Sports: How To Look After Yourself "In Season"

Being involved with sports brings a wealth of health to your life. Regular exercise increases our average lifespan, helps with mental health difficulties, and generally keeps our body well-oiled. There isn’t much regular exercise doesn’t have a positive effect on. From children to the elderly, we all can benefit from a daily dosage of activity. However, being involved in sports and exercise regimes does bring with it some risk, especially considering games like American Football, and Ice Hockey, which of course are considerably more perilous than going for jogs around the local park or lifting light weights at the gym.  Let’s take a look at how we can take a preventative step toward long-term damage in sports and other exercise regimes by taking some precautionary steps.

Stretching

From Grandpa-Joe to Hulk Hogan, everyone needs to stretch both before and after exercise. Stretching make our muscles suppler, increases heart-rate, and increases long-term flexibility. Most importantly, stretching reduces injuries such as ligament tears, muscle tears, and strains and sprains which can have a lasting effect on your body, and take months of rehab to fix. Stretching, therefore, is an important part of any exercise regime or sports. Make sure your warm-up is suitable for the sport you are doing, and don’t overdo the warm-up. There is nothing worse than tearing a hamstring during your hamstring stretch because you rushed into sprints.

Knowledge and Self Awareness

Some sports-enthusiast-readers will be uber-keen to improve fast. Whether that means getting stronger, faster, or fitter you should be aware of your current level of fitness and work to improve and excel and not jump the limit. Do not push your body beyond its current level of fitness as it is dangerous and unnecessary. Even if you feel that you are quickening the path to your goal by pushing yourself like this, you will harm yourself. Be aware of the level you should be training at and stick to it to avoid serious damage. It is also useful to understand and use the correct equipment.

It is important for runners to wear the right-soled shoes, and American Football Players to wear gum-guards. Increase your knowledge and understanding of exercise so you can reap the benefits and avoid the perils. A fantastic way of doing this is listening to your coach. They usually have a wealth of information stored to reduce risk when engaging in sports. They can also advise you on different aspects of maintaining your health, from the best ways to warm-up and cool-down to the correct diet. Bathe in their wisdom.

 

Eating Well.

Mount Sinai is a huge advocate for healthy diets. Eating well and drinking plenty of water can reduce the risk of damaging yourself in sports. A nutritious diet allows muscles to repair and regenerate after exercise reducing the risk of harming or overusing a muscle group which can lead to tier-3 tears, and months of rehab. Knowledge of your sport can help you ascertain what kind of diet you should be following.

These three top-tips are the most effective preventative steps you can take to seriously harming yourself whilst engaging in sports. Precautionary steps can save you time in the long run by reducing the risk of severe damage and rehab.

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

Spinal Cord Injury. Introducing Thomas N Bryce

Recovering from spinal cord injuries is a complex process as they can be the result of serious localized trauma or lifestyle habits. That is why it is helpful to have a professional by your side while you undergo recovery. Thomas N Bryce, our leader in Spinal Cord Medicine at the Department of Rehabilitative medicine, has been a part of our team here at Mount Sinai since 1997 and could be the answer to your problem.

Dr Thomas Bryce has an impressive academic record. Prior to joining us, he completed his undergraduate degree from Albany Medical College and received speciality training at Thomas Jefferson University Hospital. He is a leader in the field, being the principal investigator of several ongoing studies in these areas and “wrote the book” (quite literally) on spinal cord injuries having authored numerous chapters and peer-reviewed articles on the subject.

Dr Bryce’s research is focused on assessing residing pain after spine damage, use of robotic exoskeletons to facilitate walking, and stem cell implantations for neurological recovery. He has been involved in several international taskforces with the aim to reduce pain after spinal cord surgery.

He is currently Governor Cuomo to the New York State Spinal Cord Research Board. Dr Bryce’s method is intersectional. He works closely with physical therapists, occupational therapists, neuropsychologists, and other surgical specialists to provide bespoke comprehensive care.

Dr Bryce understands the intricacies that are involved in recovering from spinal cord injury.

