Fluoroscopic guided procedure at Mount Sinai

 Although at first it may sound a new deep-clean toothpaste or a strange form of horticulture, a fluoroscopy is an important diagnostic tool we use at Mount Sinai’s Department of Rehabilitative Medicine. You may have recently been, or potentially be referred for one of these treatments with one of our specialists. This week, we want to walk you through this vital piece of equipment and some of important procedures.

Firstly, What Is A Fluoroscopy Guided Procedure?

Before we answer that, we need to tell you what a fluoroscopy is. It’s nothing scary, your physician safely injects a dye into an area which allows them to investigate localized problems – which as you can imagine is much better than any alternative which may involve surgery. Our physicians can move joints, check organ health, locate a foreign body, amongst many other things. When the dye is inserted into the numbed area you may be asked to move or remain still depending on the nature of the investigation. From this point, your physician can study moving body structures as an x-ray like beam is passed through the examined part of the body which is then transmitted onto a monitor.

A fluoroscopy guided procedure in that case is the practice using a fluoroscopy to aid in providing relief to arthritis, especially in the hip joint. The physician can use the guidelines and information feedback to inject numbing agents or anti-inflammatory medications with maximum accuracy.

Why Have A Fluoroscopy or A Fluoroscopic Guided Procedure?

More often than not, your physician will recommend you for this procedure as an investigative procedure that will further increase their understanding of symptoms, underlying problems, and recovery. Sometimes however, we use the guides alone as a diagnostic or in conjunction with other diagnostic or therapeutic media or procedures. The reason therefore varies depending on your situation.

Risks and Additional Notes

There is very little risk associated with fluoroscopic procedures, whether it investigative or procedural. However, if you are – or think you are – pregnant please divulge this information with us before the exam. Other options will hitherto be discussed.

You may be asked to change into patient clothing, and all provision will be provided. Remove all piercings and leave all jewellery. We suggest leaving valuables at home.

Eat/Drink – specific instructions will be provided based on the examination you are scheduled for.

Please notify the radiologist or technologist as to your allergies or sensitivities to medications.

If you have been recommended a fluoroscopic procedure and would like to do it with us at Mount Sinai, or if you are having one with us soon and would like more information, please contact us on (212) 241-6321) to see if our physicians can further help.

What Is An EMG/NCS And How Can It Change Your Life?

At Mount Sinai’s Department of Rehabilitative Medicine, we will sometimes refer patients to complete an Electrodiagnostic test when an underlying muscle issue is unobvious. These tests are helpful in evaluating weakness, numbness, and pain; and there are two main components in the examination – the electromyographic examination (EMG) and the nerve conduction study (NCS). 

While the EMG and NCS are different tests, they’re often used together as the information from each test synergises with the other, giving a more complete analysis.

The tests will inform our physicians on unexplained muscle weakness, twitching, paralysis, and find the cause of numbness and pain the patient may be experiencing. Most importantly, it informs your physician on whether there is a muscle disorder in the muscle itself, or within a nearby nerve.

The EMG and NCS are considered non-invasive imaging tests, although there will be a needle involved. Your physician will insert a very fine needle, which acts as an electrode through the skin and into the problematic muscle. You will be asked to begin contracting the muscle by moving the area local to your symptoms. For example, the needle will be placed into the tricep, and the patient will slowly extend the arm, contracting the tricep with increased force as the electrical activity is recorded. Activity within the localized area will be visualized and available to watch on an oscilloscope and played audially through a speaker. These results can inform our physicians on the muscles ability to respond to nerve stimulation.

Nerve stimulation is often reported to causes a tingling sensation however there are no long-term effects. The EMG and NCS usually require an hour to complete and there are no restrictions in activities or meals before or after the test. Patients however do frequently feel some minor discomfort, similar to an injection, when the needle is inserted – with examined muscles feeling sore for a few days. There may also be light bruising in the affected area.

The results will also be able to help us diagnose neuromuscular diseases, and motor control disorders such as carpal tunnel syndrome or muscular dystrophy. From this point, there is no general direction as results will vary, and diagnosis will simply point you toward the optimal rehabilitation.

If you are suffering from an undiagnosed muscle issue and think you could benefit from a EMG/NCS diagnosis please contact our switch on (212) 241-6321) to see if our physicians can further help.

