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

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

What Are the Symptoms of Brain Injury?

What is Brain Injury?

Brain injury is a deterioration of the cells inside the brain. There are two distinct types of brain injury that can cause the symptoms. These are Traumatic Brain Injury and Acquired Brain injury. The former is caused by an external force – such as concussion – which causes the brain to bruise against the wall of the cranium. The latter is more commonly associated with pressure on the brain. This could come in the form of a tumor or a stroke. Often, the two terms are used interchangeably.

But What Are the Symptoms?

Moderate and severe instances of TBI are easier to diagnose. Problematically, mild cases often go unnoticed as symptoms scale with the severity of injury. With ABI it is difficult to judge the severity of damage caused as a judgement is made post damage. With TBI, we are able to judge the severity using a time-scale of unconsciousness after an impact.

The Glasgow Coma Scale

                        GCS                                         PTA                                          LOC

Mild                13-15                                       less than one day                    0-30 mins

Moderate       9-12                                         1 to 7 days                              30 mins to 24 hours

Severe             3-8                                           more than 7days                    more than 24 hours

Where GCS = verbal rating after damage, PTA = how long post-trauma amnesia lasts, and LOC = period in which the victim is unconscious.

From here, let’s walk through the main symptoms we can look out for. There are two prominent behavioural symptoms that can manifest after a brain injury: emotional and memory.

Emotional Behaviour

Brain injury is associated with a number of emotional challenges such as depression, self-control, anger management. Victims can also find themselves struggling in social situations where they did not before, that is, they may have lower levels of self esteem and anxiety. These psychological manifestations can lead to isolation, a reduced ability to function in society, martial difficulties, and keeping his or her job.

Memory

The most common post-brain-trauma experience is a loss of memory, or at the very least, a reduced capacity for memory. As memory is intrinsically linked to attention, it can be difficult to diagnose the symptom as physicians need to be careful to distinguish between memory loss and poor attention. Almost all cases of brain trauma come with a reduced memory capacity compared to people who have not experienced brain trauma; and, although patients usually experience significant recovery during the initial recovery phase, there is often an element of permanent damage.

There is a myriad of ways of dealing with this patterned change of behaviour, but it is best to contact your physician to ensure a bespoke plan that will deal with your specific case. Brain injury recovery plans are not one-glove-fits-all. The brain is a complex organism, and no two people can be expected to experience the same difficulties. As it controls every aspect of human life, when it is damaged any part of a human life could be affected.

If you would like a plan on how to deal with a recent brain injury, please contact us as it is important you speak to your physician as soon as possible. Contact our switchboard on: (212) 241-6321

Brain Injury - The Healing Process

Brain Injury has a traumatic effect on not the only the victim, but also the victim’s family. Often, cognitive, behavioural, and emotional changes can be difficult to witness - especially as victims tend to be in a state of denial about their injury. You may feel as though the person you knew has been replaced by someone else. But rest assured, you can help a loved one fight back against brain injury by having an understanding on how their symptoms work and having a structured method of reclaiming their life. This week, we will look at dealing with the life transition after someone you know suffers from brain injury.

Please remember to create a bespoke plan of action to ensure your loved one receives optimal help. As brain injury is an umbrella term, it is important you know how much to focus on distinct aspects of rehabilitation. Please consult your physician for guidance.

After brain injury, the victim’s lack of control over their mood and behaviour is a common consequence of any serious brain injury. Frequent and notable behavioural changes are anxiety and depression, but also extend to poor behaviour and a loss of memory. Their behaviour may drastically change after suffering, and depending on the severity of damage – they may never be the same again. It may be necessary to see a psychiatrist if depression or anxiety gets out of hand, and ensure they are in an appropriate support group.

Some victim’s behaviour can be unrecognizable – and they may begin acting up and misbehaving. The most effective ways of dealing with bad behaviour is in a firm but fair way. Set limits around their behaviour and how you allow them to treat you.

