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Spring & Sensibility: Staying Injury-Free in a New Outdoor Routine
With fresh leaves on the trees and perfectly mild weather, spring may just be the best time for outdoor exercises. Every year it seems, we devote at least one article to getting ready for spring,
yet we continue to treat injuries that could have either been prevented or lessened by following a few simple rules.First, always start out slowly. The main injuries we see this time of year are overuse injuries such as runner’s knee. Even if you’ve been exercising in the gym this winter, switching to outdoor activities will engage your muscles and joints in ways that they may not be ready for. In order to acclimate your body to new conditions, start by doing a lighter workout and ramp up incrementally.
Second, always have the right equipment. When changing from indoor exercises to outdoor activities, make sure you throw out your worn out running shoes and replace them with a fresh pair.
For those in-the-know, one of the best ways to pick out a new running shoe is to see a professional fitter at a shoe store or sports retailer. Some stores also offer treadmill analyses to give you a comprehensive overview as to the best shoe for your stride.Proper clothing also plays a role in staying injury free. When you’re jogging outside and perspiring heavily, wearing clothes that draw away sweat and reduce friction will help reduce overall bodily stress and maximize the effectiveness of your workout. Also, most runners are probably aware of the importance of lubricants during long jogs. If you feel any irritation in sensitive areas, then you should consult with a professional trainer or physician about a lubricant that will keep you moving with ease.
Finally, going on a strength training routine can help prevent injuries of all kinds by building up muscles and firming up the connective tissue in your joints. Strength training reduces the risk of injury by reinforcing those connections—something that cardiovascular training can’t do on its own. If you have any questions, ask a professional trainer or physical therapist as to what might be the best strength training routine for you.
So what are some of the red flags that indicate you might have an overuse injury?
Persistent pain and swelling point to injuries that may be more than just a minor sprain. If swelling doesn’t go away after a thorough icing of the problem area, that may indicate an overuse injury. Similarly, if that tweak in your knee persists even when you’re not working out, then it’s time to go see a professional.It’s always best to seek out a like-minded soul when it comes to finding out more about your springtime injury. If you’re a runner, then try to see an orthopedist who’s also a runner. If you’re a cyclist, seek a physician that knows about cycling. The reason is one of relatedness: seeing a doctor that knows your sport will help inform the diagnosis and allow for a better response to your injury.
Spring is not inherently hazardous, but there is something to say about overzealous individuals who end up as patients in our practice. Know your limits and stick to the basics: new shoes, new shirts, and, especially, a new attitude for a new season.
Have a wonderful spring and stay safe!
A Home Run for A-Rod’s Hip
Baseball star Alex Rodriguez, known to New York Yankee fans as A-Rod, is in the news again. This time around it s not because of his exploits on or off the field, but because of his experiences in the operating room. Just last month, the sports pages reported that A-Rod is planning to undergo arthroscopic surgery at the hip to address a torn labrum. This will be his second surgery.What’s amazing is that despite surgery, he’s expected to be back in full action by mid-summer of next year. How is that even possible for an athlete pushing 40? The answer lies in the non-invasive surgical technique known as arthroscopic surgery.
Readers of this space may know that arthroscopic surgery involves a camera and a couple of small incisions. Knee arthroscopy has been around for decades, but only recently has hip arthroscopy become more widespread. The benefit is that the technique is minimally invasive and allows for faster recovery times than traditional methods.
Hip arthroscopy is the method of choice for repairing labrum tears. The labrum is the soft tissue bumper that encircles the socket of the ball-in-socket hip joint. Labrum tears can cause reduced athletic performance and lead to varying levels of discomfort. If you’ve ever experience a torn labrum, you know something’s wrong but you may not know what, exactly, is the problem.In fact, A-Rod had the same issue when doctors were initially trying to diagnose what was sapping his performance near the end of the recent season. An MRI of his hip revealed the labrum injury.
There are two ways the labrum can become injured: it can either fray or tear. A frayed labrum occurs from repeated strains and the normal wear of physical activity. Torn labrums are usually the result of some sort of trauma, be it a hyperextension of the hip joint or a bad fall. The sensitive imaging techniques of MRIs allow doctors to diagnose these slight injuries and then recommend a course of treatment.The first-line treatment for labrum tear is physical therapy, which can help strengthen the surrounding muscles and tissue to allow the body to compensate for small tears. If there’s still pain, however, arthroscopic surgery may be recommended. The good news is that arthroscopic surgery is a same-day procedure, meaning you’re in and out of the hospital on the same day. Recovery can take some time, but using A-Rod as an example, you can get back to high-level activity within about 6 months—and that’s a timeline for a professional athlete. The weekend warrior could get back to normal workouts in about half that.
If you have a nagging hip injury that hasn’t gotten better for some time, then it’s a good idea to come on down and let us check it out. Even if you’re not A-Rod, we can still make sure you’re back to peak condition and rounding the bases for the company baseball team.That’s something to cheer about.