Protecting Your Legs in Basketball

Protecting the Upper Leg in Basketball

Basketball presents players with a large variety of risks when training and playing, and for the last few weeks we have been wrestling with how to deal with the most common and serious risks. The most common injury we have not discussed so far in the upper leg, made up mainly of two muscles: the hamstring and the quadricep which are considered to be the largest muscle outside of the gluteus maximus. This week, we are going to focus on protecting your quadricep from harm and preventing damage to your hamstring in basketball.

The Back of the Leg – the Hamstring

The hamstring is frequently damaged and can occur in different severities usually in training or games where the player has failed to warm up properly. It can also be the result of overuse and exhaustion. Your on-site physical therapist should be able to identify your damage as one of the following:

Grade 1 – this tends to be a mild muscle pull or strain and will tend to mend itself within a few days.

Grade 2 – this tends to be a more serious but partial muscle tear and will take weeks and even months to fully rehab and heal

Grade 3 – this is a complete muscle tear and will take serious rehab and care to mend, usually lasting months.

Of course, the time it takes to mend will be based on your overall health, severity of damage, and quality of care. As this muscle is so important in day-to-day activities, having a damaged hamstring can impede every facet of your life – and for the most part you can forget about basketball outside the confines of watching the NBA until it is healed.

The Front of the Leg – the Quadricep

It is not uncommon for basketball players to engage in hard contact and collisions when playing regardless of whether they’re at the downtown court or on the T.V. This is why basketball is a breeding ground for quadricep damage –usually sustained as a result of trauma to the front of the upper-leg. This is called a quadricep contusion.

Initially the blow is uncomfortable but many players experience swelling and increase in pain over time. If a player sustains a blow of this nature it is imperative they follow the RICE procedure and begin treatment immediately to avoid a minor injury turning into long term muscle strength and flexibility issues.

Although the damage to the quadricep and hamstring vary in both genesis and severity, if you have suffered from one of these issues it is imperative you contact a physical therapist to help you on your way back to proficiency. If you would like to contact one of Mount Sinai’s dedicated teams, please contact our switchboard at (212) 241-6321

How to Protect Your Achilles Heel in Basketball

It has always been very apparent to humankind that the Achilles heel is a serious physiological blind spot – so much so that the Greeks decided to centre a myth around this all-too-human-inadequacy. Our anatomic weakness becomes very apparent in games like basketball which require frequent sliding, stop-starting, and sudden twists. That’s why it is not surprising that every year the emergency department, doctors’ offices, and local clinics treat 355’130 basketball ankle related injuries. Whether you’re defending, blitzing, or chasing a rebound – your Achilles is always at risk of letting you down, and potentially ruining your career for the foreseeable future. This week, we want to show you some top tips to prevent this from happening.

Maintaining a healthy weight during the off-season will allow you to jump back into basketball seamlessly. You won’t have to blow off any cobwebs upon restarting your season, your coordination will still be spot on, and if you do make a mistake then you will not be punished by carrying excess weight. The Achilles is extremely weak, and one slip up could mean the end of the line for you this season.

You can also avoid damaging your Achilles by preparing yourself before a game with stretches, running, jumping jacks, cycling and long-term flexibility training. Always warm up and stretch before you play – especially in colder months if playing outdoors to avoid stiffening up.

You can significantly reduce the risk of damaging your Achilles tendon by ensuring you have appropriate equipment. Generally, the most important piece of equipment are your shoes as a good pair can save you a trip to the hospital whereas an inappropriate pair could land you in all sorts of trouble. Basketball shoes that fit, have no skid soles, and offer support to your ankles reduce the odds of you damaging your ankle.

You can further increase the odds to your Achilles surviving a rough game by using ankle braces or tape to stabilize the region.

Finally, ensure your technique is correct and your understanding of the intricacies of the game is finessed when playing. Technique improves your coordination and self-control meaning you will be less of a danger to yourself. Imagine landing a 3 pointer then twisting your ankle when landing. And understanding the game means you play your assigned position and therefore control the area around you. Listen to your coach’s advice and learn the game. Understanding your role better allows you to better avoid collision and injury from illegal or unexpected contact.

If you have recently damaged your Achilles tendon and would like to speak to one of our physicians about it, please contact our switchboard at (212) 241-6321

Why You Should Jog Twice a Week

U.S Navy SEAL William McRaven broke the internet in 2014 with an inspiring speech to then-recent university graduates. The talk began with a strange and unobvious statement that left the crowd confused: “You can change the world by making your bed.” But the message soon became clear. The Veteran was explaining that small tasks make the foundations for larger tasks. A marathon is run one step at a time, making your bed is the first step - which then leads to the next. He began each day of gruelling training, involving swimming in shark infested waters, by simply making his bed. Every small, beneficial task will lift you up a little bit each day, and eventually climax at an extraordinary accomplishment. And, even if you have an awful day – at least you come home to a made bed.

