Call 212-986-3888
Monday - Friday 7am - 7pm
  ABOUT | OUR WEBSITE

Painters, Pitchers, and Power Lifters – All at Risk for Rotator Cuff Injuries

Rotator cuff injuries are among the most common and painful shoulder-related injuries in adults, especially in people who exercise a lot. The rotator cuff (or musculotendinous cuff) in the shoulder is made up of tendons and muscles covering the shoulder joint. The rotator cuff helps to keep the shoulder in place and also works to lift and move the shoulder. Rotator cuff injuries treated at Spine and Sports Medicine are seen as a range from an impingement -- which occurs when the shoulder blade rubs or “impinges” on the rotator cuff when the arm is lifted -- all the way through a complete tear. In the mid range, the rubbing of the rotator cuff can cause injuries such as tendonitis, bursitis (inflammation of the bursa, which covers the rotator cuff), or a partial tear. Rotator cuff injuries are linked to limiting of movement of the shoulder and a dull ache in the upper arm and shoulder. At first the pain is mild but can become stronger over time. Rotator cuff injuries are common in people who lift their arms a lot, especially in athletes and in workers with heavy lifting duties.

Labels: , , , ,

Posted by Spine and Sports Medicine on 3:40 AM


| | Permalink

Sciatica – Getting to the Root of the Problem

The term sciatica describes the symptoms of leg pain and possibly tingling, numbness or weakness that travels from the low back through the buttock and down the large sciatic nerve in the back of the leg. The clinical diagnosis of sciatica is referred to as a "radiculopathy," which means simply that a disc has protruded from its normal position in the vertebral column and is putting pressure on the radicular nerve (nerve root) in the lower back, which forms part of the sciatic nerve.

“An important thing to understand is that sciatica is a symptom of a problem -- of something compressing or irritating the nerve roots that comprise the sciatic nerve -- rather than a medical diagnosis or medical disorder in and of itself,” says Dr. Kessler. “This is an important distinction because it is the underlying diagnosis (vs. the symptoms of sciatica) that often needs to be treated in order to relieve sciatic nerve pain.”

In addition to standard medical treatments, several alternative treatments have also been shown to provide effective sciatica pain relief for many patients, including acupuncture, massage therapy and chiropractic manipulation, all of which can be provided in the comfortable New York City offices of Spine and Sports Medicine.

Labels: , , , , , , ,

Posted by Spine and Sports Medicine on 3:25 AM


| | Permalink

Shark Cartilage, My Wife, and the Benefits of Glucosamine and Chondroitin Sulfate

A number of years ago, my wife had some issues related to stiffness in her joints. A nutritionist she was seeing suggested she take glucosamine and chondroitin sulfate supplements to help restore her flexibility. While research has yielded conflicting findings about their effectiveness, she began to recognize some benefits in a relatively short period of time.

Glucosamine and chondroitin sulfate are produced in the human body and are involved in the production and maintenance of cartilage that cushions joints. Glucosamine sulfate is thought to help with cartilage formation and repair, while chondroitin sulfate helps give cartilage its elastic properties and is thought to have an anti-inflammatory effect, which can help to reduce the painful swelling in the joints that occurs when the exposed bones in the joint rub together.

Both glucosamine and chondroitin sulfate are sold as dietary or nutritional supplements. They are extracted from animal tissue: glucosamine from crab, lobster or shrimp shells; and chondroitin sulfate from animal cartilage, such as tracheas or shark cartilage. So, even though I joke with my wife that she has begun growing a tiny fin in the small of her back, she has a much greater range of motion and far less overall stiffness.

Labels: , , , ,

Posted by Spine and Sports Medicine on 3:56 AM


| | Permalink

Wrist Pain and Carpal Tunnel Syndrome

A friend of mine was working at her desk recently as a photo editor at a major news agency. Without warning, a sharp, piercing pain shot through her wrist and up her arm. She described it as “an electric shock.” She thought at first it might be just a passing cramp, though she remembered she had been trying to ignore a tingling feeling in her hand and wrist for the last few months and recognized that it might be related.

A trip to the doctor indicated the possibility that the pain was caused by carpal tunnel syndrome, a painful progressive condition caused by compression of a key nerve in the wrist. “Carpal tunnel syndrome occurs when the median nerve, which runs from the forearm into the hand, becomes pressed or squeezed at the wrist,” says Dr. Kessler. “The median nerve controls sensations to the palm side of the thumb and fingers, as well as impulses to some small muscles in the hand that allow the fingers and thumb to move.” The carpal tunnel -- a narrow, rigid passageway of ligament and bones at the base of the hand -- houses the median nerve and tendons. Sometimes, thickening from irritated tendons or other swelling narrows the tunnel and causes the median nerve to be compressed. “The result may be pain, weakness, or numbness in the hand and wrist, radiating up the arm.”

