When Should You See A Doctor?

This week we are going to give you our advice on an often dreaded question:

When Should A Niggle Become Visit to The Doctor?

Knowing exactly when to see a doctor when being affected by a minor sports injury is like asking “how long is piece of string?” Obviously, it depends on the string. It is a common question asked in our field as many players have niggling pains and aches but notice that often they go away on their own. When should you go and see someone?

 There is a general key we have created to help you decide when you should visit a doctor or specialist because ultimately it is up to you. But don’t worry, we aren’t copping out – we are going to guide you through a self-diagnosis soon. But firstly, due to the nature of sports injuries we cannot all diagnose over the internet for two reasons:

i)                 Everyone heals differently

ii)               Injuries vary in severity

It is therefore difficult to determine when the ideal time is to visit a doctor without knowing more. Of course, if you have recently suffered from a sport related injury and cannot see a physician, remember the PRICE procedure we discussed earlier this month (click here to learn more).

The first question you need to ask yourself is: is this injury preventing me from functioning? Generally, if your pain isn’t bad enough to shut you down completely but still preventing you from performing at your peak day-to-day then you should see your physician. This makes it difficult to time stamp when is most appropriate as it depends on your circumstances. A bricklayer who sustained a painful blow to shoulder while playing American football will want to be seeing a physician almost immediately as it would affect his capability to function day-to-day. An office clerk may on the other hand want to wait it out as it doesn’t affect their functionality.

Secondly, and this response is mostly applicable to sportspeople, are you doing what want to do as well as you could be doing it? That is, if you have a niggle that is preventing you from functioning at your highest potential level – then you should get it seen by a physician or doctor. A slight pain in the shoulder can be ignored by most people and left to heal by itself; however, a slight pain in the shoulder for a pitcher or quarterback can diminish their performance week-in and week-out. It is also at a higher risk of deteriorating as you are using the joint more frequently and more intensely. If this is you, get it checked out!

If you have suffered from anything mentioned above and believe you could benefit from a rehab plan or require medical attention, please contact us at Mount Sinai Department of Rehabilitative Medicine for a bespoke rehab plan. We’ll get you back on the field ASAP. Contact our switchboard at (212) 241-6321

Frequent Injuries in Baseball

Most Common Injuries in Baseball

For obvious reasons, baseball isn’t considered a high-risk sport like football or ice hockey – mostly because it isn’t a collision sport. Regardless, baseball brings its own risks. You are running, jumping, sliding (sometimes) and swinging a bat at a high velocity which puts you in danger of muscle strain, especially after long practice sessions. Consequently, baseball players frequently suffer from golf and tennis elbow – their ligaments are fatigued and deteriorating over time; and we haven’t even considered the risk of falling, collisions, and the danger associated with a hard ball flying at over 99m/h (albeit a generous estimate for most).

Types of Shoulder Pain

The most commonly overused muscle in baseball is the shoulder – usually during pitching. Shoulder tendonitis is common in young athletes who use overhead throws and the windmill pitch can cause a myriad of problems, especially when combined with poor form. Torn rotator cuffs can develop in the rotator cuff tendons and older players may begin experiencing Frozen Shoulder which reduces motion and causes pain in the shoulder joint. The shoulder can become unstable when combined with long periods of overhead throwing as the motion stretches the ligaments, leading to loose joints and sometimes dislocation. Finally, and possibly all pitchers’ worst nightmare is the Shoulder Separation – which is a traumatic injury that is a result of falling or colliding with a hard object with an outstretched hand.

Pain in the Elbow

Throughout the last couple of weeks, we outlined exactly what Tennis and Golfer’s Elbow was, and top ways of curing. We will go over it quickly now, but if you want a more in-depth guide, follow the links below.

Golfers Elbow and how to treat it – Click Here

Tennis Elbow and how to treat it – Click Here

PRICE Routine to help with minor sprains – Click Here

Tennis and Golfer’s Elbow are like two sides of the same coin. When the tendons in the arm are overloaded we often experience a dull pain on the outside of the forearm. Tennis Elbow denotes a pain felt due to overuse on the outside of the arm above the elbow whereas Golfer’s elbow is in a similar location but slightly under the elbow. Follow the links above to learn more.