A regular jogging routine, even just twice a week will strengthen muscles, improve cardiovascular fitness, burn plenty of calories, help maintain a healthy weight, and even can help in building stronger bones. Our health routine and the way we look after ourselves is similar to William McRaven’s story. Just as he aimed at becoming a SEAL, we aim to be fitter, lose weight, get an early start to the day – we may even dream to one day complete or compete in a marathon. These aims are the great achievements and usually make up our deepest desires. One way we can begin working towards them is jogging. Jogging is more than a fad. It is a tried and tested way of maintaining a stable weight, helping deal with mental illnesses, and optimising the functioning of vital organs, like the heart.

The same way making his bed got him into the Navy SEALS, we can achieve health goals by going for a jog or joining a sports club, but are put down in thinking – what’s the point? If I go for one run, will it really make that much of a difference? After all, it’s only one run and I need to go on plenty of runs to be healthy. Health, like the accomplishments of Mr William McRaven, is an on-going battle of willpower. Respectively, one run is like making one bed – and Rome wasn’t built in a day.

What Do I Need to Get Started?

If you are over 40, it’s best to get a check-up with your physician and outline a plan of action. You may need to slowly build up from a walking pace – or maybe you’re ready to jump into the deep end and join a sprinting club. Either way, it’s best to get checked.

After this, you need to get some running shoes to look after your feet – don’t wear old sneakers. You should look at getting specialist running shoes. The larger your frame the more “cushion” you need in the sole – and depending on the arch of your foot, you will need more or less support from your shoe depending if you are high-arched or low-arched respectively. Any good running shop will have you jog on a treadmill and analyse you. Apart from that, grab some old clothes (it’s not a fashion parade) and enjoy building a healthier you, even though it can be a struggle, especially in the morning.

However, even if you have had an awful day, you can go back to your made bed and think to yourself “at least I went for a jog today.”

Staying Hydrated this Summer

Up to 60% of a male adult’s body is made of water. This leads us to some obvious conclusions: firstly, we are only 21% different to a banana (crazy, right?) but more importantly, we need to ensure that we top up body when we sweat. In hot weather, we tend to sweat more as the sun is beating down and we all tend to be a little more active. During summers, heat waves, and tropical holidays – it’s important we bring water alongside our sunscreen wherever we go. Let’s check out why it’s important to keep hydration levels topped up.

Water is critical for rehydrating the body after fluid loss, and it is usually recommended that you drink six to eight tall glasses of water a day (which amounts to about 2 litres). Although there are many supplements and alternatives on the market – good old H20 remains the best way of refuelling your body’s supply of water. A lot of the water we consume also comes from food – meats, vegetables, and pastas are high in h20 meaning they all contribute to your hydration levels.

Hot weather increases the bodies demand for water and other fluids tremendously. We need to account for not only our bodies basic need, but also the extra strain on our inner-water supply when sweating. We have already mentioned how much you should drink, but it may also help to be mindful of what you eat. Food contains water and other fluids. This can account for water intake but can also help manage your weight – which in the long term means your body exerts less energy to do more.

A good diet controls how much you sweat – and the less you sweat – the less water your body needs to replenish. Eating fruit and vegetables in lieu of sticky, sugary, or high carb food can help maintain weight levels and keep sweating to a minimum. You could also ditch the morning coffee as it activates the sweat glands, meaning more sweat and more hydration. If it’s a scorcher outside, it is recommended you stick to water. Maybe a cup of tea if you need a hot drink in the morning.

If you want to talk through water in-take or speak with one of our specialists, please contact our switchboard at (212) 241-6321

How Has Technology Improved the Lives of Patients?

Technology has changed the world forever by making the once inconceivable become possible. In the medical field, the development of new technology has rapidly advanced levels of treatments doctors can offer. It has brought us miraculous powers to revolutionize people’s lives, and every day brings us new tools to help tackle difficult issues. Last week, we took a look at an app Mount Sinai is developing and showed how it improved quality of treatment and patient quality of life. This week, we invite you to explore how Mount Sinai and partners are using technology to change the lives of people who were told that they would never be able to walk again.

