What Is Stress? And How Can Yoga Help You Cope?

We realize that sometimes we need to think outside the realms of the norm when dealing with stress and relaxation. If there were a safe long-term prescription to tackle stress – then everyone would take it. Unfortunately, there is not – and part of our bespoke patient diagnosis often includes taking up yoga. This is a practice that refers to loosening ourselves of bodily and mental tension while learning to consciously disengage our stress and muscles systems when they are not needed.

 

One of the most basic organic response systems is famously called the “fight or flight response”. It symbolically refers to the wild, cliched scenario in which the burly caveman, equipped with nothing more than a spear is being confronted by the sabretooth tiger. The body’s system engages – the heart accelerates, and he begins to perspire. The body has entered into a state where it is ready for a physical challenge.

 

There aren’t many sabre tooth tigers in rural, suburban, or city centres. So, what happens? Our bodies still have the fight or flight response when challenged by an obstacle (think of it as a mini sabre tooth) but we do not get the opportunity to fight or run. This means that our stress levels remain at a state of anxiety. We don’t have short term problems like the cave man, we have long term problems. If our bodies do not learn how to switch off, then our bodies remain in a state of preparation for something which never comes. This is why stress “runs us down” and we are more prone to illness and fatigue. Your body wants to run, but it can’t due to the environment we live in.

 

Yoga Can Teach You to Switch Off

 

Yoga is an interesting practice as it locates a space between effort and non-effort. You consciously engage in an activity that requires you to not engage in anything. Once we pass this somewhat paradoxical conundrum – you’ll find that yoga is simply switching off in an organized and methodological manner. Yoga is the practice of conscious relaxation. It is a way in which you can turn off your fight or flight response which will in turn increase your overall health. Conscious relaxation encourages you to release the grip of your muscles when you don’t need them – and allows you to switch off your high corticosteroid level.

 

Click here to read about how you can practice yoga and follow our series on stress related issues.

 

If you are considering yoga classes Mount Sinai offers classes with certified yoga teachers (CYTs). Please contact us on (212) 241-6321) to see if we can further help.

 

 

 

 

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

How to Deal With Sciatica, The Do’s and Don’ts

How to deal with sciatica, the do’s and don’ts

This week, we are going to look at ways of managing sciatica. In our previous blog we looked at what sciatica is, and suggested some causes of the problem. To quickly recap, sciatica is the compression of the sciatic nerve – which in turn causes pain down the lower back, through the hamstring all the way to the foot. What is most important to remember when dealing with sciatica, is that is a symptom, and not the underlying problem itself.

The first step when dealing with sciatica is diagnosing the underlying issue. The root of the problem can be anything from a slipped disc in the spine, to a spinal stenosis, or in more serious cases, a tumor. It could even come from a small fracture in the hip. Although we can treat sciatica without dealing with the genesis of the problem, you are more likely to experience a reoccurrence of sciatic pain if we do not.

We recommend that if you suffer from sciatica, get a diagnosis on what caused it. That way we can deal with the pain alongside remedying the original problem, and reduces the chances of it reoccurring.

For now, let’s look at some of Mount Sinai’s recommendations for dealing with sciatica at home.

Conservative (non-surgical) treatment is best in most cases. When you are suffering from sciatica, or begin suffering due to some other cause, apply heat or ice to the painful area. Try the ice first (48-72hrs); then use heat on the pain. Over the counter pain relievers such as ibuprofen or acetaminophen can also help with inflammation and general pain relief.

Surprisingly to a lot of patients, bed rest is not recommended. Although short term bed rest may be needed for patients in extreme pain, staying inactive and reclined for long periods of time weakens the body and extend the life of agonizing symptoms.

Upon first suffering the symptoms of sciatica, it is recommended to tone down your physical activity for the first few days, and gradually work your way back to your daily routine.

You should reduce your activity in the first couple of days – and gradually adjust your body to your usual activities. This will ensure you do not overstress any of the damaged components, and give your body time to adapt.

Patients are recommended to start exercising again after around 2-3 weeks. You should include exercises to strengthen your abdominal muscles and improve flexibility in your spine.

If weightlifting or contact (collision) sports such as American Football are part of your usual exercise routine, you should not return to your sport/hobby for at least 6 weeks since the pain began. Do not lift heavy objects or twist your back. Your physician can help identify good exercises to remedy sciatica.

