Compassion and Understanding Motivate Amputees to Recovery

One thing that all amputees can likely agree on is that limb-loss is a life-altering experience. The only question that remains for many is whether it is an unfortunate blip in an otherwise healthy and active life, or is it a blow that sinks the patient into depression, immobility and serious mental health issues. In the case of elderly and less-fit patients, the struggle is trying to recover and maximize quality of life and avoid succumbing to the palpable physical and emotional loss that comes with amputation. In both cases, amputee patients exist on a threshold where ‘Door 1’ opens to an arduous path that culminates in an amazing recovery and return to a happy and vibrant life, and ‘Door 2’ where the patient feels alone, empty, scared and a shell of their former self. If it were as easy as merely opting for ‘Door 1’, the recovery process would be easy; unfortunately it is not. And yet, even after something as life-altering as amputation, safely navigating the long and difficult journey to recovery is very possible and actually likely, provided you have the right medical treatment and support.  By putting yourself in the hands of our specialists and therapists at the Mount Sinai Department of Rehabilitation Medicine, you can guarantee to have among the world’s leading experts motivating you to a brilliant return to the ‘old-you’ through our cutting-edge medical services that are informed and guided by compassion and understanding.

In the first instance amputation seriously disrupts the little things that you might have previously taken for granted, like going to the toilet or doing the dishes. It can affect mobility and all that entails, including nipping out to the shop for some milk or going out to meet friends for a meal. It can also create a seemingly insurmountable wall preventing you from staying physically active, including riding a bike, rock climbing or participating in the sports you love. And, of course, there are a range of implications for the ways in which your physical limitations might impact on your family, not to mention your social and love life. Yet, perhaps counter-intuitively the most palpable adversity an amputee faces is mental and emotional, including anger, denial, depression, poor body image, self-esteem, quality of life and even thoughts of suicide. Those who have suffered traumatic amputations can even suffer from post-traumatic stress disorder (PTSD). Beyond this, even the most physically fit, upbeat and positive amputee patient might find their spirits dampened when faced with the almost-always long and hard road to recovery, mobility and activity that involves countless hours of physical therapy. One could say that an amputee’s best friend is patience, positive energy and their mental health; and yet, these are the aspects on which patients are often most challenged, which can impede and derail the return to a fulfilling and physically active life without the proper medical, emotional and psychological support. 

Through your whole journey to recovery – beginning with pre-amputation – it is imperative that you are guided by specialists and therapists with the expertise to make you better and the compassion and understanding to prepare you to face successfully the challenges that amputation will present. Our amputation treatment plans at the Mount Sinai Department of Rehabilitation Medicine are always personalized and consider your physical condition, mental and emotional health and life outside of a rehabilitation setting. We make sure that all patients have a full range of necessary emotional support at their disposal, including group, family and one-on-one therapy. We know how difficult it is to experience an amputation, but we also know the amazing life that is waiting for you at the end of your recovery. As such your treatment plan will guide you sensitively but with encouragement so you are able to fulfill your rehabilitation goals. We are proud to have as the foundation of our treatments the fact that we are New York City’s first amputation and prosthetic training program to be accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF), which recognizes our expertise in and commitment to supporting the needs of amputees by always improving our program and becoming the standard for modern amputation and prosthetic training care.

Here is a snapshot of some of our key inpatient and outpatient services that will guide you to recovery:

• Developing coping skills to handle the emotional stresses that may come with experiencing amputation.
• Helping you set goals every step of the way from preparation for your prosthetic to getting you ready for full mobility and participating in your favorite outdoor and sports activities.
• Helping you manage pain and discomfort.
• Providing support to increase independence and self-care.
• Access to our Limb Loss Support Group, a program designed to provide peer support to patients following amputation. It meets monthly and is led by a psychologist to discuss issues relating to body image, social acceptance and techniques for maintaining a positive attitude. 