Grassroots Innovation

Dr Ann Soungen, associate professor of rehabilitative medicine at Mount Sinai, remembers a time when engineers would come in with preliminary ideas and exoskeletons sketched on a notepad discussing the potential for developing a robotic exoskeleton to help people who were paralysed. After telling them to return when they had a prototype, they later came back to develop the ReWalk program with physicians and experts at Mount Sinai, which teaches people how to use the ReWalk Personal System.

What is the ReWalk Personal System?

The ReWalk Personal system is a battery-powered, robotic exoskeleton that is powered by a battery run through a computer placed in the backpack of the patient. It allows the patient to walk with crutches and improves knee alignment. This product, combined with ReWalk training available at selected Mount Sinai clinics, offers patients the ability to walk again.

The training centers for the ReWalk programme can be found at:

Mount Sinai Hospital One Gustave L. Levy Place New York, NY 10029 USA

Icahn School of Medicine at Mount Sinai – 3 east 101^st Street New York, NY 10029 USA

The program teaches people who have lost the ability to walk how to use a robotic exoskeleton that gives support and stability using the exoskeleton controlled by a computer. By completing the training offered, patients are able to reclaim their lives in ways previously unimaginable.

Tried and Tested: How ReWalk Changed a Patient’s Life

Father of three, Robert Woo was told in 2007 he would never be able to walk again. He suffered from a severe injury at Goldman Sachs working as an architect when seven tons of steel fell thirty stories onto his construction trailer. He said the weight folded him in half on site. Robert Woo later became the first person to be certified to purchase the new ReWalk Personal 6.0 system to use at home. It has given him to power to walk once again, stand with his wife, and walk around the park with his children – something he thought he would never be able to do again.

 If you are interested in a bespoke ReWalk plan, purchasing ReWalk technology, or would simply like to learn more, please contact us at Mount Sinai Department of Rehabilitative Medicine. Contact our switchboard at: (212) 241-6321

Your Very Own Rocky Balboa Story

Unless under the influence of post-Rocky euphoria, or a “big-fight” is taking place, most people never consider boxing as an alternative to their usual health routine. That’s reasonable. Most of us would rather get fit than bruised, and although boxing is one of the best ways to burn fat and stay healthy – it has a tough guy reputation that it’s struggling to throw. But many boxing-gyms are now accommodating “keep-fitters” and box-fit classes to encourage people to engage without fear of being pressured into the ring. Because of this, activities like blue collar boxing have been a great success and raised money for charity while keeping inactive city workers fit and healthy. Let’s jump into the ring and explain how boxing can help you fight a number of health issues and provide a kick-start to a new health campaign.

Boxing is an exercise performed for 15 minutes or longer between (approximately) 60-80% of your heart rate. This means it is aerobic. The longer your exercise and the higher your heart, the higher the capacity you are building for aerobic exercise. This kind of exercise trains your heart and lungs – and, the better shape your lungs are heart are in, the healthier your general health tends to be. If your heart is stronger, it better pumps blood around your body and the more oxygen you can take in –this is experienced in all facets of life from walking up the stairs to running for the train. More importantly, aerobic exercise puts people at less risk for heart attacks and strokes, reduces the chances of type 2 diabetes, joint pain – and improves overall life expectancy. Sure, boxing is tough, but it’s more than worth it.

During boxing training, boxers can burn up to 30 calories per minute. That means that within 30mins of intense boxing training, you could burn up to 900 calories (that’s already over half a woman’s daily calorie intake). That’s why despite boxer’s best efforts, it’s often really hard to put on weight. Training at this level is of course highly demanding and will take time to achieve - but it will allow you to keep your heart and lungs healthy whilst reducing your body weight.

This form of aerobic training has also been shown to help participants sleep at night by exhausting their body and relaxing their mind. Boxing has begun to be seen by people as a stress reliever (as opposed to a stress inducer – no one wants to get beaten up like the Italian Stallion). On the one hand, boxing is therapeutic as it allows people to punch away pent up aggression, but it also triggers dopamine to be released after training. That means less stress and more happiness.

Boxing has always been on the periphery of the fitness industry. Although it has it’s rough and ready back-street reputation that will never go away you won’t find yourself greasy and sliding around a ring getting your lights punched out. Unless of course that’s what you want to do – there’s still ample scope for that.