A bespoke plan can be constructed to suit anyone’s individual needs when going through this difficult period. Spine damage can be the result of hard trauma or lifestyle or a mix of both. Dr. Bryce can accommodate plans that involve difficult lifestyle changes. This includes both long-term habitual corrections, such as posture to post-surgery rehab.

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

Why SAD affects us in the winter

Seasonal Affective Disorder (SAD) is a state of depression that stems from the changing of the season, specifically – the summer to winter. In the winter, the days get shorter, it is cloudy and cold – but SAD isn’t a prophetic fallacy – it’s a physical reaction to a lack of vitamin D. Although there is a myriad of reasons as to how this depressive state can be triggered, none is more widely accepted than the vitamin D deficiency the body undergoes during the winter. A lack of vitamin D will create a chain reaction with other symptoms of SAD, which then feed into other depressive behaviours, in turn worsening the state of affairs. Let’s look at what vitamin D deficiency does to the human body.

Vitamin D, like all vitamins, it is a nutrient we make in our body; and most it comes from the sun. But vitamin D is unique as it is a hormone and not a nutrient like other vitamins. It works with calcium and phosphorus to create and maintain healthy bones, muscles, and teeth. Without enough vitamin D, your body will not be able to absorb calcium and other important nutrients that allow our body to function. In turn, many people with low levels of vitamin D will experience rickets, osteomalacia alongside other muscle and bone deficiencies. This leads us to be being tired, frustrated that our bodies are not functioning as it should be, and possibly lowering our immune system.

Vitamin D also has a role in maintaining stable brain hormones. Serotonin, the hormone associated with happiness, rises with the exposure to bright light – and drops in correlation with decreased sun exposure. As understood by research in medical science, people with lower vitamin D are 11 times more prone to be depressed than those with healthy does. A low level of vitamin D will cause a deficiency in serotonin, causing depressive-like behaviours to occur.

If we amalgamate these two factors, we see instantly that low vitamin D, caused by reduced sun exposure, is responsible for making us tired and unhappy. These physical deprivations feed into mental manifestations of psychological dispositions – such as bipolar – or other types of depression. It also suppresses the immune system, which can have a knock-on effect on making us ill, and then beginning the “cycle of depression”.

If you would like to learn more about how the cycle of depression works, click here.

SAD can have an extremely negative impact on your quality of life. If you need a consultation or are suffering from any of the symptoms outlined at the end of the article, please contact us on (212) 241-6321 to book an appointment.

Causes and manifestations of sciatica

Sciatica is the name given to any sort of pain caused by irritation or compression of the sciatic nerve. The sciatic nerve stems from the back of your pelvis, and runs through your buttocks, down the legs, and ends at your feet. It is the longest and widest nerve in the human body. It supplies sensation to most of the muscles and ligaments in the lower body – this ranges from the hamstring all the way to the sole of the foot.

When the sciatic nerve is compressed or irritated it can cause pain, numbness, or a tingling sensation that radiates from your lower back and travels down one of your legs to your foot and toes. Some sufferers also report a weakness in the calf muscles or the muscles that move the foot and ankle. Sciatica can range from being extremely painful to a mild annoyance, usually exaggerated by sneezing, coughing – or any involuntary or sudden movements. The pain of sciatica is localised in the lower body region, stemming from the top of your buttock downward, people also report suffering from back pain. Although this is most likely related to the problem, it will not be the sciatic nerve causing the pain.

Most cases of sciatica stem from a slipped disc. Injury or weakness can cause the inner portion of the disk to protrude through the outer ring. This is known as a slipped, herniated, or prolapsed disc. If the slipped disc compresses the sciatic nerve then we have sciatica. Most people with sciatica experience unrelated back pain. But a slipped disc is an injury in its own right; we should see sciatica as a result of this injury. We can summarise this as: Sciatica often occurs from a slipped disc; however, not all cases of sciatica are from slipped discs; and you can get sciatica without having a slipped disc. There are a myriad of ways a disc can slip. 