Any condition that exerts pressure on the median nerve at the wrist can cause carpal tunnel syndrome. Tendon inflammation resulting from repetitive work, such as uninterrupted typing, can also cause carpal tunnel symptoms.

Some tips on relieving wrist pain: Prop up your arm with pillows when you lie down; avoid using your hand too much; find a new way to use your hand by using a different tool; try to use the other hand more often; avoid bending your wrists down for long periods.

Labels:

Posted by Spine and Sports Medicine on 3:58 PM


| | Permalink

Neck Pain from a Wig?

Only in Hollywood… A recent entertainment newspaper report indicated that the wig that Keira Knightley flaunts in her upcoming 18th century movie, “The Duchess,” was so heavy that a resting post was specially made for her to rest her neck between takes. In the movie, Knightly plays a scandalous aristocrat Georgiana Cavendish, Duchess of Devonshire, and in keeping with the part, had to pull on a sky-high Marie Antoinette-style wig for several key scenes.

Wig or no wig, neck pain is no picnic.

Any part of your neck -- muscles, bones, joints, tendons, ligaments or nerves -- can cause it. Pain may also come from your shoulder, jaw, head or upper arms. Muscle strain or tension often causes neck pain. “The problem is usually overuse, such as from sitting at a computer for too long,” says Dr. Kessler. “Sometimes you can strain your neck muscles from sleeping in an awkward position or overdoing it during exercise. Falls or accidents, including car accidents, are another common cause of neck pain.”

Treatment depends on the cause, but may include applying ice, taking pain relievers, getting physical therapy or wearing a cervical collar.

Labels: , , , , , ,

Posted by Spine and Sports Medicine on 9:37 AM


| | Permalink

Sweet Dreams?

You have probably spent over 25% of your life sleeping. With that much of your life spent under the sheets, it makes sense that proper sleep and a good mattress can go a long way towards mitigating back pain and improving your health.

However, approximately two-thirds of patients with chronic back pain suffer from sleep disorders and a new study indicates that frequently interrupted sleep can make a person more susceptible to pain by altering the body's natural systems that regulate and control pain.

During the study, researchers tested the pain thresholds and pain inhibition of 32 women subjects. Those in a group that had been woken up eight times during the night showed an increase in spontaneous pain, while those in control groups who slept undisturbed did not, showing that disrupted sleep impairs natural pain control mechanisms that are thought to play a key role in the development, maintenance, and exacerbation of chronic pain.

“A sleeping disorder associated with chronic back pain should always be addressed as part of a multi-disciplinary, chronic pain treatment approach,” says Dr. Kessler. “As with any symptom of a chronic pain syndrome, the sleep disruption should not be treated in isolation without taking into account proper treatments for the chronic back pain problem that is part of the cause of the sleeping problem.”

In many cases, the right mattress can certainly help, and for those with chronic pain, getting continuous, undisturbed sleep is key to controlling the pain.

Labels: , , , , , ,

Posted by Spine and Sports Medicine on 3:44 PM


| | Permalink

Death, Taxes, and Degenerative Disc Disease

Certain as death and taxes, degenerative disk disease happens to everyone. However, not everyone who has degenerative changes in their lumbar spine has pain. Many people who have "normal" backs have MRIs that show disc herniations, degenerative changes, and narrowed spinal canals. Yet, every patient is different, and not everyone develops symptoms as a result of degenerative disc disease.

One of the most common causes of back pain and neck pain, and also one of the most misunderstood, degenerative disc disease is not actually a disease -- it is part of the normal aging of the spine. In this condition, the discs in the spine -- pillow-like pads that separate the interlocking vertebrae that make up the spine and act as shock absorbers --eventually lose their cushioning. The breakdown of the discs can result in back or neck pain, as well as osteoarthritis, herniated disc, or spinal stenosis.

When we are born, each disc is comprised of about 80% water, which gives it its spongy quality and allows it to function as a shock absorber. As we age, the water content decreases and the disc becomes less effective. Additionally, the proteins within the disc also change composition, and most of us will develop tears into the annulus fibrosus (the outer hard core of the disc). Unlike other tissues of the body, there is very little blood supply to the disc, so once a disc is injured, it cannot repair itself, and a spiral of degeneration can set in, known also as Spondylosis.

