• We Moved!

      bird2

      Just in time for the spring thaw, Manhattan Orthopedic & Sports Medicine Group is delighted to bring you:

      • a bigger, roomier waiting area;
      • more comfortable, clean and airy patient exam rooms;
      • heating and air conditioning!
      • a digital X-ray machine to provide real time results on site for patients’ convenience;
      • kiosks to help patient flow;
      • online or phone appointment option;
      • Spear Physical Therapy if you wish to use

      Manhattan Orthopedic new waiting roomWaiting roomAll this and more awaits you at our new location at 57 West 57th Street, 15th Floor. This is the new home of Manhattan Orthopedic & Sports Medicine Group, PC., a state-of-the-art medical facility in the heart of New York. Our new home is a warm and welcoming environment for our patients and friends, and a terrific opportunity for the growth and development of our staff and practice. We are also pleased to have Spear Physical Therapy at this location in order to provide continuity of care.

      Manhattan Orthopedic & Sports Medicine Group, PC still maintains their Queens location at 27-31 Crescent Street, Long Island City, NY 11102. Queens appointments can easily be made by calling 718-204-0548.

      Please call us at 212-289-0700 or use our online form in order to schedule an appointment with one of our Orthopedic Specialists.

      Come see us! We look forward to welcoming you to our new space.

      The Top 5 Secrets for Healthy Knees

      X-Ray of inflamed knees
      Knee pain is one of the most common musculoskeletal complaints, afflicting almost 25% of the US population. But there are a number of important secrets, practiced by top trainers and professional athletes, to help protect and preserve the knees. Practicing these 5 tips can help ensure good function and high performance on your knees for years to come.

      1. Quadriceps strength: Along with serving as the prime extensors of the knee joint, the quadriceps muscle group – which form the bulk of the front of the thigh – are at the same time vital for the stability and health of the joint. Even if you are not placing great demands on the knee through running, dancing, or jumping, it is important that the quadriceps remain strong. Otherwise, damage to the knee joint may occur.

      knee stretch2. Flexibility: If your knee muscles are very inflexible or you are new to exercise, start off with basic knee stretches. You should never feel knee pain in any stretch. If you feel pain in your joint, it’s time to stop and seek advice from your doctor.

      3. Cross-training: As with all muscular training, it is crucial to perform a variety of motions that involve the knee joint. A mix of exercise activities – walking, running, biking, tennis, dance, etc. – that create different types of stresses on the knee ensures that different muscle groups are engaged.

      sunset bike ride4. Low impact exercise: High impact sports and exercise – boot camp classes, step aerobics –expose the knee to significant stress, so emphasize low impact activities like cycling and swimming to protect your knees from long term damage.

      5. Maintain a Healthy Weight: Being overweight raises your risk for developing knee injuries, especially osteoarthritis. Excess weight puts additional stress on weight bearing joints, particularly the knee. Losing a few pounds can go a long way toward protecting your knees by reducing the pressure on them. The force on your knee is two to three times your body weight when you go up and down stairs, and four to five times your body weight when you squat to tie a shoelace or pick up an item you dropped. Each extra pound adds to that load!

      If you’d like to review your exercise program, or want individualized tips to help optimize your knee health, give us a call at Manhattan Orthopedics to make an appointment.

      The Well-Tuned Tendon

      Our tendons are the great connectors of our bodies: transferring the forces from bone to muscle and back again, they ensure our movements while bearing the brunt of our exertions. It may come as no surprise then that the sudden shift from indoor to outdoor activities often results in overuse injuries that are entirely preventable.

      Injury prevention involves stretching, having the proper equipment, and easing into any new routine. man stretchingTendons that aren’t prepared for a sudden change in activity can act a lot like a bundle of cold rubber bands pulled beyond their limit.

      The bundle may remain intact, but some of the individual bands may break or fray. This is roughly what happens when our tendons are subjected to new or aggressive forces. The result? Tendinopathy, a condition characterized by degenerative changes in the tendon that cause pain and decreased mobility.

      If left untreated, tendinopathy contributes to a cyclical process of worsening pain and inflammation. Initially, the pain can be discomforting yet bearable; many athletes will even continue their normal routines thinking they’ll work through it. But as the tendon weakens it overcompensates, further straining the tendon’s tiny cables and aggravating the condition.

      So how does one break the cycle? Modify your activity and adopt a regimen that puts fewer stresses on the problem area. Additionally, one should ice the problem area after exercise and take anti- inflammatory to reduce swelling and pain.

      This is also a good place to point out that our incredible team of Triarq physical therapists can help tailor a routine specifically for you, no matter where your tendon problem may be.

      Some of the more interesting developments in treating tendinopathy are new creams that combine multiple medicines as part of a multi-pronged attack against the problem area. In addition to topical pain creams such as Lidocaine or Voltaren gel, we now have access to creams that combine a few medications that may be able to relieve pain while also reducing inflammation. The combination helps our patients experience faster relief while healing faster.

      runner on pathBut our best advice is to stay healthy by preparing for the transition from treadmill to jogging trail. We know you might feel like jogging an extra five or ten miles on one of these bright and sunny days, but you’ve got all summer to do that! For everything else, we’re just a phone call away.

      Spring & Sensibility: Staying Injury-Free

      Back by popular demand. Just in case you missed our tips for training this spring, we are offering here again. Read how to prepare for your favorite outdoor activities and avoid injuries. We discuss how to start, the right equipment and clothing and strength training routines.

      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!