You can help prevent sciatica by adopting better posture and lifting techniques at work, stretching before and after exercises, and exercising regularly.

Although most cases of sciatica pass within 6 weeks, sciatica can become extremely dangerous. If you are experiencing a tingling or numbness between your legs and around your buttocks, and have recently lost bowel/bladder control, and have sciatica in both your legs – you must contact a physician immediately. Our physicians can confirm a diagnosis of sciatica based on your symptoms and recommend appropriate treatment.

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

Neurobics – Exercises to Keep the Brain Young

As we age our brain activity begins to slow down because the organ looses nerve connections and fails to form new ones. While this is a natural process there is a range of activities that can be done to somewhat reverse, or at least slow down, the mental ageing process.

Take Up a New Hobby

It has been noted that learning a new activity works to keep the brain young by keeping it active. Processing new information encourages the brain to form new connections between nerve cells and may even help to generate new cells. A new hobby can be anything from reading or taking a class to craft projects to physical exercise. New experiences trigger the release of dopamine, the neurotransmitter that stimulates motivation and perseverance in an activity and the hormone that encourages the production of new neurons.

Master the Crossword

While word and number games may just seem like a fun pass time they also have profound benefits on the neurological level. These brain exercises force various parts of the brain, such as the areas associated with language, numerical reasoning, and problem solving, to work. Over time this improves the performance of these areas and various studies have suggested that frequent work on crossword or sudoku puzzles may even delay the onset of illnesses such as dementia. This is because mental exercises force the brain to make connections and to recall information which, otherwise, can easily be forgotten as we age.

Keep Things Interesting

Just as important as taking up new activities is knowing when to stop doing an activity. If an exercise becomes habitual and routine your brain has normalized it and is no longer creating new neural connections. Much like if you do not do physical exercise the body will lose strength, without mental stimulation the brain becomes sluggish and slow. Shaking up your daily routine by adding in new elements keeps your brain sharp by constantly giving it new information to process. This can be as simple as taking a new route when you travel somewhere familiar. Instead of going into autopilot with well-established directional knowledge taking an unfamiliar route will actively engage the cortex and the hippocampus to process the new area.

It is inevitable that as the body ages the brain will lose some of the agility it had at peak age, in our mid -20s. However, keeping the brain exercised with novel activities can go a certain way to maintaining a healthy brain.

Age-Related Musculoskeletal Changes

As we get older our bodies become more fragile, as bone and muscle densities reduce, increasing the likelihood of broken bones and body instability. Movement may become slower, and walking gait may become shorter, more unsteady, and with less swinging of the arms. Older individuals may become tired more easily and perform tasks less energetically, but what are the internal processes that drive these changes in musculoskeletal function?

From around the age of thirty bone mass begins to decrease in both men and women, increasing in rate in women after the onset of menopause. As a result, the risk of bone fractures increases. One common feature of ageing is a gradual shrinking in size. This is due to fluid loss in the spinal disks. Between the vertebral bones in the back are the gel-like cushions which serve to absorb shocks between the vertebrae. With age these discs begin to lose fluid, meaning the spinal bones grow closer together and the spine shrinks. Furthermore, the actual bones begin to lose mineral content, becoming thinner. Being less rigid the spinal column becomes curved, adding to the appearance of height loss.

As with the spinal disks, lubricating fluid between joints may also be lost during the ageing process, reducing protection against cartilage rubbing together and wearing away. As a result, the joints may become stiffer and less flexible, increasing the risk of developing arthritis. As bone wears away the minerals may be deposited around joints and calcify, causing extra joint stiffness.

In tandem with skeletal wear, the muscular system is also affected by age. As bone density decreases around one's 30s so does muscle mass. The result of this muscle loss, known as sarcopenia, is that the muscles are less able to support the bones, and stress on certain joints, such as the knees or back, increases. Deterioration is not universal throughout all types of muscle, and the muscle fibres that contract faster are more susceptible to damage than the slower contracting fibres. This translates into overall slower contraction of the muscles in old age and affects physical mobility, muscular strength, and grip. Around 7% of people over 70 are affected by functional sarcopenia - age-related muscle loss – and this figure increases to around 20% of the elderly over 80. As muscles lose function people become less able to move autonomously and this may translate into the development of muscle contractures, where the muscles shorten and harden.