“Pain from DDD is initially treated with ice or heat and with nonprescription medications,” says medical director Brian Kessler, MD. “Further treatments depend on whether the damaged disc has resulted in other conditions. Physical therapy and exercises are often recommended, and in some cases surgery may be recommended if the pain is severe and disrupts a person’s ability to participate in everyday activities.”

Labels: , , , , ,

Posted by Spine and Sports Medicine on 1:19 AM


| | Permalink

Running Again

“I've been running for years,” says Spine and Sports Medicine patient Joanie R. “Until recently, I've been pain free. But, my exercise was compromised by the pain I was feeling in my ankles.”

Running injuries are very specific due to the repetitive nature of the sport, and ankle injuries are the most common sport-related injuries. Many common conditions affect runners, including tendonitis, bursitis, shin splints, ankle and Achilles problems, and more.

“Common foot and ankle injuries include sprains, strains, and stress fractures or bone injuries,” says Dr. Kessler. “Many of these injuries are overuse injuries -- injuries that result from inadequate conditioning or excessive training that places too much stress on the foot and ankle.”

Warning signs of a serious problem that merits immediate evaluation at our offices in Manhattan include the following: pain which increases during the run, locking or catching sensations in the ankle, especially after an injury, recurrent sprains or instability of the ankle, swelling across the front of the ankle joint, and localized bone tenderness, among others. When in doubt, have it checked out!

“I started treatment at Spine and Sports Medicine,” says Joanie, “and although it took some time and a commitment on my part, I am back to running again. They are very professional and motivated me to stay with the program.”

Labels: , , , , , , , , ,

Posted by Spine and Sports Medicine on 5:20 AM


| | Permalink

How To Be a ‘Beautiful Person’

The idea of sticking needles into one’s face may be hard to imagine, yet more and more people who want to slow signs of aging, particularly in their faces, but don’t want to undergo surgery or to inject chemicals, are having facial acupuncture. The aim is to tackle wrinkles, muscle tension that may be causing unsightly lines, as well as systemic issues standing between you and glowing skin. In Chinese Medicine the state of physical health, emotions, and spirit is reflected on the skin, particularly on the skin of the face.
The non-surgical Mei Zen Facial Rejuvenation Acupuncture procedure, is a holistic, natural and comprehensive skin rejuvenation program designed to restore, revitalize and relax. Mei Zen means “beautiful person” in Chinese and many are taking this route to change not only their external appearance, but also to improve total body wellness. “I like the idea of using a natural approach to ‘halt’ the aging process without using toxic chemicals like Botox and Restylane,” says an interested patient. “I've used both (don't tell anyone) and I would have loved to find a healthier alternative.” That alternative is now available, right in the New York City offices of Spine and Sports Medicine. In the past 2,000 years, more people have been successfully treated with acupuncture than with all other health modalities combined. Today acupuncture is practiced widely in Asia, the Soviet Union, and in Europe, and is now being used more and more in America. Acupuncture treatments can be given at the same time other techniques are being used, such as conventional Western medicine, osteopathic or chiropractic adjustments, and homeopathy. So, call for an appointment and “get beautiful.”

Labels: , , , , ,

Posted by Spine and Sports Medicine on 3:49 PM


| | Permalink

Osteoarthritis - Degenerative Joint Disease

Osteoarthritis is one of the issues New York’s Spine and Sports Medicine addresses on a daily basis. With a wide range of symptoms, osteoarthritis is the most common form of arthritis, causing joint pain, swelling and reduced motion.

A degenerative condition most commonly associated with people over the age of 45, some question whether regular athletic activity -- for example, the impact of feet hitting the pavement or hands hitting a punching bag -- can damage joints and result in osteoarthritis years later. Researchers considered the question of whether people who participate in regular athletic activities, but have not sustained any known injury, are at risk for developing osteoarthritis, and in a 1997 article in Osteoarthritis and Cartilage concluded that the condition can occur prematurely in certain sports including soccer, rugby, racket sports, track and field, and long-distance running. Recreational sports done at a "reasonable" level, however, do not increase risk, according to researchers.

“There's no known cure for osteoarthritis,” says Dr. Kessler, “but treatments can help to reduce pain and maintain joint movement so that you can go about your daily tasks. Taking steps to actively manage osteoarthritis may help you gain control over your osteoarthritis pain.”

Therapies that manage osteoarthritis pain and improve function include exercise, weight control, rest, pain relief, alternative therapies and, in some cases, surgery.