A Pain in the Post-Partem Wrist
We sacrifice many things for our children—sleep and a small slice of sanity are just two examples that come to mind. But for many new mothers, the constant lifting and toting of a young child can lead to a condition much more agonizing and confusing than a few sleepless nights.If you’ve never heard of it before, “New Mom’s Syndrome” may sound like a good description of overprotective mothers. In reality, it is a painful form of tendonitis that affects the tendons on the outside of the thumb and wrist. This occurs when the repetitive stresses of carrying a child results in inflammation of the tendons in this region.
Most of the people who are affected by “New Mom’s Syndrome”—known clinically as De Quervain’s Tendonitis—have often never experienced this type of pain or discomfort in their hands or wrists. Some of the blame can be placed on the natural swelling associated with the later part of pregnancy and after delivery, which intensifies the natural strains on one’s ligaments and tendons.
Indeed, some pregnant women develop carpal tunnel in the last trimester, due to the increased swelling of the wrist tendon’s that sit next to the nerve within the carpal tunnel. And if that weren’t enough, just as a new mother’s carpal tunnel syndrome is receding, De Quervain’s Tendonitis starts kicking in after delivery.
It’s true, however, that “New Mom’s Syndrome” is not exclusive to new moms. De Quarvain’s tendonitis can affect both genders, both the young and the old, but rarely do men’s bodies swell after their wives pregnancy—unless they’ve been sneaking in a few too many candy bars.
Luckily for everyone, “New Mom’s Syndrome” can be easily treated. In some cases, pain can improve by modifying the way one hold’s the child and by wearing a splint to relieve some of the strains on the wrist tendons. Physical or occupational therapy can be helpful as well. The most common and effective treatment, however, is usually a simple cortisone shot, which permanently solves the issue in most patients. If that doesn’t work, well, you might want to get your child a scooter to cruise around on. We’re totally kidding, but at least then you wouldn’t have to carry them as much!
Running the Town: Training for the NYC Marathon
The diaspora and excitement of New York City’s marathon has turned the first Sunday in November into an annual 5-borough tribute to the sport of running. Runners need not be reminded about properly training for a marathon, yet every year we see hundreds of runner-related issues, and would you believe that 90% of these injuries are due to the increased volume in training in advance of the marathon?What we commonly find are overuse injuries arising from the microscopic strains and tears on soft tissue and bone. A classic overuse injury is the runner’s knee, often caused by too much pressure on the kneecap. As runners ramp up the distance or speed of their training runs, the tissue surrounding the kneecap undergoes a considerable amount of stress because of its central role in anchoring the large muscles of the quadriceps.
Runner’s knee can be a road bump in a training regime, but that’s all it ever should be. Icing your knee and taking anti-inflammatory medicine should be enough to get you back to light exercise, but if the pain persists your orthopedist may recommend some form of physical therapy.
But what about the 10% of runners whose injuries aren’t caused by overuse? Overuse injuries are often aches that go away after about 15 minutes into a jog. If, however, the pain increases throughout one’s run, then it is likely a more serious injury to the underlying tissue. These injuries can creep into one’s daily life. Climbing stairs is painful; sitting and standing becomes an achy chore. These injuries can range from torn ligaments or tendons to stress fractures and should be addressed by your orthopedist at once, especially before any more marathon training.
That brings us to the question of whether you can continue to work out while experiencing one of the above symptoms. The answer ought to be self-explanatory, but if there is ever any doubt it’s best to take a break no matter what and do the proper stretching and icing regime.
What about shoes? We’ve said it before, but the quality of one’s shoes plays an outsized role in keeping your legs in top shape because fresh shoes with the right fit go a long way in preventing overuse injuries.
While training for a marathon, give yourself a minimum of four months in which to prepare, and try not to increase your mileage more than 10% per week. A few smart steps, both physically and mentally, can go a long way to having an injury-free New York City marathon.
But even the best preparation can’t always prevent a few small aches here and there—Manhattan Orthopedic and Sports Medical Group wants to help you in the long run, whether it’s a marathon or a quick lap around the park, we’re here to make sure you keep running.
And running.
And running.
Injuries of a Certain Age: Labrum Tears vs. Rotator Cuffs
For those of us with a few gray hairs, it’s about now in the middle of the summer that all those pickup games from May and June are starting to show their wear. An ache in the knee or a pulled bicep; these are pretty normal for an older sportsman on the weekend pitch. As frustrating as these injuries are, the real rub is how your kids can go full speed all summer long without some nagging pain to remind them of their age.
The tortoise did beat the hare, however, so a little insight into what type of injuries we get at different ages will hopefully lead to a longer and stronger summer season. The most important place to start is with conditioning. Gentle stretching goes along with any type of cardiovascular as a good base, but with games like softball or tennis, resting and icing your favored arm will help you recover faster and guard against the chance of future strains.