If you are scheduled to have an amputation – or are a family member or friend of somebody who is – and would like to discuss the ways in which our specialists’ and therapists’ expertise, compassion and understanding can motivate you through the recovery process, please get in touch with us at (212) 241-6321.

How to Treat A Jammed Finger

You’re slipping through the defence, dribbling the ball between both your own and the opponents’ legs when a hand comes out of no where and slaps the ball right into your index finger. The pain strikes immediately, you look down – your finger looks fine but there’s an agonising pain running through your hand. Soon after it swells. You stop and realise – you have now succumbed to, undeniably, the most frustrating injury in basketball, sport, or possibly history: the jammed finger.

What’ so annoying is that it seems like such an insignificant injury – but you’ve been chastised from the game of your life by a rebounded ball or a poorly timed catch; and that’s no champion ending. A jammed finger is the worst type of injury. On the other hand, what’s great is, a jammed finger doesn’t have to be the end. Treat it properly, and you’ll be back on the field in no time.

The jammed finger is archetypically swollen, hard to bend, and somewhat painful. As with most minor sporting injuries, RICE treatment is your first port-of-call; that’s of course assuming you don’t have a physiotherapist or orthopaedist to hand. The injury is usually located in the knuckle, where the blunt of the trauma is experienced. The most common form of injury sustained in this field is a volar plate injury.

When the ball hits the finger head on, collateral finger ligament can rear at the attachment at the volar plate (which is a thick ligament on the palm side of the joint) and the middle phalanx. A piece of bone is torn away by a tendon or ligament, which provokes the symptoms aforementioned. Any injury that causes hyperextension of a ligament can end in a tear of the volar plate.

It is important to evaluate the jammed finger quickly as the avulsion fracture may indicate major ligament damage, which if left alone will develop into long-term pain and stiffness. When an accident in the realm of description above occurs, the most important thing to do is check what has happened. If your finger looks crooked, dislocated, or is unbearably painful the chances are you have broken your finger or something more serious. If this has happened, you should contact your physician immediately to avoid any irreparable trauma.

If you suffered from a jammed finger, or if you suspect your finger has sustained more serious damage and would like to speak to one of our physicians, please contact our switchboard at (212) 241-6321

Protecting Yourself From Wrist Injury

Hand and wrist injuries are particularly common in basketball because of the nature of the game. Every aspect of the sport from shooting, dribbling, catching, passing, and rebounding puts the area in question at risk. If the damage to the wrist is significant it could lead a player to missing the entire season with their injury, and the problem can persist if the cause and symptoms are not managed correctly.

The most common accident in basketball is falling and landing. The extreme and sudden trauma to the area can cause bone to come out of location – especially if one lands in an awkward position. Falls can be made worse by an already weak wrist, which tends to come from repetitive motions which are found in dribbling. It can add to a surmounting issue of overuse of the wrist and cause severe damage. The weakening stress on the wrist can also come from outside of basketball, for example - people who have recently come off crutches or require strong wrist motion for work.

If you are suffering from a past injury, such as a bone fracture that did not heal properly – then the past strain or sprain may weaken the wrist, making future damage more severe and easier to come by. There are some also people who are born with weak ligaments which further increases the chance of damage and recovery period.

The two most common types of injury that come from these elements, as we briefly alluded to, are sprains and strains. Your hand and arm and held together by ligaments and tendons, which act like an elasticated tissue that holds bone together.  A sprain occurs when a ligament is stretched or torn and a strain when a tendon muscle is overused or weak.

There are some very easy symptoms you should look out for if you think you have damaged your hand in basketball. Ask yourself these questions:

·       Was there notable pain when you injured it?

·       Has there been pain, weakness or numbness in your wrist or hand since?

·       Do you have a feeling of something clicking popping inside your wrist?

·       Has the shape of your had changed?

·       Do you have trouble moving your wrist or hand?

If you answered yes to any of the questions above it is highly likely you have damaged your wrist, please contact our switchboard at (212) 241-6321 if you would like to talk to a physician.

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