Labels: , , , , , ,

Posted by Spine and Sports Medicine on 2:52 PM


| | Permalink

What Is TMJ – and How Can I Treat It?

Are you a pencil chewer, a jaw clencher? Have pain or tenderness in the jaw, aching pain in and around your ear? “You may want to give us a call,” says Spine and Sports Medicine Medical Director Brian Kessler, M.D. “Jaw pain may be an indicator of temporomandibular joint disorder, known as TMJ -- an acute or chronic inflammation of the temporomandibular joint, which connects the lower jaw to the skull.” TMJ disorders cause tenderness and pain in the temporomandibular joint — the joint on each side of your head in front of your ears, where your lower jawbone meets your skull. This joint allows you to talk, chew and yawn, and because it combines a hinge action with sliding motions, is one of the most complex joints in your body. Between 5 and 15 percent of people in the United States experience pain associated with TMJ disorders, according to the National Institute of Dental and Craniofacial Research, with women between the ages of 30 and 50 most likely to develop TMJ disorders.

“Determining the cause of a TMJ problem is important,” says Dr. Kessler, “because it is the cause that guides the treatment. TMJ problems do not fall clearly into one medical area, so we use a multidisciplinary approach to find the best treatment possible for every patient, often working with specialists from pain management, neurology and physical medicine right in our offices in Manhattan.”

Labels: , , ,

Posted by Spine and Sports Medicine on 2:44 PM


| | Permalink

My Aching Feet

I’ve been wearing the same pair of walking shoes for so long there’s barely any tread left, the material around the toes is chafed to a gauzy thinness, and whatever insole support there once was has been squashed flatter than a postage stamp. But, I love them! It’s getting ridiculous though, as I’ve suffered over the years from shin splints, bunions, heel spurs, nail problems, swelling, inflammation and soreness, as well as knee and back pain while walking. The average person walks more than 115,000 miles in a lifetime. Every walking step you take exerts pressure up to three times your body weight on your feet.

Running exerts up to ten times your body weight. We cram our feet into ill-fitting shoes, subject them to the unnatural angles of high heels, pound them on pavement and asphalt, smother them in airless socks and shoes, or simply stand on them for hours on end. It's no wonder that the skin, 26 bones, 33 joints and more than 100 ligaments in each of our feet sometimes can't stand up to the pressure.

Women are especially at risk. Of the 356 women involved in a survey by the American Orthopaedic Foot and Ankle Association, 80% had some kind of foot pain -- no surprise when you consider that 88% of them were wearing shoes that were smaller than their feet. “Ankle and foot pain can typically be caused by acute injury, repetitive stress as in running or sports, or by other parts of the body referring pain to that area,” says Dr. Kessler. “It can even be caused by improper footwear or by the way you walk. Finding the cause and getting the appropriate treatment is essential in helping you move around the city with ease and without pain.” So, while I love them dearly, I’m afraid it’s time to retire those golden oldies to the back of the closet where they can bask in the glory of the many miles we’ve traveled together.

Labels: , , , , ,

Posted by Spine and Sports Medicine on 6:33 AM


| | Permalink

Nursemaid’s Elbow

We’ve all heard of tennis elbow, but nursemaid’s elbow? Nursemaid's elbow is a partial dislocation of the elbow, which occurs when the lower part of the arm (forearm) slips out of its normal position at the elbow joint, caused by a sudden pull on the extended arm. Nursemaid's elbow is a common condition in young children and generally affects children under the age of five. The injury occurs when a child is pulled up too hard by the hand or the wrist. It is often seen after someone lifts a child up by one arm. (For example, when trying to lift the child over a curb or high step, or when an obstinate child is forcibly pulled along or lifted by the forearm.) Swinging a young child from the arms while playing can also cause this injury. When the injury occurs, the child usually begins crying immediately and refuses to use the arm.

The child may hold the arm so that it is slightly bent at the elbow and pressed up against the stomach. The child will move the shoulder, but not the elbow. Some children stop crying as the immediate pain goes away, but continue to refuse to move the elbow. Once the elbow dislocates, it is likely to do so again, especially in the 3 or 4 weeks following the injury, so don’t wait around. Give us a call.

Labels: , , , ,

Posted by Spine and Sports Medicine on 12:44 PM


| | Permalink

Summer Travel Plans? Watch Your Back!