While it is a natural process of ageing to lose both muscular and skeletal mass, the process can be slowed and prevented to a certain degree by maintaining a healthy lifestyle, with regular exercise to promote strength, balance, and flexibility. Keeping fit can also help the bones to stay strong, to reduce the risk of shrinking or breaking. To further support the maintenance of sturdy bones diet control is crucial, being well-balanced and high in calcium. Particularly women need to be aware of getting enough calcium and vitamin D in their diet as they age to lessen the risk of developing arthritis or osteoporosis. 

Our Tips for Healthy Bones and Reducing Joint Pain

 It is estimated that between one third and one half of the population of the United Stated aged 20 and over suffers from some form of joint pain. This can be caused by a variety of factors, from genetic predispositions to natural wear and tear of bones as we get older. While there may be no definite cure for chronic joint issues, there are ways that pain can be reduced so that it does not restrict everyday activities.

One tried-and-tested technique for reducing pain and inflammation around affected joints is to use temperature therapy. Cryotherapy, or ice therapy, is suggested as colder temperatures reduce the blood flow to the problem area and thus lessen swelling in the surrounding tissue. It is recommended that, on the first day pain is experienced, you should ice the area every hour for 15 minutes, reducing this to four or five times the next day, and each successive day that the pain remains. If the pain is caused by stiffness rather than inflammation, heat therapy can be used to relax the muscles and to warm up the joints so that they move more smoothly. Hydrotherapy with warm water will ease

pressure on the joints, and immersing the affected area while massaging it will stimulate blood flow to the area.

Often chronic joint pain is caused by the breakdown of protective cartilage over time. This can be counteracted to a certain extent by increasing intake of vitamin D, which is needed to help the body absorb calcium to strengthen bones. Increasing vitamin C levels can also be beneficial as it is a key component in making the cartilage that cushion the bones, and as such may reverse some of the damage. Diet plays a large role in join pain, and reducing sugar intake is an effective step to maintaining healthy joints as, if too much sugar is consumed it can begin to bond to proteins in a process known as glycation and can cause further weakening of the bones and joints.

Temporary relief from joint pain can be obtained with pain killers, however, there is also a whole range of more natural home remedies that have been suggested as having pain-alleviating properties. For reducing inflammation around the affected joints, turmeric and ginger tea may prove an effective solution. Turmeric contains an antioxidant called curcumin while ginger is high in compounds known as gingerols. Both of these active substances are known to be anti-inflammatory and as such can reduce painful joint swelling. For pain relief try taking a magnesium supplement or soaking the painful area in Epsom salts, which contain magnesium sulfate. These are effective natural pain relievers as magnesium relaxes muscles and nerve endings while also helping bones to mineralize, making them stronger.

To a certain extent bone deterioration and resulting joint pain is unavoidable, as natural processes weaken them with age. Nonetheless, there are steps that can be taken to keep bones as strong as possible, reducing joint pain to a minimum.  

Tips to keep your brain young and healthy

Changes in our brain functions are a very common consequence of ageing and mental decline may be one of the most feared results of getting old. According to research more than 16 million people in the United States suffer from cognitive impairment, which means they have trouble remembering, focusing or even learning new things.

If you are noticing some of the early symptoms of cognitive impairment such as forgetting appointments and recent events or having trouble making sound decisions here are a few tips to keep your brain healthy and young.

Exercise

Physical exercise can help the brain become more efficient and adaptive to change.  According to Harvard Medical School “research shows that using your muscles may also help your mind. (…) Exercise lowers blood pressure, improves cholesterol levels, fights diabetes, and reduces mental stress, all of which can help your brain as well as your heart.” Exercising 3 times per week is a great way to start.