If you are interested in beginning a boxing programme but are worried about your current physical condition or are unsure whether such a plan would suit your situation, please contact our switchboard at (212) 241-6321

Smart Technology to Enhance Your Home Rehabilitation

Returning home from inpatient rehabilitation can be a daunting process. Alongside the potential changes in your daily routines, it may be necessary to change the functionality of your house. In order to make this process as seamless as possible, we have developed a mobile app to evaluate your home situation. Use the smart technology funded by the Craig H. Neilsen Foundation to revolutionize your rehabilitative recovery.

A home evaluation consists of documenting the dimensions of rooms, hallways, door widths, obstacles, and other facets of you home after a serious surgery or return from impatient rehabilitation. Usually, the patient will be unable to complete this process alone and a friend or family will complete the home evaluation on paper.

The patient will receive the necessary equipment and alterations to their home to assist with their recovery. This includes new beds, wheelchairs, commodes, tub benches, and other utilities to give the patient as much independence as possible.

If the home evaluation is not done properly, the recipient could end up receiving the wrong materials, products, and equipment – or even equipment that is unsafe or unusable. A common issue with this process is slight miscalculations and poor recordings of dimension by the family member. This has a knock-on-effect of the products later distributed by the therapist not fitting the requirements of your property, which often leads to a frustrating process of rectification.

Our innovative technology curtails this issue by making the assessment form easier to fill in. This provides more accurate and reliable measurements, which allows for better decisions to be made by the clinician. The app will develop, test, and disseminate an accurate quantitative description of your house and create a precise floorplan. With accurate data, therapists can better draft appropriate changes to your home surroundings – making post inpatient rehabilitation a little easier.

For the moment, the app is being used around the country by clinicians and family members of patients at Mount Sinai as we test the Beta model. Going forward we will test it with rehabilitative facilities around the country before using feedback from community partners to develop the final versions. The application will then be available for general use.

If you believe that our home evaluation app could help you after inpatient rehabilitation, please contact us at Mount Sinai Department of Rehabilitative Medicine for a walkthrough on how to access it. Contact our switchboard at: (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

How to Recover from a Serious Injury

Everyone on a Sunday afternoon from the cheering dads on the sideline to the star quarterback is aware of the constantly looming threat of muscle tears and sprains. They happen, and there is no fail-safe way of ensuring you never receive one. Even the iced bathed and well-oil superstars with the best coaching and physiotherapy in the world cannot avoid the wrath of torn muscles – and it’s nothing to be ashamed of – even Achilles was eventually thwarted by a tear in his ankle. Maybe he should have subscribed to our blog.

Last week, we outlined PRICE – Protect, Rest, Ice, Compression, Elevate - which is the immediate response you or a physio should have a sprain or tear. The sooner after the injury you attend to the area the better effect it will have. Your physio will be able to advise you on the level of the tear (graded from 1-3) and help draft a bespoke plan as to how you should implement the routine.

In most cases, the subsequent procedure should see you through most of the recovery. For more serious damage, consulting a physiotherapist on a regular basis for sports massages may be necessary. During your first visit, your physiotherapist will likely ask you about the activity that led to this damage and conduct a thorough physical examination to determine how severe the tear is. This is especially important if there was no on-site physio after the initial damage. Your comprehensive plan could include:

·        Ice or heat to reduce swelling

·        Electrotherapeutic modalities which use sound waves to heat up and repair deeper tissue

·        Soft tissue mobilization to relieve muscle spasms or tight muscles

Your physio will include self-stretching routines to mobilize muscles and reduce long-term damage. Stretching the damaged area will allow it to regain flexibility as weakness tends to occur when you do not move or contract a limb for a long period of time. It can also affect your ability to move a joint at full range. Stretching can help loosen tight muscles and increase the range of motion after sustaining a sprain or tear. These can either be done with your physiotherapist or at the gym/home. Stretch programmes work best alongside sports massages – however, if you do not have access to these – then foam rollers (which you can find by typing “buy foam roller” into Google) are fantastic at self-massaging.

The final step to recovery is strength training. This doesn’t mean an Arnold Schwarzenegger Boot Camp but a progressive exercise routine that will gradually build up the damaged area. After a muscle is damaged but before it is fully recovered the area will still be significantly weaker than it was before. The job now is to build up to your “normal” amount – and exercises should be given according to your level of fitness and specific muscles affected. Strengthening your muscles will help you get back to your previous activities and can help prevent future injuries.

