of patients who prefer to recover in the comfort of home.

There are many benefits to outpatient joint replacements versus similar inpatient surgeries as well. Research data indicates that patients have a more comfortable and quicker recovery at home with the support of family and friends.  Patients who recover at home are at reduced risk of infection and newer, long lasting intra-operative anesthetics help to limit the severity of post-operative pain.  The procedure is also less costly, as patients don’t incur charges for tests and services associated with one or two nights in a hospital. ###

About Orthopaedic & Neurosurgery Specialists

ONS has been one of the most advanced practices of its kind in the region for more than 20 years. Headquartered in Greenwich, Connecticut, ONS is a multi-specialty orthopedic and neurosurgery physician group with locations in Greenwich, Stamford, and Harrison. All offices feature fellowship-trained experts in orthopedics, sports medicine, joint replacement and physical medicine and rehabilitation, urgent ortho care services, physical therapy centers, digital imaging and, in Greenwich and Stamford, MRI. For more information visit

About Stamford Ambulatory Surgery Center (ASC)

The Stamford ASC is an advanced outpatient surgical center owned and operated by the ONS partners.

ONS Doctors Speak to Sell Out Crowd

Dr. Paul Sethi and Dr. Marc Kowalsky were presenters at the prestigious American Shoulder and Elbow Surgeons 2019 Resident Course: Essentials of Shoulder and Elbow Surgery. The sold out event took place on November 22 and 23 at the Orthopaedic Learning Center in Rosemont, Illinois.  The course consisted of lectures and surgical exposure to arthroscopic and open procedures.  It is offered annually to 55 residents and fellows planning careers in shoulder and elbow surgery.

As one of three event chairs, Dr.  Sethi opened with a review of the principles of shoulder and elbow anatomy to help the attendees further their skills and mastery of surgical approaches and procedures of the shoulder and elbow.  Dr. Sethi also gave a presentation called, 10 Technical Tips: Arthroscopic Bankart/Posterior Repair.

Dr. Kowalsky’s presented the following day on How to Take an Elbow Apart and Put it Back Together! Posterior Family of Approaches – Sparing, Trap, Osteotomy.

Do You Have Text Neck?


It seems like everywhere you look, people of all ages are looking down at their phones.  They do it at home. At work. In school. In restaurants.  While waiting for a train. Even while walking, driving and riding a bike.  Concern about the pervasiveness of handheld devices exists for a variety of reasons, not the least of which is the detrimental affect they have on the cervical spines of children, teens and adults.  Some call it Text Neck.

By some estimates, adults spend an average of 5 hours a day using a mobile phone or tablet, while teens report using their devices almost constantly throughout the day.  As a result, more and more people are developing neck pain caused primarily by holding their heads in an abnormal way.


Consider this. A quick glance down at your phone adds about 20 pounds of unnatural force to the discs in your neck. That weight more than doubles when you are fully engaged with your device.  Putting that stress on your cervical spine for hours a day, every day can accelerate the natural wear and tear on the cervical bones and discs.

Leaning your head forward also compresses and tightens the muscles in the front of your neck and lengthens the tendons, ligaments and muscles in the back of the neck. Over time, this can cause inflammation and weakness. Abnormal flexion also can be responsible for headaches, neck pain, shoulder pain and nerve-related symptoms such as radiating pain, tingling, numbness and/or burning in one or both arms. Your chances for disc herniation and early arthritis are also increased.

Neck pain from textingGrowing children and teens can develop those problems too, but they have the additional risk for skeletal deformity. Studies have shown that overtime, younger people who strain their neck muscles by holding their heads in a forward tilt for prolonged periods can develop an abnormal curvature in the upper back and neck.  In one study, researchers in Australia noted the development of bone protrusions similar to horns in the connecting tendons at the back of the neck in young teens who had used phones and tablets since childhood. There’s a name for that too. Phone Bone.


Physical therapy and in some cases, surgery can help alleviate the symptoms brought on by the overuse of these devices, but there are other steps you can try before it gets to that point.  Youngsters should be encouraged to partake in physical activities that help develop musculoskeletal strength and reduce time spent gaming and texting.  People of all ages can engage in activities that promote good posture, such as yoga or Pilates. When possible, use a desktop or laptop with the screen at the ergonomically correct angle. Or try lifting your phone so you are holding your head properly on top of the spine.  Long term, however, the solution is easier said than done. Look up from your device and notice what’s around you. The text can wait.

Contact Sports and Shoulder Injuries


Anyone can suffer a shoulder injury, but athletes involved in contact sports such as rugby, football and hockey are particularly vulnerable to fractures, separations and dislocations caused by the parts of the shouldercombination of speed and contact force to the shoulder upon impact, according to ONS Sports Medicine Specialist, Dr. Marc Kowalsky.