If you're planning a trip, watch your back. Summer is the time for travel, but it can also be the cause of low back pain. Air travel in particular is hazardous to spinal health. Slouching for several hours in an ergonomically dysfunctional coach seat compresses the discs between the vertebrae and makes any pre-existing spine condition worse. And there’s no break once you get back on the ground, as you lunge forward to yank your heavy suitcase off the luggage carousel. Then there’s all that walking through the airport that slowly compresses the low back, so that if you have even a hint of arthritis in your lumbar spine joints, you can anticipate a spike in pain. But there are things you can do to make travel more bearable for your back, say our physical therapists:

 • Sit with your bottom fully lodged at the back of the airplane seat and place a firm cushion in the small of your back.

• Select an aisle seat and get up and move around as often as you are allowed. If you wait until the pain starts, it's too late.

• Don't be a hero at the luggage carousel. Take your time. Bend your knees, not your back and avoid twisting your spine. Heavy suitcase? Ask for help.

• If your back acts up as you stroll, pick up the pace and lightly contract your abdominals as you walk. Increasing your core strength is a great long-term prevention strategy as well.

Labels: , , ,

Posted by Spine and Sports Medicine on 3:28 AM


| | Permalink

Wizards Suffer, Too

Even Harry Potter has migraines. That diagnosis comes from Fred Sheftell, MD, and colleagues at the New England Center for Headache. Sheftell's team scrutinized all of J.K. Rowling's published Harry Potter books, looking for references to Potter's headaches, headaches that happen when the evil Lord Voldemort is nearby and that strike in the area of Potter's head where he has a scar in the shape of a lightning bolt.

More than 70% of Americans -- wizards or otherwise -- will suffer headache pain severe enough to compel them to seek medical attention at some point during their lifetimes. A small but substantial minority of patients experience chronic daily or near daily headaches, which significantly impacts on the quality of their lives and the lives of their families. Migraine symptoms include a pounding headache, nausea, vomiting, and light sensitivity.

The interdisciplinary pain team at Spine and Sports Medicine utilizes their knowledge of anatomy, biomechanics, and ergonomics and works closely with patients to assess and treat mechanical factors contributing to headaches. The team will evaluate a person’s pain response to repeated movements and sustained positions and consider the patient’s general condition and activity level. Treatment focuses on educating and empowering the patient to participate in techniques and specific exercises to correct mechanical problems.

So, whether you’re a wizard or not, if you suffer from migraines, get in touch with Spine and Sports Medicine.

Labels: , ,

Posted by Spine and Sports Medicine on 2:52 PM


| | Permalink

Why is Psychology an Important Aspect of Treating Pain?

Did anyone ever tell you the pain is “all in your head”? Well, pain is both a physical and psychological experience. Because the brain plays such a central role in the pain process, certain techniques that target a person's thoughts, emotions or behaviors related to pain are often effective.

“There are a number of self-management techniques for pain,” our Medical Director observes. These include relaxation strategies such as deep breathing exercises, muscle relaxation, guided imagery, and biofeedback. Relaxation techniques can give a person an increased sense of control over his/her pain. “This can help to reduce pain levels, and with less pain, a person is able to function better.”

Self-management techniques can also include cognitive skills such as "thought stopping" or "reframing," which can help people fend off some of the negative thoughts and feelings that often arise as a consequence of living with pain.

So, while pain isn’t “all in your head,” there are some actions you can take to help yourself psychologically manage different aspects of it.

Labels: , , , ,

Posted by Spine and Sports Medicine on 7:28 AM


| | Permalink

Game, Set, Match

It must finally be summertime -- Wimbledon is officially underway, time for the pros to work their magic across the pond on England’s grassy tennis courts and the weekend warriors here at home to break out the rackets and start tuning up their serves. Exercising is good for you, but sometimes you can injure yourself.

Accidents, poor training practices or improper gear can cause such injuries, as can repetitive stress. Some people get hurt because they are not in shape. Not warming up or stretching enough can also lead to injuries.

There are many options available to treat your condition, from ice packs and splints to the most advanced technology. Treatment may emphasize exercises for relaxation, conditioning, restoring range of motion, strength, endurance, and coordination. Specialized treatments include heat, cold, massage, ultrasound, electrical stimulation, and traction. As Dr. Kessler says, “If your pain is the result of a sports injury, we'll have you back on the tennis court or golf course in no time.”

Whether pain is all in your head or not, any athletic or bodily injury needs to rehabilitated beyond just removing pain through medications or pain relief techniques. Brian Kessler, MD says: your body needs to be brought back to its natural state of normal function, which includes pain relief, but goes far beyond it. It's being the best you can be.