      Don’t Be a Turkey: The Notorious Rise of Thanksgiving Injuries

      Thanksgiving has its staples. Turkey, for sure; family and togetherness, yes; and last but not least… strained muscles and banged up ankles? While those last two may surprise you, Thanksgiving is notorious for a rise in injuries, and we’re not talking about the damage done on the dinner table.

      Consider the touch football games that play out on the hallowed grounds of front lawns in nearly every zip code across the US. Suffice it to say, touch football doesn’t always stay touch, but the annual uptick in Thanksgiving injuries is less a story of clashing knees than of overzealous athletes.

      Sport-Specific Prep

      The broader point is one of preparedness. Gym routines or a daily jog are great for staying in shape, but new activities—like an annual game of touch football or upcoming sports like skiing or snowboarding—require sport-specific training to ward off pulled muscles and tendon strains.
      This doesn’t mean that you have to spend the summer training for any impromptu pickup games, but you incorporating some light sprints into your exercise routine goes a long way in dealing with those frantic chases up and down the field on Thanksgiving Day.

      Warming Up for Winter

      Looking past November, the winter months loom with promises of weekend ski trips, and now’s the time to start doing exercises that replicate those downhill movements.

      Most skiers are already aware of the side-to-side jumping exercises that do so well to prime the hips, thighs and knees for those downhill slaloms, but did you also know that strengthening your core is just as important for maintaining balance and supporting your lower extremities on the slopes? Getting back to the basics of weight and core training is a simple change you can make in your routine now to keep you going strong all season long.

      Heal Smarter, Not Harder

      But alas we are not invincible, and even our best preparations can’t fully protect against all injuries. When a sprain or strain gets the better of us, the most important thing is to evaluate the severity and get professional guidance.

      Contrary to what you may have been told, immobilization is not always the best approach for getting better. Minor injuries can be worked out through a combination of rest and rehab, but anything more serious requires a professional regimen that keeps you active both physically and mentally.

      So while many of you may not partake in the post-prandial tradition of pigskin runarounds, now’s the time to consider what kind of winter activities lie ahead and what you can be doing now to keep you going all season long!

      Myth-Busters: Back Surgery Edition

      There are a number of misperceptions surrounding spinal surgery, but the one we hear most often is that it simply doesn’t “work.” Let’s think about that for a moment.

      What does it mean to say surgery “works?” Are we referring to a full recovery? Are we talking about relief from pain, improved function, or preventing conditions from getting worse? There are a great variety of back conditions that require unique treatment. Saying that spinal surgery doesn’t work, does not take into account the variety of conditions, the variety of treatments and procedures, and the different prognoses for recovery.

      Such misperceptions are not necessarily the individual’s fault: doctors, too, have a role in explaining the problem or condition in detail and being as clear as possible about the diagnosis, the surgery and what to expect from recovery. Effective communication with your physician is essential and will allow you to know what to expect throughout the recovery process.

      Studies have shown that persons who are more informed about their condition and the recovery are more satisfied than those who do not fully understand what to expect. Informed patients communicate more clearly with their physicians, which in turn leads to more effective treatment. Seems pretty simple.

      At Manhattan Orthopedic and Sports Medicine Group, we pride ourselves on making sure our patients are informed and understand what surgery entails and what to expect as they pass through the stages of recovery. By avoiding confusion we make sure that our patients are comfortable and well-informed throughout their treatment.

      If you’ve been feeling a little hesitant about seeing a doctor for your back pain or have some questions you’d like cleared up, go ahead and make an appointment with one of our conscientious spine specialists today. The only thing worse than a bad back is knowing that you could have done something about it but didn’t.

      When Should I Have My Knee Replaced?

      Why you should have your knee replaced is almost always a straightforward matter: to eliminate pain and to improve your quality of life. However, owing to our active lifestyles and unique backgrounds, the question of when to opt for knee replacement surgery can be a little tougher to discern.

      Rather than waiting for your knee to give you a painful prompt, you might first ask yourself what you want to get out of a knee replacement. Some people are willing to forgo joint-intensive sports like running and tennis, so they can hold off on replacement surgery in the short-term. Others, however, would rather lick a newt than take a break from the courts, so they opt for a knee replacement earlier in life.

      Knee replacements should have a life span of at least 15 – 20 years; at that point about 85-90% are still in great condition. Individuals who opt for an early knee replacement—i.e., someone still in their fifties—will likely require another replacement procedure down the road. If that’s a factor in your decision, then it’s worth considering that individuals who receive a new knee in their seventies can expect the prosthesis to last a lifetime.

      There are, however, other factors that everyone should consider when thinking about a knee replacement procedure. If you have a history of diabetes, hypertension, or heart disease, then it is recommended you might want to have the surgery before these issues progress and make surgery more risky.

      Similarly, obese individuals should consider weight loss programs and then have their knee replacements done earlier to prevent complications that can arise during surgery and also enable them to get active and keep weight off.

      Amid all of our varied lifestyles and personal histories there’s one thing that certainly does not matter: the type, or brand, of knee replacement. There are lots of different knee replacements, but they’re all pretty much the same. If there is a best type, then it’s the one that your surgeon is most comfortable with. Just like a chauffeur who drives a BMW every day, he simply knows his BMW better than a fellow chauffeur knows his Mercedes. In the end, they’re both luxury cars. So it is with knee replacements.

      And just as a chauffeur knows how to maintain his car’s performance so too should you be nice to your knee; so don’t ever think of treating it like a jalopy.

      In short, if you live an active lifestyle and wish to keep it that way, then consider having a conversation with your orthopedist and primary care doctor when you’re still in your fifties, sixties, seventies or even eighties! Regardless of your age, if you have any questions and would like to chat over the possibilities with one of our orthopedists, call or email us today and make an appointment.

      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.

      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.