Once you start to hit middle age, those strains become measurable. The effects of age on the body are such that older athletes tend to experience bursitis and rotator cuff injuries at a much higher rate than their younger counterparts. Comparatively, younger athletes are affected by injuries such as labrum tears and other such trauma; in other words, there’s usually no doubt about the injury.
The good news is that as long as we stay fit at any age, we can usually sweat the small stuff out with some rest and ice. But as we get older, the small stuff should still be watched. Amazingly, it’s been found that 10% of patients 50 years and older have rotator tears—and most don’t’ even realize it. At 60 years old, that percentage goes up 20%. And at 70 years old, the percentage of people with rotator cuff injuries rises to an astounding 40%.
When a pain persists, it’s always best to see your doctor. If it’s a rotator cuff injury, a quick cortisone shot will sometimes be prescribed for the short term, while some form of physical therapy can provide for a lasting recovery. And while it’s never good to be out of the game, the recovery from a rotator cuff strain or inflamed bursa takes about as long as the recovery of a labrum tear, which often requires MRI’s, therapy, and sometimes surgery. The recovery from a full rotator cuff tear that requires surgery will put you out of the whole season.Staying fit and watching those aches goes a long way to staying in the game, so know your limits. Lamenting the young for their youth is as old as the hills, but that doesn’t mean you can’t compete.
ACL: A Celebrity Ligament
When it comes to celebrity injuries, few make the headlines as often or as loudly as an ACL tear. SportsCenter does its part by looping the replays to catastrophic effect, yet it’s the ensuing months of surgery and absence that does its part to turn ACL injuries into the storyline of the teams we follow and the players we watch.
When Tom Brady tore his ACL at the start of the 2008 season, the news reverberated across the NFL, spawning hundreds of articles and countless hours of pundits trying to parse the fallout. For a more recent example we turn to Derrick Rose of the Chicago Bulls. Rose tore his ACL on nothing more than a routine play, but a quick Google search shows over 100,000 results.With all this focus on ACL tears, you’d expect a little more discussion as to whom this particular injury affects and why. We can start by pointing to the types of sports played by Messrs. Brady and Rose. Football, basketball or any sport requiring sharp pivoting motions on the knee place an athlete at risk for an ACL tear. In the classic ACL tear, an athlete plants his foot into the ground and then pivots his knee in the opposite direction, wrenching the knee ligament.
That explains why ACL tears are more common in football and basketball than cycling or running. When the knee is used in an “in-line” motion, little stress is placed upon the ACL. This isn’t to say that certain athletes are exempt from ACL tears; but regardless of the sport there are certain steps one can take to minimize the chance of an ACL injury.
Stretching and lower body exercises are the most effective ways to lower one’s chances of an ACL tear, period. The ACL is an acronym for the Anterior Cruciate Ligament, a ligament that runs diagonally through the center of the knee, stabilizing the knee by connecting the femur to the tibia. Strengthening the muscles that surround the ligament allows for greater stability when dealing with the stresses of sport.There’s no way to fully prevent an ACL tear, so don’t despair if it ever happens to you. Pro athletes often rely on surgery and physical therapy to get them back to peak physical condition. Competitive recreational athletes may also choose surgery if they wish to return to the most demanding sports. For others, surgery may not always be the best option. There are still many exercises and activities one can do with a torn ACL, so before you make any decisions talk to your doctor and figure out what’s best for you. It may make the headlines, but an ACL tear won’t sideline the weekend warrior for long.
It’s Hot Outside, So Warm Up Your Back
For many people, the shift from the cold months of winter to the alluring heat of summer often means getting back to physical activities before they’re fully in shape. So whether you’re an Ironman athlete or a Weekend Warrior with a weed whacker, injuring your back has the potential to sideline your season before it even starts. Read more…
A Pitcher of Health: Injury Prevention in Little League
Spring heralds the start of the baseball season—or is it the other way around? Either way, the diamonds are filling up with millions of little leaguers as the new season starts after a long winter. These first few weeks are of particular import because of the new strains on young athletes after the off-season. Little League injuries can be as stressful for parents as they are for their children, so we’d like to offer some background as well as a few tips on how to prevent injury in one of the most injury-prone positions on any baseball team: The pitcher.
Sticks and stones may break our bones… but what exactly is a fracture?
What is the difference between a broken bone and a fracture? This is a common question among our patients. The answer: a fracture and a broken bone are the same thing. The term fracture comes from the Latin fractura, which translates to a broken bit or fragment. So, all broken bones are fractures, yet fractures themselves are divided into three distinct categories: non-displaced fracture, displaced fracture, and stress fracture. Let’s review. Read more…
The Cold Truth about Winter Injuries
Winter’s on the way, and it’s only a matter of time until the season’s hottest accessory becomes a snow shovel. The coming months have a unique way of presenting us with a new set of chores and hazards that, for all of our preparation, can wind up in a quick trip to the hospital. Never mind agility training, because slipping on ice can happen to anyone. That’s why some of the most common injuries that orthopedic surgeons see in the winter are to our wrists and backs from a variety of snow- and ice-induced mishaps. Read more…
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