Labels: , ,

Posted by Spine and Sports Medicine on 10:26 AM


| | Permalink

Pain and Pregnancy

Back pain during pregnancy probably won't come as a surprise, but that doesn't mean you should ignore it.

According to a February 2007 study in the Journal of Manipulative and Physiological Therapeutics, despite a high prevalence of musculoskeletal pain during pregnancy, few women receive treatment for their low back pain. According to Clayton Skaggs, DC, the study’s chief author, 85 percent of women surveyed reported that they had not received treatment for their musculoskeletal pain, and that 85 percent of women who experienced pain in a previous pregnancy reported pain during their current pregnancy.

“Based on the findings of this study, doctors of chiropractic and other health care professionals need to expand the musculoskeletal care available during pregnancy,” says our very own Brian Fradet, at Spine and Sports Medicine. “As a proactive step, health professionals should consider screening for back pain as part of early obstetrical care to help identify musculoskeletal risk factors and allow for early education and treatment.”

So, say something. You don't have to grin and bear it.

Labels: , , , , ,

Posted by Spine and Sports Medicine on 10:14 AM


| | Permalink

Chronic Back Pain

My brother-in law has suffered from chronic back pain for a decade or so. He’s tried all kinds of things to ease the pain and recently had a spinal cord stimulation system implanted in his back. “That’s where a tiny programmable generator and electrical leads are implanted beneath the skin,” says our own Dr. Kessler of Spine and Sports Medicine. “Low-level electrical signals are then transmitted through the lead to the spinal cord or to specific nerves to block pain signals from reaching the brain.” Using a magnetic remote control, my brother-in-law can turn the current on and off, or adjust the intensity. So now, instead of pain he feels a mild tingling sensation. Approved by the Food and Drug Administration in 1989, spinal cord stimulation has become a standard treatment for patients with chronic pain in their back and/or limbs who haven’t found relief from other treatments. Joking around, I told my brother-in-law he could now be categorized as a cyborg, but he didn’t really care. He was just happy that the pain in his back was manageable again.

Labels: , , , ,

Posted by Spine and Sports Medicine on 9:55 AM


| | Permalink

My wife, the Fish

My wife is a swimmer, always has been. She says she actually feels more comfortable in the water than she does on land. I think, perhaps, she was a fish in her past life, but that’s another story.


Like many sufferers of back pain, she responds well to water, and some physical therapy centers provide aquatic physical therapy. Our own Dr. Kessler of Spine and Sports Medicine says, "Water supports the body and minimizes the effect of gravity, making it easier for patients to start an exercise program. Aquatic therapy can be very helpful for elderly patients and disabled patients who may not have the strength to do some of the exercises outside the aquatic pool.”

Some of the most important properties of water that make exercise easier are buoyancy, viscosity, and hydrostatic pressure. These properties can counteract gravity, provide resistance, and improve muscle blood flow.

…And I thought water was just good to drink.

Labels: , , , ,

Posted by Spine and Sports Medicine on 6:58 PM


| | Permalink

Knee Problems, will it be the end for Tiger

I guess knee pain doesn’t have to be the end of a person’s active life. Take Tiger Woods. He just won the U.S. Open.

Woods, like all professional athletes, demands more from, and puts more stress on, his joints than the average person. In mid-April, Woods underwent surgery on his left knee to remove fluid build-up in the joint and repair cartilage damage. It was the latest of several procedures on the joint.

Healthy knees are lined with cartilage, which act as shock absorbers. Arthritis or injury can damage cartilage. According to our medical director Dr. Kessler of Spine and Sports Medicine, “Unlike the shoulder or hip joint which provide some degree of stability from the bone structure, the knee depends 100% on ligaments, muscles, tendons and cartilage to hold everything together. This is why the knee is so prone to injury when external forces and stresses are applied.”

Labels: , ,

Posted by Spine and Sports Medicine on 6:46 PM


| | Permalink

A pain in the Neck


My neck pain extends down into my shoulder. I know bad posture has something to do with it. It’s not nearly as drastic as the hairdresser’s situation, but it causes me discomfort nonetheless. According to the doctors at Spine and Sports Medicine, physical therapy will help me restore the range of motion, relax my muscles and strengthen my postural endurance.

The pain in my neck from sitting too long at work with my head craned forward staring at the computer screen is nothing like the pain suffered by a trampoliner in the UK who was enjoying an outdoor barbeque party and a turn on the trampoline at a friend’s house when she suffered an accident that broke her neck. A former hairdresser, she was paralyzed and told she would be in a wheelchair for the rest of her life.