Eat healthy

A healthy diet can help both your body and mind. Eating foods that are low in saturated fat and keeping your calorie intake balanced will keep your brain younger. Also, vitamins B6, B12 and folic acid, which can be found in cereals and grains have proved to reduce homocysteine levels that are linked to cognitive impairment.

Mental Exercise

Engage in activities that challenge and stimulate your brain. Try solving math problems or crosswords, painting, or learning a new craft or language.

Socialize 

By having friends and going out, you are open to new experiences and challenges. They are also a great motivation when it comes to getting involved in several activities.

Avoid tobacco, alcohol and other drugs

Excessive abuse of tobacco, alcohol and other drugs can reduce your ability to remember, focus or execute tasks.

Keep your emotions balanced

Even though extreme anxiety and depression are not linked to cognitive impairment, it is always beneficial for your metal health to keep your emotions balanced.

Maintain social connections

 Constant communication and interaction with others is very important in maintaining social connections. The ability to bond with others over a period of time is associated with lower blood pressure and better mental health.  

Avoid injuries

Head injuries such as concussions can affect your brain’s activity while getting older. Reduce the risk by protecting your head.

These are just some simple tips and tricks to help your brain stay young and healthy. They are easy to incorporate in your everyday life, and will also improve your physical and mental health. 

Supporting a Loved One through Rehabilitation

Supporting a loved one through Rehabilitation can be one of the most difficult and isolating experiences there is. Serious injuries, and the subsequent care, can affect families and caregivers as much as the individual themselves. However, there are steps any caregiver can take to do make the transition to rehabilitation as smooth as possible.

The first thing to remember to do always is take care of yourself. If, at any point, you find yourself feeling too isolated or too stressed, reach out to other people – be they friends and family, an external support group, or a doctor. Learn to relax, get enough sleep, and find out which coping strategies work best for you – and this applies to all caregivers.

Brain Injuries

Daily structure and normality are extremely helpful for those coping with a brain injury. Be sure to stick to a routine every day, factoring in plenty of rest and limiting the number of visitors and amount of noise, so as to avoid over-stimulation. Include your loved one in family activities and conversations, wherever possible, and do whatever you can to be as natural as possible with them. Remember to be respectful, treating them as an adult and being sure to consider their likes and dislikes. Point out milestones and try not to lose patience. You should also bear general safety matters in mind – make sure there is no clutter around for the sufferer to trip on, and keep sharp objects out of harm’s way.

Stroke

The road to recovery after a stroke is different for every patient, as there are a number of complex variables which can lead to someone having a stroke. The most important thing to remember, then, is that comparisons with other people’s rehabilitation can only be harmful, not helpful. Steps forward can come quickly or slowly, so have patience, measure progress, and stay positive. Depression is extremely common after a stroke, so monitor your loved one’s mood and behavior, and step in if you notice any signs of depression. Also, it is important that you are clued-up on medication and instructions given by the physician, especially those which relate to preventing future strokes. Encourage a healthy diet and exercise, and make sure all medication is being taken as prescribed.

Sports Injuries

Sports injuries vary enormously – from acute injuries incurred during a game to wear-and-tear injuries from repeated use. They can also affect vastly different parts of the body and take different lengths of time to heal, but there are some general rules which should help with all of them. Firstly, be sure that the injured person sees the doctor regularly throughout their rehabilitation, and that they take their advice and instructions seriously. Motivate them through difficult aspects such as physical therapy while being sure not to encourage them to get back into their sport of choice before they are ready.

Wheelchair

It is important to bear in mind that, life in a wheelchair can be extremely challenging – particularly for those who are new to it. To begin with, the crucial thing is simply to be there for your loved one, and to remind them of this sensitively, without constantly reminding them of the things they can no longer do. One of the trickiest things, our patients’ families find, is learning to tread the fine line between drawing constant attention to the wheelchair and conspicuously not mentioning it. This may take time and effort, but you will get there. Adapt your home to make it as wheelchair friendly as possible – this is something your hospital or medical center can help you with. Finally, be prepared to help them in any way they need – especially at the beginning. There may be a number of everyday activities they find difficult to do on their own – from bathing to dressing – and it is imperative that you lay any reluctance to one side and do what is necessary. Over time, they may well learn to do these things without you.