“The three most common injuries I see in athletes playing contact sports are clavicle fractures, AC joint separations and shoulder dislocations,” Dr. Kowalsky said.


Clavicle, or collarbone, fractures can occur along the bone anywhere between its attachment to the shoulder and the sternum. Direct trauma, and falling on an outstretched arm, are both common causes of a collarbone fracture.

A shoulder separation is the result of trauma at the acromioclavicular joint (AC joint), where the collarbone and the highest point of the shoulder blade, known as the acromion, meet. With this injury, the ligaments that hold the the joint together become stretched or torn from the force of the impact to the area.

A shoulder dislocation occurs when the head of the arm bone (humerus), or the ball of the shoulder joint, is driven out of the glenoid socket.  The injury is considered a complete, or locked, dislocation when the ball remains out of socket and requires manipulation in order to be put back in place.  A partial dislocation, a condition known as subluxation, occurs when the ball is forced out of its natural position in the socket, but is able to slip back in place on its own.


Trauma is the common denominator in these injuries, and they all can produce significant pain. Along with pain, these injuries typically cause an obvious deformity, including squaring of the shoulder with a dislocation, or a prominent bump or prominence with AC separations.  Injured athletes will also notice difficulty raising the arm, as well as tenderness, swelling, and eventual bruising.  In the case of a shoulder dislocation, the pain usually improves significantly when a physician performs a closed reduction, during which he or she puts the shoulder back in place.


Diagnosis is made initially by physical examination of the shoulder and an X-ray.

Early conservative treatment for mild injuries usually includes sling immobilization to protect the shoulder and minimize pain, along with ice, rest and Nsaids.  X-rays are used to assess alignment and the presence of a fracture.  An MRI will be considered, particularly for shoulder dislocations, if a soft tissue injury such as a labrum tear or injury to the rotator cuff tendons, is suspected.

Depending on the severity of the injury and the complexity of the treatment, physical therapy is usually prescribed to help patients gradually regain strength and mobility.  Surgery is typically considered only for significant injury with wide displacement, or for certain athletes at high risk for recurrent injury.


Of course, some injuries are unavoidable, but having proper fitting upper body gear can go a long way to dissipate the impact.  Balanced strength and conditioning in the muscles that support the shoulder is also key to help prevent an injury, minimize the extent of the injury if one should occur. Additionally, studies have shown that pre-injury strength and conditioning is also your best shot at a fast return to play.

The shoulder has several muscles that attach the shoulder blade (scapula), humerus and clavicle.  While it is important to have balanced strength in all muscles in the shoulder, the muscles and connecting tendons that make up the rotator cuff are the front line for shoulder stabilization.


As with any new exercise, it’s important to consult with a professional therapist or trainer, particularly if you have a prior injury or limitation. Strength and conditioning programs are suitable even for our youngest athletes, but the program should be age-appropriate and supervised.  Start slowly, and gradually increase repetitions, sets and level of resistance. And it is particularly important to focus on proper form.  Exercises done improperly can put unintended stress on other parts of the shoulder or even elsewhere in the body.

Trainers and physical therapists can help develop a shoulder strengthening program that’s right for you.  Many exercises to strengthen the rotator cuff can be done using a resistance band, particularly for strengthening your internal and external shoulder rotation, and the muscles in your scapula. Your posture alignment and range of motion will also benefit.

Planks are good to strengthen the core, back and shoulders, as long you maintain proper alignment. You can challenge yourself with a variation on a push up, where you start at a low plank and push up to a high plank one arm at a time.


Stamford ASC Wins Apex Award

Stamford Ambulatory Surgery Center (ASC) has received a 2018 National APEX Quality Award for Excellence in Healthcare.

“ONS is honored to receive the 2018 National Apex Quality Award because it reflects our practice-wide commitment to the highest standards of quality care and patient satisfaction,” said Seth Miller, MD, a founding partner at ONS.

This national distinction recognizes outstanding healthcare providers who have demonstrated excellence in patient satisfaction and overall care during the previous calendar year, according to a statement from SPH Analytics, the national healthcare analytics firm behind the awards.

Apex winners represent the top 10% of SPH clients with the highest satisfaction scores for measures tied directly to care and are based solely on patient feedback and evidence-based success.

For eligibility, a minimum of 300 patient surveys from each SPH client were collected and analyzed from January 1, 2018 – December 31, 2018. In all, more than 633 healthcare facilities in the United States were eligible for the award; 96 were selected as winners.  The Stamford ASC was one of only three facilities selected from the state of Connecticut.

“We applaud all recipients of this year’s award for their exceptional impact in driving satisfaction for their patients,” said Amy Amick, President and CEO of SPH Analytics.