With the Fourth of July coming up and a sweet barbeque on the agenda, I’m hoping that my neck pain will be better soon. Like the hairdresser who is now actually walking on her own, hopefully I’ll “bounce back,” too. But, just to be on the safe side, I think I’ll steer clear of any trampolines.

Labels: , ,

Posted by Spine and Sports Medicine on 6:14 PM


| | Permalink

Pain and Posture

It’s one of those things passed on from parent to child without even thinking. I’ve even found myself saying it. “Sit up straight… Don’t slouch.” My kids hate it as much as I did when I was young, but over the years I’ve seen there’s more than a little truth to this age-old nag.

Bad posture alone doesn’t cause severe back pain, and the kind of sloping, slouching, shoulder droop my kids sometimes exhibit as they’re sitting in front of the computer isn’t going to land them directly in the emergency room, but it’s bound to have an impact on their musculoskeletal systems.


"Everyone can benefit from good posture," says our medical director Dr. Kessler. "Poor positioning of the body can be improved and it’s never too late to start trying to correct postural problems."

The spine is a complex arrangement of bones, joints, muscles, ligaments, discs, a spinal cord and nerves. In a healthy spine the vertebrae, facet joints and discs are vertically stacked, held together by a system of ligaments that help support the alignment while allowing movement within a safe range. Comprised of three natural curves that form an S-shape, the spine is properly aligned when a person’s ears, shoulders, and hips are in a straight line. Without support from strong, flexible muscles, the back loses its three natural curves.

When poor posture sets in, muscles, joints and ligaments take more stress and strain than intended, causing fatigue, muscular strain, compression of blood vessels, and pain. In addition, faulty posture can affect the position and function of major organs.

Time, old injuries and bad habits take their toll on the spine as a person ages. But new treatments and better diagnostic tests can help keep back pain at bay throughout an entire lifetime.

"The spine goes through the aging process just like any other part of the body," says Dr. Kessler. "For patients with a history of back pain who are currently experiencing symptoms that are interfering with activities, the first step is proper diagnostic testing to determine the cause of the symptoms and the severity of problem. A series of imaging tests over a period of time can help determine the correct course of treatment.”

Computer use is one of the common causes of difficulties related to posture and positioning. One of the first things that happens with computer use is the user's head starts to move forward. Once the head moves forward, posture is thrown off and the body compensates for the shift. The neck moves forward, the shoulders become rounded and a compensatory sway in the back develops. The result of this poor posture is pain, muscle aches, tension and headaches.

Unfortunately, many of us adopt these habits in a whole variety of everyday positions - not only sitting at a desk, but also standing, walking, carrying things, even lying in bed. High heeled shoes, boots, tight clothing and wide belts can also shift our center of gravity and move us out of normal alignment.

Treatment goals for correcting postural problems include restoring range of motion, increasing flexibility and strengthening weak muscles. These goals can be accomplished through exercises and practice. Muscle relaxation techniques, massage and stretching exercises are also used to relieve pain and muscle tension.

"Of all the things that happen to our body," Dr. Kessler says, "poor posture is one of the easiest to correct."

Try telling that to my kids.

Labels: , , ,

Posted by Spine and Sports Medicine on 8:56 AM


| | Permalink

My Daughters Back Pack


My daughter complained of back pain the other day.

“From what?” I asked.

She pointed to her backpack, the one she carries to school every day. It looked innocent enough, sitting modestly on the floor in the hallway. She read the questioning look on my face.

“Try and pick it up,” she said, with a hint of defiance in her voice.

“Okay,” I said, accepting the challenge.

Reaching over from the waist, with my knees locked, I hooked my fingers through the arm loops and gave it a jerk. Immediately, I could feel a twinge in my lower back, but I lifted with my arm and got the backpack off the floor cleanly.

“See,” I said. “No problem.”

“Yeah, right,” my daughter laughed.

Lowering it back down to the floor and massaging the small of my back, I asked, “What the heck have you got in there?”

“The usual,” she responded. “It’s what I carry every day.”

Together, we sat on the floor in the hallway as she took the items out of her backpack one by one and stacked them into a pile: 1 copy of Arthur Miller’s “Death of a Salesman”; an oversize Spanish textbook called “Interacciones”; a humongous “History of Western Society, Vol. 2”; Vergil’s “Aeneid, Books I-IV”; “Principles and Problems,” a physics textbook; 1 history notebook; 1 geometry supplement; 1 pencil case; 1 daily planner; 2 classroom folders for biology; 3 school notebooks; 1 three-ring binder; 1 wallet; 1 cell phone; 1 make-up kit; 1 bottle of water; and $2.00 in quarters in case she lost her bus pass and had to pay for the ride home.