The first three months are the most essential when recovering from brain injury; and starting early means you can optimize success. During this time ensure you have started all physiotherapy programs, exercises, and seen your occupational therapist. This will aid in regaining communication, social, and personal skills alongside aiding with any emotional struggles you may be experiencing. It can take time adjust to changes – be patient and support each other during the process.

The most effective way of supporting a loved one is to help them form new habits. Depending on the victim’s need, you can help them improve mobility or gain function of certain parts of their body. This type of therapy will allow the patient to reclaim their life in the long term. It is important that you know your limits, and ensure there is a professional program in place. For example, a neurologist can work with your psychiatrist to help improve concentration and mood swings. Your primary doctor will refer you if necessary.

You can also aid in their recovery by encouraging a healthy diet. A healthy body is fertile ground for success, ensure the brain has all the nutrients it needs available to it. You physician will advise you on foods to avoid and alternatives if chewing/shallowing is a problem.

Finally, you can encourage writing things down to encourage neural pathways to heal. In the long-term, this will aid in allowing the victims brain to heal. More importantly, it allows the patient to keep track of calendar appointments, medications, addresses, and an emergency contact number. You could even label things in the patient’s house depending on the severity of damage.

If you would like a plan on how to deal with a recent brain injury, please contact us as it is important you speak to your physician as soon as possible. Contact our switchboard on: (212) 241-6321

How To Cope With Brain Trauma - Introducing Dr Kirk Lercher, MD

Recently, we have given Mount Sinai readers some insights into how brain injury can form, and some basic coping mechanisms to help loved ones along the way to recovery. However, we strongly advise you to seek professional medical attention after experiencing brain injury - you don’t need to go at it alone. Dr Kirk Lercher - our Assistant Professor at Mount Sinai’s Department of Rehabilitative Medicine – is our brain damage specialist; he can help guide you and your loved ones to reclaiming your former life.

Anoxic brain injury is the effect of oxygen starvation to the brain. Brain injury can have different effects on the patient depending on how long the brain went without oxygen. Kirk Lecher has undergone extensive medical training in how the brain functions post-concussion, as such his bespoke advice will help you along any stage of the healing process. Ranging from sports concussions, to spasticity management, and neuropharmacology – Dr Lercher is an expert in tackling brain damage.

Beginning his study at New Jersey Medical School, Kirk Lercher continued into an Internship, then residency at the University Hospital (UMDNJ). He finalized his studies with a fellowship in brain trauma at the Mercy Hospital of Pittsburgh.  During this time, Dr Lecher specialized in the research field of brain trauma. His research posited that synchronizing occupational and physical therapy improves recovery outcomes after strokes, and furthermore, that larger doses of therapy are associated with superior outcomes.

His research also states that many patients receive sub optimal care after a concussion and associated brain injuries. His work encourages telecommunication agencies to address the unmet needs and encourages families to seek immediate attention via this medium or directly with their physician. It is because of this that Dr Lercher understands the importance of patient care and relationships. As his research shows that a strong connection between the family of the victim and the physician optimizes recovery, Dr Lercher has incredible client satisfaction ratings with a 4.9/5 average.

Dr Lercher tackles anoxic brain injury using two synchronized methodologies. Dr Lercher himself focuses on in-clinic visits for patients, and advises on tele-rehabilitation. This combinatorial process effects as double the therapy than one would get if they solely saw their physician, or solely used telecommunications.

In practicing fantastic patient care, frequent in-clinic visits, and tele-rehabilitation, Dr Lercher sees fantastic results in patient recovery from brain injuries. His bespoke approach is the optimal support you can provide to a loved one during this difficult period.

If you would like to schedule a visit with Dr Lercher, please contact us at Mount Sinai Department of Rehabilitative Medicine. Contact our switchboard on: (212) 241-6321

How Can Traumatic Brain Injury Affect Your Life?