More serious complications depend on the causes of sciatica, such as slipped discs or spinal stenosis. Call a provider immediately if you have:

·        Unexplained fever with back pain

·        Back pain after a severe blow or fall

·        Redness or swelling on the back or spine

·        Pain traveling down your legs below the knee

·        Weakness or numbness in your buttocks, thigh, leg, or pelvis

·        Burning with urination or blood in your urine

·        Pain that is worse when you lie down, or awakens you at night

·        Severe pain and you cannot get comfortable

·        Loss of control of urine or stool (incontinence)

Also call if:

·        You have been losing weight unintentionally (not on purpose)

·        You use steroids or intravenous drugs

·        You have had back pain before, but this episode is different and feels worse

·        This episode of back pain has lasted longer than 4 weeks

Sciatica usually goes away on its own if you follow our guidelines. However, 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.

Introducing Parag Sheth

Introducing Parag Sheth – Mount Sinai’s Carpal Syndrome Tunnel Expert

This month, with our continued aim of ensuring our patients know and trust our physicians, Mount Sinai presents to you our long-standing Assistant Professor of rehabilitation medicine, Dr Parag Sheth. Dr Sheth holds a certification in Physical Medicine and Rehabilitation; his specialisation lies in Carpal Tunnel Syndrome (CTS).

Dr Sheth’s expertise is grounded in his rich and varied academic career. Beginning his studies receiving honors at Johns Hopkins University, Dr Sheth moved on to study at Stony Brook School of Medicine, and subsequently held the position of Chief Resident at St. Vincent’s Medical Center’s Rehabilitation Residency Program. Dr Sheth is now a fellow of The Mayo Clinic, where he specialised in Musculoskeletal Rehabilitation; and he has been with us at Mount Sinai for over 20 years. During his time practicing with us, Dr Sheth has always gone beyond the call-of-duty to ensure patient satisfaction.

CTS, Dr Sheth’s specialization, manifest itself as a tingling, numbness and sometimes pain in the hand and fingers. This is caused by a compression of the median nerve, which controls sensation and movement in the hand. It can sometimes be hard to identify as the symptoms are common and often go unchecked. Dr Sheth is renowned for his ability to exercise expert judgement on patient’s symptoms, but always communicates in way understandable to the patient; we believe this to be paramount to a patient’s happiness. Dr Sheth has often been praised for his ability to listen carefully, and explain the process of treatment and aftercare in a concise and easy to follow way; this has made him a patient favorite. 

His clinical focus also extends to: back pain, electrodiagnostic testing, epidural steroid injections, herniated disk, knee pain, low back pain, shoulder pain, neck pain, and spine stimulation.

Outside of his professional career with us, Dr Sheth also teaches a yearly cadaveric dissection and weekly musculoskeletal lectures where he has been awarded the Avital Fast Award and the Department Teacher of the Year award. His research has been published in Nature, Lancet, and The American Journal of Sports Medicine. 

Dr Sheth is “Board Certified” and accepts insurance plans. For more details on appointment availabilities and plan coverages, please contact our call center at: (212) 241-6321.

Recovering from a Traumatic Brain Injury

Injuries to the head or brain can have a range of effects, depending on the form the injury takes and the level of severity. Following a traumatic brain injury (TBI) many patients may display several of the same symptoms as the brain attempts to repair itself, including disorientation, mood swings, and difficulty performing simple tasks. Often after injury swelling, bleeding, or changes in the chemistry of the brain can affect normal functioning of the healthy brain tissue. As swelling decreases, blood flow is able to return to a normal level, and the patient may regain their ability to function in everyday activities.

The most rapid recovery of brain activity is likely to happen in the first six months of recovery, with the patient showing steady signs of improving in function. After this period patients may show signs of further recovery up until two years after the accident, though at a slower rate, and after two years improvement will decrease substantially. During the first six month period there are a range of actions that can be taken to improve chances of a fuller recovery.

The first important step to take during the recovery period is to get plenty of rest, so that the brain has a chance to recover and regain function. While the brain cannot regenerate cells that have died, areas of the brain may be able to take over the activities of the damaged areas by creating new nerve pathways. Avoiding stressful situations is also recommended as these can illicit and amplify mood swings and personality changes that can follow TBI. Avoiding activities where you could sustain further damage to the head is also necessary. The brain cannot recover 100% from a traumatic injury, and participating in risky activities increases the likelihood of repeat injury. The effects of repeat injury build on the original damage in a cumulative manner, lessening the chances of recovery.

Taking medicines should be carefully regulated as many can inhibit the repair of the brain. Although head injuries can cause the patient trouble in falling asleep avoid taking sleeping pills, sedatives, or tranquillisers. Many over-the-counter sleep medications contain antihistamines which can disrupt memory retention and the ability to learn new information in those who have sustained a TBI. If the patient is suffering from headaches, Tylenol should be administered over non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or aspirin which can occasionally cause the site of injury to bleed.

Occupational, speech, and physiotherapists may be employed to aid the rehabilitation process, depending on the nature of the injury, but taking these initial precautions can encourage the brain to begin a process of restoration. 