“Wow,” I said, as I gathered up the pile in my arms, careful now to bend my legs as I lifted, already feeling a little soreness in my back. “Let’s weigh this.”

With a little rearranging and my daughter’s skills in geometric positioning, we got it all onto the bathroom scale. Not the most scientific of experiments, but accurate enough to convince me of the hidden danger lurking for my daughter every day with that backpack.

“Low back pain is the most common health problem we see at Spine and Sports Medicine,” says Dr. Brian Kessler, our Medical Director, “and we’ve seen an increasing number of adolescents over the years complaining of back, neck and shoulder pain. Hauling a heavy backpack around every day can cause serious postural misalignments and vertical subluxations of the spine that can restrict movement and predispose kids to a number of ailments. We’re concerned that the damage inflicted now will be showing up 30 years later in even more serious back problems.”


According to guidelines from the American Chiropractic Association, students should carry no more than 10% of their body weight, and backpacks should have two adjustable and padded shoulder straps to equalize the weight.

I looked at my daughter’s backpack lying in the hallway. One shoulder strap was ripped nearly all the way through from the constant strain and the other was seriously frayed.

“Let’s go look at some new backpacks,” I said, as the pile of contents on the scale slowly toppled over like a wobbly Jenga tower.

“Great,” she said. “Then you can help me with my geometry.”

“Don’t push it,” I said.

Labels: ,

Posted by Spine and Sports Medicine on 8:24 AM


| | Permalink

Who Is Tommy John and What Does He Have to Do with Elbow Pain?

In life there aren’t too many sure bets, but for thousands of New York Yankees fans, just having Mariano Rivera on the pitcher’s mound at the end of a game is about as reliable an indicator of victory as anyone could want. Often considered the greatest closer of all time, Mariano has won four World Series titles with the Yankees and is Major League Baseball’s all-time postseason leader in saves. Able to throw with pinpoint accuracy at speeds up to 97 miles per hour, Mariano seems a lock to be elected into Baseball’s Hall of Fame.

But in 1992, if it wasn’t for Tommy John surgery, Mariano Rivera might never have even made it to the major leagues.


In 1974, Tommy John was a successful left-handed pitcher for the Los Angeles Dodgers. But in mid-season of that year he permanently damaged the ulnar collateral ligament in his pitching arm. While it seemed unlikely he would ever pitch again, a revolutionary surgical operation performed by Dr. Frank Jobe, replaced the ligament in the elbow of his pitching arm with a tendon from his right forearm. He spent the entire 1975 season in recovery and returned to the Dodgers in 1976, winning 164 games after his surgery—one fewer game than all-time Dodger great Sandy Koufax won in his entire career.

This operation, now known as Tommy John surgery, in which a ligament in the medial elbow is replaced with a tendon from elsewhere in the body (often from the forearm, hamstring, knee, or foot of the patient), has salvaged or extended the careers of hundreds of baseball players – including the Yankees’ Mariano Rivera.

The strain of pitching can cause serious elbow problems. “The ulnar collateral ligament can become stretched, frayed, or torn through the stress of the pitching motion,” says Dr. Brian Kessler of our pain management facility. “Overuse or repeated pressure on the elbow joint can cause small tears to form in the soft tissue, particularly where the tendons anchor to bone. If a number of these tears occur over a period of time, they can cause discomfort and reduced movement of the elbow joint.”

Today, elbow injuries are on the rise as one of the most frequent sports injuries for youngsters, and elbow surgery is rising rapidly among teen pitchers. Kids are throwing harder and harder at younger ages and are working earlier to master complicated pitches like sliders, curveballs and other breaking balls – advanced pitches that put unnatural strain on young, undeveloped arms.


To combat this trend, coaches, parents and even Little League Baseball, Inc., a sanctioning body for many youth baseball leagues, recommend limiting the number of pitches thrown by young pitchers, staying away from curveballs and other breaking pitches, and instructing players on the best techniques to prevent arm injuries.

“Repetition and torque,” says Dr. Kessler. “Those are the critical elements leading to elbow problems, especially for athletes.”

For Mariano Rivera, like Tommy John, surgery was the answer for turning elbow pain into peak athletic performance. Without it, Yankee fans might never have had the opportunity to watch a sure thing -- the greatest closer of all-time.

Labels: , ,

Posted by Spine and Sports Medicine on 7:20 AM


| | Permalink