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

Introducing Dr Joseph E. Herrera

This month we have taken an in-depth look at how sports injuries can affect your life and highlighted preventative steps to avoid sports injuries. This week we would like to introduce you to a sports-specialist at Mount Sinai’s Department of Rehabilitative Medicine – Dr Joseph E Herrera. During sports seasons it is important that players look after themselves off the field as well as on. If you are looking at rehab to get back into shape or fighting off a hamstring tear - wherever you are on your journey to recovery (or the MBA), Dr Joseph Herrera can give you some coaching tips.

Dr Joseph E. Herrera is a Board-Certified Physician who joined Mount Sinai after the completion of an Interventional Spine and Sports Medicine Fellowship at the renown Beth Israel Medical Center, New York. He then completed his residency and served as Chief Resident in Physical Medicine and Rehabilitation through a combined program of Columbia Presbyterian Medical Center and Weill Cornel Medical Center. He finished his academic career before joining us by completing a fellowship at Beth Israel Medical Center and has been named an American Pain Scholar by the American Pain Society.

His literary works extend to authoring and editing textbooks such as the “Manual to Musculoskeletal Medicine” and “Essential Sports Medicine and he is the chief editor of the medical journal “Current Reviews in Musculoskeletal Medicine.”

He is currently researching Wii Shoulder Injuries – which are injuries obtained during using the Nintendo Wii Sports devices. His past accomplishment was in adding to the cutting edge of Lumbar Discography Study – and he anticipates beginning work in adding to the literature on Plasma Rich Protein for the Elbow.

Dr Herrera is also the New York State Athletic Commission and Chief Team Physician for USA Boxing Metro which has allowed him to regularly treat and evaluate professional athletes. His in-depth understanding of his field has awarded him the Rocky Marciano Physician of the Year Award for excellence in Sports Medicine.

Dr Herrera comes highly recommended. He was selected as one of the Best Doctors in America and has won an abundant of awards and comes highly recommended by his patients. He maintains an excellent rating on our website – averaging at 4.7/5 rating. His top-rated categories are in the following:

·        He explains in a way you understand

·        He listens carefully

·        They will recommend him to a friend

If you are looking for a sports physician that can help you through rehab or someone to create a bespoke plan of action.

If you have suffered a sports-related injury, please contact us at Mount Sinai Department of Rehabilitative Medicine for a bespoke rehab plan and request Dr Herrera. Contact our switchboard on: (212) 241-6321

Tips from Coach Sinai – Drills to Prevent Musculoskeletal Disorder

When athletes compete on the world stage we know that their results are dependent on the work, discipline, and commitment they have dedicated “off the field”. We never see them practice, but we know they do. Minimizing sports injuries is just like this. It takes commitment when not in your sports gear to ensure your body is functioning in the best way possible when you are. Musculoskeletal disorder develops as a result of our habitual actions but has a severe impact during sporting activities. It is one of the leading causes of sporting injuries – and it is usually the result of seemingly unrelated facets of our lives, like our jobs (assuming our reader isn’t an Usain Bolt of the world). This week, continuing from last week’s preventative approach to physical health, we are going to outline how you can look after your body in the workplace to reduce the risk of a work-related musculoskeletal disorder.

Musculoskeletal Disorder

Musculoskeletal Disorders (MSDs) are injuries or pain in the body’s joints, muscles, ligaments, nerves, tendons and structures that support the spinal cord (from the upper neck down to the back). MSDs are distinguishable by their deep and dull pain, and numbness or stiffness in joints. Common conditions related to MSD include muscle strain in the neck, pinched nerve, carpal tunnel syndrome, and sprains. It can weaken our spine and supportive muscle groups which are then vulnerable when we engage in sport.

The Warm Up

Some injuries are the result of accidents and poor form during physical activities. Most injuries, however, are the result of or are worsened by, poor habits. That means that lifestyle is often the cause of serious sporting damage.

Experts at Mount Sinai’s Rehabilitation Center have identified that MSD is not necessarily the result of a sudden event but that it gradually develops over a period of time and is often aggravated in our work environment.

Some known factors of work-related MSD include:

·       Performing repetitive actions

·       Lack of physical movement

·       Poor body mechanics when lifting, bending or reaching

·       Poor posture at desks (such as computers and workstations)

Your Off-Pitch Coaching

The Mount Sinai team have compiled these top prevention tips to help avoid long-term problems during your work hours. By following these tips, you encourage a healthier lifestyle and minimise the risk of long-term damage during sports.