Overloading the Spine

The human spine is a wonderous structure – we really couldn’t function without it. It transmits information from nerve endings all over the body through the central nervous system to the brain, and if that wasn’t enough, it is also the structure that keeps us standing up straight on two legs. It’s worth looking after your spine. Baseball poses a slight risk to the spine. Although admittedly it is a small risk – because the spine is so important – it is worth covering.

Catchers are prone to back injury during baseball due to the crouched position and overhead throwing. Some pitchers may also experience back damage especially when using the windmill pitch.

The most common damage sustained to the spine is muscle strains in the upper and lower back. This is usually dealt with rather simply by a physiotherapist or a sports massage (and rest). However, there is also a risk of a herniated disk which is when a disc in the spine ruptures and pinches surrounding nerves. This can be an agonizing experience. If you believe you have suffered from a herniated disc you should seek medical attention immediately. Even if it was only a small rupture, the damage could be exponentially augmenting each time you play – eventually leading to a severe hernia. As always, prevention is the best form of treatment.

If you have suffered from anything mentioned above and believe you could benefit from a rehab plan or require medical attention, please contact us at Mount Sinai Department of Rehabilitative Medicine for a bespoke rehab plan. We’ll get you back on the field ASAP. Contact our switchboard at (212) 241-6321

Curing Golfers Elbow

Last week we focused on what Tennis elbow was and how we can get it “on the mend”. This week, we are going to take a look at the inverse – golfers elbow and explain how you can treat it. Both these elbow problems occur frequently to baseball players due to overuse, strain, and the repetitive motions found in pitching and batting.

What is Golfer Elbow?

Golfer’s Elbow, known as Epicondylitis, causes the inner side of the elbow joint to feel tender and painful – you are more prone to this condition when involved in throwing motions (or playing golf), yet those with manual occupations can also be affected.

The affected tendon is the common flexor tendon which attaches the flexor muscles of the forearm to the inner side of the elbow. These muscles have a myriad of responsibilities from throwing to allowing your fingers to curl up. Golfers elbow occurs due to microscopic tears that cause the tendon to degenerate. The condition becomes chronic or long-lasting if the tendon that attaches to the bone calcifies – and in rare cases, larger tears can develop causing more issues. The vast majority of cases, however, are not serious and can be self-managed.

Symptoms include pain and tenderness on the inner side of the elbow. Pain is usually felt just over the bone and is triggered by gripping, squeezing, or pulling. The symptoms are extremely telling which means no extra investigation is usually required.

How Can You Manage the Symptoms?

If the elbow is sore after physical activity, apply ice for 15 minutes every few hours. We highly recommend you follow our tips on PRICE that can be found by clicking this link.

Most cases of Golfer’s Elbow can be managed just by modifying activities. That may mean, depending on the severity of pain, you must stop playing and or training until your physician or physio gives you the go-ahead to get back on the field. A small number of more severe cases may require a steroid injection. In very rare cases surgery may be necessary.

Anatomically guided Corticosteroid injections can also be a solution. This involves steroids being injected around the tendon and its insertion into the bone. Although this is minimally invasive, there are risks and possible side-effects you should consider with your physician. 

If you have suffered from Golfer’s elbow, please contact us at Mount Sinai Department of Rehabilitative Medicine for a bespoke rehab plan. Contact our switchboard on: (212) 241-6321

What is Tennis Elbow? What Can You Do About It?

Noting that baseball season is well underway, let’s take a look at one of the more common issues affecting baseball players – tennis elbow. Most baseball players don’t play tennis, or at least that we know of, however, they seem to get this strange pain in their elbow? Why is that? This week, we will identify what tennis elbow is and how we can cure it.

What is Tennis Elbow?

Tennis elbow is a condition that causes pain around the outside of the elbow. It is clinically known as lateral epicondylitis and is often the result of strenuous overuse of the muscles and tendons of the forearm, near the elbow joint.

The elbow joint is surrounded by muscles that give dexterity to the elbow, wrist, and fingers. The tendons in your elbow join muscle and bone together and are what allow you to control the muscles of your forearm. Damage to this area causes the symptoms of tennis elbow.