Spinal Injuries

Experiencing a Spinal Cord Injury can profoundly change the way in which someone interacts with the world. As a caregiver, it is crucial that you make this transition as painless as possible. Sufferers often experience high levels of guilt, frustration, and depression – as well as physical pain – so it is your role to help prevent this, whenever possible, and never to let your loved one feel like a burden. Be prepared to face these emotions, and try to communicate openly and often with your loved one about them. On the whole, it is good to interact with them as you normally would. One of the best things to do is to work out early on which tasks the patient can complete independently and which tasks could use your assistance. Keep the whole family or household involved and be sure to nurture healthy, positive relationships – providing your loved one with as much contact with the outside world as possible.

When it comes to rehabilitation for any serious condition, your role is vital. Your love, care, and support can be the difference between a patient recovering, and them not recovering. It is a role which is exceedingly challenging, but which can be hugely rewarding and, whatever the condition of your loved one, it is always important to remember: you are doing a good job.

Top Tips for a Healthy Spine

Back pain and spinal conditions can be some of the most debilitating that there are. According to NINDS (the National Institute of Neurological Disorders and Stroke) lower-back pain is the leading cause of job-related disability, and – worst of all – back pain can be particularly difficult to diagnose and treatment can take time. All this considered, it is worth doing everything you can to ensure that you keep your spine healthy – either to manage existing back pain or to prevent its occurrence altogether. To help, this week our Mount Sinai spine care experts have compiled a list of useful tips for keeping your spine healthy.

1. Stretch and Strengthen

The spine is supported by a complex system of muscles. 20-30 minutes a day spent toning and strengthening the abdominals and the muscles in your lower back can help keep them strong and flexible, taking pressure off the spine. Stretching frequently is invaluable too. A short routine of targeted stretches first thing in the morning can help keep you supple, maintaining joint function and range of motion and reducing your risk of back injury.

2. Sleep smart

Sleep is essential for helping the body heal and repair itself after a long day, so it is important that you are maximising its effectiveness when it comes to spinal health. Research pillows and mattresses before you buy them to ensure you are getting the correct level of comfort and support for your back. If you find yourself feeling stiff or in pain in the mornings, it could also be a sign that your sleeping position is putting unnecessary pressure on your spine, so perhaps try sleeping on your side.

3. Practice healthy working habits

That spending hour upon hour sitting at a desk is bad for your body is a well-researched fact. Not only can sitting for long stretches of time exacerbate a back condition – it can even create one, as the discs in the lower spine are loaded three times more while sitting than while standing. From unsupportive chairs to desks at the wrong level, office life and a healthy spine can often seem incompatible, but there are some key things you can do to minimise this. Be sure to get up and stretch every half hour, walk around whenever you can, and do what you can to find an office chair which offers support and a desk set to the right height for you.

4. Exercise

Getting and staying active is a healthy choice for more than just your spine – but it can be particularly helpful. Increasing your heart rate will encourage blood flow, bringing nutrients to the spine to fuel it and help it heal. An exercise routine which involves aerobic activity, stretching and strengthening, as we mentioned above, is particularly good. Being unfit increases your risk of lower back pain considerably, as does being overweight, or gaining a considerable amount of weight in a short period of time. Excess weight puts extra stress on ligaments, tendons and muscles in the lower back – another excellent reason to hit the gym.

5. Listen to your body

And, finally, we would urge you to remember that pain is never normal, nor is it something you should accept. Pain, or even discomfort, in your back could be an indicator of more serious issues, so do not ignore it. Get regular check-ups and make an appointment with your doctor if you notice any pain – be that after lifting something too heavy, persistent stiffness from sitting still, or an unexplained twinge for no obvious reason. 

If you are experiencing back pain of any kind, please reach out to us by telephone on 212-241-6335 to make an appointment.