·       Take breaks during your day. This is important for people who work on their feet and those behind a monitor all day – ensure you rest your body from repetitive strain or ensure your body has time to move around.

·       Incorporate stretching and movement into whatever you do. Your body is like an engine – and stretching it is like keeping it well-oiled.

·       Practice good posture. Avoid slouching and bending in awkward positions. Always lift heavy objects with a straight and stiff back and avoid straining the neck by resting your phone between your ear and your shoulder.

·       Reduce repetitive or prolonged activities regularly. If this is impossible, then look for time to allow those muscles to rest.

·       Adjust your work area so to reduce awkward bending and stretching. If you are bleeding a radiator make sure your tools are near or don’t strain yourself trying to drag a pen with your foot.

It seems unintuitive that seemingly unrelated activities can have such a major effect on our part-time sporting careers, but they do. Reclaim your health by following these tips and ensure you do not create the musculoskeletal conditions that subsequently lead to serious damage.

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

Recovering from spinal cord surgery

Spinal cord injuries are the result of both accidents and lifestyle habits. We can avoid developing a weak spine by adjusting our lifestyles. Unfortunately, the same cannot be said for accidents. A car accident or slipping over can lead to tremendous long-term discomfort and pain with little we can do to prevent these damages, assuming you're wearing your seatbelt and not running on unstable surfaces. Nonetheless, there are ways we can tackle this issue using advances in medical science. Spine surgery can have incredible effects on your quality of life. Let’s investigate how you can plan your recovery after a surgery. Please note that timestamps are generalized and dependent on your health and recovery plan.

Spine surgery is one of the more common types of surgery, and most are minimally invasive.  Let’s take a look at what spine surgery can do for you.

Firstly, when you’re in the hospital, you may have one of these surgeries depending on what type of damage you have incurred.  

·       Diskectomy – surgery to remove all or part of your disk

·       Foraminotory – surgery to widen the opening in your back where nerve roots leave your spinal column

·       Laminectomy – surgery to remove the lamina, two small bones that make up a vertebra, or bone spurs in your back, to take pressure off your spinal nerves or spinal column

·       Spinal fusion – the fusing of two bones together in your back to correct problems in your spine

Your physician will give you a bespoke plan relating to your damage and recovery plan.

Depending on your surgery, recovery could take anywhere between 3 weeks to 6 months to recover. Other conditions that could affect your recovery is your lifestyle and bodily condition before the surgery.

Your bandages have a lifespan of approximately 9 days.  Check to see if the area has changed colour, swollen, or begins to open up. If this happens, contact your surgeon immediately. If there are no issues, you may begin to shower again. Wait 5 days before showering, and cover the incision with plastic wrap. Do not allow shower from the head to spray the wounded area. You should also want to avoid stairs for the first week or so.

Once a few weeks have passed, and the healing process is underway, you should be attempting to work your way into your previous routine. Before continuing your rehab, please note: do not sit still for extended periods of time, and inform yourself on proper posture by reading this. If you are supported by a brace or corset, you should be wearing it when sitting and walking, however, it would be unnecessary to wear the brace when you are sitting for short periods of time or using the bathroom at night. Finally, do not drive for the first 2 weeks.

Now is the point where, as opposed to what you should avoid, we can start looking at how you can actively help the healing process.

Around the 4 week stage, generally, you should be taking light walks to strengthen surrounding areas. Increase the speed or duration of the walk slowly. This allows the spine to heal itself within an active body and correct itself. A sedentary lifestyle will encourage previous problems to return. Continue to up your exercise slowly as your spine recovers.

Please note, you should contact your surgeon immediately if you experience any of the following:

·        Chills or a fever of 101°F (38.3°C), or higher

·        More pain where you had your surgery

·        Drainage from the wound or the drainage is green or yellow

·        Lose feeling or have a change of feeling in your arms (if you had neck surgery) or your legs and feet (if you had lower back surgery)

·        Chest pain, shortness of breath

·        Swelling

·        Calf pain

·        Your back pain worsens and does not get better with rest and/or pain medicine

·        Difficulty urinating and controlling your bowel movements

If this routine does not help, or you need medical attention, please contact us at Mount Sinai Department of Rehabilitative Medicine. A bespoke plan will be necessary if you suffer from other medical problems. Contact our switchboard on: (212) 241-6321