Common symptoms of tennis elbow are pain around the outside of the upper forearm – below the bend of the elbow. This pain is usually exaggerated when lifting or bending the arm, gripping small objects such as pens, or when twisting your forearm – when turning a door handle or opening a jar. It is often difficult to fully extend your arm when suffering from tennis elbow.

Pain can range from mild discomfort to severe pain even when the elbow is still and worsens when you use the damaged arm. The episode usually lasts between six months and two years depending on treatment. The majority of people will make a recovery within a year.

What Can You Do About It?

Tennis elbow will tend to get better by itself and you can recover without treatment. In most cases, you won't need to do anything but rest. There are some things you can to help speed along recovery.

It’s important that you rest your injured arm and stop doing the activity that’s causing the problem. That can mean you will have to stop playing baseball, take a break from painting and decorating, and stop doing whatever activity that is damaging the area. Compressing the area with ice several times a day can help reduce internal swelling – alongside taking paracetamol or other pain reliefs.

You should follow our PRICE procedure which you can read about here.

Physiotherapy may be recommended by your physician for more serious cases. Massaging and manipulating the affected area can reduce stiffness and improve the range of motion in your arm.

If you have suffered from Tennis elbow, please contact us at Mount Sinai Department of Rehabilitative Medicine for a bespoke rehab plan. Contact our switchboard at: (212) 241-6321

The PRICE We Pay for Playing Sports

Injuries can occur during sports even if we take all the preventative steps to shield ourselves from them. There are some steps we can take to minimize damage to an injury by following 5 steps after the impact and throughout rehabilitation – this procedure is an acronym: PRICE or RICE. Please note, this process works for relatively small tears and sprains - if you have sustained a serious injury you will need to go to the accident and emergency.

Protection

The P in Price stands for protection. After suffering a strain or localized damage during a sporting bout make sure you protect the area afterwards. Ensure no more harm comes to it and begin your recovery process immediately.

Protection usually becomes more relevant when the pain has ceased to be noticeable, but the area is still sensitive to damage. It is easy to forget about and therefore easily damaged again. Make sure to protect sensitive areas.

You can purchase area specific padding to protect damaged areas – for example – if you cycle to work and are recovering from serious knee damage – you should make sure you have a knee pad.

Rest

The R in Price stands for Rest. After sustaining damage to a ligament or joint you will need to stop aggravating the area - it is important to avoid activities that cause pain. Ideally, lie down in a comfortable position to minimize bleeding, swelling and further damage. Rest may also include the use of crutches, a protective brace, or tape/sling.

You should look to rest the damaged area as soon as possible after damage has occurred.

Ice

The I in Price stands for Ice. You should ice the injured area for 10-20 minutes every 2 hours. Use an ice pack or a makeshift “crushed-ice-in-tea-towel” to help reduce inflammation of the damaged area. Do not ice an area for extremely long lengths of time as inappropriate icing can sometimes make an injury worse rather than better.

The sooner after the impact you begin icing the better (and faster) your recovery will be.

Compression

The C in PRICE stands for Compression. After the incident you can use compression bandages to minimize swelling. If on applying compression you experience a change of colour, pins and needles, or any colour change in your extremities then the bandage is too tight, and you or the physio will need to loosen it. Ensure you remove the band before you go to sleep.

Elevation

The C in PRICE stands for Elevation. Immediately after the area has been iced and compressed you should raise the injured area above your heart – reducing blood flow to the damaged area – which minimizes bleeding and swelling. Ideally, you should elevate the limb whilst undergoing the rest of the procedure – but this can be tricky and prove to be more trouble than it’s worth.

You can continue to elevate the area in your day-to-day life to aid the limb in recovering.

PRICE is a reactionary therapy which seeks to minimize damage after impact or damage on small tears and sprains. As aforementioned, it is not a method to deal with serious damage such as a broken arm.

If you have suffered from a sports-related injury or would like to discuss a bespoke plan, please contact us at Mount Sinai Department of Rehabilitative Medicine. Contact our switchboard on: (212) 241-6321