Traumatic Brain Injury (TBI), is the result of an external force, such as a knock to the skull that injures the brain. Brain injury could affect anyone, but people who are in the military, sportspeople, old and young, and people who suffer from strokes are most likely to experience problems. Brain injury has a range of life altering traumatisms from Dementia to Parkinson’s, to loss of memory and facial recognition. Damage will scale will the level of trauma suffered from a knock.

Brain damage (TBI) is a result to a blow to the head. A knock to the head makes the brain move inside and bruise against the skull causing damage to the brain. Depending on the severity of the knock, the patient will experience a range of symptoms as the brain is starved of oxygen for a period of time.

The people most susceptible to TBI are military personnel, high-impact sportspeople, old people who often fall, and 15-24-year-old males, due to the heightened chances of taking a damaging blow to the head. However, it is important to note that anyone could be a victim.

The most common causes of brain injury are car accidents, blows to the head, sports injuries, falls or accidents, and physical violence. As we can see, there is a correlation between the most common causes, and the most vulnerable. For example, studies indicate 15-24-year-old males are the most reckless drivers of all demographics; consequently, they have a higher chance of putting themselves in situations where they could get a brain injury.

Not all impacts are life altering. Light to medium knocks to the head cause confusion, lack of spatial awareness, and sometimes nausea. In both cases, patients usually make a good recovery. With more serious brain injury, people suffer life changing and debilitating problems. Depending on where the damage is localized, the patient will experience different symptoms.

But how can brain injuries affect your life? Brain damage symptoms scale with the severity of impact. More serious ramifications include relearning to walk, loss of personal memories and facial recognition – with patients forgetting who they are. Also, depending on where the damage is localized, patients could lose motor skills or in most severe cases not know how to speak. The more severe the impact, the more severe the consequences.

If you are suffering from any of the symptoms listed, please contact us as it is important you speak to your physician as soon as possible. Contact our switchboard on: (212) 241-6321

Brain Injury – Who and How Does It Affect?

Traumatic Brain Injury (TBI) is indiscriminate in who it impacts. Although this is true, certain people are more vulnerable than others. A person who is more susceptible to taking traumatizing hits to the head is far more likely to have their lives affected by this severe injury. For example, you are more likely to experience this injury if you are a professional boxer than an office manager.

TBI is a head injury that results in the brain moving inside the skull and bruising due to the impact with the cranium. Depending on the severity of the hit, the patient will experience a range of symptoms due to the brain not receiving adequate oxygen. An important note about TBI is that it is always the result of an external force, such as a head trauma that injures the brain. This is opposed to an Acquired Brain Injury (ABI), which is the result of pressure to the brain on a gene level, like a stroke.

The most common causes of TBI are car accidents, sports injuries, falls or accidents, and physical violence. The people most susceptible to TBI are military personnel, high-impact sportspeople, an elderly who often falls, and 15-24-year-old males, due to having “high-risk behaviour”. As may be obvious, there is a correlation between the most common causes and the most vulnerable people.

It is not always immediately obvious that there has been serious trauma. Often, in contact sports, people will undergo TBI and not realize it. If you have been concussed, it is important you see a specialist.

Not all impacts are life-altering as some instances of TBI pass away relatively quickly. Light to medium knocks to the head cause confusion, lack of spatial awareness, and sometimes nausea. Patients usually make a speedy recovery. Although the brain has undergone some damage, the symptoms will only be short term. With more serious brain injury, people suffer life-changing and debilitating problems.

Depending on where the damage is localized, the patient could experience different symptoms. Brain damage symptoms scale with the severity of the impact. More serious ramifications include relearning to walk, loss of personal memories and facial recognition – with patients forgetting who they are. The patient may experience extreme emotional states and denial that they are experiencing TFI. Patients could lose motor skills or in most severe cases not know how to speak. The more severe the impact, the more severe the consequences.

If someone you know has been affected by a hard hit to the head and suffered a concussion, please contact us as it is important you speak to your physician as soon as possible. Contact our switchboard on (212) 241-6321