The Best Exercises for Strong Bones

 With advancing age the risk of developing osteoporosis rises. This risk may be increased by having lower than normal peak bone mass, and subsequent greater than normal bone loss. The chances of this happening can be lessened by doing exercises that involve weight bearing. This is because when you do weight bearing exercises your bones adapt to the impact exerted by this extra weight and the pull of your muscles by building more cells, and thus become denser and stronger. The type of exercises that are most beneficial vary depending on age.

Children

For children, bone strengthening exercises can start before they can even walk. Crawling and active play begin the gaining of muscle mass. After they have learnt to walk unaided, activities such as climbing, walking and running, and jumping all contribute to the development of strong bones.

Teenagers and Young Adults

As children reach adolescence an active lifestyle is crucial to increasing bone mass. It is around this age that the most can be done to achieve a high peak bone mass in their early twenties. All sorts of competitive sports, from soccer to tennis to martial arts are beneficial, as are more individual exercises. Skipping, body weight exercises and high-energy activities such as aerobics and dance can strengthen muscles, while putting weight on the bones, encouraging them to increase cell production. In order to build up strong bones children should aim to undertake 60 minutes of exercise a day.

 

Adults

From your mid-thirties natural bone loss begins to occur. In order to reduce the rate of this, muscle-strengthening activities should be done at least twice a week. This can include doing some of the activities that young adults do, but also less exercise-focussed pursuits, such as brisk walking, stair climbing, carrying groceries, gardening and moderate-resistance weightlifting. These activities are less aimed at building bone mass as they are at maintaining muscle strength. Adults need less frequent exercise than children, but should aim to do at least 150 minutes of cardiovascular exercise a week, on top of muscle-focussed exercises.

Elderly

For elder individuals, or those at high risk of osteoporosis and fragile bones, it is advised to avoid particularly high impact exercises. However, maintaining a healthy, active lifestyle is beneficial. Going for a walk or doing necessary housework are both good ways of keeping active throughout the day. Swimming can improve stamina and joint flexibility in a low-weight environment, while tai chi is recommended as it is low impact but can improve balance and posture while strengthening muscles in the legs.

Until a bone is broken, there are no symptoms of osteoporosis. As the likelihood of developing it increases as you age the best preventative method is to build up strong bones at a young age and to sustain beneficial exercises throughout life.

Everything You Need to Know About Strokes

This week we tell you everything you need to know about strokes: how they are caused, how you can recognise one, and how they are treated.

Causes

Strokes are caused when the brain does not receive enough oxygen. There are two ways in which this can occur. An ishemic stroke, the more common form, is caused by clots in the blood vessels which supply the brain which stop the blood flow. The second, rarer form is the hemorrhagic stroke, which is caused by ruptured blood vessels bleeding into, or around, the brain.

Symptoms

There are various physiological indicators that a stroke has occurred. It is often signalled by a sudden numbness in the face, arm, or leg, and especially on a single side of the body. This may be accompanied by sudden confusion, and the inability to speak or understand others' speech.

Trouble seeing in one, or both, eyes can result from a stroke, as can having difficulty walking, and losing balance and coordination. The final symptom of a stroke is a sudden, and severe headache.

The sooner a stroke is identified and treated, the less permanent damage it is likely to do. This is because, the sooner treatment is administered, the more of the brain can be saved.

Cures and Therapies

Accute stroke therapies are administered to try and stop the stroke while it is happening, either to stop the bleeding or to dissolve the clot. If the cause of the stroke is ischemic aspirin is given, as this has the effect of thinning the blood, preventing further clots. With hemorrhagic strokes it it a little less straight forward as the patient must be monitored to ascertain what the cause of the bleeding is. It may be as a result of blood thinning medicines, high blood pressure, head trauma, or blood vessel malformation. Once the cause is identified tre

atment can then be tailored to the patient's need. Immediate emergency care for hemorrhagic strokes is concerned with controlling the bleeding, and medications may be given to reduce blood pressure or to slow the blood flow.

In the case of quickly identified and treated strokes there may be very little lasting damage, however, for some, there may be a need for a range of therapies to relearn certain skills. Strokes can cause paralysis or movement control problems, pain, difficulties using or understanding language, memory and thinking problems, and emotional disturbances, depending on which area of the brain is affected. Rehabilitation therapy involves the input of a range of specialists including physiotherapists, psychologists, occupational therapists, speech and language therapists, dietitians, specialist nurses and doctors, all of whom work to help patients relearn skills to make them as independent as possible.

Strokes can be damaging but the key to full recovery is knowing and recognising the signs and taking early action to get medical help.  

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. 

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.